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HomeMy WebLinkAboutBuilding Permit #127-2011 - 1630 Osgood Street 8/12/2010 BUILDING PERMIT "A of "ORTH A �gLlD �6 TOWN OF NORTH ANDOVER :> - w °p APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received /L ♦D '° ACHUS Date Issued: / / " IMPORTANT:Applicant must complete all items on this page K " i�r lulu•`:Sa6g f ,rc FS F;c.n Cr,• L s i sN LSr:'a a.' # T' =L w rr, a ���..'a� ..� a ry fr t_.��Fi �a7•--:t?'su.r->.��""�"`-��k � -a ,.-r1.y t�� s ,Si. *a"t�, '�."r':+^•rt.�y�", y �'i: .+ .a aL IS 'azs. Y4„J x• � - t.-w •2 .t s���` s.=4`c?e^�,.y �� 'fit#! •��. ��.yiyT s•-�'a'P S 2• -•s1 .,�r••.,r�+'.tr+� MEN r7 s'�.��. r..� s-a• s��,/r �x 'i'c. Y y�-��•s`Y��,.'•--cry �ts(,J, .157 :J��1 �_' •: � d ----r,;r '- t ,- ' a 'R'7•y _`eFTxz.. � •, 'itxt. 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TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration ✓ No. of units: Commercialw-**'� Repair, replacement Assessory Bldg Others: Demolition Other _.i-'a•�"v._... ..._..-.�_„-. ._..:.` -d.T,tn�-- �__ �}e'•t.^.�t,�.`4�,?�z..�'r"i,--:,.rE _Et_ro�+�t�t �_ �a;acndsx,.fir ���^si�..3e��,.� y_�. t,`�*e``rc�7:u°�`""•c'�e.d='u z.uffi . lPx t ..�.� ...-3. ......-�*. Ems.•. ._. yq�c. -� _ Sr' :y DESCRIPTION OF WORK TO BE PREFORMED: is rsJI y /Sb Ff d LfiaGG S s mac. L��v.b.•c,.. i Identification Please Type or P ' learly) OWNER: Name: �c+ss ua'c $r Pcl� ore., Tn� Phones Address: 16 oaOSS �� ST o 1-4 47W ver /Le N 1 ' •7^•� vq.r -3 d `�E• �-'�-?s„�t.2j"�.oS%,�.r�?'^� ytT� 'i� }N.5"Y'' 4 "'. :i� �'7 .' ,,~ q�' �-�r !''`"G'. •c`"fel `^.fiy` '*#' •a 1�S5i}' H s q 3r i • '`''' a t•� i ',r• .., ��,ry�9 F4�1�'t`�m�"��- y 7.et,'s" 'm'` s93� '� :3•"�,," ?'° '�;cr-':fi � �� ¢•'r. - �� � �' ,...Si. ,i� baa "� r8�r� �t�s'•� a �� Y �w'�i'"�t_. -���- ���� 3'"1 •„�S.^tit+ �'f'�"'�. � `' ii �... � "r a y. :...�.X>-•+,. ,•vY-..._nra;sr_.x. � _.,��1��K^"`s:�., >iz '�.,�, r��Z4+'�55ro'r ,,. s s.a.f:c"-.z`1 ��.� ��t..., _ :'�r�.� r�°',��„� ARCHITECT/ENGINEER,- �, Z-,0rV Z,' A7.� Phone: &'/7 Address:.-IV' ,?6/7 frcS� s� &J O e Ze44 Reg. No. �P�y/ FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. , Q-4 Total Project Cost: $ 7Z,dao — FEE: $_x'70 loo q 70 Check No.: _LAI dl'f1e zy—,,k,* Receipt No.: r' s contracting with unregistered contractors do not have access to the guaranty fund S° raa .Ovrner. yS� rat�T.eycon actor -' b. ..• w....- __.. ......_m. . .__ Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming 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 - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS , e HEALTH Reviewed on Signature COMMENTS •.... Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments- Water ommentsWater & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street ;,rte _'.t .ELME i E s <. Lcacatedt�2lainfr�et �Far� e, aarent �e'/ eke' N AMP a S c F r 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 DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) I ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 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 NOTE: 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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) u a Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit -New Construction (Single and Two Family) ❑ Building Permit Application ❑ 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 ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: 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 Q tt d with the building application_ Doc:Building Permit Revised 2008 Location /6 Do (9 No. 2 7Date ^T� TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # v1�G D 233 8 � Building Inspector w ► � �t` l f C v' �, Weston Solutions,Inc. Suite 100 45 Constitution Avenue ���m Concord, 03301 www.westonsnsolutionions.com 25 March 2011 7", 12 `0111 td W Board of Selectmen TOYVN OF NORTH ANDOVER Town of North Andover HEALTH DEPARTMENT 120 Main Street North Andover, MA 01845 Work Order No. 11621.039.001 Re: Phase IV—Remedy Implementation Plan Printed Wire Board Shop Former Lucent Merrimack Valley Works North Andover, Massachusetts MassDEP RTN: 3-21863 Dear Sir/Ms: Weston Solutions, Inc. is performing environmental remediation work at the Former Merrimack Valley Works located at 1600 Osgood Street in North Andover on behalf of Alcatel Lucent USA Inc. As required by the Massachusetts Contingency Plan, we are providing this notification that the work specified in the attached Phase IV Remedial Action Plan will be performed starting on 30 March 2011. If you have any questions or comments about the work that will be performed, or other aspects of the attached submittal, please contact me at (603) 656-5412. Sincerely, WESTON SOLUTIONS, INC. J'/'i z Frederick R. Symmes, P.E. Project Manager FRS:kmc cc: Town of North Andover Board of Health G\PROJECTS\I 1621039\PWB AreaThase IV\work notification letter docs A Page 1 of 1 From: (603)656-5400 Origin ID:HIEA Ship Date:29MAR11 Front Desk-CNH ® ActWgt 1.0 LB WESTON SOLUTIONS,INC CAD:5990695ANET3130 45 Constitution Avenue Suite 100 Delivery Address Bar Code Concord,NH 03301 J1 1 1 5 1 102250225 III IIIIIIII VIIII II SHIP TO: (978)688.9501 BILL SENDER Ref# 11621.039.0M700 — Board of Health Invoice# Town of North Andover P0# r �=� #r 120 Main Street Dept# I:A(A. .a TOWN OF NORTH ANDOVER North Andover, MA 01845 HEALTH DEPARTMENT WED - 30 MAR A2 �� 7945 86218065 PRIORITY OVERNIGHT 01845 MA-US 01 MXGA BOS 11111 IN 1111111 11111 r � 50DG3OA8/IEFB After printing this label: 1.Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning:Use only the printed original label for shipping.Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation,unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic valueof the package,loss of sales,income interest,profit,attorney's fees, costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$500,e.g.jewelry,precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. �ttps://www.fedex.com/shipping/html/en//Printle'-ramQohtml 3/29/2011 'NO OTN • •r SSS-1c"US f CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 127-2011 Date: December 8, 2010 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1600 Osgood Street - OzU Properties — Jessica's Brick Oven MAY BE OCCUPIED AS tenant fit-up IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Jessica's Brick Oven 1600 Osgood Street North Andover,MA 01845 Building Inspector Fee: 100.00 Receipt: 23318 ORT#i Town of over V" T ZO l A K E O dover, Mass., �`� � �>- 2 COC HIC HEwICK V^ ADRATED `SS BOARD OF HEALTH PERMIT T Food/Kitchen Septic System DING INSPECTOR BUIL ECT R THISCERTIFIES THAT................... . �. ...... .... .... ...................... .......................................... Foundation has permission to erect........................................ buildings on . ;6.0�..... . �' ..D........ � ......................... ................. Rough t0 be Occupied as............ ..CC%►�f!I/Cr. s..... L .4 ... 'S,�.f..G ....- .. ^O.:C� t/ Chimney ��� provided that the perso accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough - Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough .................... .:........ ::..-'..-.s/..., ne..s...................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the- Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done* FIRE DEPARTMENT, Until Inspected and Approved by the Building Inspector. Burner. Street No. SEE REVERSE SIDE Smoke Det. CPHOiNE CALL) FOR DATE ° ( TIME Pte/. M vV PHONED OF RETURNED PHONE YOUR CALL AREA CODE NUMBER EXTENSION PLEASE CALL MESSAG WILL CALL AGAIN tl v De CAME TO SEE YOU WEE Y TO. SEE YOU SIGNED U2iver al 48003 1 ' R NOTICE NOTICE BUILDINc DFPr TO To ,���� EMPLOYEE-S" h EMPLOY EES EM `i �/ f �r The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 - http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21,22&30,this will give you notice that I(we)have provided for payment to our injured employees under the above-mentioned chapter by insuring with: MA Manufacturing Self-Insurance Group NAME OF INSURANCE COMPANY 10 British American Blvd. Latham, NY 12110 ADDRESS OF INSURANCE COMPANY 020005100075110 1/01/201-0 - 1/01/2011 POLICY NUMBER EFFECTIVE DATES MARTINI AGENCY P. 0. BOX 565 WOBURN, MA 01801-0665 781-935-0220 NAME OF INSURANCE AGENT ADDRESS PHONE# Jessica's Brick Oven Inc. 19 Sixth Rd. Woburn, MA 01801 EMPLOYER ADDRESS EMPLOYER'S WORKERS' COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the ser- vices provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the vel ` ti(� h� ✓� Wl�c ��e�' NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER It■■1 WB Engineers I Consultants PLLC 263 Summer Street ph.617443.4950 A Boston,MA 022'10 fx.617443.4959 �V� DESIGN AFFIDAVIT Ifthl, PLUMBING ENGINEERING DESIGN AND INSPECTION TO: 1010 Massachusetts Ave 5`h Floor Inspectional Services Department Boston, MA 02118 RE: Jessica's Brick Oven 1600 Osgood St North Andover, MA In conformance with Section 116.0, Construction Control, of the Massachusetts State Building Code, I certify that to the best of my knowledge, information and belief, the plans and computations for the captioned building were designed in accordance with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances. I also certify that I, or my authorized representative, will inspect the work during construction. This will include the inspection and review responsibilities outlined in Section 116.2.2. Upon completion of the construction, a final inspection affidavit indicating that the building is satisfactory, complete and ready for occupancy will be issued. Peter Dussault, No. 45628 Engineer's Name, MA Reg. No. A"OFR" PETE 263 Summer Street, Boston, MA A T Address AL 6 (617) 443-4950 S/OVAL ElTelephone August 4, 2010 ►.����„�,�,�� Date °l,G�AEL 4 ��'�, •, ,, ;?� As subscribed and sworn before me on = y�t� 1 * � V Notary Public ••?o, •• My Commission Expires: November 23, 2012 .cFttS.. New York - Massachusetts - New Jersey DESIGN AFFIDAVIT To the Inspector of Buildings of the TOWN of NORTH ANDOVER: In accordance with Section 116.2.1 of the Massachusetts State Building Code: I hereby certify that, to the best of my knowledge and belief, the Architectural plans, specifications and computations accompanying the attached application concerning Jessica's Brick Oven, 1600 Osgood Street North Andover Mass_ are in accordance with the requirements of the Massachusetts State Building Code, and all other pertinent laws or ordinances, including Architectural Access Board Regulations. (CMR 521) ARCHITECT NAME & REGISTRATION NO. John Pearson#4841 Architect-Massachusetts Reg. No. � Margulies Perruzzi Architects, 308 Congress Street ' a.484., ' Boston, MA 02210osson�: 617-482-3232 Date: August 5, 2010 � � � Q p INSPECTION AFFIDAVIT In accordance with Section 116.2.2 of the Massachusetts State Building Code: I hereby certify that the structure shall be built under my or my agent's observation as per Section 116.2.2 of the Massachusetts State Building Code, and progress reports wil be submitted periodically to the TOWN of NORTH ANDOVER. AR ECT NAME & REGISTRATION NO. John Pearson#4841 Architect-Massachusetts Reg. No. Margulies Perruzzi Architects, 308 Congress Street Boston, MA 02210 617-482-3232 Date: August 5, 2010 Then personally appeared the above named 3-Oh O PearsOO has made an oath that the above statement by him is true. Before me, fc.lisso� LHcar-2tA,1_ kELISSAANN L'HEUREUX ,-�/5 / i Q Notary Public / ! Commonwealth of Massachusetts Date `Coirirfiissian Expires My commission expires July 6,2012 JAOzzy Properties\Jessica's Brick Oven OSG10A\L-ConAdmin\13-Affidavits\Municipal\Design Affidavit- Jessica's.doc