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HomeMy WebLinkAboutMiscellaneous - Suite 210In Town of North AndoverHORTN OFFICE OF 3� °g ,tio L COMMUNITY DEVELOPMENT AND SERVICES A 27 Charles Street0 WILLIAM J. SCOTT North Andover, Massachusetts 01845 3 SACHUS Director (978)688-9531 Fax (978)688-9542 February 18, 1999 Patricia A. McMahan Property Manager North Andover Office Park 451 Andover Street Suite 210 North Andover MA 01845 — 5070 Dear Ms. McMahan: I would like to thank you for meeting with Lt. Meinikis of the Fire Department and myself on February 10, 1999 in regards to the complaints received by the Building Department. The complaints identified the lack of readily accessible stairways. As we discussed during our meeting, any interior work -done to -the building will -require that stairways be more accessible than they currently are. Please be advised that the alternative suggested by you, that evacuation plans be permanently affixed to various areas throughout the building is a compliance alternative that this department finds acceptable. Thank you for your. help and cooperation in this matter. MM:jm cc: file Doc/Andover St 451 complaint response 1_ 1 G 1 '1 iOARD OF APPEALS 688-9541 1 /Respectfully, Michael McGuire, Building Inspector BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 W x ,.. TQC h m m ►'r u'" � O y � � cr ® e n hr 3.`ti n9roo � � ot zm r�r r d n 20 a� d ® 0 n 01 0-0 C ,y z b> d O Ell t�MMO d z � � o r� z W CL n m m Z c cr ® e n M 0 ot zm Poemm 20 a� ® 0 n � C z 0 m m m m Cl) Cl) 0 CD _ y C � COP)10 CD CD n cl)Z CO) CD O ar =moo d =• CO) C.•i n O CD CDcr O CD CD O CD Woo P. i CD co) CD fl. co O I CO CD v CO) O 1 Z OO .O -r P-1. CD CD O OC CD 0 0 G o an �ni a R m :'? n Pop v CT7 � X r CO O oOTJ 11J a cin 7C p z � L� r: L z tel\ n y CI 0 a0 � m =C. y �m n n C. H O d a = m O d O1 N .. .. o -n a r« d CO) 3m 2 O ® co, O O :� 1 ICU, O H n cs .OZJ CO2 T a C o,m . 4% r" CD : CD m H -�� ami CA CD d 9w a f c y CD � O O COQm a N � m m A 0 C, CD 0 CD :1 m o CD c m `1 .� NCD i CD03 CD a CD CA :� C O clic � cn S g G o an �ni a o m :'? n Pop � X r O oOTJ G� a cin 7C p z � z tel\ z o co r � "IN .: z 0 ��4 M .*Q 0 c i Location s f _/� V oC P'e No. S Date TOWN OF NORTH ANDOVER Other Permit Fee TOTAL ! Check # / -3-? 4 c/ 1676 $ 3 0 /�t'Iq Building Inspector Certificate of Occupancy $ MUsE<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL ! Check # / -3-? 4 c/ 1676 $ 3 0 /�t'Iq Building Inspector �o — /(3 /-N iA— jTqWN OF NORTH ANDOVER BUILDINGI DEPARTMENT APPLICATION TO CQIN5RUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING MIZ 'i s Section for ofriciai use Ont. BUILDING PERMIT NUMBER: DATE ISSUED: –6-3 A9— SIGNATURE: —Buildins Commissioncr/lavector of Buil 'n Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 4�57 An do v, P-.- Ji - 6q,.v K -A Gy-+ (' a D 4,144 Map Number Parcel Number 14-1-106LI-O-K 1.3 Zoning Information: IA Property Dimensions: Zoning District Proposed Use LAA Areas Frontage (ft) 1.6 BUH DING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 zone — Outside Flood Zone 0 Municipal On Site Disposal System 0, 2.1 Owner of Record Name (Print) Address for Service Signature,1 Telephone - - -r--- - - - -- 2.2 Au o' -V - IV3 --- N*mb Print Address for Service: Si&nature-j Telephone 3.1 Licensed Construction Supervisor Not Applicable 0 I'% M e, 4' wr'v let 00-�- 7 CS, - 02co Address, License Number LF16 vt 4A FP2 PIov e� Li7V7 312 Eviration Date ✓Telephone I 3.2'IZZ-gisGid Home Improvementpontractor Not Applicable 0 Vt,e Compjny Name., Registration Number a43 4t ak . 4 ho ie Addrers, Expiration to . ei6� S* atu Telephone I Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea ...... A No ....... ❑ "SEC174P1, 5 PR4FI SSIUNAL DESIGN AN CX3NSI�R�C'TIO1�I-SLR'1'1�' S 1�`+t� BUi�U�NGS S tU�tII�R�:SU E" ?T+D CONSTRInCTI iN CON,t)NT, 1VIt1tRE iAi `3 , GE OF i ISED #'A+l 5.1 Registered Architect: Name: Address Signature• Telephone _� ppm yapp Area of Responsibility Registration Number Expiration Date Name: Address: Signature Total Not applicable ❑ Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibility t J Registration Number Expiration Date Name Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone Not Applicable ❑ fi Company Name: Responsible in Charge of Construction I, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Prit4 Name M / bl Fh3 �Si ture of er/Agent,' Date Item Estimated Cost (Dollars) to be Completed by permit applicant ' 1. Building ^ J ( (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of tem Q Construction from (6) 3 Plumbing Building Permit fee (a) X (b) - 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number a 6 vz at Rsvt l NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL, GAS LINE T 3'`%i . .,, . - x..: -..n s ..w ...i': r �.. ... ,. ..z'a:y / :+r, w �. S .. ....'a c "`»'i3.,,� , y `Y 4. 5•+' S t' New Construction ❑ Existing Building ❑ Repair(s) 0Alterations(s) USE GROUP Check as applicable) Addition ❑ Accessory Bldg. 0 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: i/1°.4 'hL �'� (J✓Ie c� e� �.� a Pi C. cep, t,/, 2A 2B 2C 0 0 ❑ C Educational ❑ F Factory ❑ F-1 0 F-2 ❑ USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 0 A-2 ❑ A-3 ❑ A4 0 A-5 ❑ lA 1B ❑ ❑ B Business A 2A 2B 2C 0 0 ❑ C Educational ❑ F Factory ❑ F-1 0 F-2 ❑ H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ M Mercantile 0 4 0 R residential ❑ R-1 0 R-2 ❑ R-3 ❑ 5A 5B ❑ ❑ S Storage 0 S-1 ❑ S-2 ❑ U Utility 7Specify: M Mixed Use S Special Use pecify: pecify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT _ 1, as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-954 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: �% � lr , �i, �(�'� `t''(�tFr�� �'J� �i��j ���17�, h. J`11� `.�12f �✓ �� (/7/ ��' � � �� (Location AFacility) I-Z2111� S " tuie of Permit Applicant 16 / � /(� ate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector F= — The Commonwealth of Allassachusetts Department of Industrial Accidents Off%Ce of 111yesfig2lims ==7 600 Washington Street Boston, Mass. 02111 `— Workers' Compensation Insurance Affidavit flame. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or on.e.-years, imprisonment as well,as civil penalties in the form of a STOP WORK ORDER and a fine of $100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. Ido hereby certify under the ains and penalties of perjury that the information provided above is true and correc>_ Signature //\ Date Print name ` 9\S C• Phone# 61 S-, )Vj-, C, official use only do not write in this area to be completed by city or town official city or town: permit/license H 0 check if immediate response is required contact person: (rewsed 3195 PIA) phone M: C)Building Department C] Licensing Board oSetectmcn's Office oHealth Department rjOther Cl) C/) 0 m O C N < O N y =a:mo m C9 O N CD O d n m rr,= H '-4 Im ,rt m a =rd = m m ppm N Q y C -1- 10 O CD O ' - a C = : .C.I O OZ s . m C ? N �raw: cc c ? ? o m o N U2 0 CD -J6W6ft. �y m 3 h ` , N N N C O` ccl :o a 546'. [C :� CO) -- m C. o CD N : O 3CD O� so moCIS. 0 0 ir CD 10 i1 Z C, oQ m m �c o =o: :O it CD o: 2 CD p s O c C d O y .0 P O x C "X O �. 110 O b :v n R" O x O C aa77" z C' t9 2y < O O x � d O CD MZCD y = r C• 'i'ce^^ d = y o v 0 CD ^� VJ CD C= o o �_ -� Q d CD r- CD o CD r--7 CCD D. y' CD y o to CSD v CO)CD G7 Z O CD CD o O C N < O N y =a:mo m C9 O N CD O d n m rr,= H '-4 Im ,rt m a =rd = m m ppm N Q y C -1- 10 O CD O ' - a C = : .C.I O OZ s . m C ? N �raw: cc c ? ? o m o N U2 0 CD -J6W6ft. �y m 3 h ` , N N N C O` ccl :o a 546'. [C :� CO) -- m C. o CD N : O 3CD O� so moCIS. 0 0 ir CD 10 i1 Z C, oQ m m �c o =o: :O it CD o: 2 CD p s O ^ ti B o. C d O � P O x r n "X O �. 110 O b :v n R" O x O C aa77" z C' t9 2y < O O x � C) O d O � N C N c IN i h � p � ✓i Tnorivmancc�eall�c E.- t7BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR i Number: CS 076154 1 _-N Birthdate: 09/03/1969 I i Expires; 09!03!2005 Tr. no: 6965.0 Restricted: 00 STEVENJ SUTHERLAND 196 MEDWAY RD MILFORD, MA 01757 Administrator -1 ,No 16/ 7 Date �1 ...... Z�. TOWN OF NORTH ANDOVER 0 98 PERMIT FOR WIRING This certifies that .... ......... Z�' -- ... *'****"****"*"**""**'*'*'*"**""'***""'* has permission to perform ....... ................ wiring in the building of .......................... at .............. .... North Andover, Mass. Fee ... . ....... Lic. N67 ...... ..... ...... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 0 0 14C Tommonwralth of .4fla ttr4uoetts it !-a Orpartment of Public -tttfetp BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only I Permit No. _& ;2 I Occupancy A Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code. 527 CMR 1,2:00 (PLEASE PRINT IN INK OR TYPPALL INFORMATION) Date City or Town of -{- To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described belowL��Z Zr7Location (Street & Number) _ -C/ynt - — 1 a Owner or Tenant Owner's Address Is this permit in conjunction with a• building permit: Yes � i No F (Check Appropriate Box.) Purpose of Building ©��lc�C� Utility Authorization No Existing ServiceA/1/ Amps Volts Overhead Undgrnd E No. of Meters New Service Amps / Volts Overhead J Undgrnd C No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work .s 6C11rC11 w 'Jo. of Lighting Outlets ]:N:oof Hot Tubs No. of Transformers Total K VA No. of Lighting Fixtures Swimming Pool Above— grnd. I_ In- grnd. — ! Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection ana No. of Ranges Total No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Disposals Heat Total Total No.of Pumps Tons KW No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Local Other r nnnncr1.,n !_ i i No. of Dryers HeatingDevicesDev ces KW No. of NO. of Low VOltaae No. of Water Heaters KW Signs Ballasts Wiring No, Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws ( I have a current Liability Insurance Policy including Co pleted Operations Coverage or its substantial equivalent. YES \ NO have submitted valid proof of same to the Office. YES NO _ If you have checked YES. please indicate the type of coverage by checking the aropriate box. INSURANCE BOND OTHE���Rttt = (Please Specify) (E pir�on Oatel Estimated Value of Electrical Work $/�Q r fid Work to Start __ Inspection Date Requested: ROugh _ Final yd k/ Signed under the �na P7re�naltiess of /perjury: FIRM NAME _ .i �0 S/�f� �yy _ LIC. NO. �ZS 2%f Licensee - Signature LIC.. NO. e� ��, f ,, /. / Bus. Tel. No.. 0,-T— � % rZ�,� Address � % /�i/: v 012 /L �✓'� �/ _� ^!dL_(J o Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Cl) m m M Am m m C/) m C/) 0 m 0 CD CD 0 IL 0 rz Location No. Date el &ORTh TOWN OF NORTH ANDOVER s f � . s Certificate of Occupancy $ s,cHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 151 u9 Building Insper 0 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUH DIN OTHER THAN A ONE OR TWO FAMILY DWELLING Section for Official Use Onl BUILDING PERMIT NUMBER:DATE ISSUED: SIGNATURE: C Buildin Commissionerll or of Buildings Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number. S'i /4Nr7� v�2 Sr - a AA1,9 0 VIe It /�{ ,J _, -# Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use I Lot Area Frontage ft 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ !; �.:i r �<'" i� 7 d3" :ii; .� fr is %Jt4� i�� '�5;^"•. 2.1 Owner of Record P Nehy /oyP-OFA< .116-1 ANoo&t4a- Name (Print) l+� � � Z / A/ S c..✓A ddress for Service : sfo Q Signature Telephone 11146T 8 2.2 Authorized Agent a d MA Le N0 5 C 40470 C�' ��d g�f�aT >a �4 UN i✓, /5/41 -0 %L71V 14'ame 'nt Address for Service: Sign tore Telephone 3.1 Licensed Construction Supervisor Not Applicable ❑ 0 6-/L9s tet . Mg C L66� Address License Number Licensed Construction Supervisor: Expiration Date Signature•Gu�. Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name„ Registration Number Address Expiration Date Signature Telephone v n M N, O I 9V 0 M X Z 0 Z M 90 0 ic r v M r r Z G) I, A cglvA LD H '7WAAq-- -- as @Wpm/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed u(nd//,�/ej��r the pains and penalties of perjury /// "1 ��////`/ Y> A V y 'f Print Name QQQ� Signature of Qpw/Agent Date Item Estimated Cost (Dollars) to be ��► � t � ° ✓ �g� # r :j t su ai Completed by applicantemA permit 1. Building % (a) Building Permit Fee l Multiplier 2 Electrical (b) Estimated Total Cost of �r�(� Construction from (6) / C 3 Plumbing Building Permit fee (i) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) 7C s6Q Check Number f .v.4 f. -Y i5.� r+z k'`rc' .+•�-ren Y rh k ,dn,y',s*ra.-, thS.�'? i�. '�� �'Stt o -s 11 a 'g : .y fa ei!.� `C �F. L` 3 l.a �.i.., '' .?. 3iY'E v sas x7f I} i�'Y ". M � •S't�'E � '4 �` ".. LNflt� 4�,4 Y .'l !� �l t'1 E itt?_�. 7. '� ] "� Rt F 1 f f. i.:. r ';� d�ka 1 lti f ! t t�{ 3 F ti S NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I sr 2 No 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE •�.. �:"+> r eS?. ��,P`4k'?€^t thLkS �� Y' ,;;4• { �.#t 4yf.�"�. ek: � ,}-•4y�+"fA tn" 3:_ tea'.!'. 4): �-�� h �: Signature A Telephone A 4 C, 46a O bko S, INC Not Applicable 0 Company N e: Responsible in Charge of Construction Area of Responsibility Registration Number Expiration Date Name: Address: Signature Total Not applicable ❑ Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone A 4 C, 46a O bko S, INC Not Applicable 0 Company N e: Responsible in Charge of Construction New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ,k Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: A-2 A-5 ❑ A-3 0 ❑ ]A IB ❑ ❑ B Business ❑ BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement level's Floor Area per Floor s Total Area s Total Height (ft) Independent Structural Engineering Structural Peer Review Required Yes ❑ No 0 SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 0 ❑ ]A IB ❑ ❑ B Business ❑ 2A 2B 2C ❑ 0 0 C Educational ❑ _ F Factory 0 F-1 ❑ F-2 0 H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional ❑ I-1 0 I-2 0 1-3 ❑ M Mercantile 0 4 0 R residential ❑ R-1 ❑ R-2 0 R-3 0 5A 5B ❑ 0 S Storage 0 S-1 0 S-2 0 U Utility 0 Specify: M Mixed Use 0 Specify: S Special Use 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE .Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement level's Floor Area per Floor s Total Area s Total Height (ft) Independent Structural Engineering Structural Peer Review Required Yes ❑ No 0 SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date FORM U.- LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT �S ISS tC{ la SIL b�ov .vr PHONE LOCATION: Assessor's Map Number PARCEL a0 SUBDIVISION LOT (S) STREET A81 do 0-2r ST. NUMBER *****************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED_ COMMENTS TOWN PLANNER COMM FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIO DRIVE AY PERMIIT/, FIRE DEPARTMENT /� RECEIVED BY BUILDING INSPECTO Revised 9\97 jm b/ TE Name: ma -e- /,h►c Location: 3 �� City Phone aam a homeowner performing all work myself. aI am a sole proprietor and have no one working in any capacity ® I am an employer providing workers' compensation for my employees working on this job. Company name: _ M4.c., 4S-04 &*-Y- //.,c Address (P 3 2e -3-6A & 10,0— c' die, City:�eCke, b 14 4'1-37d Phone 4p 7f!�-f17/-/d�3 Insurance Co. d4SG6941 45�91-7y Policv # tiv c 4Y0 6C 6, L Company name: Address City: Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. S Da to 10 /d a/ S Print name A-/&.�-O Phone # c 35,: Official use only do not write in this area to be completed by city or town official ❑ Building Dept F-1 Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone #: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION SEP -27-01 THU 04:59 PM FAX N0. P. 01 ACORD_,. CERTIFICATE OF LIABILITY INSURANCE 100 pATEtMM6!011 09!2 INSPOLICY EFFECTIVE POLICY EXPIRATION .r aR TYPE OF INSURANCE I POLICY NUMBER DATE IMMMF21YYILIMITS A Pn RJUCER 781-938-7500 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hastings -Tapley Insurance Agcy ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE EACH OCCVRRENCE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 12 Gill Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P, O. Box 4043 ZBN493438105 Woburn, MA 01888-4043 INSURERS AFFORDING COVERAGE INSURER A: Marc. Bay Incuranca Co. - - INSUR[D MacLeod Brothers, Inc. Attn: Doug Macleod INSUrICR B-—HOnovar Imiranca CO_ 63 Reservoir Park Drive INSURER C: EaStBm Casualty Insurance Cc - Rockland MA 02370 INSURER D: 4 1000000_ INSURER E: C-nVFFIAr,Fs THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSPOLICY EFFECTIVE POLICY EXPIRATION .r aR TYPE OF INSURANCE I POLICY NUMBER DATE IMMMF21YYILIMITS A 0. FRAL LIARIutY NOTICE TO THrt CERYIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 $O SHALL 8/01/01 8101102 EACH OCCVRRENCE a 1000000 1— r 50000_ X CCMMCRClAL GENERAL LIABILITY ZBN493438105 FINE DAMAGE Any one Iirol MED EXP IAny one Peiacnj CLAIMS MADE rX J OCCUP ! 5000 4 1000000_ PERSONAL 6 ADV INJURY GENERAL AGGREGATE 1 __-• 2000000 -- XBlkt ---—_-_--- - PRODUCTS rCOMPIOP AGG GEN'L AGGREGATE LIMIT APPLICS PER a 2000000 POLICY LOC f r'T LI U AUTOMOOILE LIABILITY ANY AUTO AMN35026310 8101101 8(01102 COMBINED SINGLE LIMIT (Ee accident) 1000000 BODILY INJURY IPor porsonl x ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) X -- X HIRED AUTOS NON•UWN4•'U AUT OG 1 ________•________-- _._. __ PROPERTY DAMAGE (Pu, amide. ) GARAGEUAMLIIY -- AUTO_ ONLY , EA ACCIDENT t 1 ANY AUTO OTHERTHAN!•- EA ACC It AUTO ONLY: AGG B EXCESS LIABILITY T 8/01101 8101102 EACH_ OCCURRENCE A ► 10000000 a 10000000 x occurs CLAIMS MADE UHN3802654 AGGREGATE 1 _ DEDVCtISLE X ROGNTION 10000 ' C WORKERS COMP[NSATION AND 8101101 8/01102 X WR SI " DER ER _ EMPLOYERS' EMPLOYERS' LIABILITY WCUO066032 E -L- EACH ACCIDENT 1 _ 100.0.000__, E -l. DISEASE - EA EMPLOYEE s 1000000 1080000 E.L. DISEASE • POLICY LIMIT DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS AD0E0 BY ENDORSEMENT/SPECIAL PROVISIONS AS rosp004s 0parations usual to a building c0nlritCtar. Rn' Ipswich Bank, 451 Andover Street, Nu. Andovor, MA CGL Special Broadening Endorszmunt 421.0080 CERTIFICATE HOLDER ADnITIONAL INSURED: INSURER LETTER: CANCELLATION ACORD 25-S (7197) 13.11 v ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED SEFOhE THE EXPIRATION Town of No. Andover QAYr; YHEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAVS WHITTEN 2.7 Charies Street NOTICE TO THrt CERYIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 $O SHALL N. Andover, MA 01845 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRE V". AUTFIORI�VRESEAYIV9 ACORD 25-S (7197) 13.11 v ACORD CORPORATION 1988 77S Fel 604:3 J.0/,lo rel t#ED 09.44 FAX 976 3S7 6049 N.1np N.ES .New England Serurity Outobel. i. 2001 Claire King 451 Andover Rc:ihy Trust 451 Andover Street — Suitc 210 North A1ido,er. `1A 01845 R.:: 1psivit;h Bink 451 Andover Street North Andover. MA Dek.r Claire As indicated during our phone conversation, we will be managing the renovation; to the interior of the subject bank. As part of oor responsibility. we must acquire a Building Permit from the Twxii of North Andover. Enclosed please find a set ot'drawing for the subject renovations. if these drawings meet with your appro%al, vvould you please sign this letter and return it U.) tree via Fax at (508) 823-4055. Your signature at the bottom of this letter grants NES Group the authority to ;r;,pl% for a building permit for the subject renovations. if you have any questions_ T may be contacted at (508-824-3553). Thank you for yotir assistance. Ver} tTul� V(i UTA. NLS Group Runel}1 H. Su•aJtz "U. 115 IM 10001,001 Via Airborne Express �-; 'F 'ti01r k�- Authorired by �.;1A' C�''v�1 Date_ U 1 f' L 200 Myles Standish Boulevard, Taunton MA 02780 Tel. 508-823.6531 Fax SO"22-9930 E-mail:mesgroup®nes-group.com • Web Site, %rwti..ne9-CraUpxoM Ba»k Des;gn Projeer Afanagarnertt - ConsalunF MacLEOD BROS. INC. Building Department RE: Permit Application I authorize the bearer of this letter Mr. Ronald H. Swartz of the NES Group to procure a "Building Permit" using my Massachusetts Construction Supervisor License #015895 (photo copy attached.) Respectfully, MACLEOD BROS. INC.. 'a �� gk Doug] a acLeod President NES GROUP New England Security October 10, 2001 . Town of North Andover, Building Department 27 Charles Street North Andover, MA Re: Ipswich Bank 451 Andover Street North Andover, MA Dear Sirs: ,Thank you for the assistance given to me during.our recent phone conversation. Enclosed please find the following items regarding the renovations of the interior of the subject bank 1. Permit Application 2. (2) Sets, of Stamped and Signed Drawings 3. Workers Compensation form 4. Certificate of Insurance 5. Letter of Authorization from Owner 6. Letter of Authorization from Contractor 7. Copy of Contractors License Please advice the amount of the Permit Fee and I will forward 'a check. Please mail permit to Ronald Swartz, NES Group; 5 Prospect Street, Taunton, MA 02780. If you further information or have any questions, please feel free to call me at my direct phone number (508) 824-355.5. Thank you for your assistance. V y t myY ours, Ronald H. Swartz NES Group r , r.:� r a o ; f� t� r PT* Enclosures. -Airborge ExXr ssB 200 Myles tan is oulevard, Taunton MA 02780 Tel. 508-823-6531 Fax 508-822-8930 E-mail:nesgroup®nes-group.com • Web Site: www.nes-group.com Bank Design • Project Management Consulting F a u� """ +�, 4 -�: iF � - i i ,+7r i T _ ''+.•. _ Cl) DO C m m 0 m CO) Cl) CD Cad Z H Cc) r '0. O C3. = y ac �c CD CD OC CD CD cr ? "C CO CD CD o CD ww s CD � � CD CZ O CO) �CD CD a v CA O 'O Z co a a O CD 0 dc CD Cc?�C2 dN 2 O —• H O Q r d O E m "0y CO m C7 O CIO CD 40 CD =r m aam o CO) CD O m H p N IF _ O � 2 ii p C-) C=2 ....+L R r CT7 n a o 7o CD CD eo on m c CD O O O N C n m cr C/)�— , .WC d (0 y ' m �^^QV -CCDca y O CD CDCD cl: O o" CD :3 z o 03:0 ti o�o I acn .^ :DOH G �O C ..=10 'n o m m m o :0 (S CL _ C -)n f r o �o coco �. o � �_ sem. (n C/) ^ OZ G rte-+ •g O In W) PC; O � :V 7d O C'' (� Z � R7 n jd O 17 O w �' z (/J y rD al O nC o 7 0% Q O New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �i�IylBOfi�, lNTfylelDK, u-� p �2�eiat R��k ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 ❑ ❑ IA 113 ❑ ❑ BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height (ft) Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 ❑ ❑ IA 113 ❑ ❑ B Business ❑ 2A 2B 2C ❑ ❑ ❑ C Educational 0 F Factory ❑ F-1 ❑ F-2 ❑ H High Hazard ❑ 3A 3B 0 0 IInstitutional ❑ I-1 ❑ I-2 0 1-3 ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 0 R-3 ❑ 5A 5B ❑ ❑ S Storage ❑ S-1 ❑ S-2 ❑ U Utility M Mixed Use S Special Use ❑ ❑ ❑ Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE ,Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height (ft) Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea .......0 No ....... ❑ 5.1 Registered Architect: 06JI44p R �,v&,eC4V Name: ' 2, CV459' Address r- woYm!qgr /J?d 2--19© 7VV- 33!---I'Y Signature ;rte 'P, Telephone * 4G Z4p O h O . , 1 N C Not Applicable ❑ Company Com N2%:U C- <-19 Mi M 4c,626,0 Responsible in Charge of Construction Area of Responsibility Registration Number Expiration Date Name: Address: Signature Total Not applicable ❑ Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone * 4G Z4p O h O . , 1 N C Not Applicable ❑ Company Com N2%:U C- <-19 Mi M 4c,626,0 Responsible in Charge of Construction I, g oNA l-0 �'wa�/L? "�- as def/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Af. . Yi✓ —0-r Z Print Name Signature of 4ow/Agent Date AM Item Estimated Cost (Dollars) to bev 1P Completed b applicant �x�l� � P Ypermit ....,'��� >, .. 1. Building (a) Building Permit Fee d Multiplier 2 Electrical (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) i 6, Check Number l ^y �F¢ R<.y ��s� {,yN n _�� ) �,a-s.,,, r�, `ci.: i i � >r .fit r . �l.. >. 1 ,/ .. ) v4. - .S N P[ 'ham*T„ J[ } 1 i �§ �. ✓.f� dy+' .. d`f.. .,9 �l i tJtr1 " -: �.. � �.-. pyF: I S.. % Yj i Ccsy I? s$ V ✓: f S/.: S . -.-;r.N.'4 ar.:� � �dFt..:f t�...4tx afk`�a rni-k :.�.�f �s � ;t ��� t �� 4's;�ra�y, ""�r� j;,1 �,'1t � � `. 3'.�'{. w�x�s�' � ,•�r� � ;,,, s �.•.. .�-;1 . r R;+.,..R.'iR Fs ,x ..M�� , :�Piv.t..�' v.. 'sf ; ,,r.8�s. >:.�. k � ,,. f?^� ,.5 's?�:=> ;'(. r X ,h� � f s � ti s� h `°f.. �!s"` �� 5 �S ,u 4 _ � i< � �: 3 � � r ; -' NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I sr 2 No 3'm SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF CHHANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE l 4 cYr-:t. F�yq•Z� "^2 d'i` +4.�`r"' K'k`y('r.,� A��uf r. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDIN�� OTHER THAN A ONE OR TWO FAMILY DWELLING Section for Official use oni BUILDING PERMIT NUMBER: DATE ISSUED: -47- SIGNATURE: Buildin; Commissioner/ edor of Buildings Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District . Proposed Use Lot Area (sf) Frontage 00 1.6 WELDING SETBACKS (ft) Front Yard Side Yard R= Yard Required Provide Required Provided ReqWmd Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.9 Sewerage Disposal System: Public 0 private 0 zone - Outside Flood Zone 0 Municipal On Site Disposal System 0 2.1 Owner of Record r5P No,0W 4*,Vvo-2 6,6e.,cA— � . Name (Print) Address for Service IV a &4W 3JEA Signature Telephone j <V 2.2 Authorized Agent 0 a 0A. L n A�1' -z- 7-;4-y"yrD1V' 1411;-0.1.171V ame nt Address for Service: 7 WK Signkure Telephone AIM �11-1" 3.1 Licensed Construction Supervisor Not Applicable 0 6-,L -95- p 0& 0 147, Mqr �.561 Address License Number YA 7-akwAo's, A14t Licensed Construction Supervisor: Expiration Date •Gum h k Signature Telephone 3,2 Registered Home Improvement Contractor Not Applicable 0 Company Name_ Registration Number Address Expiration Date Signature Telephone U M 11-1 9 0 M X Z 0 Z M 90 0 -n ic M Z G)