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HomeMy WebLinkAboutBuilding Permit #626 - 1600 OSGOOD STREET 3/29/2007 NORTH BUILDING PERMIT °`<��`° 16�"0 TOWN OF NORTH ANDOVER F n APPLICATION FOR PLAN EXAMINATION 040 o„ ..K. Permit NO: Date Received Date Issued: U 7 IMPORTANT: Applicant must complete all items on this page PILOPkTjON nrit u : PROPERTY OWNER NlAP Nd- - ZONING DISTRIGT. HISTO t1C f ISTRICT ye no " TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition El Two or more family [I Industrial "Iteration No. of units: [I Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other SepticAa •1fti/ ll Floodplain xWetndss ersh�dvistric , . , k Water/Sewer N :.. ,. . ESCRIPT N OF ORK TO BE PREFORMED: tip Identification Please Type or Print Clearly) OWNER: Name: 6-400 � c L �� �—� Phone: gS/? —4Z" Address: a CONTRACTOR',,,Norrie M :k " Phr1e x- At,Address ` S.upervisoe� COhstruct o;rv- ce s�: , Ex p date # a y Home:lmproeme t License ExC}at ;ate , ARCHITECT/ENGINEE Phone: 9 41 5 f ' E Address: Jzf� i1,1� a S� O� eg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �� �� o FEE: $ Check No.: Receipt No.:— 4r-76r-4:�'3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractorA ����-, ' J 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS r TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ permanent Dumpster on Site ❑ Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Drivewav Permit Located at 384 Osgood Street FIAE'DEPAR1 M.bNT= -Temp Dempster ori sl Located at 124 Meiw, r10 f Street ` Fire=Department sighature/date x COMMENTS : . 1 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use i i ❑ Notified for pickup - Date i ............ ................................................................................................................................................................................................................................ ....................................................................................................................................................................... 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 ❑ 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 ConstructionSin le and Two Family) ( g Y) ❑ 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location No. 2 Date 7 r U 7 NaRTM TOWN OF NORTH ANDOVER 3?O�,(`•o •1hOt F 9 + ; ; Certificate of Occupancy $ '1/00 ss�cMusEt� Building/Frame Permit Fee $ 7� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #C D s 2GGIa l Building Inspector � NORTF� Town of over • T �� - 'A E over, Mass.,---. 2� o A- COCMICME WICK V • _ Ids RATE D Ak- �5 7 BOARD OF HEALTH PERMIT, , T Food/Kitchen Septic System Aon /"O C, z BUILDING INSPECTOR THIS CERTIFIES THAT .............. �.. .; ................�......�............................................................:.............................. Foundation has permission to erect............................: ... buildings on Ov O6 ._, � ,�, ough ........ . . to be occupied as..... . . ...... . :.. ..`�...........v........!:................ ....� :..d..�d. . !C........................ Chimney Ch' provided that the person acts ing this permit shall Ing respect conform to the terms of application on file in Final this office, and to the prov�s 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 �Do PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTT TART,,S�� Rough . ...... .. �.—.....Vrr.... ce 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. DOWGIERT CONSTRUCTION CO. INC. 616 ESSEX STREET LAWRENCE, MA 01840 978 685-0306 fax 978 685-1290 CONTRACT Customer Name 1600 Osgood St. LLC Ozzy Property Mgmt Date 3/28/2007 Address 1600 Osgood Street Job Loc Bldg 30 2nd floor City North Andover State MA ZIP 01845 Job Name TriLogic Phone Qty Description Unit Price TOTAL Supply necessary material and labor to build perimeter walls as per plan with 3 5/8"studs, sound insulation and 5/8"drywall each side taped and finished to smooth surface. Install necessary horn strobes and emergency lighting. Install 10 drop cords. Run necessary power to cubes. Install perimeter doors. Remove and dispose of existing carpets. Install new carpets and VCT tiles. Paint new walls, existing drywall walls and new woodwork. Install and repair ceilings as needed. 1 TOTAL CONTRACT PRICE $75,000.00 $75,000.00 SubTotal $75,000.00 "Price does not include architectural or engineering Shipping & Handling $0.00 costs, data, telephone wiring, equipment or furniture installation. y TOTAL $75,000.00 Office Use Only -.- fjie V�arrzmz TIQNS BOARD OF BUILDING REGULA License: CONSTRUCTION SUPERVIQR 048040 • yam, Number: CS i Birthdate: 1012911955 g053.0 Expires:10!2912007 . Tr.no: Restricted: 00 TADEUSZ DOWGIEERT j 75 BRADY AVE `/ . 1 Gommissiones SALEM..NH 03079 Deportment of Indyst W Accidents Qffice ofInvestize ons 600 Waslkinvon Street Boston,MA 02111 www.massgoWdk Workers'Compensation Insurance Affidavit: Buildens/Contractors/Eiectridam/Plum rs Applicant Information' PleaPleate PrW Legjk Name (Busines5/0rW#-ationnfividu4: c C Address: 7�7 i n City/State/Zip: �c_�-��c; ./`�//� � —�,�---_ Phone#: 22 AF=a employer?Check the-appropriate box: J' / 1. employerwith — i 4. ❑ I am a general contra Type of Project(rewreo: �pbYed(full and/or part-time).* have hired the sub-contra� 6. ❑New construction 2.❑ I am a sole proprietor or paormer- listed on the attached sbea t 7. [] Remodeling ship and have no employeta These sub-canlractorg> ave working for me in any capacity. worker'comp,insurance. 8' Demohtron [No workers'comp.insurance 5. ❑ We are a corporation andits9. 0 Ming addition required.] officers have exercised their 10.0 Electrical npaira or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LO om myselfo workers'comp. a 152,11(41 and we have no 12. Roo eror additions insurance*ero�•J employees. [No workers, 0 _ -imnrance recti d.] j 1 13.0 Other t Homeow�oen T40 submit Pols*atBdav�t ®ort Poe Mian below thou Posir���OMVMndon policy�doa tCantnst�s Poet diectt this box mut doing wA°rl�stud men LQe owd&ooubmam must submit a Mw I swt rut t 'h0��acme of ttie sai}oot�Md Poeir�,am*Policy i�'oss>� InforntrsrlML t b proms workers'con'putsatlon brs�e for�,emplaym allow it d e paliq"dib afar Insurance Company Name: Poficy#or Self Expuaticn Date:/ i Job Site Address: - �:� � �� - Attach a copy of the worken,compere os policy dee"011 City/State/Zip: Fail=to secure covers as Pie(showlt g the poky number--a expiration date). � te4� ander Section 25A of MGL C. 152 can lead to� fine up to$1,500.00 and/or one-year %as well as civil *Osidm of�1 penalties of a of up to$250.00 a day against die violator. Be advised that a pies in the form of a STOP WORK ORDER and a fine Investigations of the DIA for insurance ooverAp vrificztion.e0"of this statement may be formed In the Office of I do Ira+rby et r the pabrs utd pew o fperlury aw the m f �,lrtd S• p tic b&*e ad eerr+eet Phone#: P" -7 O,Q7e121 use only. Ds not write Ie d Mit tut,to be coN feted by c4 or tom efflCIRL City or Town: Inning AuthorityPftUWUeeme# (circle one): 1.Board of Health 2.Building DePartment 3. 6.Other City TOwa Clerk 4.Etecb ieal Inspector S.Plumbic I sexor Contact Person. p l'hoae s: Mar 06 07 12:48p 6038900192 p.1 Oi►TaNiNOOnTTY1 i ACIM. CERTIFICATE OF LIABILITY 1NSURAHCE figo R#S CEt�iTRICAYE IS iSSt�EO IIS A MACII:R QF MfFOR cfiWWCAT MOM= Il�C. NOLOT:R� amagm NO w00"4m t�Awt�. � OR M.p.1�pBEaTS INSU>il4NCE Am= Armt us ©OYERACS AFFORDED Of TNS poucros BELOW. 1060 OSC O M ST1JST 8 ARIDOVEtt PW 01645 I ORaNS COQ MCA _ ? - 9 - 7 anavta ewsxn►ti » INS cc wsumm wmlaw c=lsTs=TloK co-, wc- NB1l11EN� WSR, UK 01810 ,Ns�aRea o TILEVOlIL1ESOFN4LIRANCSt1K7>EDBFJ�WF�IAvE86E1118 1EOY0tNE R 70 VMW�CER�frA WAY DOR AMl RECU9R@MEIfT.in"OR GONCITION OF AW CONTRACT OR 01f it IS SAA=TO ALL THE 7E1tIR6.E�GCI USIONS AND CONDrt10NS OF 8uCi1 tpCY PSRTAN 711E INiiNt AF! "W Sy TM poLICIN 062CRINEO WERM pcATELa�rtss►+ ►aarwu�eeLvaeosvauocxAnuus L votiC�►MR+■E1L �d+nca 1 0 ceRtr<LfAEL11T atst��.x i 50 00 c rr�u►�LuwLiTu wecfl�a< *pow* ®occua 10/26/06 10/26/07 6Vo—aw i 000 Cpg00643? oVmmL „ s 2,020,000 r�couc�s.colw�oo�oa i 0 0 um aqua j t f WC Comm*Eo NMYtEUwr 6 - �urcMoeaEt,p�Bamr pes�ee� �_.� ' AnTAUTa _ ! 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EIPiCTipB WWIAPE Sao-000 D W=703930 101S6j06 10126/07 £ -row i 500 OG "sPECwr.ea.�naer oma. oTI+E++ OF CrwATwMsn TIONS rvarcLes,o�cuEtwpi AOOEDeT�01 /SPwapRovmONB ar�noN • 60 -B -C122 CER7�iGLTE mom AMT oFTaewWVE CE=WW POUCWAes CARMLAD W FUM T1E euiMTiCe+ we Tvmar.THE osums#=vim Meu.EN064Wa TO wn 10 CATs WIMBN IIDTAM To TIE CMW Coe%ULM MN dW To TK, RE UWr.GUT FAIW OXY P�iITES To 0o sa eNAlt 1500 as== ST ProsE no ollWAI M OR uAsuro OF ANY I=illON T+e«'I6uaiA RS/MIEMTS Ok NORS'a AIWON'SR, tO► 01845Iese+ruTnA$- eun�anQso airREel�w� �AC�t�ttPORATLON'18�8 �zs(z0ouoef 1 TOWN OF NORTH ANDOVER I Construction Control Affidavit i Project Number: 0701014 Project Title: TriLogic Tenant Space— Project Location: 1600 Osgood Street, Building 30, Second Floor- Southeast Side Name of Building: Osgood Landing Nature of Project: 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 Smith Registration No. 8688 being a Registered Prefessienal EngiaeeyArchitect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, p computations and specifications concerning: P Entire Project Architectural XXX)=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 FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED 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. UNDER SECTION 116.4, 1 SHALL PERIODICALLY SUBMIT A PROGRESS REPORT, TOGETHER WITH PERTINENT COMMENTS, TO THE BUILDING INSPECTOR UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature, o facsimile) GS�E� ReHi�. C3 � Na�sss y Uk J� SUBSCRI D ND SWORN TO BEFORE ME THIS DAY OF L-1 2007 MY COMMISSION EXPIRES �G, o�C><J N ARY PUBLIC