The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 1600 OSGOOD STREET 4/30/2018 (30)8E: 0 Date... 10856 TOWN OF NORTH ANDOVER * PERMIT FOR PLUMBING Thiscertifies that..... . ................ ...� .............................................................. has permission to perform........#y&. .t................. ' plumbing in the buildings of...x North n o��.ve......r...........ss...... at.. Q.....C' C.� .-- 1............................ .......... ,Ma Fee...11..`��-'...Lic. No. �f X13 .. PZ BING INSPECTOR Check# r �f MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY _ _ MA DATE — [ PERMIT# JOBSITE ADDRESS WNER'SNAMVI 1 POWNER ADDRESS TELFAX TYPE OR OCCUPAN Y TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL�I] PRINT CLEARLY NEW: RENOVATION:® REPLACEMENT:Q PLANS SUBMITTED: YESE11 N0F_I FIXTURES'l FLOOR--' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB ( f __.� J f CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM 1 11--A DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM (, ____._.-} ._._-_._► ___�_( _—J ._,_-_( _ _( __.-F -_-_J ._.___i __._€ __ _I ___I DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER _ I _J ._ I ( I ._— FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY _ I _ I ._. E _ _I ------ _._.__..i __—I -_____G ..____J �_.__.I _..__.J I I _--_ ROOF DRAINI ___� ____C ____( __._t ___I _..__..J . _� ___.__ __.__J .__.._......6 __� ► ____( SHOWER STALL E _..__._i �.. J ___..I J I _. SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION ..__ 1 -_____( ..... . ___ .__I WATER HEATER ALL TYPES I f __- _J — I � _ _J { _ 1 WATER PIPING OTHER _--, _ I f INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES _ NO �J IF YOU CHECKED YES,PLEASE INDICATE T TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY i BOND M OWNER'S INSURANCE WAIVER:I a aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNE l A NT JEII SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application re tru and ur t o t of knowledge and that all plumbing work and installations perfo ed unde the permit issued for this application will be n com ian it ertine r sion of the INAassachusetts State PI Ing ode and hapte 142 of t General Laws. PLUMBER'S NAME _ L B LICENSE# O C ATURE IVIP JP 0 CORPORATION .. �PARTNE SHIP# LLC !, CO PANY NAME v ADDRESS ( j CITY __j STATE ZIP TEL _FAX L CELL EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPE TI NOTES Yes No g THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES r The Commonwealth of Massachusetts Department of IndustrialAccWnts Office of Investigations kvi 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information A I Please Print Le ibl Name(Business/OrganizatiorAn(lividual): O Address: City/State/Zip: A Phone#: re on an employer?Check the appropriate box: Type of project(required): 1. I am a employer �with- 4. El am a general contractor and 1 6. EJ New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. �• Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.El 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 12.❑Roof repairs insurance required.]i employees.[No workers' 13.F1 Other i comp,insurance required.] !Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I-Homeowners who submit this affidavit indicating they tie doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam 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 req uireclunder 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 veri n. Y do hereby cer fy unde e p ns an e i pe ury as to information provided above is true and co r ect. Signature: Date: '- Phone#• r " 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 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: I F 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"...every person in the service of another under any contract of hire,• express or implied,oral or.written." An employeiis defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a j oint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,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 or local licensing agency shall withhold the issuance 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 of 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 ofpublic work 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 completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)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 r members or partners,are not required to cavy workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit 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 any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"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 licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves 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 Conponwalth ofMassaclausetts Department ofJndustdal.Accidents Office ofInvestigatiom GOR Washington Street Boston}MA 02111 T01.#617-727-4900 ext 406 or 1-877;MASS.A.FE Revised 5-26-05 Fax#617-727.7749 www.wass,govaa 296 Date. ././ )!. ........ i NpR7M tiTOWN OF NORTH ANDOVER 3r p p` PERMIT FOR MECHANICAL INSTALLATION � F � F SACHUSE� i This certifies that . . . J).,.. . . . . . . . . . . . . . has permission for mechanical installation, in�the buildings of .�r ��!`� at// .. . .ea. �� . .,i,. . . . . . . .. N`o�rth Andover, Mass. Fee._ l�—Lic No.. . . . . . . . . . '�p . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer Commonwealth of Massachusetts " Sheet Metal Permit Date : — � c� Permit# �� Estimated Job Cost: 3d,$ny Permit Fee: $ -10 Plans Submi : YES NO Plans Reviewed: YES NO Business License# O Applicant License# Business Information: Property Owner/Job Location Information: Name: Z 0 tti Name: r Street: Street: Cit /Town: City/Town: Telephone: g 7 (e '�0 Y Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family Multi-family Condo/Townhouses Commercial- Office Retail Industrial Educational Institutional ft 35 000 cu. ft. over 35,000 cu. . Building Cubic Footage: under V 4 Sheet metal work to be completed: New Work: Renovation. HVAC Metal Roofing Kitchen-Exhaust System Chimney/Vents Provide brief description of work to be done: r INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes o❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box0,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Progress Inspections Date Comments E r Final Inspection Date Comments t Type of License: By ' ❑ Master Title ❑ Master-Restricted City/Town �ourneyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ Check at www.mass.aov/dpi Inspector Signature of Permit Approval l Sheet Metal Commercial Guidelines/Life Safety/Critical Systems Inspection Checklist' Yes No N/A, Set of stamped engineering documents and detailed description of mechanical system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheetmetal work being performed with proper journeyperson-to-apprentice ratios Fire dampers with access door properly installed and checked for operation Smoke and combination fire/smoke dampers with access doors properly installed- actuator checked for proper operation(May also be verified by fire department during fire alarm testing) Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) Smoke/atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm testing) Stair pressurization systems installed(where required)and operation verified(May also be verified by fire department during fire alarm testing) Grease/kitchen hood exhaust system installed with all seams and connections welded airtight with properly located cleanouts. Proper clea`ances, fire rated enclosures and pressure testing required: :, Sei ti�ii res,.~aints install; -Wh6to`re.quired'oin equipment and d�=.:.tL. •,v Duct penetrations in fire'rdtc�--wal1:3 and floors sealed Metal roofing systems installed watertight using proper materials and fasteners Flexible duct pins installed 6'-0"maximum length Ductwork installed using proper hanger spacing,hanger stock,threaded rod and angle iron Ductwork/plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining Volume dampers installed for each supply air branch duct New/clean-properly sized filters installed(final inspection) Testing and Balancing report complete(final sign-oft) Sheet Metal Residential Guidelines/Inspection Checklist Yes No N/A Detailed description and sketch of sheet metal system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper joumeyperson-to- apprentice ratios Equipment sized per heating/cooling load calculations Duct work sized per manual "D"calculations Bath/shower rooms contain mechanical exhaust fan vented outdoors Electric dryer exhaust properly installed maximum total run 35'-0", maximum flexible run 8'-0" Flexible duct runs installed 14'-0"maximum length Volume dampers installed for each supply air branch duct Ductwork installed using proper gauges and hangers Ductwork/plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining New/clean-properly sized filter installed(final inspection) Testing and Balancing report complete(final sign-off) Initial Construction Control Document To be submitted with the building permit application by a W Registered Design Professional dfor work per the 8th edition of the 4 Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: JESSICA'S BRICK OVEN Date: 12/11/14 Property Address: 1630 OSGOOD STREET NORTH ANDOVER MA Project: Check one or both as applicable: ❑ New construction X[Existing Construction Project description: OVEN HOOD VENT PIPING TO ROOF I Steven R Houle MA Registration Number: 46743 Expiration date: _6/30/201.6_,am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: [] Entire Project []Architectural [] Structural [X] Mechanical [] Fire Protection [] Electrical [] Other for the above named project and that such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I services and be resent on the understand and agree that I or m designee) shall perform the necessary professional se p u g ( Y g ) construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a Final Construction Control Document'. �N OFA Enter in the space to the right a"wet"or ��P� SS 9c electronic signature: Boz STEVEN o H L N 4 O Q �'F r S FS10NAL f ' Phone number: 603-437-2002 Email: mMcCabe&McCabe-Associates.com Building Official Use Only l Building Official Name: Permit No.: Date: I , t� t py� Y � H H H H H H H y H H 8 p 4 6 i pe b SQ 0 � P � McCABE ASSOCIATES OVEN HOOD VENTING PLAN >:. AND DETAILS 0�a er: o.ut CONSULTING ENGINEERS 75 GOODHUE ROAD DERRY NN 03058 JESSICA'S BRICK OVEN F—03 a 0123 1630 OSGOOD STREET N. ANDOVER MA HWAC SANITARY McCABE ASSOCIATES ConsultingEngineers ELECTRICAL giFIRE PROTECTION 75 GOODHUE ROAD,DERRY,NH 03038 Tel:(603)437-2002 Fax:(603)437-0123 December 12, 2014 North Andover Health Department 1600 Osgood Street North Andover MA 01845 RE: Jessica's Brick Oven 1630 Osgood Street North Andover MA 01845 Dear Mrs. Michele Grant, We are writing to inform you that our firm McCabe Associates has visited the site and found the oven door hood venting to be redesigned and is in the process of being installed. The ovens combustion air and gas venting is in operating condition. The ovens can be heated but the doors and baking operations can not be used until the door hood exhaust system is in place and operational. Please feel free to contact us if you have any questions. Sincerely, v 441 Steven Houle, P.E. McCabe Associates Consulting cell 603-548-0960 I i 8 4 I I ' H 8 i I 8 H H H H H i SCALL e H H H H H McCABE ASSOCIATES DATE' 1/12/11 �� OVEN HOOD VENTING PLAN DATE +�/++/14 CONSULTING ENGINEERS AND DETAILS MG.er: D.J.M. m r ? PRWM b'o 75 GOODHUE ROAD DERRY NH 03038 ,JESSICA'S BRICK OVEN f" �y TN: 803 137 2002 Fax:: 603 137 0123 1630 OSGOOD STREET N. ANDOVER MA Emall: McCob*0MaCob.—Auwlafq.aom