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HomeMy WebLinkAboutBuilding Permit #879-2016 - 108 MAIN STREET 2/2/2016 %&ORT11 q BUILDING PERMIT TOWN OF NORTH ANDOVER " p APPLICATION FOR PLAN EXAMINATI N Permit NO: - 61& Date Received 2 �• Lb °9 .,.. 41 pIT Date Issued: �9 IMPORTANT: Applicant must complete,�all items on this page S�CMUS�� LOCATION_ I (),SI )kl t4 '3 E T- ! ] • A 0VFJ., M4.S.S' Print PROPERTY OWNER I�tY1�V-, e,l CP Print 's MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no �L Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ AJidition ❑ Two or more family ❑ I50,ustrial Nl� ration No. of units: VCommercial epair, replacement ❑Assessory Bldg ❑ Others: i6molition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑ Water/Sewer p a Identification Please Type or Print Clearly) q OWNER: Name: TV. 13Mj1L. Phone: (0 Address: C1 DOC) I UM VA)LRT L 9C.L. M T OgOS CONTRACTOR Name: D Phone: Address: 3 M l LL, , Anlks otv , Mass Supervisor's Construction License: 3�(d Exp. Date: ` 2 f5 2v !. Home Improvement License: Exp. Date: ARCHITECT/ENGINEER �N'l���tL- MJQL Phone:_ Address: 57 , Q.?EIL � '� Reg. No. g2?,G •+ FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. r Total Project Cost: $ 1 to000 FEE: $ Oct Check No.: D` �,'3 S Receipt No.: NOTE: Persons contracting with unregistered contractors do not have ac t e gl ranty fun Signature of Agent/Owner Signature of contracto NORTy BUILDING PERMIT �`�tLE° #,, +o TOWN OF NORTH ANDOVER APPLICATION FOR FOR PLAN EXAMINATION Permit No#: Date Received 0 AYEQ��cS Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 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 El Other :Septic 0 Well Q Floodplain, &Wetland's. ❑ 1Natershed0D stncf, 4 p Woter/$ewer_ DESCRIPTION OF WORK TO BE PERFORMED:- .y Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with 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. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature A . COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments r "Conservation Decision: Comments t� Water& Sewer Connection Driveway Permit DPW Town Engineer: Signature: FIRE�DEP'A Located 384 Osgood Street � R+TMEN Y�,Tehip Durnpster.�onlsite�,,yges ,00 q Mted at 124 MaintStreet' * seg z �' ;; t$Fire De t si fir. ar"t ,. 1 Q„ p men �. gnAtur /da e..�_. +� i.lr<.,�,,;"`:�-:..aj14�_ 13' , .i .. �: K�s•.,ti;:' ��4e:'f}:'3.i:" J'- t^'t: ?��-:X'�*'-'� �,�r, ta--L� „t.*.'',_....-_.. k-"';.:.�:"`M""'�—�...� �A COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Rieger 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 L7 Notified for pickup Call Email Date Time Contact Name Doc.Building Permit 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 4 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) 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 No. � y i - Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $/ i Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �7 M1 Check#W -�1' Building Inspector i Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost $ 1409000.00 m $ - $ 1,680.00 Plumbing Fee $ 210.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 210.00 Total fees collected $ 2,200.00 i 108 Main Street 879-2016 on 2/10/16 TD Bank Interior Remodel � NORTf� own of A O .5 1. �.'�, •1 No. - � r _ s h ver, Mass �� /� � y T O LAKE COC KIC Nl WICK � x,,95 RATED U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT /�.,.:;�.,1 1..../. BUILDING INSPECTOR has permission to erect buildings on ...�.� .......................................................... Foundation , c Rough to be occupied as /I .......... .... � �':.... ..... ....... ................... p� ................J.....:. .. !✓,(• .....�.. ��... —l'� �.. �Gti... 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. ��` - �'�,tires PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU TI N STARTS Rough Service .. ....... ..�L. .�............................................... 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. Initial Construction Control Document = Y To be submitted with the building permit application by a A Registered Design Professional for work per the 8`h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title:TD Bank—North Andover,MA Date: 12/28/2015 Property Address: 108 Main Street,North Andover,MA 01845 Project: Check(x)one or both as applicable: _New construction X Existing Construction Project description: Interior renovation including finishes,furniture, and millwork. I Lewis Muhlfelder MA Registration Number: 5726 Expiration date: 8/31/2016 , am a registered design professional, and I haveprepared or directly supervised the preparation of all design plans,computations and specifications concerning : X Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Do ume Enter in the space to the right a"wet"or ��\S�re EDA electronic signature and seal: C., 3 RIGHT N. M Phone number: 617-542-1025 Email: lewism@bergmeyer.com v FO Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other' is chosen, provide a description. 1 Version 06.11.2013 ' Bergmeyer Architectural Design Affidavit Date: 12/28/2015 To: Commissioner, Inspectional Services Department Re: TD Bank—North Andover 108 Main Street North Andover, MA 01845 Project No: 15079.00 I,or my authorized agent,certify that to the best of my knowledge, information and belief,the plans conform to the provisions of the (State) State Building Code and applicable laws and ordinances. ,,MD A UF ti F v Lewis uhlfelder,AIA BRRIIGH ON., MA egistration N ofeb r#5726 Q y Of MpSS�G�J On this date of 2015, before me,the undersigned notary public, personally appeared L�wtg fn,4j=l,,e-K , provided to me through satisfactory evidence of identification,which were vn au 1w mz ,to be the person whose name is signed on this document,and who swore or affirmed to me that the c ntents of the document are truthful and accurate to the best of his/her knowledge and belief. Notary P c My Commission Expires ANDREA CLARK Notary Public Comm onwealth of Massachuseffs My Commission Expires January 4, 2019 I Bergmeyer Associates,Inc. Architecture and Interiors 51 Sleeper Street,Boston,MA 02210-1208 617 542 1025(t) 617 542 1026(t) www.bergmeyer.com t s Bank America's Most Convenient Bank® BRANCH/PROJECT: NORTH ANDOVER,MA-RENO Bank No.: 003 - 5558 FABR/RENO: REN000005475 Contract Sum: $113,000 CONTRACTOR'S ACCEPTANCE OF PROJECT AND PROJECT DOCUMENTS This Contractor's Acceptance of Project and Project Documents ("Contractor's Acceptance") is entered into pursuant to the Master General Contractor Agreement for Multiple Standard Projects (the "Agreement") between TD BANK, N.A., having an office at 17000 Horizon Way, Mount Laurel, New Jersey 08054 ("Owner") and THE TORREY COMPANY ("Contractor") made as of 02/05/2016 ("Effective Date") and except if expressly stated, incorporates all of the terms of the Agreement. RECITALS: A. Owner desires to engage Contractor to construct and/or install certain improvements (the "Project") at premises owned or leased by Owner, Exhibit PD-A annexed hereto (the "Project Site&Description"); and B. Contractor desires to be so engaged by Owner. NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties hereby agree as follows: 1. Owner hereby engages Contractor, and Contractor hereby accepts such engagement from Owner,to perform and complete the Work required to complete the referenced Project. 2. All capitalized terms used in this Acceptance and not otherwise defined herein have the meanings ascribed to them in the Agreement or if not so defined will have the generally accepted industry or technical meaning given to such term. 3. Each and every term and condition of the Contract Documents, including but not limited to the Agreement and the Project Documents are incorporated by reference herein and shall apply to the Work on the Project. Owner and Contractor agree to be so bound. (W4880833.6) C 1 i Bank America's Most Convenient Bank® 4. If there is a conflict or ambiguity between any term of the Agreement and this Contractor's Acceptance, the terms of the Agreement will prevail, unless it is expressly stated that this Contractor's Acceptance is to have priority. 5. Contractor has complied with each due diligence requirement stated in General Requirements at Section 1.2. 6. This Contractor's Acceptance may be executed in counterparts, each of which when so executed and delivered shall be an original, but all of which shall constitute one and the same instrument. 7. By its signature below, Contractor confirms receipt of the following Project Documents attached as Exhibits hereto or available on Owner's Project Management System as noted and incorporated by reference hereto: Exhibit PD-A Project Site and Project Description Exhibit PD-B Design Professional Exhibit PD-C Scope of Work Exhibit PD-D Project Schedule (Start/End Dates) Exhibit PD-E Contract Price,Allowances,Alternates & Unit Price Exhibit PD-F Additional Insurance Requirements Exhibit PD-G List of Drawings Exhibit PD-H Key Personnel Exhibit PD-I Site Specific Electronic Attachments of Project Documents Exhibit PD-J Example Contractor Scorecard (wassosas.e) ACR ® CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DDIYYYY) 2/3/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The Driscoll Agency, Inc. PHONE 781-681-6656 FAX 781-681-6686 93 Longwater Circle EMAIL P.O. Box 9120 ADMDREss,jbd@driscollagency.com Norwell MA 02061 INSURERS AFFORDING COVERAGE NAIC ft INSURERA:The North River Insurance Company- 21105 INSURED 3200 INSURERB:United States Fire Insurance Co 21113 The Torrey Company Inc. INSURERC:Illinois Union Insuranc Co 27960 3 Mill St. Attleboro MA 02703 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:7369856 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 5038354035 10/7/2015 10/7/2016 EACH OCCURRENCE $1,000,000 D CLAIMS-MADE TOCCUR DAMAGE TO RENTPREMISES Ea occurrence $300,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ]PRO- JECT LOC PRODUCTS-COM P/OPAGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 1337379795 10/7/2015 10/7/2016 Ea accident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ A X UMBRELLA LIAB XJ OCCUR 5811059871 10/7/2015 10/7/2016 EACH OCCURRENCE $20,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $20,000,000 DED X I RETENTION$0 $ B WORKERS COMPENSATION 4087272114 10/7/2015 10/7/2016 1 STATUTE ETH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? El E.L.EACH ACCIDENT $500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 C Commercial Pollution COOG27065429004 10/7/2015 10/7/2016 Limit $3,000,000 Professional Liability DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:TD Bank Andover CERTIFICATE HOLDER CANCELLATION 30 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Department North Andover MA. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD r Massachusetts Department of Public Safety/ Board of Building Regulations and Standards License: CS-043964 s y Construction Supervisor +z * MARK STEVEN TRETTEL 6 FERGUSON ST `` e MILFORD MA 01757 ..nn CA_ xpirion: Commissioner 11/28/2017 Construction Supervisor Restricted to: s of any use group which contain Unrestricted-Building less than 35,000 cubic feet(991 cubic meters)Of enclosed space- ent edition of the Massachusetts Failure to possess a curr use for revocation State Building Code is caWMASS-GOV/DPS se. DPS Licensing information visit:WW I