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HomeMy WebLinkAboutBuilding Permit #713-14 - 1593 OSGOOD STREET 4/15/2014 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received I f I Date Issued: I PO TANT:Applicant must complete all items on this page LOCATION , � S G� IS Q S -e-(J16, . j Pnnt.'J I��tI Z) f& 10L2f. PROPERTY OWNER- _ C ti tC't o G,Qt� via ��t _ Print 100 Year Old Structure yes f MAP NO: PARCEL: ZONING DISTRICT: Historic District yesMachine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District El Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 7/ .4�6 Z zC V Identiticatio Please Type or Print Clearly) OWNER: Name: N ti c1�a�c� �i ct � 'n�� k- t`� Phone: Address: CONTRACTOR Name: C fCu / to o Phone: Ztl S-1-1 3 ?P' Add ress: 0d n 7Q 72-J Shit/ 12) it' n r f 67 Supervisor's Construction License: ©6 0 L 2_ v Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTr BASED ON$125.00 PER S.F. Total Project Cost: $ 3-5,60, 40 FEE: $ 6- Check No.: Receipt No.: d � NOTE: .Persons contracting lwit�h_funregistered contractors do not have access to the guaranty fund Signature of Agent/Owner c,✓ �✓`^ WV Sig afure of contract V I Plans Submitted LJ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ -Certified Plot Plan ❑ Stamped Plans ❑ TW-E--OF:;SEWERAGEDiS-P-OSAL i Public Sewer ❑ Tanning/Massage/BodyArt ❑_ . Swimming Pools ❑ Well ❑ Tobacco.Sales _ToodPackaging/Sales ❑ Private(septic tank,-etc- ElEl Duinpster on Site THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE:APPR- "ED U- /I CANNING DEVELOPMENT` ❑ �7 COMMENTS l� 10/ e CONSERVATION Reviewed on Signature COMMENTS YEALTH Reviewed on XSi nature VV COMMENTS ter' i 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 DPW Tovvo Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT. Tenip Dumpster on site .yes no Located at,124,Mair; Street--- `' r, Fire Department"signature/date-" COMMENTS �'' - im-ension Number of Stories: Total square feet of floor area, based on Exterior dimensions._ ..Total-land-area; sq. ft.: ELECTRICAL: Movement of.Meter,location-, asst or service drop requires approval of :Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL.Chapter166.Section 21A-F and G min.$10041000.fine NOTand DATA— (For department use I ArLz' 4 r � } i - El Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department . The following itra=list of the*uired.forms to be-filled out-for the.appropriate.permit to be obtained. Roofivg, Siding, Interior Rehabilitation Permits oRuilding Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.1.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 o Building Permit Application o Certified 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) ❑ 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 o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses Li 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 from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw-�al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must bP submAted with the building application Doc: Doc.Building Permit Revised 2012 Location No. 7/3- Date •'= TOWN OF NORTH ANDOVER ri n i �' • • Certificate of Occupancy $ Building/Frame Permit Fee $ f&E � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# �' Building Inspector Location No. Date i . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /db� Check# 0 �/— wilding lnspector Of Nox7M 32.tt• OL O p 4 X78 tiCHUSE{0 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 713-14 on 4/15/2014 Date: September 4, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1593 Osgood Street MAY BE OCCUPIED AS The Cork Stop IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Nicholas Pa antonakis— 1591 Osgood Properties LLC P g P 1593 Osgood Street North Andover,MA 01845 r Wilding Insp ctor Fee: $100.00 Receipt: 27991 Check :8280 I � �yORTl1 ty Town ofndover 2 C - No. h ver, Mass, coc N1c eye wrcw y1' I U BOARD OF HEALTH Food/Kitchen Septic System PERMIT T THIS CERTIFIES THAT I... ... .... �.K•....1�T�o►,� S BUILDING INSPECTOR ............... ..... ... ....�. .. d . ... . ... ...... has permission to erect .................... buildings on ...Irl.. .......��. .�� ........... .... Foundation y� . f6ugh ' to be occupied as ..... ........ !!.��/..4..�+.�.�Ar....A-s..... .!w... fe �!� ...... Chi neY rovided that the erson acce tin this ermit shall in eve res ect conform toterms of theapplication p p p g p ry pincl � on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES-IN 6tNTHS ELECTRICAL INSPECTOR., UNLESS CONSTRUCTI L COP& _���= Service ..... ........................................ BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin Rough Display in a Conspicuous Place on the Premises --Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. L% NORTH Town sAndover to No. ooh ver, Mass, CDC"ICAW.CK 1- 0t#A rE D ok,? S U BOARD OF HEALTH Food/Kitchen PERMI-T T Septic System � THIS CERTIFIES THAT ............1.. ... .....caor.pw...... 0.'.'P.... ....1. ... d�S.. .... ...... BUILDING INSPECTOR has permission to erect . ..................... buildings on �.1 �..�. O.&J. .0.10d Fofndai.......... ..... N �s_,eaw to be occupied as ..... ........1.V.�1�. .. 1�. �i.... !j:......� ... ...� X15'..... .!!............. Chi provided that the person accepting this permit shall in every respect conform to a terms of the application final '� on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES-IN6 NTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI Rou h .r`�..i_ -� .. g Service ................. ...... .......................... BUILDING INSPECTOR. GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. _Y�v F NORTH Town ofndover _ : � O , to �. h ver Mass o COCNI9 (4 C MI WICK I. TEO S V BOARD OF HEALTH Food/Kitchen Septic System PERMIT T I � s BUILDING INSPECTOR I THIS CERTIFIES THAT ...............�... ... ..... .�.. -.....�T�,, ,, .... ....�. S j .. d ........ . .... ...... has permission to erect .................... buildings on ...�. q..a.......0. .�� ........... .... Foundation 1 ,/� F�ugh to be occupied as ..... ........ .a.✓... ..��.ou....*s......# R... fe .4.1a5....�!!!�........ chi ney provided that the person accepting this permit shall in eve respect conform totermsof theapplication p p p g p ry p on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES-IN 6 NTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI Service .. ................. ...... .......... ........................... final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. - Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 31500.00 m $ - $ 42.00 Plumbing Fee $ 5.25 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 5.25 Total fees collected $ 152.50 1593 Osgood Street 713-14 on 4/15/2014 Tenant Fit Up-The Cork Stop I i NORTH Town of 2 I, Andover 0 A- I _n No. _7 — I3 Iz n ,� oh ver, Mass, COCLAKE NICMl WICK 1 �A �V S RATED I L) BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT �... ... ..... �..�....�....�.� has permission to erec;?M4' ................ buildings on ... . .. . 0Foundation Rough to be occupied as ...... .....�.��.4... ....�.�i....A�s......��.....fe .��.1!lS:..................... Chimney provided that the person accepting this permit.shall in every respect conform totermsof the application Final on file in this office, and to the provisions of,the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6NTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI Rough Service ................. ...... .......................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name(Business/Organization/Individual): (4o Z/oQ,t Address: O City/State/Zip: 5 GO 4-U,(I'Co T'fi Phone#: 3 7�1 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 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.t 7• ❑Remodeling ship and'haveno employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. g Building addition [No workers' comp.insurance 5. El We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑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.❑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 aie doing all work and thenhire outside contractors must submit a new affidavit indicating such. tContractors 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:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 requiredunder 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 certtfy under the pains and penalties of perjury that the information provided above is true and correct. Sinature__ � Date: -3 —j 7 Phone#: -7 1-1 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.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: 1 - i Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Super icor License: CS-060120 NICKOLAS L NIKOLOPOULOS,- PO BOX 325 = i� 10 Swampscott MA 0J907 tXplrailOn Commissioner 07/22/2014 I I i I i 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-contractors)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 maybe 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 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 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 Gmmonwoalth of Ma ssachv.:setts Doparlment of Industrial Accidents Office of Iuvestigations 600 Washington Street Boston,MA.02111 Tel,#617-727-4900 0A 406 or 1-877-MASS AFE Revised 5-26-05 Fax#617-727-7749 WWW.Mass.gouldia N&N CONSTRUCTION 437 WESTERN AVE LYNN MA 01904 781 -581-3785 THE CORK STOP NICK PAPANTONAKIS 1593 OSGOOD ST FOTIOS STAMOS N. ANDOVER MA 617-293-8557 1) REBUILT OF 76FT OF 2X4 WALLS AND CLOSE OF 12 WINDOWS . 2)INSTALL SOME OUTLETS AND INSLATE NEW WALLS TO CODE. 3)INSTALL 1/2 INCH SHEETROCK ON NEW WALLS. 4)TAPE AND PLASTER WALLS AND PRIME AND PAINT 2 COATS ENTIRE SPACE WALLS AND CEILINGS. 5)INSTALL NEW TILE FLOOR. 6)TAKE AWAY ANY CONSTRATOR DEBIC. r' LABOR MATERIAL 12 5 00.00 NICK NIKOLOPOULOS CONSTRACTOR NICK PAPANTONAKIS c"J't 4— 9 ( I'S FOTIOS STAMOS i 30'-10" II — � I �,,REFRIDGERATED DISPLAY WINE RACKS CASE I J u - , I rn ,REFRIDGERATED DISPLAY — J CASE z li d� 12'-0" in I a 0 I N 69-1" 10'-0" 14'-9" 0 POINT I OF SALE COUNTER REFRIDGERATED DISPLAY/WALK-IN COOLER N i 0 MOP ' SINK z THE CORK STOP I Ro' OIL ET o 1593 OSGOOD ST 00 NORTH ANDOVER, MA 01845 P3 FLOOR PLAN SCALE: 3/16"=1'-0" I 4' 0 4' 8' 12' GRAPHIC SCALE 3/16"=1 '-0"