Loading...
HomeMy WebLinkAboutBuilding Permit #940-15 - 1060 OSGOOD STREET 5/19/2015 NORTH BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIO Permit No#: - Date Received �°SSgAreD CHus�`�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION /010 ®S'6'00 cl Print �'�....�.t�-�c-� PROPERTY OWNER / "�� Print 100 Year Structure yes r o MAP PARCEL:��ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg CYbthers: ❑ Demolition ❑ Other ❑ Septic El Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: ;2. ul�e,11.s s%- Mz-A! .�q", Q-/ Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: f� t,f e n-s� F �, Phone: 5' ? Sr/ Email: "q :2- _ )z fb /1 1. Co *4 , Address: G // Supervisor's Construction License: C.P 0-7, 7/f Exp. Date: /o2/js Home Improvement License: /',o Exp. Date: SAS//-- ARCH ITECT/ENGI NEER -ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 00 Total Project Cost: $ FEE: $ M.--- Check No.: 41� Receipt No.: :�6 -F1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund r J Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ' TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanuing/Massage/Sody Art ❑ Swimming Pools ' . 0'•, Well ❑ Tobacco Sales ❑ Food Packaging/Ales '05 ❑ •-� Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF o U FORM \//PLANNING & DEVELOPMENT Reviewed On Signature_ I COMMENTS NO x.Tr .(6(L W0r�, 1 i I d' ONSERVATION Reviewed on Signature COMMENTS I HEALTH Reviewed on Signature COMMENTS � �}" � ZiIe4014` ' t w Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafter& Sewer Connection/signature& Date Driveway Permit DPW Town Engineer: Signature: FoL�,FatedD�eatp�`�1aM2�r4ttmMeainntSs�ereg.nt aturme%ptltEauempst_eRr onts-i t_ eyes Located-� -sgood St9r-e--e�tIRE DEA, — T� no err ,..-�. _ l ...`.'[ e e J '� �-.o..r.®,v3. yae_. _aza a rFc yurdsu`�rvrneems- ve.-...�_-- nra.--.c.--mss. t cz��wms- rim-� —�•.ffi • V _ Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. i Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine j NOTES and DATA— (For department use) LASA L::_LJ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 F Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. i Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks :re Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location 10/1,0 , zzl�t�� No. Date • - liq /J<�- TOWN OF NORTH ANDOVER y Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ 'r TOTAL $ Check# TFIF . Building Inspector Location V� 0,5 v No. 140-0:5 Dat . - TOWN OF NORTH ANDOVER . T;En r ' Certificate of Occupancy $Io Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 3 e 1 ; d: Buildind)nspe for 1 of MORTM 1 ice. •.•' -^ p 'b�'°+,,,,••`'419 49 SSACRUSt CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 940-15 on 5/19/2015 Date: June 9, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1060 Osgood Street— Cure Laser -_--- MAY BE-OCeUPIED AS a Tenant-'it-Hp Iii ACC-ORDANC-1J W-IT-H THE-PROVISIGN-S OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Care Laser/Tiam Realty LLC 1060 Osgood Street North Andover,MA 01845 I Building Inspector Fee: $100.00 Receipt: 28902 Cheek : 92257195-4 NORTH t-- T ..own of t E 1., Andover x o : - 1 No. 9L I L^KIh ver, Mass q v; COCMICNl WICK S U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System Mom THIS CERTIFIES THAT ........ ...... .fer-& . ..... .......U-C.:.. ......C(4r,<,...... .4.S ....... BUILDING INSPECTOR ................. . ARoug n has permission to erect .......................... buildings on .....l. . .Q...... .���cod.....�: � ��to be occupied as .... '�!` d ....... . ..... 0...provided that the person accepting this permit shall in every respect conform tothe terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. MI3'fVG INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI T RTS Rough Service ... ..................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner v� Street No. Smoke Det. �`—�� �a 01 AORI:1H 3a,�. ••' ooL A X17 OLn°rr^t49 SSACH°'E CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 940-15 on 5/19/2015 Date: June 9, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1060 Osgood Street— Cure Laser --- ----MAY-BE-0-C-CU-PI-E-DAS a Tenant Fit-Up-IN AC-CORDANC-E-W-IT-H-T-HE-PH-OVISI-ONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Care Laser/Tiam Realty LLC 1060 Osgood Street North Andover, MA 01845 Building Inspector Fee: $100.00 Receipt: 28902 Check : 92257195-4 KORTH own oAndover - 1 No. h ver, Mass, ISI 'Q COCNIC14 w1cK '� �,9 A°R�►rE o ►�Pa�,��5 S U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT .............x. J+M......� .. ..... .......1.(. .:.. ...... lF .......LCI. - �....... BUILDING INSPECTOR ................... AFounationhas permission to erect ................... buildings on .....1.Ql�c�......�.��l�. Jam.:....... . . . .....to be occupied as � " P`�— �!� ... ....... 0.... .Tr. '.' -�X,..:..provided that the person accepting this permit shall in every respectconform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. MB)tJG INSPECTOR ! VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR . UNLESS CONSTRUCTI T RTS Rough Service ... ..................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final j No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner o7 Street No. Smoke Det. • I AOR T#iWn To Andover 0 k to No. - oh ver, Mass, v R 1� A_ C0C"1CNIW#CK 7�A�R�TED PPa,`'�5 S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System 7tAln BUILDING INSPECTOR THIS CERTIFIES THAT ........ ......Kf_& ..... .......I.�. .:.. ......0 ......C.: . - ..a�..R....... has permission to erect .......................... buildings on .....�Q(9a........�c� I� ..... ....................... Foundation Rough to be occupied as � �d` -....... !} ...� ....... ......+N�.... .r -. ..:.. Chimney provided that the person accepting this permit.shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT I T , RTS Rough Service .............. ... ..................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. I D and J Construction 9 McKenzie Circle Tewksbury,MA 01887 978-452-0536 office 978-815-9363 cell Proposal PROPOSAL SUBMITTED TO: Care Laser PHONE:248-469-5147 DATE:4-29-15 ADDRESS: 1060 Osgood Street,N. Andover,MA 01845 EMAIL: maralg@care-laser.com We propose hereby to furnish material and labor—complete in accordance with specifications below,for the sum of: see breakdown below All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practiced. Any alterations or deviation from specifications below involving extracosts will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents,or delays beyond our control. Owner to carry fire,tornado and other necessary insurance. Our workers are fully covered by Workman's Co enation Ins e. Authorized Signature , Office Manager Note: We may withdraw this proposal if not accepted within 60 days. We hereby submit specifications and estimates for: Renovating of interior to include: Painting of interior according to submitted paint schedule$3,800.00 Installation.of VCT flooring.according to submitted schedule $5,985.00 Installation of grey laminate on cabinets and drains and wood on front of counter wall $1,200.00 Installation of 5 new interior wooden frame doors with handicap hardware. Room#111 to be 36"wide and one partition$3,400.00 PS Cost of doors with hardware $325.00 Installation of 44"x 48"window with safety glass in room 102 $565.00 Acceptance of proposal—The above prices, specifications and conditions are satisfactory and are herebyaccepted. You are authorized to do the work as specified. Payment will P p y be made as outlined above. Date of acceptance: 5/4/15 Signature: Signature: t nrH AN n 13 OE �°sD.•a•� Gn Cr 13 TOWN OF NORTH ~ . • APPLICATION F " ANDOVER * .,+ OR PLAN EXAMINAT10 .� -b,.,.o•�<�' Permit No#: �SswcNVS Date Received Date Issued: IMPORTANT:App 11 s e cant must com fete all items on thi LOCATION , O O pS a ;7-- PROPERTY OWNER ' 3 ure y� Prim /pp Year Strom no MAP PARCEL:7 ZONING DISTRICT: Historic Distrid yes Village yes no Machine Shop e _ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building 0 One family 0 Addition 0 Two or more family 0 Industrial 0 Alteration No.of units: ❑Commercial 0 Repair,replacement 0 Assessory Bldg _ thers: 1�Demolition 0 Other ' ` Fl ins d ' 'aVetCands' ";'. ,Wtel�sheDistrict DESCRIPTION OF RK TO BE PERFORMED: Y rX t e:A fiS- iN t/t+. Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: f- Go�.A&Z Phone: 9 i Email: "T ) o/, a Address: Supervisor's Construction License: C-P &Z- 7__Y ____Exp. Date: -Z is Home Improvement License: o .3 Exp. Date: ARCHITECT/ENGINEER _ Phone: Address: Reg. No. FEE SCHEDULE BULDING PER611T:$1200 PER 0 00 OF 711E TOTAL ESTWATED COST BASED ON$125.00 PER S.F. Total Project Cost $ /Y �J-b FEE:$ Check No.: Receipt No.: NOTE: Persons contrachn wit d contractors do not have access to the guaranty fund Scanned by CamScanner The Commonwealth of Massachusetts Pr1nt Form __,. _.. Department of Industrial A ccidAts Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): L 't 3— Address: City/State/Zip: �® ,�v,L _ glP Z K Phone #:_y 7r 6KS,Z o-- 3 Are you an employer? Check the appropriate box: Type of project(required): 1.E!' am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. [] Demolition working for me in any capacity. employees and have workers' insurance.$ 9 ©building addition comp.[No workers' comp. insurance required.] 5. We are a corporation and its 10.EJ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Namedy- Policy#or Self-ins.Lic.#: 1Z 2, f r/C.5 y.2 5'�'S Expiration Date: ,,2 ;z"// Job Site Address: /O p ®U U a a Y 6-7— Ci /State/Zi ty p:1y 4 A� o c„&A, Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a in of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify u er the pains d penalties o perjury that the information provided ab ve is t ue and correct. Signature. Date: r 0� Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACID,Rf �- CERTIFICATE OF LIABILITY INSURANCE T HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGH DATE( 015 ICATEDOES NOT AFFIRMATIVELY OR NEGATIVELY AMENp 03/02/2015LOW. TIi13 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CO UPON T1•IE CERTIFICATE HOLDER.THIS REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HSTITUT EA COD OR ALTER THE COVERAGE AFFORDED BY THE POLICIES NTRACT BETWEEN THE ISSUING)NSURER(S),AUTHORIZED IMPORTANT:-if the ceAiflcate holder Is an A statement on this certi ADDITIONAL INSURED,the poliy(lea)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the pulley,certain policies may requict. ttcate doss not confer rights to the certificate holder in ties of such endorsement(s). re an endorsement PRODUCER Schaffner Insurance Agency INTACT 1147 Main St PHONE (978)851-2727 Tewksbu -MAIL AIC No)- (978)640-9375 Tewksbury.,MA 01876 robert.a.sehafiner@verizon.net Phone (978)851-2727Fax (97$64INSURERS AFFORDING COVERAGE INSURED ) 0-9375 INSURERA: HUDSON INSURANCE CO NAICa OW CONSTRUCTION INSURER B: COMMERCE INSURANCE 9 Mckenzie Cirde INSURER C: BERKSHIRE HATHAWAY INSURANCE Tewksbury INSURER D: Ma 01876- INSURER E: - COVERAGES CERTIFICATE NUMBER. INSURER F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE BEENlSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT RESPECT RTO CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL NN EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WHICH THIS ILTR TYPE OF INSURANCE ADD BR THE TERMS, GENERAL LIABILITY - POLICY NUMBER MUCY EFF �OUCY EXP M10 LIMITS © COMMERCIAL GENERAL UABiLI Y EACH OCCURRENCE $ 1,000,000.00 A ❑ ❑ CLAIMS-MADE ❑ OCCUR DAMAGE TO RENTED ❑ PREMISES Ea o g HBD10006301 11/30/2014 11/30/2015 MED EXP Anyone arson) $ ❑ PERSONAL&ADV INJURY s GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ❑POLICY ❑ PRO $ 2,000,000.00 ❑ LOC AUTOMOBILE LIABILITY PRODUCTS-COMP/OP AGG $ ❑ ANY AUTO CEO eBINED SINGLE LIMIT B ❑ �T00WNED SCHEDULED NM t $ ❑ AUTOS BODILY INJURY(Per person) $ 500,000.00 ❑ HIRED AUTOS NON OWNED P95558 10/17/2014 10/17/2015 BODILY INJURY(Per accident $ ❑ ❑ Auros � 500,000.00 ❑ PROPERTY AMAGE [] UMBRELLA Lipa Per a d $ 100,000.00 C ❑ EXCESS LIAR -OCCUR $ ❑CLAIMS-MADE EACH OCCURRENCE g WORKERS []COD PENS OHN$ AGGREGATE $ AND EMPLOYERS'UABIUTY ANY PROPRIETOR/PARTNERIEXECUT V Y/N $ PER El OTH C OFFICERIMEMBER EXCLUDED? N I A !r:(MandatorytnNH) R2WC592555 02/21/2015 02/21/2016 E'L'�CHACCIDEN7 dobe°Adm $ 100,000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE100,000.00 w Wry E.LDISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF pPERATiONS I LOCATIONS!VEHICLEg(Attach ACORD 101,Additional Remarks Schedule,if more ' ':Paco is required) CERTIFICATE HOLDER — CANCELLATION -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIOtNs- � j L3g-00 L,rL 3 Sr` tr i i 1 = T±tir1YiC!)ed1? �Ptii1C➢'\14ae1' r,w: sk— CS-023711 DANIEL N INGERSOLL 9 MCKENZIE CIR TEWKSBURY MA- 01876 rr=-,,::,; 3:•: 12/17/2015 r%�r Y`rnrnrrvrrrrrr�/,�r�' �(rr..,rn•�rr,r•/L, �:�� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 100ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: -I*egistration: 107538 Type: Office of Consumer Affairs and Business Regulation �,Expiration: 8/4/2016 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 D&J CONSTRUCTION I j Daniel Ingersoll / 9 McKenzie CircleP Tewksbury,MA 01876 Undersecretary Not v without signs