Loading...
HomeMy WebLinkAboutBuilding Permit #242 - 1600 OSGOOD STREET 9/28/2007 rAORTII BUILDING PERMIT 0�,��E° ;6q"o TOWN OF NORTH ANDOVER te ~'` op APPLICATION FOR PLAN EXAMINATION Permit N0: OO Date Received 7 p�RyTfD�PP\`�y G� �SSACHU`'�t Date Issued: IMPORTANT Applicant must complete all items on this page b ` �, . IR PROPER 'YflU1�lER u . MAP 'Of SPAFtCEI� ZOI ING Di � ,v Astor c D�str ct yes � no �` �� � � � ,,. TYPE OF IMPRO_VEMENT PROPOSED US Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial FYA�ration No. of units: ❑.Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑?`Se tics 01 fell , '� Flt od,plaa I�k'wbtlan� S ® i lacers ed'©s rpt t� x Q11aterewer . _ .. � >x; _ _ DESC IPTI N OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly - OWNER: Name: / co ' �S Phone: �! Address: C9e T 't 6P „ '"rr ., ,s � " s, � a ,a �� ��m7 .� ^ .yam� � � �z, z^ �c7 +�i �.�r �`.. CC?NTRAGTR Narne � Phor Al �: s z ri cam %, 42 St:apervlsors Construction Lieneeft s ` iso r x Y f vtx� a w Homy ir �ro�Iement'� cerse ;.3 r; ExpgDa# r 3, .. ARCHITECT/ENGINEER b ',,APhone: Address: 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: $ � 7 � FEE: $ b—A- LZ Check No.: `70 P-,Z Receipt No.: o`2 U&O 7 NOTE: Persons contractin 'th unregistered contractors do not have access to the guaranty fund y Signature, of AgenOwn Slgnature„of contractg Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 ❑ 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 i i DATE REJECTED DATE APPROVED HEALT4i ❑ ❑ COMMENTS r Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/S9nature & Date Driveway Permit Located at 384 Osgood Street FARE1EpARTMENI` Temp 3D'ump s�tel" n site es P Y ne Locafed at 124,M iKSfr6bfF 46 �* lire Department stgnafiure/dafie x. ur I COMNFENT ` 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.$10041000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date ..................................................................................................... ......................................................................... 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 Per 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 Li 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 ❑ 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 i +r CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 242 (9/28/2007) Date: November 16 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1600 Osgood Street KDSA—Blgd 20 2nd Floor MAY BE OCCUPIED AS Commercial Tenant Fit UD IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: KDSA LLC 1600 Osgwdd Street Blgd 20,2nd Floor Orth Amlavr 01845 _ Buil ing Inspector I Location No. L12-- Date 7 NORTH TOWN OF NORTH ANDOVER 10 i / �V-�• Certificate of Occupancy $ Building/Frame Permit Fee $ ` s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # L 0 O U 6 Building Inspector NORTIy T0VM 0 2 - Andover No. 0q:o �` dower, 1Vlass., O LAK COCHICHEWICK %p ADRATED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT. PJA.....-.........9�.D..1.2.0................................................................................ Foundation O �.l � c� T +o�ii,�tL. .... buildings 0 ... .. .. .r ...1...... . .. ..... .... ... N .toush �'�=-�,��'•��•� P has permission to erect.................................... g ................... to be occupied as......iiw`ww. .......... ....� ...r. .......!............................................................... ch v ovided that the person accepting this erm' shall in eve aspect conform to the terms of the application on file in in P P P g P F 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. �l� PERMIT EXPIRES IN 6 MONTHS r � ..�.• ELECTRICAL INSPEC'c .° r UNLESS CONS'1'RUC t S �Ou �,,.. �,' �/, �.igh�..............Q Service n B ECTOR Occupancy Permit required to Occupy Building GAS INSPECTOR--- Rough NSPECTOR/Rough I Display in a Conspicuous Plwe on the Premises — Do Not Re7'�-.jve Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. 01 SEE REVERSE SIDE Smoke Det. 1 TOWN OF NORTH ANDOVER Final Design Affidavit Project Number: 0707081 Project Title: KDSA TENANT FIT-UP Project Location: 1600 Osgood St. North Andover, MA—Building 20 2nd Floor—North Hallway 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 P. Smith Registration No. 8688 being a Registered Ppefessional Engine=F/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural )000( 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 HAVE PERFORMED THE NECESSARY PROFESSIONAL SERVICES AND EITHER MY REPRESENTATIVE OR I HAVE BEEN PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK HAS PROCEEDED IN ACCORDANCE WITH THE DOCUMENTS SUBMITTED 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. I AM SUBMITTING THIS FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp(no facsimile) r Ry P. NO-8688 y o NORTH ANDOVER, MA. Jar. 9TH OF M'��5�, SUBSCRIBED AND SWORN TO BEFORE ME THIS L ty DAY OFV,'Ve4�e1� 2007 (+CJ)'� � MY COMMISSION EXPIRES 917 kdd NOTARY PUBLIC - 77:91. 1)ONNAM.WMEDGE NOTARY PUEUC ,TS ,.rY NORTIy Town or. . over No. 0 1. dover, Mass., COC KIC KE WICK � AoRAT E D `s BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ��� � ��� � � BUILDING INSPECTOR THIS CERTIFIES THAT.. ......... ... .... ..t.. .............................................................................60) Foundation /foo �, has permission to erect........................................ buildings on ................... ... .. ..,�.�.�i/..1.T....,�iid.t... �.... Rough to be occupied as Chimne rovided that the arson acce tin this arm' shall in eveFespect conform to the terms of the application on file in Final P P P g P 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 MONTHS UNLESS CON STRU TS ELECTRICAL INSPECTOR Rough .......... ............................... Service B 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 Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: 0707081 Project Title: KDSA Tenant Fit-up Project Location: 1600 Osgood Street—2nd Floor— Building 20 North Hallway Name of Building: Osgood Landing Nature of Project: Office Renovation for 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„°F a; €ftgiReeF/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. Signature and Stamp (no facsimile) �c,(ERED 14 41-27•�f l FRY No.8688 9 NORTH ANDOVER, MA. 5 g5 G� SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF fKle 2007 MY COMMISSION EXPIRES .6.�'!/Q NOTARYAB& Mar 06 07 12:48p 6038900192 P•1 CE i � 2 Ate- � ICATE OF L1AB ` ,� �OF INEONLY Me EMOD aft t x060 645 #nurM I�FO�cpyE �'H OO tum DOIlRZ� t%8f "�'=GR �-` - mumin a .ate a 8 vomm 8A7;1t gamma �► 01610NO vifm „ a OR CANAVIM OF AW CONWO-r at o ,raie►�s a �+�"'E yrs. r'O`cc uws0�"�p1OaD° aarsa a d GeNew L&MKW s 50 00 waiurr s�eo Mca.A+e4 s 0 0 .A.Mow ®occw IO/Z8/Oi 10/26/ .* 'w�► s 2 0 CpP00�43T ,wow c O Q s toff XPNM cater we °au�rauwr c wean► lesaaeN�+B VAYA= ALLUVMWAVMS xNipYt�OAViOS � s twtgoAums AUTO s c waaa�r Zvorr Aec s far^= ►La°a+rrY s ao a cwem a s s +ow c ' rJL6vm- 6/06 10/26/07 a soa.�au- nr 10/2 e► a 500_t100 703830 �- - D tenon eoa�prat nO 703930 pust►ue�t s 500 Op rsr.as+.r� � �esio�pt�ssooa7eYeno�ir • 6p _8 —01 GTE w=wAwtw7"sv wA Pouc""CANCFLL� m a OwtE t116118�.fPE UWAS UtSUPM VALL MOW=' M1R1�_� � umomr OWEDFAMERrm OF ANY IOND 11lON re a' .frs Aon CR 1600 as== ST .�ea �'�'► SDWR MWOVXR, IML 03.845 � or,lea ACOM25(200"ei The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations i. � Z 711 ±, t f ►_. . 600 Washington Street Boston 11IA 02111 r iw www mass gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ib! Name(Busint-,ssforganiritioNlndividunl): ( to r f 1,N, Address: a6 City/State/Zip: ./&—Phone#: Are you an employer?Check the appropriate box: Type of project(required): l. am a employer with_!; r l_0 4..0 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors- 2.❑ !am a sole proprietor or partner- listed on the attached sheet 7. EMCemodeling ship and have no employees These sub-contractors have 8. F] Demolition working for me in any capacity. workers'comp.insurance. q, ❑Building addition (No workers'comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12,0 Roof repairs_ insurance required.]t employees.[No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box d t mast also fill out the section below showing their workers compensation policy infnmation. 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 Not mast attached an additionat sbcd showing the rune of the sub-contractors and their workers'comp.policy information. f am an employer thatis proving workers'conWensaAion inwmncefor my enWoyees. Below is the policy and job site information. /f Insurance Company Name: t 1 ��tr`4 Policy#or Self-ins.Lie.#: (� L� i� 10 ?2 g tO Expiration Date: O Job Site Address: 0 19 `2;� City/Statc/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 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 cerrb r order the pains and penal es o djury that the information provided above is true and�� �•�• - r Signature: Date: Phone fl- Q -M_ '�1`7 2�— � _- Official use only. Do not write in this area,to be completed by city or town official i City or Town: PermWLicense# 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#: i ,:/sie CJr o�:vr�cn9zu�ea�C� a�✓j�sac�ivaelta BOARD OF BUILDING;REGULATIONS License: CONSTRUCTION SUPE VISOR L e Numbe --GS, 048040 Birthdate: l0/2911955 -. Exp+res :10/29/2007 Tr.no: 8053:0 � 5 ResMcted 00 TADEUSZ DOVUGIEERT 175 BRADY'AVE SALEM, NH 03079 Co nmtssioner ti Location �d� fyo�s-T �✓�/ �<N� No. Date NORTH TOWN OF NORTH ANDOVER 0 s 9 Certificate of Occupancy $ �ss+cMustt� Building/Frame Permit Fee $ /,7�737 , Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #7� 2064 i v Building Inspector