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HomeMy WebLinkAboutBuilding Permit #564 - 2370 TURNPIKE STREET 3/7/2006 f NORTp, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �SS�cNuse� Permit NO: Date Received:3 � Date Issued: A/zi/I [MPORTANT. Applicant must complete all items on this page LOCATION Print PROPERTY OWNER �� Print MAP NO.:_ j V6Ak. PARCEL: 7 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential F]New Building E One family Ej Addition G Two or more family Industrial Alteration No. of units: L Repair, replacement C Assessory Bldg !Commercial ❑ Demolition Moving(relocation) ❑Other �� Others: L Q1 Foundation only DESCRIPTION OF WORK TO BE PREFORMED r$ t}wt>o -TZ ,l Identification Please Tvpe or P int Clearly) OWNER: Name: -Fiozp— Phone Signature Address: CONTRACTOR Name:-! L t t 00 D ,L S Phone: It-?8. 6$j 3553 Address: z2z / G= -T- iso oJ�R r-1 a If Supervisor's Construction License: 005712— Exp. Date: i v Zoo-7 Home Improvement License: Exp. Date: ARCHITECT ENQyINF.FR 1o56?N LA FRA Sse Name: Phone:..!q 2�- .A55o� �llte5 Yn/c . Address:.&Ne CCS 5 qua k 4induck 61 k f O Reg. No. 2-02-b5 FEE SCHEDULE:BULDING PERMIT.•$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON $12.5.00 PERS F. � --- /®D , Total Project Cost :$ 10,000 xI0.00=FEE:$ Check No.: Receipt No.: SEWARGE DISPOSAL __ TYPE OF Swimmm Pools � Tanning/MassageiBody Art _J Public Sewer - _ Tobacco Sales — Food Packaging/Sales WefF.&* !✓ Permanent Dumpster on Site Private(septic tank,etc. it NOTE: Persons contracting with unregistered contractors do not have access to the guararrtp fimid Signature of Agent/OXer Signature of Contractor Plans Submitted l�]— Plans Waived ❑ Certified Plot Plan r- Stamped Plans j i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit j ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ ' COMMENTS DATE REJECTED DATE APPROVED HEALTH- ❑ ❑ COMMENTS I Zonuig.Board of Appeals: Variance, Petition No: -. --, Zoning Decision/receipt submitted ves e Plannin�a,Board Decision: Comments Conservation Decision: Comments. Water&Sewer connection signature&date Temp Dumpster on site yes no Fire Department signature!date r Building Permit Approved and Issued by: Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total square feet of floor area,based on Exterior dimensions. fi Total land area,sq.A.: s: NOTES and DATA—wor department use) Doc:INSPECTIONAL.SERVICES I)CI'.1R1'y11:.N'i':GI'I(31Z1I 15 Crraied JNIC Lm._406 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 sad Building Permit Application o Debris Removal Fon- W/10Workers Comp Affidavit VAJS oto Copy Of H.I.C. And/Or C.S.L. Licenses o� C of Contract py w- rloor Plan Or Proposed Interior Work Sal'B }'�tJ..i �S1p►��:'D, Addition Or Decks o Building Permit Application ❑ Form U ❑ Surveyed Plot Plan o Debris Removal Form 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) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Form U ❑ Certified Proposed Plot Plan o 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 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:INSPEC"riONAL SERVICES DEPARTMENTMFORA105 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT ` / 1/� ` 6!1 f' PHONE LOCATION: Assessor's Map Number 6 0 .� PARCEL SUBDIVISION LOT(S) STREET a3 70 ST: ST. NUMBER OFFICIAL USE ONLY RE ENDATIO S OF TOWN,AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED 'n DATE REJECTED COMMENTS V 1� � �, elf' TOWN PLANNER DATE APPROVED DATE REJECTED / COMMENTS C✓,ccKs+�( �L �c.,�n,,, �i rrs�,, INECTOR-H AL DATE APPROVED �l DATE REJECTED ,, EP IC INSPECTOR-HEAL DATE APPROVED 7 O DATE REJECTED COMMENTS 4>%,,ov �r�tt7jr .�- i' S s :74 1 a•�p�,o rn;.nc�. 1 PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT6- RECEIVED BY BUILDING INSPECTOR DATE 4r^x ✓fl6 �bY11/I�492U16lGLWL O��/'��pgt1�L4/d6�d BOARD OF BUILDING REGULATIONS F _ License: CONSTRUCTION SUPERVISOR 9 Number: CS 005712 Birthdate: 10/23/1955 Expires:.10/23/2007 Tr,no: 2807.0 Restricted: 00 STEVEN C MATSES SUTTON ST NA —_� N ANDOVER, MA 01845 Commissioner I. 3 Tlie Cori!rruoniuidih 6f-,M _kdChuser s Dr�rart»ierrt of Irrrlr strtR!���irfen . ; , IV 1 pj/f ce TQ-of Ir:nestrgniorrs t dflQ j;' sjrtrtgtori Street Bsw TUvston,:AM 02111 Ill CA 1 I cc 1 ,, _ n. ivtvrtr nrnssg©v%dQ e crs' Coni `ensat"Aljon asurance�1iTidaVst t3uiicietslCvrttr�tcfozs/Elcc ...I., s/P,; w ers Work P. Please Pnnf Le' Bbl ,,' i�cant Xnfii t.lnati©a j� the{B+�s�ness�Orga Eton cltvtdt_at); a ' dress '7 I I §� ,~• " Phone# 3' $' 6$5 .,�� CtiylSiate/Zap ' I .1 Ir vv,�c. hit.n` _ Arc yot►anmploycr� Check the approprlafe boz TY1e flt pro�cct(rcgnrrev) 4, ]� I ani a general cor%iractor and I w- 1.bEyy construction 1 faiiti a eritp)oyerwth 1. have hired the sub=canttactors ,. eml loyees(Tull nd/or past tame). 7 - Reniodet�ng - hsted on tl;e attached�heei t 2.Immm SAME,Q 1. ub a sole proprte or or partner-; . - Dernohtton 7`he suU-eorrUactors nave 4 ❑ Ship and have no ernplvees - AP, workers' camp tnsurattce: 9 :[] Buildrng addtttot1.x "M alatzntworking fvt mean,any capacEty t TIM9 to[Nu _.b.ts'coir- insurance 5 We are a corporation end its IO. Elecincal repairs or addttrons ; .: oliicers hive exercised their reRttted] r 1 t. PlumUtn i arcs or additions '' rt ht of exem trcn er ML - g - 3„[] I an a homeowner doing all worTc g, p p c ,12,§t(4),ana:_we have no 12sQ Roof repairs myself [No workers comp 1 utsurance equtte t Employees [No workers' 3❑ fluter —1 .UV -outiolitiottnsuranibib rt xiired j e?mp _ I '}inn titnni that eiteck3 ibox N t t,tuslalso Fitt out the section txtov sttnwtng them wiirke istde'rnolmctot mitt t s -1 it atFidavtt vtJicotmg such Y l <lonKoa+krs who sutnnttv.hs 8[{adavtt tndtcattig they are doing sU work-arid then hire ou15 tic mforinaiion tGonttactocs that check tht box must attacl►ed a-addthonet sheet showing the name- thesatrcontractors and�hei(worke�s comp po - 1,;nm art:errtlrtrt�ter that is I 1,providrrrg K�vrkers'cbtniter:5atrort tnsr�rartee for ntJ�emrlo��eec, Below i3 thepottcy and Job site r►tMUSTfflTiiiiiiM . t Insttranee Corti an Name S 0.d��rte U P y � 10 Exptratton IIate O�____ Fohcy#E or Sell=rns Lie # W fm44P!7 r. ., an an v Is A 6 SEteAddress tm. _10pity/StatelZrp. t�itaclE a co of the iyorkers compensai�an pottcy declarairon Page(slowrng rite policy nuriibcr and exptratren date) PyKAHN . A. -`I atlurt io secure co erage as required under Soctron SS".11A of MGL:c 152 can lead to tlte;imposttion of -r -.1 al penalties of a tine up to$.i,SOD OO andlor otic year mpnsonuient,as well as civil penalties to the Tor-1 o'-a STOP WORK ORDER a 11 a tine oTep to X250Imn.00 a dray' , 16W t the violators $e advised that a ccipy of this statement may fie Torwarded to ther.Office of InvesttgatEons of the DIA Car;insurance eoveage venticatitit t . 1 do liereh}�rey7rf}�trader t11 he�t ns nridpcnattres of per�rrr}��Irat llie r t ui rre �roir�2r6.ot�ided�bovie rs trice mrd cr��r eco jmv� St "aturcr. IIIate Z 1�'i f e % Phone# t ...p _j rrsc�vnl�t Do xo[rt�rtte izt flits trrerr,to&e eonepleted by crt��or_tort_Ijs offre1.ral Ir ' - Ctty or Ti►wn: 6. PermilJLicensts# r. _6_�.,:_,��__.-�j,::­,r.Q­I�,1�Z1-r�3I�_..:,'.:�.,:Q__,'��-j-�:,1-r 6_:�_.611,,'r6,V',�,_�-_:__�_�___M r'�,_,t:I tssuEng Anthn pity(clrcte vne). 1;;I3oard of stealth 26. ,:guiidin Department 3 Ciiyfltvwl_'' crI Ctet ,6. cat►nspeetvr 4 filuu,binglnspector x fi Oiltcr: l Fhotie# t Gantaci Verson. = r I v vv IN yr till Lv v ten, 1viH►a0ti%,n u ar,i i a TELEPHONE 11:e� (978)623 8350 JACK PETKUS,P.E. DIRECTOR — FAX (978)623-8359 ni 9,8119111111 DEPARTMENT OF PUBLIC WORKS WATER TREATMENT PLANT 397 LOWELL STREET 01 81 0-441 6 sample information DATE: 2/8/2006 date&time: 2/8/2006 location: 2370 Turnpike St. N.A. NAME : M. Petrosino sampler: MP sample e: grab ADDRESS: 2370 Turnpike St. sample ID:# 2370-w North Andover, MA received by: AC TELEPHONE: 978-420-8444 PROBLEM DESCRIPTION Test for total coliform (TC-MF 100 mis) ...................................................................................................................................................................................................................... TEST RESULT Total Coliform-well 0/100 mis COMMENTS: CHEMIST OR ENVIRONMENTAL ANALYST �- Pnnted on 100%Hecycte0 Paper with 30%Past Consumer Waste. THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A101/CM CONSTRUCTION MANAGEMENT EDITION Standard Form of Agreement Between Owner and Contractor where the basis of payment is a STIPULATED SUM 1980 EDITION THIS DOCUMENT HAS IMPORTANT LECAL CONSEQUENCES; CONSULTATION WITH AN ATTORNEY IS ENCOURAGED, This document is intended to be used in conjunction with AIA Documents A201/CM, 1980; 13141/CM, 1980; and 8801, 1980. AGREEMENT made as of the 1$ day of ��jn-'" 'R'" in the year of loo(m BETWEEN the Owner: 71 me 1'24 TL-)e"y 5-mvrl- ib4 !r and the Contractor: • �•.JT's 0Jc2, NIS• c)164 � The Project: the Construction Manager: the Architect: �-- -�_ �CjeAe�S e C Jcq.t N1� The Owner and the Contractor agree as set forth below. • Copyright 1975 @ 1980 by The American Institute of Architect,1735 New York Avenue,N.W.,Washington,D.C.20006.Reproduction of the material herein or substantial quotation of its provisions without written permission of the AIA violates the copyright laws of the United States and will be subject to legal prosecution. IA DOCUMENT A101/CM•OWNER—CONTRACTOR AGREEMENT•CONSTRUCTION A 4 n4/rren --4 can 4 ARTICLE 7 THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement,the Conditions of the Contract (General, Supplementary and other Conditions),the Drawings,the Specifications, all Addenda issued prior to and all Modifications issued after execution of this Agreement. These form the Contract, and all are as fully a part of the Contract as if attached to this Agreement or repeated herein. An enumeration of the Contract Documents appears in Article 7. ARTICLE 2 THE WORK The Contractor shall perform all the Work required by the Contract Documents for (Here insert the caption descriptive of the work as used on other Contract Documents) l_(D t K-1 C( '7GYL ^�{Z�.t.rJI W S S . ARTICLE 3 TIME OF COMMENCEMENT AND SUBSTANTIAL COMPLETION The Work to be performed under this Contract shall be commenced and, subject to authorized adjustments, Substantial Completion of the Work shall be achieved not later than (Here insert any special provisions for liquidated damages relating to failure to complete on time.) IA DOCUMENTA101/CM OWNER-CONTRACTOR AGREEMENT•CONSTRUCTION A4 A4IPRA __4ORA 0) ARTICLE 4 CONTRACT SUM The Owner shall pay the Contractor in current funds for the performance of the Work, subject to additions and deductions by Change Order as provided in the Contract Documents,the Contract Sum of f(0/000 . 0 o �i'c�.> -ri4aJs paio'0 OuAd-� The Contract Sum is determined as follows: (State here the base bid or other lump sum amount,accepted alternates and unit prices applicable.) ARTICLE 5 PROGRESS PAYMENTS Based upon Applications for Payment submitted to the Construction Manager by the Contractor and Project Certificates for Payment issued by the Architect,the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided in the Contract Documents for the period ending the day of each month as follows: Not later than days following the end of the period covered by the Application for Payment, percent( %)of the portion of the Contract Sum properly allocable to labor, materials and equipment incorporated in the Work and percent( %)of the portion of the Contract Sum properly allocable to materials and equipment suitably stored at the site or at some other location agreed upon in writing, for the period covered by the Application for Payment, less the aggregate of previous payments made by the Owner; and upon Substantial Completion of the Work, a sum sufficient to increase the total payments to percent( %)of the Contract Sum, less such amounts as the Architect shall determine for all incomplete Work and unsettled claims as provided in the Contract Documents. (if not covered elsewhere in the Contract Documents,here insert any provision for limiting or reducing the amount retained after the Work reaches a certain stage of completion) Payments due and unpaid under the Contract Documents shall bear interest from the date payment is due at the rate entered below, or in the absence thereof, at the legal rate prevailing at the place of the Project. (Here insert any rate of interest agreed upon) (Usury laws and requirements under the Federal Truth In Lending Act,similar state and local consumer credit laws and other regulations at the Owners and Contractor's principal places of business,the location of the Project and elsewhere may affect the validity of this provision.Specific legal advice should be obtained with respect to deletion,modifrcadon or other requirements such as written disclosures or waivers) A DOCUMENT A101/CM•OWNER-CONTRACTOR AGREEMENT•CONSTRUCTION A 4 n4 rrne—4 osln Z ARTICLE 6 FINAL PAYMENT Final payment, constituting the entire unpaid balance of the Contract Sum, shall be paid by the Owner to the Contractor when the Work has been completed,the Contract fully performed, and the Architect has issued a Project Certificate for Payment which approves the final payment due the Contractor. ARTICLE 7 MISCELLANEOUS PROVISIONS 7.1 Terms used in this Agreement which are defined in the Conditions of the Contract shall have the meanings designated in those Conditions. 7.2 The Contract Documents,which constitute the entire agreement between the Owner and the Contractor, are listed in Article 1 and, except for Modifications issued after execution of this Agreement, are enumerated as follows: (List below the Agreement,the Conditions of the Contract[General,Supplementary and other Condfions],the Drawings,the Specifications,and any Addenda and accepted altemates,showing page of sheet numbers in all cases and dates where applicable) s IA DOCUMENT A101/CM•OWNER-CONTRACTOR AGREEMENT•CONSTRUCTION A 4 n4 rrreA __4 can A Location G t No. 6 Date Z TOWN OF NORTH ANDOVER O Certificate of Occupancy $ S - &o CNUs t� Building/Frame Permit Fee $ / U 0 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �S r Check # 19(j *i 4 Building Inspector