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Home My WebLink AboutBuilding Permit #431 - 401 ANDOVER STREET 1/22/2009 BUILDING PERMITof NORTH q t,t Ll D.tib• ~O TOWN OF NORTH ANDOVER c? APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 14pDAATED �� CHUSE� Date Issued: �SS'g IMPORTANT:Applicant must complete all items on this page 1. LOCATION ] Print L PROPERTY OWNER_ G7 Lt r� 17A 6CtWl--7 Print MAP NO: �' PARCEL: '. ZONING DISTRICT:.Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer. DESCRIPTION OF WO K T PREFORMED: �BE 1oC Identification Please Tye or Print Clearly) OWNER: Name: J n(,cw Phone: Address:__At- 6cvet, ARcmue"e,, q0 vr,d =f loucvJqa. 017Y5 CONTRACTOR Name: /V� v rpt _—LUm4W Phone: Address: ` Supervisor's construction License: Exp. Date: Ho Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $cay Check No.: -7 (,, S Receipt No.: % U-2 NOTE: Persons contracting with u registered contractors do not have access th1grZ Signature of AgentlOwner ' Signa#ure of contra tor, Location No. Date Hon N TOWN OF NORTH ANDOVER ~ 9 Certificate of Occupancy $ Building/Frame Permit Fee $ s�cHus Foundation Permit Fee $ ` Other Permit Fee $ ` 4 TOTAL $ Check #-76 21803 - Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans 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 DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS Nk HEALTH Reviewed on Signature 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 DPW Town Engineer: Signature: Located 384 Osgood Street EIRE DEPARTMENT Temp'Dumpster on site yes no Located at 124 Main Street Fire Department signature/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.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 ❑ 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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) j ❑ 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 4 ❑ 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 NOTE: 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 DEPARTMENT:BPFORM07 Revised 2.2008 T� ✓1�-Po�,,.o�u.P,Q/! ��/G�aa .Lw.oetf Board of Buiiding,R¢gulations.and Standards Construction Supervisor License License: CS 55288 ptrai�i 3!5/2010 Tr# 254.48 =Restriction. Q0 TIMOTHY R QQINLAN y 34 TRINITY CT NO ANDOVER,MA 01845. s. 4101 4,.Io,,e` S/ SLI-{e /o/ _ i, � rJ� JAI j { I i fi T t. , tkORT#q To VM of Andover , No. d14 0 dover, Mass., tL- LAK COCHICHEWICK 0RATED BOARD OF HEALTH Food/Kitchen PERM. IT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT................QA .........N..em... ......................... ............................................................ Foundation f -74i t i . ......... .. ........... + has permission to erect........................................ buildings on .. . ....�R........ Rough 4 Chimney to be occupied as....... -$4 06.k. ............q........& wo..".4t....................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 `3 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU TARTS Rough Service ..................... ...................................... ........ ....... BUIL ................W%4kjK Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. 14EE'REVERSE SIDE Smoke Der. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute;an employee is defined.as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,orthe o receiver or trustee of an individual,partnership, associatin or other legal entity,employing employees. However the owner of a dwelling house having not more than three ap artments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maint-nance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall nort because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state o r local licensing agency shall withhold the issuance or renewal of a license or permitto operate it business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence 04 compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit compl-etely,by checking the boxes that apply to your situation and if necessary,suPP1 sub-contractor(s)name(s), address(es)) an d phone number(s)along with their certiticate(s)of insurance. Limited Liability� Companies (LLC)or LimrteeLiability Partnerships shi s(L LP) with no employees other than the members or partners,are not required to cant' workers'compensation insurance. If an LLC or LLP does have fn _. employees, a policy is required. Be.advised that this aciavit may.be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the.affidavit. The,affidavit should be returned to the city or town that the application for the prmit or license is being requested,not the Department of Industrial Accidents. Should you have.any questions regi -din the lain or if you are required to obtain a workers' compensation policy,please call the Department at the nM--nb--listed belov,% Self--insured co«panies should enter their self-insurance license number on the appropriate lire. City or Town Officials Piease be sure that the'aff►davit.is complete and printed ieQfbiy. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you g PP regarding the applicant. g Please be sure to fill in the permitAicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/iicense applications in arty given year,need only submit one affidavit indicating current policy inforination(if necessary) and under"Job Site Address"the applicant should " „ aPP waste all locations in (city or town). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or Iicenses. A new affidavit must be filled out each year. Vfhere a home owner or citizen is obtaining a licenses or permit not related to any business or commercial venture (i.e. a.dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of investigations would like to thank you.in advance for your cooperation and should you have any questions, . please do not hesitate to give us a call. The De a-tment's address telephoneand fay numb.: The Commonwealth of Massachusetts Degartm5nt of-industrial Accidents. Office of Investi-gations 600 'Washtington Street Boston; MA 42111 Tel. # 617-727-4900=t 406 or 1-9—/7-MASS.kFE Revised 5-2645 Fax 4 617-727-7749 WWW.mass.gov/dia matt mcgarry From: Shelley Kelley[skelley@nedermatology.com] Sent: Wednesday, January 21, 2009 4:09 PM To: matt mcgarry Subject: Cubicles Attachments: 0121091556.jpg; 0121091552.jpg Hi Matt, I'm attaching very poor pictures (sorry about that)-but hopefully they give you an idea of the electrical connection for the cubicles. There is 1 of these connections per"set" -right now we have 3 sets (two sets=4 stations, one set= 2 stations), however the new configuration will have only 2"sets" (one set=6 stations, one set= 3 stations). As far as the value goes, I spoke with Leila. She says that they are worth around $2300-keep in mind that we currently have 10 stations, and will only be putting up 9 of them. Please let me know the name of that company that you have mentioned, unless of course you find out that we can use the reception desk that is upstairs. Shelley Northeast Dermatology P: 978.470.1603 F: 978.470.1722 For Truth-based Skincare... Checkout our new product line visit: http://www.intelligentaesthetics.com ...the end of false hope! -� ' J 1 � � v