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HomeMy WebLinkAboutBuilding Permit #580 - 1600 OSGOOD STREET 3/6/2007 NORTil BUILDING PERMIT o�ts,.o TOWN OF NORTH ANDOVER 'r? o` 0 ; p8 APPLICATION FOR PLAN EXAMINATION , Permit NO: `� Date Receivedgc►+us���y Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION x P. , t PROPERTY OWNER../ 00 :i ca s Print . MAP` N& PAk EL: Z61NWG DISTRICT:-HISTORIC DISTRICTyes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ®-Gemmercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other I Septic;, ( WeII Foodpla'tn 11�etlands. l Watersleds#rift Wade/Sewer u ter. DE2C TION O OR TO BE PREFO MEDS Lzi Identification PMIT y e or Print Clearly) OWNER: Name: Phone: Z/- Address: CON OR- Na �� 1 � Phri�ev _ ro Address: Supervisor's Constr +✓tio `License Exp: Dater 5 Home �,,l pr©rrement License, Ex s- Date: ARCHITECT/ENGINEER ,��12 m�4mac Phone: �� Address: 4��5 .1�ln r 'tZ Z�'-�o- �jPa -Reg. 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.: �a Receipt No.: NOTE: Persons 'contracting with unregistered contractors do not have access to the guaranty fund Signature of AgenilCJwne ignature of contractor 1� 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 ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ n h Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments C Conservation Decision: Comments Water & Sewer Connection/S9nature& Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT Temp Durr,ster on siteY es no Locate0'4,4'12 Maim Street Fire Departure °siglnaturetdate _ ¢.. COMMENTSv. i I 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 ❑ Notified for pickup - Date 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 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 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 ❑ Engineering Affidavits for Engineered products 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 Locaiion /bo Uftiv��( �� 2,,/,/ %la0 YL - _ / No. �_ � Date MORTM TOWN OF NORTH ANDOVER O��,. o ,•14, 0 9 Certificate of Occupancy $ CHus �',S'' •E�� Building/Frame Permit Fee $ S�cN Foundation Permit Fee $ R Other Permit Fee $ TOTAL $ Check # n Building Inspector tJ Locationgaa f/d lJ No. 5m Date NaRT� TOWN OF NORTH ANDOVER ifi—ca te of Occupan y $ • i 'sswCHusEtBT3i1�in�F�ame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ ' TOTAL $ Check <47 j — 2 0 U -- Building Inspector �1 M } • CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 580 (3/6/07) Date: Apri13, 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1600 Osgood Street Bldg-20 MAY BE OCCUPIED AS Kodai - Tenant Fit uu IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE - BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Ozzy Properties 1600 Osgood Street North Andover MA 01845 Building Inspector . 1 TAORTH Town of t . 4 over No. 0100BO _ o = A E dover, Mass., • G ' �' COCHICKEWICK AERATED `S BOARD OF HEALTH PERMIT. T 1111F Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ........ .. .0 .. ..... .... ... ...:.............................. Foundation has permission to erect....... .... ...... buildings on t&.91.14.01 .I .V..... . .. ... ..... ® Rough to be occupied as............ . �. Chimney .... .... ........ ................................................................................................ provided that the person ccepting 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 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 3 PERMIT EXPIRES IN 6 MON Final ELECTRICAL INSPECTOR UNLESS CONSTRUzru ARS 3 x ................................. ...... .. Service BUILDING INSPECTOR 3 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 DEP TMENT Until Inspected and Approved by the Building Inspector. Burner ( - Street No. 3 b l - i SEE REVERSE SIDE Smoke Det. NORTH Town of Andover No. ' E dover, Mass., • ` ' �' COCMICKEWICK y1. ADRATED P'Pp% `S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT/:04........0.. .. ..Q ..alu.. .....Wxd•••• Foundation has permission to erect....... .... ........................... buildings on........ t.�P. ..I..... .( .V..... �. Rough e d!!..1d( �_ • Chimney tobe occupied as............ .......A................................................................................................. provided that the person ccepting 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 3 PERMIT EXPIRES IN 6 MO Final ELECTRICAL INSPECTOR UNLESS CONSTRU AR Rough 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. 9Xe eomvmonareald �✓�aaoac/%uaelk BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS. 048040 i Birthdate: 10/29/1955 e Expires:,10/29/2007 Tr.no: 8053.0 4 Restricted: 00 TADEUSZ DOWGIEERT 175 BRADY AVE G- SALEM, NH 03079 Commissioner f r - ' � �rie 1°amxmaozurea.� a�✓�aaoar/ucael� BOARD OF BUILDING REGULATIONS 'License: CONSTRUCTION SUPERVISOR Number: CS 048040 Birthdate: 10/29/1955 Expires:,10/29/2007 Tr.no: 8053.0 Restricted: 00 TADEUSZ DOWGIEERT 175 BRADY AVE SALEM, NH 03079 C } Commissioner j TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: 0701007 Project Title: Kodai Flow Research Tenant Space Project Location: 1600 Osgood Street, Building 20, Second Floor- South 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 PFefessienal EngineeF/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 COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signat p(no facsimile) �S.�ERED ARph�� 4 41 Qw ,GORY P. NO.8688 y NMAMOVFA ArtA. F SUBSCRIBE z SWORN TO BEFORE ME THIS& DAY OF 2007 MY COMMISSION EXPIRES ,�?% al� do da N ARY PUBLIC Mar 06 07 12:48p 6038900192 p.1 V1/1V/iVVf ea•.ry •.ao ..�. DATEWiNDOI+t•fYYI ACM. CERTIFICATE OF LIABILITY INSURANCE 1 16/2Q07 tH�S CEATiFlCA7E iS ISSv®A$A MATTER C INMRVAnON ►RooucEa Q -S ANO A NO f�IC3HHT5 UPON THE CERt1FtCATE HOLOWL CERTIIchn ND OR 24.V. S nqsuvao Tr Aort CZ C' ALTERAFFOROEO By T1A1E POLICIES BELOW. 1060 096000 STRSST NAICS mom ANDOVM MA 01695 _ COVERAGE 78— 9 — 7A swim lxwto a e�arrw►*f >BST� =s c0 .,. mum® DOT GVM �sq+Mpp'L'IGeT t7D-. ILQC. arauREa e: rrauaER C 8 vmwzg PUBIC tN tea a OVSR, 2� 01810 ttlausleR TMEPOUCE3 �tiM110Ei �BBOWNAYE8SE11lgiUEti707ME1NSINiFA OM F*R RE8P6CTTOEFouoy VN THC VAY REDO AWf Rte.tE�eA on CONORIWI OF ANY CONTId1C1 OR OTTER 00 MM"T VOM My P6RTAN THE fltE{IRAMCE ACI�ORDFA 6�►rxE ta0uC168 oEscRlYw WEFdW IS susiEcr,ro nu E TEtttui.exc�oSfoN.s,we acR+DrtaNs OF SUCH votacr'u"ed� E a s 1 0 00 G09VAL LIAEL Y Vmmm i 1-0.099 ®OCCUR 30/26/06 10/26/07 • 1,000-000 CPP006443? Guam JAGRoom s OCL -ty_gp0A0@ s 1 0 0 cpm AOoaEmmE Lan MiLss PER i ra��DY roc cow SINtiLEtJMfr i m[Twomfi A s um �Noeb�q AIiYANTD appRYNIJUat s =OWNEDAVIOS 1t+�t I S6HEMLMAUTM eODIlY1NJNRt+ s j NVCLOAtlf+O3 1�'f�� VMR NDf10YYMEQ s P=WAWWFD MWA A OWE ------------ S AtROONl7.EAACGtOENt i a aMWOEUASUff OTNaaTNAN QAACC a ,�Nrnviza wsaaNLr. Am i MM OCCURRENCE B=Gvummvw LVZLWY Aamoon Qtanix6ltuoE s _ s p{�LKlttitF s .. • I�•rEKrtoN s waartnseorroays�taa+�no ei�lewwtoe� s 500 0G EwvLarws L«saiR D ,000 """""'"a.,�I CA . toulom DONC703930 10/26/06 10/26/07 as- '6" e 5 O S Er"cttE-tsauCruMtt s SOOiQ00 oT}Ea O gp�pUUFoXU fQIA110NSnDCA710NiiV@M�LENCI�MCW810N6ADDEDBYH001 �S K' alODla • 60 -8 — 12 CLWtWr-AT£ R stttwto ANY aF1 weDvE DR SCrtalt�P Pauaea es eANceLLcn aFfoNfc TOE luiRlAtOt+ Om TNENEw.Im 15SUr G tNSNRER%,YLL ENDFAMDa$wu lu 0�C S F EK ML orzy $ ND�ICE TO TIE WAlm IRI ti WTV I{AMw TTS AGENTS Ok 1600 Os600D ST tt�oos+No oaLwArioN ot:L,Aau�r of Anr ta11D tIrON T►E t+r6tlaiti An I NORTH ANDOVlSR, til 01845 -F ly L 0 ca&or wtmtDaaso wasarTn� MAOOM t»CRPOIw%' 1918 ACOR025P2OMMS) �_• The Commonwealth of Massachusetts y Department of Industrial Accidents I Office of Investigations 600 Washington Street 1, uiu Boston,MA 02111 www mass. ov/dia t ► g Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(13usincss/organi-ration/Individual): D99 C j Address: r--4 4 S City/State/Zip: t.,o et AAPhone 3 0,t:�7 Are you an employer?Check the appropriate box: Type of project(required): 1. am a employer with _ (cO 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 etnodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers'comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ 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 I I.❑ 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.] *.My applicant that checks box#t must also till out the section below showing their workers'compensation policy information. 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:_ LP V` Policy#or Self-ins. Lic.#: O [.J2936 Expiration Date: /0 �©_2 Job Site Address: _ 0 d _(9 r 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. do hereby c erliunder the pains and penalties oerjury that the information provided above is true and correct. r Si nature: Date: D Phone 4: C/ � �5` 7 2-1 2--_ Official use only. Do not write in tris area,to be completed by city or town ofjicial. 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#: 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 2/21/2007 Address 1600 Osgood St Job Loc City North andover State ma ZIP Job Name KODAI Flow Phone Research Qty Description Unit Price TOTAL Supply necessary material and labor including necessary permits and build out approximately 1,000 sq ft. as per preliminary plan by GSD. Price includes building of walls as per lay out, installation of electrical service, including electrical panel. Install parabolic lighting and electrical outlets as per Ozzy standard. Modify duct work and registers as per new lay out. Install oak door in metal frames. Install 2x4 suspended ceiling as per Ozzy standard. Adjust sprinkler heads as per new lay out. Install emergency lighting and horn strobes per new lay out. Paint new walls and woodwork, colors to be picked by others. Install new carpets and cove base, Ozzy standard. TOTAL CONTRACT PRICE $30,140.00 "Price based on preliminary drawings and is subject to change based on final engineering plans. SubTotal $0.00 Price does not include arcitectural or engineering Shipping & Handling costs, data, telephone wiring, equipment or furniture installation TOTAL $30,140.00 �� Office Use Only TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: 0701007 Project Title: Kodai Flow Research Tenant Space Project Location: 1600 Osgood Street, Building 20, Second Floor- South 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 PFE)fe5SieRa1 Efigineef/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural XXXXX (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 COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signat Ap(no facsimile) I����� r ��, 60RY P. y N0.8688 F � SUBSCRIBE SWORN TO BEFORE ME THISAb'_"�� DAY OF 2007 MY COMMISSION EXPIRES N ARY PUBLIC