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Home My WebLink AboutBuilding Permit #513-13 - 170 PLEASANT STREET 1/15/2013I , TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received- TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Res(dentiat 0 New Building 0 Addition 11 Alteration 0 One family D Two or more family No. of units: 0- Industrial VCommercial "epair, replacement 0 Demolition 0 Assessory Bldg 0 Other 0 Others: F, dA tR 67 lis Identffication Please Type or Print Clearly) OWNER: Name: Phone: ARCHITECT/ENGIN FEE SCHEDULE. Phone: No TOTAL ES77MAM COST BASED 014 $126.00 PER S.F. Total Project Cost 4�3' mx FEE: $ Check No.: —Receipt No.: NOTE: Persons contracting watt unregistered contractors donot (save access to the guarantyfunf-) re . at i -. 'bf Aeng i10wner-`",-'. ighUre b cdntmaddtor Plans Submitted . D Plans Waived El Certified Plot Plan ❑ Stamped_47ns ❑ N P!arls 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 CONSERVATION COMMENTS HEALTH COMMENTS Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes ti Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW TowEngineer: Signature: uocatea M4 us ooa street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at'124 Maim"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 Kin-rme nATA _ lF:nr rlPnnrfinent usel JAA_ OOA--VP_ C�ns�a�1 oC a ® Notified for pickup - Date I F Doc.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. Roofing, Siding, Interior Rehabilitation Permits u Building Permit Application o Workers Comp Affidavit o Photo Copy Of H. I. C. And/Or C. S. L. Licenses Li 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 L3 Certified Surveyed Plot Plan L3 Workers Comp Affidavit L3 Photo Copy of H.I.C. And C.S.L. Licenses u Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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) u Building Permit Application Li Certified Proposed Plot Plan Li Photo of H.I.C. And C.S.L. Licenses Li 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 appal 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 Doo: Doc.Building permit Revised 2012 011 n 0 Q Location - v No. 15' ,-�) Date Check #'—1 (0� 26090 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL Building Inspector JAN -01-2007 12:01 AM King Design Associates 17813934228 P. 1 ♦ w • • •h:_. "Wal' 3./ V, of C7966 wn r�mr+�r e%Vir TVD. Lel vt'' -''t 7'..)a at VICSrh C.5 _. PROJECT LOCATI N • i �d T `e a ,{ % I i No Il`' "' ( ii 1► MA ARC T' DAVID A. FARMER OF KING DESIGN ASSOC.. INC 10 HIGH ST MFDFO . IVIA 02 55 IN ACCORDANCE WITH SECTION 107.6 OF THE MASSACHUSETTS STATE BUILDING CODE, EIGIiTH EDITION L DA'ViD. A. FARMER REGISTRATION NO. $3� 3 EEING A REGISURED PROF'1JSSj0NAL ARCHITECT HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, CONeUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT 2` ARCHITECTURAL _ . STRUCTURAL MECHANICAL FIRE PROTECTION--ALCTRICAL OTHER (apacify) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE PROVISIONS OF THE MASSACUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGZMERIN'G P ACTFCES 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 CONSTRUC'T'ION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMNE 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 107.6- 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 procedures for all oode-required controlled material. 3. Bepresent at intervals appropriate to the stage of construction to become, generally familiar with the progress and quality of the work and to determine, in general, if the work being performed in a manner consistent with the construction documents. I FURTHER CERTIFY THAT TnE WORK WAS COMPLETED IN ACCORDANCE WITH THE DOCUMENTS APPROVW FOR THE BUILDING PERMIT AS PER SEC'T'IONS 107.6.2.2 AND 107.6.4, RIGH H EDITION OF THE MASSACHUSETTS STATE BUILDING CODE, DAVT>D A. ]FARMER PERSONALLY APPEARED BEFORE ME AND SUBSCRIBED AND SWORN TO BEFORE ME THIS 2.A DAY OF A- Zo I QFFICIAL SaAi — JEFFREY P. KING NOTARY PUBLIC ,(;0") wMTN OF 9WXHV8ETf6 My Comm. Expires Mor. 8, 2013 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 43,500.00 m $ - $ 522.00 Plumbing Fee $ 65.25 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 65.25 Total fees collected $ 752.50 170 Pleasant Street 513-13 on 1/15/2013 Renovate commercials ace, replace plumbing fixtures p ! M • • ''wwn �I1 CCl O cc O m o V w i•r b � m Z m Q — c Z N v J d 1 J fte v///^ + E cm Q h <� Z 1-- 0 L O N _ * CL M E //•� Lm a Z H N � W o c ; v '^ y I w O J=E0Z �U 2:yoo _ W '> c W J �2� a- 2E CL °'CL 'S a> M4, m o c 0 c c Q L UO) 'a .OCL H V m _W == d'a O O 0 umi w - -o-- 16. LL 'y N C LU E O N C. d N Z N o '� = O Nin w I.: Ch i 0 ED r_ c CD m U 0 cc z CL LLI x CLLI L Z z z O cr LL OIn Z a z z IC O C7 co O m J J U. N y C O a LU + Y Y i N N N N z v 'O U F+ "6 C _Cu � C t L u 'i m L N +) C O O w O O L C O s O ; N C O O 7.� E LL "N LL Q' U LL cr LL Q' ; N LL W LL CO N N ''wwn �I1 CCl O cc O m o V w i•r b � m Z m Q — c Z N v J d 1 J fte v///^ + E cm Q h <� Z 1-- 0 L O N _ * CL M E //•� Lm a Z H N � W o c ; v '^ y I w O J=E0Z �U 2:yoo _ W '> c W J �2� a- 2E CL °'CL 'S a> M4, m o c 0 c c Q L UO) 'a .OCL H V m _W == d'a O O 0 umi w - -o-- 16. LL 'y N C LU E O N C. d N Z N o '� = O Nin w I.: Ch i 0 ED r_ c CD m Massachusetts - Department of Puhllc Safety Board of Building Re4,-ulations and Standards Construction Supervisor License License: CS 93870 TIMOTHY W GAGNE 3 CANDY LN MERRIMACK, NH 03054 ('urrun issi� ntcr Expiration: 6/10/2013 Tr#: 18003 The Commonwealth of Massachusetts Department of Industrial Accidents Office of In vestigutions 600 Washington Street Boston, MA 02111 www.mass.gov/daa Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Na.tne City/State/Zip: 1 � 014602�one #: Are you an employer? Check the appropriate box - �j 1. Q I am a employer with 4. m a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. Q V4'e are a corporation and its required.] officers have exercised their 3. Q I am a homeowner doing all work right of exemption per MGL myself [No workers' comp. c. 152, §1(4), and we have no insurance required] t employees. INo workers' comp, insurance reauired.l Type of project (required): 6. Q New construction 7. ['remodeling 8. ❑ Demolition 9. n Building addition 10.Q Electrical repairs or additions I L Plumbing repairs or additions 12.Q Roof repairs 13.❑ Other 'Any applicant that ebecks box 41 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they am doing all wort: 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. f am an employer that is providing workers' egntpensation insurance for my employees. Below is thepolicy and job site Wyormadon. — -., I _ /11 :assurance Company ?olicy # or Self -ins. Lie. #: 6�4�%7 Expiration Date:s / n 'ob Site Address: _j� City/State/Zip Utach 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 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 & up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. do hereby certify under the pains and penalties of perjllry lit at ill information provided above is true and correc4 denature' bate gone #: Official use 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 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone � | � � ! ! !�� fill � CAW togs k uj _ to � CL � � | £ � LL |00, o � .,Fj f ■ s � � O � � � � � � � Qualifications 1. Engineering not included 2. Separate metering not included 3. Energy code 4. Sprinkler or fire alarm shut down fee not carried 5. Voice and data did not carry but would like to bid on 6. Any Ceiling removal for HVAC will be a change unless it is minor 7. Carpet is figured for for remodels (Sundries C-46) Allowances Time frame from start to finish 170 Pleasant st. N. Andover Ma. Demo 2 Days Patch walls 1 Day Replace ceiling tile as needed 1 Day Millworktbathroom equip 2 Days Plumb Sink 1 Day Misc. Electrical 1 Day Flooring 2 Days Painting 2 Days Total # of Days to complete 12 to 14 Days Page 4 Division 10 Specialties Bathroom equipment allow Specialties sub -total Division 15 Mechanical H.V.A.C. Existing to remain HVAC sub -total Sprinklers Existing to remain Sprinkler sub -total 575 $575 $0 $0 Plumbing Demo and reinstall New ADA sink at Lab 1 sinks Plumbing sub -total $7,420 Division 16 Electrical Existing to remain Misc electrical at cabinets Misc electric at new reception Added electric 300 Electrical sub -total $1,150 Page 3 Division 6 Woods and Plastics New reception desk 6 W. 2,130 Lab Millwork Upper cabinets w/lowers w/counter 13 If. 6,175 Process room counter w/cabinets 10 If. 3,750 Woods and Plastics sub -total $12,055 Division 7 Thermal & Moisture Protection N/A Thermal & Moisture sub -total $0 Division 8 Doors and Windows Change existing door hardware 4 ea. Window at reception Doors and Windows sub -total $1,095 Ceiling Textured drywall ceiling Repair as needed very tough to match exact Ceiling sub -total $950 Paint Paint walls Doors Entire ceiling Added painting 500 Paint sub -total $2,280 Flooring Carpet 27 syds 999 VCT 182 sf. 364 Base 181 1f. 543 Flooring sub -total $1,906 Page 2 Job Proposal From: Proficient -Builders Inc. 100 Conifer Hill Park unit # 308 Danvers, Ma. 01923 Job Name: Quest Diagnostics 170 Pleasant Street North Andover Date: 2!7/2012 (revised 3/23/2012) revised 4/16 Division 1 General Requirements Permit and fees Dumpsters/trash pick up Final clean up Project Management Supervision Laborer Added overhead Insurance Misc protection General Requirements sub -total Division 2 Site Work Interior demo Flooring & base Misc ceilings Dust control Added Demo. Site Work sub -total Division 3 Concrete Floor Prep Allowance Concrete sub -total Division 4 & 5 not used Page 1 1,800 $11,875 $3,520 $600 s 1 ea. 400 1 ea. 650 500 sf. 225 2 weeks 1,400 2 weeks 3,600 P/T 800 3,600 2 weeks 750 1 lot. 450 1,800 $11,875 $3,520 $600