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Home My WebLink AboutBuilding Permit #224 - 478 CHICKERING ROAD 9/30/2008 i NORTH BUILDING PERMIT o� b�ti -' t1�,lD � TOWN OF NORTH ANDOVER 3? 4w ,. ° APPLICATION FOR PLAN EXAMINATION h n ! Permit NO: Date Received ��SSACHUS Date Issued: �Y PORTANT:Applicant must complete all items on this page .LOCATION 478 CHICKERING ROAD,NORTH ANDOVER,MA. Print PROPERTY OWNER S&N REALTY LLC Print MAP NO: _PARCEL: �Or ZONING DISTRICT: Historic Distdct 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 WORK TO BE PREFORMED: BUILDOUT OF NEW DENTAL SUITE AND OFFICE AREA Identification Please Type or Print Clearly) OWNER: Name: DR.ANNE TODD Phone: 978-352-8673 Address: 27 MULBERRY LANE,BOXFORD,MA.01921 CONTRACTOR Name: R&R EDWARDS CORP. Phone: 617-389-7431 Address: 87B LINDEN STREET EVERETT,MA. 02149 Supervisor's Construction 'License: CS 38316 Exp. Date: 08/15/2009 Home Improvement:License: 10 0 0 5 0 Exp. Date: 06/08/2010 ARCHITECT/ENGINEER KING DESIGN ASSOC. INC. Phone: 781 -393-0400 Address: 10 HIGH ST.MEDFORD,MA. 02155 Reg. No.8333 FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. �� 6 Total Project Cost: $ 215,0 0 0. 0 0 FEE: $ Check-No.: ✓ Receipt No.: /✓�S/ NOT f 1 Persons acting with unregistered contractors don t have acces o the guaranty fund �ig�n@&� e A�-- 0.9./2.7/2008 Agent/Owner Sj gnatyre of contractor A/Location V 7,f No. �/ Date04 NORTH TOWN OF NORTH ANDOVER D Certificate of occupancy • � • • $ / 00 ��s'• E<� Building/Frame Permit Fee $ G- 4C Nus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ -� Check # �6 " �t 2155 Building Inspector i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans i 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 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 FIRE DEPARTMENT Temp Dumpster on site yes *** 14, no Located at 124 Main Street Fire Department signature/date off' COMMENTS Dimension ONE 1755 Number of Stories. Total square feet of floor area, based on Exterior dimensions. � Total land area, sq. ft.: I 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 I i Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. I Roofing, Siding, Interior Rehabilitation Permits m Building Permit Application ® Workers Comp Affidavit m Photo Copy Of H.I.C. And/Or C.S.L. Licenses r Copy of Contract b 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 wilding Permit Application 4ed--Surveyed Plot Pla �y orkers Comp Affidavit �� ! '"Photo Copy of H.I.C. And C.S.L..Licenses y Of Contract j Ioor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ,,a-ngineering 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 Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o 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 o 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 NORT1y Town ofAndover 0 No. oz:7-A, oy dower, Mass., T O -- LAKA. T C OC E HICHEWICK 5 RATED BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT f 5�.............. � .... ..... �� ..............................................:...............:.....................:- ........ Foundation has permission to erect........................................ buildings on y. a ... ....."V�n.rf, Rough to be occupied as............... ... !( ��. Ul. ..................... '....:. .... h/L.-t '....... Chimney provided that the person accepting this permit shall in every respect con of rm to the rms 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 PERMIT EXPIRES IN 6 MONTHS ` 1 , ELECTRICAL INSPECTOR. UNLESS CONSTRUCTION ST TS Rough ................ ..... ... Service ..... . ...... .. . SBU---T-L�DIN66' ...... .... .... . INSPECTOR 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. SEE REVERSE SIDE Smoke Det. proposal R & R EDWARD CORP. GENERAL & ELECTRICAL CONTRACTORS 87B LINDEN STREET, EVERETT, MASSACHUSETTS 02149 TELEPHONE (617) 389-7431 FAX (617) 394-9343 Page No. 1 of 1 Pages PROPOSAL SUBMITTED TO PHONE DATE DR.ANNE TODD 1 -978-387-6025 109/29/08 STREET JOB NAME 27 MULBERRY LANE 478 CHICKERING ROAD CITY, STATE AND IIP CODE JOB LOCATION BOXFORD,MA.01921 NORTH ANDOVER,MA. ARCHITECT KIDATE F P NS JOB PHONE NG DESIGNS 08181008 we hereby propose to furnish materials and labor necessary for the completion of: 1 .PLUMBING: $ 36 ,640.00 2.ELECTRICAL: $ 20 ,015.00 3 .FLOORING: $ 6 ,525 .00 4 .PAINTER: $ 10 , 400.00 5.HVAC: $ 8, 400.00 6.ACOUSTICAL CEILING: $ 4, 960.00 7 .DEMO,TRENCH WORK, SAWCUTTING,CONCRETE PATCHING: $ 6 ,880.00 8.DOORS: $ 5,200.00 9 .DRYWALL,FRAMING, INSULATION: $ 13 ,240 .00 10.WINDOW&DOOR REMOVAL .AND RELOCATE TO NEW LOCATION: $ 5,760. 00 11 .BUILDING PERMIT:ALLOWANCE $ 1 ,980. 00 12.GENERAL CONTRACTOR:DUMPSTERS,STOCK,P.LANS,LABOR, OFFICE COST,OVERHEAD&PROFIT: $ 45,000 .00 13.DENTAL CHAIRS&CABINETRY SUPPLIED&INSTALLED BY PATTERSON DENTAL: $ 50 ,000.00 WE PROPOSE hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: TWO HUNDRED FIFTEEN THOUSAND DOLLARS AND NO/CENTS dollars 4.215 ,000.00 I Payment to be made as follows: All material is guaranteed to be as specified.All work to be completed in a substantial workmanlike manner according to specifications involving extra costs will be executed only upon written orders,and will become an Authorized extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond Signature our control. Owner to carry fire,tornado and other necessary insurance.Our workers are fully covered by Workmen's Compensation Insurance.The parties hereto agree that in the event that the contractor engages an Note: This proposal may be attorney to enforce any provisions in this contract,the owner shall be solely responsible for the payment of all withdrawn by us if not accepted within 30 days. the contractors reasonable attorneys fee. ACCEPTANCE OF PROPOSAL The above prices, specifications and condi- tions are satisfactory and are hereby accepted.You are authorized to do the wor as specified.Payment will be made as outline above. * Signatur! 09/30/08 Date of Acceptance: Signature f NORTp JL Town of North Andover Office of the Planning Department Community Development and Services Division �Ss�cHusEt Osgood Landing 1600 Osgood Street Building#20,Suite 2-36 P(978)688-9535 North Andover,Massachusetts 01845 F(978)688-9542 Anne Todd,DMD,MMSc 27 Mulberry Lane West Boxford,MA 01921 September 11,2008 Dear Ms.Todd According to the North Andover Zoning Bylaw Section 8.3.2.c.i,Waiver of Site Plan Review,your request for a Change of Use at 478 Chickering Road, will not require an application for Site Plan Review. The waiver request is granted based on the following information: • The property will be converted from its current use as a restaurant to a dentist office, a use which is permitted in the General Business District, according to the Town of North Andover Zoning Bylaw section 4.131(1). • The only exterior changes that will be made to the building will be the relocation of the double door that faces the parking lot. That door will be relocated from the right side of the building to the left side, closer to the accessible parking spot,making the entrance more convenient for individuals with disabilities. • There will be no to changes the Q g e pazkinb and landscaping areas. The number of parking spaces will remain the game. • A new sign will replace the existings' in the azkin ot` p as well the sip on the roof. You will need to contact the Building InspectZr for a sign permit. If there are any questions,please let me know. Regards, Ju Tymon,AICP Town Planner cc: Jerry Brown,Inspector of Buildings IIS BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 i The Commonwealth of Massachusetts /)I Department of Industrial Accidents �. Office of Investigations ` 600 Washington Street Boston, MA 02111 t';w www mass.gov/dia Workers' Compensation p on Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): R&R EDWARDS CORP. Address: 87B LINDEN STREET Ci /State/Zi EVERETT,MA. 02149 617-389-7431 �' p: Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑X I am a employer with ONE 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ® Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9• ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised.their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.El Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4), and we have no 12•❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑ Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this a;;idavit indicating they are doing ail 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company NameASSOCIATED INDUSTRIES OF MA.MUTUAL INSURANCE COMPANY. Policy#or Self-.ins. Lie.#: AWC. 7 014 6 4 2 012 0 0 7 Expiration Date: 1 1 /2 0/2 0 0 8 Job Site Address:478 CHICKERING ROAD,NORTH ANDOVER City/State/Zip: MA. 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance ance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct: Si ature: Date 09/27/2008 Phone#: 617-389-7431 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Board of Building Regulations and Standards d�� aaoaa�ue�lla at and Standards HOME IMPROVEMENT CONTRACTOR Constrt�ctlpn$uppryi 1` Registratip(I: 100050CS 38316 t EXPlrat)0n: 6/8/2010 Tr# 267256 81511945 B - Type: Private Corporation _. I _ Tr# 4451 , R 8 R EDWARDS CORP. ; Edward Russell EDWARD D RUS$ r - 87 B Linden St 87 B LINDEN �s Everett,iV1A 02149 Adnunutra' l or EVERETT,MA 02149"' Commiccloner i i I �I `f k II NOTICE NOTICE TO 4 TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that l(we) have provided I,(),. payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSETTS MUTUAL INSURANCE COMPANY NAME: OF INSURANCE COMPANY 54 THIRD AV(=NUE P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY AWC 7014642012007 _ 11/20/2007 - 11/20/2008 POLICY NUMBER. 300 Congress Street EFFECTIVE DATES Suite 104 Albert J Tonry Company Inc — _ Quincy MA 02169 (617) 773-9200 NAME OF INSURANCE AGENT' ADDRESS PHONE R & R Edwards Corp. 87 B Linden St. Everett, MA 02149-2113 EMPLOYER ADDRESS 09/25/2007 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE nnr»>r�L TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be giver, to the injured employee. The employee may select his or her own physician. The reasonable cost of the services,provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. in cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER CONSTRUCTION CONTROL PROJECTNAME. Buildout of Dental Offices for Dr. Anne Todd PROJECT OWNER: Dr. Anne Todd PROJECT LOCATION: 478 Chickering Road ARCHITECT: DAVID A.FARMER OF KING DESIGN ASSOC,INC 10 HIGH ST.,MEDFORD MA IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING CODE, SIXTH EDITION,I. DAVID A FARMER REGISTRATION NO. 8333 BEING A REGISTERED PROFESSIONAL ARCHITECT HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECTXXX ARCHITECTURAL STRUCTURAL MECHANICAL FIRE PROTECTION_ELECTRICAL OTHER (Specify) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF KNOWLEDGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2: 1. Review,for conformance to the design concept,shop drawings,samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled material. 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,in general,if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.4.,I SHALL SUBMIT PERIODICALLY A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE North Andover BUILDING COMMISSIONER. UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. ARC figp,'S/j, N0.8339 Ps5 DAVID A.FARMER PERSONALLY APPEARED BEFORE ME AND SUBSCRIBED AND SWORN TO BEFORE ME THIS 23rd DAYOF Sep ber, 2008 & OF'-K;lAL SEAL JEFFREY P.MING NOTARY PUBLIC COMMOD."WEALTH OF MMSACHUSEM My Comm.Expires Mar.8,2013 . Proposat l R & R EDWARD CORP. GENERAL & ELECTRICAL CONTRACTORS 87B LINDEN STREET, EVERETT, MASSACHUSETTS 02149 TELEPHONE (617) 389-7431 FAX (617) 394-9343 Page No. 1 of 1 Pages PROPOSAL SUBMITTED TO PHONE DATE DR.ANNE TODD 1 -978-387-6025 09/29/08 STREET JOB NAME 27 MULBERRY LANE 478 CHICKERING ROAD CITY, STATE AND IIP CODE JOB LOCATION BOXFORD,MA.01921 NORTH ANDOVER,MA. ARCHITECT DATE OF PLANS JOB PHONE KING DESIGNS _T 08/18/2008 We hereby propose to furnish materials and tabor necessary for the completion of: 1 .PLUMBING: $ 36 , 640. 00 2 .ELECTRICAL: $ 20 , 015. 00 3 .FLOORING: $ 6 ,525.00 4.PAINTER: 5.HVAC: 10 400. 00 $ 8, 400.00 6 .A000STICAL CEILING: ' $ 4 , 9"60.00 7.DEMO,TRENCH WORK,SAWCUTTING,CONCRETE PATCHING $ 6 ,880.00 8.DOORS: 5 20 $ 0. 00 9.DRYWALL,FRAMING,INSULATION: $ 13 240.00 10.WINDOW&DOOR REMOVAL AND RELOCATE TO NEW LOCAT�On:I $ 5 ,760 .00 ,760 .00 11 .BUILDING PERMIT:ALLOWANCE $ 1 , 980. 00 12 .GENERAL CONTRACTOR:DUMPSTERS,STOCK,PLANS,LABOR, OFFICE . COST,OVERHEAD&PROFIT: $ 45,000. 00 13 .DENTAL CHAIRS&CABINETRY SUPPLIED&INSTA'LLED BY PATTERSON DENTAL: $ 50 ,000. 00 WE PROPOSE hereby to furnish material and labor—complete in accordance dance with ab v o eecifi sp cations,for the sum of: TWO HUNDRED FIFTEEN` THOUSAND DOLLARS AND NO/CENTS collars �21 5 ,0 0 0. 0 0 Payment to be made as follows: All material is guaranteed.to be as specified.All work to be completed in a substantial workmanlike manner according to specifications involving extra costs will be executed only upon written orders,and will become an Authorized extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond Signature our control. Owner to carry fire,tornado and other necessary insurance.Our workers are fully covered by Workmen's Compensation Insurance.The parties hereto agree that in the event that the contractor engages an Note:This proposal may be attorney to enforce any provisions in this contract,the owner shall be solely responsible for the payment of all withdrawn by us if not accepted within 3 0 the contractor's reasonable attorney's fee. rt days. 0 1 ACCEPTANCE OF PROPOSAL The above prices, specifications and condi- tions are satisfactory and are hereby accepted. You are authorized to cio the wor as specified. Payment will be made as outline above. * Signature Date of Acceptance: 09/30/08 Signature