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Building Permit #524-2016 - 202 SUTTON STREET 10/29/2015
SG,W)uNz-V l�12116 � I10RTH BUILDING PERMIT % /Anis iv0 t �Cf� .%'� TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: �'"� Date Received n �4SSg Date Issued: I ti cNUSI TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family D Industrial iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic n Well Fic�odpI in Wetlands fi Watdrsh'edrD strict .` Water/Seaver s.. �LA,> u c f a u �.l 6 'I'LNly S s 44- ,� n C � �:. l�% C•J (,i t�� ro<e'ri ! 1 L4y...r S} t\, t �. Mw l�0.1 — 10'A 6e- -/''�^r 0 C'. V- tj o..S . e, - r:} �- ;,, +i1,.. .J OWNER: Name: Q Identification Please Type or Print Clearly) i✓� �\-mac T . A ,pets Phone: 41--Y - 6 $ 6 -1 S -L L r ARCHITECT/ENGINEER D 4Z / A rcJ\', e-cL,,,rc— Phone: 21 g0 Address: t GO M4:^ S l,J o6,, r- _ ,MA ot q of Reg. No. FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. a?a-z Total Project Cost: $ / $L06 t . 0v FEE: $ 2- Z-0 Check No.: 9 Receipt No.:7-C1988 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Ki Permit No#: Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received ry- q_ IMPORTANT: Applicant must complete all items on this nate I LOCATION PROPERTY OWNER MAP PARCEL: Print Print 100 Year Structure yes no ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement 0 Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 11 Septic ❑ Well, ❑ Floodplain ❑ Wetlands D Watershed District n water/Sewer UtSGKIPT ION OF WORK TO BE PERFORMED: Identification - Please Type or Print Clearly OWNER: Name: Phone: Address: A Contractor Name: Phone: Email: Address: Supervisor's Construction License: Home Improvement License: ARCHITECT/ENGINEE Exp. Date: Date: Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. • $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ _ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund I Plans Submitted LT Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer El Taming/Massage/Body Art El Swimming Pools El Well. El Tobacco Sales 0 Food Packaging/Sales El Private (septic tank, etc. El Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS Aid CX-1-Fw-(qA Chi c-R'� 51 cot's -rp �c HrLaygcl by lAj5�or e(- 81�r5 I � CONSERVATION COMMENTS HEALTH COMMENTS 0 Reviewed on Signature SV Reviewed on Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: Comments Conservation Decision: Commen re .,- - e - .Zoning Decisionfreceipt submitted yes Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: , Located 384 USgood Street �-9ToMpIQunp�terQns pyp§,--RoL 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 DANCER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine Nu I tb anal DA I A — wor rievartment use EJ Notified for pickup Call Ema Date Time Contact Name Doc.Building Permit Revised 2014 RIM 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 4, Building Permit Application 4. 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 OTE: 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 Workers Comp Affidavit 4- Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/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 . TOTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products TE: 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 2014 Location No. Check M�q O Date 1v Z91 ItS TOWN OF NORTH ANDOVER, Certificate of Occupancy $ loo Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $� 1 Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 184,964.00 m $ - $ 2,219.57 Plumbing Fee $ 277.45 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 277.45 Total fees collected $ 2,874.46 202 Sutton Street 524-2016 on 10/29/2015 Tenant Fitup 4' ti'4n. ✓�1°� YSSwC"or. CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 524-2016 on 10/29/2015 Date: January 8, 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 202 Sutton Street MAY BE OCCUPIED AS a Fitness Studio — Miami Fitness IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: LBM Realty Trust 202 Sutton Street North Andover, MA 01845 Buildiing Inspector Fee: PrePaid $100.00 Receipt: 29588 Check: 9898 -. Ln r L *7 = C O c6 C Co O V Q. 4% �a o L N E O= = iis . ca (� L �-Cc � N � CD . > cc ca a> was' O d > N O as O z U) c c > H L Q. Q ai H O CL (D Nm N W = -0 - O O LL In- to y = �� O W .E vN i C.1 Q O .a cn d y . N m O H .c . CLov F. i z G CD z CO ZD Lu IL Cf) X 0 W V H CO d z m ti f- 2 2 S E o o z N oCM � •E W W O 0 � O � a CL C Q O -� V J � �CL Oma,� z W O CL V N 0 \ 7 Q W W` \WWc E �. W W o Z :c,J Z� ? 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MEN� � ENE�. \ ENE� MENE mmmm 2\ . }k� 2RQ2 \ �-�- — � � - `2 < % 22 ' � ---- •� § , / / - C%4 �{ ! w 2 q - z 00 $\ lip � ! k au � i_� � JI�2 ! k 2\ }k� 2RQ2 \ �-�- — � - — - / - < % ' � ---- •� , / / - ,2 r _ au � i_� � JI�2 Charles Construction Company Inc. ZUMBA TENANT I - I - Demolition $ 5,000.00 Rough Carpentry $ 4,000.00 Both Stages t Finish carpentry $ 5,000.00 Allowance painting $ 5,500.00 Metal Stud/Drywall/Acoustical $ 27,500.00 Mirror $ 9,600.00 Cutting Glass Barre $ 5,010.00 Floor covering $ 38,000.00 For HW & EHW Doors and Frames $ 4,000.00 Alum Door $ 4,500.00 Plumbing $ 14,000.00 HVAC $ 12,500.00 Electrical $ 29,750.00 $ 164,360.00 Fee $ 20,604.00 $ 184,964.00 As of 10/19/2015 200 Sutton Street Sawtooth Building E TA "I "JT7 efir � a CONSTRUCTION COMPANY, INC. October 19, 2015 Re: Miami Fitness Scope of work The following is based off of plans titled "Miami Fitness & Lifestyle" dated 10-13-15 drawn by DB2/Architecture. General Conditions: 1. We assume project duration of approximately 10 to 12 weeks in one phase. 2. A licensed superintendent will be assigned to this project 3. Mechanical, Electrical, Plumbing, and Fireproofing drawings not included. Continuous Work: I. Throughout term of project, premises will be swept cleaned daily for dust control and safety. Rough Carpentry: 1. Build Wood framed stages as to Drawing A-101 2. Build Access ramps leading into Studio 1 Finish Carpentry: 1. Reception Desk M! CONSTRUCTION COMPANY, INC. 2. 2 - Storage Cubbies with integrated bench Doors & Hardware: 1. 3'0" x 7'0" Solid Core Wood Doors 2. ADA Hardware 3. Aluminum Glass Double Door leading into Studio 1 Gypsum Board: I. Furnish and Install all new interior partitions (metal stud) and insulation per print as to plan A-101 in a Class III finish. To be delivered in "Ready to Paint" fashion. 2. Patch and Tape all current non finished areas. 3. Bathroom partitions to be 10' High Acoustical Ceiling: I. Furnish and install new ceiling in "Kaplan" Area. Tile: Armstrong 769 tile Mirrors: 1. Mirrors panels to be 7' Tall adhered 2' off the floor with no cuts. Mirrors shall be placed along the perimeter of Studio 1, excluding existing brick wall and windows. 2. 12 Cuts for Mounting Brackets Flooring: I. Furnish and install Studio 1 floor: a. 3/8" Acoustical Sound Mat F,"' _-A, 7" V APJ N -11r CONSTRUCTION COMPANY, INC. b. 2 Layers of 3/8" Plywood with Green Glue c. 1 Later of 1/2" MDF Plywood d. Choice of either Armstrong Ascot Hardwood or 1/2" Prime Harvest Engineered Wood 2. Reception Lobby: Daltile Sandalo Ceramic Tile 3. Common Corridor, Storage, and Reception: Mohawk Mixology Carpet 4. Bathrooms, shower, and Janitorial: Armstrong Standard Excelon VCT Ballet Barre: I. Furnish and Install 30' of Single Fixed Height Wall Mount a. Hardwood Ash (1.5" diameter) b. Metallic Silver Collared Brackets 2. Furnish and Install 24' of Single fixed floor Mount a. Hardwood Ash (1.5" diameter) b. Metallic Silver Collared Brackets c. Metallic Silver Single Fixed Height Fitness Floor Stanchion (top of barre height @ 42") Plumbing: 1. Furnish and Install a. 2 - Wall Hung Kohler toilet & Sloan #110 Flushometers b. 2 - Wall hung carriers c. 2 - Lavatories Kohler and 4" Faucet 3 t W Alk CONSTRUCTION COMPANY, INC. d. 1 - 24"x24" Mop sink and Valve e. 1 - 36"x36" Shower and valve f. 1 - ADA water cooler and glass filler g. 1 - 50 Gallon electric HW Heater set on Stand above Mop Sink h. 1 - ADA fixtures as shown on Plan. HVAC: 1. In Studio 1: Install Spiral ductwork, registers, and grill from 4 Ton Split System (Supplied by Realty) 2. Office area and Lounge: Two zone ductwork control system, grills, and registers. 3. Bathrooms: Inline bathroom exhaust fan, ductwork and registers. Electrical: 1. Furnish and install (5) type "A" lighting fixture 2. Furnish and install (16') Type "B" light track. 3. Furnish and install (7) type "C" lighting fixtures. 4. Furnish and install (6) type "D" lighting fixtures. 5. Furnish and install (9) type "E" lighting fixtures. 6. Furnish and install (7) type "X1" lighting fixtures. 7. Furnish and install (4) industrial paddle fans. 8. Furnish and install (17) duplex receptacles. 9. Furnish and install (4) single pole toggle switches. CHA RLES CONSTRUCTION COMPANY, INC. 10. Furnish and install (5) occupancy sensors. 11. Furnish and install (1) GFI receptacle. 12. Furnish and install (2) floor boxes. 13. Furnish and Install (2) plaster rings and pull strings for voice/data 14. Furnish and Install (4) Voice/data outlets and cabling to common area on wall at column line B-5 15. Furnish and Install (5) dedicated 120 volt ampere circuits. 16. Does Not Include Any Lighting for Studio 1 Painting: 1. Painting of Interior Partitions with 1 coat primer and 1 coats finish of Benjamin Moore Paint. Colors TBA 2. No Painting of the brick is permitted. 4 5 2c)z S,� S�,4 HL - �, h+Ness david c. burton, riba, leed ira m. baline, aia, teed C'mWARCHItectu re PARKING REQUIREMENTS Miami Fitness & Lifestyle October 26, 2015 Per the Building Code Review on Permit Set dated October 26, 209_5_: Use = Indoor Place of Amusement or Assembly Occupancy Load = Business (100 Gross) = 8 Recreation Room (50 Gross) = 40 Total = 48 BUILDING CODE REVIEW APPUCfi131-E CODES 1. BUILDING MASS. STATE BUILDING CODE 8TH EDITION 2. MECKWICAL MASS. STATE MECHANICAL CODE 3. PLUMBING MASS. STATE FUEL GAS AND PLUMBNO CODE 4. ELECTRICAL MASS. STATE ELECTRICAL CODE 5. ENERGY MASS. STATE BUILDING CODE, ARTICLE 13 (780 CMR) 6, FIRE SAFETY MASS. STATE FIRE PREVENTION REGULATIONS, 527 CMR 21 7.ACCESSIBLITY MASS, STATE ARCHITECTURAL ACCESS REGULATIONS, CMR 521 8. ELEVATOR MASS. STATE BUILDING CODE, ARTICLE 30 (780 CMR) DESCRIPTION CODE REF. PROPOSED Nfusentu 1.5 per I RW annual visitors Use N. Andover Zoning Bylaw Indoor Place of Indoor Place of Amusement orAssea ty ArnusernentorAssenft Constrx"On Type Table 601 111 or 11/ same HeW WW Area Table 503 Tenant AM 2,730 SF Arenas and Stadiums 0.33 per seat OCCUPANCYLOAD 50 per nine (holes), plus the palling requirements for food or be\ gunge uses described above Business V2ble 10G4.12 100 Gross (7301100) 8 Pecreabon Room Table 1004.12 50 Gross (20(101?0) 40 TOTAL 48 Per the Zoning Bvlaw of North Andover Amended Mav 20, 2014 Section 8.1 Off Street Parkinq and Loading: Public Assembly = .25 space per person based on the design capacity of the facility (.25x48) Total Parking Required= 12 spaces Total Parking Available on Site = 240 spaces --CuharaVRecmdoesllEntertalnmeut public Assentbl y 0.25 per persoa hi pertained capacity Nfusentu 1.5 per I RW annual visitors LibraW 4.5 per ksf GFA Religious centers 0.6 per seat Cinleum Single -Screen: 0.5 per seat: Up to 5 screens: 0.33 per seat; 5 to 10 screeus: 0.3 per seat 'Cheaters (five for mauce) 0.4 per seat Arenas and Stadiums 0.33 per seat Golf Course or Country Club 50 per nine (holes), plus the palling requirements for food or be\ gunge uses described above Heakh Clubs and Recreational Facilities ? per player or 1 per 3 persous penuitted capacity www.db2arch.com 660 Main Street, 15' Floor, Woburn, MA 01801 david c. burton, riba, feed ira m. bafine, aia, feed Site Plan dated February 8, 2001 3 UDSTON & MAINE RAILROAD i r r , f l (12) DEDICATED PARKING SPACES ALLOCATED TO ML4MI FRNESS & LIFESTYLE www.db2arch.com 660 Main Street, 1" Floor, Woburn, MA 01801 e i i a g 1 Oi i 1 � - 1 I 1 I I 1 1 1 I 1 I I - I I 1 1 OI 1 1 ?$ 1 1 e aavuQ� ®R m `91 # �i yy e _77�� g �® lU WSJ o gb: n 4 T<Z0 O 4 Q xw~V1_* QUO 0<0 aavuQ� ®R m `91 # �i yy e _77�� g v tU gb: y ®� rF ■�Y s LL, Z� — 1 lap -- _ _l LU 1 e a H a 1 3 a f e L a _ e ® L 1' a i e I e o � Mo c IE ® ayu�-y V o ti # yA 6 P E� y ®� ■�Y �r-[---- 0--- l �j 0 z z GLa I pRoi OFA.. wzw- - C C31 Irz ON OO ?J I = N. nlnnl O i�i���i�i�l♦� 1 � ��1♦��i�i�i+�1 J I i - �1�H IIr i 111, 91"I'll jj /��'///����m////////J mmm,���j'% oil ll�� y�.l rr ■rr�■ rruu ll�1i111111 L I! /�� ( til♦ 1��'.�;: - l�j '1 I � , ' ' �/ MEN , 1, off-11111SO � 1 /1 0 0 0 © © ocr Q b 3 6 W J Z s C i z� W s$g$g gg $g g9 ¢$q Ali 3 3 3 V g [ $zg $t t $gt W � � LL o� F _ W W = m o O �A ® a €4�r1 ' £' ffil-¢ �� C'l1 8E Se��i2�i3 a � ait mass ��tt yygg i lYYY�E��d2 s 6 s� � � Z a a Y RR _, rl Iuu1 ILVL Y�� 0 ® \ l� CO O Q RL - � Eli s V Z V Q r a CDof Q N211 0 NZ S O f ® -.�..a.� IN T : a Noll �i�pv g®y Woo �m i.��=�� �iie�s$i-•�^�£e��$Z�si������a<��s���Sm�um+,`$8��� �°fS'�33$ �y�# ® 1 `d' t Ti t £'_ ®a.2;1`djig hL nji 11 � ED g a- � 0- \ . E§ |00 RJR q ,§LL david c. burton, riba, leed ira m. baline, aia, teed C'W2/ARCH511ec tube PARKING REQUIREMENTS Miami Fitness & Lifestyle October 26, 2015 Per the Building Code Review on Permit Set dated October 26.2015: `�.s "' Use = Indoor Place of Amusement or Assembly == % s Occupancy Load = Business (100 Gross) = 8 Recreation Room (50 Gross) = 40 Total = 48 BUILDING CODE REVIEW APPLICABLE CODES 1. BUILDING T MEC14ANICAL 3. PLUMBING 4. ELECTRICAL 5, ENERGY 6. FRE SAFETY 7. ACCESSBL ITY 8. ELEVATOR MASS. STATE BULDI NG CODE 8TH EDITION MASS. STATE MECHANICAL CODE MASS. STATE FUEL GAS AND PLUMBING CODE MASS, STATE ELECTRICAL CODE MASS, STATE WILDING CODE. ARTICLE 13 (780 CMR) MASS. STATE FIRE PREVENTION REGULATIONS, 527 CMR 21 MASS, STATE ARCHITECTURAL ACCESS REGULATIONS, CMR 521 MASS. STATE BUILDING CODE, ARTICLE 30 (780 CMR) SCRU TIOR CODE REF. PROPOSED GENERAL Library use N. Andover Zoning WawIndoor Place of Indoor Place of Amusement or Assenft Arnusernent or Assembly ConsvuchonTWe Table 601 11 or TV Same Hekft and Area Table 503 en it Area 2.730 SF 0.33 per seat Golf Cause or Counhy Club OCCUPANCY LOAD Health Clubs and Recreational Facilities Business able 1004.1.2 100 Cross (730!100) 8 Room V±le 1004.12 1 50 Gross (21XINO) 40 TOTAL 48 Per the Zoning Bvlaw of North Andover Amended Mav 20.2014 Section 8.1 Off Street Parking and Loading: Public Assembly = .25 space per person based on the design capacity of the facility (.25x48) Total Parking Required= 12 spaces Total Parking Available on Site = 240 spaces CakuraltRecrratioaaVE.tertainment Public Assemb , 0.25 per person in pennitted capacity Aluseturn 1.5 per 1.000 annual %isitors Library 4.5 per {sf GFA Religious CetterS O.ti seat Cinemas Single -Screen: 0.5 per seat: Up to 5 screens: 0.33 per seat: 5 to 10 screens: 03 per seat Theaters (live fomnance 0.4 per seat Arenas and Stadiums 0.33 per seat Golf Cause or Counhy Club 50 per nine (holes): plus the parking requirements for food "beverage uses described above Health Clubs and Recreational Facilities 2 per Player or I per 3 persons pex- pined capacity www.db2arch.com 660 Main Street, 1st Floor, Woburn, MA 01801 david c. burton, riba, leed ira m. baline, aia, feed Site Plan dated February 8, 2001 BRSTON & MAtNE RAILROAD `• (iz) OEOICATEO PARKING SPACES ALLOCATED TO MWNI FITNESS & LIFESTYLE www.db2arch.com 660 Main Street, 11` Floor, Woburn, MA 01801 db2/ARCH 1LIs( C:ucrs david c. burton, riba, teed ira m. baline, aia, feed rnt^�, PARKING REQUIREMENTS SA Miami Fitness & Lifestyle October 23, 2015 1: Per the Building Code Review on Permit Set dated October 13. 2015: a. """, ='I> Use Group = A-3 'f Occupancy Load = Business (100 Gross) = 8 Exercise Room (50 Gross) = 40 Total = 48 Y'rrYYY BUILDING CODE REVIEW APPLICABLE CODES 1. BUILDING MASS. STATE BUILDING CODE 8TH EDITION 2. MECHANICAL MASS. STATE MECHANICAL CODE 3. PLUMBING MASS. STATE FUEL GAS AND PLUMBING CODE 4. ELECTRICAL MASS. STATE ELECTRICAL CODE 5. ENERGY MASS. STATE BUILDING CODE. ARTICLE 13 (780 CMR) 6. FIRE SAFETY MASS. STATE FIRE PREVENTION REGULATIONS. 527 CMR 21 7. ACCESSIBILITY MASS. STATE ARCHITECTURAL ACCESS REGULATIONS, CMR 521 8. ELEVATOR MASS. STATE BUILDING CODE. ARTICLE 30 (780 CMR) DESCRIPTION CODE REF. N111setlrn PROPOSED GENERAL i d.5 per ksf t< A Use Group Section 304 A-3 A-3 Construction Type Tabie 601 III or IV same Height and Area Table 503 Arenas and StadmmN Tenant Area 2.730 SF Golf comSe nt Country C'Inb requilemellts for food ur bcseraee Ines OCCUPANCY LOAD Health Club- and Recmational Facilities Business Table 1004.1.2 100 Gross {730!100) 8 Exercise Room Table 1004.1.2 50 Gross (2000!50) 40 TOTAL 48 (15'er the Zonino Bylaw of North Andover _Amended Mav 20: -2014` Section 8.1 -Off Street Parking and Loading_ Health clubs and Recreational Facilities= 1 space per 3 persons based on the design capacity of the facility (48 person/3 space) Total Parking Required= 16 spaces Total Parking Available on Site= 240 spaces Cult u raVRecreationat/E me rtain [Hent public Asembly _ _ _ _ 0.25 per person in perwitted capacity N111setlrn t L5 per 1.000 annual visitors Libran i d.5 per ksf t< A kelieious Ceiders i 0.0 per seat �41� C'iuelnas Stu,,^_le Scteeu• 0 5 per seat L -p to 5 wfeeus� _ _ _ 0 ':{per teat. to -1 0 Set t). PctLseat 1lteaters (live pelfol 111"I tce3 _ _ U 4 pcl WIT Arenas and StadmmN i 0.: pelt StatY_ _ 50 per nine (!toles). plus tate parkmp Golf comSe nt Country C'Inb requilemellts for food ur bcseraee Ines 666 dewribed above Health Club- and Recmational Facilities 2 Pet plavel of 1 !lel ; pelsons pelmitted ca tacos• www.db2arch.com 660 Main Street. I"' Floor, Woburn, MA 01801 david c. burton, riba, leed ira m. baline, aia, teed Site Plan dated February 8, 2001 — _ - OMNI & MAINE RAILROAD ` e � 1i ar�f • - 1^'`\• i4.F!- jig? i / fL j��• jr ifs < w or C JR r LOT. sREa�` acres /*• 9 . Y (16) DEDICATED PARKING SPACES ALLOCATED TO MIAMI FITNESS & LIFESTYLE www.db2arch.com 660 Win Street, 1-` Floor, Woburn, W 01801 Fast Food 1 15.0 per ksf GFA Fast Food (with -drive through facility) I . 12.0 per ksf GFA ®Mice ani B us�neas Services , "'. ..._ _.,. R&D establishment, manufacturing, industrial services, or extractive industry 0.8 per ksf GFA Data Processing/Telemarketing/Operations 6.0 per ksf GFA Medical Offices (multi -tenant) 4.5 per ksf GFA Clinic (medical offices with outpatient treatment: no overnight stays) 5.5 per ksf GFA Veterinary Establishment, Kennel or Pet Shop or Similar Establishments 0.3 per ksf GFA Bank Branch with Drive-in 5.5 per ksf GFA Funeral or Undertaking Establishment 0.05 per ksf GFA Other Business or Office Uses Not Otherwise Listed Above 3.0 per ksf GFA Tndustirial ..._ _.,. R&D establishment, manufacturing, industrial services, or extractive industry 0.8 per ksf GFA Industrial 2.0 per ksf GFA Manufacturing/Light Industrial (Single -Use) 1.5 per ksf GEA Industrial Park (Multi -tenant or.mix of service, warehouse) 2.0 per ksf GFA Warehouse 0.7 per ksf GFA Storage 0.25 per ksf GFA Other Industrial and Transportation Uses Not Otherwise Listed As determined by the Planning Board, but not less than 0.25 per ksf GFA Golf Course or Country Club 50 per nine (holes); plus the parking requirements for food or beverage uses described above Governmental a'nd Educational Elementary, and Secondary Schools 0.35 per student; plus 1 per 2 employees College University Determined by parking study specific to subject institution CulturaURecre�tionaUEntertanment Public Assembly 0.25 per person in permitted capacity Museum 1.5 per 1,000 annual visitors Library 4.5 per ksf GFA Religious Centers 0.6 per seat Cinemas Single -Screen: 0.5 per seat; Up to 5 screens: 0.33 per seat; 5 to 10 screens: 0.3 per seat Theaters (liveperformance) 0.4 per seat Arenas and Stadiums 0.33 per seat Golf Course or Country Club 50 per nine (holes); plus the parking requirements for food or beverage uses described above Health Clubs and Recreational Facilities 2 per player or 1 per 3 persons permitted capacity j. 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Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston, MA. 02114-2017 www mass.gov/dia sV• Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE PILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeaiblV Name (Business/Organization/individual): 0^0" k -4S. • COA a �-� ..�3 if h C nW., n < <4 71A (. Address: �)- a o S4 r 4-,_ 1� City/State/Zip: 0, kklay'-cr I AAI OfVt Phone #: Are you an employer? Check the appropriate box: 9T X, 6Cr. Ss'2.b 1.❑ I am a employer with : employees (full and/or part-time).* 2. Q I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.F1 I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I haye hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.$ 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have na employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. E�Kemodelirig 9. ❑ Demolition 10 Building addition 11.❑ Electrical repairs or additions 12. F1 Plumbing repairs or additions 13. E] Roofrepairs 14. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who sulimit 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. X am an employer that is providing workers' compensation insurance for my employees.' Below is the policy and job site information. Insurance Company Name: T 1'4rt.�.0 rC T •n S••r 4-A C. e. G w s Policy # or Self -ins, Lir,. #: (o N v b' q r60n 1Q 9 - "+-1 < Expiration Date: (e h% % l (v Job Site Address: 7. OZ S --� L-.. S-� r K City/State/Zip: N. 144A0&'t-' M'4 01 Y 4 C Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA. for insurance coverage verification. I do hereby certif under d pain andpenaldes ofpeiyury that the information provided above is true and correct. ature �. Date: j� 1-2 Z / le t!5 -- Sign Phone #• 6-,�V G S L k�Z C 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): i 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract 61 liire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who eviploys persons to iib maititenait66; construction or`repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every. state or local licensing agency shall withhold the issuance or renewal of a license or permit io operate a business or to construct buildings in'ttie'eomniohiyealth ter any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill -out -the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and -phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance: If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Ihdustrial Accidents foi confirmation of insurance coverage. Also be sure to sign and date the afitdavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you'are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly:`Te Depahnfeiithas provid4d sp'ac'e at the bottom of the affidavit for you to hili out in the event the Office of Investigations -has to contact.you regarding the applicant. Please be sure to fill in the permit/license number which will be used{asa reference number. Iii addition, an applicant thatmust subrnit,inultiplep9rmit/license applications in any given year, need only submit one affidavit -indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "al( locations in , (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 wwwmass.gov/dia .� a►R®® CERTIFICATE OF LIABILITY INSURANCE 6/26/2015 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT 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 PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an ondorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 'PRODUCER CON 17MT NAME 'Mathias Insurance Agency, Inc PHONE 978-688-5531 1 CNo.978-687-7460 Al No FxtL 200 Sutton Street, Suite 160 E-MAIL ,,f Andover, MA /{ 010p 45 ADDRESS: _ �NAICB s INSURER(S) AFFORDING COVERAGE INSURER ATMNavigators Specialty Insurance Co INSURER B : Safety Insurance Co i -North INSURED Charles Construction Company, Inc. PO Box 847 INSURER a First Mercury Insurance Co North Andover, MA 01845 INSURER D Travelers Insurance Company INSURER E :: INSURER F: 06/06/15 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. NOTWITHSTANDING 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. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. INSR LTR - TYPE OF INSURANCE ADDL' INSD -',."`.�--,......�- D .,—. POLICY NUMBER 1- _ QIDD,YYYYMM/DD/YYYY .POx.97 LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE LII OCCUR IS15�C�T�133�.12I� I p5/16/15 .. 05/16/16 y EACH OCCURRENCE $_„ l r 00 0000 I PREMISES Ea occurrence $ _ MED EXP (Any one person)� $ s — PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: JECT LOC POLICY PRO- �� F OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OPAGG $ $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTO HIRED AUTOS X AUTOSWN�D { { i 6213523 06/06/15 06/06/16 COMBINED SfNGI.F-L%ffT--- Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident $ PROPERTYX Per accident) A $ 1,000,000 C UMBRELLA LIAR EXCESS UAB X OCCUR CLAIMS -MADE Nom'' XOOOOO4370102 p��, 1 16/15105/16/16 III EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 — DED RETENTION$ $ + Ii! D I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFF, ndaCER/MEMBER EXCLUDED? ❑ (Matory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 6HuB-980OM24-7-15 06/11/15 06/11/16 STATUTE ER E L EACH ACCIDENT $ 1,000,000 --- E.L. DISEASE -EA EMPLOYE $ 1,000,000 E L. DISEASE -POLICY LIMIT $ 1,000,000 I i I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Town of North Andover Building Department 1600 Osgood Street Bldg. `20, Suite 2035 North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE* WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATIVE ACORD CORPORATION. All rights reserved. ACORD25 (2014/01) The ACORD name and logo are reQ.Wred rocks of ACORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -005712 Construction .Supervisor rr- STEVEN C MATSESY� 202 SUTTON ST r t` r t -�s NORTH ANDOVER MA1� t r, jZCK Expiration: Commissioner 10/23/2017 GANNO-1 OP ID: SCDO . 11% R CERTIFICATE OF LIABILITY INSURANCE �� DATE03/31/2015Y) 03/31 /2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT 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 PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 978-688-6921 Macdonald 8, Pangione Insurance P.O. Box 428 Fax: 978-688-5350 104 Main Street North Andover, MA 01845 CONTACT PHONE FAX A/C No Ext : A/C No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Donald Schemack INSURER A: Preferred Mutual Ins Co 15024 EACH OCCURRENCE $ 300,00 INSURED Gannon Built Shane Gannon INSURER B: PERSONAL & ADV INJURY $ 300,00 16 Elm St INSURER C : INSURER D: Haverhill, MA 01830 INSURER E: INSURER F: LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS L 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. NOTWITHSTANDING 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE D L UB POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS AUTHORIZED REPRESENTATIVE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_1 OCCUR North Andover, MA 01845 BOP0100723059 03/31/2015 03/31/2016 EACH OCCURRENCE $ 300,00 DAMAGE TO RENT PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 300,00 GENERAL AGGREGATE $ 300,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRoi El OLICY JPEC LOC PRODUCTS - COMP/OP AGG $ 600,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS L COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVEF—]NIA OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below STATU- OTH- TORY LIMITS I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) for job located at 1211 Osgood St No. Andover MA CERTIFICATE HOLDER CANCELLATION ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept Maura Deems AUTHORIZED REPRESENTATIVE 384 Osgood St North Andover, MA 01845 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD