HomeMy WebLinkAboutMiscellaneous - 4 HIGH STREET 4/30/2018 (4)NORTFM\
BUILDING PERMIT a
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TOWN OF NORTH ANDOVER o -
APPLICATION FOR PLAN EXAMINATION
Permit No#: N �Plk Date Received RATEo �e��•c5
SACHIIS
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER (' C C
Print 100 Year Structure yes no
MAP PARCEL: k5ct ZONING DISTRICT: Historic District no
Machine Shop Village (feD (reno
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
[I Addition
El Two or more family
❑Industrial
Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑_'Septic ❑'1Nell
Floodplain °WetlantlsM
`1Natershed'Vistnct.-
4_ ®-Water/Sewer
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t-� Identification - Please Type or Print Clearly
OWNER: Name: \,
Address T u i
Contractor Name:
0J
N T.Y_W� Y-1 (-
6 naWl(l 6--.
Supervisor's Construction License: � d 6 � 32 L+_ Exp
Home Improvement License: ,Exp. Date:
1a+lao' 4t-tqts j
ARCHITECT/ENGINEER 6—U_ Phone:
0Z,2_1 c)
rl—
Address: -Tu f'1 N V�,,�r Reg. No.
c� 'U "
FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $100000 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ q ® ' --O.0- FEE: $ oZ Fa
Check No.: �-3 Receipt No.: 9��6y
NOTE: Persons contracting with un^egistered contractors do not have access to the guaranty fund
31J
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
I.
Public Sewer ❑
Tanning/Massage/Body Art ❑
Swfi ming 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 m U FORM
PLANNING & DEVELOPMENT Reviewed On Signature
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
.Planning Board Decision: Comments
{`r
l;onservation Decision: Comments
Wafter & Sewer Connection/Signature & Date Driveway Permit
]DPW Town Engineer: Signature:
��Fire�Depa �ment�s
�4
1 C®MMEN+T�S;,� �.
` � � ^ N• t �� Wfi fit.) i ���/
Located 384 Osgood Street
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
®ANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
Doc.Building Permit Revised 2014
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
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/Cross Section/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
TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
4. Building Permit Application
4� 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
2012 IECC Energy code
Engineering Affidavits for Engineered products
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: Building Permit Revised 2014
s
Location
No. 7/ 41
Check #,;1--?e-C
29-804
Date /-' /161A
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $
TOTAL
Building Inspector
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CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 714-2016 on 12/10/2015 Date: December 23, 2015
THIS CERTIFIES THAT
THE BUILDING LOCATED at 4 High Street — Suite 216
MAY BE OCCUPIED AS a tenant fit up IN ACCORDANCE WITH THE PROVISIONS OF
THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS
MAY APPLY.
Certificate Issued to: RCG West Mill LLC
4 High Street
North Andover, MA 01845
Building Inspector
Fee: Prepaid $100.00
Receipt: 29804
Check: 2366
OF MO Th 9
SSA[Hust
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 714-2016 on 12/10/2015 Date: December 23, 2015
THIS CERTIFIES THAT
THE BUILDING LOCATED at 4 High Street — Suite 216
MAY BE OCCUPIED AS a tenant fit up IN ACCORDANCE WITH THE PROVISIONS OF
THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS
MAY APPLY.
Certificate Issued to: RCG West Mill LLC
4 High Street
North Andover, MA 01845
pf
Building Inspector
Fee: PrePaid $100.00
Receipt: 29804
Check: 2366
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scam
architecture
December 22, 2015
Mr. Gerald Brown
Inspector of Buildings
Town of North Andover
1600 Osgood Street
North Andover, MA 01845
Re: West Mill tenant fit -out for
4 High Street, Suite 216
Dear Mr. Brown,
The tenant fit -out for Suite 216 on the second floor of 4 High Street at West Mill in North
Andover, MA, was to the best of my knowledge, belief, and understanding constructed in
conformance with the construction documents issued for building permit dated December
10, 2105 Permit # 714_2016 in accordance with 780 CMR Commonwealth of
Massachusetts building code.
During the course of construction, representatives of our office made periodic visits to the
site to observe the progress of the work.
Sincerely,
Saam Architecture
Linda Smiley, Principal
saam-arch.com (216) 496 3647 655 Summer St Boston MA 02210
JK Contracting LLC Proposal
31 Richmond Street
Weymouth, MA 02188
Proposal Date: 12/10/2015
Proposal M 197
Project:
Bill To:
David Steinbergh,
Suite 216,
4 High St,
N.Andover, MA 01845
Description Est. Hours/Qty. Rate Total
Plans and Permits
256.00
256.00
Demo
300.00
300.00
Wall Framing
550.00
550.00
Heating & Cooling
2,500.00
2,500.00
Electrical & Lighting
1,000.00
1,000.00
Insulation
300.00
300.00
Interior Walls, Board and Tape
2,000.00
2,000.00
Painting
1,000.00
1,000.00
Floor Coverings
1,800.00
1,800.00
General Conditions
400.00
400.00
Cleanup & Restoration
100.00
100.00
Supervision
1,020.60
1,020.60
Thank you for your business.
Total
$11,226.60
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PRODUCER
Dupont Insurance Agency, Inc.
18 Copeland Street
Quincy, MA 02169
(617) 479-9121
INSURED
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31 Richmond Street INSURER D :
Weymouth, MA 02188 INSUReaE:
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OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOREE EXPIRATION DATE THEREOF, NOTICEWILL BE DELIVERED WCORDANCE WITH THE POLICY PROVISIONS.ORRIZE•D REPRESENTATIVE
,Bridget McGowan
01888.2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 25 (2010I05) E -Mail: apedranti@crowninshield.com
Phone. F
Massachusetts Departmer*.t of Public Safety
Board of Building Regulations and Standards
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License: CS -066334
Construction Supervisor
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KIERANT WHELAW
31 RICHMOND STR
WEYMOUTH MA, 02'J
��=/►l"^'� CA— Expiration:
Commissioner 09/26/2017