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HomeMy WebLinkAboutBuilding Permit #490 - 550 TURNPIKE STREET 12/19/2011Permit NO:�J Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applicant must complete all items on this pale LOCATION \4c-- �% e I -D Uu ��► �'�! Print Print MAPNO: PARCEL: ZONING DISTRICT: Historic District yesAn Machine Shop Village yes 100 year-old structure yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ,' We111 OtFiloodpla�m ®Wetlands !� Wates'` eYrshed.District} Water/Sewer, JL0 OWNER: N OF WORK TO BE PERFORMED: fr—t OYi l .M19 I 1 ,ASI 4 WA (Identification Please Type or Print Clearly) --731 --74Sl Address: TV a,- r IV--& lam. f --b oV�v�. I MA - CONTRACTOR Name: ic44(e ig t ( (C, 1 a,;7 � Phone: '710 --c1 1 j�-??C) 6 , Address: Supervisor's Construction License: Home Improvement License: 5 5'$621 Exp. Date: Exp., Date: ARCHITECT/ENGINEER t4 Phone: Address: Reg. No. it 2 FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATEDOST BASED ON $125.00 PER �- cm r Total Project Cost: $ i, -)UV, 00 FEE: $ ,! Check No.: � Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to t41? ran �u fl Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer j�1 ' /❑l 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 COMMENTS Reviewed on Signature ZonhIg 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: FIRE DEPARTMENT - Temp Dumpster on site yes Locate)e-N4 Osgood Street(noJ 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 2011 June/mi --r„rgr.... vys1S.iT�YY 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) ❑ 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 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: Doc.Building Permit Revised 2008mi Location No. Date - MORTIy TOWN OF NORTH ANDOVER f � 0 •. • p� 9 i } ^e y Certificate of Occupancy $ s4CMUs <�' Building/Frame Permit Fee $ Foundation Permit Fee $ L Other Permit Fee $ TOTAL $ v ,'�? Check # 0 � 24897 Building Inspector CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 490-2012 Date: February 9, 2012 THIS CERTIFIES THAT THE BUILDING LOCATED ON 550 Turnpike Street, North Andover, MA 01845 Sprint Store MAY BE OCCUPIED AS a SPRINT STORE in ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Sprint Store/ I Mobile Sprint/I Mobile 550 Turnpike Street North Andover, MA 01.845 BuildimgInspe for Fee: $100.00 Receipt 24897 O z • 07 • ICA W Cd 9 o as c Cis O A6 O N C O V V u' c n ca m c Cc N CDC ;Z is O. N CD CO o 0 ca a cm CD c co W �mm o CD 3 mC4 �• f m N A E CD ,o aco�� O Q N mom 'wNo. r cc '� Z o O no Q m i m C :n o H w N o $ ~ umlCOD C O+=+ flt N dt N C y.r u w �E N CLCJ ® �E c C4 n cCD . O� i A .. D E- s ..-C-L m E ca N M CDN C O cm m m cm C m 0 CM c �C N m Z O Z O O F. U rm IQ to O A 4;3- r �p O CD � O � w Z co CL O y C 0 cm CO2 O CD O �O .CO2g03 m m CL ~ _ = O.a CD O i m O d CL CMa c.,o C3 Cc "FL C3 C G3 C3 CL. V y O C C 0 W U) `<< w 4.1 ,`DO •u w , ~ O O w v U)w p O .0 C w U p Ci w w p�. rx G p G o as c Cis O A6 O N C O V V u' c n ca m c Cc N CDC ;Z is O. N CD CO o 0 ca a cm CD c co W �mm o CD 3 mC4 �• f m N A E CD ,o aco�� O Q N mom 'wNo. r cc '� Z o O no Q m i m C :n o H w N o $ ~ umlCOD C O+=+ flt N dt N C y.r u w �E N CLCJ ® �E c C4 n cCD . 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V/,968i MEOUN4 ro PANeU MASOWITE PAo re- IW W4vp FV -AMB# me,Kltwzl - Z04STWcTlpt4- - ;IX T4+ rp: \,fP6uOA1MAr VIM. -781 i 'lassachusctts - Department Ad Puhlic S;it'ctj �'= i Bbard of Building Rc!-ulutions and St:uular(is Construction Supervisor License License: CS 55862 FRANCIS J MICHIENZI s1 87 MIDDLE ST Fes, ` 71" „ WOBURN, MA 01801 " 6-- Jam- �r Expiration: i 11/6/2012 <'ummissiun�•r Tr#: 5230 1 1 The Commonwealth of Massachusetts Department of Industrial Accidents j Office of Investigations 600 Washington Street nli'I Boston MA 02111 s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/individual): Address: ( Sr K9 City/State/Zip: 2l ry Phone #: -7Y(_ 9 3 � - V FO 6;? Are you an employer? Check the appropriate x: Type of project (required): 1. F1 I am a employer with 4. 1 am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* 2. ❑ 1 am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. 7. Remodeling ship and have no employees These sub -contractors have 8. Q Demolition working for me in any capacity. [No workers' comp, insurance workers' comp. insurance. 5. ❑ We are a corporation and its g, ❑ Building addition required.] officers have exercised their 10. E] Electrical repairs or additions 3. ❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 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' 13.�yOther '�` comp. insurance required.] *Any applicant that checks bait l 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 subcontractors 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 Name: nC' U d 6 NSU M A N C tv N Policy # or Self -ins. Lic. #: c, l S--0 `-1' Expiration Date: So 1 (k k 7— Job Site Address.-95t?li 12i-� �1 Cj City/State/Zip: r� l�- V eY�tA44 Oj e,+s— 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 coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Sienature: Date: Phone #: 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 #: Michienzi Construction & Development, Inc. December 8, 2011 HG Construction PO Box 2148 Rockville, MD 20847 RE: NEW LOCATION AT 550 TURNPIKE STREET IN NORTH ANDOVER, MA OJ, We are pleased to quote the sum of $7,500.00 (Seven thousand five hundred dollars) to furnish labor and materials as per the email on October 13, 2011 and plans as designed by Sprint dated July 8, 2011 telephone call with OJ. Breakdown: • Concrete Demolition: Saw cut, break floor, remove & E/B • Concrete: Fill in all trenches with concrete • Drywall: GWB walls and all patching of walls • Doors & Frames: Standard 6 panel masonite pre hung • Glass & Glazing: NIC • Install Furniture: Install owner supplied furniture package • Ceilings: By LL • Painting: See clarifications • Flooring: Install Ceramic Tile & VCT Flooring • Rubber Base: F & I rubber base. • Floor Prep: Patch floors, allowance carried • Fire Protection: 0.00 NIC Fire Alarm: 0.00 NIC • HVAC: 0.00 NIC • Electrical: See clarifications • General Conditions: Supervision/ Project Management • Plans: Included • Dumpster: Debris removal & trucking • Cleanup: During construction • Equipment Rentals: Saw cutting machine & Jack hammers • Trucking: Gas Permits: Allowance carried • -)O.H. & P: TOTAL: $7,500.00 11 Sixth Road Woburn, MA 01801 Phone 781-935-8806 Fax 781-937-9507 www.mich'ienziconstruction.com '.a Michienzi Construction & Development, Inc. Clarifications • Furnish & install metal stud walls with 5/8" GWB to the existing ceiling (10' high) as per the plans and also patch the existing walls as required ready for paint. • Furnish & install all necessary wood blocking for the new pre -hung door. • Furnish & install one 3'-0" wide x 6'-8" high 6 panel masonite doors in a pre -hung wood frame with passage sets. Door will have hinges, passage set and floor stop. • Furniture package to be furnished by Sprint and installed by GC. • Install ceramic tile flooring (24" x 24" or 18" x 18") in the sales areas supplied by Sprint. GC to provide grout and tile adhesive. • Furnish & install new VCT flooring in the storage room and the toilets. • Existing concrete floor to be delivered smooth at all areas ready for Sprint flooring. All existing walls ready for paint by LL. Paint all new and existing walls with Platinum Grey and new & existing doors/ frames. • Furnish & install rubber base at all areas. • HVAC: All HVAC work by LL and is existing. • New bathrooms: No work. All work as part of Landlords work which also includes all finishes. • Plumbing: Not included and by LL. • Fire Protection: Not included and by LL. • Fire Alarm: Not included and by LL. • Lighting and Power: Not included and is existing. • All signage furnished & installed by Sprint/ sign co. • ACT Ceilings are existing and no work is required. • Permit fees by GC. Allowance carried at $250.00 • Final Cleanup by GC • GC can provide any additional costs as required by Sprint but at this time only included all work per plan and email scope. • Includes sign install. • General Conditions: Supervision, project management, cleaning, trash removal for construction debris only and cleaning. • All Plans provided for building permit by Michienzi Construction. If you have any questions regarding this letter, please contact our office immediately, if not please sign below with a 25% deposit. Timetable: 15 business days (3 weeks) after the building permit is issued work will completed and on this project work will not proceed till the Landlord's GC is completed 11 Sixth Road Woburn, MA 01801 Phone 781-93578806 Fax 781-937-9507 www.michipnziconstruction.com z S 0. rA wl Cd c O c v iW ' R O u v v C7 •o.'o C%. c o m CD Ea CF C/) m o_ ar.�r+i D �• $ - z H E c om C2 O cm \,o m c E O. r.+ CA m CD m d C43 C42 m 3Cp va cm m 9 y CS Cf) ._ . O V) C4) O O C., CD A U .a�� m a m S - 9 cm Cf� ,S o c y. a w CD g m Qv�o. C O G c , c C2 p '. 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CD cCD •O H O m= O m N :a .. y m$~ COD c m W C iv ++ � Z co C._.,OC Z ccm •tA C W �E v � ca L.3 co 0.0 1 L#* a m. �-s cc a� CoCO co) Q O a` f O Om COD O L* O O m m CD CD C.CD ♦..� D O � O d CL �a c o � � v J .� O C Z CD CL V h c C C c cc d C W W W W N ACORE° CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 12/13/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: (781)933-3100 Fax: (781)933-9048 SALEM FIVE BOYLE INSURANCE SERVICES, LLC 445 MAIN ST WOBURN MA 01801 fCOONTACT Salem Five Boyle Insurance Services, LLC a° No Ext: 781) 933-3100 uc Ne: (781) 933-9048 MAIL ADDRESS: insurance.services@salemfive.com ADDRESS: PRODUCER 11697 CUSTOMER ID: INSURER(S) AFFORDING COVERAGE NAIC # INSURED MICHIENZI CONSTRUCTION & DEVELOPMENT INC 11 SIXTH ROAD INSURER Flremans Insurance Co 31325 INSURER B :Union Insurance Co 31325 INSURER : Continental Western Insurance Co 31325 WOBURN MA 01801 INSURER D: Technology Insurance INSURER E INSURER F GUVEKAGE5 CERTIFICATE NUMBER: 51 39f RFVISIAN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, Fyrl I PRIONq AND CONDITION,; OF St JrH POI Irl MITS -HOWN E" MAY HAVE BEEN RFDUCFD BY PAin rl AIMS INSR TYPE OF INSURANCE ADDT SUER POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MMIDDNYYY MMIDD LIMITS A GENERAL LIABILITY CPA009657118 10/02/11 10/02/12 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Eaoccurenm $ 250,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X OCCUR MED. EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC $ B AUTOMOBILE LIABILITY MAA009657217 10/02/11 10/02/12 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X NON -OWNED AUTOS $ $ C UMBRELLA LIAB X OCCUR CUA0102402-18 10/02/11 10/02/12 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTNE OFFICERIMEMBER EXCLUDED? NIA TWC3295034 10/02/11 10/02/12 WRY UMTS °TM $ R E.L. EACH ACCIDENT $ 500,000 -- E.L. DISEASE -EA EMPLOYEE $ 500,000 (Mandatory In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) L,rK 1 mIGA I E KULDEK CANCELLATION Sprint SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 550 Turnpike St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Attention: Gerard F Boyle Jr, Pr en :ORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights The ACORD name and loco are registered marks of ACORD