HomeMy WebLinkAboutBuilding Permit #845 - 1600 OSGOOD STREET 6/21/2007 NORTFI q
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BUILDING PERMIT t o
I TOWN OF NORTH ANDOVER o
APPLICATION FOR PLAN EXAMINATION
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Permit NO: U Date Received
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
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LOCAT[Oan
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PROPERTY OWNER';;
MAP 1`f{3 P RCEL ZONING`t ISTRICT� HISTQRGC DISTRICT yes no
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
i Septics ❑cWell �"; ❑ fflodpla►tt O V1�ettands ( �1Nerhedlisrict;;
F dF
n WaterfSewer 5 ,
D SCRIPTION OF WORK TO BE PI�EF6 ED:
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J60/1- 14 e k2
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
I
S Y
hone,
CONTRACTOR Name
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Address
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Supervisor's O;onstructio Licen��e °4�� � Exp Oats a h
Home Irrtprovement Licer%se ` � Ex
Pabate:
ARCHITECT/ENGINEER Phone:
Address: ll T Reg. No.
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contract
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
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ l
S
Tobacco Sales r ❑ Food Packaging/Sales ❑ �
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
I
Zonik Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Comments
?Conservation Decision: Comments
Water & Sewer Connection/Si nature & Date Driveway Permit
Located at 384 Osgood g Street
FIRE DEPARTMENT empDumpse"r on site yes
Located at-1 24 Main Street.
rtmerw#si � t
Depa gnature/date
p
t
COMMENTS, " ;^ �,'
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.s100-s1000 fine
NOTES and DATA— For department use
s
❑ Notified for pickup - Date
...................................................................................................................................................................................................................................................................................P.
Doe.Building Permit Revised 2007
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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
Li Building Permit Application
u Workers Comp Affidavit
u Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
u Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
L3 Building Permit Application
Li Certified Surveyed Plot Plan
u Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Mass check Energy Compliance Report (If Applicable)
o 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)
o Building Permit Application
u Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
u Workers Comp Affidavit
u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
Li Mass check Energy Compliance Report
u 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
Doe:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
Location �G�U L
No. yip Date `Z
�oR,M TOWN OF NORTH ANDOVER
3?O�t•`•D '•,MOG
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Certificate of Occupancy $ —�
• o, <«mss. •'' •
"e°'E<� Building/Frame Permit Fee $
s�CMus
Foundation Permit Fee $
n
Other Permit Fee $
TOTAL $
Check # 4(: /3
2G6 ,- 4t
Building Inspector
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BOARD OF BUILDING REGULATIONS
license: CONSTRUCTION SUPERVISOR
Number CS 048040
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Birthdate; 10/29/1955
Expires.10/2912007 Tr.no: 805.3.0
Restricted: 00
TAD EUSZ DOWGIEERT
175 BRADY AVE
SALEM, NH 03079 Commissioner
TOWN OF NORTH ANDOVER
Construction Control Affidavit
Project Number: 0606066
Project Title: Fence and Turnstyle Demolition
Project Location: 1600 Osgood Street Site
Name of Building: NA
Nature of Project: Removal of existing site fencing around portions of the site, including misc. accessory
security buildings and tutnstyles.
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 PFe€essienal
€figiaeer/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
Entire Project Architectural )OOOOIX 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, I 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 COMPLETI READINESS OF THE PROJECT FOR OCCUPANCY.
,ERED A
Signature and Stamp (no facsimile) �G\S P
RYby
Na 8688
NORTH ANDOVER,
MA. y
' PSS
SUBSCRIBED AND SWORN TO BEFORE ME THIS AY OF �y�\ �, 2007
MY COMMISSION EXPIRES
TA Y PUBLIC
XAORTH
Town of
0
No. LA-
�` 01, dover, Mass., �i' �l• O �'
o
COC MIC HE WICK V
�d ADRATED
7`S ` BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.....G/.Z. ... ...� ............................................................................
................................. Foundation
has permission to erect ....................................... buildings on ../ .4.10......4990 ..�04 .T.................... Rough
to be occupied as....�... [�9f/'�! wooV /� 4A 914,
...•.. Chimney
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 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
11 PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRU ART'S
Rough
.......... ...................................................... Service
BUILDING ECTOR
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 Smoke Det.