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HomeMy WebLinkAboutBuilding Permit #875 - 350 WINTHROP AVENUE 6/6/2012 i pORT/l BUILDING PERMIT o� tL�o ,sgao TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: f✓ Date ReceivedAr ��SSgcHus���y Date Issued: IMPORTANT:Applicant must complete all items on this page y ,K.'rwJ.•,ww. -e ;;a'�r t ",. r�, -r •a.», n".r1:*r t,'r. ^;"'� aft �Ji+ esY "'y-Ee`}. .h"". .STs :t ti- .r.^y :"l '.is` ; s. : i I ,Y + , o ,q,,,• � LO�GATIONAb,vJt Plh-SP�ILT� �Jco.J�I�/Zp� AV`l�/C�:`�, Y0INNERZ 17 - J- PROPERTs eZ �4 Pnntl s L I �MAP�NO: PARCELz>ZONINGiDISTRICT'!ti Histonc,Dist�ict' M yes no n. VilI"ei'''y eso t n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial teration No. of units: ommercial air, replacement Assessory Bldg Others: Demolition Other Septic. v11e11r• t `" Fliodplain Wetlands c, 'WafershetlDistnct3` . _ :Wates �' :. ... ,.r -. . DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: I'S-t-4 -wp t)bvr4- AQtKI-i 'l�i2usr— Phone: 43fi8-(646-fl1e(o Address: ieer--7' ��1�1 Y—S&X ' fes- cif 8 Ak CONTii N r RAC�TORt ,Address , �c'vS�•C!t�,''Sr�rt�:�.��I t�xS�a�'`� �'hl-'0�� - - - - - SEx Daey? zotupervisorbslConsctioncens � Z �A � s • L© c� - � �.,, . LCJI' d ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PER,MyI,T.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ i(J3o FEE: $ �� Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contr for Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL I 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature II COMMENTS I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes s Planning Board Decision: Comments I Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit I DPW Town Engineer: Signature: Located 384 Osgood Street FIREDEPARTMENT Temp'Dum.pster on site yes ,no �. Located at 124,Mdin�Street .,Fire Department icinature/date' -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.$10041000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date �_ _ ---- - ...� Doc.Building Permit Revised 2008 i Building Department i i The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing g, Siding, Interior Rehabilitation Permits ❑ Building Permit Application j a Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o 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 o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L. Licenses o 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 Li Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products MOTE: 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 DEPARTMENTMFORM07 Revised 2.2008 1 4 O Date.u!�l ?,l.��...... . NpRTM TOWN OF NORTH ANDOVER o? ' p� PERMIT FOR MECHANICAL INSTALLATION � p 4 h �7SSAC NUSEIS This certifies that has permission for mechanical installation in the buildings of . . . . . . . . . . . . . . ... .. . . at �,Y-J��.// �- . . . . . ., North Andover, Mass. Fee40.1..0). Lic. No.!`.k ). . . . . . . . . . . . . . . . . . . . . ... . . . . . GASINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer ��, 1��� _��.�� ��. �.�� - I Retail Management& Development 881 East Street Tewksbury Massachusetts 01876 978.851.0200 978.851.4962 f Real Estate Development Architectural Services May 8, 2012 Leasing and Acquisition Judith M.Tymon,AICP Town Planner Town of North Andover 1600 Osgood Street, Bldg 20, Suite 2-36 North Andover, MA 01845 RE: North Andover Mall,350 Winthrop Avenue Request for Waiver from Site Plan Review,Olympia Sports Dear Ms.Tymon: Delta& Delta Realty Trust,owner of North Andover Mall,has signed a Lease with Olympia Sports for the remaining portion of the former CVS space at North Andover Mall. Delta&Delta Realtv Trust respectfully requests a waiver from Site Plan Review for this renovation of existing retail space. With respect to the construction to be performed by the Owner's general contractor, please be advised of the following: There will be no change to the building's footprint; The use,retail store,is consistent with the zoning in the district;and There will be minimal changes to the building facade,the sign canopy will not be changed, storefront windows and a door will be installed. Thank you for your attention to this matter. Very truly yours, DELT DELTA REALTY TRUSS John Matthews Landlord's Representative � r10Rtry Cf<�°D e�40 Town of North Andover Office of the Planning Department s e9 ,r a T4s••_°..�s� Community Development and Services Division S tCHUSE Osgood Landing 1600 Osgood Street Building#20,Suite 2-36 P(978)688-9535 North Andover,Massachusetts 01845 F(978)688-9542 To: Gerald Brown From: Judy Tymon Re: 350 Winthrop Ave.,North Andover Mall Date: May 8,2012 After receiving a request for a Site Plan Review waiver from the owner of the North Andover Mall, located at 350 Winthrop Ave., I have determined that the change of use from pharmacy/to retail does not warrant a Site Plan Review and thus qualifies for a Site Plan Review Waiver, based on the following: 1. There are no changes to the building footprint. 2. The use (retail) is consistent with the zoning(Business 3) 3. The proposed changes do not have a significant impact on the site or adjacent properties and will not impact vehicular or pedestrian traffic,nor will it impact environmental resources. Please let me know if you have any questions. cc: John Matthews, Delta&Delta Realty Trust Judy Tymon, AICP Town Planner BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Commonwealth of Massachusetts Date: Sheet Metal Permit - /2 Permit# G G Estimated Job Cost: $ 7� Permit Fee: $ Uv Plans Submitted: YES NO Plans Reviewed: YES NO Business License Applicant License# �S~ Business Information: Property Owner/Job Location Information: Name: lne2611"7z �' , 4:5",74 SGS. Name: �Del 714 q 1�)elm 12e4l f y I`2 us 7- Street: 16,5j s t T' Street: City/Town:l,-wAs h u2 y City/Town:/1/0,07`4 4'Am"'t /:27 �? " Telephone:,? Telephone: G 2.7-4�'zlo — 8 Photo I.D.required/Copy of Photo I.D. attached: YES ty— NO Staff Initial J-1/M-1-unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq.ft./2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutionn/al Other Square Footage: under 10,000 sq. ft. over 10,000 sq.ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC X Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents . Air Balancing Provide detailed description of work to be done: e c5 YS 1 e -f o, a� (� rD`v �PS INSURANCE COVERAGE: I have a current liabilityinsurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: type a of indemnity El Bond El liability insurance policy [�, OWNER'S INSURANCE WAIVER:I am aware that the licensee does have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only ry �✓ Owner ❑ Agent uV —2—�i V —'—(2 Signature of Owner or Owner's Agent By checking this box[],I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and Installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: By ❑Master Title ❑Master-Restricted citylTown ❑JourneypersonFNumber: e of Licensee Permit# ❑Journeyperson-Restricted Fee$ El Check at wwwmassg /dpl Inspector Signature of Permit Approval The Commonwealth of Massachusetts Department of Industrial Accidents nN Office of Investigations - "_ 600 Washington Street J E=:� - ' ,';; Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ContractorslElectricians/Plumbers /Applicant Information Please Print Legibly Name(Business/organization/lndividual): Commercial Comfort Service, Inc. Address: 1059 East Street -City/State/Zip:Tewksbury, MA 01876 Phone#: 978-851-5954 Are you an employer?Check the appropriate box: Type of project(required): 1.91 1 am a employer with 17 4. ❑ I am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6• New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ® Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in an capacity. employees and have workers' M Y P h• 9. ❑ Building addition (No workers'comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions J.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.[J Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.7 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policv information. I Homeowners who submit 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Peerless Insurance-Excelsior Insurance company Policy#or Self-ins.Lic.#: WC2660458 Expiration Date: 02/22/2013 Job Site Address: Olympia Sports, 350 Winthrop Avenue City/State/Zip:North Andover, MA 01845 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 XMvestigations of the DIA for insurance coverage verification. i I do hereby ' under the pains and penalties of perjury that the information provided above is true and correct. Si nature: Date: f'�6 Phone#: 978-851-5954 Official use only. Do not write in this area,to be completed by city or town official 7 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#: i r n- — �U BEES. s¢y t 1,1 kill 7' ` COMMONWEALTH OF MASSACHUSETTS SHEET METAL WORKERS " s DWIGHT L DAV N c 43 ORIOLE DR `ANDOVER MA 01810 34aLICENSE NO. EXPIRATION � DATE SERIAL NO. COMMONWEALTH OF MASSACHUSETTS SHEET METAL WORKERS ASA BUSINESS _ ISSUES THE ABOVE LICENSE TO 1 DWIGHT, ' DAVIS COMMERCIAL COMFORT SERVICEI 1055 ,,EAST. ST �'TEW`KSBUR:Y MA 0 1876 0000 41: 10/26/12 968771 ' Sheet Metal Commercial Guidelines/Life Safety/Critical Systems Inspection Checklist Yes No N/A, Set of stamped engineering documents and detailed description of mechanical system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper journeyperson-to-apprentice ratios Fire dampers with access door properly installed and checked for operation Smoke and combination fire/smoke dampers with access doors properly installed- actuator checked for proper operation(May also be verified by fire department during fire alarm testing) Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) Smoke/atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm testing) Stair pressurization systems installed(where required)and operation verified(May also be verified by fire department during fire alarm testing) Grease/kitchen hood exhaust system installed with all seams and connections welded airtight with properly located cleanouts.Proper cle:y,ances,fire rated enclosures and pressure testing required. _` Se>sr•�ii res,amts installed:xrliF:tz iequired.'on egtiipment and dut:�.o,v Duct penetrations in fire'ratc-;4 m-all:;and floors sealed Metal roofing systems installed watertight using proper materials and fasteners Flexible duct runs installed 6'-0"maximum length Ductwork installed using proper hanger spacing,hanger stock,threaded rod and angle iron Ductwork/plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining Volume dampers installed for each supply air branch duct New/clean-properly sized filters installed(final inspection) Testing and Balancing report complete(final sign-off) I