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HomeMy WebLinkAboutBuilding Permit #555 - 85 FLAGSHIP DRIVE 3/28/2008 BUILDING PERMIT cF Noer" q ,TulD 46 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION a Permit Nd: s Date Received "qo°""'�`rep ��"�y* r ��SSACNUS�� Date Issued: —�U�—© IMPORTANT:Applicant must complete all items on this page a LOCATIfJN „;,t RC3PERTY OIEF , - aar# - VIAP 140:_, PAR 1 �OIa11Ntj.Dl��R1CT: I-1istorac 0 lct yes nD acffih .Shop Village� yes ,no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration .z/ No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other :lila®dilai ..tletlatds Watershed 17istric# Fwat�rlSewer DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: {,'" lGc��h iG- -� _ Phone: 97 ' Address: 0S o' U 1 l 4 CQNTRA�TOR Name• ; C' one .Address, ` _ t t - w SupeNisor's.Construction`License, , - Exp. Bate t* / to qe 1r provernent License: En_ Date; 1 ARCHITECT/ENGINEER kD4 Phone: Address: 3F- adz 'P4 • JES6,< / ,� Reg. No. s� 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.: f d Receipt No.: gl o_? d NOTE: Persons contracting with unregistered contractors do not have access to the guaran igraature of�►gent/ caner. _ 7.77777� S� nature, contractor 1 Location CJ ��� No. *��S , Date -5,1114 ,.ORT1y TOWN OF NORTH ANDOVER O' GD � . .•1►O • • Cw A • ; , Certificate of Occupancy $ sACMUSE�� Building/Frame Permit Fee $ 129 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ` Check # B ;ZF 1 2 1 G30 Building Inspector 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 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Conne,Ction/Signature &Date Driveway Permit Located at 384 Osgood Street FIRE DP ►RTijVIEiVT -°T�mp ©unapster.o� site. yes no Lticatedt 12 iiin.Sfreet. - _ :F re IDepartrnent MS nature%da#e :�COM ME,.NTS 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 2 1 A—F and G min.$100-$1000 fine NOTES and DATA- For department use j 0 Notified for pickup - Date Doc.Building Permit Revised 2007 ' 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 o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses . o Copy of Contract o 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 o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Cirossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Ener Compliance Re Energy p port (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) o Building Permit Application ❑ Certified,Proposed Plot Plan o 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 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 I Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 I I Revised 2.2007 - � r10RTF�w 'q 0 Of And 0 No. �....�. ; o dover, Mass., . :3 LAKE COCHICHEWICK V �ORAT E D P' 5 1v E BOARD OF HEALTH Food/Kitchen . PERMIT T D Septic System BUILDING .INSPECTOR THIS CERTIFIES THAT �'.......... ...............................................n.......................`............................................ Foundation H / , f has permission to erect............:........................... buildings on ... .`r.��.'......�!��..��a............................... Rough ��G✓ISd�t%'��/ Gr ��'1 �f1� t - Chimney to be occupied as..................................... !�.Wn '.......:......�....... ..... . . . . . .. . .. . . . . . . . ... ............ provided that the person accepting this permit shall in every respect conform to the terms f the application a.. 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR. UNLESS CONSTRUCTION STARTS Rough -. StD ........................................ Service ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final 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. The Commonwealth of Massachusetts ^s Department of Industrial Accidents ► 1 Office of Investigations � lULPi i600 Washington Street Boston, MA 02111 wwwov/dinzass. g a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): Address: City/State/Zip: Phone #:_ 71/-- Are you an employer?Check the appropriate bo Type of project(required): !.[11 am a employer with_ 4, i am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on.the attached sheet. 1 7• ❑Remodeling ship and.have no employees These sub-contractors have 8. ❑Demolition, working for me in any capacity. workers' comp. insurance. 9 ❑Building addition [No workers'comp, insurance 5. F1 We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3,❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 13.[x]Other A- comp. insurance required.] *Any applicant that checks boz#1 must also fill out the section below showing their workers'compensation pol icy 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. 4Cotttractors that check this box must attached an additional sheer 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: 1W / Policy#or Self-ins. Lib.#: c2 t5 7 Expiration Date: Z-- Q`Q Job Site Address: City/State/Zip: " . Attach a copy of the workers' com ensatio 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 Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of that .nation provided above is true and correct. Signature: Date- —�3 Phone#: Official use only. Do not write in this area,to he completed by city or town offrcial. I 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# MAR-28-2008 03 :55 PM Koch Architects 978 356 6056 P. 02 � c^ Construction Control Affidavit Project: 85 Fiagshlp Drive Project Number: 80317 Handicapped Access North Andover MA Date: March 28, 2007 In accordance with 780 CMR (Commonwealth of Massachusetts Building Code) Section 116.0 Construction Control, and specifically Sections 116.2.2 Architect'sI Engineer's Responsibilities during Construction and 116,4 On Site Project Representation, I, „.....................RainerKach NCARB Architectural Registration No. MA 505.6,,, being a registered architect, have prepared or directly supervised the preparation of all design plans, computations and specifications for the above named project and I state, that such plans, computations and specifications meet the applicable provisions of the Commonwealth of Massachusetts Building Code, all acceptable engineering practices and applicable laws and ordinances for the proposed use and occupancy. As it may be required and applicable for the project, I will monitor the construction process and provide the following tasks: 1. Review for conformance to the design concept.*shop drawings, samples and other materials which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approve the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stages of construction, 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. 4. Be present at the construction site on a regular basis or as proposed in the attached inspection schedule, and/or I will send other appropriately qualified design professionals, to determine that the work is proceeding in accordance with the documents submitted with the building permit application and the applicable provisions of the Commonwealth of Massachusetts Building Code, S. Provide the building inspector with an original, stamped report for each site visit, scheduled or otherwise. 6. issue a Statement of Project Completion at the time the construction is considered substantially complete and ready for occupancy understand, that no CERTIFICATE OF OCCUPANCY will be issued until all reports and a statement of project completion have been submitted to the satisfaction of the building inspector/code enforcement official. Slgned and Sealed: No.50 Distribution: Building Department Client Architect Contractor t Field 01"A ' t:,rtrr.i`.1... +.^l'5 .•L+. a5'g'.,;:F^ttlt.:.P! i 97K.'i .:6 A5 i,t;.5?mil.. '.978.356..1 16 f \--4-JJ/ZD/,U0 10-.00 rxa bUUt'I UUM IND HE vi 001 Cott ,k a ° • o [y�, ructgco.,, nw!Lies DIVISION OF SCOTT COMPANY March 24, 2008 fii&ty Five Flagship, LLC 1VIr.Joe Scott,Trustee 12 Rogers Rd Haverhill,Ma 01835 PROPOSAL We are pleased to submit this proposal for a future ADA access ramp per plan dated March 17, 2008 by Koch Architects. 1. Permit. 2. Architectural plans. 3. Excavate,install sono tubes and pour 3,000psi concrete. 4. Install steel brackets on foundation to support beams. 5. Install pressure treated 2"x 10"with 5/4"x 6" decking boards. 6. Supply and install rails per plans. 7. Install lattice skirts, down to finish grade. 8. Paint by others. 9. Supervision and final clean up. We Propose hereby to furnish material and labor— complete in accordance with above specifications, for the following: Ten Thousand Dollars $ 10,000.00 The above-proposed prices are valid for 30 days from the date of this proposal. After 30 days,prices are subject to change. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other 395 Main Street Salem,New Hampshire 03079 12 Rogers Road Wardhill, Haverhill, Massachusetts oi835 603 894 -4952 978 374-0034 Fax: 978 373-6944 Telephone. t ) R ) ( ) .mus/Z5/UtS lb;St$ 1''AA !1' WJ6Z0t$Ul TWIT (:UM IND FE IQJUUI k I necessary insurance. Our workers are fully covered by Worker's Compensation Insurance. Acceptance of Proposal -the above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Owner: Contractor-Scott Cos, o o. Signature Signature, i Date of Accep B Date II