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HomeMy WebLinkAboutBuilding Permit #89 - Exception 8/8/2006Permit NO: i Date Issued: APP', r" r AWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received2 ✓� I IMPORTANT: Applicant must complete all items on this Daize LOCA PROPERTY O MAP NO / 0' t ! D � 2 PARCEL: ZONING DISTRICT: TYPE, AND USE OF RTTiT.n1N(_' urcmnn1r1r. TiCtmT TYPE OF IMPROVEMENT i vav t. LlU 11\ll. 1 PROPOSED USE 1 P.13 U Residential Non- Residential 0 New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ation No. of units: ❑ Assessory Bldg ❑ Repair, replacement ❑ Commercial ❑ Demolition 0 Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only n ucr''n TPTT/1AT /lT OWNEI Address — .♦ 1 v "L' ri%�F�r%JI%_1VJLZiJ .. 11 dcr t -c r - oS -�r-� Identification Please Type or Print Clearly) CONTRACTOR Name:�/,,�a, c �cPhone: rg Address: Supervisor's Construction License: D y :52 Exp. Date: O Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: 9 Address: Reg. No FEE SCHEDULE: BULDINC PERMIT: $12.00 PER $100 OF THE TOTAL EST/MATED COSTpBASED ON $125.00 PER S.F. Total Project Cost :$ 3'I;Ez x12.00=FEE:$ Check No.: (D Receipt No.: `� C Page I of 4 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ ._., Public Sewer ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Well � Permanent Dumpster on Site ❑ Private (septic tank, etc. ❑ Electric Meter location to proj ect NOTE: Persons contracting with unregistered contractors ao not nave access to cne guuruney junu Signature of Agent/Owne Signature of contractor P �aed7E]wCertified Plot Plan ❑ Stamped Plans ElPlans Submitted � THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer DATE REJECTED ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE APPROVED DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED Comments Temp Dumpster on site yes—no— Fire Department signature/date EN DATE APPROVED Building Setback (ft.) Dimension Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided- rovided Dimension Number of Stories: Total land area, sq. ft.: NOTES and DA I A — Page Doc: INSPECTIOJ` Created JMC. Jan2006 Total square feet of floor area, based on Exterior dimensions. 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 Addition Or Decks ❑ Building Permit Application ❑ 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) New Construction (Single and Two Family) ❑ Building Permit Application ' ❑ Certified Proposed Plot Plan J ❑ 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 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:BPFORM05 ---I pave 4 0f4 Check # Building Inspector I zlt Location No. Date, TOWN OF NORTH ANDOVER 41 - Certificate Occupancy $ of C14U t Fee $ Building/Frame Permi 7-0 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Building Inspector I CA m m m m _ CO) ,a z CDCL O d _=r a� '00 .o 0 0 CD . Q -_ .. .. toCD CI! CD O 7 LTJ CO2 d _ d Cl) _ C7 C 0 C_ CO2 CD O _ �F CD CAS CD I 0 �r CCD 0 C CD O -.y o Q H m m d o m C7 C 1 O H m rF Z ?-0 h —4 0 o.=rM m O O* m N C y SI 11 :=rO > >,p O n O co o ZN 0 CD Ci Oven 1. V C =y7 VJ O C=O N m n c) cocr O O ISM O \ pf iy I lk 06 H CCD m '^ ..IE o H NCD O CD CD N� r7 O m ON FF Cc P. O O o jrO j O z H �o^ m� i CO2 CD0 CL's Cl) VI: N CD ~" o m �q a d w w Crl 4 GO �. o w 0 � ro � O . ?' 1F�yy r� omq 0 0 c TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: 0510100 Project Title: Main Front Lobby — Building 20 Project Location: 1600 Osgood Street, Building 20, 2"d Floor Name of Building: Osgood Landing Nature of Project: Renovation & Construction of Main Front Lobby In accordance with Section 116.0 Registered Architectural and Professional Engineering Services -Construction Control of the Massachusetts State Building Code, I, Gregory P. Smith, AIA Registration No. 8688 being a Registered Pfefessiefia;Engineer/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural _XXXX_ Structural Fire Protection Electrical Other (specify) Mechanical FOR THE ABOVE-NAMED PROJECT AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR 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 materials. 3. Be present at intervals appropriate to the state 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. UNDER SECTION 116.4, I SHALL PERIODICALLY SUBMIT A PROGRESS REPORT, TOGETHER WITH PERTINENT COMMENTS, TO THE BUILDING INSPECTOR UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND RW,INESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp (no facsimile) BEFORE ME THIS DAY OF 2006 A DOWGIERT CONSTRUCTION CO. INC. qV616 ESSEX STREET LAWRENCE, MA 0184.0 978 685-0306 fax 978 685-1290 CONTRACT I,— Customer Name 1600 Osgood St. LLC Ozzy Property Mgmt Address 1600 Osgood Street City North andover State MA ZIP 01845 Phone J Date 7/31/2006 Job Loc Job Name Main Lobby and Entryway into BLDG 0 Qty Description Unit Price TOTAL Supply necessary material and labor for main lobby and entryway into building #20 Remove and dispose of glass fagade and entry doors and replace facade and doors with new as per specs by GSD. Remove existing ceiling and replace with new ceiling. Install new lighting as per specs including emergency lighting and horn strobes. Remove existing flooring and install new tile and carpeting. Repaint existing sofets, new woodwork and new walls. *Price does does not include asbestos removal, architectural or engineering costs, or hazardous material removal. TOTAL CONTRACT PRICE $137,338.00 SubTotal $137,338.00 $0.00 Shipping & Handling TOTAL $137,338.00 Office Use Only Department of Indua&W Aecidena Offlce oflws*ations 600 WasbinS on S&m Boston, MA 02111 www-massaov/dfa Workers' Compensation Insurance Affidavit: Bunters/ContractorsMectridans/Plunmben Name MusinesworpnIzadonfIndividual):, Address: Phone #:'? % - Z!:2 I) -- Are-- Are y employer? Check the appropriate box: i. M i am a emplOya with 4. 111 am a general contractor and I employees (fall and/or part -tine):' bave biped the dab-eontraclon 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub-eontraclms have working for mein any capacity workars' comp. i> acx. [No workers' comp. inatnwnex 5• © We are a Corporation and its requba] ods have exorcised their 3. ❑ 1 am a bomeowner doing all wank right of oxen g1tion per MGI, myself [No workers' comp, a 152.$1(4), and we have no insurance requim&] t MVIOYM- [NO workers' con4• k mance ramired.l Type of project (r"drem: 6. ❑ New contraction T. ❑ Remodeling S. ❑ Desmlitin 9. ❑ Building addition 10.0 EUcuicai repass or additions 11.j Pka6ing np*s or additions 12.0 Rooftepans 13.❑ O&w •Any applicant Ant dMb boa[ # 1 Mort dao fill out Aa section blow daawriea *& w0dM' ooa4mftd= policy mos - t Homoow ncn wbo wAwM Aid 4Mvk indica-1 dwy = doft dl Trott acid Am ba owide ear I c1w - Mort submit a wsw alta ,* ism sock tconvoctors Ant d wok Ala boos must Muedbad w additional Chace s MMM Aa aama ofik nb•coodaelors amt flair wrodum • .P• pdi.Y isfornntion. lam an employer drat is providhog ww*ers' ivxW rsadon buunsrree fir dry ONPAPYM Bdow b drsp@ ft aMi�job sbs lnfor mdera /f — n Insurance Company Name:_ Policy # or Self -ins. Lie. Job Site r. T Expsation Dace: fo � T CitYlState2ip: �'�T �y!i'� Attach a copy of the workers' compensation policy declaration page (showing the policy namber and e:piratlon date). Failure to Seton coverage as Mg" w9a Section 25A of MGL C. 152 can head to the imposition of criminal penalties of a fine up to 51,500.00 and/or one-yearprisanment, AS well as civil penalties m the form of a STOP WORK ORDER and a fine of up to $250.00 a day against ft violator. Be advised slut a copy of tris statement may be forwwded b the OR%e of Investigations of the DIA for insurance coverage verification I do hereby ceno under du Paw asd penahks of pedwy licit the In wm&*w rovldsd � p abrrs is tars and cirrect 7 q9° — QJ?elal use mitp. Do not write In thb dna, to be completed by ciV or town *,okid City or Town: Permwueesse t Inning Authority (drde one): 1. Board of Health 2. Building Department 3. Ckyrrowa Clerk 4. Electrical Inspector S. plambng Inspector 6.Other Contact person: phone g: mov 08 05 09:30a FROM :: i��BERTS/�I INSURANCE FAX NO. : 97EWAM14-4 �3«i[w CERTIFICATE OF ARMTHIS LIABILITY ! i ii SUI UlllT7t --- c" M. p. A06talil'rs IAB. AGE=, Inc. erm accufwWca • o00 000 1060 os000n sMMET Houm ALIM T HORT8 MMOVRR, MA 01845 978-683-8073 WBURERR urstmEo fl01RsI1JRR' CdRSTILEICTYC6f ODIwmi ZNC. elk ! 175 SPimy AVa 10/26/05 MsuaEn t wouRER C SUM, 88 03079USURER :sUMAL ACMM6ATE s 2000 000 Ot t 6038900192 P.1 - Nov. 08 2895 10:44AM Pili Ag- I ORTE.YYYj APFCRWRO COYERAOE Iia, ExTera ort E POIJCIEb eELdW. NA_ _ICs �T THE POLKNES OF WWRANCE LWED SELONY HAVE BEEN MVEO TO THE WMRED NAMED ASOUE FOR TME PO(= MWD INDICATED. NOTYVIr W MDOG ANY REQUU03W 4T.:ERI1( OR WHO 10M OF ANY CONTRACT OR OTHER DOCUMBff WRM RESPECT TO T M W TMS CERTIFICATE WAY BE ISSUED OR MAY PERTAIN. THE MSURANCE AFFORDED BY THE POLK= DE SCMW HEREIN M SUBMECT TO ALL THE TER IM EXCLUSIOMSAND CONOaWM OF SUCH POLIC�SiAOp(EG16TElNyYSSMOMMw►rw[vt:wCCu ocnurrn�.oa�ne ..r.e OZZX MOPMRTZES , LLC. aMoutfl ANv of THE ADOVL oEsca�Eo PoucrEs eE e:iuAety rv>arconF TNe oanre+AraN 8 vomim pmm oA'M TMEREOF. TAE r8S(AN6 AWnM YMLLUOVAICR TO LVXJO DAYS WRIT1eN AI!rOom MR 0181 O NO= TO Tle CESTW"TE HOUMM KAMM TO 7M UWr sur F^Lfji , 10 W s►rrr t MIPOSE NO ONUGATM OR LJM MY OF ANY KM UPON TtiE *jS=m aS AGENTS OR ACORO25(20MM) TwomponAm `ABLUV POLWNUNMRGOMM _ UlllT7t --- erm accufwWca • o00 000 CommElemoErmmALlfAmm aAatsrAnx ooam ER—mlasLft w s 50 OQO 3Cp3616 10/26/05 10/26/06 As:ootR(Argwpswera s JLCL PEumm4Aays(AIRr s 1 000- :sUMAL ACMM6ATE s 2000 000 OWL A T!UWrAPPLES rmPROOUGTS-COs! AAiG i1,000,000 POIJCY UM wuroMOSREt Way ANYAUTO 1E�1srN�t,EtrMrr ALLOWNEOAUMS SCNEDIlLEO WJUFW s AUT06 (P- _._ .. HUMAUTM NOrtOWMFOAUrOs 9ODLypuuwf s PROPEf"V VAMME (P�rrmd�M) OARAOELMBtUTY AUTOONLY-EAACSOM a RANVftM EAA= s •—• _—...• OTNEAttNN At/ MLY. Aa s EPOESSAMANROAAUAUABLW tMoccume CE s OCCUR gAMMAW J ACs(iAEOA':E s OEOUCrlLE s Famm o"EWLt MroRrcCRSCaMr�NSATtONAND oYERsuAeutY DONCS00548 10/26/05 10/26/06 t+-EACrAACC�FNT s 5--f 0 00 D s bi1pi _ ELDMWE-EA GMWMs – 50 000 OTtrErt E.LV3EW.P0UCYLWr s 300,000 oesaevrAorAOPOPEnATwAarIOCAT+orurvEfncx�A Ao�uu�o�AooE(rwE�woRSEw(EHrraPe�PnowsgNs 603-890-0192 rxorrcv.&x u r OZZX MOPMRTZES , LLC. aMoutfl ANv of THE ADOVL oEsca�Eo PoucrEs eE e:iuAety rv>arconF TNe oanre+AraN 8 vomim pmm oA'M TMEREOF. TAE r8S(AN6 AWnM YMLLUOVAICR TO LVXJO DAYS WRIT1eN AI!rOom MR 0181 O NO= TO Tle CESTW"TE HOUMM KAMM TO 7M UWr sur F^Lfji , 10 W s►rrr t MIPOSE NO ONUGATM OR LJM MY OF ANY KM UPON TtiE *jS=m aS AGENTS OR ACORO25(20MM) The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire- Marsha! P. O. Box 1023 State Road, Stow, MA 01775 PERMIT Date: North Andover permit No Dig Safe Number ( Cityof Town) (if Applicable) In accordance with the provisions of MG -L.1 4 8 Chapter1Q_ as provided in section-511—CMR 34 Stan Date This Permit is granted to: Full name of person, Firm or Corporation Permissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be 25' from structure if unable to place with required Restrictions: rl oaran, rl,rmnetPr rn,r.t•_ he covered with nlvwood or tarp end of work day ( Give location by street and no., or describe in such manner as to provied adequate identification of location ) Fee Paid$ 50.00 �/� ��•.� Fire Chief This Permit will expire j d` ... f ( Signature of offrcal granting permit) Off cal granting permit ( Title ) -MMOO' TWIC PI=PMIT Ml 1CT R1= r-nNCPIf_11nt M'l V Pn.gTl=n I IPr1N T141= PRFMICI=C -*� t i -1 TIONS _ _ r. BUIL G ie �porvrrraru�" c Y ' BOAR pONSTRUGT►ON SUPER iSOR lot License. C . 048040 Number: GS 10!2911955 ► g-rthdate: Tr, no: 8053.0 a" Expires: 1012912007 Restricted: 00 DOWGIEERT TADggpY AVE C �/ '_ 175 NF1 03079 COMM SS ner SALEM,