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HomeMy WebLinkAboutBuilding Permit #656-2017 - 351 WILLOW STREET 12/20/2016V/f4)-q �� � U UILDING PERMIT v l� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received 291A6 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential J'New Building ❑ One family 0 Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: 'Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: A Demolition ❑ Other ❑ Se, ptic q Well 1i Floodplain b Wetlands ' 9 Watershed Dsfrict p Vllater/Sewer — . w._,. v ....._ _.._ ._.. DESCRIPTION OI- VVUKK I u bt rtNrLJKivitu: AN Identification - Please Type or Print Clearly OWNER: Name: ,-� Phone: RLC- C�Q,(�, A9 3 c Address:A Contractor'Name'CYq- Phone= CM Address: 1, u.. IVcN Supervisor's Construction License: CS-_aQ_rJ-�_ Exp. Date: Icy--M_t Home hT, Date:...... . - __ ... ARCHITECT/ENGINEER MAQkC <-R9W\ C,EL_l Phone: Lcrn C- I GO C3U 1 L�7� Address: 1 Qicv'F-la U- rQ - CSittt�C� fa C)QIC��k Reg. Ido. � 1 , � FEE SCHEDULE. BULDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost-.$ 1 13 , © tom D FEE: $ Check No.: L5�4 Receipt No., NOTE: Persons contracting with unregistered contractors do not have: access to the guaranty fun S_ignatu�77 e_of_AgenRb ner Si nature of col' itractC- I: w�Q1 Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ TYPB'5F SEWERAGE DISPOSAL Public Sewer ❑ Tanuing/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 PLANNING & DEVELOPMENT Reviewed On IZ- I I Z(Uignature _ k- COMMENTSVff' ,1 V � � �1Y� �t 1(''�Gyyae . 71zL)zf'-)1(0 CONSERVATION COMMENTS HEALTH COMMENTS Reviewed on Reviewed ons 'l T n, I io i nature n J Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 FIRE DEPARTMENT - Temp Dumpstee�rro�on site yes no Located at Main Street Fire Department signature/date COMMENTS d Street -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.sloo-sl000 fine Doc.Buildhag Permit Revised 2014 Building Department a 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) ❑ 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 o CCof Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products DOTE: 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 Doe: Building Permit Revised 2014 Location�t�, 14, JL) No. Datev— TOWN OF NORTH ANDOVER Cerfificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $— - TOTAL $ Check # 29/1 r, Builcring InspectoV i J1,1 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 1109000.00 m $ 1,320.00 Plumbing Fee $ 165.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 165.00 Total fees collected $ 1,750.00 351 Willow Road - Bake and Joy 656-2017 on 12/20/2016 demo ramp and build a trash room Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPB'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ SV+'»nmg 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 - 11 FORM PLANNING & DEVELOPMENT Reviewed On Vj ) I jZd4ig nature t I, I I CL COMMENTS CONSERVATION Reviewed on _ Signature COMMENTS HEALTH P COMMENTS Reviewed on Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decisio Comments Comm Water & Sewer Connection/Signature & Date Driveway Permit DPW Town. Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site Located at 124 Main Street Fire Department signatureldate_�� COMMENTS Locaiea jb4 usgood Street no y C � rt � 10 0 0 CD n Z N rmlok CD O CL o _� CL�� N -a O vCD cD o CL = cr _ CD CD � o � cn CD i N• C• C � v 0 CO) z 0 o �CD 0 CD 0 0 z Z cn m-0 mN N n m O X z C f)55 cn O O 0 00-0 C —i C N C 0' CD 0� Ci • Q" 0 m o ? �- in ?F �• -n 0 0 —0. 0 mh � 0 Co x o� � D O , + c0 CL 0 y O � rt �•� � CD CD -0 C CQ O N - _hNCD � 0 yCD cn Q• O 0 = CL 0 cm 0 =c CDN•: -- n,CDCL< CCD WIID� r ch 0 - CD in ) :� N0 i a o f _ Penn", CD C E� Ln CD C.)y 0' Co T ;T7 v_ �' 1' �� r N �0 T 0 0 � 0 T CL .Z7 Ln N Co T ;T7 T N .;a T Z7 T r) .Z7 T Ln T 3 M O O O 3 O O O O O0 OT• m cu C C fll N _S O O 00 = m O O' m r* Z S n S 5 O rD S O- P1 Ln� \ O <N O A rt S r r- W O N T m C 3 W m n 2 o nz N � c� o m 0 m m D m m y �4 c C c The Commonwealth of Massachusetts Department of Industrial Accidents Office of'Investigations 600 Washington Street Boston, MA 021.1.1 www.mass.gov/dia Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Bttsine s/OrganirationlTndividual): Address: J r to ;\k ,r t lig Citv/State/Zip: ( l: , ti- Phone #: Are ,you an employer? Check the appropriate box: I . ❑ I am a employer with 4. ❑ T am a general contractor and 1 employees (full and/or part-time).* have hired the sub -contractors 2. ❑ Tam a sole proprietor or partlisted on the attached sheet. ner- ship and have no employees working forme in any capacity. [No workers' comp. insurance required.] . ❑ T am a homeowner doing all work. myself.. [No workers'comp. insurance required.] t These sub -contractors have .employees and have workers' comp, insurance.$ 5. W 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' insurance Type of project (required): 6. F] New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. F-1 Electrical repairs or additions I LF1 Plumbing repairs or additions 12, ❑ Roof repairs 13.0 Other parking lot 'Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I lomcowners who submit this affidavit indicating they are doing all work and then hire outside contractors tnustsubmit a new affidavit indicating such. i C nrtractors that check this box must attached an additional sheet showing the name of the sub -con tractors. and state whether or not those entities have employees. if the sub -contractors have employees, they must provide their workers' comp. policy number. l aril an employer that is providing workers' compensation insurancefir r my employees. Below is the policy and job site in formation. Insurance Company Name: 1 ti { ,t { ,_- r Wo-usa t -. Policy # or Self -ins. Lic. #: WJLCL t f 2u 27 ILAC31t_e Expiration Date: 351 Willow Street South Job Site Address:_ 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 51,500100 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine (if tip 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 u„ Viler the pSkisfand penaltr'es of perjury that the information provided above is true and correct.: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # October 21, 2016 Issuing Authority (circle one): 1. Board of health 24 Building Department 3. City/Town Clerk 4..I lectrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Initial Construction Control Document W To be submitted with the building permit application by a - lo Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Bake `N Joy Trash Room Addition Date: 12/13/2016 Property Address: 351 Willow Street South, North Andover MA 01845 Project: Check (x) one or both as applicable: x New construction Existing Construction Project description: This project consists of the relocation of the existing trash compactors, and the addition of a small room to faEilitate their use. The room will be approximately 250 SF, concrete masonry unit construction, with structural steel roof beams. I Mark Carnicelli, MA Registration Number: 9156 Expiration date: 8/31/2017, 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 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 electronic signature and seal: Phone number: (617) 328-7899 x219 Building Official Name: Permit No.: Date: Email: mcarnicelli@cmcdesign-build Building Official Use Only 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 Registered Design Professional for work per the 8th edition of the °vee Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Bake `N Joy Trash Room Addition Date: 12/13/2016 Property Address: 351 Willow Street South, North Andover MA 01845 Project: Check (x) one or both as applicable: x New construction Existing Construction Project description: This project consists of the relocation of the existing trash compactors, and the addition of a small roorn to facilitate their use. The room will be approximately 250 SF, concrete masonry unit construction, with structural steel roof beams. r I Mark Carnicelli, MA Registration Number: 9156 Expiration date: 8/31/2017, 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 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 continents, 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 electronic signature and seal: Phone number: (617) 328-7899 x219 13ui[ding Official Name: Permit No.: Date: Email: mcarnicelli@cmcdesign-build Building Official Use Only ,.�ir:�ir�r 0 Alir� -- rn t? � REE w A rH,C.r�"It 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 1 1 2013 v 56z� �o o � o� Toz � m izy z0 O n y Q 7 i 0 O� 'r a d Q� to * The Morin -Cameron I GROUP0 ON:Q= February 1, 2017 Donald Belanger Inspector of Buildings Building Department 120 Main Street North Andover, MA 01845 Re: 351 Willow Street South Owner/Applicant: Muffin Realty Trust Dear Mr. Belanger: It has come to our attention that Bake'n Joy has submitted a Building Permit application for the solid waste disposal room for the above property. It is our understanding that the proposed location of the solid waste disposal room is slightly different than the sketch plan that was approved in July 2016 showing same. As requested please find enclosed a site plan which has been revised to reflect the latest architectural design for the improvements to the proposed building at the above property. This includes the location of the solid waste disposal room. If you have any questions please do not hesitate to give me a call. Sincerely, THE MORIN -CAMERON GROUP, INC. John M. Morin, PE Principal JMM/kmm Enclosure cc: Muffin Realty Trust Paul DePew F:\KATHYM\BakeNJoy1230\N0I (2014 Bldg. Addition Rear)\Building Ins ltr.docx CIVIL ENGINEERS • LAND SURVEYORS • ENVIRONMENTAL CONSULTANTS • LAND USE PLANNERS 66 Elm Street, Danvers, MA 01923 978.777.8586 FAX 978.774.3488 Providing Professional Services Since 1978 www.morincameron.com