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HomeMy WebLinkAboutBuilding Permit #154 - 1211 OSGOOD STREET 8/29/2006 TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION OF�t"ao 06�tio
a oL
i 0
* rt
Permit NO: �,, Date Received
Date Issued: v 2 SSgcHUS����
IMPORTANT: Applicant must complete all items on this page
LOCATION 9// Oy 0_?) sl:�
Print
PROPERTY OWNER
Print
MAP NO.: PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
ew Building ❑ One family
❑ Addition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units:
❑ Repair, replacement ❑ Assessory Bldg A<Ommercial
❑ Demolition
❑ Moving(relocation) ❑ Other ❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
Identification Please Type or Print Clearly) // �/
OWNER: Name: Phone: 1 /—7 6 70
Address:
CONTRACTOR Name: �iU �7h Phone: ZS
Address:
Supervisor's Construction License:t9ql 6Lz,)— Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST&4SFD ON$125.00 PER S.F.
Total Project Cost :$ :2C-, � FEES 00
Check No.:T7(' 3 Receipt No.: cap
Page 1 of 4
I
TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑
F1Tanning/Massage/Body Art ❑
Public Sewer
Well F1Tobacco Sales ❑ Food Packaging/Sales El
Permanent Dumpster on Site ElPrivate(septic tank,etc. 11 Permanent
Meter location to
project
NOTE: Persons contracting
with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner 166v Signature of contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
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
Temp Dumpster on site yes—6—
Fire Department signature/date
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required Provided Required Provides Re-q—ui-r—ed--7 Provided
Dimension
Number of Stories: Total square feet of floor area,based on Exterior dimensions.
Total land area,sq. ft.:
NOTES and DATA—(For department use)
e
Page 3 of 4
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created 1MC.Jan 2006
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
Addition Or Decks
❑ Building Permit Application
❑ Surveyed Plot Plan
❑ 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)
❑ Mass check Energy Compliance Report (If Applicable)
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
❑ Mass check Energy Compliance Report
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
Dae:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Pave 4 of 4
Location 1A// �� dy S�,—
No. 4S� Date
2 U�
�oRTM TOWN OF NORTH ANDOVER
3: �� •• oL .00
Certificate of Occupancy $
a •Eta' Building/Frame Permit Fee $
s�cNus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ 1
Check #/ 74V
19524
Building Inspector
F NORTH ''
Town of 4 ©ver
No.
?,o o dover, Mass.,
CO—C—lc
V
C:)
AERATED PPS` '`
�`s BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
♦ BUILDING INSPECTOR
THIS CERTIFIES THAT...... .. .... ff �.4*...................................... ...... .. -.. �.�,. ...... Foundation
has permission to erect........................................ buildings on� .//.. s ../?n
Rough
1
to be occupied as.................. ......�.... ..... .. .......... . imn.. h' ev
provided that the person ac mg this permit shall i everyrespe rm to th ter s tali on i '" final
this office, and to the provisions of the Codes and By-Laws relating to the Inspect , 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 CONSTRUCTION ST S Rough
............................ ......... . ..
Service
RDILDAIM 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 j
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
p0 X35 p00 cf enClosed space
(MGL C';112$:601)
1A tlAasgnry only'
1G 1A.'2 F mily/hlgmes
Failure to possess a:Current edition of the 7
;Massachusetts State Building Code 1 - : lC1F111L
is:cause forrrevocation of tins license:
Al
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A
Bs(rt tl9FJII
� M'A
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QIG SAFE.CALUCENTM, (888)344 7233 Re s � `
4ETi3:NfiTH j
— - �t�3T1 T 1us t
Ff �
Boal t�:of Buuding Rcgulat�ons anal Sfan �aQ fijcens r registration
valid,for indtvidul use oni`
r _ bgreHe expiratt0a�date it found return to.,
v 40ME IMPR VEMEN CON f rAG l ;
'B. 'F 4,%iiildtrig Rdgt+lations and Stand-ir
Registratron: 129474 bne itsliburton:Plate Rin 1361,
E3piratoilc 9/9fQGTp. 3o #on, a 01 $
Typhi t3BA - r
I<Qrk NgOOReriodelir ontractol '-'
PTEfit NG ,TH
53•Short St I''00t
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Signa
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i.owelf M(�01852 �c}3iiuu�fa'alor _�,
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ACORD CERTIFICATE OF LIABILITY INSURANCE CSR DG DATE(MM/DD/YYYY)
PETER-4 08/23/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Byam Bros-Mahoney Insurance HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
191 Pawtucket Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lowell MA 01854
Phone: 978-454-2926 Fax:978-937-0745 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Commerce Insurance Company
INSURER B:
Peter Ngeth dba K-N General
Construction INSURER C:
35 Ruth Avenue INSURER D:
Dracut MA 01826
INSURER E:
COVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
P LICY EFFECTIVE P LI Y EXPIRATI N
LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYY DATE MM/DD/YY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 300,000
COMMERCIAL GENERAL LIABILITY HJP606 DAMAITYREIVTED—
PREMISES(Ea occurence) $ 100,000
CLAIMS MADE ElOCCUR MED EXP(Any one person) $5,000
A X Business Owners 12/13/05 12/13/06 PERSONAL&ADV INJURY $
GENERAL AGGREGATE $ 600,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $
POLICY PRO LOC
JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR F-1 CLAIMS MADE AGGREGATE $
DEDUCTIBLE
RETENTION $ $
WORKERS COMPENSATION AND TORY LIMITS ER
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
LOWELL2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THERREEOeF,THE II[S�SCUIN�GAINSURER
yWILL
eENDEAVOR
T�O(�MAIL
(�y10 DAYS WRITTEN
NOTICE TaTF7E`C2�'�P&Tf°FfOL'DPNAN40�'i'H�LiEFI';�Btl�F1��LRE TO DO SO SHALL
CITY OF LOWELL O
IMPOSE NOBLIGATION OR LIABILITY OF A
375 MERRIMACK STREET ,NY KI "UPON THE INSURER,ITS AGENTS OR
LOWELL MA 01852 REPRESENTATIVES.
lAUTHORIZED REPRESENT
Byam Bros,;/
ACORD 25(2001/08) ©ACORD CORPORATION 1988
The Commonwealth of Alassachusetts
Department of Industrial.Accidents
Office of Investigations
600 Washington Street
Boston,M4 02111
www.mass.bgov/din
I
Workers' Compensation Insilp.rance Affidavi : Builders/Contractors/Electricians/Plumbers
,kpplicant Information Please Print Legibly
NamelBttsincssrf)rzaniiation/IndiviJua/l): /
;address: �j �f�7 141 —
City/State/Zip:
Are you an employer?Check the appropriate box: Type of project(required):
I.❑ 1 ant a employer with 4. El am a general contractor and 1 6. E] New construction
mployees(full and/or part-time).* have hired the sub-contractors
I am a sole proprietor or partner- listed on the attached sheet. ' Remodeling
❑
ship and have no employees These sub-contractors have 3. ❑ Demolition
working for me in any capacity. workers' comp. insurance. y, ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
required.] officers have exercised their
3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs
insurance required.]t employees. [No workers' 13.0 Other
comp. insurance required.]
`Any applicant that checks box 1J 1 must also till out the section below showing their workers compensation policy information.
+f lomeowners 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 their workers'comp.policy information.
I am cin employer that is providing workers'compensation insurance for my employees. Below is the policy end job site
in%ormation.
Insurance Company Name:
Policy 'f or Self-ins. Lic. 4: +_��d� — Expiration Date:
Job Site Address: 'U/ `r City,'State/Zipf/1--� r�"
,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`,IGL 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 tine
Of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certijy--unn(eer the pains and penalties of'perjurp dint the information provided above is true
//allnd/correct.
Si! nature: ( � Dater D V b
gflic•ial use only. Do not write in this arca,to be conipleted by rill or town official.
City or Tow n: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical inspector 3. Plumbing inspector
6.Other
Contact Person: Phone#:
PROPOSAL
PROPOSALNO.
SHEET NO.
DATE
PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT:
NAME ADDRESS
---
ADDRESS WAIkK
DATE OF PLANS
,7Y1
PHONE NO. ARCHITECT
q 12Z) SeV, 6/t7 L
We hereby propose to furnish the materials and perform the labor necessary for the completion of
jV4
All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications
submitted for above work, and completed in a substantial workmanlike manner for the sum of
Ao��kid Dollars ($ !2,
with payments to be made as follows:
"Ede
-7 — �w'
6o 0 /--
7 Y' C 65 Respectfully submitted
Any alteration or deviation from above specifications involving extra costs
will be executed only upon written order, and will become an extra charge Per
over and above the estimate. All agreements contingent upon strikes, ac-
cidents,or delays beyond our control. Note - This proposal may be withdrawn
by us if not accepted within—days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work
as specified. Payments will be made as outlined above.
Signature
Date Signature
D8118
U�'A PROPOSAL
WOMEN'S
MEN'S
0
C) OFFICE
CD
50 GL
O HOT WATER TANK
f
O DOUBLE SINKT MIRROR
{
. j
O
� I DPEDICURE SPA
O °
MANICURE TABLE
RECEPTION DESK
CD
o
CD
0
II
� 4� E
WAITING AREA
.,_..
UNIT 3B - 1211
PROPOSED PLAN
NOT TO SCALE
OSGOOD STREET / ROUTE 125
1
CRUSHED STONE
w w
OVERHANG o 0
A13OVE i -------------
- - - - - - - - r - - -
A 119 a -n 120 g
I '°`
'OUNDATION WALL AND CONCRETE LnI C Y�WOMEN'S %i 'WOMEN'S: �i C
.oI 113 `IIS -T- I
SAVE BEEN CONSTRUCTED. -}- SHEAR WALL LOCSEE STRUCTURAL
)ATION DRAWINGS FOR ' I -'g I FOR FOUNDATION
129
'ATIONS OF ALL SLEEVES °D I �9 118 I DETAIL AT ROOF
ND COLUMN BASEPLATE I I B
AN IIG I
11'-9 1/8• 1111 112 115 I HALLWAY
CID
113 , - _, 111 C 121 I"l_
• 0 O j i-i MEN'S\`I g, MEN'S i\�1- I Lr
_� I C i In i /�`� IIG i J 2
• , \�/ ,
ATTIC ACCESS HA
--SAND FOLDING LAD
- --13T T D4"-- ABOVE
2'-6 3/4" 3 12"
COOLER
IIs SALES AREA
0
' m
cc
r
" B TENANT #4
0
_4. 2,094 SF+-
TENANT #3BMINIM M DISPLAY AREA
3 1/2 32'-2
2 I/2 119
#3A 1 ,062 S F+-
+_ A O
n
TYPIC
SE---
BI B
_OCATIONDORMER LOCATION O co v
ABOVE - - ---
IL 1 19'-1 5/8' ~
A C / A co
122 ---
-
-- _ ��_�,
a
- - - - - - - - - - - - � � - 4.1\AJ - - - — ° J --
- '
BOVE
--
all �so�ao� �
BUILDING FILE
i
i
TOWN OF NORTH ANDOVER
Office of the Building Department
� pORT/� q
Community Development and Services
,0 - °p 1600 Osgood Street, Bldg. 20,Suite 2035
North Andover, MA 01845
978-688-9545
�.9 A�RATEO I'PP .�5
SSACHUS
Gerald Brown, Building Inspector August 21, 2014
To: Matthew Egge,Jean Enright
Fr: Gerald Brown
Re: 1211 Osgood Street (McLay's Florist)
In response to your request for a zoning analysis for the above address I have made the
following determination.
Based on the Zoning Bylaw of the Town of North Andover,Section 8,Table of Off-Street Parking
Regulations under Food and Beverage, 15 (fifteen) spaces are required per ksf GFA. Square footage of
Unit#4 is 2,094 which would require 30(thirty) parking spaces. Currently there are 50(fifty)spaces
provided for all of 1211 Osgood Street,that has five storefronts. Based on business flow of the existing
businesses and the fact that the peak usage for a restaurant is after 5 pm,there would be 36(thirty six)
spaces available.
It is my determination that the parking for a proposed restaurant conforms to the Zoning Bylaw
parking regulations.
Also in the Zoning Bylaw of the Town of North Andover,Section 8,Table of Off-Street Parking
Regulations under Notes No.8, if desired at a future time, seasonal outdoor seating is also allowed as
long as the seasonal outdoor seating area does not exceed 25%of the indoor seating or a total of 20
(twenty) seats whichever is greater.
Sincerely,
��Lf�V✓
Gerald Brown
Building Inspector
Attachments(2)
increase in units or dimensions of buildings, structures or use, such spaces to be provided in at
least the following minimum amounts provided in the following Table of Off-Street Parking
Regulations and accompanying notes below.
Table of Off-Street Parking Regulations
Use, . Parking Spaces Required
Residential
Single-Family Dwelling Unit
Multi-Family Dwelling Unit 2 per dwelling unit
Studio 1.25 per dwelling unit;
One Bedroom 1.5 per dwelling unit
Two or More Bedrooms 2 per dwelling unit
Accessory Dwelling Unit 1 space per dwelling unit
Sleeping Room 1 space per unit or room;plus 2 for
owner/manager
1.25 per guest room;plus 10 per ksf
restaurant/lounge;plus 30 per ksf
Commercial Lodgings meetingibanquet room(<50 ksf per guest
room)or 20 per ksf meeting/banquet room
(>50 per guest room)
Elderly Housing Independent Unit 0.6 per dwelling unit;plus 1 per 2
employees
Elderly Housing Assisted Living 0.4 per dwelling unit;plus 1 per 2
employees
Group, Convalescent,and Nursing Homes 1 per room;plus 1 per 2 employees
Day Care-Center 0.35 per person(licensed capacity)
0.4 per employee;plus 1 per 3 beds,plus 1
Hospital/Medical Center per 5 average daily.outpatient treatments;
plus 1 per medical staff;plus 1 per
student/faculty/staff
Retail/Service
Grocery(Freestanding) 6.0 per ksf GFA
Discount Superstore/Clubs(Freestanding) 6.0 per ksf GFA
Home Improvement Superstores 5.0 per.ksf GFA
Other Heavy/Hard Good (Furniture, Appliances, 3.0 per ksf GFA
Building Materials, etc.)
Personal Care Facilities 2 per treatment station,but not less than 4.3
per ksf GFA
Coin-Operated Laundries 1 per 2 washing and drying machines
2.7 per ksf GFA interior sales area,plus 1.5
Motor Vehicle Sales and Service per ksf GFA ipterior or storage/display area,
plus 2 per service bay
Motor Vehicle Laundries/Car Wash 2,plus 1 per each 2 peak shift employees
Other Retail Not Otherwise Listed Above 3.5 per ksf GFA
Food and Beverage
Restaurant(non-fast food and/or with no drive- 15.0 per ksf GFA
87
i
4
Accessory Uses
1 per room used for office,or occupation
Home Occupation or Home Office space;plus 1 per non-resident employee;
lus 1 er dwelling unit
Notes:
1. ksa equals 1,000 square feet.
2. Where the computation of required parking spaces results in a fractional number of 0.5 or above,the required
number of parking spaces shall be rounded up to the next whole number.
3. Where fixed seats are not used in a place of assembly,each fifteen(15)square feet of floor area in the largest
assembly area shall equal one(1)seat.
4. Where uses are of the open-air type and not enclosed in a structure, each square foot of lot devoted to such
use shall be considered to be equivalent to one fifth of a square foot of gross floor area.
5. Where development of a site results in the loss of on-street parking spaces,the number of on-street parking
spaces lost shall be provided on the site, in addition to the number of spaces required for the use unless
otherwise stated herein.
6. The Planning Board shall have the discretion to allow between 4 -6 parking spaces per 1,000 square feet of
Gross Floor Area for retail development in the Village Commercial District.
7. In appropriate circumstances,where the provision of adequate off-street parking is not otherwise feasible,the
Planning Board may include on-street parking within the determination of adequate parking arrangements for
a particular use,particularly in the so-called Downtown Area which for the purposes of this Section shall be
defined as the following areas:(i)Main Street from Sutton Street to Merrimac Street,including 200 feet from
Main Street on the following side streets; Waverley Road,First Street, Second Street, and School Street; (ii)
Sutton Street from Main Street to Charles Street;(iii)Water Street from Main Street to High Street;and,(iii)
High Street from Water Street to Prescott Street.
8. Seasonal outside seating for food establishments shall be exempt from Section(a)of this regulation as long
as the seating does not exceed 25%of the indoor seating or a total of twenty outdoor(20)seats,whichever is
greater.
b) Accessible Parking.
Parking facilities shall provide specially designated parking stalls for persons with disabilities in
accordance with the Rules and Regulations of the Architectural Access Board, as amended (521
C.M.R.) implemented by the Architectural Access Board of the Commonwealth of
Massachusetts Executive Office of Public Safety and Security or any agency superseding such
agency. Accessible parking shall be clearly identified by a sign stating that such parking stalls
are reserved for persons with disabilities. Said accessible parking shall be located in the portion
of the parking lot nearest,the entrance to the use or the structure, which the parking lot serves.
Adequate access for persons with disabilities from the parking area to the structure shall be
provided. To the extent that any provision of this Section 8.1 conflicts with the Rules and
Regulations of the Architectural Access Board (521 CMR), the Rules and Regulations of the
Architectural Access Board shall govern.
5. Design Standards
All required parking areas shall have minimum dimensions as follows:
a) Dimensions of Parking Spaces and Maneuvering Aisles.
On any lot in any district, parking spaces and maneuvering aisles shall have the minimum
dimensions set for the in the following table and Section 8.1, unless specifically stated elsewhere
in this Bylaw and/or as modified upon the recommendation of the Planning Board.
Minimum Parking Space and Aisle Dimensions for Parking Lots (in feet)
89
i
Enright, Jean
From: Enright, Jean
Sent: Thursday, August 14, 2014 8:21 AM
To: Brown, Gerald
Cc: Enright,Jean; Bellavance, Curt
Subject: 1211 Osgood Street (McLay's Florist)
Attachments: 1211 Osgood St. complete Planning Board App 8 01.pdf
Hi Jerry,
Attached is the filing for the proposed restaurant at 1211 Osgood Street. The filing includes a listing of current tenants
and a parking analysis. Will you please review it and provide a Zoning Analysis memo with your determination as to
whether the parking conforms with the Zoning Bylaw parking regulations. I will need to include your memo in the
Planning Board packet to be sent on August 28,2014. Thank you.
Jean Enright
Planning Assistant
Town of North Andover
1600 Osgood Street, Suite 2035
North Andover, MA 01845
Phone: 978-688-9535
Fax: 978-688-9542
Email: ienright@townofnorthandover.com
Web: www.TownofNorthAndover.com
1
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CommadY went n
Special Permit—Site Pian Review lication 71
Please type or print deaaty.
1.Petdioner.1211 Osgood SteeL LLC
ftfiffwWs :1211 Osgood SteK NoM Andover.MA 01845
Tdepttoae rttmbw.978-683-3164
2-Owners of tate Land:1211 Osgood Sfre et LLC.Janes IYAngdo aced Fiacdt Tom,MmWem
Addrms: 1211 Osgood SueK tilt Andovw,MA 01845
Number of yeas of ammstap. Ten Yeats
3.Year lot wAs camf ed. PfiarbI970
4_description of ftposed Pr+sal RW!dy is flte sdgect of Amuavy g,21164 Site flan Specd Pwrit and a Mamh 16,2005
kAdditicatm of ftral Pen=fry Mhcate WAC unts and add salty bolads. Pefd ner seeks.to amrd Me man by
wto Spetd C.avffiau 1.b afbw for a mstauraet use an 2M4 sf of flee c (ufd4). Peftf<orter vM dwwsMe Out
re sl peak lour paftv dwmid wA w=when offer mUfform ums am dosed,amwq for sett parlEM SW*
dining ftmt pwad to meet or exceed vagwwm s
5.description of Pmadses: The pmxd is located at the kof row 125(OsgaW Sfceef)acrd Badw Ste.
6.Addmss of R gmmty Being erected.-1211 Osgood StEet l
Zoning lltstrict tB
Assessors IhW- 216 Lott. 035
registry of dream:Ekwk is 9i3 Paget 94
7.EXts&q Lot Ply see pwmas gVEcaffan ad m=ded OaM for aMeM fo 97,8,9,10,11
Lot Am(Sq.F): BUMEM HeWtt
Street FroaUge: Side Sedmcks:
Front Sem Rw Setback
Floor Area hath: Lot Comae:.
&RvposedLot(if k):
Lot Area(Sq.FQ.- Wilift ilft
Sf ed swe :
Front Seff3adC Rears
Floordma Rgo: Latcamm9e:
t9ge4oF.6
16M Odd SkeeL NoM Andavw,BP S,SaTz 2-W PkMm Dept.,Mawadwsett 01845
Ptaw 9M-680-9535 Fax 378.61 . 2 Web www-b=&xuffTarT&vnrcam
� J
R
TOTAL GROSS FLOOR AREA OF
TENANT SPACE=9,108 SF ° °
° ° ------------------
--------------
SPRINK ;TOIGt -�T01� p
I t I
ELEC. - -
1 T010- I t0lQ 1 Q
I f01L, I R
I plI
1 UNIT#1 UNIT#2 UNIT#3A UNIT#3B -
------ BAKERYIRETAI.L ;=f01Li VACANTIRETAIL INSURANCE/OFFICE NAILS/RETAIL
2,036 GFA 2,036 GFA 2,036 GFA 2,036 GFA Efi
I I
L----- °1 RI
I I KKK111 I
I I
I n n I
1211 OSGOOD STREET, NORTH ANDOVER, MA-TENANT AREAS AND PARKING ANALYSIS-8-1-2014
1211 Osgood Street Parking Analysis Zoned -GB
Parking Parking Parking +
Zoning Required Spaces Provided Provided on
Use GFA Parking Required on Site Site after Spm Remarks
Business not Open
Unit 1 Bake /Retail 2,0361 5/1000 GFA 10.11 10 0 after 5 m
Unit 2 Vacant/Retail 1,8001 5/1000 GFA 91 9 9
Business not Open
Unit 3A Insurance/Office 2,117 1/300 GFA 7.1 7 0 after 5 prn
Unit 3B Nail Salon/Retail 1,061 5/1000 GFA 5.3 5 5
Proposed Peak Restaurant
Unit 4 Restaurant 2,094 15/1000 GFA 31.4 19 36 Use is Dinner
Totals 9,108 62.9 50 50
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PROP.NEW ON _-
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PONOP,IY%,E,SIGNO J �' R•M1 8 A F TORE I 12.9j
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OSGbOD STREET (ROUTE 125k,�EL°DST ¢H
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I SCALE:I'�20' DATE: SEPTEMBER 3,7003
--- REN.MARCH 9,2005
20 o 20 40 __.
N : Po7D rT-(oNAd, NOTES ASD By ((;�-SD A66a,�4Afr--5
AjTACktir--V b�PN65 o.1 POND q"(o:2 r-O)IZ. <1VDJ'r1oA/.,tL_ 1/VFQte ATljp� . Asramucr�s�a�5ncas u .
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�PPu��knlT, OW^1CIQ 0F KeurtD = 12-11 056r001) STREET LSM ITED <tR-T EFK-579 PP FrtoNE: Q�8-683'3/b`f-
1211 0 ShooD , T`E-
I Required Lot(as regAVd by Zoning By[aw}:
Lot Area(Sq.FQ: Building freight:
Street Frontage: Side Sacks:
Front Setback: Bear Setback:
Floor Area Ratio: Lot Coverage:
10 6casfing Buffdig(if applicable):
Ground Roar(Sg.Ftp): 9 of Floors:
Total Sq.FL: Height-
Use: Type of Construction:
t1.Proposed Building:
Ground Floor(Sq.Ftp: 9 of Floors:
Total Sct_Ft, lfeigtt
Use: Tyke of Construction:
M Has there been a prenrious application for a Special.Permit from the Planning Board on these premises?JES
If so,when and for what type of construction? Wood Frame
13 Section of Zoning Bylaw that Special Permit fs Being RequesteCParliing Reqs b allow for restaurant use in 2094
I unit Wdhh 9103 sf rew center-
14.
ennter14.Petitioner and Landowner signature(s):
Enreny applies for a Special Penuit shat be made on this fornn,which is the offmd farm of the Planning Board.Every
appkafion shad be tied wifh the Town Clerk`s office. It shall be the responsibRy of the peffimw b furnish all suppw&V
docnanerrtatin wM ft appffcationt.The dated copy of this apprtcation reed by the Tmm Cleft or Planning Office does
not absolve the aWicannt from tftis responrsibiffq.The peftm shall be respoiisible for atf expenses for Mg and legal
nottl -- - Fafuce th comply Frith application requirements. as cited herein and in the Planning Board Rules and
RegWg§wm may result in a dismissal by the Planni' . this a �.
Per's re: 12� �S�oaD GG
f
PrW or type nonan ham: �l tlZ 6 S
fBv 's Signature:
Prtt or 4W Fairer:here_ j
15.Please list title of plans and documents you vall be aftaching to this ate.
approrred Site Pian Spm Perml Signed and Recorded
Space Plan showhg size and locat€on of eacfr of fm ung on site_
Ewa of proposed restaurant nese in Unit 4 2094 sf
Page]of6
1600+Osgaml StMK NOFth Amfover,RldgA,Sante 2-36 PlannEng DepL,Lfts-dchuseft 011845
Phoma 976.65.9535 F�x 976.688.9542 Web w=.
I
Date....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
S CHUS
This certifies that ...........&PAY...... ..�T54<. ......./
has permission to perform ............
y 51.......................................
wiring in the building of....W,#7Z--17... ......Re-h, w......
at..... .......(Q�f.00.........S7............... North Andover,Mass.
Fee.lZ.S� Lic.No.A!�P/ 7.�....... ........
�C:;L IN WFOR
Check # No pi�
comawnweaK O`vad6ac" Official use Only
i �°Parfasent o��i�s�ivicas Permit No.
BOARD OF FIRE PREVENTION REGULATIONSOcc 1paney and Fee Chedmd
save blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All wade to be rafammed is acmdmmce with th e M rots Mecbieal Code 0GC),527 CM MOO
(PI.Fd ST+'PRINTINEYW 0A7TPEALLW0RMTIONj Date: /a /�/ J >O
CR)r or Town of: _ g (o N f3 0 U/--4, To the Inspector of nes:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Locatlop(Street&Number) �,2// �i oo
Owner or Tenant 9 e Z a Telephone Ne.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Boz)
Purpose of Building Rp-rc, Utility Authorization No.
Existing Service Amps I Volts Overhead❑ Undgrd❑ No.of Mercia
New Service �i_ Amps / Vohs Overhead❑ Und Na of Meters
Number of Feeders and Ampacity
y Location and Nature of Proposed Electrical Work: C=Wkdm
the table Embe waived by the of Vow.
No.of Recessed Luminaires No.of Cell.-Susp.(paddle)Fans No.of Tatal
Transformers KVA
No.ofLumfnaire Ouutlets Na of Hot Tubs Generators KVA
Na of LLumiimaires Swimming Pool AbOve ❑ ❑ Ba•° U cy g
o.of Receptacle Outlets Na of On Burners n=ALARMS Noy of Zones
No.of Switches No.of Gas Burners 140.0 oa an
Initiatin Devices
No.of Ranges No.of Air Cond. Tons N&of Alerting Devices
No.of Waste Disposers Heat
Totalsp um r ITonsIxW No.orselpContamed
Detection/Alertingy Devices
No.of Dishwashers Space/Area Heating KW ❑ unto
}� SCyostnnection ❑ ��
No.of Dryers Heating Appliances KW Na of Devices or curt
No.o ester
`► Heaters KW a Si Ballasts Dataoo..of evices or FAFUIVSIeUt
No.Hydromassage Bathtubs No.ofMotors Total HP NO.OfD ons nw .
- Na of Devices or ent
OTHER
.tM&add Gaal detail¢dadred oras required by theh%rpeaw ofWv'
Estimated Value of Electrical Wozlc (Wier required by municipal policy)
Work to Stark Inspections to be requested in accordance with MEC Rule 20,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electricalwork MR issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial egtuvalenL The
undersigned certifies that such coverage is in force;and has exhibited proof of some to the permit issuing office.
CHECK ONE. INSURANCEa BOND ❑ OTHER ❑ (Specify:)
I terkh,underthepalns andpenalBes ofpedWy,that the Ittfmmatimt on this appffeadon is true andcompkt&
FERMNAW--BUddy Electric Inc. LIC No-- 92017 A
Lim: Vincent B. Landers Jrgig t. ,�y LiC.No.223 84 E
(�.fqrftbk vwr lama to in the licensemanberfi)m) Bus.TeL No.978-3 5-T4 5 5
Address: _24 Vglga e 'Dr R7.Anfloypre Ma 01845 AIL TeLNo.:
*Per NLGs..e.147,s.57-61,security work requires Department of Public Safety-S"License: Lia.No.
OWNER'S RMYRANCE WAIVF,R I am aware that the Licensee does not have The list ' msurancx
required by law. By my signature below,I hereby waive this nammally
Owner/Agent I am the(check one owner ❑owner's a enL
Signature Telephone Na PERMIT FEE:S
t
The Commonwealth of Massachusetts Print Form
ti Department of Industrial Accidents
Office of Investigations
I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual):Buddy Electric Inc
Address:24 Colgate Dr
City/State/Zip:North Andover, Ma 01845 Phone#:978-975-4455
Are you an employer?Check the appropriate box: Type of project(required):
1. ✓❑ I am a employer with 2 4. ❑ I am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g. ❑Demolition
working for me in an capacity. employees and have workers'
g Y P h'- 9. EJ Building addition
[No workers' comp.insurance comp. insurance.:
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 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 anew 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 Name:Penn Millers
0
Policy#or Self-ins.Lic.#:PGW 1305280 Expiration Date:12/01/2011
�s
Job Site Address:/e��,� ! ` ''�C>� �f_, City/State/Zip: f, f•I,�C'f / p oliclS'
r
Attach a copy of the workers'compensation policy declaration page(showing the policy umber 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 fine
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.
I do hereby certify under the pains andpenalties o[XeduLy that the in ormation provided above is true and correct.
Si ature: Date
Phone#:978-375-0722
Official use only. Do not write in this area,to be completed by city or town offwiaL
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#:
Location UZ�
'
No. - o 4 Date `:p
AORT#q TOWN OF NORTH ANDOVER
F 9
# Certificate of Occupancy $
Building/Frame Permit Fee $
s�CMus
Foundation Permit Fee $
Other Permit Fee $
TOTAL
11,0.3 L
Check # .
Building Inspects
U
TOWN OF NORTH ANDOVER
- SIGN PERMIT APPLICATION
Site Owner
SczVlL I rL ✓01 V1 N V o% Applicant �`irc�0 Z'�c,vt o!/c• ,2- V5 `"03
Site Address a, 1 Size of Proposed Sign17/ /
How attached: a) Against the wallIllumination: a) Not illuminated ( )
b) Roof O b) Internally illuminated_ ( )
c) Ground c) Externally illuminated
d) Other ( )
Materials:���,� S�PP� ✓c� ��.���i���
Proposed Colors: Background t
Lettering m ' C`' yl
Border I� �✓i C�iC��fe ,
Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged unt
• Photographs of building an application on the appropriate form furnished by the Sign Officer has
been filed with the Sign Officer containing such information including
Material sample photographs, plans and scale drawings, as he may require, and a permi
ti Color sample / for such erection, alteration, or enlargement has been issued by him.
Site or Plot Plan (Required for all free-standing signs)V Such permit shall be issued only if the Sign Officer determines that the
Drawings of proposed sign 1/ sign complies or will comply with all applicable provisions of the By-Law.
Other, specify
Will sign overhang any public road or walkway Yes ( No 1�
If Yes, Name of Agency who will provide liability insurance:
AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED
DATE FILED: `
SIGNATURE OF APPLICANT
revised:jm-8/98
NORT1�
O'
`o`w`D 411 TOWN OF NORTH ANDOVER
SSACNVS�
NORTH ANDOVER, MASS
SIGN PERMIT
DATE: 2-28-2006
PERMIT 39-06
THIS CERTIFIES THAT Limited Partnership - McLav's Florist
has permission to erect. Externally Illuminated Ground Business Sign
on 1211 Os000d Street provide that the person accepting this Permit shall in every
respect conform to the terms of the application on file in this office, and to the.provisions of the Codes and By-Laws
relating to the Sign Regulations in the Town of North Andover.
Violation of the Zoning of Sign Regulations, Section#6, Voids this Permit.
ILLUMINATED SIGNS EPRjBITED-
Inspector
of Buildings
V
U a
6z, i j
Town of North Andover Town Clerk Time Stamp
Community Development and Services Division
FECEIVED
Office of the Zoning Board of Appeals TOW,;j C?. cptCF
400 Osgood Street
North Andover, Massachusetts 0184.5 2005 NOY 21 PM 4: 25
Gerald A. Brown Telephone (978)688-9541
Inspector of Buildings Fax (978)688-9542
T FA 1'.
e,
A0...
This is to certify that twenty(20)days
have elapsed from date of decision,filed
Any appeal shallp_�W
be filed within Notice of Decision without filing of a al.
Date
(20)days after the date of filing Year 2005 JoyGe&Bradshaw
of this notice in the office of the To"010k
Town Clerk,per Mass.Gen.L.ch.
40A, §17 Property at: 1211 Osgood Street
NAME: Frank Terranova HEARING(S): November 8,2005
ADDRESS: 1211 Osgood.Street PETITION: 2005-031
North Andover,MA 01845 TYPING DATE: November 18,2005
The North Andover Board of Appeals held a public hearing at its regular meeting in the Town Hall top
floor meeting room, 120 Main Street,North Andover,MA on Tuesday,November 8,2005 at 7:30 PM
upon the application of Frank Terranova,1211 Osgood Street,North Andover requesting a Special
Permit from Section 6,Paragraph 6.6.D.2 of the Zoning Bylaw in order to build a permanent ground sign
greater than the maximum 25 square feet and maximum 8 foot height. Said premises affected is property. Q-
with frontage on the Southeast side of Osgood Street within the G-B zoning district. Legal notices were
sent to all names on the abutter's list and were published in the Eagle-Tribune on October 24&31, 2005.
The following voting members were present: Joseph D. LaGrasse,Richard J. Byers,Albert P.Manzi,jqI ,
David R_ Webster,and Daniel S.Braese.
The following non-voting members were present: Ellen P.McIntyre,Thomas D.Ippolito,and Richar&M. >
VaillancourL
—0
M
Upon a motion by Albert P.Manzi,III and 2rd by Richard M. Vaillancourt the Board voted to GRANT go)! Z7
Special Permit from Section 6,Paragraph 6.6.D.2 of the Zoning Bylaw in order to allow an externally lit
ground sign frame to be 17'9-1/2"high by 12'3"wide,with a tenant sign area of 7'5"high by 9'5"wide
beginning 4'6"above grade per Site Development Permit Plan,Proposed Retail Facility,Plan of Land in
North Andover,Massachusetts,for developer F.K.Realty Trust, 1211 Osgood Street,North Andover,
Massachusetts,Date: September 3,2003,Rev:March 9,2005,revised for ground sign dimensions: C=
09/21/05,Additional notes by GSD Associates: 10/7/05 [by]Stephen E. Stapinski,R-L.S#29876 and C=)
Robert C.Daley,R.P. Civil Engineer,Merrimack Engineering Services,66 Park Street Andover, cri
Massachusetts 01810,Layout&Materials sheet 3,and Signage Elevations and Details,Retail Center, 1211 —0
Osgood Street,North Andover,MA date:09-19-2005,revisions: 109-28-2005,2 09-29-2005'3 10-6-2005 "1-'
[by]GSD Associates,LLC, 148 Main St.Bldg A,North Andover,MA 01845, Sheets A6.1&2. Voting in Cr
favor: Joseph D. LaGrasse,Richard J.Byers, Albert P. Manzi, Ill,David R. Webster,and Daniel S.
Braesc.
Page I of 2
\TTEST:
True Copy
Town Clerk
LN 141
-- Town of Nor handover-- Town Clerk Time stamp
Community Development and Services Division
.,+ Office of the Zoning Board of App 1g��,RECEIVEQ�,F'GC
Ydr: =
`;,•`'...•.'�o4(10 Osgood Street
North Andover, 'Vlassachusetts 0184-
16
05 NOV 21 PH lt: ZS
Gerald A. Brazen Telephone (978)688-9541
Inspector of Buildings Fax (978)688-9542
HASP
The Board finds that the applicant has satisfied the provisions of Section 10,Paragraph 10.31 of the zoning
bylaw and that 1211 Osgood Street is an appropriate location for this sign structure and will not adversely
affect the General Business district along the state Route 125 neighborhood. The Board finds that there
will be no nuisance or serious hazard to vehicles or pedestrians because the proposed sign area will begin
4'6"above grade and the vertical supports are 10' wide,allowing pedestrians and vehicles to see each
other. The Board finds that adequate and appropriate facilities will be provided by a concrete foundation,
tube steel frame,steady,stationary external lighting that is shielded and directed solely at the sign,and
landscaping for the proper operation of the proposed self-supporting ground sign. The Board finds that the
proposed self-supporting ground sign as shown on the above plans is in harmony with the general purpose
and intent of this Bylaw,and this sign shall not be more detrimental than the existing self-supporting
ground signs in the neighborhood.
Note: The granting of the Variance and/or Special Permit as requested by the applicant does not
necessarily ensure the granting of a building permit as the applicant must abide by all applicable local,
state,and federal building codes and regulations,prior to the issuance of a building permit as required by
the Building Commissioner.
Furthermore,if the rights authorized by the Variance are not exercised within one(1)year of the date of
the grant,it shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a
Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)
year period from the date on which the Special Permit was granted unless substantial use or construction
has commenced,it shall lapse and may be re-established only after notice,and a new hearing.
Town of North Andover
Board of Appeals,
rl
C �
Ellen P.McIntyre,Chair
Decision 2005-031.
M35P8.
Page 2 of 2
r
ESSEX
Md4Z
' r
I2'-3"
WOOD FRAME
SIGN WIDTH ANODIZE, DAR BRONZE 2X8 INFILL.
ANODIZE, DARK BRONZE ALUMINUM METAL CAP 4
ALUMINUM METAL CAP FLASHING ROOF. G.
FLASHING ROOF. G" X C 12
TUBE STEEL �1
PLAZA NAME SIGN �;� \ 12 :� 1-'
TYPICAL.
ALUMINUM FORMED LETTERS /
POST MOUNTED. �/ \�\�1
8'-0" COLUMBIA SLE V X C TUBE STEEL FRAME
CLAPBOARD SIDING ---- - SGOOD FLUORESCENT TOP
TO MATCH BUILDING. �.OMMONS MOUNT SIGN LIGHT BOTH SIDES G
8'-0" COLUMBIA SLE OF SIGN. ATTACHMENT LOCATIONS
FLUORESCENT TOP 10.
MOUNT SIGN LIGHT ........... . .. _
TYPICAL BOTH SIDES
OF SIGN. TUBESTEEL
FABRICATED ALUMINUM 10" MCLAY'S FLORIST IO• 10" Z = TYPICAL. G„ G" � ¢ ¢ N r
SIGN CONSTRUCTION WITH L _� _� H v N
INDIVIDUAL TENANT SIGNS. TENANT #3B w co
`o
4 5F PER TENANT. z Ii ¢ SIGN - ® .o 9
\ in o ao
OPTION FOR ROUTED OR = w g d`
VINYL GRAPHICS AS REQ.
DREAM DINNERS z _ Z c o w
ALL COLORS TO BE r z u`–,
vi cD z l– LL
MANUFACTURER'Suj
STANDARD COLORS. ANTASTIC SAM'S
FINAL GRAPHICS t FONT TO PVC TRIM AROUND BA X I'-2" X I-I/4"
BE SELECTED t APPROVED STEEL TUBE COLUM40, -
CHAIFERED BASEPLATE C
1 "'2" TENANT #1 "'2 BOLTS. ANCHOR ATTACHMENT LOCATIONS
BY OWNER.
II I/2" rn COORDINATE W/ SIGNAGE
PVC TRIM AROUND I I/2 _ REQUIREMENTS.
STEEL TUBE COLUMN - 9 5 n Iv CONCRETE WITH ; OPIERS ARE I'-4" X I'-4"CHAMFEREDm " W/ 8 u5 "L" BARS ANDII I/2' II I/2" z 6 EDGES AND TOP GRADE ry 1 >-
CONCRETE WITH I,-4" o J 5 tt3 TIES.11-4" FLOWER PLANTER AROUND El]
EDGES AND TOP r BASE OF SIGN.
C! F
W/� 5 BARS I0
N
LONG DIRECTION AND 10'-10' o
GRADE 1 24 BARS IN SHORT
10'-10" I I o I — — DIRECTION. z0
L — — — J _ Lu— — Wa
CONCRETE - - J L - - - J G-O" I 4'-0" c9 w
FOUNDATION X ® z 0
SIDE ELEVATION OF GROUND SIGN n
DETAIL OF GROUND SIGN n g Z
SCALE: r/z'�r'-a' � �J v1¢
ELEVATION OF GROUND SIGN C-0" COLUMBIA SLE SCALE: 1/1• r'
SCALE 112'-r-o FLUORESCENT TOP MOUNT
SIGN LIGHT. INSTALL AS
0 0 o PER MANUFACTURER'S
INSTRUCTIONS. R = I-G r; F
CONCRETE FOOTING I/i
ALUMINUM
METAL CAP 2" DEEP FABRICATED w w
0
FLASHING. 2� G" X G" – ALUMINUM SIGN PANEL I.L/z – 0 w o >
�OtG TUBE STEEL – FASTENED TO BUILDING. — i o � z C o
o TYPICAL. '/z' 1 i o C-) ¢
I" DEEP HIGH DENSITY FOAM cLAY' S FLORIST ¢ o
I'-2" X 1'-2" 0 0 0 — REPLACABLE TENANT SIGN.
z e BASE PLATE. w O
CLAPBOARD 1..V2'..... .. _.... I vz' z
SIDING TO r, OPTION FOR ROUTED OR 101-01
CROWN
. ............._.....:...............
CROWN 8021 MATCH5-I/2" 5-I/2" VINYL GRAPHICS AS REQ. este: 09-19-2005
AND BASE BUILDING. 1'-4 X 1'-4'
WMG23 8112A CONCRETE PIER. I-t/2" I-I/2" ALL COLORS TO BE ELEVATION OF TYP.TENANTBUILDING SIGN SU6MTTED FOR SIGX PERMIT
MANUFACTURER'S
TO MATCH �: - .a 4'-0" I-2" SCALE. V2'=r-o' NOTE: TYPICAL FOR TENANTS al, $
STANDARD COLORS. IQ os-za-zoos
BUILDING. DREAM DINNERS 1 McLAY'S FLORIST, awxo re+.„.>xat axF.
FINAL GRAPHICS t FONT TO -- Q os•zs-zoos
FOOTINGDETAII n BASEPLATE DETAIL /� BE SELECTED 1 APPROVED uxxu.u.eT—.7e
G" X G" ` SCALE 112'-I'-o' `� SCALE.,1'_r'-0' 3
TUBE STEEL 0 BY OWNER. _...— .:_ _ ©InAMr z�WS
3 _
TYPICAL. 2
2' DEEP FABRICATED ALUMINUM SIGN PANEL FASTENED TO UNDERSIDE —I I/2'. a
1' .M.J. chk.G.P.S.
OF FRONT OVERHANG. PERPENDICULAR TO FRONT OF BUILDING. ' McLAY S (2) G'-0" COLUMBIA SLE I/2 c d`
o FLUORESCENT TOP MOUNT a p xaosGsoa, T�uc
FLORIST R�
SECTION THROUGH SIGN n I" DEEP HIGH DENSITY FOAM REPLACABLE TENANT SIGN. = SIGN LIGHTS. INSTALL AS – > " r„r�•,r,.•�„ `n•ro:�s
PER MANUFACTURER'S _. .. :.... I I/2' n ""
SCALE 1' rR Ka iN 1lM1N
OPTION FOR ROUTED OR VINYL GRAPHICS AS REQ. r INSTRUCTIONS.
1. .. ..._. ©. ....
2'-0" I L L .,tea sti.s."rona vw"wsr.ie
ALL COLORS TO BE MANUFACTURER'S STANDARD COLORS. NOTE: SEE SHEET AG.I
• FINAL GRAPHICS E FONT TO BE SELECTED E APPROVED BY OWNER. ELEVAnONO INGSIGN n FOR ALL BUILDING ELEVAn N ILDI n A6.2
SCALE: r/2'-r'-a' t SIGN LOCATIONS. SCALE V2'�C-0' NOTE:TYPICAL FOR FANTASTIC SAM'S i
NOTE:TYPICAL FOR ALL TENAN75. 1
1 TENANT¢3B.
PRIMARY TENANT SIGN- PRIMARY TENANT SIGN TENANT 23B
AREA = 22 SF AREA = 11 SF FRONTAGE
(TYPICAL OF TENANTS (TYPICAL OF TENANTS AREA = 119 SF
al. DREAM DINNERS FANTASTIC SAM'S AND 43B).
AND McLAY'S FLORIST).
KTI9
r7u
TYP. TYP. TYP. TYP. TYP.
................... ........
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t��t. ...f.1.1.--........... . ........I
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I—— I TERAIT ne ------
<
- <
TENANT al* —SECONDARY—J L FANTASTIC SAM'S SECONDARY L McLAY'S FLORIST H 1,11 M " ;z
83 '%
FRONTAGE TENANT SIGN FRONTAGE TENANT SIGN FRONTAGE 0 rn o -?
:4.1 -b '?-
AREA = ILI SF PERPENDICULAR AREA = 231 SF PERPENDICULAR AREA = 42L SF w co
TO BUILDING. TO BUILDING
2'-0"W X I"-0"H = 2 SF DREAM DINNERS 2'-0"W X I"-0"H = 2 SF g ¢ 0) a,
SEE I/A6.2. FRONTAGE SEE 1/A4.2.
co
FRONTMARON SHOWING TENANT FRONTAGE AREA AREA = 283 SF o z
SCALE. 718--1'-0-
EXTERIOR LIGHTS
ABOVE DOORS.
.................... ................. ........................... ....... . .........- ........... ........................
........... .......... .........
............................. .......... . .....
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7 ..................- ...........-............... ................. ............ ............................................
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...... ........ ....................... .......... j
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POR ELEVATION Tl
U)z
0 U)
0<
SIGNAGE REQUIREMENTS--TAKEN FROM THE ZONING BYLAWS OF THE TOWN OF NORTH ANDOVER MA,AMENDED MAY.2004
TENANT BUIL PRIMARY BLDG. SECONDARY BLDG. GROUND SIGN AREA 0
DING TOTAL SIGNAGE AREA
FRONTAGE SIGN AREA SIGN AREA AND MAXIMUM HEIGHT 441- 4'-0' COLUMBIA SLE
TENANT 81 131210 IT z
SF 21 SF 2 SP 14 SF 38 SF TENANT C FLUORESCEIN TOP MOUNT
0
FANTASTIC SAM'S 231 SP 11 SF 2 SF 14 SP 33 SF FANTA5nC SAR'5 SIGN LIGHT ATTACHED TO g=
o UNDERSIDE OF SOFFIT. U)L�
DREAM DINNERS 283 SF 12 SP 2 SP 14 SF 36 SF DREAM DINNERS INSTALL AS PER
TENANT 13B III SF_ 11 2F 2 SF 14 SF 33 5F TENANT 135 MANUFACTURER'S
INSTRUCTIONS.
M,LAY'S FLORIST !211L5 SF 141 21 SF 2 SF 14 SF 38 SF MdArs FLORIST uj
AREA OF "OSGOOD
TOT2312 SF I-
PROALVIDED 100 SF 10 SF 10 5F 5 SF AT TOP OF SIGN 15 SF 180 SF COMMONS" POST- SIGNAGE MOUNTED TO uj <
TOTAL '70%OF TOTAL BULGING FRONTAGE-415 SF 10%OF TOTAL BUILDING FRONTAGE-231 5F 0%OF TOTAL BU AG- MOUNTED LETTERS. FACE OF BUILDING.
LLJ
ALLOWABLE 200 SF MAX.PER TENANT-64E21 25 SF MAX.8'-0'HIGH MAX.SIGN-L,02-31 _FRONTAGE*ILI SP-14031 ct�
5 SF. I.-
SPECIAL PERMT NO NoES IROJID 111114 U) W
110 TIES-10 1111rl MAX.1AX-11.-0 14EIGIIT = Q ILLJ
REQUESTED ABOVE GROUND-1.407-3- TO EXCEED MAX.SF.AND >
HEIGHT ABOVE GROUND E G.C. REVIEW FOR 0
4,902-31 SIGN UPOTH o 0
NOT "S TO
0
0
ADDITIONAL
0
DDIiIONA LIGHTING AND I z
T L
TOTAL AREA L C IC EO c
U, 0 z
SIGNAGE REQUIREMENT CHART [ELECTIRICALTLREQUIREMENTS.j ) rn <
3 OF GROUND o -1 0 3::
X
SIGN = 15 SF. TYPICAL FOR FANTASTIC LLJ 0
EXTERIOR LIGHTS TENANT al McLAY'S FLORISTcr - Z
ABOVE DOORS. FRONTAGE FRONTAGE X7AJL A T SIGNA GE SAM'S AND TENANT 43B.
AREA = 210 SF TOTAL AREA OF AREA = 542 SF SCALE-'J14--1'-0- doft: 09-19-2005
TENANT SIGNAGE 6 SUBMITTED FOR SGN PER 1T
(SHOWN SHADED)
10 SF
0928-2005
.................
...........
&Ot-_21-2005
...........
.......... tW
74?
.............
10-6-2OD5
TYP. urr. I=T
TtW
..................
dr.A.J.D.S.S. hIk.G.P.S.AREA OF SINGLE--
TENANT SIGNf.
........................... ®2005 GSD A
LLC
............
14 SF
..................
LEFTELEVA77ON SHOWING TENANT FRONTAGE AREA GROUND SIGN SQUARE FOOTAGES n RIGHTELEVA71ON SHOWING TENANT FRONTAGE AREA
SCALE 1/8'-1'-0- SCALE 11*2'-1'-0' SCALE, 1A,="-o'
A6. 1
p;
ORiN��
I �
V '
e,K
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 249 (10/5/2005) Date: November 17, 2005
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 1211 Osgood Street
MAY BE OCCUPIED AS Retail Floral Shop IN ACCORDANCE WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER
REGULATIONS AS MAY APPLY.
Certificate Issued to: McLays Florist Shop
1211 Osgood street
North Andover Ma 01845
Buildin Inspect
hoR ' ,'j �
T1
0" Of And
0
No.
,So �` dower, Mass., •
0 LA
COCMICMEWICK
7�S'QATED pPG KC:'
4 BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT..P ays � S00
Foundation
y`Coe
has permission to erect....Ifrm' ...... buildings on ....../.� .... ....D.......................................�.. .............. Rough.
to be occupied as �� ....V. .p. .to ........F f or& ' kpfi--�
Chimneyprovided that the person accepting this permit shall in every respect conform to the termte application on file in Final ) ,,( 6,
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. CA PLUMBING INS FACTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough (z°;I 5 r3 I Q,,,,-
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIONS TS ou D 4C >p L, _ IJ-
.�.... Service
BUILDING INSPECTOR
Occupancy Permit Required to Omipy Building GAS INSPECTOR 7
t /
Display in a Conspicuous Place on the Premises — Do Not Remove
Rough
,,(
P Y P o-V _
No Lathing or Dry Wall To Be Done FIRE DEPT• !TM/p,
Until Inspected and Approved by the Building Inspector. Burner A } v'E
Street No. l t
Smoke Det.
SEE REVERSE SIDE
TOWN OF NORTH ANDOVER
Final Design Affidavit
Project Number: 0404042—A
Project Title: 1211 Osgood Street Retail - McLay's Florist
Project Location: 1211 Osgood Street, N. Andover, MA
Name of Building: Osgood Commons
Nature of Project: McLay's Tenant fit-up
In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction
Control of the Massachusetts State Building Code, I, Gregory P. Smith, Registration No. 8688 being a
Registered PFOfessional EngineeF/Architect, HEREBY CERTIFY that I have prepared or directly supervised the
preparation of all design plans, computations and specifications concerning:
Entire Project _ Architectural_XXXX_ Structural Mechanical
Fire.Protection Electrical Other (specify)
FOR THE ABOVE-NAMED PROJECT, AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS
MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE, ALL
ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED
USE AND OCCUPANCY.
I HAVE PERFORMED THE NECESSARY PROFESSIONAL SERVICES AND EITHER
MY REPRESENTATIVE OR I HAVE BEEN PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND
PERIODIC BASIS TO DETERMINE THAT THE WORK HAS PROCEEDED IN ACCORDANCE WITH THE
DOCUMENTS SUBMITTED FOR THE BUILDING PERMIT, AND SHALL BE RESPONSIBLE FOR THE
FOLLOWING AS SPECIFIED IN SECTION 116.2.2
1. Review for conformance to the design concept, shop drawings, samples and other submittals which are
submitted by the contractor in accordance with the requirements of the construction documents.
2. Review and approval of the quality control procedures for all code-required controlled materials.
3. , Be present at intervals appropriate to the state of construction to become generally familiar with the
progress and quality of the work and to determine, in general, if the work is being performed in a
manner consistent with the construction documents.
I AM SUBMITTING THIS FINAL REPORT AS TO F CTORY COMPLETION AND READINESS OF THE
PROJECT FOR OCCUPANCY. v\S�EREDgq�y/
Q� GORY
Signature and Stamp(no facsimile)
No.8688 9
CNORT DOVER
o �
�J
q� 1OF MASSPC
SUBSCRIBE AND W BEFORE ME THIS DAY OF wo"005
MY COMMISSION EXPIRES ml
NOTARY UBLI
a
Np11iN
•t 1`1�n9sL��.
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 249 (10/5/2005) Date: November 17, 2005
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 1211 Osgood Street
MAY BE OCCUPIED AS Retail Floral Shoe IN ACCORDANCE WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER
REGULATIONS AS MAY APPLY.
Certificate Issued to: McLays Florist Shop
1211 Osgood Street
North Andover Ma 01845
oft Az
Bui Ting nspec A
Location
U
No. oe Date /2-
TOWN
TOWN OF NORTH ANDOVER
h 9
` Certificate of Occupancy $
♦ i #
cNus Building/Frame Permit Fee $
s�
Foundation Permit Fee $
Other Permit Fee $
TOTAL
Check # fa
18821
+Building In K6tor
I&ORTFf
41,�,
TOWN OF NORTH ANDOVER
�1Ss�c14uS��
NORTH ANDOVER, MASS
SIGN PERMIT
DATE: 10/27/2005
PERMIT 25-06
THIS CERTIFIES THAT Limited Partnership - McLav's Florist
has permission to erect. Externally illuminated Wall Sian
on 1211 Osgood Street provide that the person accepting this Permit shall in every
respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws
relating to the Sign Regulations in the Town of North Andover.
Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit.
ILLUMINATED SINGS ARE PROHIBITED
Inspector of Buildings
,qty
TOWN OF NORTH ANDOVER
400 Osgood Street
SIGN PERMIT APPLICATION
Site OwneTel #��� ApplicantM CLAY S FLen) T
Site Address_1211 Uc4Aoo1;> 5 rK05(" , NO Ty /fit =12, /AA Size of Proposed Sign /
Map iW Parcel
_ �� Estimated Cost of Sign--4
fit- 8
How attached: (a) Against the wall Illumination: (a) Not illuminated
(c) Ground ( ) (b) Internally illuminated
(d) Other
( ) (c) Externally illuminated''•
Proposed Colors: Background Ye-A tPcN�b.
Materials;
Lettering
Border ,
Required Attachments:
Photographs No permanent/temporary sign shall be erected, or
Material sample building enlarged until an application on the appropriate form Color samples furnished by the Sign Officer has been filed with the
Sign Officer containing such information including
Site or Plot Plan (Required for all free-standing signs) -Z copies, Photographs, plans and scale drawings, as he may
Drawings of proposed sign require, a permit for such erection, alteration,
Other, specify or enlargement has been issued by him. Such permit
shall be issued only if the Sign Officer determines
that the sign complies or will comply with all
applicable provisions of the By-Law.
Will sign overhang any public road or walkway; Yes ( ) No
If Yes, Name of Agency who with provide liability insurance:
AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED.
Date Filed:
Signature of Applicant ]
NOR7F1
TOWN OF NORTH ANDOVER
bAw*to
,Sg�ICHugfc�
NORTH ANDOVER, MASS
SIGN PERMIT
DATE: 10/27/2005
PERMIT 24-06
THIS CERTIFIES THAT Limited Partnership - McLav's Florist
has permission to erect. Externally illuminated Ground Sign
on 1211 Osgood Street provide that the person accepting this Permit shall in every
respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws
relating to the Sign Regulations in the Town of North Andover.
Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit.
ILLUMINATED SINGS ARE PROHIBITED
Inspector of Buildings
�ORTM
f
°'•""�`~"' "� * TOWN OF NORTH ANDOVER
°'►ate°►�,y'�
,SswCHUg�
NORTH ANDOVER, MASS
SIGN PERMIT
DATE: 10/27/2005
PERMIT 25-06
THIS CERTIFIES THAT Limited Partnership -McLay's Florist
has permission to erect. Externally illuminated Wall Sign
on 1211 Osgood Street provide that the person accepting this Permit shall in every
respect conform to the terns of the application on file in this office, and to the provisions of the Codes and By-Laws
relating to the Sign Regulations in the Town of North Andover.
Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit.
ILLUMINATED SINGS ARE PROHIBITED
Inspector of Buildings
G, Ile (1"1n1ll[tltll ra1t4 ttf Mass a djusetto Office Use Only
Department oj'Mihlic Sajrty Peonit No.
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Occupancy & Fee Checked
1l90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL. WORK
All work to be perfurmoI in aecuufance wilh the Ntas"achuaelts f.lectriral Code, ,27, CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dalejj/_ ,
Y 1 L +!c i r i 3 — ---------- p
Cit or Town of � �— __ To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)-12,
2, �
Owner or Tenant ' � �o .f-- is -— --- _
Owner's Address
Is this permit in conjunction with a building permit: Yes - No ❑ (Check Appropriate Box)
Purpose of Building __— --.Utility Authorization No. _-
Existing Service _Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps J Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work ��'y �' /r� Lj _
TOTAL
No. of Lighting Outlets No. of Hot Tubs No. of Transformers K_VA
A oveIn-
No. of Lighting Fixtures Swimmin Pool rnd. ❑ 'md. ❑ Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets :2 1 No. of Oil Burners Battery Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
Total No. of Detection and
No. of Ranges No. of Air Conditioners ' Tons Initiating Devices
Heat Total Total No. of Sounding Devices.
No. of Disposals No. of Pumps Tons KW No. of Self Contained
No. of Dishwashers Space/Area Heating KW DetectionlSounding Devices
Municipal
k No. of Dryers FleatinDevices KW Local❑ Connection ❑Other
! No. o No. o Low Voltage
No. of Water Heaters KW Signs Ballasts Wirin
t
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
a rL Te ,y, f"',I_LDioy IC e-o — — —
INSURANCE COVERAGE: Pursuant to the requirements of Massachustles General Laws
I have a current Liability jns ranee Policy including Completed Operations Coverage or its substantial equivalent. YEKO fl !have submitted valid proof
of same to this office. YErl NO C]
t If you have checked YEY please indicate the type of coverage by checking the appropriate box.
INSURANCE JJLJ BOND ❑ OTHER❑ (Please Specify) _.__._
(Expiration Date)
Estimated Value of Electrical Work S
e
Work to Start F1 i /V 1 Inspection Date Requested: Rough /y / — Final
Signed under the penalties of perjury:
FIRM Nt�AAE,t -rv(L ..N %v ----- -- -- LIC. NO.
r f'n 1-✓1/6/M
� � 12 LIC. NO.nee Signature
l/a Bus. Tel. No./a e_?f z y"J i3?J�
—J
lddress � �( E001 "Lice
_
Alt. Tel. No. 2/j
)WNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the insurance cover,iye or its substantial equivalent as required by Massachusetts
ieneral Laws, and that my sig(inture on this permit application waives this requirement. Owner Agent (Please check one)
Tnlnnhnnn Nn PFRMIT FFF g
i
�wc d
Location 1Q1(
No.
o;?q q Date b 4
TOWN OF NORTH ANDOVER
F
i
Certificate of Occupancy $
�'�s' •E,� Building/Frame Permit Fee $
sACNUs
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ sem'
Check #_ e�
1
8634 IVU
Building Inspector
--- e --- TOWN OF NORT i. NDOVER BUILDING DEPARTMENT
JkPPLICATION TO CONSTRUCT REPAIR,RENOVATE,CIIAIVGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
L _ OTHER THAN A ONE OR TWO FA.VIILY DWELLING
iT€ris sei�tion for Official Use OnIV
BUILDING PERMIT NUMBER: r / DATE ISSUED: O �' _,�
A 10
SIGNATURE:
Building Commissioner or of BuildingsDate
swnam _t: arm Il�11?+DRi�!Moot ; ` :;.!z.
1.1 Property address: 1.2 .--.sse�ssors i•:iap and Parcel Number:
_ Doo 's
Map Number Pard Number
1.3 Z x»ng Information: FI Property 1)intatsiats: y..�
Zonin .District Proposed Use----- -- LcN Arca(s Fronts ft
1.6 BUILDING SETBACKS(ft) M
Front Yard Side Yard Rcar Yard
L:7—Required Provide Required Provided Required Provided
1.7 Water Supply AG.L.C.40.§54) 1.5. Flood lone information: 1.8 Sewerage Disposal System:
Public ❑ Private ❑ 'Zone Outside Flood Zono ❑ Municipal On Site Disposal System 0
SEG1It>N :�PROPERTY OWN
1.1 Owner of Record
0 e2
Name(Print) Address for Service:
Signature 'Telephone
2.2 Authorized Agent
Name Print------ --- ---- Address for Service: — - - z
la 0
i
Signature-- - Telephone -- - — z
7Piy iAV47 J.`�fr. -*7.�, ;...JM:..}■; :.11 �("' ; `;�+::Y
a
-
3.1 Licensed Construction Supervi. r Not Applicable ❑
�7
ess License Number O
Licensed Construction Supe icor --- _y -- -- ---
i�G, � �j✓ /? �- Expiration Date
Signature _ Telephone _ W�
3 2 R.egisteroxl I1ome Improvement Contractor Not Applicable i-i ----
- &j(w1w'V I 9 `�
,kmpany Name ---.-... -- - ---- ---- -
Registration Number
tel -
-
--- 71�e�r' Expiration Date --- z
—---------— — -- ...__.._----- ---- y�
Signature Telephone -----
SECTION 4-WORKERS CONMENSATiON(X G.L C 152- § 25c(6)
Y ------- ---
?!off rkers rcImpensation Insurance affidavit must be,.ompleted,md submitted with this application. Failure to provide this affidavit will result in the denial of the_
i:,uuance of the building permit. _
Signed affidavit Attached Yea....... No.......Li
SECTION 5-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES FOR BUMPINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO'?80 CMR 116(CONTAINING MORE THAND 35,008 C.F.OF.E1,4CLOSED SPACE)
�.l Registered Architect:
-- C7 /, Q
Name:
Address
62
Signature Telephone
51 Registered Professional Engineer(s)i
lL—��5d C• Area of Responsibility
Name: 1
Registration Number
Address:
Expiration Date
Signature Total
Not applicable ❑
Name:
Registration Number
Address
Signature Telephone Expiration Date
Mune Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name -- -------— Area of Responsibility
Address — Registration Number
Signature Telephone Expiration Date
5.3 Generai Coattactar
ID4yt
Not Applicable ❑
Company Name: --- — --- -- --i-
Responsible in Charge of Constmction i
A
aG7'Ieg 6%)ESCI'3dP'1'ION OF PROPOSED 4'V9')RK (check all applic:ablc)
New Ccnstruction Fll Existing Building ] Repair(s) Alterations(s)
Addition
Accessory
=- -
Accessory Bldg. Demolition Other Sp!c —
Brief Description of Proposed Work:
60I �k I3 60c) r alav-evim,
8v3v / o P7 y' ht'yb ar11
,S nO?(7-USE GROUP AND CONSTRUCTION TYPE.
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 A-2 L A-3 --- IA -
AA ❑ A-5 ❑ IB
B Business C 2A
C Educational 0 2B
F Factory u F-1 a F-2 a 2C
H High Hazard ❑ 3A
IInstitutional ❑ I-1 ❑ 1-2 ❑ I-3 313 Ll
M Mercantile Fj 4 n
R residential L R-1 ❑ R-2 a R-3 =i 5A
S Storage ❑ S-1 ❑ S-2 h _ 5B ❑ _
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use Specify:
COMPLETE TMS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34: — Proposed Hazard Index 780 CMR 34:
S�CTIl3N.$BUILDIN. )SCI ANAR) A'.
BUILDING AREA EXIS_T1_NG if applicable) PROPOSED
Number of Floors or Stories Include - --
Basement levels
floor Area per Floor s
Total Area(st)
Total Heilht(tt) - --------------- ------ --- ------- -- --.�
Independent Structural Engineering Structural Peer Review Required _ Yes No ❑
SECTION 10a Owner Authorization- TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR"PLIES FOR BUILDING PERMIT
I
___,as Owner of the subject property
Hereby authorize to act on
My behalf, in all matters relative two work authorized by this building permit application
Bate
Signature of Owner -�--- --
1.2 W ~-EVA W:#? 1'+ X111 Y[' , I '/I�CT�E ` A�l' NY771
1, _ G( U (, N G V''C-ecv- ,as Owner/Authorized
Agent
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury
bU,y 4 Gg
Print Name 1411
Signature of Owner/Agent Date
SECTION It.-ESTIMATED CONSTRUCnON COST.
Item Estimated Cost(Dollars)to be 0 F"CUL,USE©NLY
Completed by permit applicant
1. Building ♦ i f1/�cJ� 0 C7 (a) Building Permit Fee
I O_�
Multiplier
2 F..lectrical (b) Estimated Total Cost of
Construction from(6)
3 Plumbing i (k 0 0, Building Permit fee (a)x(b) r-
4 Mechanical(HVAC)
5 Fire Protection $�d n t r
6 Total (1"+2+3+4+5) Check Number
r
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS IS- 2 ND 3 kD
SPAN
DEMENSIONS OF SILLS
DENMNSIONS OF POSTS
DM4ENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATL-:RIAL OF CHEM14EY
IS BUILDNG ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
g
sJI/
Boston, MA 02111
' t www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant InformationWe
Please Print Legibly
Name (Business/Organization/Individual): ba U � Ytw H
Address: q l)— F 0 1Q*0 -14
�' �1'`lkovetl-
V-0 y hone #: l �f S City/State/Zip: uh 6'/ S 7 7
Are you an employer?Check the appropriate box: Type of project(required):
1.�'l am a employer with-- 4. ❑ 1 am a general contractor and 1 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ 1 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. workers' comp. insurance. q. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs
insurance required.]t 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 their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. �
Insurance Company Name: 1
Policy#or Self-ins. Lic.#: ii rW �- —/)--7 7 f� Expiration Date:
Job Site Address: ( t �5�&V __7 V AI � c/ City/State/Zip:
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
tine 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 fine
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.
I do hereby certify under re ins and penalties of perjury that the information provided above is true and correct.
f�L� r/
Si nature: Date: 1 / �
Phone#: g 7 T-F/5 '77q5—
Official
77q5—
Official use only. Do not write in this area,to he 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#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to till in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-26-05 Fax# 617-727-7749
www.mass.gov/dia
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
at: i ")- )( e)'�dodd W- is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c11, S150A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
I OA.
The debris will be disposed of in:
(Location of Facility)
Signature of Permit Applicant
Fire Department Sign off:
Dumpster Permit
Date
t NpRTH '9
omm of 4Andover
No. Z �„
lL A o dover, Mass., • D
COCMICMEWICK
7�ADRATED
BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
AV lb Ir j �� BUILDING INSPECTOR
THIS CERTIFIES THAT... ................... .v. ..........................................1..'�.a. ......... .... `..... .... Foundation
�
has permission to erect....�NI�Ni.�!.... buildings on ......� r..... .s.. ...........�.......t7............ ..0............... Rough
to be occupied as V p. h for ' kAfi.i� Chimney
............ ......... ............. ... .......... . .......................................... .... .....................................provided that the person accepting this permit shall in every respect conform to the terme application on file in 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. 3 CA PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTIONS TS ELECTRICAL INSPECTOR
Rough
.r.... .. 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 Smoke Det.
tx Q_C l A, s
1=[0n( S a0
FORM U - LOT RELEASE FORM wew
CJVA 1k0_rC1a( M&S
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT d' c, Ib 5 PHONE
LOCATION: Assessor's Map Number PARCEL 8
SUBDIVISION LOT (S)
STREET t> © © b '{" ST. NUMBER — (ZI?y 2 7
OFFICIAL USE ONLY**********************
REC )VIENDATIONS 4FTOWN AGENTS:
CONSERVATION ADMINIST OR DATE APPROVED Q
DATE REJECTED
COMMENTS
OWN P ANNER DATE APPROVED d
DATE REJECTED
COMMENTS
A,&
FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
—7 _
PUBLIC WORKS- SEWERMATER CONNECTIONS p�
DRIVEWAY PERMIT
FIRE DEPARTMENT ke_qu1/tS SP�i� kl�/ ,Q�dT��- 7r��� MQS tt �p�: + A,/l e �ei �'e�✓n, , f
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 Jim
r
Date..... !.........—.....�?.�
MOR7M
°t<�``°;•�"° TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
•O+An° '•��'ly
ACMUSE�
This certifies that
has permission to perform .........! .............................................C
......................
wiring in the building of....... .. ...4.f'►z..4��f......................................
( 2l �'
at......... ............?.........©...S � 1�......:�..� .. ..�~.............. ,North Andover,Mass.
F77 .. . ........Fee.. r ic.No. . -j....... . //J . .......
*� ELECTRICAL INSPECTO~��Rte"
Check # 3 O 7bo 2-
I tM t.UiMVJUJV"E.Al"11 Ur iVAM6 . 11L11U.u.i i u
D PAR111WOMB KSAFRY Permit No.
J B0ARD0FF=FREVHM0NRDGrJLAT70NS a2120 j 7
Occupancy&Fees Checked
APPUCATTON FOR PERNIlT TO PERF ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUS S ELECTRICAL CODE,527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work descri below.
Location(Street dt Number) 2 a rJ o,,er.
Owner or Tenant C
Owner's Address
Is this permit in conjunction with a building permit: Yesy No [:3 (Check Appropriate Box)
Purpose of Building o jr n x rt?C 01--� Utility Authorization No.
Existing Service Amps�� Volts Overhead Q Underground [Z) No.of Meters
New Service O C) Amps Zo /2 0}SVolts Overhead Q Underground No.of Meters
Number of Feeders and Ampacity t vn 3 O ? o Z
Location and Nature of Proposed Electrical Work
No.R Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above rn Below Generators KVA
ground ground
No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwasher Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Local Municipal Other
Connections
No.of Water Heaters KW No.of No.of
signs Bailasis
No.Hydro Massage Tubs No.of Motors Total HP
OTHER•
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EMMNAME LioerneN. 4-27 P'
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`t,,� OWNER'SB4SURANCEWAIVEP;Ianawa dmtdclj anedoeomthonftRmneo mWcritssubmarrialtxllpWmtasmp dbyMmzb=NG=sWLm
andthatmys aecndtispain[appicabmwanesEsra#an I
(Please check one) Owner 1:3 Agent ^
Telephone No. PERMIT FEE S
Signature w
DEPAJU 11WOFPUffiJC,'SAFE77 Permit No. ✓�B S
BO4RDOFFYREPREmvnoNRDGUTATIw527amizo
Occupancy dt Fees Checked
APPLICATTONFOR PEIZNIlTTO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED hN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,S27 CMR 12:00 � /j/
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 2. l©�
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number) 2 a C/ Am"10
Owner or Tenant
Owner's Address
is this permit in conjunction with a building permit: Yes No (Check Appropriate Box)
Purpose of Building 0 lr r -,, C l 4, Utility Authorization No.
Existing Service Amps ...4.Volts Overhead Underground No.of Meters
New ServiceQI 0 Amps Z / L O tSVolts Overhead Underground Q No.of Meters
Number of Feeders and Ampacity C 0'1 '30 7 °�-
Location and Nature of Proposed Electrical Work
No.of Lighdng Outlets No.of Hat Tubs No.of Transformers Tout
KVA
No.of Lighting Fixtures Swimming Pool Above Below Generators KVA
ground and
No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of On Bunk»
No.of Ranges No.of Air Cond. Tota FIRE ALARMS No.of Zones
Toro
No.of Disposals No.of Heat Total Total No.of Detection and _
Pumps Toro KW Initiating Devices
No.of Dishwasher Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Local Municipal Other
Connections
No.of Water Heaters KW No.of No.of
sign Bailasis
No.Hydro Massage Tubs No.of Motors Tota HP
OTHER-
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(Please check one) Owner M Agentr
Telephone No. PERMIT FEES a C)
t
i
,�--"p
Date..................................
NORTH
TOWN OF NORTH ANDOVER
o p PERMIT FOR WIRING
,SSACMuS�
Thiscertifies that ... ....................:....................................................................
has permission to perform
.... ........... ......
wiring in the building of `.-r. .... �0..............................................
r.-- North Andover Mass.
Fee`f ......... Lic.No.� 3 iS' '........... .................
IrLEcrmcAl�INSPE&OR
Check # ,v/
57 ;
Jim 1. ilwyluly"rtiWli Ur lnrsa unv usl1 �•••— --�•••,
DEPAR71NWOFPUBIK Permit No.
BOARDOFFREPREVEMON ON55rcmi im 'j ov
Occupancy&Fees Checked
APPLICATTONFOR PERMT'TO P ORMELE=CAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSAC SSTS ELECTRICAL CODE,527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 5—" 0 S
Town of Notch Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical workde crir below.
Location(Street&Number) (d, 116-1" I d V
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit:/ Yes No (Check Appropriate Box)
Purpose of Building "ell 1, �r( Utility Authorization No.
Existing Service Amps / Volts Overhead Underground a No.of Meters
New Service Ret Amps/Z6 /,W g Volts Overhead Underground i No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above Below Generators KVA
ground 1:1and ri
No.of Receptacle Outlets No.of On Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Heat Total Total No.of Detection and
h
Pumps Tons KW initiating Devices
No.of Dishwashers Space Area Heating KW No.of No.of Self Sounding
Devices
tained �a
ILI Detection/Sounding Devices _
No.of Dryers Hating Devices KW Local Municipal Other
Connections
No.of Water Heaters KW No.of No.of
Signs Bailasia
No.Hydro Massage Tubs No.of Motors Total HP
OTHER•
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OWN9VSMRANMWA1V 3kIamawarethattheLionisedapsrotheretheaauameoa�e,�arilstrialegivalent n�i>�dbyN1t�Ch�sGalmalLaws
arcsthatmy4gnA=ondtispewitff1c mwaivesdristet}iw=
(Please check one) Owner a Agent a
Telephone No. PERwTT FEES /
signature Owner
Jim v�'ly"U � n VLatsl i u ..••• .
D PARTAIENTOFPUBLJC ��
Permit No.
BOARDOMREPRE'VEIVMV Sl709�no
Occupancy Qe Feea Checked
APPLICATIONFOR PERMI'lTO P ORMELECTRICAL WORK
•�j
ALL WORK TO BE PERFORMED IN ACCORDANCE Wirth THE MASSAC SSTS ELECTRICAL CODE,527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 5=e2 � OT _
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work de ri below.
Location(Street&Number) /X I l
6
Owner or Tenant
Owner's Address
is this permit in conjunction with a building permit: Yes No (Check Appropriate Box)
Purpose of Building �(}u�Get�: C 2 f Utility Authorization No.
Existing Service Amps �Volts Overhead a Underground No.of Meters
New Service �� Arnps/ZDV Volts Overhead M Underground v No.of Meters 'I
Number of Feeders and Ampacity ` G�� '�� ~
Location and Nature of Proposed Electrical Work co, ,ri g wR_ -s
No.of lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above Below Oeneratars KVA
ground 1:1and
No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Unite
No.of Switch Outlet
No.of du Burners
No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Toro
of Disposals No.of Heat Total Total No.of Detection and
Pumps Toro KW Initiating Devices
to.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
o.of Dryers Heating Devices KW Local 0 Municipal 0 Other
Connections
D.of Water Heaters KW No.of No.of
Signs Bailasis
Hydro Massage Tubs No.of Motors Total HP
R•
Com Alm�tibdctegtieraftctMe®dnGalvalLawa
actn=LdALy1s==FbrgmditCmVjw Qihatskillide4iain YES NO
wbriadva0ptoofefmciohe0ffir.YP,S a if}ouhmedgededYBS,p�eiil3c*QleWcfamWby
BOND� GUM � ���1�
LL B#abonDate
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`OWNER'SP6L ANCEWAIVER;Iamawaethetthel�oe�edommtln�Iheir neao�eaisslb��oalegivala�tasIogliredb5'Mtt�fi�etlsC�arlalLawa
Idthat mysgr9=cnthispamiffkub'Mwanesd6teq�wast
(Please check one) Owner � Agent M '
Telephone No. PERMIT FEE S /
Signature
�-- Ila?
U 4��17j/-7,-701
t,�,� ,.�'o � -of y► p �/�is G��
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Date..17� .. .... .. ..
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pOFTM
o? TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
. 9
�,SSACHUSEtS
1
This certifies that .-'!r1 "`. . . . . . . .
has permission for gas installation7: "" .. . .. .
C
in the buildings of . . . . . . , . . . . . . . . . . . . . . .
atX .. . . . . ..Z. . . . , North Andover, Mass.
Fee ! . . Lic. No... . . :. . . . . . . . . .
(/ GAS INSPECT�R '
Check#/fc�
122
i
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
{ (Print or Type,
�dCt�l NO
over Mass Date 517-A�O�
City, Town Permit # 12- 2,
Building1211 iad <S Name Owner's R16
AT: Location
V COQ
Type of Occupancy:
GNewRenovation ElReplacement ❑vEr
Plans Submitted Yes ❑ No ❑
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SUB—BSMT.
BASEMENT
ISTFLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
! 6TH FLOOR
7TH FLOOR
•
STH FLOOR
(Print or Type) - Check One:. Certificate
Installing Company Name 1�f� Q 1 A ` `Umbo' � Corp.
Address a ❑ Partnership
❑ Firm/Company
Business Telephone�. � r ` Name of sed Plu er or Gasfitter
yA )Onh
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurance including completed operations coverage.
Signature of Owner/Agent
I have a current liability insurance policy to include completed operations coverage.
By TYPE LICENSE:
Title ❑ Plumber Signature of Licensed
Plumber or Gasfitter
City/Town ❑ Gasfitter ' I l -r-
Ms
APPROVED (OFFICE USE ONLY) aster
❑ Journeyman License Number
FORM 1243 A.M.SULKIN W. 1989
BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
i
FEE
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
NAME do TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
PERMIT GRANTED
DATE
GASINSPECTOR
Date. e.
s
HORT: ti TOWN OF NORTH ANDOVER
Of ��•o ,
° PERMIT FOR PLUMBING
,SSACMUS�
l
This certifies that .. r�. . !: .c'.'. .. . . . . . . . . . . . . . .
has permission to perforpA--��`� . . . . . .
plumbing in the buildings of� f> . . !.�-Q�: �!'. . . . .
* at . . . f ,:-. . . . . . . . Northnd fiver, Mass.
Fee '�Lic. No.1117
y/ ( PLUMBING INSPE ;0F�
Check U
6 4 613
MASSACHUSETTS UNIFORM A/CATFOR PERMIT TO DO PLUMBING
(Print or Type)
City, Town Permit #Building ' Owner'sAT: Location Z�l �� Name
Type of Occupancy:
New Renovation ❑ Replacement ❑
Plans ❑
FIXTURES Submitted: Yes ❑ No
z
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IA
2ND FLOOR
3RD FLOOR
4TH FLOOR
r STH FLOOR
STH FLOOR
`
7TH FLOOR 11 A
STH FLOOR
(Print orT,►pe) Gr, �ih �lU i,►,�,n �-�Check,� e�eau
rp
Address Company Name ^ ❑
l S 7® ❑ Firm/Company
Business Telephone roil (agr " -A 3 Zq Name of Li Plum or Gasfitter
At,C?f"lh
I hereby certify that all of the detaik and information I bare submitted(a entered)in abort app6ation are frac and acaaate to the best of my
knovAodge and that all plumtima vat and i0VARK60ns perfarmed ander Permit hand for this application Ta be is oompimm with all pertinent
provWons of the Maaaelazwo Stale On Code and ChapW 10 of the t ewd lies. `
I bavo informed the owner or his meat that 1 do net have M ty insurance indodin completed operations coveraie.
Sipr�edOwer/Aaait
I have a anrreat iabih'ty inaaanee poiry to Wade completed operations WWMr-
x-- IL
By SiJigitum of Licensed Plumber
Tide Type of Plumbi ase
City/Town 11 1Sf Master ❑ Journeyman
APPROVED (OFF=USE ONLY) License Number
BELOW FOR OFFICE USE ONLY
4 FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS
FEE
NO. i
APPLICATION FOR PERMIT TO DO PLUMBING ,
NAME A TYPE OF BUILDING
LOCATION OF BUILDING
L
PLUMBER
PERMIT GRANTED
DATE
PLUMBING INSPECTOR
a-
I
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,Mass. 02111
Workers'Compensation Insurance Affidavit
• Applicantinformation Please PRINT legibly
Name: 2JG h vefi Y\
Location: 1 '
�� a i n � eei- Phone#
/r�,x
City l/ r� Policy#
❑ I am a homeowner performing all work myself.
❑ I am a sole proprietor and have no one working in any capacity
.or',,am an employer providing workers'compensation for my employees working on this job.
Co an name: en V\ 'Nffi6'AA tt
Address: O��1 �1A t V\ P 1
Ci Phone#
Insurance Co. CC/VXn b r �' O�^ Policy# t e K 4 330
: ,.t.,rtn r .-� +ry ) Yv{r?k.kt. rci<S .•m t h{ }. t } Fn. �Y`u,�...•{'1 .
',.,s,;i:::�w+:i4c'�r;r'..w......f, +is:S'':$den...?�=rSaku�v�t�. bfrt'y:E- ....>w�,t"n+.t.. r.,.•.e .(.. .. ,+ .. .
I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below
who have the following workers'compensation policies:
Company name` -
Address:
City: Phone#
Insurance Co, Policy#
'nF l '�,{, ,.'�+}"•ci� _ f� r.':14^"..c+f,;`VPt 5;::>;d2' y n
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal
penalties of a fine up to$1,500.00 and/or one year's imprisonment as well as civil penalties in the form of a STOP
WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be
forwarded to the Office of Investigation of the DIA for coverage verification.
I do hereby cert!"fy pains and penaldes ofperjury that the information provided above is"e and correct.
Signature Daft 5-1t4l6;
Print name
k��Vl I VP<<In Phone# cjY)` "33�
Official use only do not write in this area to be completed by city or town official
{ City or town pemrittlicense# ❑ Building Department
❑ Licensing Board
❑ Check if immediate response is required ❑ Selectmen's Office
❑ Health Department
Contact n: phone# ❑ Other
1 ,
b
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation
for their employees. As quoted from the "law",.an employee is defined as every person in the service of
another under any contract of hire,express or implied,oral or written.
An employer is defined as an individual,partnership,corporation or other legal entity,or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or
the receiver or trustee of an individual, partnership, association or other legal entity, employing employees.
However the owner of a house having not more than three apartments and who resides therein,or the occupant
of the dwelling house of another who employs persons to do maintenance,construction or repair work on such
dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be
deemed an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for
the performance of public work until acceptable evidence of compliance with the insurance requirements of
this chapter have been presented to the contracting authority.
^;•i'r:;:: �� t,
ytt."S�•
Applicant
Please fill in the workers'compensation affidavit completely by checking the box that applies to your situation
and supplying company names, address and phone numbers as all affidavits.may be submitted to the
Department of Industrial Accidents for confirmation insurance coverage. Also be sure to sign and date the
affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the
"law" or if you are required to obtain a workers' compensation policy, please call the Department at the
number listed below.
';orf. .1Tn 37A ,i'je ',{.�
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the
bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding ,(
the applicant.Please be sure to fill in the permit/license number which will be used as a reference number.The
affidavits may be retuned to the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any
questions,please do not hesitate to give us a call.
The Department's address,telephone and FAX number.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations •,
600 Washington Street
Boston,Mass. 02111
FAX#(617)727-7749
Phone#(617)727-4900 ext.406,409 or 375
2
3 7 n 2
Date..................................
MORTH
°!t"`°;•�"� TOWN OF NORTH ANDOVER
° PERMIT FOR WIRING
1- P
o
# i ;
gACHUSE�
This certifies that
�4 has permission to perform ...:..a..:. ". �- �
wiring in the building of........ `rr. e.. �j rxG-�+
c. :.... . .. . .... .........................
at./—'//................. .....--:..... ...................... ,North Andover,Mass.
ni U
Fee... ...... Lic.No.............. ......�,X'��.
...........................
ELECTRICAL INSPECTOR
Check # 1171
i
(,ommonweatfh of Masdaclraje//d Official Use Only
2epartnrenl o��ire Services Perrnit No. 3 f
Occupancy and Fee Checked Ob `'-
BOARD OF FIRE PREVENTION REGULATIONS (Rev. 11/99] leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MGC),527 CMR 12.00
(PLEi1SE PRINT N INK OR TYPE-ALL ILL INT-•ORAL l T ION) DaIc: •S-_g-Ga
City or Town of: N r% % .er To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
( ) 1.2. 11
Location Street& Number
Owner or Tenant MC Ltu C kor A Telephone No.
Owner's Address
Is this permit in conjunction with n building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building Wilily Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters,
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
MOS FPC. k1AVN NZ 1 p k rAiA
Completion of the(ollowintable may be waived by the loo ector of JVires.
No.of Recessed Fixtures No.of Ccil_Susp.(Paddle)Fans No.of Total
KVA
No. of Lighting Outlets No.of blot"Tubs Generator's KVA
No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ o.o mergency rg iting
rad. rnd. Batte Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No-of Detection andInitiating Devices
No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices
Heat Pump Number "Pons KW No.of Self-Contained
No.of Waste Disposers Totals: Detectiort/Alerting Devices
No.of Disln.vashers S ace/Area Heating KW Local Corylnicipal
p g ❑ Connection Other
No. of Dryers Heating Appliances KW Security Systems:
No.of Devices or Equivalent
No.of Nater K1V Nof No.of Data Wiring:
Heaters Sins Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total hIP Telecommunications Wiring:
No.of Devices or E uivalent
OTHER:
Attach additional detail ifdesired,or as required by the Inspectorof{Vires.
INSUR.A,NCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to(lie permit issuin-office.
CHECK ONE: INSURANCE PQ BOND ❑ OTHER ❑ (Specify:)
(Expiration Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: {`WO2— Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certifj•, ander the-l ains acrd penalties ofperjur)-,that the information on this application is 0•tte and complete.
I,IRM NANIE: � m lc kc LIC-NO.: =31,01
Licensee: SOhil M�S � Sibnaturc LIC.NO.:
(If applicable,enter ..eccutpt"in the license numberlinc.) Bus.Tel.No. 972 23G 755
Address: bOX- U Alt.Tel.No.:
OWNER'S INSURANCE WAIVER: I am aware that e icensee docs not have the liability insurance coverage normally
required by law. By my simnature below, I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent.
Owner/Agent 0�
Signature Telephone No. Pl:Ri3fIT FE-E: S Q
ROUGH FINAL
1211 Osgood.Street McLay's Florist
Site Plan Review
The Planning Board herein approves the Special Permit/Site Plan Review for the
renovation of the site and building located at 1211 Osgood Street in the General Business
GB Zone. McLay's Florist, 757 Turnpike Road, North Andover, MA 01845 requested
this Special Permit. This application was filed with the Planning Board on July 17, 1997.
The Planning Board makes the following findings as required by the North Andover
Zoning Bylaws Section 8.3 and 10..3:
FINDINGS OF FACT:
1. The specific site is an appropriate location for the project as it is located in the General
Business Zone along a major roadway, surrounded by Agricultural, Commercial and
Residential Uses;
2. The use as developed will not adversely affect the neighborhood as the proposed use is
less of an impact than those which are allowed in the district.;
3. There will be no nuisance or serious hazard to vehicles or pedestrians;
4. The landscaping approved as a part of this plan meets the requirements of Section 8.4
of the North Andover Zoning Bylaw;
5. The site drainage system is designed in accordance with the Town Bylaw
requirements;
6. The applicant has met the requirements of the Town for Site Plan Review as stated in
Section 8.3 of the Zoning Bylaw;
7. Adequate and appropriate facilities will be provided for the proper operation of the
proposed use.
Finally, the Planning Board finds that this project generally complies with the Town of
North Andover Zoning Bylaw requirements as listed in Section 8.35 but requires
conditions in order to be fully in compliance. The Planning Board hereby grants an
approval to the applicant provided the following conditions are met:
SPECIAL CONDITIONS:
1. Prior to the endorsement of the plans by the Planning Board, the applicant
- - - - - -
-must-comply with the-followingconditions- -
-------- -
a) The following information must be provided to the consultant and to the
Planning Department for review and approval and the appropriate changes
made to the plans:
i) Confirmation of the property acquisition of the Massachusetts
Highway Department by the applicant.
b) Corrections and additions must be made to the plan as follows:
i) A picket fence will be constructed from the easterly potion of the
building to the southerly portion of the site and then back to the
entrance drive from route 125. The fence shall be of a construction
substantially similar to the attached detail.
ii) The free standing sign shown on the plan is not considered part of
the approval by the Planning Board. The applicant will be allowed
a 90 day time period which they shall have the ability to erect a
temporary sign on the building. The temporary sign shall not exceed
the area requirements of the Zoning By-law. Such sign shall be
removed at the end of 90 days. The approval of the freestanding
sign shall require an amendment to the site plan.
C) A bond in the amount of $2,000 dollars shall be posted for the purpose of
insuring that a final as-built plan showing the location of all on-site utilities,
structures, curb cuts,parking spaces and drainage facilities is submitted.
The bond is also in place to insure that the site is constructed in accordance
with the approved plan This bond shall be in the form of a check made out
to the Town of North Andover. This check will then be deposited into an
interest bearing escrow account.
d) A construction schedule shall be submitted to the Planning Staff for the
purpose of tracking the construction and informing the public of anticipated
activities on and off the site.
e) There will be no banners of any types placed across the fences.
fj There will be total screening around the dumpster with a stockade fence.
g) The chain link fence will be of a coated type with either black or dark green
coating. The fence shall run from the westerly potion of the building in a
westerly direction to route 125 then running along 125 to the north westerly
property bound then running easterly to the north easterly property bound then
running back to the buildings easterly side.
3 = =moo . —V .�
e 5
2. Prior to the start of any work on site,
a) The Planning Board must endorse the final site plan mylars. Three(3)
copies of the endorsed plans must be delivered to the Planning Department.
b) This decision must be recorded at the Essex North Registry of Deeds and a
certified copy of the decision delivered to the Planning Department.
c) The applicant shall determine the preexisting conditions of the noise levels
emanating from the site area, at the property line at a height of 6 feet, to
determine the baseline noise conditions of the site area. The noise survey
will provide evidence of the origin of surrounding noise and a baseline
condition from which the applicant can determine their increases. The
noise levels shall not increase the broadband level by more then 10 dB(A)
above the ambient levels or produce a "pure tone" condition at the property
line as set forth in DAQC Policy 90-001, the guideline for 310 CMR 7.10.
3. The applicant's contractor shall insure that the construction of the facility
will not cause undue nuisance to adjacent businesses. Methods such as the
following must be employed:
a) Construction shall not begin prior to 7:00 am and shall cease at 6:00 PM
for exterior work, and may continue to 11:00 PM for interior work.
b) Construction shall be limited to weekdays,Monday through Friday during
the above hours. Construction may occur on Saturday during the hours of
7 am to 5 p.m. to facilitate a shorter construction period.
C) Dust mitigation methods such as site watering to insure that dust does not
leave the site during construction shall be implemented.
4. Prior to FORM U verification (Building Permit Issuance):
a) Acopy of the Highway Access Permit from the Massachusetts Highway
Department must be submitted to the Planning Department. If the permit is
not necessary then a letter confirming such from the applicant will be
required.
5. Prior to verification of the Certificate of Occupancy:
a) All improvements outlined in the plans referenced below must be
completed as certified by the applicant.
b) The applicant must submit a letter stating that the building, signs,
r
v
landscaping, lighting and site layout substantially comply with the plans
referenced at the end of this decision as endorsed by the Planning Board.
C) The Planning Department shall approve all artificial lighting used to
illuminate the site. All lighting shall have underground wiring and shall be
so arranged that all direct rays from such lighting falls entirely within the
site and shall be shielded or recessed so as not to shine upon abutting
properties or streets. The Planning Department shall review the site. Any
changes to the approved lighting plan as may be reasonably required by the
Planning Staff shall be made at the owner's.expense.
d) The building must have commercial fire sprinklers installed in accordance
with a design approved by the North Andover Fire Department.
6. Prior to the final release of security:
a) The Planning Staff shall review the site. Any site screening as may be
reasonably required by the Planning Staff will be added at the applicant's
expense.
b) A final as-built plan showing the location of all on- site utilities, structures,
curb cuts, parking spaces and drainage facilities must be submitted to and
reviewed and accepted by the Planning Staff and the Division of Public
Works.
7. All truck deliveries must be made to the site via Route 125.
8. Any stockpiling of materials(dirt, wood, construction material, etc.)must be
shown on a pian and reviewed andapproved by the Planning Staff prior to the
stockpiling. Any approved piles must remain covered at all times to minimize any
dust problems that may occur with adjacent properties. Any stock piles to remain
for longer than one week must be fenced off and covered.
9. In an effort to reduce noise levels,the applicant shall keep in optimum working
order, through regular maintenance, any and all equipment that shall emanate
sounds from the structures or site.
10. The hours for trucks entering the site for shipping,receiving and waste hauling
shall be limited to between the hours of 6 am and 10 p.m. Monday through
Sunday. Snow plowing may occur during operating hours and at least two (2)
hours prior to the opening of the facility and four hours after the closing. Snow
must be removed from the site to avoid the use of parking spaces as snow stacking
areas.
♦ cefrs ccc S 4�t�" e
Q
for longer than one week must be fenced off and covered.
8. In an effort to reduce noise levels, the applicant shall keep in optimum working
order, through regular maintenance, any and all equipment that shall emanate
sounds from the structures or site.
10. Any plants, trees or shrubs that have been incorporated into the Landscape Plan
approved in this decision that die within one year from the date of planting shall be
replaced by the owner.
11. The contractor shall contact Dig Safe at least 72 hours prior to commencing any
excavation.
12. Gas, Telephone, Cable and Electric utilities shall be installed underground as
specified by the respective utility companies.
13. No open burning shall be done except as is permitted during burning season under
the Fire Department regulations.
14. No underground fuel storage shall be installed except as may be allowed by Town
Regulations.
15. The provisions of this conditional approval shall apply to and be binding upon the
applicant, its employees and all successors and assigns in interest or control.
16. Any action by a Town Board, Commission, or Department, which requires
changes in the plan or design of the building, as presented to the Planning Board,
may be subject to modification by the Planning Board.
17. Any revisions shall be submitted to the Town Planner for review. If these revisions
are deemed substantial, the applicant must submit revised plans to the Planning
Board for approval.
18. This S e ial P nmit approval shall be deemed to have lapsed two years, which shall
be on c'?S , from the date the permit is granted unless substantial use or
constru tion has commenced. Substantial use or construction will be determined
by a majority vote of the Planning Board.
19. The following information shall be deemed part of the decision:
20. Plan entitled: Site Plan Review Set
Merrimack College Student Residences
North Andover, Massachusetts
Prepared for: Merrimack College
315 Turnpike Street
a
�.Qg Ht Yh 484-"
C t�p { G 142"i R���i
h 7.a"a ugh f3s � C_
North Andover, Massachusetts 01845
Prepared by: Sasaki&Associates Consulting Engineers
64 Pleasant Street
Watertown, Massachusetts 02172
Scale: 1"=40'
Date: June 13, 1997
Sheets: 1 through 9
cc. Applicant
Assessors
Building Inspector
Conservation Administrator
Director of Public Works
Engineer
File
Fire Chief
Health Administrator
Planning Board
Police Chief
P%�; Information ----------------.._- --------. ._----------
N sT 111-1d On
Engineering• Consulting• Testing
REPORT OF CONCRETE COMPRESSION TEST
� 4 5 RAS
TESTED FOR: BRANT BALLANTYNE PROJECT: PROPOS EDTAIL DEVELOPMENT
TEC NORTH AND R, MASSACHUSETTS
TEN NEW ENGLAND BUSINESS DRIVE D s
SUITE 107
ANDOVER, MA 01810
REVISION ##2
DATE: November 29, 2004 OUR REPORT NO.: 446-40176-3
FIELD DATA:
LOCATION OF PLACEMENT Foundation Wall: West; North; Southwest; Southeast
DATE PLACED November 29, 2004 SUPPLIER Kingston Ready-mix
TIME 08:20 am DELIVERY TICKET NO./TRUCKNO. 75242
SLUMP,IN. 7 1/2 MIX NUMBER AND PROPORTIONS ---
AIR CONTENT,% 3 .5 CEMENT
AIR TEMPERATURE,OF 39 WATER
CONCRETE TEMPERATURE, OF 69 FINE AGGREGATE ---
DATE RECEIVED IN LAB November 30, 2004 COARSE AGGREGATE ---
FIELD DATA SUBMITTED BY PSI ADMIXTURE ---
MIX DATA SUBMITTED BY Kingston Ready-mix
NOTE'APPLICARI F ASTM-STANDARDS UNLESS BERME INDI ATED SLUMP Gtd3-00'AIR GONTFNT �'++-9Z(ElSCLSlDINEBALUBE�G1064-
__9$_�LINDERSC31.00(Ertl i IpIN g+ ) L4PLING C772-98
COMPRESSION TEST RESULTS
ASTM C39-01;C1231-00
SPECIMEN I TEST TOTAL CYLINDER CYLINDER COMPRESSIVE
LABORATORY IDENTIFICATIONI AGE DATE OF I LOAD DIAMETER AREA STRENGTH
NUMBER OR SET NO. (DAYS) TEST (LBS.) (IN.) (S0.IN.) (PSI) TYPE OF BREAK
I I
1 ! A 7 i12/06/04 90650 6.00 X28 .271 3210 1 Cone i
1I C 28 ; 12/27/04 147220 6. 01 28 .37 , 5190 Cone & Shear
28 112/27/04 1 149950 6. 01 28 .371 5290 Cone & Split
1 D 28 12/27/04 149670 6. 01 28 .371 5280 i Cone
I I
I I
I i I
I I
SPECIFICATIONS
28 4000
REMARKS: X Cylinders made by PSI representative. X representindersative.ickLd up by PSI Test results comply with applicable
— — X specifications.
Cylinders made by Architect's or Test results do not comply with
_ Contractors representative. — Cylinders delivered to PSI laboratory. _ applicable specifications.
Respectfully Submitted,
Professional Service Industries, Inc.
THESE TEST RESULTS APPLY ONLY TO THE SPECIFIC SAMPLES TESTED AND MAY NOT BE INDICATIVE OF THE ENTIRE CONCRETE PLACEMENT.
REPORTS MAY NOT BE REPRODUCED,EXCEPT IN FULL,WITHOUT WRITTEN PERMISSION BY PROFESSIONAL SERVICE INDUSTRIES,INC.
PSI A-200-4(7)F
Professional Service Industries, Inc.•905 Turnpike Street,Suite H•Canton,MA 02021 •Phone 781/821-2355•Fax 781/821-6276
Location ` a ©S G C)o "�k)
No.
Date
NORTIy TOWN OF NORTH ANDOVER
O
Certificate of Occupancy $
Building/Frame/Frame Permit Fee $
s�C14U 9
Foundation Permit Fee $
Other Permit Fee RA24 $ � 0
TOTAL $ d
Check # 103 St
17 6 3 6
Building Inspector
� R
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH3�aAOQ({NE1yOR TWO FAMILY DWELLINGMa
'l „3i .:}S" .�., �0.i.S t F-..• Vj{�sNM{Jse
`v}
BUELDING PERMIT NUMBER: / DATE ISSUED: q_t (r
M
ic
SIGNATURE:
Building Commissioner/Inspector of Buildings Date z
SECTION 1-SITE INFORMATION O
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
/f.// D5mag ST
Map Number Parcel Number —
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
R red Provide Required Provided ReqWred Provided
1.7 Water Supply M.G.L.C.40. 34) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT FH6101 District Yes �Jn rn
2.1 Owner of Record
Name(Print) Address for Service
Signature Telep one
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone 90
SECTION 3-CONSTRUCTION SERVICES
3.1i
Licensed Construction Supervisor: Not Applicable ❑
sed Construction Su isor: 00 �
License Number
11
Addres >
Expirati n Dat a�
ature elephone F°'aa
3.2 Registered Home Improvement Contractor Not Applicable ❑
Comp ny Name M
Registration Number r
Address
z
Expiration Date
Si nature Telephone
SECTION 4-WORKERS COMPENSATION(NVLG.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
-Signed affidavit Attached Yes.......❑ No.......❑
SECTION 5 Description of Proposed Work check au a Hcable
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY.
Completed by permit applicant
1. Building (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 Plumbing Building Permit fee(a)x (b)
4 Mechanical HVAC / —
5 Fire Protection
6 Total 1+2+3+4+5 Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner/Authorized Agent of subject property
Hereby authorize_ to act on
My behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, as Owner/Authorized Agent of subject fr
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief
Print Name
Signature of Owner/Agent Date
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 15 2 3
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS {
SIZE OF FOOTING X —
MATERIAL OF CHIMNEY
1S BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
c ( S
Town of North Andover
Building Department 3? y`�t4*o M6'64*o
27 Charles Street i° �o
North Andover, Massachusetts 01845
(978) 688-9545 Fax (978) 688-9542
O • \bb
<ec..cncwc• 1.
Building Demolition Affidavit
SACNUS����
DATE - 'O
11
OWNERS NAME &ADDRESS �� Gc�Lr7"S�
i�R/�iV`D f/�P !�/r /J.Sc�Do� �T. ./' •/�i�G�rr G—�
PROPERTY LOCATION 44W&.41, 77•
DESCRIPTION
CONTRACTORS NAME &ADDRESS
ff r
DEPARTMENT SIGN-OFFS
foe DP "'o�
D-P.W./WATER �'^ EWER -� g�zc>��L(
GAS ln, T-3- 6
ELECTRI �'9�O VeV-j'zp
TELEPHONE
GAM=,E
TAXES t
---- POLICE O
-- FIRE /Z�E
DUMPSTER-ON/OFF STREET
DIG SAFE NUMBER 2Go43S0(o l
BLDG- INSPECTOR DATE RECD
North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c11, S150A.
The debris will be disposed of in:
(Location of Facility) .
Si nature of I Oermit-Applicant
g-j- tg 141
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this projecf through the Office of the Building Inspector
NORTH
Town of over
0 .
No.
LA over Mass.,
COCHICHEWICK
ATED
BOARD OF HEALTH
Food/Kitchen
PERMIT T E Septic System
le/ ly ...................5......... a A BUILDING INSPECTOR
....... ... .... .. ....
THIS CERTIFIES THAT........... ........... .. .... . IrFoundation
has permission to oRM... 1L........... buildings on ........ 0-10..b........ ..... Rough
to be occupied as.. Chimney
.F ....................5...... 1kf....................................................................
provided that the person accepting this permit shall In every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws elating to the 1pspection, Alteration and Construction of
Buildings In the Town of North Andover. :; as/.q PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES N 6 MONTHS Final
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
OR g6
Rough
.......................................................Wdo-&.... ..
- 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__Jl Smoke Det.
r
GAFFNY CORPORATION CONTRACTORS
55 Union Street, Lawrence, Massachusetts 01843 Tel: 978-689-7575 Fax: 978-681-0707
January 10, 2004
Town of North Andover
400 Osgood Street
North Andover, MA. 01845
Attention: Robert Nicetta
Re: 1211 Osgood Street
Please be advised that as of this date Gaffny Corporation Contractors (Gaffny) is
no longer involved in the above referenced project. Therefore, Gaffny wishes to withdraw
our application for a Building Permit with the following licenses:
Tim Gaffny Lic# CS005097
Mike Yob Lic# CS075780
Also attached please find the following original documents:
Permit# 186—Permit to Raze issued 9-14-04
Permit#253 —Permit for Excavation and Foundation issued 10-14-04
Thank you for your cooperation in this matter as well as your complete
cooperation throughout Gaffny's involvement in this project. RECEIVED
JAN 12 200
BUILDING DEPrr
REC
*Timaf�hv N 1 2004
B ILDING DEPT.
NORTH `
Town of Andover
No. -
q_l� _a
LA�o dover, Mass. D�
COC HICHEWICK
R4 TED
BOARD OF HEALTH
PERMIT T E Food/Kitchen
Septic System
THIS CERTIFIES THAT...........d....:�...C....� �...��......... ........��.r.�'...!s�........��.0.....A...... BUILDING INSPECTOR
Foundation
has permission to .�t....lZ... .Z..' ........... buildings on ... 'IS G 1b...... S.�'..... Rough
t0 be occupied as..iw. �'.. �~�. I Chimney
... ......R.!'Rt............................. .... .......................................................................
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws elating to the I spection, Alteration and Construction of
Buildings in the Town of North Andover. 43 3014P PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
s �
,�/ ou
........................................•-•••••••••••••................................ 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 BeDone FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
_ Street No.
SEE REVERSE SIDE — 1 Smoke Det.
GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec, etc.
WaUs at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip-Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate.
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girls-solid brick or steel plate bearing at foundations
'/"air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min.22x30 w/3'headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
Firecode S/R wood frame of"0"clearance fireplaces&stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8%of floor area.
Of required glazing shall be openable.
Bedrooms required min.20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing-Smoke Chamber-Finish
Smooth parging,clean joints, 8"solid @ combust. Surf.
DECKS: Separate permit required:
Lag to house, provide flashing.
Rails min. 36" high, Baluster max space 5"on center.
Over 8'above grade, use 6x6 posts w/lateral bracing.
Lag all posts and rails.
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee- $30.00(Be Ready).
Certificate of occupancy required prior to occupying structure.
RTfy
Town o 4Andover
0
No. _w
z leo 4 ndover, Mass., n,%,r ani , � �
�, � ^
M x
�►` Q C LAKE I+, T
C OC MIC ME WICK �
SRATED P`?" C:)
1 SACHUS` i
IT
FOR
EXCAVATION FOUNDATION
AND
THIS CERTIFIES THAT ..:�. .��.. , :�Z�Q..., .?`.~ ...Qe.FR:. Y................
has permission to excavate and pour foundation at .........c. n.. .... !s :.. .... i. ......................
for the purpose ... ................
The person accepting this permit must return to the office of the Building Inspector a certified plot plan show
of building thereon before Foundation will be inspected.
VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS
The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS
assurance that a permit for entire building structure will be granted.
t3r �.. .................
SEE REVERSE SIDE BUIL DING INS PEC TOR
GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
z
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec, etc.
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip-Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate.
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girls-solid brick or steel plate bearing at foundations
'/2"air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min.22x30 w/3'headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
Firecode S/R wood frame of"0"clearance fireplaces&stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8%of floor area.
'A of required glazing shall be openable.
Bedrooms required min.20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing-Smoke Chamber-Finish
Smooth parging,clean joints,8"solid @ combust. Surf.
DECKS: Separate permit required:
Lag to house, provide flashing.
Rails min. 36" high, Baluster max space 5"on center.
Over 8'above grade, use 6x6 posts wllateral bracing.
Lag all posts and rails.
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee- $30.00(Be Ready).
Certificate of occupancy required prior to occupying structure.
Date.�
3837 f
ORT"
•1�o TOWN OF NORTH ANDOVER
o �
PERMIT FOR PLUMBING
,SSACMUSEt
This certifies that --Q
has permission to perform .::.- - ',ct . . . . . . . .
f
plumbing in the buildings
at�.L�. . .G.. . . -.- � . . . . . . . . ., orth Andover, Mass.
Fe e,90. . . . . . .Lic. NOYPP.;? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
10/16/98 12:19 q(y ()()
WHITE:Applicant CANA uildfflgDDept. PINK:Treasurer
. .. .`Type or Print) • - - - - • � •...w . . .. �. _... ..t..;• ,"i "v, �-�ua)o/.hG i ;
NORTH ANDOVER
,Mass.
Building Location 1y,/l dS 600y ST' Permit I •'
4'
Owners Name
.�
V • New '❑ Renovation Replacement E] Plans Sybmitted II � ' •
FIXTURFS '
N O Q1 O Z ~ O
• W Y .a P. . . ?• V < N .• a O � � � b'l
Z In < ¢ ¢ 2 h as z O Z ee
0 496
on 4n
to x ¢ < z ¢ a sy < t 3 >K •
iv z o a ac a a w Q CC J z tc a .o w
w = < xO Z x �C a o t < Y < W W
•i ~ > r- O N = W � Z O Q m z W t-
o
< < a < O a < ¢ is as < o < �-
Y -A tp 0 O J = 1•• aA 4. O G < O Q
Sua BSMT.
BASEMENT
IST FLOOR {
2ND FLOOR
3RD FLOOR
ATH FLOOR
6TH FLOOR
6TH FLOOR
TTHFLOOR '
8TH FLOOR
(Print or Type) / Check one: Certificate
installing Company Name Corp. 4;7&
Address. 14W11WWe1r_ 57--- Partner.__
Firm/Co.
Business Telephone 7
Name of Licensed Plumber: _
I1 Insurance Coverage: Indicate a type of insurance coverage by checking the
t appropriate box:
Liability insurance policy Other type of indemnity F] Bond ❑
Insurance Waiver: I, the undersigned, have been made aware- that the licensee of i
this application does not have any one of the above three insurance coverages.
I
Signature of ownerlagent of property Owne,r Agent�x ❑
I bcmbp ccttifr Wat all of tlw dctails and in(otmalion 1 ha.c sutodnit lcd lot camcd)in ahts-applioliow sial:feet Z:84,41 to Ow btu ei al
�. • k"torkdgc and tkal all pluabint was and inslallationt loco(at mcd undct rt:tlllit issued(*(this applicuion will Ito M Ol1NIPljawq milk w p"a""P`,
vlsioaa of the Maaaclwsclls$lalc Plumbing Code and Cluptct 142 of 111c(:cnct&I UwL sr
iII .
By
Title . Signature of 'Lice ed Plumber
City/Town: O Type of Plumbing License
iJ
zoapr rn 7oFFICF USE OHLY1 Linen a Number 0 Master ❑ Journeym&4
Jan-22-98 02 : 54P Landers Electrical Co . 978682- 1646 P .01
at Tlee Dowdlt'
77re Colnnlonweallh of Massocllusetis
' ter.Fl 4,
Dcpariment of FaUMC Safcfy
4r.partT a Tw O.ee�ra
VOARD OF F:inE PFIEVEIII WI REGUUIt'1C)ItS S27 Cb1R t2W 3/90 tF.a.. ►1...11
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR1<
An welt w SLe petfetmeJ In aeeerdanee r.Stl►i1.r Tiaraschweegtt E31clrical Cede. S27 CMII 12:00 Q
(MEA-SE PRlirl III INK OR =E ALL TltF0RfWr10I') • Date-
City or Zoon 6t� /(/r1 lZ77V6eZ11- Se the Inspector of WIrest
Sa wadtrsl"d arplies for a perbie to perfory the electrical %mtk described below.
laRaation (Street L timber) /,-.P// �� 4� C
71
Comer or 2enanc CIC L/ ,�s L D/,' /5: 7
Los .J
c•�
Loser's Address - 141Yle—
Is this perult in conjunction smith a building Ferolt: Yes 0 Ito ❑ (Check Appropriate Dox)
hexose of DuLldins >—ZC'�� S r Utility Authorization 110.
Ezi-sr-ting Service Amps 1 Yoits Overhead ❑ Und=rd ❑ Prs, of 14ters__
Te- Service Asps / Sols Overhead ❑ Undtrd ❑ No. of I-Seters
Tauber of Feedcra and iapacf ty
Iaeontlon and Nature of rIca l Hark
Fa_ of Lighting Outletstla. of Not Pubs 11a. of Transform•_rs ToVX
tsI
&s- of Lithting Fixtures SwErreing Fool. Etnd. ❑ Srnd. © Generators 1:VA
tic.Ax- of Rece tacle Ovt3ets Ito. of Oil aurners Amt er EUnits ey Lighting
p / R:ttery Units
F_ of Switch Outlets No. of Gas Burners FIRE MAIM Ito. of Zones
Tot:I Ila. of Detection and
is. of Ranges ho. of 'Alr Cond. tons InitioH na Devices
io. of Disposals tie. of pumps • loons ptzl ori lio. of Soatnding Devices
Na. of Set( Contained
ls. of v_stivashers Space/Ares Uzacing rV Detection Soune[ng Dtvl cts
a Connectl
ia_ of Dryert heating Devices T74 Local ConntctlonEjothtr
Mo, of ho, of l.ow Voltage
Fv, of mater Slesters rw SErns Ballasts 1lirinx s
Srm. Ilydro ILsssage Subs So, $f ISotors Total IIF
Epi ILK
rV51MAIICE CDVERAGEI rursuent to the requirements of Massachusetts General Laus
I have is current Li bilSt Insurance rolicy Including Cocrleted OPerstlons Covtregeor I a snbstsntial
elul.alent. IF.S I10 [� I have suTnittcd vnlld proof of sane to tIr[a office. t'ES(ti 110 L]
F1 yoct Mar�Ftojzme
cd IESr please Indicate tits tyre of Coverage by checking the appropriate box.
rt1SU=TtCE ❑ onmx❑ (rleese Specify)
—( xr rat on untcT
Estimated Yalu% of Electrical Norlc S
=ork to Start �_/5 I,g Inspection Date Rer;uestedt rovZh � L- Final
r:t�ed under the penalties of
F1 KAIM Al6 ESS ELf C'7-,e YL �-� ��ltt'. L1c. 7110. //
L{censee t/ ���R;7^ L�x1bCr ' �i 55lgnature / - �� _ =LIC. ILO. /`7"sj��
� 6e°rl ST /1/� l�C�E /9d Cl arra. Tel. No. P E-'e 7
trddresa %CGza. G'
Alt. Tel. tio.
r±.lMER'S IRSURJ.ItCE 1IAIYERt E an aware that the Llctnsee does not have the insurance[overate or its n—ice=o
stantial equlva[snt ss requtred by llassnchusetts cenersl laws list arm signature on thls pe t
application valves this requirement. R+ner . Agent (Flesse ci,cck one)
Teltplsone Slo: rERIIIr FEE 5 1
SIgnetwra of O.nser a= sent ' 1
01/22/98 15:58 TX/RX N0.7542 P.001
N2 " 'j c� Date........ .... .... ....`%
- r
�aORTM
°f,�`'°:•�"a TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
AcNU`��
Thiscertifies that .................. .pp.................^^.......((................................................�
has permission to perform ......F C 1M.Or Q `...............................................
...............
wiring in the building of..... �........���<<r S f
............mC.. ..
...... ... a,
OS ��Xi �Sf
at..... /...............f........... 12
................................. ,North Andover,Mass?
acO+
Fee...'5..: �.. Lic.No./¢S �a
ELECTRICAL INSPECTOR
O
C " fl tLfi �
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
U4t Lfommonwab of &10*1_
Erpnrnncrrt of Pubtic *nfttg Occupy A Fie Cid
BOARD OF FIRE PREVENTION REGULATIONS 527 CMA 12:00 also Pam b"k)
APPLICATION performed In accordance
PERMIT TO PERFORM ELECTRICAL WORK
withAll work to be the fvfassacnusetts Electrical Code, 527 CHAR 1100
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dote /—A 3—
. c�
Q* or Town of NORTH ANDOV R To the Inspector of Wlnec
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) _/)) Y d Sero 6 lJ S—/
Owner or Tenant rfz/I .1ik fpvt14Yv6LJl4 • / M11 w{rS.
Owner's Address 16;11 is 66o 1) S,7`
Is this permit in Conjunction with a building permit: Yes _ NO
(Check Appropriate Box)
Purpose of Building 4G I I S . IeS - Utility Authorization No.
Existing Service 1a 6 Amps 116 lA f/d Volts Overhead 'y�Undgrnd C1 No. of Meters •'
New Service Amps _J Vous Overnead _ Unagrna C No. of Meters
Number of Feeders and Ampaclty
Location and Nature of Proposed Electrical WOrK -t° W l/zi TcS al-c�t �Qw r k�,j�t✓
No. of Lignting Outlets I No. of `-lot -_=s r I No. of Transformers Total
KVA
No. of Lighting Fixtures i Swimming Pcoi Aocve.— ;n•
Srro _ Srno t—
_ I Generators KVA
No. of Receotacte Outlet I No. or Oil curners I No. of Emergency Lignung
Sartery Units
No. of Swttcn Outlets ( No. of Gas =_rrers FIRE ALARMS No. of Zones
No. of Range I No. ct Air C„r.c. .01al No. of detection and
!CSS Initialing Devices
No. Of OisoOsalsI No.ol Heat 'o:ai ..otai
Pur---s 'ons ;Vv No. of Sounding devices
No. of Sett Contained
No. of Disnwasners SoacerArea .+eaur.o 'r•% OetectiorvSounatng Devices
No. of Oryers I Heating Cev ces Kw — Municibal
Connection ^Other
No. or - vu j Low Voltage ;
No. of Water Heaters KW I Signs 'aitas:s Wiring
No. Hyaro Massage Tuos ' I No. of !Notcrs ,otai HP
OTHER.
INSURANCE COVERAGE. Pursuant :o the requirements ai %Iassacnt sers ;enerat Laws
I have a current Liability Insurance Policy mousing C;me etec Ccerauons Coverage or its substantial equivalent. YES — NO — 1
have aubmtRed valid proal of same to the Office. YES = VO = It you nave criecxsa YES. pease inorcate the type at coverage oY
cnecking the ao crisis oox. C
INSURANCE�BONO = OTHER = (Please Scec.`.1 �� ���II' JW SUgi41e jn11f WUILl2 -��-�1
/
Zj. 7
Estimated Value of E!sctncal Work S 5Z6. a I raf(n Data,
Work to Start ��1� �� Inscec:ion roar• Aac6es:ec: Rougn Fnal /a3'�d
Signed under :he Penalties 1 ort
FIRM NAME S t VY ��� -&I-lo,��
Licensee �•-PAP/2/Z& 12 S jj e � UC. NO.�� �/6�
UC. NO.
y
Address /6� JAW C S / /f1U/F�/ j/� Bus. 'rol. No. J
All. Tel. No. J C,Z
OWNER'S INSURANCE WAIVER: 1 am aware that the t-:censee ^_ces mot nave ins insurance coverage or its substantial eyurvelent se rw
hS
qurreo by Massacusetts General Laws. ano trial my signature an ^.s :ermit aopiicauon waives this requirsitnism. Owner Agent
(Plea" check onel-
• i
iieonons No. PERMIT FEE S 4✓ L/ {
G �•-� � �.�.• lSpnatwe oI Owner or Agenn
sJaY
L6. U i- Date...l.�
NOR7M
°ft °:•�"� TOWN OF NORTH ANDOVER
O P
PERMIT FOR WIRING
Cr
•O+,no.''��.h CL
ACNUS� 6
O
This certifies that s 1`� .�.. ..(
. ...L...... . ......... ....
.. ... .,. ..........................................
has permission to perform .....V` G (� t` �
.............................°........ . ................
wiring in the building of
...�u. . �.....................................................
o
at.... .�.�.... S�U...........�........................... .North Andover,Mass.,,
pp M
Fr:. Lic.No.d` ..............................................................
ELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
` Location �Z
No. " Date 7
NORTFTOWN OF NORTH ANDOVER
,� cA Certificate of Occupancy $
Building/Frame Permit Fee $
CNUsEt� Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
n
Building Inspector
Div. Public Works
CERTIFICATE OF USE & OCCUPANCY '�i
Town of North Andover °'
R � �
Building Permit Number T m-QA Date JAnuary 93. 1998
* TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES ON 4/23/98
THIS CERTIFIES THAT
THE BUILDING LOCATED ON
MAY BE OCCUPIED AS . Retail Florist outlet IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND i
SUCH OTHER REGULATIONS AS MAY APPLY.
CERTIFICATE ISSUED TO
�+ . °°
f p
ADDRESS 12-11 OS C O O D %'T
J ""'� Building Inspector
Temp. Certificate of Occupancy subject to the following conditions which must be
completed prior to 4/23/98
1) Construction of handi-cap ramp
2) Installation of ha.ndi.-care rest room
3) Installation of fire alarm per N.A.F.D.
4)' Low spots in yard & along Barker st. must be filled within 14 days weather
permitting
L
LANDERS
ELECTRICAL. CO., INC.
January 23, 1998
No. Andover Fire Department
ATTN.- Andy
124 Main Street
No. Andover, MA 01845
RE: McLay' s Florist
1211 Osgood Street
Dear Andy:
Per your recommendations, we will install the following
at McLay's Florist, 1211 Osgood Street, North Andover:
4 Horn Lights
1 in each (2) bathroom
1 in front of store
1 in back_ of store
1 Heat in Garage
1 Double-Pull Station at Front Door
1 Double-Pull Station at Back Door
1 Smoke Detector at Front of Store
1 Smoke Detector at Fear of Store
1 Smoke Detector in Cellar
Master Bo=; at Front Door w/a 4-Zone Annunciator
1 Zone Pulls
1 Zone Smokes
2 Sures
This will be installed as soon as the equipment is
available.
Sincerely,
Terry Landers
Vice-President
Landers Electrical Co. , Inc.
TJL/dcm
CC., Bob Nicetta/
Frank Terranova
1000 OSGOOD STREET P.O.BOX 783 NORTH ANDOVER,MA 01845 TEL(508)686-3828 FAX(508)682-1646
Town of North Andover NCRTH
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES ° .: A
30 School Street
�► North Andover,Massachusetts 01845
WILLIAM J.SCOTT 9SSACHUS�S
Director
Memorandum
To Robert Nicetta,Building Inspector
From: Kathleen Bradley Colwell, Town Planner
Date: January 20, 1998
Re: 1211 Osgood Street- McLays Florist
I am writing to inform you that the majority of Board issues have been resolved for this project
such that an Occupancy Permit may be issued subject to the following conditions:
• The site lighting must be completed prior to occupancy. Mr. Terranova reported to me this
afternoon that the lights will be installed by tomorrow.
• The entrance to the site from Barker Street and any low points in the parking area must be
graveled within 14 days, as soon as the weather allows.
The Planning Board is holding bond money for the remaining items required by the site plan
review approval. If you have any questions please do not hesitate to call me at 688-9535.
CC. R.Rowen,Planning Board Chair
F. Terranova
•
JAN 2 1 SW
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Town of North Andover °E NORTH
OFFICE OF 3? t`"f D /6.6 °L
COMMUNITY DEVELOPMENT AND SERVICES °
30 School Street
North Andover,Massachusetts 01845
WILLIAM J.SCOTT SSACHUS�
Director
Memorandum
To: Robert Nicetta,Building Inspector
From: Kathleen Bradley Colwell, Town Planner
Date: May 29, 1998
Re: !Occupancy of 1211 Osgood Street(McLays)
I have reviewed the Planning Board's site plan approval for 1211 Osgood Street.The following
items remain outstanding prior to occupancy:
a) All improvements outlined in the plans must be completed as certified by the applicant.
b) The applicant must submit a letter stating that the buildings, signs, landscaping, lighting and
site layout substantially comply with the plans.
c) The Planning Department shall approve all artificial lighting for the site.
I will inform you when the applicant has completed these steps.
CC. W. Scott, Dir. CD&S
F. Terranova
JUN 2 1998
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
„J
,350 YRS.
6 t4OR” J
p NORTH ANDOVER FIRE DEPARTMENT
* CENTRAL FIRE HEAD UART R
Q E S
124 Main Street
Ss4CHU5North Andover, Mass. 01845
WILLIAM V. DOLAN Chief (978) 688-9593
Chief of Department Business (978) 688-9590
Fax (978) 688-9594
To: Robert Nicetta,
Building Commissioner
From: Lt. Andrew Melnikas
Fire Prevention Officer
Re: McLay' s-Osgood Street
Date: May 28, 1998
This letter is in regards to the McLay' s building on Osgood
Street. Sprinklers are not required as the size of the
building fails to meet the required square footage.
The fire alarm system has been installed and does meet the
requirements of the North Andover Fire Department.
Please call should there be any questions.
Lt. Andrew Melnikas
Fire Prevention Officer
T:,
MAY 28
SERVING PROUDLY SINCE 1921
Nf„(Type or Print)v arasaa %04%4V6ha •a a_avt%aav,as•fVfl i-G[l1Y
� . i is ,. .�, • ,.� _
NORTH ANDOVER ,Mass. :a:f:`. pate;' -,;2 '30-,7
Building Location 1 /,� 9 g ad d s T' Permit I ;
Owners NameZe1'
v New '0 Renovation E] * Replacement ( Plans Syibmitted
FIXTURFS
z in M�
O W O 2 !•• > idO
W
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SUB-,BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
TTK FLOOR
8TH FLOOR
(Print or Type) Check one: Certificate '
Installing Company Name C ] Corp,
Address Partner.__
Firm/Co.
Business Telephone /v g- -7- 73 Q3
Name of Licensed Plumber: 4;
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy Other type .of indemnity [::] Bond Li
Insurance Waiver: I, the undersigned, have been made aware- that the licensee of i
this application does not have any one of the above three insurInce coverage$.
• Signature of owner/agent of property Owner Agents% 0 ,
I bwb Cellify Wal all of i)1c details and info,nsalion 1 Lave suLimillcd or cntcicd)in alw,.c a '
r l rMioliost rise lase and lots a Iles Mft r�
�.• hwowkdgc load[hal all plumbing work and installations lrct(o,mcd under reauil 116ued(or this applieatiow will bein p ;ii Mkk so patio”
YLiG"of lbs M"A"A sells Stale numbiat Code and Chipset 142 a(Ilic Genual LawL w
•
Title • Signature of 'Licensed Plumber
City/Town:
Type of Plumbing License
�
I I z QDonvrn 7OFFICF USE ONLYI License Number El Master [] Journeys"
Date.,ll�/9 . .
_ 35' 3
NORTh
�<< •° •1�v TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
7 SSACHUS� ti
4 /
This certifies that la
has permission to perform
. . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . `YI.-� .�f4�. S. .�'�u.. . . . . . . . . . . . . .
' at./.) /./. .0--, S;,.O C'. . . .-y. . . . . . . . . . . . . . . North Andover, Mass.
Fee� Lie. No.7�C.t. . o
PLUMBING INSPECTOR
3 �
r o
I
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
121� L,6-42-k
Location 2 C/ U , 14
No. 02-(zj-I l Date (''I" I t~`"
• - TOWN OF NORTH ANDOVER
�ED
D •
Certificate of Occupancy $
� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee S I'v -5 $
TOTAL $
Check# I�
v ` ` `' Building In pector
NORTH
p�ts�eo 16'9ti0
O�
yo '� p TOWN OF NORTH ANDOVER
T
A"`""'�""'`' * SIGN PERMIT
7 �Rwren rPa ,�5
�SSACHIlS��
DATE: June 2, 2015
PERMIT: 020-15
THIS CERTIFIES THAT Jason Ostrowski has permission to erect two signs
on 1211 Osgood Street Suite 2 A 18'x120" "The Soul House" and Directory sign
provide that the person accepting this Permit shall in every respect conform to the terms of the application on file in
this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover.
Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit.
a, INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED
Inspector of Buildings
Amount Paid: $30.00
Check 2113
Receipt# 28869
SIGN PERMIT APP LH CAS®�
1600 ob,19 i Street I��uflXrmg 20,Sante 2-36
�C® Jl`�0.7-NORTH AI`�I(DVI;Z ; Dare: Z$ 1
Name of applicant who is Purchasing the sign _ ,,,^� ,
Site Owner � C it L,� � -------
,�--r------ Phone#of applicant who is purchasing the sign—Cq-73? )2(_CC "Z$t11?
Site Address Oa U� qiG(' Name of sign company
Rhone
IPireeIl Size of]Proposed Siga�
How attached.- a)Against the.wall : �llunninafion: a)I�Tot-Mun2inated.
�C� _L��vl' b)Internally illuminated
b)Roof
c)Groundc)Exteknally illuminated
d)Other Materials: • i�I M n S/n.,n (..�} C �S
]Proposed Colors: Background f,.J L i t
Lettering (
]order—Z�6� ®st of Si p — 6
• Re¢pnnuneall Attae➢nunnermts^ 1`J®te: No pea�n.aanent/te�n or •
Photographs of building p aay sign shall be erected,or enlarged until an
Material sample application on the appropriate form finnished by the Sign Office has been filed
Color sample with the Sign.Officer containing such information including photographs,plans
Site or Plot Plai a and scale 4rawings,as he may require,and a pernnit for such erection,alteration,
(Required sigd for.all free-standing signs) or enlargement has been.issued by him. Such permit shall be issued only of the
Other,specify
c f proposed sign Sign Officer determines that the sign complies or wa11 comply with all
®they}specify ;
applicable provisions,of the ley-Law.
Will sign +"'
overhang any public road or walkway Yes( ) IST®(✓�
If Yes,Name of Agency who mill provide liability insurance:
ANINC
DATE]F1LED:
Receipt# Check#
y
Revised 10.31.2006Form Sign Permit Application SIGNATURE OF• APPLICANT APP�®yvDy
IBi
120 in 1� , TBE SOBS nom kt ARRSTQDI03C1Ia0
�BE�S� �0• S' '�'9 8T�D sc�a° 18�� TBE SOBS SOBS VeaasNac>aaa
�I
_ _ � lBE�S� �• S� �;a a s��crataa
a eKurt R.Wicks:
N Q
' I
4
r91.. iACR VL
oThe Soul House date 5/21/15
2MMo
sign anter 1112 Osgood Street, N. Andover, MA designed by N Earle
___............ ...... file name The Soul House Bulldlne SI¢n.olt
0
Panel to replace Fantastic Sams
r-
stic
M A 1 q A 1V p T A� �S►il .
NINO
=ALp�y
AllsR,
tate
1
QeFUSCO & Son Ragan Wery `
,
_ ;j
�- 110 in - — —
BARE & CYCLIXG
TEE SOUL EOUSE kt STUDIOS
p,o.: The Soul House date 5/21/15
�� @ sign center 1211 Osgood Street, N. Andover, MA designed by N Earle
w ORCIMAD STMU.H WRHIU-f 0,
11 Me name The Soul Mouse Tewt Sign,plt
Sales Associate Neeka Earle details 1I6"x 110"x 3/4"Panel for D,'F SIZp
3/4"Raised PVC Black Border
Dimensional Letters Painted Flack
Date-?..'�-?;/./5..........
NORTH
�r "' L TOWN OF NORTH ANDOVER
o s PERMIT FOR WIRING
1SS,C►N9��4
This certifies that .....<. _/............ t 7../1.........y.,.�..................................................
has permission to perform .f"7,V'.. ... :....1 f'. ..4......
wiring in the building of...%. ../........... �i,tic_.........................................................
10211 CSIs n G cf' c 1/..:................................North Andover, ss.
at ...................................... ?......................
?ee...�°J55 Lic. No.�.l.�•'S-3 ..................
..... ..... .....9
ELECTRICAL INSPECT
&ieck# `f d
Print Form
Comrrtoruuealth o� assacaiusefts
Official Use Only
oLJeParErnerr�o��ire�eruices Permit No. )- /Ml
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] Icaveblank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(M C),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
City or Town of: 1QPR-rA4 A4-A: To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)
Owner or Tenant 5-o tf L AaJ SC Telephone No.
Owner's Address I OSac,yQ S*
Is this permit in conjunction with a building permit? Yes ❑ No Q (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps 1 Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: frCi$,yl-�L Esc ;T 5,t 4,*4 <44+,,IJF ae57
Completion of the followingtable may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting
3 d. rnd. Battery Units �—
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Wtiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
Heat PumpNumber Tons KW No.o l ontained
No.of Waste Disposers Totals: __ -- --- ---.. Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other,
Connection
No.of Dryers Heating Appliances KW Security Syyssttems:
No.of ems:*
or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No,of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired.or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑✓ BOND ❑ OTHER ❑ (Specify:)
I cerlify,under the pains and penalties of perjury,that the information on t s appl' ation is true and complete.
FIRM NAME: DAVID ELECTRICAL CONTRACTING LLC LIC.NO.:
Licensee: DAVID HAGGAR Signature LIC.NO.: 14963
(Ifapplicable,enter "exempt"in the license number line.) Bus.Tel.No.:978-682'6262
Address: 87 BELMONT ST,NORTH ANDOVER, MA 01845 Alt.Tel.No.:978-375-5734
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)[Jowner El owner's a ent.
Owner/Agent PERMIT FEE. $
Signature Telephone No. �
V
COMMONWEALTH OF MASSACHUSETTS
� e o o - e •
BOARD IN
Ei ECrR I C I ANS €
;,ISSUES THE FOLLOWING LICENSE AS :A
REG I,STFRED MASTER ELECTR'I C I'AN': '
'I if
KR1.:STOPHER D HF,GGAR
b,L
631 RIVERSIDE -AVF '`,: w
��
APT::: 2x'..
H:
AVE ILL -:14 O1830-67:
21553 '4 07/��!1 32655
3 Lr 7 Date. .. ,�.12.1,).]r. .
Np/tT/y TOWN OF NORTH ANDOVER
pF 4 1ti
e p
0 ' `A PERMIT FOR MECHA14MAL INSTALLATION
•
SSACHUSEtt
-
This certifies that . . . . . . . . . .
has permission for mechanical installation /ISP 104A- 'G. . :/in the buildings ofrQ`.��. �1� 1(,�,. . .� .t -+ . . . . . . . . . . . .
at . . ., . . .�l't . .r 11. . . . . . . . . . ., North And ver, Mass.
Fed,-36. . . . Lic. No...�.� .a b�/�j1 Z. . . . . . . . . . . . . . .
GAS INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
b
S(hely srooh �. �aas �0.�5 C�1�a�a
Q02WO9775
APPUCA11ON FOR PERMIT
r, DIG SAFE NUMBER
City or Town 'V o o w f�_c./ .
Date 4 IL - Start•Date:.
In accordance with the provisions of M.Q.L. Chapter 148,as provided in Section 10A application is hereby made
by �) a Ai
PWn3=
Address
(Street or P.O.Box)M or Town)
For permission to (state clearly purpose for which permit Is requested) Rake` alterations to/or install the
tem.
.24 11 OS
Name of competent operator(If Applicable) ELi avi S� 00 �6f LZ.Date Issued-rejected By.
( 71
*fAppftwQ
Date of expiration Fee - $Paid Due
.--- ------ +.—.,.,.—_ ---__..--_.--_..._...---.,.--
VF"of&W 0 94&446� .
(MV. 9D 19- Maw 90 5, e&& 6$ta,GAW 07779
PERMIT
City or Town DIG SAFE NUMBER
Date
Start 4ate:
Permit Number('d applicable)
In amordance with the provisions of M.G.L:Chapter 148,as provided in 10A this permit Is granted
to
(FuM rmme of person,Fmt or corporation)
for
Restrictions: ,
at --- --- - -
(G ive location by street and no.,or dascn7w In wo rnenneras to pmOde adequate Iden0catlon of location)
Fee Paid$ This'Permit will expire on
Signature of Official Granting Permit Tdfe
Commonwealth of Massachusetts
�!J : Department of Public Safety
SPrinkler•c4)nt,-urtor
License: SC-004522
EDWARD
.1PlaLAN931 F �
N ANDOVER OT 845 Z -#1'
commissioner 'Expiration:
03/20/2016
�y
The Commonwealth of Massachusetts
Department of IndustrialAccidents
a , a 1 Congress Street,Suite 100
Boston,MA 02114-2017
www mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information yam/ Please Print Legib
/ ly
Name (Business/Organization/Individual): "dK V f '
Address: 0 ?� X4 S l
City/State/Zip: L. W Ale— A otq4hone#:
Are you an employer?Check the appropriate box: Type of project(required):
en-
1.[1 I am a employer with employees(full and/or part-time).* 7. ❑New construction
2.F1
I am a sole proprietor or partnership and have no employees working for me in $, remodeling
any capacity.[No workers'comp.insurance required.]
9. ❑Demolition
3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
10 ❑Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs M
These sub-contractors have employees and have workers'comp.insurance.$
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
IL
*Any applicant that checks box 41 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 Name: l� �
Policy#or Self-ins.Lic.#: W C C., �Q C) � 3 a r, piration Date: a Y D
Job Site Address: City/State/Zip:A Al'�'P JV
Attach a copy of the workers' compenidtion policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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 fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido hereby c tify under to pains andpenalties ofperjury that the information provided above is true and correct.
Si nature: Date: 2
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.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the cityor town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
Tel. # 617-727-4900 ext. 7406 or 1-877-NIASSAFE
Fax# 617-727-7749
Revised 02-23-15 www.mass.gov/dia