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Home My WebLink AboutBuilding Permit #0711-2017 - 351 WILLOW STREET 1/12/2017 NORTH 4 17 BUILDING PERMIT S / CC- o��pf. 1 ,6 ,. �" � - TOWN OF NORTH ANDOVER OWN APPLICATION FOR PLAN EXAMINATION `' -z permit No#: C;L�� 1 Date Received S ED S , 9S •ac�us�� j Date Issued: LVOORTA.NT:Applicant must complete all items on this page �w PROPERTY';®WNER m V t ��. L► . - Pnnt 10DtYe ra Structure s* yes, no MAP -ate �ARCEL:'"I � _` ZONING DISTRICT_ _I�i.� `Histonc4®istnet yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential t9 New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: XCommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 1Ne11 ❑ Floodplain 11 Wetlands`` Watershed District - . _ - ❑Water-Sewer _ DESCRIPTION OF WORK TO BE PERFORMED: N0 PT-H G V,3 QCN 7E-YD- Identification- Please Type or Print Clearly OWNER: Name: �itArCC Phone:g —4 131 Address: - Phone-* 1'� p 3`�4 e ��q Contractor'Name:'CY^rl C � ,-... � - 77 7, ._. . Address: 1 PilJTE. tk — . Supervisors Construction License:_C`�.-0g695_CExp. Date: 1 -q_-�4..`"3 Exp. Date:. Home Improvement License: . . __ - - •- q ARCHITECT/ENGINEER M ,�AQN1CC ��- Phone: Address: 1 Por Nth-iJR, sura 9 u�ty� , _Peg. No. (�'`(l� FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ �C . Q FEE: $ '.. 33') Check No.: 1 t Receipt No_: 3/453 MOTE: Persons con ting with an, eo actors do not have:access to the guaranty fund 6igr ature_of_Age ntlOwher Signature of contractor'' J Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ TypF-OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swh ing 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 e U FORM PLANNING & DEVELOPMENT Reviewed On IWO SignatureUL_ 1 i COMM ENTS �v� Z n 6tx1')5nC4 Vem I I • f 7 CONSERVATION Reviewed on Si nature - I COMMENTS HEALTH Reviewed on Signature COMMENTS ZoningBoard of Appeals: Variance pp , Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS -- A . `limension 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-,- rop,-.- res approval of Electrical Inspector Yes No ®ANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A–F and G min.$1oo-$1000 fine NOTES and DATA — (For department use) r ❑ Notified for pickup Call Email ate Time Contact Name Doc.Building Permit Revised 2014 — - — r 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) o 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 COTE: 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:Building Permit Revised 2014 1 Location No. O�-j f -fir" Date,Gsl • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ i Check# ` Building Inspector = . w: 1 ttORT11_ - ic . - ve- A � 0 No. h o h ver, Mass, 401 / • A coc LAKG �,9 p°R�lrEo o`r C7 S U BOARD OF HEALTH Food/Kitchen PERMIT& LD .T Septic System THIS CERTIFIES THAT r .., .,..,,., BUILDING INSPECTOR . ...,.... ....................... ................................ has permission to erect . ................... buildings on .�..:�j► oer� ."',` .. ......... Foundation •5 yy.. . Rough tobe occupied as ..... .. r.. ............................................................................... Chimney .r . y provided that the person acceptingthispermit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST, ION Rough Service .� .y ..... ,...c... ... ....... :.. BUILDING INS Final GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 111 ,000.00 m $ - $ 1,332.00 Plumbing Fee $ 166.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 166.50 Total fees collected $ 1,765.00 Foundation 100 351 Wiilow Street 711-2017 on 1/12/17 new building expansion Initial Construction Control Document To be submitted with the building permit application by a _ 0 Registered Design Professional for work per the 8t'edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Bak N' Joy—Process Expansion Addition Date: December 12,2016 Property Address: 351 Willow Street South,North Andover,MA Project: Check(x)one or both as applicable: X New construction X Existing Construction Project description: Structural design and detailing of new 12,000 square foot steel-framed process addition with a process and an office mezzanine. 1, Stacy R.Flood, MA Registration Number: 42868 Expiration date:June 30,2018 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning : Architectural X Structural Mechanical Fire Protection 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'. Enter in the space to the right a"wet"or P`,A OF k4e electronic signature and seal: !oma STAACY yam m o O00 TU A e d v Phone number: (978) 562-6499 Email: srflood@verizon.net IST A Building Official Use Only Building Official Name: Permit No.: Date: Note 1.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 Initial Construction Control Document To be submitted with the building permit application by a d Registered Design Professional for work per the 8t1' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Bak N' Joy—Process Expansion Addition Date: December 12,2016 Property Address: 351 Willow Street South,North Andover, MA Project: Check(x)one or both as applicable: X New construction X Existing Construction Project description: Structural design and detailing of new 12,000 square foot steel-framed process addition with a process and an office mezzanine. 1 , Stacy R. Flood, MA Registration Number: 42868 Expiration date:June 30,2018 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural X Structural Mechanical Fire Protection 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, l 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'. Enter in the space to the right a"wet"or � OF u� electronic signature and seal: o�o� rAt v R. m v OBD UrAA ¢ Phone number: (978)562-6499 Email: srflood@verizon.net pA v Building Official Use Only BuildinLOffiicial Name: Permit No.: Date: Note 1.Indicate with an`s'project design plans,computations and specifications that you prepared or directly supervised. If`other'is chosen, provide a description. Version 06 1 1 2013 100-00 FLOOD CONSULTING Structural Engineering PROGRAM OF STRUCTURAL TESTS AND INSPECTIONS For compliance with Chapter 17 of the 8'Edition of the Massachusetts State Building Code Project: Bake N' Joy—Process Expansion Addition Project Address: 351 Willow Street South,North Andover,MA Project Owner: Bake N' Joy,Inc. Owner's Address: 351 Willow Street South,North Andover,MA Structural Engineer of Record: Flood Consulting Architect of Record: CMC Design-Build,Inc. This program of Structural Tests and Inspections is submitted as a condition for permit issuance in accordance with Chapter 17 of the 8' edition of the Massachusetts State Building Code. It includes a schedule of Structural Tests and Inspections applicable to this project as well as the names of individuals and the identity of other agencies intended to be retained for conducting these tests and inspections. The Structural Engineer of Record (SER) shall review records of all inspections and tests. These tests and inspections shall be furnished to the Building Official, Owner, and Architect of Record by the relevant agencies. The SER shall review inspections and testing reports and shall give written notice of non-conforming work to the Contractor for correction and the Owner's representative. The Program of Structural Tests and Inspections does not relieve the Contractor of his/her responsibilities and obligations to comply with the Contract Documents. Furthermore,the results of the Program of Structural Tests and Inspections do not relieve the Contractor of his/her responsibilities. Interim reports will be submitted by the Structural Engineer of Record to the Building Official, Owner, and Architect of Record. The schedule of interim reports shall be approved by the Building Official prior to permit issuance. A final report documenting completion of all required Structural Tests and Inspections and correction of any discrepancies noted in the interim reports will be submitted by the Structural Engineer of Record to the Building Official, Owner,and Architect of Record prior to the issuance of a certificate of use and occupancy. Job site safety is solely the responsibility of the Contractor and not part of the Program of Structural Tests and Inspections. Material and activities to be inspected do not include the Contractor's equipment or the means,methods,and procedures used to erect or install the materials or assemblies listed. OF Prepared by the Structural Engineer of Record: �, STACY Stacy R.Flood,P.E. R. N _r �LCCC} 9Vo.42888 STRUCTURAL 12/12/16GIST Signatu Date Registration Seal fissro AL IST Owner's Authorization: Building Official's Acceptance: Name(please print) Name(please print) Signature Date Signature Date 56 Laurel Drive • Hudson, MA 01749 • TEL: (978) 562-6499 • FAX: (978) 562-6246 00000 Structural Engineering PROGRAM OF STRUCTURAL TESTS AND INSPECTIONS For compliance with Chapter]7 of the 8'Edition of the Massachusetts State Building Code Project: Bake N' Jo —Process Expansion Addition Project Address: 351 Willow Street South North Andover MA Project Owner: Bake N' Joy, Inc Owner's Address: 351 Willow Street South North Andover MA Structural Engineer of Record: Flood Consulting__ Architect of Record: CMC Design-Build Inc This program of Structural Tests and Inspections is submitted as a condition for permit issuance in accordance with Chapter 17 of the 81' edition of the Massachusetts State Building Code. It includes a schedule of Structural Tests and Inspections applicable to this project as well as the names of individuals and the identity of other agencies intended to be retained for conducting these tests and inspections. The Structural Engineer of Record (SER) shall review records of all inspections and tests. These tests and inspections shall be furnished to the Building Official, Owner, and Architect of Record by the relevant agencies. The SER shall review inspections and testing reports and shall give written notice of non-conforming work to the Contractor for correction and the Owner's representative. The Program of Structural Tests and Inspections does not relieve the Contractor of his/her responsibilities and obligations to comply with the Contract Documents. Furthermore, the results of the Program of Structural Tests and Inspections do not relieve the Contractor of his/her responsibilities. Interim reports will be submitted by the Structural Engineer of Record to the Building Official, Owner, and Architect of Record. The schedule of interim reports shall be approved by the Building Official prior to permit issuance. A final report documenting completion of all required Structural Tests and Inspections and correction of any discrepancies noted in the interim reports will be submitted by the Structural Engineer of Record to the Building Official, Owner, and Architect of Record prior to the issuance of a certificate of use and occupancy. Job site safety is solely the responsibility of the Contractor and not part of the Program of Structural Tests and inspections. Material and activities to be inspected do not include the Contractor's equipment or the means, methods, and procedures used to erect or install the materials or assemblies listed. Prepared by the Structural Engineer of Record: ` aLtt� a� Stac R. Fl od P.E. o STAGY o� �n N R. a PLOt�D No 68 12/12/16 5TRUCTURAt Signatu 9QF��CtiTEp�U Date Registration Seal Owner's Authorization: �s, t" Building Official's Acceptance: Name(please print) Name(please print) Signature Date Signature Date 56 Laurel Drive Hudson, MA 01749 - TEL: (978) 562-6499 - FAX: (978) 562-6246 The Commonwealth of Massachusetts Department of Industrial Accidents w Office of'Investigations W 600 Washington Street 4 Boston,MA 0211.1 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly lNan'ie (Business/Organization/Ijidividual): Address: 1 :t y City/State/Zip: Phone#: Are you an employer? Check thl appropriate box: Type of project(required): 1.❑ :1 ani a employer with 4. ❑ i am a general contractor and 1 employees(full and/or part-time),* have Hired the sub-contractors b E] New construction _.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have $. ❑ Demolition working= for me in an capacity. employees and have workers' Ycomp. insurance.) 9• ❑ Building addition [No workers. comp. insurance p' requited.] S. IX We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their I I. Plumbing repairs or additions _,,❑ 1 am a homeowner Being all work ❑ g p myself [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4), and wehave.no employees, [No workers' 1.3.[�] Other parking lot comp.insurance required.] 'Any applicant that checks box ill must also fill out the.section below showing their workers'compensation policy information. I loincowners 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 3n additional sheet showing the inane of the sub-contractors and state whether or not those entities have employces. If the sub-contractors.have employees,they must provide their workers'comp.policy nwrnber. I ain an employer that is providing=workers'compensation insurance far my employees. Below is the policy and job site inlbrniation. Insurance Company Name: h%4rMrs_ 61- �A)&if„)StA(2 Policy#or Self--ins.Lic.#: V1i€'c,Z i l Zto_a)..1i'01 is Expiration Date:��/� �"� Job Site Address:_ 351 Willow Street South City./State/Zip: North Andover, MA 01845 _ ...._...._ J Mach 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 maybe forwarded to the Office of Investigations of the DTA for insurance coverage verification. I do hereby certify u er•thepa' s acid penalties of perjury that the in/brmation provided above is true and correct,; Signahirc: ; CX�_ _ Date: October 21, 2016 Phone#: 1° . a4 )r. zy Official use only. Do not write inthisarea, 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. License: CS-094656 Construction Supervisor KAREN F CURRAN ! , 70 UNION ST MARSHFIELD MA 0 Commissioner Expiration: 10/09/2017