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HomeMy WebLinkAboutMiscellaneous - Building 3O / A S Location No. 'of q1 Date �S a 0 NORTq TOWN OF NORTH ANDOVER O? • • Ow Certificate Occupancy $ of �' b'••°''<�' cwust Building/Frame /Frame Permit Fee 9 $ Foundation Permit Fee $ Other Permit Fee r$ TOTAL $ a 17 3 , l0 v Check # i OLA fit (61-11 — Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING .4-13MAKE.RU Sect MEN Section for Official Use OR, MMMMMMM BUILDING PERMIT NUMBER: DATE ISSUED: AO 00 -?/7 SIGNATURE: .2— -)-990 Try'ilding Commissio !Ls of Buildings Date ,�or 1.1 Property Address: dc, 1.2 Assessors Map and Parcel Number: a� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area (sf) Frontage (11) 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide R 4 1 Provided ReTtind /Povided 1.7 Water Supply M.GI.C.40. 54) 15 Fl—aZone Information: 1.8 Sewerage Disfml SSyetfi- Public 0 Private 0 zone — Outside Flood Zone 0 Municipal On Site Disposal System 0 2.1 Owner of Record wLp,e I Name (PAnt) Address for Service: AFFRbaa /-e- k 0178- 7a b-- 6 70 0 Signature Telephone 2.2 Authorized Agent WALL &I I X11 (WW446 ck) (CAVo7TT- AWilrS 11760Q Name Print Address for Service: 9- 7SO- 0079' Signa re Telephone t 3.1 Licensed Construction Supervisor Not Applicable 0 '? �b-mas UR n q5qs, Address ' ®(gad Licensed Construction Sulf1mr: 0,3io 8 00 Expiration Date t afore Telephone Registered Home Improvement Contractor Not Applicable 0 Company Name_ Registration Number Address Expiration Date Signature Telephone 0 I M 0 M 0 Z M 90 0 -n F M Z G) Workers Compensation Insurance affidavit must be completed and submitted with this application. issuance of the building permit. Failure to provide this affidavit will result in the denial of the Si ned affidavit Attached Yea ...... No ....... ❑ sEcrrorl s 1 > o (WALDMI 4--' c+ rTs WOTON RVT " 04"Gs AND $MOO1S,9v tT:-rb ,, .CONSIIISN CO3 4I � Tb 7f f! I21S +CANT 1 N MQRE 3 GF Of J iC .€MS) D Si'ACi j 5.1 Registered Architect: K -r N,I i 05 l2r�f�P„ni�i✓ Name: C„Jd,nl /� y Address /N W/4 /14W Signature �C. & o 8111C4,S76Ae Telephone 6tG/�K ;�..216tst�ere��'rnfenat Fad ;s 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 2 Company Name: �P.�U 4�f Ci 4-�c.� 1 I ((•1q /^ � c T-/VC (�Ol���l�J �t�lv� Not Applicable ❑ Responsible in Charge of Construction New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: u /�11 Cr�S Ci7o�1% 6 6 ❑ A-3 ❑ ❑ IA 113 ❑ ❑ B Business IK BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Lq Basement levels A— /Pvc Floor Area per Floor s Total Area s Total Heieht (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 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 IK 2A 2B 2C ❑ ❑ C Educational ❑ F Factory ❑ F -I ❑ F-2 ❑ H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ M Mercantile ❑ 4 ❑ R residential ❑ R -I ❑ R-2 ❑ 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 BUH DING 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 Lq Basement levels A— /Pvc Floor Area per Floor s Total Area s Total Heieht (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 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 I, (L� lS Jia l C i l✓t (vh((}{ �t,�(L 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 7Afflp.S' Print Name a 3 aCan We of Owner/Agent Date Item Estimated Cost (Dollars) to be Completed by permit applicant 5 � fi 14 1. Building L�ZZ �l o� (a) Building Permit Fee 1 J e Multiplier 2 Electrical (b) Estimated Total Cost of L' 3 �Q, d Construction from (6) 3 Plumbing Building Permit fee (a) X (b) a 4 Mechanical (HVAC) $1,100.00 5 Fire Protection 6 Total (1+2+3+4+5) 131 00 Check Number f X. . r A �h ,li+ E 1 ':. ryJ fi t! e�3'�L �i; 1 i Xyj S �ii`�Ri'0-'u {I "i a �v E Y t�.�S: {..l a✓34(N>S {ES a'...s S.i t { '1 A�i2' .�1251y SS, `.�!}4``� NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T ABERS IST 2ND 3 SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIIVNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE _ ?'- �. �-� .J. �'Sa �2 '�-as ..}.. _ Y.F` •a fir.. n. ' ... K '.c ....?'m .iSf-� 'k �C' b �S! ,$ # -- ° FORM U - LOT RELEASE FORM INSTRUCTIONS: This farm is used to verify that all nec2-ssary 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 APPLICANT Jf, PHONE 700 LOCATION: Assessor's Map Number PAROL SUBDIVISION LOT (S) STR1=8T ST. NUMBER ***** OFrIC1AL USE ONLY` RECOMMENDA T IONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT�j'L d'f L(' RECEIVED SY BUILDING iNSPECTCR DATE Revised 5197 im t y Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover. Massachusetts 018=15 WILLIAM J. SCOTT Director (978)688-95',1 Fax(978)688-9542 In accordance with the provisions of MCL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant C/ 0 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 11 B L'G:'• %L` 0P .-2 ?!:.',-LS 683.)<4I HLILDING 63:,-95•?5 CONSE:,VATION 633-9536 HE.-ILTi: 6"03-')5-0 PL.\NN!NC 683-'1:_: JAMES H BURNS 23 SADDLE HILL RD BOXFORD,. MA 01921 Administrator `.. ,:",i* ' , - 2 ✓T1. VlQ7%7/IIidIEC�iCI L/G ✓{' iUlM91A.0 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR. . Number. CS . 045457 Birthdate: 03/08/1964 I Expires: 03/08/2001 . Tr. no: 8194 Restricted To: 00 JAMES H BURNS 23 SADDLE HILL RD BOXFORD,. MA 01921 Administrator The Commonwealth of Massachusetts Department of Industrial Accidents wice at/nYesaptluns 600 Washington S/reet Boston, Mass. 02111 'TTorkers' Compensation Insurance Afflidayit 77 %,dl{t.•LtK�:j�tL �tlti�IP:�. t�t'v« J�.'^ ::!•.0.4�;�»'/.� •4i� locaien� r r r I am a homeowner peforming all work myself. [ am a sole proorte:or and have no one working in any capacity I am an e^lp(oy(e(;�p/r�oPviding workers' compensation fort rnY eej Ploye-" working on this job. COMO.ary r,3TZ: l"'G\(����� �1 ]iJ� I�l(1 1 WitI I oc4oss 4, -Tu C 78 7,�0 ©off ininr7,sor co. U -y -"M MfV1fX nM;' - 41 �� {? �...a, `fO7 f7 I am a sole proorie:or, general contractor, or homeowner (circle one) and have hired the contractors listed be;ow who have the following Workers' compensation polices: compInv name. atidre:�: C,t'r' nhnnr "• inzar-.nee co Failure to secure coverage as requtrea under Section 25A of N1 L 15: can lead to the imposition of criminal penalna of a fine up to Si 4:00.00 lac/or one year.' imprsonmcnt as well as civil penalties in the corm of a STOP WORK ORDER and a fine of S100.00 i day against me_ I undernUod that a copy of this ita,cment may be for�nrccd to the Office of !nvesugations of the DIS, for coverage verification. ! do hereby cer±undains and penal t l oeriury that the information provided above is tree and coorrec_Signanrc Date aJ!a000 plat ra :.e �Js p`:one . ! `7JO — V () / otTfc:al use only do no( write in ;his arca to be compietcd by c:tv or town otTicial city or town: permiuliccnse » . C: if immcdiite response is reautrca comae: person: (,-,— :/15 ?!.") phone r; r Suilding Department Licensing Board [Jc!ec:mcn's Offcc Hcatth Dcpar:mcnt r:Othcr AFFIDAVIT FOR ARCHITECT AND ENGINEER THE COMMONWEALTH OF MASSACHUSETTS COMMONWEALTH OF MASSACHUSETTS SS: COUNTY OF ESSEX M0 his 13th day of January, A.D. 2000, before me, )J� 1— Linda S. Smiley, who, being duly sworn, deposes and says that she will review the preparation of drawings for new exit and C -Port demising wall on the second floor of Building 3 at North Andover Mills in North Andover, Massachusetts; and that she will review and/or provide for the proper checking of all the working drawings and shop drawings for construction; and all modifications to the existing structures will be designed for construction in accordance with applicable provisions of Chapter 1, Section 116, Massachusetts State Building Code, and that such plans conform to all the applicable provisions of the Massachusetts State Building Code, and that all the materials used in the construction will be selected by specification by her or her registered professional Designee in accordance with the Controlled Materials Procedure therein defined. Linda S. Miley M SyUaeribed and sworn to before me thiday of CU A.D. Notary Public Commonwealth of Massachusetts My Commission Expires June 9. 2006 3 Notary Public My commission expires on \\Advfs0l\Projects\Projects\Affidavits, Bldg. Insp. Letters\YALE WORK C -PORT AFFIDAVIT.DOC AFFIDAVIT FOR ARCHITECT AND ENGINEER THE COMMONWEALTH OF MASSACHUSETTS COMMONWEALTH OF MASSACHUSETTS ) SS: COUNTY OF ESSEX ) Ohis 13th day o anuary, A.D. 2000, before me, Gn-trolun Linda S. Smile h Smiley, who, being duly sworn, deposes and says that she will review the preparation of drawings for new exit and C -Port demising wall on the second floor of Building 3 at North Andover Mills in North Andover, Massachusetts; and that she will review and/or provide for the proper checking of all the working drawings and shop drawings for construction; and all modifications to the existing structures will be designed for construction in accordance with applicable provisions of Chapter 1, Section 116, Massachusetts State Building Code, and that such plans conform to all the applicable provisions of the Massachusetts State Building Code, and that all the materials used in the construction will be selected by specification by her or her registered professional Designee in accordance with the Controlled Materials Procedure therein defined. Linda S. ley Su ribed and sworn to before me this/5�� of Jan A.D.P�( . ------------ -- -- )Pq Notary Public Notary Public Commonwealth of Massachusetts My Commission Expires My commission expires on June 9, 2006 \\Advfsol\Projects\Projects\Affidavits, Bldg. Insp. Letters\YALE WORK C -PORT AFFIDAVIT.DOC Y AFFIDAVIT FOR ARCHITECT AND ENGINEER THE COMMONWEALTH OF MASSACHUSETTS COMMONWEALTH OF MASSACHUSETTS ) SS: COUNTY OF ESSEX ) O this 13th day of Lanuary, A.D. 2000, before me, ) Linda S. Smiley, who, being du y sworn, deposes and says that she will review the preparation of drawings for new exit and C -Port demising wall on the second floor of Building 3 at North Andover Mills in North Andover, Massachusetts; and that she will review and/or provide for the proper checking of all the working drawings and shop drawings for construction; and all modifications to the existing structures will be designed for construction in accordance with applicable provisions of Chapter 1, Section 116, Massachusetts State Building Code, and that such plans conform to all the applicable provisions of the Massachusetts State Building Code, and that all the materials used in the construction will be selected by specification by her or her registered professional Designee in accordance with the Controlled Materials Procedure therein defined. ('/Z� < � � -, � ��- Linda S. Smi y Subs � ed and sworn to before me thi��day of A.D. -Ij =Public Notary PuAc NotaCotnrnonweaithM commission ex fires onMy CommiY P June \\Advfs0l\Projects\Projects\Affidavits, Bldg. Insp. Letters\YALE WORK C•PORT AFFIDAVIT.DOC 7 January / YALE Mr. Robert Nicetta Building Commissioner Town of North Andover 27 Charles Street North Andover, MA 01845 Dear Mr. Nicetta, This letter will serve as my approval as the representative of Yale Properties, Property Manager for North Andover Mills, that the attached construction document as specified in this letter and marked Exhibit 3 for the erection of a new demising wall between Buildings 3 and 11, second floor, and the installation of a new emergency exit (Building No.3 rear) for our tenant — C -Port Corporation, is hereby 'approved' based on the scope of work indicated. Attached please find three sets of these documents along with the signed affidavits from the Architect and Engineers. The following construction documents have been reviewed and approved by this office: ARCHITECTURAL A201 ALTERATIONS TO BUILDING NO.3 / 11 C -PORT / NET MANAGE If you should have any questions, please do not hesitate to call either myself or my Building Engineer — Arthur Boujoukos, Yale Properties. Many thanks for your help and advice. Sincerely, David G. Cohan Property Manager North Andover Mills One High Street, North Andover, Massachusetts 01845 Tel.: (978) 682-8708 Fax: (978) 682-8713 w A x Ou u w° U) o r_w z z Q C cz w° to Etoiti w C4 O w 12 co w a O w U W rL cn id u. p U � z d C7 m w w d A C W cn v O cn ui c= O 4o : W v C7 cc r ':A Vl� m c : W 40� :co m :�. Ea UJ C co oE� Z I� � .0 = o lk. _ao �y...1 F l to i U H � m E.0 � m Z ym� cn C/) cm _r m O m Z O H d Q �3ym= o N t W cc, � r=.. 'OLm.. � � � • .. c �... •VJ = ,- W = Z LU �E Ca -O L .y O �. LU m amzc g tv COD a m� O� _ A L CM y j= -0 co — 'E CD CDm O i Q O CL CM<CO3 cv Cc J-0 O C Z CD C..) CO) c C C •= m CL— h 0 i 0 U) U) W W crW 0 N2 2 *17 5 NORTH 0 0 US Date :7:.� ...... .................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......... ........... Z/�' has permission to perform ...... ........................... ... wiring in the building of . Y'"', i ..................... /' '/ ........ ........................ at ..................... ... ....... ........ . North Andover, Mass. Feek./' ...... .... Lic. ................. ... / ...... ......................... ELECTRICAL INSPECTOR !7 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THEOOMMONWE4L2HOFM4SSACHUSL77S office Use only DEPARTMMENT OFPUBLICSAFM BOARDOFFIREPREt'ENTIONREGMTIOASS27©MIZ1 A0 Permit No. Occupancy & Fees Checked APPLICATION FOR PERMIT TO PERFORM ELEM57CAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACI USSTS ELECTRICAL COMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street 4 Owner or Tenant Owner's Address To the Inspector of Wires: Is this permit in conjunction with a building permit: Yesc] No (Check Appropriate Box) Purpose of Building a p [-�*k 16 Utility Authorization No. Existing Service �_ Amps/ Volts Overhead a Underground M No. of Meters New Service Amps / Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA groundg1:1round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices Ne,. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Locala Municipal a Other Nei. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER IL h ==Comm Laws IK-AeactimtLmbkyhwmcePbbcycrJu&ngCanpkt ComaWorits si bslantiale4ivdlat YES NO itmeabntledvdidptaifofs8reb,he0ffim YES rJ NO r7 If}(utmedv*WYES,plea9emk*thet)peofo erWbydcckigthe INSURANCE ® BOND r7 OIIF&R M (Pl mSpecify) EtmWedVakuedElecdcal Wade $ WodcbSt t 'LID hspectimDaleReVesied Ra,glt Final Signed undaTr n > RM .� LicaseNa Siwe BtsinessTdNa 076X1,9'5 —%S dd,,41�-qr S/ aa;�L Z& Ak.TdNa OWNER'SIIv'SURAI AN>✓R;IamawatethattheLiar;sedom not theinumcewymWorrtssh�legtavalatasrecgmWbyMasadxs&CasalLaws anddetnry-qgmauecnftpameppticabmv i�esthism matxrrt. (Please check one) Owner a Agent a Telephone No. PERMIT FEE $