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Home My WebLink AboutBuilding Permit #779-13 - 575 TURNPIKE STREET 5/17/2013NORTh q BUILDING PERMIT TOWN OF NORTH ANDOVER 3 APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �9SS Date Issued: L-11� 13 AC IMPORTANT: Applicant must complete all items on this Date TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition 11 Two or more family 11 Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other neo �is Etats >le►J �Cte fcefi" °�S� "�� iL��r`'2!••.va Fo S n hof � OWNER: Name: Address: rr Identification rPleas'eI Type or Print Clearly) I.�� S �Lcvdi (4 Phone: 917 �`�3 . 81`�0 ARCHITECT/ENGINEER 6(d'r0Cb �f5' tlx Phone: ((.-b3) Lf3z '864 Address: `i t:)•.r'a N n -to $ Reg. No. 777 - FEE SCHEDULE. BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 35 I47— FEE: $,So�.2•40--o Check No.:— 1z Receipt No.:�1'G VvZ NOTE: Persons contracting)vith unregistered contractors do not have acces a guaranty fund -i � 'i q TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Issued: PROPOSED USE Date Received Residential IMPORTANT: Applicant must complete all items on this page El New Building 0 One family 11 Addition D Two or more family El Industrial El Alteration No. of units: El Commercial El Repair, replacement Print D Others: -'71W OWN It RIL 0 eari q-1dJ uct Ur *-Ai yes n C.f .7 �: � is ri�c -istdct yes riot Machine pAl , 81909 yes3 riot __ .TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building 0 One family 11 Addition D Two or more family El Industrial El Alteration No. of units: El Commercial El Repair, replacement El Assessory Bldg D Others: El Demolition 0 Other DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: ARCHITECT/ENGINEER Phone: 13 Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ O Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ 3 C Stamped Plans ❑ TWE OF SEWERAGE.DISPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑ .. .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 COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConnectioniSignature & Date Driveway Permit DPW Tavv A Engineer: Signature: Located 384 Osgood Street FIRE DEPARfM'ENT -Temp Dumpsteron site yes no Located at 124,Main.Street.. Fire Departriieitit-signa-tuire/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.$10041000 fine NOTES and DATA — (For department use El Notified for pickup - Date Doe.Building Permit Revised 2010 Building Department The fol owing 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 app al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm tied with the building application Doc: Doc.Building Permit Revised 2012 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ ri 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 PLANNING & DEVELOPMENT ❑ COMENTS DATE APPROVED El U• I L - U• I L •---•Vi CONSERVATION ■ ■ COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ 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 Located at 384 Osgood Street Location 7-7 / (/•^ i'i L2 No. 7 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ /v 09 Building/Frame Permit Fee $��z o � Foundation Permit Fee $ a Other Permit Fee $ rt TOTAL $ Check # 26407 Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 35,142.00 m $ - $ 421.70 Plumbing Fee $ 52.71 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 52.71 Total fees collected $ 627.13 575 Turnpike Street Suite 27 779-13 on 5/17/2013 Minor Renovations to Doctors Office Ew ft O CD 0- w w t N _ w CO m O M _ N d t O Z O a J O 2 z m co z Cl) w CLX LLIa : V :W :a 0 Z m Cl)MNi H o v , W z 1' • E O i O z Q O N AI C .� W Q .E m m a � t 0 Q V J cc CD+ W O V y •c CL U) D LU N W W ce W U) JWd W a a O x z z a LL z a o Z Z z a V Z W a W W0 a m D J LL E W Y Z Y N m N ` cu C N Y O 7 = C 10 to i to 7 N O O .Q N OO -C O C O N C O C O +`• LL N LL d' U L- d' LL d' Ln LL 4' LL m N In O CD 0- w w t N _ w CO m O M _ N d t O Z O a J O 2 z m co z Cl) w CLX LLIa : V :W :a 0 Z m Cl)MNi H o v , W z 1' • E O i O z Q O N AI C .� W Q .E m m a � t 0 Q V J cc CD+ W O V y •c CL U) D LU N W W ce W U) LAL ALDAROLA DESIGN A S S O C I A T E S, P C Architecture ❑ Interior Design ARCHITECTURAL AFFIDAVIT Project Number: Project Title: -M Project Location: , Name of Building: Scope of Project: h4lWmL Rt%kn~ Date: I, Joseph V. Caldarola, MA Registration No. 7728 being a registered professional architect have prepared or directly supervised the preparation of the architectural design plans, computations and specifications for the above named project and that, to the best of my knowledge, belief and understanding such plans, computations and specifications meet the applicable provisions of the 8t" Edition of the Massachusetts State Building Code. I shall perform the necessary professional services and be present on the construction site as needed to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following: 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 Chapter 17. 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 and this code. Upon completion of the work, I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. Signed by: Date: 0 4 Birch Street, Derry, NH 03038 (603) 432-8404 (Fox) 432-2706 Architect's stamp: Massachusetts Department of Public Safety + Board of Building Regulations and Standards Construction Supen'isor License'. C$-097119 I `.. ROBERT A PA`R`RIS-~' �? I 480 TURNPIKE STR 0 SOUTH EATON 5r1Expiration 1 Commissioner 03/25/2014 SdQ/nogsseYY'NUAM :llsiN uo1jewJo;u! 8uisua3rl Sdd xy •asuaall S141 10 u011e30nW jot asnea sl apo 8ulpling alels s:aasn43essejN ay;10 uoljlpa;uauw a ssassod of ajnllel -cords pasojoua Jo (ju 166)1aa3 otgno 000`S£ UMP ssaj ureluoo goigen dnoi`d asn ,Cur jo sguTpimg - pa:Pijsa-iun OP ID: JT ACORO- ##-� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDOIYYY'') 1 01/25113 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. n IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemen s . PRODUCER 781-935-8480 DeSanctis Insurance Agcy, Inc. 781-933-5645 100 Unicom Park Drive Woburn, MA 01801 NGAOMNTACT PHONE FAX Nor: E-NANL PRODUCER CUSTOMER Ip t PARRI-1 INSURER(S) AFFORDING COVERAGE MAIC A INSURED Parris & Associates, Inc. 480 Tumpike.St. S. Easton, MA 02375 INSURER A: Acadia Insurance Company INSURER III: Safe Insurance Co. 39454 INSURER C: INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMRFR- . RFVISION NUMBER: THI$.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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER MLI PwYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1.000,0 001 PREMISESe encs s 250,0 A X COMMERCIAL GENERAL LIABILITYPA020521316 CLAIMS -MADE OCCUR 01/28113 01/28!14 MED EXP au person) S 5,0 PERSONAL & ADV INJURY s 1,000,00 GENERAL AGGREGATE $ 2.000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,00 -- — POLICY J(- ,0T- ....._ .. .Loc JS AUTOMOBILE LIABILITY `OMB SINGLE LIMIT $ 1,000,00 ANY AUTO BODILY INJURY (Per perwn) S B ALL OWNED AUTOS X SCHEDULED AUTOS X HOMO AUTOS 6216522 01/28/13 01/28/14 BODILY INJURY (Per eaidem) S ' PROPERTY DAMAGE (Per ��) _ s s X NON -OWNED AUTOS s X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 2,000,000 AGGREGATE s 2,000,00 A EXCESS UAB CLAIMS -MADE UP033383113 01128/13 01/28/14 DEDUCTIBLE r s $ RETENTION S A WORKERS COMPENSATION AND EWLAYVtV LJASIUTY ANY PROPWlTORNARTNERIEXECUTIVE YIN OFFKER#AMBER EXCLUDED? a 01mus My in IINI N /. A CA0205215516 MA 01/28113 01/28114 X 1AFA I I ATH E.L EACH ACCIDENT S 500,004 EL DISEASE - EA EMPLOYE s SAO. M SCR WOPERATIONSbelow I E.L. DISEASE - POLICY LIMIT S 500100( OESCR P`nON OF OPERATIONS I LOCATIONS/ VEHICLES (ARech ACORD 101, AOMa" R&MwM Schalule. M more open to m***M Evidence of Coverages. TOWHO-1 SHOULD ANY THE ABOVE DES ISED POLICIES BE CANCELLED BEFORE To Whom It May Concern TME- .. ._. _. TION\ DATE_ TH , —NOTICEIL BE DELNERED IN Y ACC ANCE YY THE POLI PR VISIONS. AU(7 988-2009 0 RAT 0 I rights reserved. ACORD Z5 (2009/09) The ACORD name and logo are registeo marks of ACORD c= Arris t ssoClates COHSIMCIM UdgeMCHI . May 13, 2013 E -Mail: Chuck. Labins(@steward.orrR Mr. Chuck Labins Corporate Real Estate & Facility Steward Health Care Systems, LLC 500 Boylston Street, 5th Floor Boston, MA 02116 RE: SMG Prakash Office 575 Turnpike Street, Suite 27 North Andover, MA 01845 Dear Mr. Labins, Per our conversation we have modified the scope and pricing of the work as follows: Construction Scope of Work: • Architectural / Engineering Fees for Permitting $ 3,500.00 • Selective Demolition & Removal $ 3,250.00 • Supervision / General Requirements / ICRA $ 7,250.00 • Rough / Finish Carpentry $ 1,750.00 • Casework / Millwork (limited to new reception top) $ 2,100.00 • Sealants / Caulking $ 320.00 • Doors, Frames & Finish Hardware (7 openings) $ 3„260.00 • Glass & Glazing (2 new sliding windows) $ 1,260.00 • Metal Framing & Drywall $ 4,880.00 • Acoustical Ceiling Grid & Tile (patch / match only) $ 720.00 • Patch / Match Flooring & Base $ 640.00 • Painting (new areas only) $ 1,250.00 • Electrical & Data (new areas only) $ 2.700.00 Subtotal $ 32,880.00 Sales Tax $ 742.00 Fee $ 3,973.00 G/L Insurance Premium $ 247.00 Building Permit Fee $ 800.00 Total Budget 38,642.00 Please call should you have any questions accordingly. Thank you .for the opportunity to work with Steward Health Systems once again. EKG 480 Respectfully, n Robert A. Parris, President Patrick Murphy Street - South Easton, MA 02375 • Tel: (508) 230-0255 - Fax: (508) 230-2543