Loading...
HomeMy WebLinkAboutBuilding Permit #637 - 21 HIGH STREET 4/30/2008BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �,3 Date Issued: d . OK IMPORTANT: Date Received �1- 3v - Oeq must complete all items on this LOCATION `� 1�l \ G- N J7 , N z "-,e, KC t41J6,js`--- Print PROPERTY OWNER R Lam--'PAWOoasn- ����--�--�- p Print MAP NO: PARCEL: ZONING DISTRICT: Historic District Is Machine Shop Village no 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, re lacement Assessory Bldg Others: emolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: �,rn <<4-3 J&-� nom••— e6V)a-,KC-0 pLhe,14 . Identification Please Type or Print Clearly) OWNER: Name`�,, �y.,1z 2F�NQ W c-+ Phone:kc�`-1.-o-Lf- / Address: � r ( V vA t -.q 10 CONTRACTOR Name: Kvc Y(L� Phone: b Address; ��Lh�� N <J t W �% V tl o J ` t✓�— Supervisor's Construction License: e- by'3 4- Exp. Date: Home Improvement License: \,fl $YaL a Date: k ( V ARCHITECT/ENGINEER Phone: �aL"Z _�Z-j � 1-51- - Address: 1 (3-� e4*4 c d Reg. No. L"5 Z$ O FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED N $125.00 PER S.F. Total Project Cost: $ q., (3 y kN — FEE: $ t 0 r Check No.: -� Lc-�P( L Receipt No.: a � � 1 I . NOTE: Persons contracting with unregistered contractors do not have access to the gua ,fund $gnature of Agent/OwnerU/-,,----------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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT Temp Dumpster on site yes no Located at 124 Main Street ` Fire Department signature/dateZ Oo 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-$1 000 fine NU I t5 and UA 1 A — wor 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 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 ❑ 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 Location -01. -Au J7, No. -4- Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ CHU IL Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 21 i'l 9 14 Building Inspector O Z 0 0) Cl) O Z 0 CHANGE ORDER Distribution to: RCG North Andover Mills LLC - David Steinbergh RCG Builders LLC - Skip Rose East Mill - Common Areas 21 High Street North Andover, MA ' RCG North Andover Mills LLC TO: (Contractor) 17 Ivaloo Street Somerville, MA 02143 Change Order Number: Initiation Date: Architect's Project No.: Contract For: 4 29 -Apr -08 BLDNCOM Lobby Renovations Phase: - Common Area Improvements/Sitework L-- _ Contract Date: 12 -Jul -07 You are directed to make the following changes in this contract as a result of approved Change Estimates: CE # Date Approved DESCRIPTION Amount Demo 1st & 4th Floor Bathrooms & Offices 22 4/29/2008 Demo I st & 4th Floor Bathrooms & Offices $7 475 00 General Conditions: $404.00 Fee: $1,121.00 Total: $9,000.00 Total AIA Chanse Ordermount• $9,000.00� The original Stipulated Sum was $188,301.31 The net change by previously authorized Change Orders $24,000.00 The Stipulated Sum prior to this Change Order was $212,301.31 The Stipulated Sum will be increasedby this Change Order $9,000.00 The new Stipulated Sum including this Change Order will be $221,301.31 The Contract Time will be unchanged ( ) days RCG North Andover Mills LLC OWNER 17 lvaloo Street Address Somerville, MA 02143 - hur DATE y , 2- Ly RCG Builders LLC CONTRACTOR 17 Ivaloo Street Address Somerville, MA 02143 BY C DATE 4/29/2008 E x O A rn u O LE v cn Cd O a GO) z O w O g2 U id w a V w Go w CdW x O W U w' 5� cn � w F G m w G w W a w v a c0 O cn ©� Q w3 uIc 1 o 47 14 . � �QO � ti : O Gp O c.�. ,N s CBCL N _R N 3 m co c c , CO ��r N W o �mo ® N O m O pct vc�z .: CL o CD CA Cl) c = 41 O r p COD O e.. eNv = "'. m W C W C m r" c �' •N"a L A c . N mi =.-. O p -0 V !E cm C COD C. m 'F. F. O H1 = Wcl N = .. o E CDd N CO C / N 0 a H c O m CD CC m c 1 R-0 a co O CD Z O D H M co L CL CD C O co C.1) ev CL C40 O V CA c O ev .0 _cc C. CA raw _O V co CL CO) O 0 co 3 Q CD a. CL c 4 cc O CO a) CL V! C LLI 0 U) LLI vI W W C9 W N)