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Home My WebLink AboutBuilding Permit #90 - 1600 OSGOOD STREET 8/8/2008 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o`No oT 6 qti (� Permit NO: 1 Received 79 DgATED Date Issued: 00' - SS ACH�1S IMPORTANT: Applicant must complete all items on this page LOCATION 0 Pri ff PROPERTY OWNER D � L Print MAP NO.: PARCEL: 3 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑ Addition ❑Two or more family ❑ Industrial �ation No. of units: ❑Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED ` _ c L Identification Please Type'or Print Cle rly) OWNER: Name: Rhone: Address: / Phone: CONTRACTOR Name: 7 C� 72 � Address: Supervisor's Construction License: Exp. Date: / (b r Home Improvement License: Exp. Date: r ARCHITECT/ENGINEER z;;?� r te_ Name: Phone: Address: -leg. No. FEE SCHEDULE.BULDING PERMIT.•$12.00 PER$1000.00-OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ x12.00=FEE:$ dAk Check No.: V 3 Receipt No.: 7 Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art ❑ Public Sewer "`` . IN Well F1 Tobacco'Sales" �Ly ^` ' J ❑ Food Packaging/Sales �❑ � Permanent-Dumpsteron Site- F1Private(septic tank,etc. ElElectric Meter_.location to project NOTE: Persons contractin wit registered contractors do not have access to the guaranty fund Signature of Agent/Own Signature of contractor --�� Plans Submitted ❑ aived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ 9 []Water Shed Special Permit 4 ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature&Date Drivewa Permi Temp Dumpster on site yes_no Fire Department signature/date Z Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. I Total land area,sq. ft.: NOTES and DATA— For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTM ENT:BPFORM05 Created JMC.Jan.2006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 Pape 4 cW4 Location A/ a ' r, o °�— No. d Date �oRT� Irk- TOWN OF NORTH ANDOVER * Certificate of Occupancy $ �ssuN�sEt�' Building/Frame Permit Fee $ ��r� Foundation Permit Fee $ Other Permit Fee $ � TOTAL $ Z1 check lt� 43 Building Inspector NORTH own of No. 940 0 -re o dover, Mass., • COCHICHEWICK AERATE D p'Pa\ '`� S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System . � BUILDING INSPECTOR THIS CERTIFIES THAT...... ...... - .... ....... ...........�..i....... ..1e ...... ......................................................... Foundation has permission to erect........................................ buildings on/60 a ....... ?.�.. A� Rough to be occupied as........s .� . . .0..%J.. ......Q .. .� ....... Il ..�' �Q ...:............... .............. Chimney y e provided that the person acc pting this pern�lt shall 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. 3 V f 1 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough afo`**_� PERMIT EXPIRES IN 6 MON Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST1ffS Rough ......................................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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 6/7/2006 Address 1600 Osgood St Job Loc City North andover State ma ZIP Job Name BUTA Phone Qty Description Unit Price TOTAL Supply necessary material and labor including necessary permits and build out approximately 1,226 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 side lights on interior office doors. Install oak doors in metal frames, Install windows as per plan. 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 carpet and cove base Ozzy allowance$12 per sq yard installed. TOTAL CONTRACT PRICE $33,960.00 *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 $33,960.00 Office Use Only ` + Dtpa"Ment of IndyMWd Accidents Office ofix"3*11d ns 600 Waslkinjun Sheet Boston,MA 02111 www.nressaov/d1e Workers'Compensation Insurance AMdavit: Buflders/ContractorsMectridj,=Mombers AvyUcant Information Muse Print Name(Businesstorganizaticm4ndMd=Q: ` Address: City/State/Zip: Phone#: �-- Are y employer?Cheri:the appropriate box: Type of project(required): 1. I on a employer with -- -1— _ 4. ❑ I am a general contracor and 1 employees(fall and/or part-time).* have hired rite sob- mesons 6. 0 New cnnatruction 2.❑ I am a sole proprietor or partner listed on the attached sheet.t ?. ❑Remodcling ship and have no employees These sub-contractors have B. ❑ Demolition working for me m any capacity. workers'comp.insttrana 9 ❑ g addition [No worker'comp.inatuance 5• ❑ Weare a corporation and its required.] officers have exercised their 10•0 Electrical npaas or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No worken' comp. c- 152,#1(4),and we have no 12.0 Roof repair inmrance required.]t empkpyees.[No worker' 134:3 other cw4-ice requka] 'Any wpt�do cheab Vox d 1 mwc doo tits out ga section bdo�r sti=bg ftb arcs en'aonVft don poor t Homeowner Mbo a*M*ttus AM&Wk indicaft Soy am doled an WMt.d gsa bim ON"oosI I I M mutt submit a ww adfihvk becaRift OWL teonvaelms gat cbeck flus boos mast sttwW sn edddcnst shoat dbowmg the name of&g snb =ftC n sad gds W oduta'GMVL pdky iaEbmudm I am an employer"Is providhV>Nmherscompense den insurance fir m Below It the psdley re ld job alas Insurance Company Name: Policy#or Self-ins.Lie.#: Ltd Expiration Date: Job Site Address 6•o go I City/Stammip: vv✓ Attach a copy of the workers'compensation policy declaration page(showing the policy ramber and apiratioe date). Failure to secure coverage as under Section 25A of MGL c. 152 can lead to&e imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year =well at 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 OtVic a of Investigations of the DIA for insurance coverage vgificad m I do hereby certify tender the pains aid pentrGtlm of perjury cleat the in oraitdloat pmvlkd above b urs and eirrrd S' Phene#: FB%oard m&. Do not write in Ah tree,to be completed by ct4'or sown offlc d n: rermifR.leca:c ority(circle ore): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.plumbing Inspector or: Phone 0: Nov 0�8 05 09:30a 6038900192 P. 1 FROM :ROHERTS INSJW 4CE FAX NO. :5786833147 Nov. 08 2005 10:44AM PI-11 ACDMw CERTIFICATE OF LIABILITY INSURANCEamow ODrl".0 1118/2005 " TMa CERTIFICATE IS MMM M A MATTER OF OWORMATM x.P. ROU1'8 INS. AGEI=, SNC. ONLY AMD COMPM MO R14MT6 UPON TME CER WVATS 1060 OSGOOD STMET THE T UC MffM O r . MORT8 11NDd M, MR 01845 978-683-8073 INSURERS AFFOl W&COVERN06 MAICi 1Ne DOW GrZRT COIQBTa EjjC-TT oawAtI<fc xmc_ *am& ESSEX INSURER W _ 175 amy AVL sutam c SAWN, NS 03079 WMRMM O VAW s�►SUIiER t .. ._ COVERAGEQ TM POLICIES OF IDLMOMW-E US7ED 88-OW NAVE BEEN ISSUED TO 371E INSURED MWW A80VE FOR THE POLICY PERIOD 1tMATED MNWtTNSTANDM ANY REOURE31ENT 7ERMI OR WHOMON OF AMY CONTRACT OR OTHER OOCUTAm 1MiN RESPECT TO VMC"7MIS CatyMATZ MA BE ISSUED OR MAY PERTAIIM t}1E INSURANCE AFFORpEp BY THE P'OLIpE3 OESCRi8E0 IMM 1S GMECT TO ALL THE TERM&EXCUSSIOM NO C M"UMg OF SUM POLICES.AOMM-CaATE LMYt1TSSNOWNMAY"AVE-EWA REOUCSO8Y PA1OCtM XL r4PRg_• �_.• POUCY NUUM _ Lam. •._.` ORAL LIA"LUY wcn OCCUM 6MCQ s -1,000,000 x OOMMMlALOENERALLfMLl Y rREt4nsEs�:MIFCUYn]� s Q00 CWMSMf1OE OCCUR MEDExPtkhr�PM�I A 3CP3616 10/26/05 10/26/06soNALaAovwuRY s 1 QQQ00- G�JIGRAL AGGAMATE s 2 OOO 000 OWL AAI.'RE'1;ATELWT APPLM FM� PROOLICTti-COM//OPAGG i Q 0 Q POI ICY LOC AUTOMOSILE WISQITY ANVAUTO StNGIELVOT s ALLOVMWAUTOB QO BWJURY 6CNEOULEQAl1T06 (PvPawnYRYs NWED AUTOS NOM4 WME0AUT08 90DILVPUURY s _ — PROPERT/OAMACE (R�rreddirrl OARAOElMIBiIOY At MDNLY_rAACCKIENT i OTNERTMAN EAACC s AUOONLY. . AGO i E10ESMWDREIL( t1 ALWAL EACH OCCLMRENCE s OCCUR 1� j OABMAM AfsGREtiArE i OEONCTILE s RFFRMON s i MAXOM RffiCMP&M7IONANO EwLOYERS umLITY TO Z ANr DONC600548 10/26/05 10/26/06 tt EACNACIIOENT s _ 5fl0 00 D ' rxr tuomT E l ONEASE-EA i 300,000 �L oT►ee bm" EL OMEAss-FOUCVLomff s 500 000 oExrevtloNOF OrERATIaNSnoumot+srvMna.Ese ExcLusiopsAanEUYY ENDORSE1�tENrrsPcernLPr+ans�aNs JMM 2 CERTtFlCATE HOLDER CANCELLATON Ozzx PROPERTIES, LLC. SHOULD ANY OF T t ADOK OEEGOSED POUCE8 8E CAMMV.&V PECARE TM OWMAMIQ S DUNDEE PjMK DATE TMWOF.RE tMING MURER 1MU.&MAYOR TO NAL 10 DAYS VrMrrM ANDOVSR MA; 01810 NOTICE To T e CERTIFICATE HOLM NAMED TO RIE LEFT OUT FAILUR!10 UO SO srw.L *POSE NO OOUGATM OR LIAMURY OF ANY KM UPON ME*MMfl fM AGMT&OR ATw- AT ACOR025(200WO" VACOROCORPORATi MISU � S The Commonwealth of MassachuseM Department of Fire Services Office of the State Fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 PERMIT Date: _ jP s-dam North Andover permit No Dig Safe Number (Cityof Town) (If Applicable) In accordance with the provisions of M.G�.L•114 8 Chapter_1.4_as provided in section—Ul— MR 34 Start Date This Permit is granted to: Full name of person,Finn or Corporation Pennissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be 25' from structure if unable to place with required Restrictions:clearance dumpster must be covered with plywood or tarp end of work day at (Give location by street and no.,or describe in such manner as to provied adequate identification of location) Fee Paid$ 50.00 Gla'. 1/�� Fire Chief i Si nature of offiwl granting permit) Offical granting permit (Title) This Permit will expire y �ir� f. ( g ��' TN1C PERMIT MI ICT RF r-ntAICPi(_I illi ICI V Pn-gTt=i1 i lPnM T149= PP1=M1C1'C �u ALOf 11 !la��&MV-7 CsULPMONS' BOARD OF BUILDING RE CONSTRUCTION SURERVISOR License: 048040 .,. Number: CS Birthdate. 10t2911955 8053.0 no: fres:1012912007 Tr: Exp Restricted:.00 ' • GIEER . TADEUSZ DOW TC .;. 175 BRA NH�3p79 Commissioner SALEM,