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HomeMy WebLinkAboutBuilding Permit #173 - Alcott Village 9/9/2008 NORTH BUILDING PERMIT o* tLID ,bgtio TOWN OF NORTH ANDOVER 02 -� °�, APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received p�garec c5 �SSwcHusEt Date Issued: ' ; IMPORTANT:Applicant must complete all items on this page LOCATION AL[o7T VAY Print n PROPERTY OWNER ALCoT' VFLLg6t 9aMEccJNCR5 17SSociA7loA Print MAP NO: PARCEL. ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 4 TYPE OF IMPROVEMENT PROPOSED USE f Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORM -A7/Czj 7`0 14 0 Tim 7`0 �X i--r 77iv� civ r Identfication Please Type or Print Clearly) OWNER: Name: Auo? VcLAGE 1Jo1qE0W1VEjes Ass-oc- Phone: Sv$4'v 111ANEA.2 PAFSlbFA17 ' 72-681-66'72. 51V44r Ga0s-rc/nJ� Pg&T D.recfoe 478-682-2Sq Address: 21 ALC07T 4/Ay 'zo Acc07T L�Ay CONTRACTOR Nam lt'PAMew Phone: Address: ,Se - 0/ Supervisor's Construction License: rs Aa,_6 Lo Exp. Date: e �+ Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. J . FEE SCHEDULE:BULDING PERMIT:$1172.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED rON$125.00 PER S.F. Total Project Cost: $ FEE: $_��[� Check No.:�©/ Receipt No.:�y NOTE: Persons contracting with unregistered contractors do not have access t e my fund Signature of Agent/Owner J Signature of contrac or Sri oldsfein li Location LcoT1' � No. / Date D NORTH TOWN OF NORTH ANDOVER I F? ° • O� • s Certificate of Occupancy $ • //40- �'�s'•� t<� Building/Frame Permit Fee $ wcMus Foundation Permit Fee $ Other Permit Fee $ r. TOTAL $ Check # 2 I 4H G Building Inspector 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 J Signature COMMENTS VV (� i HEALTH Reviewed on Signature COMMENTS �I 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 FIRE DEPARTMENT Temp Dumpster on site yes no Located at 324 Main Street; Fire Department signature/date COMMENTS 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) r r I I i ❑ Notified for pickup- Date L__......-..._-.... —---..._..........--- - _............-- --.....................-- ---.........................- --............._.........._ ....._......_.........- Doc.Building Permit Revised 2008 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 ❑ Floor/Crossection/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 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 ,a- Certified Proposed PIo1Pla -------- ,-Er- Photo of H.I.C. And .S.L. Licenses •� Workers Comp Affidavi ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ,a—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 with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 g„�®RTI-� 0 0Andover No. / o dover, Mass., 'O I� COCKICMEWICK y^ 7 AORATED PPS SCC BOARD OF HEALTH Food/Kitchen PERM, IT T D Septic System 1� BUILDING INSPECTOR THIS CERTIFIES THAT...... ... . ...... ................... .......... ..................... Foundation ////c has permission to erect.....WAk ......................... bu' ings n........1..'r R.... .. �.�... . �...... Rough to be occupied as...... .....CIM......... .. ........................................... Chimney provided that the person accepting this permits all m every respect can or toAt ms 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 j VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES N 6 MONTHS ELECTRICAL INSPECTOR CJNLESS CONSTR T TS h Roug .................................... Service BUILDING INSPECT Final Occupancy Permit Required to Occupy wilding 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 z Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i JOHN SCHOONMAKER 1 BRANCH MANAGER NORTH ANDOVER POST OFFICE log UNITED STATES ME P05ML SERVICE 131 MAIN STREET NORTH ANDOVER MA 01845-9998 978-683-2890 F'.978-688-1293 www.usps.com John.Schoonmaker®usps.gov . ' h e r I BUILDER CONTRACTORS 118 Fordway Ext. Derry,NH Division 603.231.8581 231 Hampstead Street Methuen,MA Division 978.687.4079 Building Proposal Submitted To: Great North Property Management,Inc. Phone:603-436-4100 x 18 95 Brewery Lane Fax: 603-766-6548 Portsmouth,NE 03801 Date: April 22nd 2008 Job Name:Mail Hut Job Location: Rt 125/Units 4&3 Facia Job Phone:Contact:Don/ 602-231-8581 Requested By: Susan Maher—Alcott Village I We hereby submit specifications and estimates for: Specifications RE: MAIL HUT Retrofit existing Electrical but at rear of Unit 36 Propose attached front portico style build-out to existing electrical but roof structure out to 29 6"x 6"x 84"PT posts mounted on 2#bracketed 18"x 48"concrete sonotube supports covered by 6"concrete pad with 2#48"side walls and an open front entry,to be finished to match Design/Decorum of existing hut,not to exclude following size,shape,materials,and color Removing existing mailboxes to new but and bolting into floor,breaking up old pad and removing Includes all labor/material for aforementioned work. Cost to retrofit for Mail Hut $9700.00 ** Any "structural rot"found while retrofitting will be identified to Owner/Alcott Association for approved repairs to commence.Minor repairs involved in retrofitting are included in cost to build. ** Price does not include any electrical wiring.Solar light packs can be priced for review/approval BDC will install supplied solar packs„ We can price additional lighting/electrical separately upon request WE PROPOSE hereby to furnish materia[and labor—complete in accordance with above specifications,for the stun of.$9700.00 Nine Thousand Seven Hundred and Zero dollars and Zero Cents Payment to be as follows Depost 50%w/order, Performance payments to completion Final payment with completion 7 Terms & Conditions continued—Page 2 Page 1 Of 2 i Ali artwork is the property of BOControctors.Any design or layout presented to client may not be utilized unless purchased from BDContractors. To incorporate WContractors drawings,proposals,or quotes without use of their services will require payment.Thank you. ♦ 1{ I BUILDER CONTRACTORS 118 Fordway Ext. Derry,NH Division 603.231.8581 231 Hampstead Street Methuen,MA Division 978.687.4079 Page 2 of 2 -Alcott Village-2008 Mail Hut proposal Terms& Conditions I DESIGN COST: The sketch deposit covers minimal costs involved in developing a concept.It does not cover the actual purchase of a custom design,which would be figured at an hourly rate,with a quoted minimum price.The sketch remains the property of the designer BDC Contractors.holds the right to disapprove of any attempt to alter the design by secondary contractors such as Carpentry or other vendors.Any deviation in conceptual design negates our visual expectations of final product to Alcott Village.We are bound to provide the installation and necessary to I Retrofit but pertaining to the new MailBox area only PRICE QUOTATION GOOD FOR 00 DAYS: PRICES as indicated above,are for the replacement and installation work only.Typography omission,overtime, j changes and/or Time additions,delays caused by client,special consultations and all other work expenses that can not be Estimated accurately in advance will be billed extra unless otherwise specified herein. FINISHED ART: ..Mechanical design,will be released for use for the Town Building Dept.and review of the client only. Mechanicals,original art,sketches and materials originated by the designer are the property of the designer,and will be held for the client to execute repairs, unless otherwise advised we hold the right to be compensated for our design as it pertains to building designs,landscape designs,electrical or irrigation layouts. . SPECIAL:..............Conditions on client's purchase orders in no way negate the above Conditions of Sale.In ordering work described above,the client accepts all of these conditions whether noted on his purchase order or not. UNUSUAL CONDITIONS: (i.e.Existing Building conditions.)are encountered during installation that could prohibit our work progress,will be dealt with separately and accordingly to move forward with completion of any retrofit or installations that could cause additional cost in material and labor to complete,those costs if they apply do not in any way negate any part of the proposed contract,or this contract from their payment schedules and or final payments. THE CLIENT:........Agrees to pay all costs of collection in the event of default of payment by the client,including a reasonable attorney's fee.In the event of delinquent payments the job will halt until payment is received,the client will be charged a rate of 1.5%interest for every month after the first 30 days Authorized Signature: The above prices,specifications,and conditions Acceptance Signature: are satisfactory and are hereby accepted. You are authorized to do the work above as specified AcceptanceDate: Payments will be made as outlined above. i I i I i All artwork is the property of BDContractors.Any design or layout presented to client may not be utilized unless purchased from BDContractors. To incorporate BDContractors drawings,proposals,or quotes without use of their services will require payment.Thank you. I i Massachusetts-Department of Public Safet. Bard of Building Regulations and Standards. �� Construction Supervisor License License: CS 65690 Restricted to: 00 JEFFREY S AGNEW 55 CHASE ST METHUEN,MA 01844 Expiration: 7!3112010 F'ummissianer Tr#: 870 I 1 , 4 ti a�,N v a yp 4 a �r 4 a s sy i p#j t Ov 1 �e • s s � . �"'��. u�ie t r £ .,y.,,` :`:'`y Y'tr b•,vr1 �„ ��' �,.�;. t •' � r f 1�•' }utx luU=} s2 i v Sul ggss �3 i t c, l t l 1•r:� x�, 1 a x � a s gyp'• � y� 3 � ^.•` \ �";" t ?.-2} `i��`49 "x 3 4 Y r'� .y 1 l�k�'k Y�d? •1ti k, `r t S t ' #b �, �,2 3 e e�,. `"''b�� �..Y x r� t�� �i��x'� �•' tip, �. t •. k� a?• bw� s�x? t i �S.'§� lw^ �'tt'.. '� � }�' sad• �N,y =,� I tt �t W8"w sow a F a Now n, Vv di ', -j � .� �' rad"`"°^`",r.".r-:.� m a�• t WAW �gqu e 3 Y f .. .. ; -.w d f i va �u. l�oil ll l lill j f ` �! r ae n r Delivered. Lot Price: 2567.84 Freight: (177.84) Included In Above Pricing Quote Prepared For: Stuart Goldstein Taxes: We Are Not Authorized To Colleot Sales Tax In MA. North Andover, MA. 01845_ Lead-time: 3 to 4 wks. ARO ptus transit at this time PH 978-682-226.4 Installation is not included. spgoidstein@comcast.net Quote is valid,for 45 days from '05/30/0.8 Notation: Front Loading, Recessed Mt"., 4C'Honzontal USPS Star dai { } _ Finish: Cpticsnal, Engraved Doors Qr I.D. Tags (R,U tolerance of 1/4') DEPTH ID It 0vera tt( .A.)66,112- . F2ouh-npenEng(R.O:) -- - A a_ 55 9fS6" V CP V Q. . } 4CrT2 -20 4CFr2-20 Notations -J„ Effective October 6, 2.006 4C Horizontal Mailboxes U.S.Mai1 suppl:y,Inc.. are required for all neve construction that has not applied for 3065 N.124th ZIL a building permit prier to 1a/6/06. Broollcicel-3Y 53005 Phone: 800.571,0147 1✓a1X:"800-589=1066 Sales Rep: Joel fl'rtlZ vlSil our wobsite.www.usma#SUPplycom i 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 employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint 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 of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants j Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)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 members or partners,are not required to carry workers' compensation insurance. If an LLC.or LLP does have employees,a policy is required. Be advised that this affidavit may be 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. I � 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia The Commonwealth of Massachusetts c Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 t iw www.mass.gov/dia i Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers Applicant InformationT p Please Print Legibly Name(Business/Organization/Individual): 3DLGov-ST2u6T-7UAJ �9 /Z6A/VUA7-/OA) 6� Address: UJA-Ir ALk 7— City/State/Zip: l Phone#: (a 93 .23 l Y lel j Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. E]New construction employees(full and/or part-time).* have hired the sub-contractors 2. l am a sole proprietor or partner- listed on the attached sheet. t ?• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their ME] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself[No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.L1 Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this af',idavii indicating they are doing nil wutk and ii,en hire outside coniraciors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. _ Insurance Company Name: �1 f!/Vt�bws,r`� /plc 50 rL4AJL� 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 required under 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigati e DIA for insur erage verification. !do a certify under ins and penalti��perj�uiyhatthe information provided above is true and correct Sianature: Date: Phone#: Official use only. Do not write inn this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: `a� 5 57e3d v �� �� - N/F HOPE N sl N C-4 N Zg.O6' 29 _ \ SCA R SEE DEED BK. 1017 PGS. 26,3-26Z-' 33 32 . \a3 y PLAN 5090 M 26. 0 80 5Gp `a \ N/F-TROMBL y m - i 31 7 t , . \�� , °O O SGA 3 SCA i SCA 3 t 1 f �1 1 t SCA SGA EXISTING N t + SCA , 2 , RfG}}T OF y`vq 1�--- cn I sca 1�a• 81046-4 1! co . . /84.00• —'�s-- tl , ca+ s s'AS SCA t SCA 3 •! -- 3 / SCA 2 Z SCA( `� sG►++ SCA 3 8�+ X36. 2. - Li -$CA b 3a 3T d8 3s SCA 3 ` N4 'SCA 1; SCA3Sc4 SCA 3 S�A,3 SCA 3 4j�•4 ac4/, ' __[•_- / i SCq �.$CA t _ SCA 3 1 scq 21 i 20 ` SCA3 sCA;SCp k43 SCA;_-- _`- SCa 32.26' � SCA� � i t f _ �a3 I SCq 3 SCA 3 -SCA -i a 1 1 SCA 3 S + i - S V 7 8 I�IS4 +3 SCA �SCAI L ' Is"3:. i-SCA; 18 12 13 32 �-- 14 15 SCA 3 ror + ' 'SCA 232./O' ail n°D� l `1e a N B!"52. 2., a 1 a= scp 2 sc� 3r: „1 1 Q X93 i. 4�s ,os6 84= �p N .S 8 `34' p mss. c ° Awit -- Q: y ro9N+s S T EE PLAN ENTITLED:PLAN OF ACCESS EASEMENT TO BE CONVEYED BY rpt MERRIMACK COLLEGE. INC. TO FRANCIS J. TROMBLY AND MARYEMMA S. TROMBLY NORTH ANDOVER, MASS. SCALE 1=20' JULY,1978 I I