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HomeMy WebLinkAboutBuilding Permit #670 - 120 WATER STREET 5/13/2008 BUILDING PLKMI I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION , Permit N0: Date Received °q�T•o•°" �� �SSACHU`��� Date Issued: IMPORTANT;Applicant must complete all items on this page OWL TYPE OF IMPROVEMENT PROPOSED USE - Residential Non- Residential ❑ New Building ❑ One family ❑ Addition D Two or more family ❑ Industrial ❑ Alteration No. of uriits: [I Commercial ❑ Repair, replacement ❑ Assessory Bldg [I Others,: emolition ❑ Other DESCRIPTION OF WORK TO BE PREFtMED: Identification Please Type or Print Clearly) _ -- OWNER: Name: a.Z9<.-G , Phone: l �0 ID Z.l Address: d��n xF' I I W0111 a , a f , q ARCHITECT/ENG IN EER �v-i e-- Phone: 6\'7 Address: 1�1 �y� �`i ��►T � O irkA 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: $ % `A- 1z Q FEE: $ 1 LrrL-t—� Check No.: `3�t Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 151 Plans Submitted H Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑g TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanni.ng/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 DATE REJECTED DATE APPROVED PLANNING &-DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ . ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water $ Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street 4 tP' •'s'.. 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract i ❑ Floor p FI r Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products I� NOTE: 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 u Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application a Certified Proposed Plot Plan u ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: 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 I I Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location l 2o "67- 3 A f6 d No. v Date -1 �© °RTM TOWN OF NORTH ANDOVER .5 i • _ ; ; Certificate of Occupancy $ ��- �� MuS<� Building/Frame Permit Fee $ --�-�� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # . _ '� 53 Building Inspector w I � � � � f ✓� �arivrsaoiuuea� o�✓�aaaaT�zaeeC�-a Board ofBuildmgRggulatAWN, andS.`tan_dards Construction Sup`ervFsor L4,& License' ii� CS 66334 Birthdate 9/26/1956 <. �s Pira ton X2¢/2009' Tr#' 3.— '13 .— I<IERAN T WHESc+fYYYr\\\ x `'' i 31 RICHMOND ST o ff _ 02188 � � Commissioner` I• `—`—'— __.v,,,d ..e._�---«_. - —__ _.�...______.. .rte-"�'_'..."`. I cuL— . Th e Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 North Andover PERMIT Permit No Date: (City of Town) If Applicable Dig Safe Num In accordance with the provisions of M.G.L14 8.Chap.ter_,1Q as provided in section_ � „ This Permit is granted to: ����ZW V A,- A S�7 ('�R 3 4 �L L 1� Stun Date Fu1I name of person,Firm or Corporation Permissionto locater dumpster foconstruction/renovation/demolition of building. Comments: dumpster must be . 25 ' from structure if unable to lace with re uired Restrictions:clearance dumpster must be covered with Plywood or tar end of work da at _ /�o Gv 9Tfvt �i y (Give location by street and no.,or describe in guch mann ovi equate identification of location) Fee Paid s 50.00 • Fire Chief This Permit will expire -� (Signature of olfical granting permit) Offioalantro � Bpermit (Title) i Distbu CHANGE ORDER RCGLLCtion to: -David Steinbergh RCG Builders LLC -Skip Rose East Mill Residences Change Order Number: 1 21 High Street,North Andover,MA Initiation Date: 12-May-08 Architect's Project No.: 07002 RCG LLC Contract For: Adaptive re-use of existing commercial TO: space into 20 residiences 17 Ivalon Street (Contractor) Somerville,MA 02143 LContract Date: 12-Jul-07 li You are directed to make the following changes in this contract as a result of approved Change Estimates: CE# Date Approved DESCRIPTION Amount Demolition-4th Floor Building 3A 1 5/12/2008 Perform all Demolition work in accordance with Khalsa Design Inc.drawing A-1.00 $10,909.00 Dated 5/9/08,Project Specifications General Conditions: $0.00 Fee: $1,091.00 Total: $12,000.00 Total AIA Change Order Amount: $12,000.00 The original Cost Plus was $809,378.00 The net change by previously authorized Change Orders The Cost Plus prior to this Change Order was $809,378.00 The Cost Plus will be increasedby this Change Order $12,000.00 The new Cost Plus including this Change Order will be $821,378.00 The Contract Time will be unchanged ( )days RCG LLC RCG Builders LLC __......... OWNER CONTRACTOR 17 Ivaloo Street 17 Ivaloo Street Address Address Somerville, MA 02143 Somerville, MA 02143 BY DATE5 L , 7�rt,'�j DATE 5/12/2008 i NOTICE NOTICE OTIC TO TO EMPLOYEESEMPLOYEES r • I l I The Commonwealth of Ma S' sachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 604 Washington Street, Boston, Massachusetts 42111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21,22& 30, this will give you notice that I(we)have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE P.O. BOX 4070 BURLINGTON MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC 5005531012008 05/10/2008 - 05/10/2009 EFFECTIVE DATES POLICY NUMBER 24 Federal Street 4th Floor Boston Insurance brokerage Inc Boston, MA 02110 617 556-7000 NAME OF INSURANCE AGENT ADDRESS PHONE RCG Builders LLC 17 Ivalon Street-Suite 100 Somerville, MA 02143 1 EMPLOYER ADDRESS 03/10/2008 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDT AL TREATMENT'.:-., The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employeemay select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by tlie,insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that _ the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER I NORTH c ® of 6 over ti ,. ;. No. = s zs A o dover, M.S. d /� COC NIC ME WICK y^ 7,9 ADRATE D A '�y `r BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.� .... .011 4 . ... .... .......... !. ...�.............� ........... . . "" "' _ #(attonR. has permission to erect........................................ b ings on . .. .......W .......i�.......*.....� • • to be occupied as...... :t+. .......... .......... (ft v...Mr.. Chimney �.... ... provided that the arson acce tin this ermit shall eve res ect conform to th arms oft application on file in P P P g P �l P Final 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 UNLESS CONSTRtJ ELECTRICAL INSPECTOR T> Rough .... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE J1 Smoke Det.