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HomeMy WebLinkAboutBuilding Permit # 10/19/2016 BUILDING PERMIT ? TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION - Permit NO: d i R Date Received / nreo at*C�3 Date Issued: C IMPORTANT: Applicant must complete all items on this page /% f/ i.' v "7 TYPE ✓iii ,,,,�/ r, / r„ ,/r.,, ..,.., f^`""'"�Y'^�^^".... // ,:✓./ :% // +�++ ,. / /i/„/„< / �!r ria/�... i,,,/ TYPE OF IMPROVEMENT PROPOSED USE T Residential Non- Residential 1 New Building Cl One family Addition [] Two or more family ❑ Industrial Alteration No. of units: El Commercial Repair, replacement I 1 Assessory Bldg 1 Others: Demolition n Other ,/,�I��, , Is -h� � � 1 �, '�y e' /r7J Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: ------------- <� ,i / / ✓i ///irr/ %// ,, /ilii r/ / ,,.,,r, ,� ,,/// � r„' ✓, /, r /// //.., / / � „ ` /. �((,�'�,7(( � ./ ,,,,,,,. � 7( r pp /�, ,r. ri.,�.,g�it/// ,.:/ /ii.D / „«,/ i„,✓a /i r'r// // %;�'. 1 �, `Wr °', � /,N✓r3�, ! r '/�, / / / //„ ,,,;,i� ,�„,��, //;r „ WK,; ,;,,r�% /////. i„r/,.✓ //f///r//' r /,,,/�i/ r//i 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: $ , o FEE: $ Check No.: it Receipt No.: G?' NOTE: Persons contracting with unregistered contractors elo not have access to a gac rantyyfund ,Signature of Agent/Owner Signature of contractor .. ¢ t40RTfj .9 own of 0 � ver, Mass, to IV * do 5 U BOARD OF HEALTH Food/Kitchen PERMIT . T LD Septic System THIS CERTIFIES THAT U.Var!r P AY.0 1, f?(F#*.....�.o� w. .M` BUILDING INSPECTOR has permission to erect .......................... buildings on ......�.y0.... i4...''.1.� AMM.A.0 Foundation Rough to be occupied as ..........�........�.10...........PrAk.1c" .........., ...................... Chimneyprovided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 LESS C TRUCTI TARTS Rough .......,. .. .. .. . .... .. BUILDING INSPECTOR Final GAS INSPECTOR Occupaney .Permit Required t® Occupy 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. Smoke Bet. GC160 Hampton Cast Iron Pellet Insert 26 7/a 24 3/n 16 3/n I WL 43'/6 01 0 3336 41 I/S 3�4 a 2206 0 �d 12 3/n GF160 Wood Pelfet Insert INSTALLED AS A FIREPLACE INSERT STOVE MODEL (FPI) 1 A INSTALLS COMME UN MODELS SUR PIED DE POELE. Minimum clearances to combustible materials./ Les degagements minimums aux materiels combustibles: A Sidewall to center of unit (De la paroi au centre de ('unite) 24" 610 mm B Sidewall to surround panel (De la paroi a 1'entoure le panneau) 2" (51 mm) C Bottom of unit to an unshielded 12" (305 mm) mantle (Le fond de i'unite a un manteau de cheminee non blinds) 33" (838 mm) D Unit to top facing (protruding W [19 mm]) (De ('unite au sommet du parement) 0" (0 mm) E Unit to side facing (protruding 3/4' [19 mm]) (De 1'unit6 au cote du parement) 0" (0 mm) F From door opening of unit to edge of floor protection (De la porte ouvrant au devant de protection de plancher) 6" (152 mm) G From side of unit to edge of floor protection (De I'ouverture de Porte pour prendre parti de protection de plancher) 6" (152 mm) These dimensions are minimum C clearances. It is recommended that you :::tD ensure sufficient room for servicing, routine cleani _and_maintenaULg V The unit must be installed with a minimum of 6"(152 mm) of floor protection in front Q of and to the sides of the door opening. G F r i GFI60 Wood Pellet Insert VENT TERMINATION REQUIREMENTS: IT IS RECOMMENDED THAT YOUR PELLET STOVE BE INSTALLED BY AN AUTHORIZED DEALER/INSTALLER. Letter Minimum Clearance Description A 24 in (61 cm) Above grass,top of plants,wood, or any other combustible materials. B 48 in (122 cm) Beside/below any door or window that may be opened. (18"(46 cm) if outside fresh air installed.) C 12 in (30 cm) Above any door or window that may be opened. (9"(23 cm) if outside fresh air installed.) D 24 in (61 cm) To any adjacent building, fences and protruding parts of the structure. E 24 in (61 cm) Below any eave or roof overhang F 12 in (30 cm) To outside corner. G 12 in(30 cm) To inside corner, combustible wall (vertical and horizontal terminations). H 3 ft(91 cm)within a height To each side of center line extended above natural gas or propane meter/ of 15 ft(4.5 m) above the regulator assembly or mechanical vent. meter/regulator assembly I 3 ft(91 cm) From any forced air intake of other appliance 7 12 in (30 cm) Clearance to non-mechanical air supply inlet to building, or the combustion air inlet to any appliance. K 24 in (61 cm) Clearance above roof line for vertical terminations. L 7 ft(2.13 m) Clearance above paved sidewalk or paved driveway located on public property. K B Opens _ jRestricd�on C G D tu T opens• ®Termination Cap H Gas Meter ®Air Supply Inlet a 1 MINI a :r ,� a, M GP160 Wood Pellet Insert OUTSIDE FRESH AIR CONNECTION RECOMMENDED-THROUGH WALL WITH VERTICAL RISE AND HORIZONTAL TERMINATION Outside fresh air is mandatory when installing this unit in airtight INSTALLATION homes and mobile homes. NOTE - This venting configuration is only for use with the A Fresh-air intake is strongly recommended for all installations. Built-In Installation. Failure to install intake air may result in improper combustion as well as the unit smoking during power failures. When connecting to an outside fresh air source,do not use plastic or combustible pipe,A 2"minimum (51 mm) ID (inside diameter)steel, Termination cap, aluminum or copper pipe should be used. It is recommended, when you are installing a fresh air system, to keep the number of bends in the pipe to a minimum. 90°elbow Wall framing Outside I wall Vertical section of vent pipe ...................... r - Wail strap 2`0 Optional Elbow _ Horizontal frame for ���; ti i thJmble i MASONRY FIREPLACE '' out tee INSERT INSTALLATION Wall thimble Rain Cap Fresh-air intake Steel Plate or Flashing r Damper Removed or Fastened Open Martel(8"deep) r Min.8"from of stove Claan-cut teo F Min.B" If holes already exist fresh-air Intake can r s Floor be taken through the s - protection back of the fireplace or through the ash Masonry Fireplace Combust6bte Floor r dump. O'EmEmn I GF160 Wood Pellet Insert OUTSIDE VERTICAL INSTALLATIONS INSIDE VERTICAL INSTALLATIONS Rain cap—� Rain cap---+I I ift T— 1 c 24" (B9 cm) Flashing (69 cm) Flashing 3"(7.5 cm) cm) Clearance Clearance _—_ Support bracket Support �j Tee with bracket cleanout 4—/ ii Type"L„ vent f� j 1 Tee or 90* ----------- ---- // elbow a Type "L" vent t � j Ems, COLON-1 OP ID.TL 'CERTIFICATE OF LIABILITY INSURANCE DATE(MM1D01YYyyl 1010412016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT= If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Wilmington Insurance Agency NAME; Wilmington Insurance Agency Five Middiesex Avenue Unit 14 PAarcNri £x!l 978-658-3805 i Fac,r 7SST-5724 P.O.Box 1010 Wilmington,MA 01687-0880 ADDRESS; _ John F.Doherty INSURERS AFFORDING COVERAGE _ NA10 N _ INSURER A;Ace American Insurance Co INSURED Colonial Fireplace LLC INSURER B:Arbella Protection 41360 474 Wilmington, ton,Mt INSURERC-Ohio Securi Insurance 24082 Wilmington,MA 01887 �-.• _ INSURER D: INSURER E=•__ ~� INSURER F: COVERAGES CERTIFICATE NUMBER- REVISION NUMBER: THIS IS TO CERTIFY THAT 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES-LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN RI X66L SUER LTR TYPEOFINSURANCE FNSD WVDi POLICYNUMB£R POLICY EFF POLICYEXP 1lf1V11170lYYYY MtyTlOD1YY LIMITS C l X coMmERCIAL GENERAL LIABILITY IEACH OCCURRENCE $ 1,000,00 CLAIMS MADE [?�] OCCUR BKS56005897 0311412016, 0311412017 PRDA-MAG C$EP CNTEIence} S 141rOD MED EXP(Any a^.a Person) $ 1,000 , —•- PERSONAL&AOV INJURY $ 1,eDQ,00 GEM%AGGREGATE LCMIT APPLIES PER: GENERAL AGGREGATE 2,OD0,04 X POLICY D PRO- ❑LOC PRODUCTS-COMPlOPAGG .$� 2,000,00 dECT OTHER: S AUTOMOBILE LIABILITY I COMBINED SINGLE L€MIT $ 1,000,040 B �.................._._ ANY AUTO 1020028151 04/01/2016 4410112017 BODILY INJURY(Per I— ALL OWNED X{{SCHt=OULED _ AUTOS AUTOS I BODILY INJURY(Per accidera) $ X t11REDAUTOs AWT OS PROPERTYDAAIACE •S _ Per accide rt 3 I UMBRELLA lIA6 OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE S DED RENTI TEONS I - S WORKERS COMPENSATIONl AND EMPLOYERS'LIABILITY Y i N X STATUTE X ER- A ANY PROPRIETORIPARTNEWEX€_CUTIVE 6S62UB2E12396214 04/01/2016 04/01/2017 E,L.EACH 5 1 GFF€CERtMEMRER EXCL"JDEO? ;� N 1 A _ ,000,00 IMandatory in NH) If yes,dascriha under E.L.DISEASE.EA EMPLOYEE!S 11000,00 DESCRIPTION OF OPERATIONS below 1 E.L.DISEASE-POLICY LIMIT $ 1,000,170 DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES (ACORD 101,AddiSlonal Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN-28 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE. DELIVERED IN TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street Suite 2035 North Andover, MA 01845 AUT14ORLZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION, All rights reserved_ ACORD 25(2014101) The ACO RD name and logo are registered marks of ACORO I 'd VU-9 L99 9L6 oul AOu86V Sud U0J6U!Wl!M d 6V:70 9 L 170 ,F Massachusetts Department of Public Safety -/0-11C-irrclrI'm!!J '. Board of Building Regulations and Standards Office o€Consumer Al(alrs8c)ausiaessRegutatiao License: C5-105920 OMEIMPROVEMENT CONTRACTOR Construction Supervisor iB 1414 Type: 'Vegistration: xpiration 4111201.7 Corporation SCOTT M HAYf±S COLONIAL FIREPLACE 6 CANTERBURY AVE �s HAVERHIL.L MA 01830 SCOTT HAYES 474 MAIN ST WILMINGTON,MA 01887 Undersecretary Expiration. Commissioner 08119/2018