HomeMy WebLinkAboutBuilding Permit #756 - 790-800 WAVERLY ROAD 5/17/2007Permit NO:
Date Issued: 5-- /-�" — y
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
I_ IMPORTANT: Applicant must complete all items on tI --
LOCATION
Print
PROPERTY OWN
v� iwhp2 LT- I
MAP NO.21 23 PARC EL -f aAA_ -71%
TYPE AND USE OF BUILDING
ZONING DIS
HISTORIC DISTRICT VFS n
V-ttl•!D \
O �
x
N. -
TYPE
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
❑ One family
❑ Two or more family
No. of units:
❑ Industrial
❑ Repair, replacement
❑ Demolition
❑ Assessory Bldg
Commercial
qi. )&!
❑ Moving (relocation)
XOtherElOthers:
Ty
❑ Foundation only
DESCRIP iluN OF WORK TO BE PREFORMED
0 �-- �pi u l
Identification Please Type or Print Clearly)
OWNER: Name: LLA.tlZ I tJUL���-7 Phone•( -l7 -33Z -S tq,a
Address: Qnhvcf� F N��-scW di(,A 0 4 6 1
CONTRACTOR Name: ]22974
Address: Z5 "alyla D
Supervisor's Construction License: G G4 6-4 f Exp. Date:
Home Improvement License:
Exp. Date:
ARCHITECT/ENGINEEReh _ `�- Sc� Name: Phone: DC7-2�2 - q Z22.
Address:
Reg. No.
FEE SCHEDULE. BULDING PERM] T.- 572.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S. F.
Total Project Cost :$ ZOO..y o(Z) FEE:$ '�3c5(=> o
Check No.: S16 5 V
Page l of 4
Receipt No.: a 0 0-� a -
TYPE OF SEWERAGE DISPOSAL
Tanning/Massage/Body Art ❑
Swimming Pools ❑
Public Sewer ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales [I
Private ❑
Permanent Dumpster on Site ❑
(septic tank, etc.
Electric Meter location to
proj ect
IN U4 E: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner
Plans Submitted ❑
Plans Waived ❑
Signature of contractor
Certified Plot Plan ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
A
COMMENTS
'�
Zoning
Zoning Board of Appeals: Variance, Petition N
Zoning Decision/receipt submitted yes
Planning Board Decision:
DATE REJECTED
❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
DATE REJECTED
DATE REJECTED
11
Comments
F0 -
Stamped Plans ❑
DATE APPROVED
DATE APPROVED
DATE APPROVED
Conservation Decision: Comments
Water & Sewer connection/Signature & Date Driveway Permit
Temp Dumpster on site yes—no— Fire Department signature/date
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required
Provided Required Provides Required Provided
Dimension
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
NU I LN and DA 1'A — (For department use)
Page 3 of 4
Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created JMC. Jan2006
Building Department
The following is a list of the required forms to be tilled 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
Addition Or Decks
❑ Building Permit Application
❑ 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)
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
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:BPFORM05
Page 4 nf 4
Locationof% %/
No. —2T6 Date
TOWN OF NORTH ANDOVER
-00
Certificate of Occupancy
.� b•,..o .•`
Building/Frame Permit Fee $ �y
Foundation Permit Fee $*
Other Permit Fee $
TOTAL $
Check # C
2ULL2
Building Inspector
05/14/2007 14:19
ENGINEERS
ARCHITECTS
PLANNERS
CONSTRUCTORS
May 14, 2007
6172429824
343 Congress Street
Boston, Massachusetts 02210
Voice 617.242.9222
Fax 617.242.9624
www.okoorp.com
Mr. Gerald Brown
Building JAspector
Town of North Andover
1600 Osgood St.
North Andover, MA 01845
RE: Mechanical Field Report # 1
Walgreens Plaza
Waverly Road
Permit No. 043
EK Project No. 0500.13.272
Dear Mr. Brown:
EDWARDS & KELCEY
We have been to the site to observe the Walgreens mechanical system as built construction for
conformance with the specifications permitted for construction. As of May, the mechanical system is
substantially complete with ductwork, air devices, roof, mounted Equipment and low voltage control
wiring installed. We are reporting that the mechanical work completed to date, appears to be in
compliance with the plans and specifications permitted for coAstruetion.
Should you have any questions please feel free to call.
Very truly yours,
Gulam Mustafa, P.E., .LEE.D AP
Mechanical Department Manager
Gm/grn
c: Russ Benassi — D. F. Fray
N OF �ASs'4t�
~z MUSTAFA
MECHANICAL y
41455
JA2005 Projects1050013272\D--cntq\ConstmctionlFietd Rap =\Mechanical Field Report 05-14-07.doe
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