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HomeMy WebLinkAboutBuilding Permit #824 - 1503 OSGOOD STREET 6/11/2007 41 4101'u hAJ t►ORTW r BUILDING PERMIT of�t��D �b 6+ I TOWN OF NORTH ANDOVER `' i/6�/ ? �+APPLI0� o CATION FOR PLAN EXAMINATION %_ * o4q w ti Permit NO: �� Date Received 3 DRATD `�9 9SSAC G + Date Iss _Z_.r Z IMPORTANT: Applicant must complete all items on this page Idt 411 HIST�RLG TRIC „nr� A TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building a2V1 Te,,Q,4 ❑ One family ❑ Addition Cv,qave- ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg Others: �� \ ❑ Demolition ❑ Other 1 et[c VllellFlocdplatr � Wdtlar�d atrshed District u 'Vllaterew .rte .. ,. ". � m. _. IM ; DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: r-�-CV a c � Phone: t-2- o 1 Address: I CT(o� <o �� sAvAout -r A c -77 � � s� �a .` Ar COLI RACTOt �rr�e 7 Address = x Y' - ,ria „ r m r - .f -`��a�✓ ` dye _77 „ Az- a •'" ^» =_, Supervisdr's Constru tion ensu ��� SEX Date. Hdme lmaproyemervt,•Llc , a r� CC ARCHITECT/ENGINEER t rv-, v�il� Phone: (:) Z 73-� Address: J, �J 8 '� A - Reg. No. ��S_7 or FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �-� FEE: $ LIQ a� Check No.: _ Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ �-� p THE FOLLOWING SECTIONS FOR OFFICE USE ONLY 0 INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DAATE APPROVED PLANNING & DEVE OPMENT ❑ 1011 "'i41 o COMMENTS L4=, Dom, A„ DATE REJECTED DATE APPROVED CO ERVATION ❑ El OM S i DATE REJECTED DATEAPPROVED HEALTH ❑ COMMENTS ZC5 7 5 -7444- TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ j l Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ i � Il I zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes j i I I Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit Located at 384 Osgood Street r k R , FIRS DEPARTMENT -,'temp Dutlpster on site yes no Located of 1� 4 Mair Stet Erre:Departmentsignatu a/dater w . 57 Ct)MMENT'S r x h Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land areasq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan o 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan w ❑ 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 ❑ Engineering Affidavits for Engineered products NOTE. All dumpster permits require sign off fromFire Departmentprior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 I Revised 2.2007 1 NORTH o oAndover No. .�. . o '� dover, Mass., O 1. COCMICMEWICK V 7�S 5 RATED 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System � ' 1 BUILDING INSPECTOR THIS CERTIFIES THAT �Iy�,. �.... .Q ,.hA�Ts C'" 1 !J� r4v� ...... . .. ..... ............... .................. .................................. ...-.......... Foundation has permission to erect........................................ buildings on .... ..... ....?.................. Rough to be occupied as.....&. •:••.•... •� h I�in v res Chimney provided that the person accepting this permit s a eery respect conform to the terms of the 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S Rough ................. Service BUILDING INSPE TOR 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 Ingpector. Burner Street No. SEE REVERSE SIDE Smoke Det. 03/29/2007 23:45 FAX 508 362 9718 N E DESIGM SMITH KELLY Q001 ua1zf.zuu( ui.:A,v I:FN'UA MGI LUMHANY PAGE ©= OFFICE OF BUILDING INSPECTOR 70WN OF NORTH ANDOVER ' CO STRU TIO N CGNTR ` PROJECT NUMBER: PROJECT TITLE• PROJECT LOCATION: t � NAME OF BINLdINO: h c (7:�r LS fi NATURE OF PROJECT:_ fnl> 2-7 u► _ v '�4 f{ r.� 1 IN ACCORDANCE WITH AF%7,pLE 116 OF THE MASSACHUSETTS STATE WIT COOS, 1' REGISTRATION NO. BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HERESY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT Q ARCIITECTURAL-,& STRUCTURAL O MECHANICAL D FIRE PROTECTION ELECTRICAL 4® OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT.TO Tl I IIEST OF MY KNOWLEGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET TMS AFftjCABLE PROVISION OF THE MASSACHUSETTS STATE.BINLD m CODE,All ACCEpTABW ENGIN MNa P'RA ncES. AND APPLICABLE LAWS ANO ORDINANCE3.S FOR TME PROPOSED USE AN[)OCCUPANCY. I FURTMR CERTIFY THAT I SMILLL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPR&&ENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO OETERMING THAT THE PE WA D RESPONSIBLE FOR TW FOLLOWING AS SPECIFIED ryIN SE�pN 1 B 0 ��� 1. Review,for avr>formgr>ce to the desw concept,shop M►t &.a11IEJtes and other s<brr>ltte� which ane stabrrtil by ft Corlhactor In mo dove with the r8QY w"er%of Um duction dm"lm qt. 2 Reviewand approval of the gtaity mgl P10ceddures for all oodere"red cw*oIIed oarms. 3. 89 Present st htmsls apPrvprfet6►to MIe stage of=Wmnmto Mm. 9�MN fatttillar VA@aw PrO9mft and 4Lffi ty Of the vmrk and to dstwrM e,in general, N the w"Ie W" Periorrrled In a nmm&eonddent me the ewabudim doLvrrteb. PURSUANT TO SECTION 1162.2 184ALL SUBMIT WEEKLY, A PROGRESS REpORT TOGETHER WITH PERTINENT OOWAENTS TO TME NORTH ANDOVER BUILDING INSPECTOR. UPON ION OF THE SAT18FCACTOR�Y COMPLETIONAND READINESS OF THE PROJECT R OSUSMrr A FINAL REPORT ASCV.- SU RIBED AND SWORN TO M j/ BORE M+IE THIS ��_t]AY OF e�-�- SUSAN E.KIND PUBLIC WOMMic Cwronomweafth of Massachj%C SSIOM EXPIRES L1PL e7 My C�mmia xn fetes Nrndnl>¢r29,2{ID7 MAR-27-2007 TLE 12:12PM ID: PACaE:2 Saint Miguel's Construction Company 1000 Osgood Street N.Andover, MA 01845 -4 3/25/2007 Proposal Submitted to: JOB NAME& LOCATION Gregory Cafua Dunkin Donuts N. Andover, MA 17 Prides Circle 1503 Osgood St. Andover, MA 01810 978-852-9846 We hereby submit specifications and estimates for construction of: Dunkin Donuts unit The total contract sum is $40,000 Any work requested by customer not specified in this contract will be billed separately. This agreement is made between Mr.Gregory Cafua and Saint Miguel's Construction Company A��Authorized Signature Date of Acceptance 3 a, Note this proposal may be withdrawn by us within 10 days. PAYMENT SCHEDULE AT SIGNING OF CONTRACT: $20,000 AT COMPLETION: $20,000 TOTAL: $40,000 i 15�fis r?Fanvnwniveaac o ✓�uaYtttLGe% ' BOARD OF BUILDING REGULATIONS AKI I License: CONSTRUCTION SUPERVISOR = Number: CS 081897 Bifoliate 10/23/1967 , Expire s:lU/23t20U7 Tr..no: 7778;0 Restricted:_06 GREGORY J_-NOLAN` 13 WOODLAND AYE KINGSTON, MA 02364 Commissioner A ✓��0�97A1t.69ElllPA.LLfL Q�✓��LQ06tLGfLCf•6P.�6 Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 154517 Board of Building Regulations and Standards Expiration: 3/15/2009 Tr# 254570 One Ashburton Place Rm 1301 Boston,Ma.02108 Type:, Individual GREGORY J.NOLAN GREGORY NOLAN 13 WOODLAND AVE.' �••� KINGSTON,MA 02364 Administrator Not vali wt ignature 00735,00 O:d enclosed space (MGL C112 S.BUL) 1A,-Masonry only 1G-1&2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for.revorxtion of this license. DIG SAFE CALL CENTER: J888)344-7233 ATE ACORD„ CERTIFICATE OF LIABILITY INSURANCE D7/2007/13:08 Y) 03127/2007 13:08 PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fred C.Church HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 41 Wellman Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lowell,MA 01851 800-225-1865 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A American Home Assurance Co. St.Miguel Construction,LLC INSURER B: First MemInnce Company 1000 Osgood Street North Andover,MA 01845 INSURER C: Harleysville Worcester Insurance Company INSURER D: INSURER I-- COVERAGES 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. INSR ADDL POUCYNUMBER POLICYEFFECIIVE POLICYEXPIRAiION TYPEOFINSURAN DATE 1MMfODfYYI LIMITS GENERALLIABILITY EACH OCCURRENCE $1,000,000.00 DAMAGE-T70 RENTE15- X COMMERCIAL GENERAL LIABILITY PREMISES Ea ocGaence $50,000.00 CLAIMS MADE OCCUR MED EXP(Any one person) $Excluded B FMMA0001322 10/5/2006 10/5/2007 PERSONAL&ADV INJURY $1,000,000.00 GENERAL AGGREGATE $2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000.00 POLICY F1 PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000.00 ALL OWNED AUTOS BODILY INJURY (Per Person) $ C X scHEDUI.EDAUTos BA5J1149 7/21/2006 7/21/2007 X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN FA ACC $ AUTO ONLY: AGG $ EXCESSNMBRELLALIABILITY EACH OCCURRENCE _ $_ OCCUR FICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORD COMPENSATION AND IAC sTATu- o R Y EMPLOYERS'UABIUTY A ANY PROPRIETOR/PARTNER/EXECUTIVE WC8948464 7/21/2006 7/21/2007 E.L.EACH ACCIDENT $1,000,000.00 OFFICER/MEMBER EXCLUDED? EL.DISEASE-EA EMPLOYEE $ 1,000,000.00 If yes,descnbe under 1,000,000.00 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENr/SPECIAL PROVISIONS Operations usual to Carpentry&Construction CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town Hall DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL lO DAYS WRITTEN orlh Andover,MA 01845 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) Client# 3411 Mst# 06-07 Pols2 Cert# 0 ACORD CORPORATION 1988 it The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name(Business/Organization/Individual): C� \ Address: L d<,o nSeo®� S r r City/State/Zip: N . r1&f 6 17 Are you an employer?Check the appropriate bo:: 1.�.I am a employer with �' 4. ❑ I am a general contractor and I Type of project(required):, employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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 any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.t 9• ❑Building addition required.] 5. ❑ We are a corporation and its 10.[1 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL insurance required.]t c. 152,§1(4),and we have no 12•0 Roof repairs employees.[No workers' 13Q Other comp.insurance required.] CL/ *My applicant that checks box#1 must also fill out the section below showing their workda'compensation policy information. t Homeowners who submit this affidavit indicating they aro doing all work and then hire outside contractors musts informit ation. new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers comp.policy oli number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. An,a.cS, „ra,�«G�. Insurance Company Name: j`�ss �(9r1PySv lig 1��^Cesiafh5utz��Ca F•n,MA ocU 13 7 t o/s 7T-7 Policy#or Self-ins.Lic.#: j3 A 5 S�iy a �,� g,4a Expiration Date: Job Site Address: 1 5 O-_� o saw 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 e. 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 covers a verification. I do hereby certify and a airs Wallies of perjury that the information provided above is true and correct Si afore /Z7 / —y Da e• Phone � l [6. fjlcial use only. Do not write in this area,to be completed y city or town ojjtciaL ity or Town: Permit/License# suing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector Otherntact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requiresµll emplo oinrovideworkers,compensation for their the service of another under any contract�oflhire,s Pursuant to this statute,an employee is defined as"...every person 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 partnership,association or other legal entity,employing employees. However the receiver or trustee of an individual,p p+ s therein,or the occupant of the owner of a dwelling house having not more than three eenconstructiond who eor repair wok on such dwelling house dwelling house of another who employs personsto do maintenanc 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 o�ll�cue t bu=ilding inhh utmmold the issuance onwealth for any renewal of a license or permit to operate a business or to 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 t signand chin he affida not the affidavit shof d be returned to the city or town that the application for the permit license is g requested, 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. the permit/ number which will be used as a reference number. In addition,an applicant Please be sure to fill u that must submit multiple permit license applications in any given year,need only submit one affidavit indicating current policyinformation(if necessary)and under"Job Site Address"the applicant should write"all locations in-(City town)."A copy of the affidavit that has been officially sor tamped or marked by the city or town maybe 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 bum 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-$77-NMSSAFE Fax#617427-7749-- Revised 11-22-06 www.mass.gov/dia i bex t�.q A.Q Q F G 4 "Y * i, 9 eaAtC rik.tt wt �` SDkgrmez Ppr SSS tC�U a � PUBLIC HEALTH DEPARTMENT Community Development Division � 1 May 24, 2007° Cafua .anagement Co., LLC Attn: Greg Nolan, Director ot'Development: 1000 Osgood Street North Andover, MA.01845 Re: Plan review—Dunkin Donuts at 1503 Osgood Street 'Dear Mr. Nolan, This correspondence is to inform you that the North.Andover Health Department has received your revised application for a new food establishment at 1503 Osgood Street. With these revisions the plan dated 5/21/07 has been approved. A copy of this approval will be forwarded to the Building Department. Be advised, if any substantial changes in the plans occur during construction you are expected to advise the health:Department. Once basic construction is complete and the equipment is in place, please contact the health office for a construction inspection to veri4,that you have built it to plan. At that time we will sign off the building permit. The final health inspection should be requested approximately 24- 48 hours prior to opening the establishment. At the final inspection, it is expected that the premises will be ready for business. If you have not already done so, please make sure that all permit fees are paid prior to requesting the final inspection. To receive the permit to operate at the final inspection: i) The establishment will be clean of all construction materials 2) The hand sink and bathroom will be stocked with a wall mounted paper towel and soap dispensers 3) Handsinks should be labeled"hand wash only" 4) There must:be test strips for the sanitizer on site 5) There must be Sanitizer on site. Directions on mixing the sanitizer should be posted. G) The three-bay should be labeled "wash, rinse, sanitize" 7) Gloves must;be on site, Please note that:the state does not recommend the use of latex gloves due to some person's sensitivity to latex that may cause them illness. S) At minimum, employees should be trained on the sick policy and sanitation basics. 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 078.688.0540 Fax 078.688.8476 lAte A vnimtownofriorthandover.corn • You must meet the state code requirements to be allowed to be open for business including, but not limited to the list above. This correspondence is a Health:Department plan approval only. Please be advised that other departments may have specific requirements. This approval does not supersede any other department's request regarding other town or state regulations. Please contact this office if you have any questions regarding this correspondence. We look forward to working;with you in the continuous effort to provide safe food the public. Sincere ya san Sawyr,R. �a, Public Health Director �v Cc- file Building Dept:. i 1600 Osgood Street, North Andover, Massachusetts 91845 Phone 97$.688.9549 Fax 978,688.8476 Web unimtouuno#northandover.com The Shelburne Architects T 413.625.2584 Joseph P.Mattei&Associates,AIA F 413.625.2329 25 Guy Manners Road E imatteiftughes.net Shelburne,Massachusetts 01370-9630 5/16/07 Mr.Gerald Brown Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 / J / Re; Convenience Store 1530 Osgood Street North Andover, MA Architect's Site Visit Report#SVR 0530-2 Date of Visit: 5/15/07 3:30 pm Present on Site; General contractor, site contractor,carpenters and laborers,sprinkler and electrical con- tractors. Work in Progress; Exterior;site contractor working on infiltration system. Carpenters finishing entry gable. Interior; miscellaneous electrical and sprinkler work. Items Requiring Attention: Fire caulk at framing is to be installed by the insulation contractor. 50 pound per square foot loading to be posted adjacent to attic access ladder. General Comments; Exterior;gas island canopy and slab on grade complete. Convenience store brick masonry, siding,fascia and soffits installed. Roof and storefront windows in place making the building water tight. Interior; under slab plumbing installed and concrete slab on grade in place. Interior wood stud framing complete, blocking, nailers and draftstopping complete. Roof trusses braced and installed as per shop drawings,ready for insulation. Electrical rough inspected, HVAC trunk lines installed,fire suppression sys- tem rough installed. All work appears to be in conformance with the original working drawings. Submitted by The Shelburne Architects on an, P ject Manager 6 - 22 JOSEPH P,MATT T11 Joseph P. Mattei,AIA, Principal a No. 3ss7 6REENFIEI D,1idS§ �F,4(TH OF M'F The Shelburne Architects is a Full Service Architectural Firm Serving MA, VT, CT, &NH. Page 1 of 1 NO R Th► pF���Eo Te gtioo ,. -- H 2 � O COC "ICHIWKN s N RArED SACHUS TOWN OF NORTH ANDOVER Sign Permit Date: June 6. 2007 Permit Number: 042- 07 THIS CERTIFIES THAT, 1503 Osgood Street, LLC - Dunkin Donuts Has permission to erect Wall sign 17.36 sq ft —non illuminated On 1503 Osgood Street provided that the person accepting this Permit shall in every respect conform to 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 INTERNALLY]ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings s SIGN PERMIT APPLICATION �14 1600 Osgood Street Building 20, Suite 2-36 ;ZZI TOWN OF NORTH ANDOVER Site Owner 1503 Osgood Street LLC Applicant John smolak_ Esq Tel 97s_327_s9l-5 Site Address Size of Proposed Sign 2.98 sq ft each (3 total) May 34 Parcel 7 Illumination: Not illuminated✓ How attached: a) Against the wall n/a b) Internally illuminated b) Roof n/a c) Externally illuminated c) Ground n 1�, d) Other dire tional Materials: aluminum cabinet with polycarbonate (plastic) Proposed Colors: Background white fa Lettering dark brown Cost of Sign $500 each Border dark—brnym Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until an Photographs of building application on the appropriate form furnished by the Sign Office has been filed Material sample —see attached specifications with the Sign Officer containing such information including photographs, plans Color sample —see attached specifications and scale drawings, as he may require, and a permit for such erection, alteration, Site or Plot Plan(Required for all free-standing signs) or enlargement has been issued by him. Such permit shall be issued only of the Drawings of proposed sign —attached Sign Officer determines that the sign complies or will comply with all Other, specify applicable provisions of the By-Law. Will sign overhang any public road or walkway Yes ( ) No (X) If Yes,Name of Agency who will provide liability insurance: n/a AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: Receipt # Check# Revised 10.31.2006Form Sign Permit Application SIG TUBE OF APPLICANT APPROVED BY ��G PAINTED WOOD CUPOLA (ILLUMINATED)WITH COPPER ROOF IX- CONVENIENCE STORE � SIGN PANEL I u I r I I IEli r n u u iL9.._1 — — L� Commonwealth of Massachusetts City/Town of NOWMAN System Pumping Record R CEIVED r` Form 4 FEB 3 2009 DEP has provided this form for use by local Boards of H7here. s may a used, but the information must be substantially the same as that provierby"" dp t your local Board of Health to determine the form they use. The System Pum Ing4mr.'U ?W"`A i 3 i ed to the local Board of Health or other approving authority within 14 days from a pumping date in accordance with 310 CMR 15.351. A. Facility Information Important: l U When filling out 1. System Location: forms on the 15 d 2) 059 do V 5 i computer,use only the tab key Ad re to move your01114.9 cursor-do notCit /Town i State Zip Code use the return Y key. ��`----�� 2. System Owner: Ran �eVelop^rnev\� Name Address(if different from location) Citylrown State Zip Code q-78- 375 - 49U Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: 71A­10Gallons 3. Type of system: ❑ Cesspool(s) [Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): / [2/ 4. Effluent Tee Filter present? [9 Yes El No If yes, was it cleaned? [ Yes ❑ No 5. Condition of System: alimi 6. Sy tem Pumped By: Name Vehicle License Number Ipswich Water Company Treatment Plant 7. Location where contents were disposed: Ipswich, MA 01933 i Signature of Hauler Date I Signature of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Location No. Date MaRTM TOWN OF NORTH ANDOVER + Certificate of Occupancy $ �— Building/Frame Permit Fee $ y�►- 4CMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # -54 Z,- 20L56 ----'�' (� Building Inspector