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HomeMy WebLinkAboutBuilding Permit #222-14 - 1600 OSGOOD STREET 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �f Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION ---Z.16ye �oc a,�,5J 5,f Print PROPERTY OWNERZa 4DO I Print 00 Year Old Structure yes no MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential. ❑ New Building ❑ One family El Addition El Two or more family El Industrial K�feration No. of units: E�Cbmmercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer i DE*RIPTION F W RK TO BE PERFORMED: l 00 C Identification P ease;M—(Q2:%V or Print Clearly) OWNER: Name: hone: Address: �c�cD CONTRACTOR Name: Phone: Address: �-� Supervisor's Construction License: Exp. Date: Zodi�lls Home Improvement License: Exp. Date: ARCH ITECT/ENGINEER� �� �,©C Phone: Address: �S E.4 S 7` (c� uc o� 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: $ ,a 17 C�� FEE: $ 71�24 Check No.: 93 9 19 Receipt No.: NOTE: Persons contractin �'h u re ered contractors do not have access to the guaranty fund Signature of Agent/Ow Signature of contractor x - - Plans Submitted Plans ived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYP ,-OF-.S 7WER-AGE.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 :CONSERVATION Reviewed on Signature ,r COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes N Planning Board Decision: Comments Conservation Decision: Comments t !later& Sewer Connection/Signature& Date Driveway Permit DPW Tovvo Engineer: Signature: Located 384 Osgood Street i FIRE DEP;4RTMENT - Temp Dump er on site yes no . Located at'124 Mair Street Fire Department signature/date- 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.$100-$1000 fine NOTES and DATA— (For department use B Notified for pickup - Date Doe.Building Permit Revised 2010 Building Department The fohowing is'a list of the required forms to be filled out for the appropriate.permit to be obtained. Roofivg, 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 o 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)_ o 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 casts if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building Permit Revised 2012 Location No. �'� D • - TOWN OF NORTH ANDOVER • b . Certificate of Occupancy $ /0,0— Building/Frame 0oBuilding/Frame Permit Fee $ 6 q Foundation Permit Fee $ Other Permit Fee $ TOTAL $ q ` 5 Check# �/ , Gov JJ [.: uilding Inspector NORTH ti i r r a tr SSFlCItt1`+E4 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 222-14 on 9/10/2013 Date: November 1, 2013 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1600 Osgood Street MAY BE OCCUPIED AS Watts Regulator office buildout IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Ozzy Property Management,LLC 1600 Osgood Street North Andover,MA 01845 Building Inspector Fee: PrePaid $100.00 Receipt: 26835 Check : 9349 NORTH Town of EAndover 0 No. h , ver, Mass, w COC L Ke NICHTWICK I.4 A�agTE D S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ... _KP . . ...�....�... BUILDING INSPECTOR� .. ............. .........�.... .... �yFoun ation / has permission to erect ......................... buildings on ...�� ....... e. . "r ............................... u �r � t✓,=;p �. to be occupied as �..... imne provided that the person accepting this permit shall in every respect conform to the terms of the application Final 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS 4a /7 pZ'y 17e � Service �;. .... ................... BUILDING.INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. � SEE REVERSE SIDE NORTH own of t 11Andover O - .:�:_ / � h ," ver, Mass, �J�i " w� COCNICKl WICK A�4ATED I,e�`�,�5 S u BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System ��; p / , ���, BUILDING INSPECTOR THIS CERTIFIES THAT ... ...-....:............. ...r ...:.................:.... ........ . : ,;..�A:�r.�:Vo " .. buildings on 9�_ Foundat �n � f io has permission to erect ........................ g ...: �... .....�. � ....�`."............ /" ,r �� 'ugh ) ! to be occupied as .......... :! ....... :f...s::. .., c............................................................. im—n—e),, provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and 13 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 ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS 43a �- 'Z"yds Service .........„r:..� .. .�.. .:: ... .............................. final �� BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE October 31, 2013 Mr. Gerald Brown Inspector of Buildings Town of North Andover 1600 Osgood Street North Andover, Massachusetts 01845 Re: Watts#3 space interior office fit-up, floor 2, Building 20, Ozzy Properties 1600 Osgood Street,North Andover, MA Dear Mr. Brown: Based on site visits through 10/31/13,the Watts #3 space interior office fit-up, floor 2, Building 20, Ozzy Properties, 1600 Osgood Street,North Andover, MA has been reviewed by us, and to the best of our knowledge and ability, this project has proceeded according to the drawings dated 09/06/13, with minor revisions,prepared by this firm: R. Rumpf&Associates, Inc. Furthermore, this project is substantially complete and ready for occupancy. If you have any questions regarding this project,please call my office. dry• •.n�w,',:� Sincerely yours, V LJ SA9_EW1, Stephe . Le ore q. MASS. Proje ch' SWL/occtltrl R. Rumlpf& Associastes, Inc. Engineering, &Architecture 75 North Street Box 4483 Salem, Massachusetts 01970-6483 978.740.5025 978.740.5026 fax Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 513760.00 m $ - $ 621.12 Plumbing Fee $ 77.64 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 77.64 Total fees collected $ 876.40 1600 Osgood Street - Watts Regulator 222-14 on 9/10/13 Tenant Build Out OORTH Town of EAndover 0 No. , , ver, Mass, 1� / COPC PC.,..CN ,•1 �d A�RAtEO S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ... �J. ........ •.... .,�. ev f : tl� �6 Foundation has permission to erect .......................... buildings on ......................:��raa�...S t ............................. Rough ..................................................... to be occupied as ..........�,��,�G����.:......�k��..�:��:��.��°. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ......... .... r..r:^................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE i Initial Construction Control. Document I' To be submitted with the building permit application by a ti d Registered Design Professional for work per the 8th edition of the �aM s�•��� Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Date: d(.Z Property Address: (/ �/ Project: Check one or both as applicable: New construction Existing Construction Project description: I A Registration Number: Expiration date: , am a VJ+ registered esign professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural [ ) Structural [ ] Mechanical ] Fire Protection [ ] Electrical [ ] Other for the above named project and that to the best of my knowledge, information, and belief such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports (see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final Construction Control Docurnbnt:l., Enter in the space to the right a"wet"or .i electronic signature and seal: n -A a. ! Phone number: (` 6 ` • %��� Email: Building Official Use Only Building Official Name: Permit No.: Date: E Version 06 11 2013 04/18/2013 12,44 9786833147 PAGE 01101 OAi E IMMIDDIYM) R' CCPRO CERTIFICATE OF LIABILITY INSURANCE 14/18/2013 I HIS CERTIFICATE I$I)3SUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT$ UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES Ni}T AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORiZED REpRESENTATiVE OR IbRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the caruficate holder is sn ACOITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION 13 WAIVED,subject to the terms and eondMOr11%'Of the POIIcY,COrtdin P011cles MAY rat(Uire an Edorsement. A statement on this Cerdfleste doss not confer rights to the certificate holder In lieu of such entlors®mrnt(s)• sRODUCER NAME: M 1? ROBERTS INS A0C3t INC Pfc0N ,�. (878 683-80 3 Ar,No:(978)683-3147 1060,�Osgood Street D C RESS:�QmPrcbertsinsurance.com North Andover, MA 01845 rta LMRlel AP'R`QRdMS COVEM(W iA1C0 INSURER A;MERCHANTS INSURANCE INSURED DOWQXERT CONSTRUCTION COMPANY INC. INSURER 8!=AM INSURANCE 175 BRWY AVE INSURER C: SALEM, NH 03079 INSURER o: INSURER E: INSURER F! COVERAGES CERTiFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE iNSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWiTH:3TANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHiCH THiS CERTIFICATE MAY RB ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITiONS OF SUCH POLICIES;-LiMrrS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, iLim TYPE OF IAM SAJBR EFF hISURANCE IN POLICY NUMBER D MIDD LIMITS GENERAL LIAKI Y EACH OCCURRENCE S 1,000,000 =ACRE TO RENTED X COMMERCIAL GENERAL LIABILITY P EMI ES Ep eeeurrenee g 100,-000 CLAIMS-MA04 CI OCCUR MED EXP(Any ens person) $ 51000 ,py I CtdF9157.6Q6 03/23/13 03/23/14 PERSONAL BADV INJURY s 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LINIT APPLIES FtR: PRODUCTS-COMPlOP AGO $ 2,000,000 POLICY PR0 q LOC A AUTOMOBILE LIABILITY (Eq ancidomt $ 1,000,000 ANYAIJTa 03/31/13 03/31/14 BODILY INJURY(Perp6lAon) & }1j ALLt rODg ED X SCHEDULED PIQ'� �4 13001LY INJURY(Per eomdenl) S NON-OWNED eeracaoent B X HIRED AUTOS X AUTOS S X UMBRELLA LIA9 X OCCURCLTP9142034 03J33f13 D3/23114 EACH OCCURRENCE s 1,000,000 A EXOGGS LIAR CLAIMS-MADE AGGREGATE 8 RETENTION$ $ WO KERS C,0 PENSATiON VdCSTATU D AND EMPLOYERS'LIABILITY Yrs 10/26!12 10/26t13 TORY ► I ER� ANY PROPRIETOPIPAnTN:RrEXEGJTIVL NIA DONC33814 Q E.L.EACH ACCIDENT S 000,000 OFFICER"IIEMaER EXCLU 7E0? M A-10mery In NH) ESL DISEASE•EA EMPLOYE >F 1,000,000 IP s,tleseribe under DISEASE•POLICY LIMIT E 1,000-000 DvodIPTION OF OPG:tATIONS below E.L. OESCRIPTiON OF OPERATIONS J LOCATIONS 1 VEHICLES(AtIeW ACORD 101,AdO tonal Remarks Shcedule,M mo+p spam is r*gLdftd) THE CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS PER THE PERMS OF THE WRITTEN CONTRACT AND AS PER THEIR I>+TF.REST IN THE INSURED'S OPERATIONS ON A PRIMARY AND NON—CONTRIBUTORY BASIS CizATIFiCATE HOLDER CANCELLATION OZZY PROPERTIES INC 1600 OSGOOD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ST LLC DUNDEE: OrFICE: PAM LLC THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED iN DUNpWa STATION LLC 0=9Z Z ACCORDANCE WITH THE POLICY PROVISIONS. REDISPRING LLC HERI'T'AGE PLACE LLC 21 H014S ST LP ZORCCN LP C/O 022Y AUTHORIZED REPRt SENTATNE PROPERTIES 1600 OSG OOD ST NO.ANDO I 01998-2010 ACORD CORPORATION, All right,$reserved, ACOR026(2010/06) The ACORD name and logo are registered marks of ACORD I Massachusetts - rmet oPublic 5at'et�Department Board of Building Regulations and Standards Construction Supervisor License License: CS 48040 ,r TAbEUSZ DOWGIERT 17,x;BRADY AVE R, SALEM,NH 03078 Expiration: 10/2g/2013 y l'ommismimer Tr#: 5561 i Y, 1 - I The Commonwealth ofMassachusetts Department of Industrial Aecadents Office of Investigations 600 Washington Street Boston,MA 02111 www°mass gov/dia Workers' Compensation Insurance AMdavit: Builders/Conti°actorsA Electracians/Pllmbers AyRficant Information PIease Print Le °bl Name (Business/Organization/Individual): Address: 7 _� & r z City/State/Zip: Phone#: �lS 7 Are you an employer? Check the appropriate box: Type of project(required): am a general contractor and I 1.�employer with 4.��r � � I e 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. [] Remodeling ship and have no employees These sub-contractors have g. Fj Demolition working for mem any capacity. employees and have workers' 9. 0 Building addition [No workers' comp.insurance comp.insurance. required.] • 5. [] We are a corporation and its 10. Electrical repairs or additions 3.[] I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. p arra an employer that is providingworkers'compensation insurance for soy employees. Below is the policy and job site information. _ / �— Insurance Company Name: �rr^o � „ = �A Policy#or Self-ins.Lie.#: Ci ��� l Q Expiration Date: fob Site Address: City/State/Zip: Glio .-ttach a copy of the workerscompensation policy declaration page(showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a :ine 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 )f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the 0 lee of nvestigations of the DIA.for insurance coverage verification. 'do hereby certify under the pains and penal, !f eriury that the informraation provided above is trace anis correct �i afore: Date: 'hone#: Official aese only.•.Do not write in this area,to be completed by city or town official •City or'Town: Permit/License# Issuing authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk electrical Inspector.5.Plumbing Inspector 6. Other / 1�, / (''nn-ket Percnn, �l o �. p!°til \.kt- r_r, Phone#: -`�_lO Q"3 y2 7