The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #526 - 946 OSGOOD STREET 4/7/2009BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:� Date Received " 0 �f 01 Date Issued: l( - I / IMPORTANT: Applicant must complete all items on this Daae I LOCATION o1 �li1J ► ► i�� .w Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Villaqe ves no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial / Alteration No. of units: Commercial o/ Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTIONOF •- TO BE PREFORMED: Identification Please Type or Print Clearly) ° t OWNER: Name: Rtc+(_b Xz��. Phone: M CONTRACTOR Name: c5f t4A X mJim Phone: ("Er— /-I 1 I Address: Supervisor's t;onstruction License: C fz bo t n,b Exp. Date::fZ.;zV / e l r Home Improvement License: . Date: 5, Address: 3 'kK h r(_z>T N - 40011 Reg. No. 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.: 1102, Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner SignatureTof contracto 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 PL NTNG &DEVELOPMENT COMMENTS NSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osqood Street FIRE DEPARTMENT - Temp Dumps�er o site ye no Located at 124 Main Street "Z Fire Department signature/date y -� 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 Location q/ f1 dS�yd S7— No. �2 Date &ORTIq TOWN OF NORTH ANDOVER Certificate of Occupancy $ Nus t� Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 1 9 �- U Building Inspector m m m m VI m y mm y C � d V! C7 10 CD CD C�7 z y CL im � O CL CO) C CD CD O Q CD CD CD 0o co � C CD y CD CL O y Co CD y O -oCD z oCD CD0 _C c -0,10 o _ O �-y O Q NSO CO) _ CL cmCIS m C7 Z NCS maC =r.0 H �•1 0. ...r R. m N T ? a .. a o comm o y Co N 0-, -0: m n = N m .2., O m s0 O (7 01 ZC•CO'1 Co o m N CL m CL O ..?`� 'V^J O mc s vJm O m J C a CD O d N zN p• d icr fD Cn n a N r,7 c.0I co CA m N Q= i m , CD t = CO : 0 � n � o C CDo C„CID O y C� 02 CID m � N o d cm p _� a O o. r v Cn O rt Crt z CO',rJ I ,zy y w G � w Cn M r'' O Zi m O G a- r' d., O :3 ::r- O G x O G a rA � o cn p O a x v v CD I Contract for work to be performed @ China Bloosem 946 Osgood street North Andover Mass. Base on Maclaren Associates Inc Dwg. A.2 & A.2 As stated on Plan A.2 & 3 Phase 1 & @ project are combined Detail fo all specs on plan Included Area 1 Area 2 Area 3 Area 4 Area 5 Area 6 Which inicuded Electrical Plumbing Fire suppression HVAC All Phases of work stated on Plans Stamped DWG submitted to Town of North Andover Sprinkler permit obtained Dumpster permit obtained Building permit will be pick up by Wed. 4/9 or later Total cost for phase 1 $66,650 Total cost for phase 2 $118,550 $185,200 Equipments to be supply & installed as follow I ADS new dish washer (ADC -44 Conveyer by ADS)�U&ta� New layout s/s dish washer set up -4010 . True (TUC -72 cooler) True -60D-4 New Eagle hand sink (2) Prep sink (2) 3 -comp sink (1) spec faucets (3) New hot water storage tank New lites spec on plans Once activate initial order will find out approx. deliver time Payment schedule Initial ordering for equipments & material $75,200.00 Job started 4/10 Labor 17 -Apr $15,000 Labor 24 -Apr $15,000 Labor Labor 1 -May 8 -May Bal. Additional items will be added to the exisiting project repair exisitng dish washer location floor Existing FRP kitchen ceiling Suhi & salad cooler s/s cabinet for sushi chef All materials & labor work at nite & days Pro design & construction 550 Adams street # 303 Quincy Mass. 02169 Wallace Ho Cell 617-959-4111 Fax 888-213-0645 e-mail wallaceho@comcast.net Included all work on plan shown Sprinkler work Plumbing Electrical carpentry flooring Paneling Equipments S/S shelfings Demolition Trash removal Altro flooring (except Liquor storage room) Eshaust hood for Steam Grease traps Gas work Budget estimate for outside dinning room relocated buffet & bar & sushi area $135,000 Not include the outside new windows $15,000 $15,000 $60,000 E_ ) § 8 2 a § \ . � ) a "��'",• OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: G�J d01 - I PROJECT TITLE: 'C 40?0S4 iM Mj Ch4-t t� Ac 'P�wssb H \fir , PROJECT LOCATION:__ �I �(p D SC�pp� cam- . , Nam .t NAME OF BUILDING:_ C kil N A NATURE OF PROJECT: V-krArSt,� IN2%=- E WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUI DI.NQCODE, IT N_ REGISTRATION NO. 0 BEING A REGISTERED PROFESSIONAL ENGINEER%ARCHITECH HEREBY CERTIFY THAT 1 HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT SCJ ARCHITECTURAL 0 STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT 1 SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 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 materials 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the 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 116.2.2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REP( SATISFACTORY COMPLETION AND READINESS OF THE PROJECT S SCRIBED ANDS SWORN T B FORE ME THIS, AY OF W_4 NOTARY PUB IC MY COMMISSIC6tgZ VP'r' otary u is My Commission Expires November 1 Comm^nweaith of Massachusetts 2013 5� The Commonwealth ofAlassachuretts j jl>!i Department of Industrial Accidents. Office o InvestiQ ations idl 110 Washington Street Boston MA 02111 r wWKI. mQss.; oz�/din Workers' Compensation Insurance .kffidavit. B uilders/Contractors/Electridians/Piambers DPHCant Information Name (Business/OrganizationMdivi dual): Address: City/State/Zip: Are you an employer? Check the apps 1. ❑ I am a employer with employees (full and/or part-time).* 2X 'Jam a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 10 SLI I am a general contractor and I have hired the sub -contractors listed cm the attached sheet I These sub -contractors have workers' comp. insurance. ❑ We are .a corporation and its Officers have exercised. their right of exemption per MGL c. 152, § 1, (4); and we have no employees. [No workers' comp. insurance re uir d Type of project (required): •6. ❑ New construction 7. ❑ RemodeIing . 8. ❑ Demolition 9. ❑ Building addition 10:❑ Electrical repairs or additions I l.❑ Plumbing repairs or additions 12:0 Roof repairs q e ] 13•❑ Other `Any appli ant.that checks boa # 1 .must also fill out the section below showing thzi workers' compensation poircy rnmmsation, t Homeowners whu submit.this aiidevil indicating they are uoitt= El: r•:, ;�+ Contractors that check this box must ached an addiTional sheet showing he me °f y �utaf& wnuar.tors roust submit a new atn`aavit inai�i rg -such. ofthe _ ^ •5 c�„Mors and their workers' tomo ...,r:,.., r •• wluyer Lam is provuung workers' compensation insurance for ng' employees. Below is the oft ._....... V information p c�. and job site Insurance Company Name: Policy # or Self -.ins. Lic. #: Expiration Date: Job Site Address: Attach a copy of the workers' compensation otic decia Cit'/State/Zip: (^ policy ration page (showing the policy number and expiration date). .Failure to secure coverage as required tinder Section 25A of MGL C. 152 can lead to the imposition of criminal penalties of a fine up to 517500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORD ORDER and a fine of up to .S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Of ER a Investigations of the DIA for insurance cov,,,age verification. I do herebp certify under the pains and penalties of perjury azar the in or % maiion provided above is true and correct Official use onip. Do not write in this area, to be coMoleted by city or town o cin[ City or Town: _ Permit/License iT Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Towrt 6. Other Clerk 4. Electrical Inspector S. Plumbing Inspector Contact Per -son: Phone Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined. as ".. ever -y person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and inclucii-ng the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, associate on or other iegal entity, employing employees. However the owner of a dwelling house having not more than .three ap ar-trne dwellingnts and who resides therein, or the occupant of the house of another who employs persons to do maimenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state o- r local licensing agency shall withhold the iissuance or renewal of a license or permit -to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence cl-f compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public worlle until acceptable evidence of compliance with the insurance requirements of -this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit compi-etely, by checking the boxes that apply to yotr situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have _ employees, a policy is required. Be advised that this afficl-avit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Aisc be sure to sign and date the affidavit. Tne.affidavh should be returned to the city or, town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have, anyquestions rePat-r-ding the lata or if you are required to obtain a workers' compensation policy, please call the Department at the nm -Lm C, .--d below. Self-insured companies should entry their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed IeQibly. The Department has provided a space at the bottom of the affidavit foryou to fill out in the event the Office of Investigations has to contact you regarding the applicant: Please be sure to fill in the permitthcense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/heense. applications in arty given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Adcx-ess" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or Iicenses. A new affidavit must be filled out each year. V%rhere a home owner or citizen is obtaining a Ilcens� or permit not related to any business or commercial venture. (i.e. a dog license or permit to burnleaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you. in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The CommonWtEdth of Massachusetts Department of Lr dustrial Accidents. Office of Investigations 600 Wad-lin=ton Street Boston; IIIA 02111 Tel. 4 617-727-4900 *.-t 406 or 1-877 MASSAFE Revised 5-2645 Fax 4 617- 77-2 7-774 9 wvtfu'.mass.g ov/dia