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Home My WebLink AboutBuilding Permit #494-2017 - 350 WINTHROP AVENUE 11/10/2016fl��r BUILDING PERMIT f.`` a�� aV` TOW N OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Per N0.A Date Received .f Date Issued: 140Z? �RATlD 9SSArgo IMPORTANT: Applicant must complete all items on this LOCATION 350 Winthrop Ave. No. Andover MA. 01845 Print PROPERTY OWNER Delta MB LLC 875 East St Tewksbunt MA 01876 (978) 851-0200 Ext. 213 John Mathews Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village ves no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial (X Alteration No. of units: IR Commercial ❑ Others: ❑ Repair, replacement ❑ Assessory Bldg ❑ Demolition 0 Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District R Water/Sewer Dental office construction as per Architect stamped plans To include nonbearing metal stud walls/ Plumbing/ Electrical/ HVAC ducting/ Sprinkler head relocation. Identification Please Type or Print Clearly) OWNER: Name: Delta MB_ I Lc Phone: (978) 851-0200 Ext 213 Address: 875 East St. Tewksbury MA. 01876 John Mathews CONTRACTOR Name: Phone: (603) 463-5790 Rnnqld Marrift Mprritt rnnetmr•tinn Address: 15 Haynes Rd Deerfield NH 03037 Supervisor's Construction License: Exp. Date: CS -061160 05/15/2017 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER _ David A. Farmer Phone: 17) 413-7027 Address: 1493 ramhrit19P St ('amhridoe MA 09139 Reg. No. 8333 FEE SCHEDULE. BULDING PERMIT. • $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 25s, 900 .00 FEE: $ �` Check No.: 3-7- Receipt No.: 31l f NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner /6tw, 7I&IA..&- Signature of contractor g, .4 /A Plans Submitted ® Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans FX 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 DATEAPPROVED PLANNING &DEVELOPMENT ❑ �. �O 2Q K.1I0 COMENTS4 N� jj� CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes X raft; Located at 124 Main Street Fire Department signature/date COMMENTS - � � M Dimension � f , Number of Stories: 1 Total square feet of floor area, based on Exterior dimensions. 2,672 Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No X DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use) P6 Notified for pickup - Date Doc.Building Permit Revised 2012 Permit No#:— BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FORPLAN EXAMINATION" Date Received Date Issued: LMYORTANT: Applicant must complete all items on tbis'page 7-77- - 7-7- —7-7-74 -:7- LOCATION . to PHU -5 P R -TY, OWN R R 8tfidcqudrye^ S 110 TR =yes h - DI& istb- 6 MAR A4 R. E Lk H ri ZONING Machine. Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building 0 One family 0 Addition 0 Two or more family 0 Industrial Alteration No. of units: —E] Commercial —0 El Repair, replacement 0 Assessory Bldg El Others: 0 Demolition El Other . - Esbotic,gWell" ,If I ❑ F1.b _!ao Wetlands. '--, Wat& -e District Wafer/Sewer DESCRIPTION OF VVUKK 10 kit FtK1-UK1V11=U; Identification - Please Type or Print Clearly OWNER: Name: A,J,J----. e: i 14 ARCHITECT/ENGINEER Phone: Address: Reg. No.. FEE SCHEDULE. BULDINGPERMIT, MOO PER $1000-00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. f.'--'-rotal Project Cost: $ FEE: $ Check No.: Receipt No..: NOTE: Persons contracting witli unregistered contractors do not have-- access to the guaranty fund f Sidnature of contractor, Plana Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ TYP13 bF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF e U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signatu CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on nature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comme Comments Water & Sewer Connection/Signature k Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT' Temp Dumpster on site yes Located at 124. Main Street Fire Department signatureldate COMMENTS W- Locatea 6m usgooa Street no -Nmension 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-$1000 fine Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. r 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/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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o 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 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit N 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. 494' " Zr11--;- - Date 1041/d 's TOWN OF NORTH ANDOVER Certificate of.Occupancy $ Building/Frame Permit Fee $% y Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 3:7zl? Building Inspector / Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 255,200.00 m $ - $ 3,062.40 Plumbing Fee $ 382.80 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 382.80 Total fees collected $ 3,928.00 350 Winthrop Avenue tenant fit up dentist office 494-2017 on 11/10/2016 0 O = LL O o O m u O O LL v O_ GJ N O W Z Z m C O 7 OO LL = C L U f9 = LL O Z Z J d L :30 O Q' C LL O ~ Z u �� V J W -C O!1 U In C LL CK O W v1 ? Q (� L UO d' LL Z W a W W Ix 6L L m Z N N v u O N N E r 1 .Q O � O O 06 W _ C Q d w E U 40 L C' W w L 3 �tmL CL L m c > � L y O N > O O i z 2 CCZ W m a ui G W CL �i LS w •V ��^1 00 L- CL Q. CU J -0 O /d Z U) C -4W Merritt Construction Lqft 15 Haynes Road7) D 03037 DeeUl OSALrfielc� N.H. Tek (603) 463-5790 j Proposal #: 92616 Sheet #: 1 of 4 Date: 09/26/2016 Proposal Submitted To Name: Gentle Communications Street: 200 Fifth Ave. City: Waltham State: Mass 02451 Tel: 781-647-0772 Fax: 781-895-9995 Work to be Performed at j Street: 350 Winthrop Ave. City: No. Andover State: MA. 01845 Date of Plans: 09/13/2016 Architect: Paul Zbruz Plan # We hereby propose to furnish all the materials and perform all the la r necessary for the completion of Dental ice as per above Plan and attached Specifications Sheets. If Information_ to be supplied by Gentle Dental is not received in a timely manor we may charge extra as to offset cost, Special Note: Items to be supplied by others and installed by Merritt Construction: Paper Towel Dispensers. Gentle Dental standard specs will override Dental Co. specs. Clean box letter dated 04/13/2016 Architect to review and Stamp designers plan only. Not included in this Proposal : Licensed. Engineer, Lead, H.V.A.C. Unit, Outside of building, Storefront, Rear Door and entrance, Fire Alarms, Separation walls, Concrete Allowance cut to a maximum depth of 6", or existing code violations. All material is guaranteed to be as specified, and above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of Two Hundred and Fifty Five Thousand Two .Hundred Dollars: $255,200.00 to be made as follows: TBD Any alteration or deviation fi°om above specifications involving extra costs, will be executed only upon written orders and will become an extra charge over and above the estimate. In the event that a payment is not made when due and we commence with legal proceedings to collect monies owed, you agree to be responsible for all costs of collection, including attorney fees and costs. In addition, any unpaid amount will bear interest at the rate of 18% from due date. Respectfully Ronald C. Merritt Note: This proposal may be withdrawn if not accepted within 10 Acceptance of Proposal The above prices, specifications and conditions are hereby accepted You are authorized to do work as specified Accepted by Date: ?/-9 ��g?c 1,6 Signature: Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 80' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Gental Dental of New England Date: 10/3/16 Property Address: 350 Winthrop Avenue, North Andover, MA Project: Check (x) one or both as applicable: New construction X Existing Construction Project description: interior fit -out of an existing building for dental office including interior partitions, MEP, finishes, etc. I David A. farmer, AIA MA Registration Number: 8333 Expiration date: 8/31/17 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': X Architectural Structural X Mechanical Fire Protection X Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. ERE D ARCy Enter in the space to the right a "wet" or�A electronic signature and seal: 0 No. 8333 CAMBHiDGE, u� l MA �Jo Phone number: 617-529-3875 Email: d—farmer@comcast.net A Building Official Use Only Building Official Name: Permit No.: Date: ivote i. indicate with an 'x' project design plans, computations and specifications that you prepared or directly supervised. If `other' is chosen, provide a description. Version 06 11 2013 October 7, 2016 Zoning/Code Analysis — 350 Winthrop Avenue, North Andover, MA Project: Gentle Dental of New England Zoning: Property address: 350 Winthrop Avenue, North Andover, MA (existing building) Zoning District: B-3 Use: Dental Clinic Parking Requirement: existing Code Analysis: Applicable Codes: - 2009 International Building Code w/Massachusetts Amendments 780 CMR - 2009 International Existing Building Code - 2012 International Mechanical Code - Fire Prevention and Electrical Regulations 521 CMR Incorporating NFPA 1 - Massachusetts Accessibility Regulations 521 CMR - Massachusetts Plumbing Regulations CMR Building Use/Occupancy: B (Business) per IBC 304.1 Construction Type: Type III (IBC 602.3) Life Safety Systems: Supervised Automatic Sprinkler System Fire alarm system Use Group Separation: None Occupancy Load: Use Group B; project SF = 2,267; 100 SF/person = 22 Exit Access Common Path & Travel Distance —100' allowable (Business) — maximum travel distance 62' Travel Distance Allowed Per IBC Table 1016.1 — 300' Allowable Business Corridor Width — Allowable per IBC Section 1005. 1, CMR Exception 2: 0.15"/per person — Provided: %Z occupant load of 22 people = 11 people per egress route = 2.4" (44" min. per IBC 1018.2); 5 '-7" minimum provided Corridor rating — None required for Use Group B per IBC Table 1018.1 Stair Enclosure Ratting — N/A The Commonwealth of Massachusetts 4A�Li�;Itycopf�Ow!nl)- In accordance with theprovisiom ofKGL. Department of Fire Services Office of the State Fire Marshal P. Q. Box 1025 State Road, stow, MA 01775 PERMIT Permit No (If Applicable ) Chapter 10as provided in section 5 2 7 CMR 34 'ASS FrNESE^ :'r_cr Date: /d FINg -Sak Number This Permit is granted to: Start Date Full name of person, Firm or Corporation locate dum ster for construction/renovation/demolition of structure comment': dum ster be 251 from structure or covered with tarp or plywood Restncnons: at end of workday Permission to at Fee Paid� ( Give location by street and no., or describe in such manner as to provied adequate identification of location) . � This Permit will expire 01 ° granting penuit) 0ffi granting permit(Tule) MMy TWI_C PPRMIT MI IRT" RF r-r)m-qPK'_1 fnj LCi V Of'lgTi=n i IPf' m TNF pRI;MICFC 4 \ The Commonwealth of Massachusetts Department of IndustrialAccidents X Congress Street, Suite 100 Boston, Al 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers. TO BE FILED WITH THE PERNffl"mG AUTHORITY. Applicant Information Please Print Legibly Name (Business/OrganizatiorAndividual): Ronald Merritt Address: 15 Haynes Rd. City/State/Zip: Deerfield NH 03037 Are you an employer? Check the appropriate box: Phone #: (693)463-5790 LE] I am a employer with employees (full and/or part-time).* 2.❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 30 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 have hired the sub -contractors listed on the attached sheet These sub -contractors have employees and have workers' comp. insurance.? 6.Q We are a corporation and its officers have exercised their right of'exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp, insurance required.] Type of project (required): 7. ❑ New construction 8. ® Remodeling 9. ❑ Demolition 10 [❑ Building addition 11. E] Electrical repairs or additions 12. ❑ Plumbing repairs or additions 13. E] Roof repairs 14. F1 Other ;Any applicant that checks box #1 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. ;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 thepolicy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. M Expiration Date: Job Site Address:_ _ 350 Winthrop Ave. City/StateJZip: No 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 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 certify under the pains and penalties of perjury that the information provided above is trite and correct Sienature: A� 2&AAI�`i`_- Date: 11/2/2016 Phone #: (603) 463-5790 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): ; 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone Massachusetts - Department of Public Safety Board of Building Regulations and Standards Constr-ucticn %nervi%r License: CS-061160 RONALD ME +� C D'E m a, HAYNES DEERFIELD Expiration Commissioner 05/15/2017 .Dimension Number of Stories: 1 Total square feet of floor area, based on Exterior dimensions. 2,672 Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No X DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) Notified for pickup - Date Doc.Building Permit Revised 2012 1� Plans Submitted ® Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer IX 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 PLANNING & DEVELOPMENT ❑ DATEAPPROVED COMENTS �' 11 C t� `TU► U11� �� ti s CONSERVATION ❑ ❑ COMMENTS HEALTH COMMENTS ❑N DATE REJECTED DATE APPROVED Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes X r4a Located at 124 Main Street Fire Department signature/date COMMENTSfr�,�I vx le