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Home My WebLink AboutBuilding Permit #381 - 91 MAIN STREET 12/5/2008 NORTH BUILDING PERMITOSS""'o '6qq• TOWN OF NORTH ANDOVER F t`be =� °� APPLICATION FOR PLAN EXAMINATION 1 y Permit NO•- Date Received ° ��SSACHUSE� Date Issued: IMPORTANT:Applicant must complete allitemsonthis page LOCATION 1f t5 �� ' � V1,— rflftiU 5C- &A "fief &005 PROPERTY OWNER T&(! CZ fl 1 tlnf �� (2E7F Print ,r� MAP NO: t--9 PARCEL:6rO ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial (—Cepair, r lacement Assessory Bldg Other : tzoion Other Ilerr�} ( W ACe MW� Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: j w►oux- of 14ta,-� Ple+p� Ue e+ *YA IRe Pkee wINEW hood. Sfr;hless 6 � V t4F�r *nJ AnSiL Pw- RV GvR ndvey 0,%m p&l n nS,e PAe- ?erwtt' - bob- Rep mov.► oniv) IdentificationU orn Please Type or rant Clearly) OWNER: Name: ?t0J-e,R A;11 PMC0V(' a Phone: 7%-691• �3q7 Address: CONTRACTOR Name: D006i 10 Phone: 979- M-7 7a Address: 22- -ju m on J-• '` kie-e- - N AA&Kf` '4V ol`6g5- Supervisor's Construction License: t.S Of512-A Exp. Date: 91201 zoto ; Home Improvement License: 13 ,9775 Exp. Date: 5/E3 j 01 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 O THE OTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ I. O ab t��ti UdG�E: $ / C) Check No.: oq Receipt No.: NOTE: Persons contrac ng ith e'is r contractors do not have access to the guaran nd Signature of Agent/Own t `f=on rr `r-f 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 Reviewed on Signature COMMENTS HEALTH Reviewed on Signature t,COMMENTS 1 Zd�ing Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street 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 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 2008 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 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:BPFORM07 Revised 2.2008 2 LocationT �1'f No. Date /497' � TOWN OF NORTH ANDOVER s Certificate of Occupancy $ �'�a,;K ;•� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ li TOTAL $ i Check # V`U I 2 17 r �,J Building Inspector The Commonwealth of Massachusetts K JI Department of Industrial Accidents G; Office of Investigations 600 Washington Street Boston, MA 02111 www.rnass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Obcl Please Print Leaibi Name (Business/Organization/Individual): � � ��'�'� Address: Z SU VVV VUL, City/State/Zip: �t � Phone#: R V ST-7 - 7 Z�O Are you an employer?Check the appropriate box: 1.7 [ an a employer with 4. ❑ I am a general contractor and I Ty peQuired): ,,�employees(full and/or part-time).* have hired the sub-contractors 6 2.yI I1 am a sole proprietor or partner- listed on the attached sheet 7. ��, ��{{ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its 9• ❑ Building addition required.] officers have exercised.their ]0:❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1.(4),and we have no insurance required.] t employees. [No workers' 12.❑ Roof repairs comp, insurance required.] 13.❑ Other *Any applicant.that checks box#I.must also fill out the section below showing their workers'compensation Policy information. t Homeowners who submit.tbis t:%idavir indicating thep att doing 0 v.ork acid then hire outside contractors rnusi submit a new atndavir indiearng such. iContnictors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.Policy information. Jam an.employer that is providing workers'compensation and or ,employees, Below is the Policy andjob site information fP cY J 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 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 5250.00 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 dTrc under ns and mettl es of ofperjury that the information provided above is true and correct S i anature: i Date: Phone#: 9 - 1?- ' 7 270 Official use only. Do not write in this area, to be completed by city or town offcciaL 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 4 ' NORTM ToNwvn ofgAndover No.42 lover, Mass., I T O LA E COCMICMEWICK V^t ORATED P**' -`C S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System IBUILDING INSPECTOR THIS CERTIFIES THAT..........kja`,.c....... gw-w ...................... ...._.............................................................. Foundation has permission to erect........................................ buildings an ... .�:../L....ry k1. .. .......................'............ Rough Chimney to be occupied as........ S7 22 SU{nfY) 1 _U� mA- Q1 � INVOICE NO. Nc,lt� a�J S D 4 — 0 LL SRiPPED 70 IVIA tIADDnESS7 ADDRESS !!( ! rnia T _ CITY,STAT ,ZIP CIT ,STATE ZIP v 3� Nor- h � 7 63 7 7 i0t)STOMER'S ORDER ISALESPERSUN TERMS JDATE /Off J r I i i A1C l/ be "Pfo✓c-.l Be Def Au i i I adams SCD8740 • Imp, •y Ipi L L'. ACityDiscount ID: 13208 Page 1 of 2 .r` My Account � Buyers Guide I FAQ!Help I 'W My Car Csm Your source fa food srxvice ek�ripment 1-888-949-9813 9a��1-7Pt,+EST ira-i _C_ityDis_c_o_u_nt TD: 13208 8Ft Stainless Steel Restaurant Range Grease Hood NSF M ' N FPA96 a. Many Other Sizes Available Inventory ID: 13208 ACftyDlscountl List Price: $1,,312 r00 tfiewlerggrimogg Our Price: $1,073.25 y. Description and Manufacturer Information Please note:Hoods are manufactured to order.They are usually manufactured and Manufacturer Information shipped out within 10 business days.Delivery times vary depending on your location. Thank you for your understanding and patience. Manufacturer. Superior Hoods This is NOT the entire Hood System that you would need.This is only for the major Mo-dei: VS.E42-8. components as they apply to NFPA 96 Codes.To the right we have listed specific List price: x1,312.00 accessories for this model.Please check with your local code department for specific items that you will need. Dimensions —� This hood is 8 feet wide,4 fee:deep,and 2 feet tail at the back. Hest for most wail mount eight: 31 lbs. commercial hood applications. For use in medium to heavy cooking environments.The Width: 96 in. grease cup and aluminum filters are included. Depth: 42 in. Per the manufacturers specifications,this hood would require 2700 CFM at 5/8"Static Height: 1 124 in. Pressureif at least one side is against a wall. Shipping information • 100%Stainless Steel ConstructionShipped from restaurant They are Superior to others in that they are made of 100%Stainless Steel,not just what is Equipment warehouses in seen. Unlike those that are made of Stainless Steel("where exposed")and Galvanized Tucker,GA 30084 Metal,these will stand the test of time and regular cleaning. JPacking 888..0.0 JGI harge: • Shallow Front Design Customer Pick Up feature the shallow front design(standard 16 inches tall but can be as short as 6 inchest)so that they can be used where low ceilings are present(and the taller cooks and INot Available(Shipping Only) chefs will not have fo worry about banging their heads)but the hood still drops down closer lHandling Fee: 11$44.00 to the cooking surfaces in the back.This allows even more of the fumes and grease- ladened vapors to be pulled out of the building. • Larger,20 inch high Filters The filters in the hood are standard 20-inch high as opposed to 16-inch high.This provides more filtering surface and therefore is more efficient and quieter to operate. This hood is brand new,shipped directly from the manufacturer.The above picture is representative of the style of hood and is from the same manufacturer. For a list of frequently asked questions regarding restaurant hoods,click here. If you have additional questions,please contact our Hood Specialists on(888)949-9613 ext 451. http://www.acitydiscount.com/restaurant_equipment/product_detail_print.cf n?lnvlD=13... 11/11/2008 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 138775 Expiration::5113/2009 Tr# 272031 Type: Individual i DOUGLAS DALKE DOUGLAS DALKE � � 22 SUMMIT STREET MA 01845 Administrator N.ANDOVER, , - Nlassachusetts- Department of Public.Safet\ Board.of Building Rel-ulations and Standards Construction Supervisor License License: CS 95124 Restricted to: 00 DOUGLAS DALKE Ks 22 SUMMIT STREET NORTH ANDOVER,-MA 01845-" -Expiration: 5/20/2010 ( onuni�siuner Tr#: 1532 NC �` r�---- 75'� IZew�ova o iA- ctieel-me(AL E�In�ry hood d"j- geplflce WOO �� u � fiQ �(� (srC�►S F t' . 5vPe.^w tv-w F T 1t9(v it y Gh�Fr�q c Ve4io'ci 491 NeA4 RS X11 ovo Noel loCA+►•ael '544-," "A'11 ae zns+-tN4l teN�,rd, on 09ICt" ?V uj.R. n►ulvty Tine Pco}rcklan V 4Aar- f cIAki 44L. Sek,#A-e�e�. �bod ins- �+►`o� only will be PVC-0--e –by k4w.w M44 lot- p- De* fto� loc�t�� tak�d on (p��4 uh�-s 73" F/r Acrer ,T, 0 - <� ?7" � a I -SRovfioP �` �' 16 i l` M ` 1 �—$y'' —--�► 33�I