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HomeMy WebLinkAboutBuilding Permit #796-13 - 799 TURNPIKE STREET 5/21/2013El TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: X112 Date Issued:f—/ i IMPORTANT: A plicant w LOCAION ` sGa l 17 ` �PROPER�TY�0INNER 1liMAPjN®�{A ©PARCELtZONING Date Received must complete all items on this page aunt-.=100Year,0ld St�uct ru e� )ISTRICT Historic District yes nod MachierShop=Villaget`yesi rind"', TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑Industrial Iteration No. of units: &e"6'mmercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: [I Demolition 11 Other ❑Septic ❑ 1Nellntls� - ' l©�F1NatershstAter/Sewe.rat TEI T; D CRIIPTITIUNI- UUKK. I U t5t r G 1 ct'/d� CiC" O rUkmr-u. rz 00 ko I 4A�Vvj OWNER: Name: Address: /30 t CONTRA67,T, 'Name; ' k'o 7.� {Address: { Su{pervlsor�sConstructiorifLi / 4 Phone /SY , aTil xp i I 3Ia �1—Phone: Col., �15 a 30 ARCHITECT/ENGINEER Address: hh� , , Reg. No. FEE SCHEDULE- BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. i FEE: ' Total Project Cost: $ Check No.: / Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ;Signature of Agent/Owner� ` . Signature `of contractor, �, 1 - Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ i -- 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 MOTE: 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 subm:ated with the building application Doc: Doc.Buil Jing Permit Revised 2012 I � I f 1 Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE 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 DATE REJECTED PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE APPROVED El Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: t Conservation Decision: Com Comments ing Decision/receipt submitted yes Water & Sewer Connection/Signature & Date Driveway Permit DPW Tow � Engineer: Signature: Located 384 Osgood Street FIRE -DEPARTMENT Temp Dumpster on site yeas no' Located at 124 Main Street ent Fire Departmsignature/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 2010 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 2010 Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public SewerSwimming Tanning/MassageBodgArt ❑ 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 . DATE REJECTED DATE APPROVED F1 1 — 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 i Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Tows Engineer: Signature: FIREE®EPARTM=NT =Temp Dumpster on site yes Located at 124Main''Street-.: Fire Depa'rtmert signature/date : ` COMMENTS Located 3M U no e Street 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 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'Ated with the building application Doc: Doc.Buil Jing Permit Revised 2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: _42 Date Received TYPE OF IMPROVEMENT PROPOSED USE l?honeL Residential Non- Residential ❑ New Building ❑ One family ❑ A dition ❑ Two or more family ❑ Industrial f,Alteration No. of units: &e1o"mmercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 1 r,'i❑'SepticY Well; ` O'Floodplain;.­� E,Wetlands� f 7` 03 WatershedI®istridV .❑ titer/Sewera of D CRIPTION OF ORK TO BEP FORMED: 0Cc- G i Qaj-) CL cc, k, ca r/it T Tt�v_fl L e or Print Clearly) OWNER: Name: 1� Vol rt`trtP,f"SLLc Address: rnGJaa/ 65bc CONTRAC:T,OR l?honeL .Ngme _: a i 1 �C 'Address.9y..Cf.. �S1 SupervisorasA.Construction License: �J.625� ,.. Ezp+ Dato of � _wlrnprovement License . _ Homey '.r. �. Expo Date _ .. . ARCHITECT/ENGINEER SI ofV, Phone: C/: ty - /d �Q 1 Address: 933 acth-1 Lit �;/� Reg. No. FEE SCHEDULE: FEE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ �I i, d . Check No.: /0-F© Receipt No.: NOTE: Persons contracting with aanregistered contractors do not have access to the guaranty fund Signature'Mof Agent/Owher ,'`° 'Signatureiof contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location No. 6 — Date Check # Aa0 TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL 26425 Building Inspector Location / K) 0'e ,of 1'C-@,, No. T (D — a Date 9d� TOWN OF NORTH ANDOVER do e Certificate of Occupancy $ 4 fl Building/Frame Permit Fee $ C .0 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #� Bu� ing,lnspector CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 796-13 on 5/21/2013 Date: September 20, 2013 THIS CERTIFIES THAT THE BUILDING LOCATED ON 790 Turnpike Street MAY BE OCCUPIED AS Interior Offices, Conference Room, Kitchen — Suite 203 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: KS Partners, LLC 130 New Boston Street Lowell, MA 01851 , , , I �-' /JX-, . - Buil ing Inspe for Fee: $100.00 Receipt: 26890 Check :1089 4 m m X m CO) CO) F) 0 " p _ O N = < m - M CL 0 r5'`°o m O0 CLC N• z o ��� v,' ,.N p• fR ,Wf O T C 0 0 Q. m � 0 cn 0 cn. N =' CD M • N0 CL cu ig = p�Co -a o Q r+ no O W s m c� Z y C =_: (D CD O Z CL o co M •= � Q _ to _ z o � "a c� STO CL�• c� a� n— �� _ CD =r ° O � 9 " (DcD o p �' rt .•�j CD 0 cn = CD Z -i Z rt c CL D= �� CO CD cn CD 57 0 Z CD U,n 0 v ' o o, •� O z D �. O CD o• �• a f\ t -N y 0 LnV) W 3 O O2 O rt 77 z 0 T ;;o 7 O S T Ln O' O v (,ao � � T O O 3 ' T' (� T O 3 O O °1 3 c c O D V) T m O �. a n Ln -nm m m Z � 2 A s C W z W / C C z 3 W G z LA M 70 Z H oO z H pW Ta \ \ � W 0 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 1391972.00 m $ - $ 1,679.66 Plumbing Fee. $ 209.96 Gas Fee 100 comm. $ 1100.00 Electrical Fee $ 209.96 Total fees collected $ 2,199.58 790 Turnpike Street 796-13 on 5/21/2013 Construction of new interior offices, conference room, kitchen e if t Mo 'rM o ,°dry 1j7 �°'Mn° rrM4�9 SSACNUSt CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 796-13 on 5/21/2013 Date: September 20, 2013 THIS CERTIFIES THAT THE BUILDING LOCATED ON 790 Turnpike Street MAY BE OCCUPIED AS Interior Offices, Conference Room, Kitchen — Suite 203 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: KS Partners, LLC 130 New Boston Street Lowell, MA 01851 Buil ing Inspe for Fee: $100.00 Receipt: 26890 Check :1089 Q. r� H UJ zam fi O W coCl) Cl) o � I— �: v m � y J � (DO >, a Z F- N : � c 0° �, U - tq . _ as �° W o� � D > c � H L; m OM >a = Z N O W p o o '75 H V N .c c v' V) a� .�.- r Lu a,'> c c W J o t- �a Q- Z ca 00 U) tm cr c = c . Q i i eC 5 O 2 0> t Q N Q).2 m 0) co cc W = ,a O C �' Li 'NR N C O .Q t O LU E V v O W L v a).- O P L CL 0-0 . U) J x aoo 0 ti a v E � O O Z O N 0-- :2 .E m m a� O �+ O V i O � a CL cp Q O� 'a �CL O CD r Z V N Rf 0 CLM CL U) LLI vI W LL! 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C9 W DSH )DESIGN GROUP Architects m Engineers m Construction Managers CONSTRUCTION CONTROL AFFIDAVIT PROJECT TITLE: INTERIOR RENOVATION OF SECOND FLOOR OFFICE-ORCHIRD MATERIALS PROJECT LOCATION: 790 TURNPIKE STREET, NORTH ANDOVER, MA SCOPE OF PROJECT: PARTIAL RENOVATION OF THE EXISTING SPACE, INSTALLATION OF NRW PARTITIONS AND NEW CEILINGS. In accordance with 780 CMR Section 107.6.2 of the Massachusetts State Building Code, I Davood Shahin, Registration # 8186 being a registered professional architect with the firm of DSH Design Group, 233 Needham Street, Newton, MA 02464, hereby certify that I have prepared or directly supervised the preparation of the renovation plan indicating addition of new offices, new fire safety and exist devices and relocation of few sprinkler heads within the existing space and that, to the best of my knowledge, such plans meet the applicable provisions of the Massachusetts State Building Code, all acceptable architectural practices and all applicable laws and ordinances for the proposed use and occupancy. I further certify that I, or my authorized representative 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 107.6.2.2: Subscribed and sworn to me this 30`h day of April 2013 My Commission Expires: MONISH MA t Public W Commission Eon Dodi 20.2020 233 Needham Street, Suite 31k0 Newton, MA 02 T- 611- 454-1230 F- 611- 454-1231 www.dshdesi2ngroup.com Client#: 58856 KSPARTNERS1 ACORDTM CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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, 4/30/2013 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 Cb—NTA—CT NAME: HUB International New England AHONNo Ext):978 657-5100 AIC No): 866-475-7959 299 Ballardvale St ss: nee.certificates@hubinternational.com ADDRESS: Wilmington, MA 01887 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS - COMP/OP AGG $ 978 657-5100 INSURER(S) AFFORDING COVERAGE................................_NAIC - ......... _... ..... __.................................. .. ..................... .......... #............. AUTOMOBILE INSURER A: EastGUARD Insurance Company 14702 INSURED KS Partners LLC eta/ INSURER B : INSURER C : I COMBINED SINGLE LIMIT Jefferson Equity! Jefferson Office Park -- 130 New Boston St Ste 303 INSURER D --------------- ----- Woburn, MA 01801 INSURER E .................. ..... .... ..-..............................-------- ....... ...................._ .................... .......... INSURER F: ANY AUTO COVERAGES CERTIFICATE NUMBER: RIPWRION 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 CONTRACTOR 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. 'N ...R............................................................................................._...... S ADDL SUBR1 _....._........................ POLICY EFF POLICY EXP )_.____ .................._..........._............ .............LI LTR TYPE OF INSURANCE INSR WVD I POLICY NUMBER_ _ MMIDDIY_Y_YY MITS (MM/DDfYYYY) + _ GENERAL LIABILITY CCURRENCE $ j EEDACH��OEE COMMERCIAL GENERAL LIABILITY PREMISES OEa occue_nce $ CLAIMS -MADE L l OCCUR _ C ! — ( MED EXP (Any one person) j $ PERSONAL & ADV INJURY j $ GENERAL AGGREGATE ;$ GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS - COMP/OP AGG $ POLICY 171 ECT LOC IF $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT -- I,..i.Ea_accident/ .............._..._.._._......._........._�_$.........................__..........._._.._.................. ANY AUTO BODILY INJURY (Per person) Is _._..._. ALL OWNED SCHEDULED AUTOS AUTOS .......................................................................... t BODILY INJURY Per accident ! $ ( ) NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per acadent Is --- - - $ ... -- UMBRELLA LIAB _...-- OCCUR EACH OCCURRENCE is L....._..._ EXCESS LIAB CLAIMS -MADE ........................-......_.............................__........)._.........._....._......._......................._.._..........._ � AGGREGATE is DED RETENTION $ is A WORKERS COMPENSATION KSWC420995 4/11/2013 04/11/201 X WC STAT U- 0TH•; AND EMPLOYERS' LIABILITY Y / N T()RY LIMITS I ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ® N / A I E.L. EACH ACCIDENT $500,000 (Mandatory in NH) Ifyes, describe -i E.L. DISEASE - EA EMPLOYEE $5000 000 t..............................................._.. under I.DESCRIPTION OF OPERATIONS below I .......................................................................................L................... E.L. DISEASE - POLICY LIMIT 1$500,000 I i i DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 107, Additional Remarks Schedule, if more space is required) re 790 Turnpike St, North Andover MA. Town of North Andover 120 Main St North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9� .VC C4vo6 ..— U 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S912430/M908254 EH002