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Home My WebLink AboutBuilding Permit #199-2012 - Suite 300 9/8/2011 NORTH BUILDING PERMIT of.1t�Vo ,baa i°� b° o� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: / / '�Q`2' Date Received 'qo°`"""'" ". y* ��SSACHUS Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION -7 5/ A 2,)doy 'r 5�< loy' 1 e, � PROPERTY OWNER o/ Z2 Print MAP NO: PARCEL aP ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Add' ' Two or more family Ind Itera ' No. of units: ommercial epair, replacement Assessory Bldg Demolition Other Septic Well Floodplain Wetlands Watershed District W er/Sewer SCRIPTI NOF WORK TQBE PREFOe- 7747 �, OSS ✓ � ,e c�11 � Y &,777t X n Identificatiofi Please Type or Print Clearly) OWNER: Name:(/ LLC Phone:// Address (/ 77 1 ea S aq CONTRACTOR Phone: Address: l 4 d Supervisor's Construction License: y� � _Exp. Date: C / Home Improvement License: Exp. Date: r ARCHITECT/ENGINEER O3,f ,L/ L�[��c,SS�Tl�/f� Phone: fV9 �2_0 ? 2 5 Address:Q/�� G��,��nL)nLlo� 1117A-Reg. No. Yl✓3 FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $/ � � �� FEE: $ Check No.: (� Receipt No.: y�6 NOTE: Persons contracting with unregistered contractors do not have access to the - aranty fund Signature of Agent/Ow Signature of contractor _ Location ys� /7 �O�f' s°,,,I,-e 3 DO-Z_ No. Date NORT► TOWN OF NORTH ANDOVER O:�•� o :•1:yrO 3? �. • O AL F w Certificate of Occupancy $ A40'00 CHU <�' Building/Frame Permit Fee $ O U Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r 6 Check # A0 2 , 24560 huilding 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 Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Punning 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 124 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 ❑ Notified for pickup - Date ----.............-----........................_.........................----...-..............._..........................................._..._.........._-----.._._..._...._._._..._,_........._-......._........._....---. ........................................................................................ _ 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 ❑ 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 with the building application Doc:Building Permit Application Revised 2.2008 M e �aawcxKe ' CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 199-2012 Date: October 11, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 451 Andover Street, Suite 300-2, North Andover, MA, 01845 Melina Dement and Denise Henneberry, MAY BE OCCUPIED AS tenant fit-up for physiology office IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: NAOP,LLC 93 Union Street Suite 315 Newton,MA 02459 BuildingInspector Fee: 100.00 previously paid Receipt: 24560 NORTH Oover .o 0 No. 10 W dover, 1Vlass., • � � �- LAKE � COCMICHEWICK ' �70 RATED P "`C� 7 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR AM THISCERTIFIES THAT.................................................................................................................... ....................................... Fou. d do has permission to erect........................................ buildings on to be occupied as......... ...?�Y e�` .. ... Ch' ne 0A/b / provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Fina 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 INSPECTRR UNLESS CONSTRUCTION TARTS q-7_ f.:..... ,�K :•�." �: ",-„-.... ... .... .... 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 App Lbspector. Burner Street No. _ E.� � s Smoke Det. � �-fl'�—7� ,t4,ORTH ndover TO" Of No. A KI E 0 dover, Mass., L COCHI C.E.C. ��S RATED PP�� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System AM BUILDING INSPECTOR THIS CERTIFIES THAT............................................................................................................................................................... Fouadatio Fou_d io has permission to erect......................................... buildings on ........ ............. .... ..... ...... .... . ........ ....... . .. .... ...... . . Ro Chi ne jjj to be occupied as......... ... ........................................................................................................ 0 provided that the person accepting this permit shall in every respect conform to the terms of the application on file �i� Fina OA 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 INSPECT qR UNLESS CONSTRUCTION . TARTS 7- ......... ............................. Service BUILDING INSPECTOR I'-- C 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 Aplir% 4 4111,mector. Burner Street No. SEE 4. Smoke Det. NORTH T "0 of over No. }[ o , dover, Mass., 4 O - LAKE COCHICHEWICK 21,95 RgrED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR C THISCERTIFIES THAT..............................p./r7...................................................................................................................... Foundation has permission to erect........................................ buildings on .............................................................................................. Rough to be occupied as.........��'v�`'' G G .. Chimney ...... ................... ................ .... .......................................................................................................... provided that the person 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 5 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough 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. TBurner Street No. SEE REVERSE SIDE Smoke Det. 104, The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kvi- 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lerdbly Name(Business/Organization/Individual): P,0 �� Address: V6 Illy - City/State/Zip: p Phone#: 0206 — Are on an employer?Check the appropriate box: Type of project(required): 1.VI am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' y p �'• t 9. E]Building addition [No workers'comp.insurance colnp.insurance. required.] 5. E] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other 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. $Contractors 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:,jaw 1 616 Policy#or Self-ins.Lic.#: (/V C 0 /; Expiration Date:_f/—0 ?—,?0// Job Site Address: 7 / AYl loLlelt 17, � co—,q City/State/Zip:&,r 4- 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 Investigations of the DIA for insurance coverage verification. I do hereby certify un he pain d penalties of perjury that the information provided above is true and correct. Si atur Date: Phone#: "' J 0 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.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 06/06/2011 MON 14;29 FAX 978 683 0028 FRAVEL INSURANCE AGENCY 2001/001 ACORD CERTIFICATE OF LIABILITY INSURANCE DA�6/3/111 PRODUCER THS CS"FICATE IS ISSUED AS A MATTER OF INFORMATION Fravel Insurance Agency ONLYANDCONFERS NORIGHTS UPONTHECERTFICATE 231 Sutton Street HOLDER THIS CERTIRCATEDOFS NOr AMEND,EXTEM OR suite in ALTER THE COVERAGEAFFOROM BY THE POLI CICS OLOW. North Andover, MA 01845 INSURERS AFFORDING COVERAGE MAIC P INSURE) INSURER A Zuri ah Insurance CO VS Property Services WSURETIa Granite State Ins Co _ Lisa M. Gomes DBA -W M(C:Nautilus insurance 515 Lowell St. Suite 3 wsuReR D: Peabody, ba 01960 -• _. _. I RBRe COVERAGES 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 SUB,IECTTO ALL THE TERMS,EXLUSIONS AND CONDITIONS OF SUCH POUCIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D E POLICYNUAIEER POUCYEF I POULYO(PRATON - LIMITS GENERAL UASLTTT ( ( EACH OCCURRENCE S 1,000,000 a V I dAWUFArw r.FNMA1 IMR]eV Ara AAAgna0r.a t A 1'37/4 n I n 1e-7 i'1 1 R12AR70RENTED . - -{- -._-..-�-.. �- -••�•••••�••� �.,,�,,�V +V/&fj+a (Es 0=1F a LIUUVU,UVU �. 9")- LAMS MADE L4�i OCCUR r MED ew!!NXore persm) IS 5.000 �PEaSONALdnaVuuuRY I S 1,000,000 9 MEALAGGREGATL• .E 2,000,000 GEN.LAGGREOATEUMRAPPLIES PER: PRODUCTS-COMPAPAGG IS 2,.0-0-0,0-0.0-- POLICY Inc o Ma uws conMt9IMmSINGLEUMrt s ANYAUTO (Eaa[dd") _ AILOVIMED AUTOS BODILY WJURV S SCHEDULED AUTOS (Por PRSQF) HIRED AUTOS .._.. _. BODILY NJURY S ._I Non-0uaNCD AUTOS (FeraWOW9� PROPS TYDAMAGE S (kraCelft4 CARAGEUABR= AUTO ONLY-eAACCIDEVT S I EAACC S• __ HftNT LYN ANY AUTO AGG 15 ` EI(CESBMMBRELLAUABILTTY EACH OCCURRENCE I vu%,VK 8 %uwtsM/iVC I AGGREGATE _.. 'S S C II _ OEDUC TELE JAN002544 10/2/10 10/2/11 s 5,000,000 RETENTION S Is WDRKHMSCOAIPENSIRION MIDRTU- OTH- B DAFLOYFAS'LIMI.17Y we 8266712 11/3/10 11/3/11 X ANYPRORMeTOR1PARTNEROWCUTM EL EACH ACCIDENT s 100,000 at="Rf3%►MM8M sates DOUR WI EL DISEASE•[A EMPLOYEE s M00,009 ZCol tpo odor PROVISCNSb*w ELOLs,E.PoucvUMIT s 500,000 OTHER 1 D BSCRIPM N OF OPMATMNS I LOCA71ONSI VEH eLESI MCLUSKINS ADDED SYENDCRSEMENT/SPECIAL PROVISIONS Roston DevelopGent GLoug Mit al and rira.t General Realty Corp is named as an additional insured CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POUCIES8E CANCELLED BEFORE THE EVIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TOMNL 30 DAMWR1YWM Boston Development et al NOTICETOTHECERTIFKATEHOLDERNAMED,TOTHELEFT,BUTFAILURET00050SHALL and First General Realty Corp IMPOSENOOBLIGATION ORLIABILITY Or-ANY WHO U IN$URER.RSAGEMTSOR REPRESENTQIVES. AUTHORUM REPRESENTATIVE ACORD 25(2001108) m CORD CORPORATION 1988 i i i uset(%- Bcpa+'tmcnt+rf c �;Nufrli Building" +fct� Rc�t+latinn, Construction Supervisor License License: cs 1043$0 LISA GOMES 40 HIGHLAND ST PEABODY, MA 01960 ••nuui.�i•ne Expiration: 9/1/2013 Tr-,: 104350 a US Property Services 515 Lowell Street Peabody MA 01960 978-836-1206 September 7, 2011 First General Realty Corporation 93 Union Street, Suite 315 Newton Centre,MA 02459 Re: 451 Andover Street Suite 300-� To Whom It May Concern: To follow is the work that is proposed for tenant fit-up at the address noted above. This work is being performed in accordance with the architectural plans provided by JDLagrasi and Associates. The project will consist of the following: I. Demolish all interior partition walls except for the bathroom and one rear office 2. Construct walls are per the plans 3. Readjust ceiling file system to accept the new wall layout 4. All Fire Alarm equipment will stay active during this work 5. Install carpeting through out 6. Install basic electrical 7. Plumbing fixtures to be reused 8. HVAC system to be installed 9. Reuse light fixtures throughout 10. Removal and disposal of debris 11. First General Realty Corporation will supply the dumpsters Total cost perform the work described above shall be (Forty-Five Thousand,Eight Hundred and Sixty-Five Dollars) $45,865.00 Exclusions: • Fire Alarm ,cy Terms: a. Materials selections are final; any changes made may result in additional charges b. Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge over and above the estimate. c. Payment terms: Final payment within 10 day of completion Acceptance of Proposal The above prices, specifications and conditions are satisfactory and are hereby accepted You are authorized to perform the work as specified Payment will be made as outlined above. Signature: Date: Architects JDLaGrasse & Associates, Inc. Joseph D.LaGrasse,AIA Architects, Engineers & Land Planners Thomas E.Galvin,AIA Julianna E.Hoch,RA CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: 2161M2 PROJECT TITLE: North Andover Office Park PROJECT LOCATION: 451 Andover Street,3rd Floor,Suite 300-2(Called Unit 301) NAME OF BUILDING: Building 1 SCOPE OF PROJECT: Construction of Interior Suite 300-2,3rd floor at 451 Andover St. In accordance with Section 116.0 of the Massachusetts State Building Code I, Joseph D.LaGrasse.AIA MA.Reg.# 4153 being a registered Professional engineer/architect hereby certify that I have prepared or directly supervised the preparation of all design plans,computations as specifications concerning: Entire Project X Architectural Structural Mechanical Fire Protection Electrical Other For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2.2: 1. Review of shop drawings, samples, and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix 1. Pursuant to Section 116.4,I shall submit periodically,a progress report together with pertinent comments to the Building Inspector. Upon completion of the work,I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. Joseph D.LaGrasse,AIA 5� Q QNiL 4183 gjzla ig ature /E i eer of ArchitectDate ANDOVSKW One Elm Square T 978.470.3675 1420 Celebration Blvd. Andover,MA 01810 1H OF F 978.470.3670 Celebration,FL 34747 AA26001333 www.lagrassearchitects.com