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HomeMy WebLinkAboutBuilding Permit # 1/27/2017 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION # Date Received 6L-2 � 1 Permit NO: Date Issued: IMPORTANT:Applicant roust complete all items an this page Ira) TI®N +� Print r PROPERTY OWNER Pnnts, p DO�Year Q!d Strucfure yes no MAPNO .._.PARCEL Z(7NING D1STRIGT � H[s#pT[c Distract yds rap - Machine Shop,Village es TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building .One family addition 11Two or more family [I Industrial ❑Alteration No. of units: [I Commercial ElRepair, replacement ElAssessory Bldg Li Others: ❑ Demolition ❑ Other ❑ Sept[c - N Well Floodplain ❑11Vetlards ❑ Wa#ershed D[str[ct - DESCRIP ION OF WORK TOB PERFORMED: S ld�ntificationPlease Type or Print Clearly) Phone: OWNER: Name: Address: qj- C�/?S W� (��,�vU-�✓ /�� C4NTRAC�TOR;`Name._ �. rC. -� Add"cess:_ -- Superv[sor's Corlstriact[on Licenset� _ Exp Date — Home Im Pra�ement License Exp „Da _._ _ � . ... ._ . te: ARCHITECT/ENGINEER�..OW6COC--- V �U _ . Phone: I o Address:_0 0 ft2o c S� l 1d� -.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 COSI: $ � D 0 FEE: $T Check No.: Receipt No.-. NOTE: Persons cont acting with unregistere contractors do not have access to the guaran ,..,.:.. . . Si lature of 6-b trac .,.. nafure af.A `_�w.Owner g . � . g Plans SufJmitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped P s ❑ FLFRONT, LINE FIRE PROTECTION, LLC Proposal sS L W&V NOO A0 ,MO t iftviii 0 o%'l lj ( 7✓ l r rJ / / 'i r/rJi/%//i//�ri ,'i r r ri i '>� 1' ��fi r,✓l)/�//�/'�,�G. �Id��///r, / ///r... 1 �ri�,r./ r,i, /, i ',:,/ :..%,;,r%/a;///// , r :;;f c %' rrr , r f,; -/ % ' '�1%///�i��%l/1���/1���✓'//�1�1� �,�/�% %. z.. , l�arrr Ar o r J I /Il ' r %r✓ / �/i/err/iilrilri�����/ IAIA�IIIIXAAAAIAIAAIIAAIA i i PROTECT �� t AR l�' iii �Ii�IW�� ,�✓, ,;;,�, '/ '%r 1/ ��/�%/�i���'��:'�%���� /l��/��1/ r / j� ✓ �l//r/�� l%/J�� /ll/,It � � J v�� PJ� 1 t e i I I i i I I I RESIDENTIAL SPRINKLER SYSTEM MODIFICATION FOR SINGLE-FAMILY BUILDING AT 95 Lyons Way, North Andover, MA 01.845 FIRE PROTECTION DESIGN NARRATIVE I LA HENCE V -RQ O ' 1 PROTECT N No,3891 Designed By: At Et ' Front-Line Fire Protection,LLC INTRODUCTION AND BUILDING DESCRIPTION The purpose of this Fire Protection Design Narrative is to describe the proposed residential wet-pipe automatic sprinkler system modification in conjunction with the renovation of the 3-story building located at 95 Lyons Way, North Andover. The Building has three levels above grade. This building is constructed of combustible materials throughout and meets the criteria of Construction Type V according to 780 CMR, Sprinkler system will be installed throughout the building with an aggregate area of 8100ft2. Any concealed combustible spaces shall remain in accessible. Such spaces are not permitted to be used for storage of any kind. CODE REVIEW/HAZARD CLASSIFICATION The Massachusetts State Building Code (780 CMR) classifies this building as Type R-2 construction(Section 310.1), Section 903.2.8 (780 CMR, 8`h Edition)requires buildings of Use Group R to be provided with an automatic sprinkler system designed and installed in accordance with 780 CMR 903.3. Exception 1 (Section 903.2.8, 780 CMR) States that Buildings other than R-1 Occupancies and R-2 Dormitories,having no more than three dwelling units shall be permitted to have an automatic fire suppression system installed in accordance with 780 CMR 903.3.1.3, provided that every automatic sprinkler system shall have at least one automatic water supply source in accordance with NFPA 13D where the minimum quantity of stored water shall equal the water demand rate times 20 minutes. Section 903.3.1.3 (780 CMR) states that Where allowed, automatic sprinkler systems shall be installed throughout in accordance with NFPA 13D. Per these referenced code sections, the sprinkler system for this building has been I� designed in accordance with the requirements of NFPA 13D (2013 Edition). The system shall assume the hydraulically most demanding sprinklers in a single compartment up to 9 two (2)residential sprinklers operating at the flow and pressures specified by the manufacturer(defined in the hydraulic calculation section). 1 j. SPRINKLER SYSTEM DESCRIPTION The building has been protected by existing fire sprinklers system which ties into the domestic water supply,to accommodate the expansion of the building, new sprinklers will be installed and connected to the existing piping. All residential pendent sprinklers shall be GL 4906 sprinklers with a K-Factor of 4.9. These sprinklers require a minimum flow of 13 GPM and a minimum pressure of 7 PSI and have an associated maximum spacing limitation of 16'x16. Residential sidewall sprinkler shall be GL 4431 with a K-Factor of 4A. These sprinklers require a minimum flow of 15 GPM and a minimum pressure of 11.6 PST for 14 X 14 coverage. NOTE: Per the requirements of the Massachusetts State Fire Marshal, all sprinkler contractors installing CP VC pipingfor automatic sprinkler systems shall be certified by a CPVC representative HYDRAULIC CALCULATIONS There is no new hydraulic remote area created in the system due to the system modification, no hydraulic calculation should be required. a 3 2 r . l 1 i Comalnwealth of Massachusetts Apartment of public Sa eW License. SC?ioo48 Sprinkler Contractor cHARLIE RODGERS 4.ALDERSGATE WAY r INARTki READING NIR 111164 _ ( _ Expiration; 11/1512018 Commissioneer I i The Commonwealth of Massachusetts F Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 �a www.mass.gov1dia ,�. Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. c TO BE FILL,D WITH THE PERMITTING AUTHORITY. Applicant Information 1 �^ please Print Le ibI Name (Business/Organization/Individnal): -I� l�}�.�l �- ���C � �••e Ad&-Css: 1 fav ilctZ S 1.0. a o 9 City/State/Zip: n• OAC OU-6-; H4. Ol ey.-Phone#: 7040L Are you an employer?Checktlie appropriate box: Type of project(xaquired): 1. I am a employer with__J employees(full and/orpart-time).* 7, L]New construction 2,❑1 am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition I❑lam a homeowner doing all work myself[No workers'comp.insurance required.]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or aro sole 11.❑Electrical repairs or additions gropiietors with na employees. 12•❑Plumbing repairs or additions 5, 1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. ❑ 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance,$ []Other �iM SPlan1C.�•Cly 6.F1 We are a corporation and its afiicers have exercised tracts right of'exemption per MGL c, 14. � oyees.[No workers'comp.insurance required.] 152,§1(4),and we have no,en2pl *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit#his affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box mustatfached an additional sbeet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-coritracFors have employees,they must provide their workers'comp.policy number. I am an employer that is providing-wotkess'compensation insurance fop my employees'Beloiv is the policy and job site information. // ,y Insurance Company Name:&r t-?s . L! aAO Policy#or Self-ins,Lic.#: 0 I y ys7 ""0 Expiration Date: 15- Job Site Address: % 0/7 (SCJ c&/ _ City/State/Zip: Attach a copy of the workers' c mpensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL o. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under ill pains and allies of pet jury that the information provided above is true and correct. Signature: Date: _a ' Phone#• Official use only. Do not-write in this area,to be completed by city or town official. City or Town: Permit/License f Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.plumbing Inspector b.Other 9 Contact person: Phone#: i ® DATE(MMIDDIYYYYI AC� CERTIFICATE OF LIABILITY INSURANCE 0112612017 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 pollcy(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 CON NAMEA T Chris Gregory Gregory Insurance Agency,Ltd PHONNo (978)356-0491 we No: (978)356-5227 EMAIL chris re a insurance.com Po Box 625 AADRESS: Lg 9 rY INSURER(S)AFFORDING COVERAGE NAIC# Ipswich MA 01938 INSURERA: CITATION INSURANCE COMPANY 46274 INSURED INSURER B: Admiral FRONTLINE FIRE PROTECTION wsURERC: Liberty Mutual 1820 Turnpike Street#209 INSURER D: INSURER E: North Andover MA 01845-6483 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WV0 POLICY NUMBER fMMIDDfYYYYI (MMIDD/YYYY1, X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 F;vl DAMAGE TORE TED CLAIMS-MADE OCCUR PREMISES Ea occu r ace $ 50000 MED EXP(Any one persony $ 5000 B CA000026269-01 01/26/2017 01/26/2018 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 HPOLICY X JE� LOC PRODUCTS-COMP/OP AGG $ 2000000 X OTHER: $ AUTOMOBILE LIABILITY Ee acccldsDmL LE LIMIT $ 1000000 X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNEDX SCHEDULED BBQC41 09/25/2016 09/25/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS HIREDAU70S X NOON-OWNED PROPERTY DAMAGE $ Per accident TOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 B X EXCESS LIABCLAIMS-MADE GX000000302-01 01/2612017 01/26/2018 AGGREGATE $ 4,000,000 OED RETENTION$ $ ER WORKERS COMPENSATION STATUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1000000 C OFFICERIMEMBER FXCLUDED7 N/A 804579-01 02/15/2017 02/15/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Sprinkler System Installation:Service,Repair&Inspection d CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover AUTHORIZED REPRESENTATIVE North Andover MA ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD