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HomeMy WebLinkAboutBuilding Permit #Exception - 1060 OSGOOD STREET 5/1/2018 (4) BUILDING PERMIT O� N V 1 q 3Z y6� flo.t616 TOWN OF NORTH ANDOVER - - APPLICATION FOR PLAN EXAMINATION 70 � Permit No#: Date Received wreo Po-`45 gSSACHUS�� Date Issued: IMPORTANT: Applicant must comp ete all items on this page LOCATION' /&VO ' Print PROPERTY OWNER,bo—lk d SGNIlop s Print /7 100 Year Structure yes no 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 ❑ Others: ❑ Demolition ❑ Other El Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District, Q Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: /Yo o Cj/C!t/ Gr D k Co eSvY f Coro Identification Please Type or Print Clearly OWNER: Name: Ve-Y-o �C �CnP�h Phone: e�f'7- y13- Sam Address: /.2(, break 34- i Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: V Home Improvement License: Exp. Date: 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. Total Project Cost: $ FEE: $ 00 Receipt No..a ��-3 Check No.: p NOTE: Persons contracting wit unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM i PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS i CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on b f Signature ZAA.- COMMENTS i W r t✓� �+.-� A Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes f< Planning Board Decision: Comments Conservation Decision: Comments Wafter & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: FI_RE,DEPARaTMEaNT empDum s .m � 4 T ste _ Located 3 Osgood Street 4pr onsite syn - IiLocated at12,_fM Sf�eet Fi`r�e De _p�aAtinent signature/d'a'te � ..,. � � �_.��� �COMMENTS• � Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. 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 NOTES and DATA-- (For department use) I ❑ Notified for pickup Call Email Date Time Contact Name Doc.Buildinb Pen-nit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. 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 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) 16 Building Permit Application :6 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 a S4 6 .�� No. Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ �— Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check# Building Inspector Ot NORTH O S`r�CINSE CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Change in Occupancy Date: May 26, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1060 Osgood Street MAY BE OCCUPIED AS a restaurant - Dicor _IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Veronica Penella 1060 Osgood Street North Andover,MA 01845 Building Inspector Fee: $100.00 Receipt: 228831 Check : 89 of NORTH IO. 9 4 �'SS�CINSE4 9 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Change in Occupancy Date: May 26, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1060 Osgood Street MAY BE OCCUPIED AS a restaurant - Dicor _IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Veronica Penella 1060 Osgood Street North Andover,MA 01845 Building Inspector Fee: $100.00 Receipt: 228831 Check : 89 COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 1600 OSGOOD STREET Buildings 20 Suite 2035- Ph 978-688-9545 Fax.978-688-9542 APPLICATION OF CERTIFICATE OF INSPECTION ( ) Fee Required(Amount) $ ( ) No Fee Required Date: Accordance with the provisions of the Massachusetts State Building code, Section 108,15, 1 hereby apply for Certificate c Inspection for the below-named premises located at.the following address: Street and Number /CXO OS9d� S 4- AUdr �nC�c�Jfr �/f Name of Premises �)r Cr ieeS *4 U/'o//7f Purpose for the Premise is used. S u rc.o7 Licenses(s) or Permit(s)Required for the Premises by Other Governmental Agencies: Contact Person_ Telephone License or Permit A enc Certificate to be issued to Verorn+c r-, Pe-/I e l(c— SoO Address Telephone ly/7 -q 3 Email Di(-e Ka, R S �&L)re-6 f(Q) 6Ma i l 0611 Owner of Record of Building Address Name of Present Holder of Certificate Name of Agency, if any SIGNATURE OF PERSONS TO WHOM CERTIFICATE TITLE IS ISSUED OR HIS AUTHOIRIZED AGENT DATE INSTRUCTIONS: 1) Make check payable to: Town of North Andover J 2) Return this application with your check to: Building Dept., _ '600 Os nod Street, BLDG 20 STE 2035 North Andover MA 018.45 PLEASE NOTE: Application form with accompanying FEE must be submitted for each building or structure or part thereof to be certified. 3) Application and fee must be received before the certificate will be issued. 4) The building officials shall be notified within ten (10) days of any change in the above information. CERTIFICATE# EXPIRATION DATE: Application for Cl.Revised 7112 MD i i INSPECTION REPORT FORM LASSIFICATION PASSES INSPECTION YES NO DATED WNER JILDING NAME OR NO rREET LOCATION !PE OF OCCUPANCY -Day Care❑ Auditorium ❑ Restaurant ❑ Cafe ❑ Gym ❑ Apt ❑ :hoof ❑ Common Victualer's ❑ Liquor ❑ Place of Assembly ❑ OPERABLE CIT SIGN yes ❑ no ❑ 3HTED EXIT SIGNS yes ❑ no ❑ JMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS JMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STOREYS IIERGENCY LIGHTING SYSTEM dry cell ❑ wet cell ❑ operable ❑ kRINKLER�SYSTEMperable ��0 �! � rigaga pre sure EALARM SYSTE M "•u expifed ECTRIC EQUIPMENT VIOLATIONS yes ❑ no ❑ �E RESISTANT CURTAINS OR DRAPERIES yes ❑ no ❑ 'RESSES LAWFULLY DESIGNATED unobstructed ❑ yes ❑ no ❑ ,NDICAP ELEVATOR yes ❑ no ❑ AIRS PROPERLY RAILED yes ❑ no ❑ ,LLS AND STAIRWAYS LIGHTED ,es ❑ no ❑ ILITY ROOM—CLOSETS yes ❑ no ❑ DIATOR GUARDS yes ❑ no ❑ FIS MES-H-AN yes ❑ no ❑ ,W HEATED NO. FIREPLACES yes ❑ no ❑ ,ILER ROOM CONDITION: >PECTOR. BRIAN LEATHE. r TOWN OF NORTHANDOVER BOARD OF SELECT MEN GENERAL APPLICATION This is a general application for a license that the Board of Selectmen may grant. All license applications to the North Andover Board of Selectmen mast be accompanied by the following information htdicatC if license is: neW N 1111 cfcr, change of dba F Other List of B=se(s)applying for.- common or:common Vichuff" Package Store Aft Alcohol ®ClassI No.cfvelides fer&spW. Rcammant All Alcohol Package Store Wive&Matt H Ab.ofvd4des sardisplay:_ © Restaurant R►me&Malt EjFomme Tdkr © flub All Alcohol Veb bele fa:IIue/Taxi No of Velma Annual Eatntainment SuadxYEntertaimnent Q Elechunic frames-list below: hzkcbox Billiard Table M.of tables: BUsmess Name Please attach copy of business certificate if applying as dba or individual. if business is a corporation or LLC, please attach: - 1. Certificate of Goal Standing from the Spry of State's Office. Z. Corporate Vote authorihng business at the location- Address ocatio -Address of licensed Premises(include zip code): b6o mailing address(if different than above address): Name of individuallapplicant authored pto apply for licenser Business tel.no.of applicant •l.f� ODRI Business email:_ i CO V% � t F.UN:(F.T N-) LA-1— g0 Please check one of the follo ` . own premises �1 ease Pproperty YunderP&S • `s Name and of property ovener if different from li holder: MAW If appli caW please attach copy of l and/or Purchase and Sales Agreement. Do year currently hold a similar lice=? Wiwi type? WA thwe you previously applied for a lice?(Yes)F] (NOWN Ha eyou ever had a license revoked? (Yes)F' (NoIf yes,please indicate v&y,. l _ t E F • F r • i f t , ' t If there is a building or structure associated with the license,please submit the following (preferably on 8112 x 11"paper-no larger than 8112 x 14"): 1.Floor plan(include seating area), and 2. Site plan indicating parking areas and access to town ways. If applying for a Class I or Class H license, please submit a plot plan that shows: 1.The number of the vehicles on display 2.The exact location of the vehicles 3.Customer parking 4.Office area Proposed h urs of operation: h Monday )�oo em- •0Q Thursday ),-00 om- _l'•f aa, Tuesday /Y oao�M Friday ).Room- 10-(J)�rn Wednesday 0, - :0 ab day) ' *m- )0.-'Mon Sunday/V-' 0 Mh C� (Specify liquor sale hours if different than regular establishment hours): Has the applicant operated a similar business?(If applicable) Name of Business: Address: Federal Tax No. (If applicable): I certify that the North Andover Police Department may run a criminal records check for any prior - offenses and that this information may be transmitted to the Local Licensing Authority at their request. Date: Signature:44 I certify under the penalties of perjury that I,to the best of my knowledge and belief, have filed all state tax returns and paid all state and local taxes required by law. Date: Signature: I certify that I have read through the conditions included with this license and agree to comply with any further stipulations that the Licensing Authority may from time to time approve. I also hereby authorize the Licensing Authority or their agent to conduct whatever investigation or inquiry is necessary to verify the information contained in this applicatio Date,• Signature Please contact the Town Clerks Office at(978)688-9501 if you have any questions regarding this application form. Reviewed and amended:2011 I 2 i Dine steetp !, r Spa i� � s,cear t 2 WAg. 'i lw&sZW5 _ ` "�• "<y h 1 t `ti :y Y�p'"}.F;Ri�,ie M.NL rti. � may,,, (���.y'•,. 11Cr Lo � � t 6 4 fva! u Sm Entrance 4 49Z& 6>wmnwm&wMo,f 1 Jw"A71vl Wb�e c f&&,Xva,el, —qo&tow,; ./� ua a 4&� 02133 Wdliaw Francis Calvin seuetuy of the Commonwealth May 7,2015 TO WHOM IT MAY CONCERN: I hereby certify that according to the records of this office, DICOR RESTAURANT CORP ' is a domestic corporation organized on April 30,2015,under the General Laws of the Commonwealth of Massachusetts. i I further certify that there are no proceedings presently pending under the Massachusetts General Laws Chapter 156D section 14.21 for said corporation's dissolution;that articles of f dissolution have not been filed by said corporation;that,said corporation has filed all annual reports,and paid all fees with respect to such reports,and so far as appears of record said corporation has legal existence and is in good standing with this office. In testimony of which, I have hereunto affixed the Great Seal of the Commonwealth on the elate first above written. Secretary of the Commonwealth Processed By: jbm i I \y Page 2 Did you hold an entertainment license from the Commission pursuant to section 183A of Chapter 140? . If yes,was it for the exact same entertainment being requested in this petition? .I e ,the applicant or representative,certify to the foll ' g: I have read and understand all the requirements that may be imposed upon the applicant under Chapter 140, Section 183A this license and those policies of the Licensing j Commission regarding entertainmen L That the only form of entertainment which may be allowed on the premises, if the application is approved, will be that which the Licensing Commission approves based upon my application. That all statements provided herein are true and are complete as possible. That I understand that this license may be suspended or revoked should the Commission find that any items of information sought and given on this application are either untrue or not complete, or, that the applicant is found to have conducted the entertainment ' outside the provision of the above cited laws and regulations and outside of the approval given on such license or permitAl j i ;�;�Lure of Applicant Date; i E F f �yR j ! t j The Licensing Corson for tile to Tarn of North Andover APPUCATIONFORANEI RrAMCMLICE The undersigned reqxctfaRy applies for an entertainment license as follows: IACATION OFPR ) CLASS OF LICENSE: DESCRIPTION OF PRS: HC)URS OF-OPERATION:Weems –4-IMPM Fhme check appropriafc iiem(s): JEFICI BO% J Afl4tPLWMS t� MONO: CABIN:TV: VVIDF.SGBE@�TV KYA—CASA OPER.TV if YA--m"S:A YA t INSTRU AL music:� NO.OF RIMUMEUPTS•N` A Type of What floors VOCAL MQSIa No of persoas DANCING BY PATRONS: Type of DmdiW, s What Floors? Somme of dance floor: Eihi�' n or Trade Shorey Describc P1w- Descrilm i Mowing Picture Shaw. Describe:. Fkw Shoe: Desen"ix Afire Rveist Desi F