The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #351-11 - 799 TURNPIKE STREET 10/26/2010 NORTH BUILDING PERMIT TOWN OF NORTH ANDOVER ti ` APPLICATION FOR PLAN EXAMINATION *y *'0 _ I11 TEy I J w 1• 'r Date Receivedor, Permit NO: �9SSACHU5�� F Date Issued; IMPORTANT: Applicant must complete all items on this age r .s Xt' �P.Hnt 5_,, NER_14 fPROP `Tky .�. � . } � M pNp��►�� P��A-RCEL��d _ �Z®N,�INGIDIS;fRICT� _ - - - �_ Histoc,®rstnc�t ! -a.�e•a� Q � iM ges achene fYe rin TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ One family ❑ New Building ❑Two or more family ElInd stria) [Id' 'Adn - commercial eration No. of units: El Assessory Bldg ❑ Others: ` ❑ Repair, replacement 11 Other ❑ olit Demion s ` - ®xFloodplam � Watershe ®tstnct ❑ e jands p , ,. I DESCRIPTION OF WORK TO BE PREFORMED: �Identi c tion Please Type or Print Clearly) Phone: r-� 2�►�� ► /OWNER: Name: ✓Address '�°I '?�11iu_ a Turn _ Pe Nne Si s `�TRA`C'T'� �. .1� '.ra'�s- r t y Ott", Y � � t o evsesCoup � nsrctiS77, •�� i/`+.'.*�4c--. dE`�X��}�D4a"�t•-`�• •.'_z. "w J Exp Date r .. --�-�•- I-I�.ome - - fO O �DA� I p �A Aft Phone:�i81 3�3~ ��" ARCHITECT 833 'I KING DF-St&N p`�S�G. 'MAco2.1S � � Reg. No. Address:10 RI CK 417 M�ft� FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$X25.00 PER S. . Total Project Cost: $ b ®` FEE: $ Receipt No.: � � � Check No.: aran f nd N E: Persons contracting with unregistered contractors do not have access to g JA t ' nature of contract r ._N.. r ent/Ovvner., -- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ ' 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 ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED (PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS i ' HEALTH Reviewed on Signature COMMENTSZA Zoning_Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date t Driveway Permit I DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTM ,�gTemp ®umpst IRK u i',int .sc�.t a-yt ,�s— , , L ted at1.24 MainLSt�eet a , * .?wr" Ssy.+ .�.waf��ar b ..t �,. �y' ,. {�.2_. 'S. i Fo'eD,epartment;signature/datea x. �� _; r �� .y_ �Y Sb,Rzr 47= ! .i k fid. } t{, 1 rnnn�nt��vT� I 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 { U Notified for pickup - Date __J Doc.Building Permit Revised 2008 E 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 offrom 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 One To Be Returned ❑ Two Sets of Building Plans ( ) 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 offrom 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 DEPARTMENTMFORM07 Revised 2.2008 Location :7-7 l4.e--r/ No. Date NpRTp TOWN OF NORTH ANDOVER opt...° ,•,�C f � a } ° ;+ Certificate of Occupancy $ Building/Frame Permit Nust Fee $ s�c Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 236G4 Building Inspector NORTH TO" O Andover No. 04S, L A K E fl dover, Mass.,loop Z!® GOC HIC HE wI CK S RATED BOARD OF HEALTH PERMIT D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..........Leonv-d.......... ...........� 4...... ...'................................ Q..(om.......................""' ' •5 C "" Foundation has permission to a t........................................ buildings on .......'?..L ....... ....4-.q.—n........... Rough t0 be OCCupled.aS.. ... . .l!!1,. ..Ax........................ �.�.......... ......1�... lr.......................�. ;.�•�.......A-fY. Chimney provided that the p rson accepting this permit shall in eve respect conform to the term f 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 ELECTRICAL INSPECTOR UNLESS CONSTRU z TS Rough .......................... .-_ .... ........... ..... Service . . ... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. Miiss.tchusetts- Department of Public Safety Board of Building Regulations and Standards C Construction Supervisor License License: CS 40515 Restricted to: 00 ROBERT A DOYLE 14 COUNTRY CORNER RD WAYLAND, MA 01778 C—�, _ Expiration: 7!26/2011 Cununisiuner Tr#: 18788 i i The Commonwealth of Massachusetts �F Department of Industrial Accidents In Office of Investigations 600 Washington Street Boston,MA 02111 s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Name (Business/Organization/Individual): F Address: �;Z City/State/Zip: Phone#: 3D9 3S`8 �9c13 Are�yo�uemrployer?Check the appropriate box: Type of project(required): 4. I am a general contractor and I construction ❑ g New 1. ployerwith�-- — 6. ❑N employees(full and/or part-time)•* have hired the sub-contractors n mng odeli p listed on the attached sheet. FJA 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. F1 Demolition working for me in any capacity. workers'comp. insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their right of exemption per MGL 11.0 Plumbing repairs or additions 3.❑ I am a homeowner doing all work g p p myself.[No workers'comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#I 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. TContractors 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 Name: Policy#or Self ins. Lic.#: �%'`TO 5 Expiration Date: ,r 11'2 I/ Job Site Address: R � City/State/Zip: No. 4bovaL lMA51 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 InvestigatijofthnMforancecoverage verification. I do herebs and penalt7ofpeJYuiy that the information provided above is true and correct Signature: Date: h 2 /0 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#: CONSTRUCTION CONTROL PROJECT NAME: Renovation of Existing Dental Offices PROJECT OWNER: Dr. Jeffery Leonard PROJECT LOCATION: 799 Turnpike Street — 1st Floor 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, SEVENTH 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 PROJECT XXX ARCHTFECTURAL STRUCTURAL MECHANICAL FIRE PROTECTION ELECTRICAL OTHER(Specify) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF KNOWLEDGE,SUCH PLANS, COMPUTATIONS AND SPECiF1CATIONS"d1E'ET TIIE APPLICA;3;,E 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 PROJECF FOR OCCUPANCY. aED Fc WICONo.893� RDy IVA DAVID A.FARMER PERSONALLY APPEARED BEFORE ME AND SUBSCRIBED AND SWORN TO BEFORE ME THIS 8th DAY OF October, 2 010 P 1 SEAC P.,KING PUBLIC htr.8'2013 DOYLE AND MATTHESON, INC. Date: October 10,2010 Proposal to Construct Dental Office for Dr.Jeffrey Leonard Located at: T. Turnpike ST.North Andover,MA According to plans by Patterson Dental Co. Drawing# 10B075 and the following description of the scope of work. 1. Acoustical Ceilings: A) 2X2 reveal edge Armstrong Dunegrid and tile. 2. Existing Walls: A) Sheetrock repair to new condition on exterior sheetrock walls. 3. New Interior Walls: A)Metal studs, insulation and 5/8" sheetrock to 10' height. 4. Soffits: A) Soffits at front desk and reception area. 5. Doors: A) Solid core birch doors with metal frames, and Schlage hardware. 6. Flooring: A)Vinyl floors at operatories, bathrooms, lab and staff areas. B) Carpet at remaining areas. Final selection to be determined. P.O.Box 5506 •Wayland,MA 01778 •Tel.(508) 358-2993 9 Fax (508) 358-4681 DOYLE AND MATTHESON, INC. 7. Paint: A)All wall, soffit and ceiling surfaces will receive latex primer and finish coat in color(s) selected. B)Doors and frames will be painted with oil base paint in the color selected. 8. Heat/Air Conditioning: A)Reduct existing system with ceiling delivery system. 9. Cabinetry: A) Custom laminate cabinets as indicated on plan. 10. Concrete: A) Cut,remove, dowel and re-cement floors as needed for underground services. 11. Electrical: A)Per plan 12. Fire Alarm: A) Per plan 13. Lead: A) as indicated on plan 14. Plumbing: A) Per plan. P.O.Box 5506 •Wayland,MA 01778 •Tel.(508) 358-2993 9 Fax (508) 358-4681 DOYLE AND MATTHESON, INC. * Building Dental Offices For Over A Quarter Century 15. General Conditions: A)Labor B) Supervision C)Dumpsters, miscellaneous materials D) Permit and Insurance Contract Amount: $ 252,570. Construction duration: 14 weeks Invoicing: 1St and 15th each month Final Payment due upon issuance of occupancy permit. Acce ted f i a Robert Doyle 6 Doyle and Mattheson, Inc. Dr. Jeffrey Leonard P.O. Box 5506 • Wayland, MA 01778 • Tel. (508) 358-2993 • Fax (508) 358-4681