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HomeMy WebLinkAboutBuilding Permit #103-2011 - 1820 TURNPIKE STREET 8/4/2010 BUILDING PERMIT Of 0ORT11 A TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ° : .. �-a � D4 �L Aa. . ,> Permit NO: Date Received �SSACHUS�� Date Issued: 0 IMPORTANT:Applicant must complete all items on this page LOCATION L9 — 3 a L) c ti Print ' PROPERTY OWNERST �/ " ! Y4 t L. Print MAP 210 ZOK PARCEL: ` ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential v/New Building One family Addition Two or more family Industrial Alteration No. of units: commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: ® < 0 F - SE,4Soi{s IPA VsIc,.,l "�he<-�.�,, v�►,�-���� vl-J e- W.H� t7 �jw/ �iy p� -1 -1;7k n S'1, ` -�7 1 L-L) Identification Please Type or Print Clearly) OWNER: Name: Phone: 6 0- Y 7 7- g�6 3 Address: vh4 16-13 CONTRACTOR Name. 'rol rI c e rc A M Phone: 1y '7 9`" 7 77- S'00 . Address: I'Z5 / AL r► 51 � _ i1 r�, #t =r je -7 ! 0/ ,Yy 7 Supervisor's Construction License: l 7 913 S Exp. pate: 7/L?19-0 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER JRctmct)rg194r,4 Phone: 1 oos- 36/-x222 Address: '9 Do,in" '1,(,k ,, FrMMJ,aw, IV e17y / Reg. No. CEO FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $�, c200"'C9 0 FEE: $ Check No.: Receipt No.: �� 2 NOTE: Persons contracting with unre ' to_ contractors do not have access to the ara fu ignatureof enOwner nd Agt/ signature of contractor 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 i DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT I COMMENTS i CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS i Dimension Number of Stories: 1— _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 Doc.Building Permit Revised 2010 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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building 9 PP u Idin 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 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:Building Permit Revised 2008 Location If No. Dateof 40RTh TOWN OF NORTH ANDOVER 3 � 0 a /c Certificate of Occupancy $ o Building/Frame Permit Fee $ �a 6 0 3ACHUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �� 6 Check # 2321 Building Inspector ' ORTH Town of � Andover L A K E _O dover, Mass., Q COC NIC HE W ICK ��• ADRATED S S BOARD OF HEALTH Food/Kitchen PERMIT . T D Septic System THIS CERTIFIES THAT S7l�a-/F /� �� ci ��L. BUILDING INSPECTOR ..........................................4 C� Foundation has permission to erect.. ............................. ......... buildings on . ...... .?�......... '' ...5 ................... ough to be led as occup ........................... ..... ..........1� S��sa. ...S,� ��, • �,f'..tT..... `i�•z; hi ney ,y provided that the person accepting this permit shall in every respect conform to the terms of the applicatioh on file in j this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of nal I Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR [Rouervghi _ ..........:.......................... ce BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the- Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: PROJECT LOCATION: l��� �`����'� '� S�'. �• n���l< NAME OF BUILDING: S 0,17 e I,. 1 I /14 M CA- NATURE ANATURE OF PROJECT: -t—f- I cx 4- F, - lJ e IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I,21a� �/ 7R•t SA-f .2845 MD REGISTRATION NO. _ BEING A REGISTERED PROFESSIONAL ENGINEERIARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL 0 STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. . AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 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 stage of construction to become, generally familiar witWhe 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. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY , A PROGRESS REPORT OF Mqss9c TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPE: mows" I SHALL SUBMIT A INAL REPORT AS TO THE RAMA'?V1NS 'CSV COMPLETION OF THE WORK, SATyAPRASAD ACTORY COMPLETION AND READINESS OF TH PROJEC F OCC A Y' No.aa s oCWn I NATURE B RI RN RE ME THIS DAY OF MY COMMISSION EXPIRES Va? o�� M.E.A. Engineering Associates Inc. Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 CONSTRUCTION CONTROL AFFIDAVIT START OF PROJECT PROJECT TITLE: Tenant Fit Up Doctors office PROJECT LOCATION: 1820 Turnpike Street North Andover MA NAME OF BUILDING: Stone Wall Plaza North Andover MA In accordance with Section 116 of the Massachusetts Building Code,I,Alfred E.Muccini,Registration No. 23539,hereby certify that I am a Registered Professional Engineer. I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL MECHANICAL ✓ FIRE PROTECTION ✓ ELECTRICAL ✓ OTHER(SPECIFY) PLUMBING ✓ FIRE ALARM ✓ for the above named project, and that, to the best of my knowledge, such plans, computations, and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I shall perform the necessary professional services and be present on the construction site in accordance with my contract with the owner to determine that the work is proceeding in accordance with the documents approved for the building permit,and I shall be responsible for the following: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special engineering professional inspection if critical construction components requiring; controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. 4. Periodic progress report with comments to the Building Inspector. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COME F-_T''{X4, ND REWOFJECT FOR OCCUPANCY. t ,.tr �< Fi 'ni.l 10, f, J Subscribed and sworn to before me this day of 20� r..w g� KIMBERtYA COLI Notary Public My C s %&XR'i 9tut-PMbl ; s MY.Commbslon Esptrmi fe 'O14 i I Final Report & Affidavit of Inspections For compliance with the 7th Edition of the Massachusetts State Building Code Project: STONEWALL PLAZA Location: 1820 TURNPIKE ST, N ANDOVER MA Owner: STONEWALL PLAZA LLC Owner's Address: 1820 TURNPIKE ST, N ANDOVER MA. Architect of Record: N /A Structural Engineer of Record: D. G . Comerford To the best of my information, knowledge and belief, all work associated with the above referenced project has been completed in accordance with the contract documents and all work is in compliance with and inspections itemized in the Program of Structural Tests and Inspections submitted for permit have been satisfactorily completed and all discovered defects have been corrected. Comments: The final inspection related to this project was made on December 4, 2008 and all items found to be in general accordance with the design documents at the time of inspection The Program of Structural Tests and Inspections does not relieve the Contractor or its subcontractors of their responsibilities and obligations for quality control of the work, for an design work which is included in their y g e r scope of services, and for full compliance with the requirements of the Construction Documents. Furthermore the detection of or the failure to detect, deficiencies or defects in the work during testing and inspection conducted pursuant to the Program does not relieve the Contractor or its subcontractors of their responsibility to correct all deficiencies or defects, whether detected or undetected, in all parts of the work, and to otherwise comply with all requirements of the Construction Documents. 0 OF Respectfully Submitted, DALgo Structural Engineer of Record �' CIVIL D. G. Comerford91 o.4i726o Type or print name S�0N AL Signature Date 71Z2 !() g / Registration Seal i 1la�sachu.ett. Department lof Public Safc`[N Board of Building,; Re,,:ulation. and Standards Construction Supervisor License License: CS 17935 Restricted to: 00 FRANCESCO FODERA 2 FRANKLIN ST READING, MA 01867 �y__14� Expiration: 7/29/2011 < neaii.•i,o. Trz: 19552 �11r DRtV3 5.57483054 07-x-2131 3 07-2 N y CLASS REST NGT SEX1• , D 647 M FODER A FRANCESCQy 2 FRANKLIN ST READING.MA 01867-1117 :. . m.asro57 i i TE '`'� INSURANCE 3/13/CERTIFICATE OF LIABILITY IN DA/13/ODIVY2008 8 PRODUCER (978) 696-0007 FAX: (978) 345-6811 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Employers Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 281 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 7B Fitchburg MA 01420 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Savers Property & Casualty Resource Management, Inc. INSURER B: Alternate Employer: GFM General Contracting wsuRERc Corp. , 281 Main Street, Suite 5 INSURER 0: Fitchburg MA 01420 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN DING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR ADD'L - ...-... -.-._.. ... . ..._....... .._ TYPE OF INSURANCE ' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE _ $ COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED PREMISES(Ea occurrence) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ — PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: ' PRODUCTS-COMP/OP AGG $ PRO- - POLICY LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $(Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ i , ANY AUTO . ; OTHER THAN EA_..ACC $.._.. -.... .. .- AUTO ONLY: AGG i $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ! CLAIMS MADE — AGGREGATE $ DEDUCTIBLE $ RETENTION $ - A WORKERS COMPENSATION WC STATU- - OTH. AND EMPLOYERS'LIABILITY YIN _:TORY.LIMITS: X ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED ❑Y - .--.1,000,000 (Mandatory in NH 1/1/2010 1/1/2011 E.L.DISEASE-EA EMPLOYE 1,000,000 If yes,describe under WC0002526 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Covers the employees of the named insured leased to: GFM GENERAL CONTRACTING CORPORATION 325 NORTH MAIN STREET - UNIT 15 B MIDDLETON, MA 01949 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION for record only DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Judy escott/KATHYM ACORD (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(z00oosot) The ACORD name and logo are registered marks of ACORD Ac®R® CERTIFICATE OF LIABILITY INSURANCE OP ID cA OATE(MMIDD/YYTYI OPDSCO-1 06/14/10 PRooucEa THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dadgar IngUranCe Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON TME CERTIFICATE 400 Nest Ct>Mingg Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 6725 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn MA 01801 Phone;781-933-2626 Faxs781-932-6341 INSURERS AFFORDING COVERAGE NAICft INSURED ""— INSURER A: IlolyokA Mutual Inc co In ealaw 1,4206 INSURER 5: QFM Contracting INSURER C: 3J5 Nor tb Ma a 8 t Unit 158 INSURER D: Middleton DSA 01944 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ?96K KWT RATION LTR R TYPE OF INSURANCE POLICY NIM 999 DATE IwMIOD DATEFQUUY k+ POLICY IDD/YY IINIR9 GENERAL LIABILITY EACH OCCURRENCE S 1000000 A X COMMERCIAL GENERAL GPP701780401/01/10 01/01/11 PREAtlSES(Eeoocurence) 3100000_ _J CLAIMS MAOE FC OCCUR MED EXP(Any one person) E 5000 _ _ PERSONALE ADV INJURY 1 1000000 ` GENERAL AGGREGATE f 20000oQ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS•COMP/OP AGG $2 Q Q QQ Q Q POLICr .. JFERQ LOC AUfOMOSILC LIABILITY A ANY AUTO CONNED SINGLE LIMIT $ 1000000 CA9012129 01/01/10 01/01/11 (Ea accident) Ili L ALL OWNED AUTOS BODILY INJURY S X SCHEDULED AVTO5 (Per mson) $ HIRED AUTOS BODILY INJURY = X NON-0W NEO AUTOS (Per eccldent) • "��'' PROPERTY DAMAGE ti (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC L AUTO ONLY: AGG S EXCES&UMIBRELLALIABItRY EACH OCCURRENCE S 1000000 A XOCCUR (� CLAIMS MADE GII00060S4185 O1/01/10 01/01/11 AGGREGATE s 1000000 S DEDUCTIBLE. S X 'RETENTION $3,0000 s WORKERS COMPENSATION AND EMPLDYERS'LIABIUTY TORVLtMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT i DCFICER/MEMBER EXCWOED? N ee.describe un0er E.L.DISEASE--EA EMPLOYEE $ SPECIAL PROVISIONS below E.L.DISEASE•POLICY LIMIT S OTHER A Property Section CPP7017004 01/01/09 01/01/10 Contents 10404 A Equipment Float* CPP7017004 01/01/09 01/01/10 Deductibl 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS CONTRACTOR FAX 781-944-2609 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BF-ORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN xxxxxxxxXxxxxxxxxxxxxxxxxxxxxx NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL XXxxxxxxxxxxxxxXxmmxxxuEZxx XXXXXERxxxxxxxxxxxxxxxxxxXXxxx WOW NO 08uOp71pN OR LIABILITY R OF ANY KIND UPON THE INSURER, S AGEtiTB OR REPRESENTATIVES. A RRED RE ATtVE ACORD 25(2001108) ®ACORD CORPORATION 1988 i Gr, M 0� 325 North Main Street Unit 15-13 Middleton, MA 01949 Office: 978-777-8007 Fax: 978-777-5004 TA J 7'6 L CL,9 ri T 2 t'�-C 7— o OJ.0 d Total