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Home My WebLink AboutBuilding Permit #692 - 315 TURNPIKE STREET 5/1/2006,%ORTH pf t�ao .e,ti0 p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SS/1CHUSE� r Permit NO: Date Received: "�43 Date Issued: IMPORTANT: Applicant must complete all items on this page I LOCATION 315 Turnpike St. North Andover Volpe Center Print PROPERTY OWNER Merrimack College Print MAP NO.: PARCEL: 1rn .7kin FTrr d -%r 13IT77 nIN14- ZONING DISTRICT: RiCTnRIC" DISTRICT YES 0 I Irr, Ei1lU UOU RJr LV1LL111V TYPE OF IMPROVEMENT ---- -- --- - PROPOSED USE Residential Non- Residential C New Building C One family 0 Addition 0 Two or more family C Industrial N Alteration No. of units: E Repair, replacement 0 Assessory Bldg Commercial 0 Demolition C Moving (relocation) [I Other 11 Others: 0 Foundation only DESCRIPTION OF WORK TO BE PREFORM IED Remove masonry, Install overhear, door Remove ceramic tile and replace with new, remove and replace ceiling tile -=Remove benches and shelving, painting Identification Please Type or Print Clearly) OWNER: Name: Merrimack College Robert Coppola Phone: 978-837-5118 Address: 315 Turnpike St. North Andover, MA 01845 CONTRACTOR Name. Sasso Construction Co., Inc. Phone: 978-694-4111 Address: 231 Andover St Wilmington, MA 01887 Supervisor's Construction License: 012453 Exp. Date: 2/27/2008 Home Improvement License: N/A Cornerstone Architects ARCHITECT/ENGINEER Name: 8 Calista Terrace Exp. Date: Phone: 978-399-0240 Address: Westford, MA 01886 Reg. No. 6559 FEE SCHEDULE: BULDING PERMIT. S10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ 35,000.00 x 10.00=FEE: $ 3 5 0.0 0 Check No.: Receipt No.: Pace Iol'4 TYPE OF SEWARGE DISPOSAL Public Sewer Well Private (septic tank, etc. ❑ Tanning/Massage/Body Art Swimming Pools Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ Electric Meter location to project r yr -13 cuturucung win unregrsterea coturacrors ao not have access to the guaranty [tnd Signature of Agent/Owner ame6l,- Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stampe P ans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes DATE REJECTED DATE APPROVED ❑ ❑ ❑ Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED DATE APPROVED ❑ ❑ Planning Board Decision:Comments Conservation Decision: Com Water & Sewer connection signature & date Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 a k Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. Created 1MC. Jan.^006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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 DE, PARTNIENT: WOR N105 rage 4 of 0 Location 7,10 � 0,r_ c-IrL. 4 Date T= TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check # 46160 C, 7 65 (-� C<L� Building Inspector 4 , f AGENT NUMBER POLICY NUMBS. ISSUED BY THE STOCK INSURANCE COMPANY HEREIN CALLED THE COMPANY 1111WC 1 68 AMERICAN HOME COMPANY 013-82-1005-00 • SASSO CONSTRUCTION COMPANY INC 2 1 ANDOVER STREE WILMINGTON, MA 01 87-0000 , SEE NAME AND ADDRESS SCHEDULE - WC990610 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INFORMATION PAGE pimMember Companies of American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 TPA INSURANCE AGENCY, INC. 10 NEW ENGLAND BUS CTR DR ANDOVER, MA 01810-1096 VSURED IS :ORPORATION )THER WORKPLACES NOT SHOWN ABOVE: SEE NAME AND ADORES ITEM 2 1 POLICY PERIOD 12:01 A.M. standard time at the Insured's FROM mailing address PREVIOUS POLICY NUMBER RENEWAL 007758571 errucnlll r - wcggo6lo 10/01/05 To lo/01/06 _ r ......a ♦ha c4A4AC iistad ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the worKers a.onNo,,,o.•-•• __.. _ here: MA ,. 1 B. Employers Liability Insurance: Part Two of the policy applies to the work n e 1,0 0 , 000 each accident The limits of our liability under Part Two are: Bodily Injury by Accident $ 1 000.000 policy limit Bodily Injury by Disease $ Bodily Injury by Disease $ 1,0 10.000 each employee C. Other States insurance: Part Three of the policy applies to the states, if any, Ifs>:ea nurv. AK AL AR AZ CO CT DC DE FL AHI IA ID IL INKS KY LA MD ME MI MN MO MS MT NC NE NH NJ NM NV NY OK OR PA RI SC SD TN TX UT VA VT WI ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. A Tn c oration required below is subject to verification and change by audit. Estimated Estimated Total Rate Per Premium Classifications SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES EXPENSE CONSTANT (EXCEPT WHERE APPLICABLE BY STATE) 284 MA Remuneration $100 OF Re - Code Number r�� muneration XX Annual ❑ 3 Y Int Annual ❑ 3 Year TOTAL ESTIMATED PREMIUM if In below, interim adjustments of premium shall be made: DEPOSIT PREMIUM Quarterly 0 Monthly Semi -Annually 0612 ENDORSEMENTS (FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC99 08/19/05 PARSIPPANY 82 Issuing Office Issue Date 39967 INSURED'S COPY $1,4( 1 r Authorized Representative wC 00 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): S a s -go f' ; on r n -, T nc Address: 231 Andover Street City/State/Zip: Wilmington, MA 01887 - Phone #: 978-694-4111 Are you an employer? Check the appropriate box: 1. I am a employer with / �/ 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors listed on the attached sheet. I 2. ❑ I am a sole proprietor or partner- These sub -contractors have ship and have no employees working for me in any capacity. workers' comp. insurance. 5• ❑ We are a corporation and its [No workers' comp. insurance officers have exercised their required-] 3. ❑ 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. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 101-1 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other, 'Any applicant that checks box ill must also fill out the section below showing their workers' compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: American Home Assurance Co Policy # or Self -ins. Lic. M wry 7; ,; 8 r, 7 1 Expiration Date: 10/l/06 Job Site Address: 315 Turnpike Street City/State/Zip: Nori-h Andover, MA Attach 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 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th pains and ocnalties of perjury that the information provided, above is true and correct Signature: Dater 7 Phone #: q19- &C/ Oficial use only. Do not write in this area, to be completed by city or town ofjk ak 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 #• Aug -05-99 r , � „MIM 03:59P North Andover Com. Dev. 508 688 9542 P.O- PROJECT NUMBER: PROJECT TITLE: OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT LOCATION: 315 Turnpike Street NAME OF BUILDING: Volpe Center NATURE OF PROJECT; IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE. 1, Charles Cochran 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 ❑ STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS. COMPUTATIONS ANO 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 BE PRESENT 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 SMALL 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 apprcvat 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 s✓M A.9 with the progress and quality of the work and to determine, in general, if the work is beingo 1W CHARLEA. S performed in a manner consistent with the construction documents. COCHRAN C'{ a PURSUANT TO SECTION 116.2.2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT4 N0.6559 TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSP - ESTFORD a �MA q� UPON COMPL—=TION OF THE WORK. I SHALL SUBMIT A FINAL REPORT AS TTHOFMA O �► SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR 0' 1 s� JI171`W a UrcC SUBSCRIBED ANORN TO BEFORE ME THIS of Sr DAY OF 19��CO NOTARY ELIC MY COMMISSION EXPIRES Anthony J. Pimentel NOTARY PUBLIC My commission expires March 26,2010 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: Wood Processing LL&S Salem, New Hampshire (Location of Facility) A- e4' Signature of mit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector CA m X m X CO) CO) E, m M C C ? o to = O =0 cr N =fooo n m o m O H CD �'. C �• 77 O z -=ro y � y o � °: o �' 'fl o a =r ti C d m o m H o imoo' o = 0 o m ;; U2 0 '.� C) O C y. n CO) 'C O ►� c �(7%. CD C -• H O Z y r C n '"m a CCD O '0 to o s_? 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