HomeMy WebLinkAboutBuilding Permit #269-2012 - 800 TURNPIKE STREET 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION I vrY) i S�
Print
PROPERTY OWNER f:�"S ?C;1,r tV��'�S LL C Unit#
Print
MAP NO: PARCEL:
_V��O ING DISTRICT: Historic District yes no
Machine Shop Village yes
t 100 year-old structure yes
TYPE OF IMPROVEMENT PROPOSED USE C
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
P Iteration No. of units: Uldrommercial i
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑"Septic Well `Floodplain VJetl`ailds '' 'Watershed Disfrict
rO Water/Sewer
,� r DESCRIPTION OF WORK TO BE PERFORMED:
C'
1-evxv` ti vim• ��0 Dov' �-� z.x�s�i�� ������,� �,.,�IIS �w,s��r�c�-
3 �2v� Grxic3�-S S fe
(Identification Please Type or Print Clearly)
OWNER: Name: ICS PCA rA,\r\er"S 1t C Phone: cs60
Address:_ AVLy
CONTRACTOR Name: Ks C Phone: S6?o 05t 6
Address: 13U � � `.>GSk?1,4 S� l�t/O/�✓�-L ,MA)
Supervisor's Construction License: a.S"�6' Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER��N I V— Phone: 1q- `15 q, Q30
Address: �t "cam , MA M&Y Reg. No. S/E&
FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ ���,�Q� FEE: $ P,3<5�010
Check No.:— Z7 Receipt No.: 4?y6011
NOTE: Persons contracting with unregistered contractors do not have access t the guara ty un
Signaturerogent/Qwner
': Siaiafure of.contractor_ .
I
i
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer D/ Swimmin Pools El
Art ❑ g
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 - 11 FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
1 COMMENTS �
I
CONSERVATION Reviewed on
Signature
I
COMMENTS
HEALTH Reviewed on Siqnature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
I
Planning Board Decision: Comments
I �
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
I
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site yes Located 384 Osgood Street
no
Located at 124 Main Street j
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 Dieter 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.$1o0-$1000 fine
NOTES and DATA— For department use
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2011 June/mi
i
J
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 Bid
, g Pern
Addition or Decks
1 ❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Com Affidavit
davit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
0
❑ Flo or/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
� g Permit
ermit
' 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 BldgPermit
mit
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
1
must be submitted with the building application
Doc: Doc.Building permit Revised 2008mi
Location roo 7Urly,a" ,�F SfiyN`7;74=
No. �� '"X0/-2 Date V,2
NORTq TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
t
24668 B Id ng Inspector
's
11 sas.scltu'�cttt-rDc(
s.ss'tmctit sal'Public°`ufct�. i;
�;'. Bpartl o(�.Bttt(tlin�L.Re�ul.ttion�ltntl St,ttstl:st t4�,
Construction-Supervisgr>,License
L,L ,
f License; GS_ 85258
Restricted to: 00
r
:.JOSEPH. TURNER
694 WESTFORD ST
HOWELL,MA 01851°
` t z¢�ration; 1112112011
10756
r
The Commonwealth of Massachusetts
Department oflndustrial.Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass gov/dia
Applicant Inforlmation
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
_
n Please Print Legibly
Name(Business/OrganizatiorAndividual):
Address: U
City/State/Zip: Phone#:
o
[E] I
an employer?Check the appropriate box: _
a em to er with �j- 4. Typeofproject(required):
p y ❑ I am a general contractor and I
loyees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
a sole proprietor or partner- listed on the attached shget. 1 7. ❑Rem.odeling
and have no employees These sub-contractors have8. []Demolitioning for me in any capacity. workers'comp.insurance.
workers' com .insurance 5. 9• ❑Building addition
p ❑ We are a corporation and its
red.] officers have exercised their 10•❑EIectrical repairs or additions
a homeowner doing all work right of exemption per MGL 11.[]Plumbing repairs or additions
lf. [No workers'comp. c. 152,§1(4),and we have noance required.]r employees. 12•❑Roof repairs
[No workers'
comp,insurance required.] 13.❑Other
'Any applicant that checks box#1 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 sub-contractors and their workers'comp.policy information.
-rain 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.#:
Expiration Date:
Job Site.Address:
City/State/Zip:
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
fore 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.
fP J rY
r do hereby certify under the pains andpenalties o er•'u that the information psovideil above is true and correct.
.i nature:
Date: 6 1 Id o,/
`hone#: a
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 S.Plumbing Inspector
6. Other
Contact Person: phnnn 44.
DSH/ DESIGN GROUP Architects m Engineers m Construction Managers
CONSTRUCTION CONTROL AFFIDAVIT
PROJECT TITLE: INTERIOR RENOVATION OF SUITE 203
PROJECT LOCATION: 800 TURNPIKE STREET,NORTH ANDOVER,MA
NAME OF BUILDING: JEFFERSON OFFICE PARD
SCOPE OF PROJECT: RENOVATION OF THE INTERIOR LAYOUT.
In accordance with 780 CMR section 107.6.2 of the Massachusetts State Building Code Eight Edition,I Davood Shahin,Registration 4
8186 being a registered professional architect/engineer 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_all-design plans,-computations.and specifications
concerning:
ENTIRE PROJECT ARCHITECTURAL. 7£ FIRE PROTECTION
MECHANICAL ELECTRICAL STRUCTURAL
OTHER(Specify)
For the above named project and that,to the best of my knowledge,such plans,computations and specifications meet the applicable
provisions of the Massachusetts State Building Code,all acceptable architectural i engineering practices and all applicable laws and
ordinances for the proposed use and occupancy.
-I further certify that I,or-my authorized-representative shall per€orm the necessary professional services acid-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
1. Review of shop drawings,samples and other submittals of the Contractor as required by the Construction Contract Documents as
submitted for building permit and approval for conformance to the design concept.
2. Review and approval of the quality control procedures for all code required controlled materials.
3. Bep resent 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.
?D ARC
Q� QJ py�Z Off'
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No.B 6
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NE N
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`GF9ITH MPc,S
233 Needham Street Suite 300 Newton. MA 02464 T- 611- 454-1230 F- 611- 454-1231 www.dshdesignprouD.com
NpRT#i
own of ``
:- - �-_- Andover -
LAKE o , dover, Mass.,
COCHICHEWICK
ADRATED
`S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT....... ..L/Qi' /vF�.S.... ......................................................................................
- Foundation
has permission to erect.... buildings on ...90.0...../V 1,,y �° E ,S'�.......,�vv ° ds
........! Rough
to be occupied as......... � ,cam Chimney
provided that the person accepting this permit shall m every respect conform to the terms of 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
UNLESS CONSTR.UCTIO TARTS ELECTRICAL INSPECTOR.
Rough -,-
--^ ...
............... ......... .... . ........................... ....
.. ervice
BUILNG INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIRE-DEPARTMENT
Burner
Street No.
SEE REVERSE SIDE Smoke Det.
i
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i
9 -7il10
his" 7si� i
ZGl t
IP
,�°
power restored to this area soon. Your service can not
be energized until the repair is completed.
NORTH
Town of
.. .
0
No.
LAK E o , dover, Mass.,
COCHICHEWICK
%dS RA7ED
7 BOARD OF HEALTH
PERMIT TFood/Kitchen
a Septic System
f� BUILDING INSPECTOR
THIS CERTIFIES THAT........��!�....� N. .
. ......................................................... ........................... Foundation
has permission to erect.... g �-. ....`1�'.... . ' g 6
buildings on .. �l�a.....!�'.r,v . �....�E... 5.............. ter .QC's ou h C
to be occupied as................................. ..........A'`...........,�'�...e ..... Mimney
provided that the person accepting this permit shall in every respect conform to the terms of 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 CONSTRUCTION TARTS
...... ..., �.... ... ..,ti.................................... ...
............... y a..... ... Service
BUI�LDING INSPECTOR
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
F
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. oL
GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY 0K)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec, etc.
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip-Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate. ,
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girls-solid brick or steel plate bearing at foundations
'/"air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min.22x30 w/3'headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
Firecode S/R wood frame of"0"clearance fireplaces"&stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8%of floor area.
of required glazing shall be openable.
Bedrooms required min. 20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Fouting-Smoke Chamber- Finish
Smooth parging,clean joints,8"solid @ combust.
DECKS: Lag to house, provide flashing.
Rails min. 36" high, Baluster max space 5"on center.
Over 8'above grade, use 6x6 posts w/lateral bracing.
Lag all posts and rails. -
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee- $30.00(Be Ready).
Certificate of occupancy required prior to occupying structure.