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Home My WebLink AboutTENANT FIT UP FOR B GOOD BURGERBUILDING PERT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION ORTHIT 0 LE 0 , 6 t., . ;4' • I 4 414'4; Permit No#: , - " Date Received 47 PA'Vss,,c4f31 s'''''''ATED sAtcHu, Date Issued: , 7 IMPORTANT: Applicant must complete all items on this page LOCATION "T' Print , PROPERTY OWNER ,,,t ), 2,t, .......,- Print 100 Year Structure yes no MAP PARCEL: ZONING [DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building El Addition Alteration 0 One family 0 Two or more family No. of units: 0 Industrial 0 Commercial 0 Repair, replacement 0 Assessory Bldg 0 Others: 0 Demolition D Other 0, ,io on: op:10,01400,,,,i 111,,,,' 101 )11 \0 ‘c , , doll - il 01„i0011101P i 414 4 , ^ 1,'" i D 4 0 1 11 114141 "" 4011414144111 'Hi , ogro, mom 1 014 4 +I 1111 oolo Hoot 14 M 44 44 M1101111ungliiiiiirm71111111111111111111111111111111110111111111111111L111111 #01:10, '' ' ,A:11610P III ‘a 44'4' \ "* IWPW)*(Q11141 II 101,,,,vi‘1,,,10,0000, [ ip ),,, ordliiiiiIIII0,1 00 141P4W 000000011l,1111 0 i Ilk 414 0, DESCRIPTION OF WORK TO BE PERFORMED: TMT •FTwr Lur (37, B trob Identification - Please Tyw or Privt Clearly Phone: 6 1 OWNER: Name: ) iiiit. NJ t. \ I ,,, , - Address: Contractor Name: Phone: t 6 7 -- Email: Lic,o,r -AsT: PKT Address: Supervisor's Construction License: ' ( Exp. Date: '-' Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: 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: $ -...-.--.., Z ) ----FEE: $ r-Otir 7 Check No.: 15 [ , Receipt No.: NOTE: Persons contracting with unregistered contractors do not have ccess t he aunty fund rsTgalireilf; All):1'=VG ' 'e ' t'igi '..1 r ot d /1/7Zid/irral/iii-'0 o - '-' ii'''re'l'i" '"1.,"7 itIf 1 i 4 I lliiiiWilfigk Plans Submitted _ Plans Waived — Certified Plot Plan _ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer — Tanning/Massage/Body Art _ Swimming Pools ❑ Well — Tobacco Sales C Food Packaging/Sales ❑ Private (septic tank, etc. 1 Permanent Dumpster on Site C THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on COMMENTS 2 7 tr Signature, K> 1 4„, 7Gi ✓ 14 q/ `//') Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit ]DPW Town Engineer: Signature: Located 384 Osgood Street y. 93 . a) y 0 c� 0 CD C� t/n O '3 O co 'O -o o Cm) CD CD CD o CO WC CD CD c2m co tro o CD tom/?• 0 O A' -a z 0 •-o- 0 0 CD W30 01 pa.szn 210103dSN1 ONIa1Ifl ionNiSNOO SS31Nf1 VIOLATION of the Zoning or Building Regulations Voids this Permit. o 0�o ▪ CD o = o ▪ ='-o o y 2. 6. o o - 0. F(1) ci) o sr) 2 was N 0 co a s•n - mom cn -a o < CO o O ran.,, y 13 o o, a CZ. �cp CD • CO 0. wm - m D3-a w�. CD 0 -® co 3 00 CDCD cn 0 o n o-h >0 ID 73 (13 ®' O. 0 m 11 m co C. CO ---' o Contractor Contact Wallace E-mail B Good Burger 111 Turnpike street North Andover Pro. Design & Construction co.LLC Wallace Cell 617-448-8998 wallaceho@comcastnet 218 Willard street Quincy mass 02169 Description Performed By Architectural Jordan N/A BOH Application B Good N/A Fire dept. Review Pro Design No Cost Electrical corp. finishes Pro Design $27,000 Temp lights & power During demo Pro Design $3,500 Plumbing & gas corp. finishes Pro Design 35,000 Big Dipper Pro Design 7,500 Hood exhaust & fresh air Non -heated Pro Design $18,000 Interior hardware's corp. finishes Pro Design 3,800 Walls framing & finishes corp. finishes Pro Design 20,000 Slab cut/ removed For plumbing Pro Design 8,000 Flooring corp. finishes Pro Design 14,000.00 Mint Box corp. finishes Pro Design 4,000.00 Lightings corp. finishes Pro Design 6,000.00 Roofing Mall rooferMall roofer 4,200.00 Bathrooms corp. finishes Pro Design 8,400.00 General building supply Pro Design 26,000 Dumpster & trash Pro Design $5,000.00 DPW permits Pro Design $1,800.00 Permits Pro Design $3,800.00 Grand total $196,000.00 Rents s VI V Eq Gina sic syt .1 in 10' Ta les :hairs vo,v r t s Teciai Vur 0 John 1.."n Pendants John ( signage • Fire Alarm 111 Unknown os sign Simplex John Olint ispensm e k son Aionsi Mod Cc 411 a;I•PMEW � ,The Commonwealth of Massachusetts Department ofIndustrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 , www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH T Hie, PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: Z1i5 tlJtli 57 6 City/State/Zip: Ozia cei 6 c Phone #: 4e7- Are you an employer? Check tile appropriate box: 1.0i am.a. employer with employees (full and/or part-time).* 2 ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.Q I am a homeowner doing all work myself [No workers' comp. insurance required.] t . ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole profiietors with no, employees. It5 I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.t 6. Q We are a corporation and its officers have exercised their right of exemption per MGI, c. , 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] • *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. teontractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have . employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. Type of project (required): 7. ❑ New construction 8. CA' emodelirig 9. ❑ Demolition 10 El Building addition 11. ❑ Electrical repairs or additions 12.0 Plumbing repairs or additions 13. [i Roof repairs 14. D' Other I ant 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. #: w C Z —?— 3 S-f 64- --03 Expiration Date: 5/ 5-7 / e. _ T— e iRJ�'- Job Site Address: t (1 (i,t-'0-14 t 5 ` S5f4-7K City/State/ZipV Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required underMGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofpeijury that the information provided above is true and correct. Date: -�f/—/ 7/ Z / `5 &nature: Phone #: (7- 4-4-8 - 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. ElectricaI Inspector 5. Plumbing Inspector 6. Other • Contact Person: Phone #: r1ORTH 0 * 4,1SSACHUS- North Andover Health Department Community Development Division April 24, 2015 Fresh Choices, dba b. good James Pinho, Manager 100 Andover Bypass Ste 202 North Andover, MA 01845 Re: New food establishment review; b. good, 99 Turnpike Street, Eaglewood Plaza Dear Mr. Pinho, The Health Department received the plan revisions submitted for the new establishment to be known as "b. good" located at Eaglewood Plaza, North Andover. All issues noted perfidiously have been addressed and the application has been approved. Looking forward towards pre -opening; prior to receiving your permit to operate you will, at minimum, have two to three Health Department inspections; a construction inspection and a fmal food inspection. When all equipment and structural elements are in place, a construction inspection should be requested. It is not expected that the equipment be up and running at this inspection. Please call the Health Department a few days ahead to avoid any delays. At that time, a complete punch list will be provided by the inspector. Once completed, please call the Health Department for re -inspection. The Building permit will be signed off by the Health Inspector when the list is satisfied. Once all other departments are satisfied with the construction, the building department will then grant you occupancy approval. As it is difficult to anticipate details at the time of this letter of approval, the next steps toward opening will be based on the specifics that exist at that time. The Health Inspector will instruct you on the process, and you will discuss together, when you may begin bringing in food and when food preparation may begin. Just prior to issuing the Food Establishment Permit to Operate, the inspector expects to view food properly stored; on shelves, in refrigerators, in storage closets etc. Each establishment opening is unique, so feel free to contact the Health Department at any point in the process. Bttoware-um-e-comro-n pitfall h can c-aus-e-daa-y-in opening-if-rrot-complied-with. All lighting over food prep, service and wash areas must be non- breakable. This includes hanging lights or pendants over the bar area. No unprotected glass can be over food areas. Also, North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 b. good plan approval April 24, 2015 any ceiling tiles over food or food prep areas must be washable and all high wash floor areas should have a curved base coving along the walls. Bathroom walls must be non -porous surface behind all fixtures and splash areas; at least 4 feet high and curved base coving along the walls. **Please submit the enclosed general food establishment application and your annual fee of $185.00. Note that a final food inspection will not be scheduled until the application is received and all permit fees are paid.** **Please complete and submit the enclosed dumpster peiinit and annual fee of $60.00.** Some of the items needed to receive the permit to operate are: 1)The establishment will be clean of all construction materials; floors and surfaces all cleaned. All contractors shall be complete. 2)The hand sink(s) and bathroom(s) will have immediate access to wall mounted paper towel and soap dispensers and they must be stocked. 3)The ladies room will have a covered trash can for feminine item disposal 4) Signage: Bathroom(s) must have "employee must wash hands before returning to work" signage; hand sinks must have signage "hand wash only"; 3-bay labeled "wash, rinse, sanitize"; prep sink "food prep only" 5) Sanitizer bucket should be made up and test strips available. 6) Label grease trap per plumbing code If you have one or more interior grease traps please note the plumbing code 248 CMR 10.09 (m): 1.A laminated sign shall be stenciled on or in the immediate area of the grease trap or interceptor in letters one -inch high. The sign shall state the following in exact language: IMPORTANT: This grease trap/interceptor shall be inspected and thoroughly cleaned on a regular and frequent basis. Failure to do so could result in damage to the piping system, and the municipal or private drainage system(s). 7) Signage for allergens and disclaimers placed as required by law 8) Proper disclaimers on Restaurant menu as needed. 9) Gloves must be on site. Please note that the state does not recommend the use of latex gloves due to some person's sensitivity to latex that may cause them illness. 10) At minimum, employees should be trained on the sick policy and sanitation basic 11) Directions on mixing the sanitizer should be available to the staff. Thank you for your cooperation in this matter. If you have concerns about any of the above conditions; please contact the office. We look forward to working with you in the effort to provide safe food to our citizens. If you have any questions, please contact our office at 1-(978)-688-9540. Sincerei Susan a. e HSSIRS Public Healt ector North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 b. good plan approval Items of Deficiency noted Page 7 #4 Written policy to exclude or restrict food workers who are sick or have infected cuts and lesions was indicated but not described or provided. April 24, 2015 Corrective Action Please revise; describe procedure, type of containers etc. OK Page 8 #8 - It is indicated that all PHF's will be "kept on ice" when they are Please describe in what capacity not refrigerated in order to minimize length of time in the temperature these items will be kept on ice. danger zone. This meaning of "on ice" is very vague. OK Page 9 Table - It is indicated below the table that PHFs are cooked to order and never cooled, however, soups are listed on the menu and their reheating process is indicated on the following page. Page 12 Table #16 - Location of "waste" grease storage receptacle was not provided Please review the cooling process for the PHFs that are listed on your menu OK no cooling of phf; discarded Please provide location of grease storage receptacle for fryolator grease OK in trash area Page 14 #22 - It is indicated that ice is made on premises but ice maker location is not provided Please indieate location of ice maker has ice machine Page 15 #24 - Calculations for necessary hot water was not provided Please provide calculations OK Page 15 #26 - No information provided on backflow prevention devices Please describe how backflow prevention devices are inspected and serviced OK Page 16 #35 - No information provided about how linens will be cleaned off -site Page 16 #37-38 Location of clean and dirty linen storage was not provided Please revise OK outside company Please provide location for both clean and dirty linen storage OK storage area Page 16 #39 - No indication of type of containers used for bulk -food Please revise OK storage Page-16-#40---No specifications-provided-f-or Pexha t hood Please -revise -OK -received Page 17 #43 - No information provided regarding prep sink North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Please detail answer OK Fax: 978.688.8476 b. good plan approval April 24, 2015 3 Hand Wash Sinks were indicated in the legend of drawing A6.00 however Please review and indicate only 2 were shown. where the third sink is OK. 2 handsinks; I 0 feet from prep, warewash and cooking areas. In the additional prep area there is no hand wash sink present Please revise OK plan changed *Discuss Tablet vs. Paper faun of MSDS booklet Procedure for access in case emergency OK North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476