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HomeMy WebLinkAboutBuilding Permit #227 - 11 OLD FARM ROAD 9/25/2006 TOWN OF NORTH ANDOVER NORTIl APPLICATION FOR PLAN EXAMINATION <I'_' 6,gtio Permit NO: 6^ 17 Date Received O Py Date Issued: rL� SSACHUs�S�y IMPORTANT: Applicant must complete all items on this page LOCATION r pyq /ed PROPERTY OWNER �Q,j) I 'I'• n 1 'It (✓`e T E� int MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family IR'Addition ❑ Two or more family ❑ Industrial N,Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OFyv ORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name:fau Pho e:�78 643 Address: 11 V yn CONTRACTOR Name E ( ) 64k+, f'14 Phone: Address: 08 I'"I{�111� � S-414 )L2A ) U- 4. 03F23 Supervisor's Construction License: d�. -72 Exp. Date: r 26 r 8 Home Improvement License(: �^ Ex/p. Date: ARCHITECT/ENGINEER b2. J �1 { Name: Phor,( : e � ) e � Addres ! Reg. No. $ � FEE SCHEDULE:BULDING PERMIT12.00 PER 1000.00 OF THE TOTAL ESTIMATED COST SED ON$125.00 PER S.F. Total Project Cost :$ �, , y J FEE:$ Yq 4)f 49d Check No.: 6po Receipt No.: Page I of 4 TYPE OF SEWERAGE DISPOSAL, Swimming Pools ❑ Public Sewer ❑��/ Tanning/Massage/Body Art E] Well Tobacco Sales ❑ Food Packaging/Sales 11❑ Permanent Dumpster on Site F1Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with egistered contractors do not have access to the guaranty fund (/ Signature of Agent/Owner � r Signature of contrac IP Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS T REJECTED DATE APPROVED CONSERVATIO J �. COMMENTS �KK DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS 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 Temp Dumpster on site yes vl/Fire Department signature/date ,� ,/ Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided- Dimension rovidedDimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq.ft.: NOTES and DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 i 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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 DEPARI'MENT:BPFORM05 pave.4 0f4 Location Xc�( No. Date NORTh TOWN OF NORTH ANDOVER f 9 Certificate of Occupancy $ 'ss�cMust` Building/Frame Permit Fee $ `- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �d 196 '1 Building Inspector R s�,� .0(\ 1 `o Pv - f �'� �l , 0L.rj �'A�R.M ;,� S 3Er'0�3dE ��I,tf� o;� 08 q��7 v tea• 10 V � 41, \ (r I 0 - 1=00 T) .F40T1G- M ' I. s r M lea. 9318 O i '1- L A kg ptl 4C 915 SF-� o lU I J W !�� �N 0 F Mqs CY Z A 5�r � DANIEL 1;1 00 QL. o a JOHNSON H No. 29642 � `gN�CSUR ao O M ' �Oosts�j sus/s 4 RAI STOW CONSULTANT`S 5 C �! L Ef ! "= 4 0 ?A iJ, IZ 1984 S HEREBY CERTIFY THAT THE BUILDING ON TRIS PROPERTY REG. LAND SURVEYORS 15 LOCATED As SHOWN ON PLAN AND COMPLIC5 WITHTHE 14 MA55ASOIT BLVD. JONIN& SET BACK REQ UIRE MENT5 OF THE TOWN OF NORTH ANDOV6'YLj= FURTHER CERTIPY THAT THE A60VE DWELL1wG- PL,�ISTOW, 1�H• 03845IS NOT LOCATED INA FLOOD PLAIN POWE• _����'_ _____ TEL. (603)'.38Z'7320 NORTfy own of No. ' L A E dover, Mass., 2.re COCMICMEWICK V °RATED PP�� •(5 i BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT..... L........ i.+*................................................................................................... BUILDING INSPECTOR Foundation has permission to erect........................................ buildings on .1,....I6.Id...SrA.... .................................. Rough • to be occupied as..,.q.t.W......ad ......04* %......Ar.....�it .... .. �....�........ Chimney provided that the person accepting this permit shall in every respect conform to the terms De 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 q2D wo' PERMIT EXPIRES IN 6 NTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU S TS Rough ............. ................................. ............. Service BUILDING TOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. DATE(MM/DDfYM ` " • TM CERTIFICATE OF LIABILITY INSURANCE 1 09/11/2006) PRODUCER (603)382-4600 FAX (603)382-2034 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insurance Solutions Corporation ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 60 Westville Rd HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Plaistow, NH 03865 INSURERS AFFORDING COVERAGE NAIC# INSURED David Devellis dba DeVellis Carpentry" INSURER A: Peerless 24198 198 Main St INSURERB: Granite State Insurance (AR) Sandown, NH 03873 INSURERc: Hartford Underwriters (AR) INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDINI 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE GENERAL LIABILITY CCP8068536 08/27/2006 08/27/2007 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,000 FA nmurAni,e) CLAIMS MADE OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICYF_j PRO JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F1 CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TBA MA WORKERS COMP 08/08/2006 08/08/2007 OR STATUY ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ LOO OOO B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER 6S6OUB5457C12 08/04/2006 08/04/2007 E.L. Each Accident $100,000. C H Workers E.L. Disease-EA EMP1 $100,000. �ompensation p E.L Disease-Pol .Limit $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Paul Aceto BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 110 Old Farm Road O KIND UPON THE INSURERjU A ENTS OR REPRESENTATIVES. North Andover, MA 01845 AU OR EDREPRES TATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) o4K°RT a-1 TOWN OF NORTH ANDOVER y., ° 4 OFFICE OF p BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 �91Y SACHU5E�4y North Andover, Massachusetts 01845 Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: t? JOB LOCATION: J 0 z �_A Pm. 1"z_4 Number Street Address Map/Lot HOMEOWNER ctid „ lad _ 2 ame Home Phone Work Phone PRESENT MAILING ADDRESS)J 0 Z O City TownMA ✓ State Zip Code The current exemption for"homeowners”was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Artdovcr Building Department minimum inspection proceduresZ- irements d that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE :APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 68N054I r_'0,NSE1mk riON hK3=9530 0535 HEAL"T H OS-0540 PLANNING 68X- 0535 DEVEWS CAL PENMY 198 Sandown, NH, 0, DE VELLIS CARPENTRY _'� PROPOSAL_ QUALITY WORKMANSHIP RESIDENTIAL•COMMERCIAL - PROPOSAL SURMi TIED TO: tvn�Er -- „ •.�.•._•••,� ��.•. WORK To BE PERFORMMEU Al VANE DATE:,OF PLANS'._. _ '� !'� '•>���P }i e,irr rebv F,roflose to furnish ei too±Pdtert tls a%(f 'f r LF S�y-=- .w.�•��.�es��.�y.� a�,� -- .rv,.. r.� i U(rl the i'dborn Comp1rtion of / «._. ......,.... { 41.,,::3___---�U/C� < __ r� !.i`•.. __ .. �/!c-�y�`.._ y �.L.L /._kms<f �_—r� �• 1':.c'J a_ d I �'_--_-._. gam-[ �. �.ri- �y1L�.��T�f✓ �{} Y^F�r J�.'L�-��. ,�I; —+! � � ^�` -_. ,_. 4Q AT_ •-+.,+�'W_..._.._.. ._. ate-- � t i ,, Ate rrlatesia3i `,� guarantee�t tra LrJ as S},r3CifiHtl, arra ''-he �Ucrvl yr rEr rr o � be Pellor*mnalrred in ar.^cr�t��r,c�, ,.with fhl- dra virlc�s anc, SF3L' 'f7C3?IC`PIS�y+SLI S�C}rllt4'E]Ct St7f' cti!LIVE. rA'prk f# ?5 l::pr}1'rJlyytr+i, Ct i!9 c: ul t.)�$pj� {p?Iry i VU(>CKf7i.31111t r$ i' an,IC�.' for tr a SUPn of: wi?►r ,a yr nerit,to be as follows } ,"I oc'i o,Ito, , ,l:"!t0 1 1 bre.n.:v�:ng n:rx'a post; 95(jFCttU!iY.:aU�`n',Iyfa9Cf ,�'r �'"'di Lrs' I wn UH Vsur,:f CU Jet/d(:Cn e!:ft<li rn •r., will der,t+n1i✓h,rpnul a,b>,Lf:I,F.Nr3H &K'1&Ny,4r.14r:.1;. A,I q�LW1^-PpL1 ccreinryo•a rrx,�aU,krc \ _ - -. acriaw.+s.-r,a?lays 6eYor:a[,;r cr,nn!.f rr r Per—__ - f V)t -This 11i propria May bt+!w,i lawn t �, s_ncst-ar� hC'1 :y t .•:,n�'i8rj •'til'n I]3 yv. ACCEPTANCE: OF PROPOSAL Thc,ath;vo prices,SPer_&f,1V0n5 an%d cvnditlons,a.;Q safiviam.,e avd ara tifi*by a{;Ceptad. Y�oJ are a{ttht)ri-F.ed YC}e`I b'-'maide as ouflrned st,nw, ' aha wc:rk as specified. preyrlants will _1r DATE.______..__ A -r25 Haat) - -_..__.....,......_._......._-_,..,_......_._.......�........»......_..._.........._.�._..,...,.�._». - - ✓!ze i�anvnw�uurcr,�� o�./f�,aaoaT,Luioetla BOARD OF BUILDING REGULATIONS ' License: CONSTRUCTION SUPERVISOR Number: CS 005743 Birthdate: 03/26/1954 Expires: 03/26/2008 Tr.no: 19521 Restricted: 00 DAVID J DEVELLIS 198 MAIN ST G �� SANDOWN, NH 03873 Commissioner 4 i # 2&2 ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS . 780 CMR Appendix J (effective 3/1/98) A licant Name: &II r�'�'^ kq4b Site Address. l d'�' . ,rA r-m IZ _ PP Applicant Address: I 1 CiryrTown: , t!i ✓w �). Q 1��J�✓ P''A . Use Group: 71`6 -f. Date of Application: Applicant Phono: ' 533-1 Applicant Signature: Compliance Path(check one): Prescriptive Package (Limited to I- or 2-family wood frame buildings heated with fossil fuels only) Package (A through KK from Table J5.2.Ib): -Heating Degree Days (HDD6,) from Table J5.2.la: (For items.d. through i., fill in all values that apply from Table 15.2.I b:) a. Gross Wall Arca 2 sq.ft f. Wall R-value R- 13 V Glazing Area' g 0 sq.ft. g. Floor R-value fit-30 r c. Glazing %(10o x b*a)_ 'J .7 % h. Basement wall R- d. Glazing U-value U- •33 i. Slab Perimeter - e. Ceiling R-value R. 3 O j. Healing AFUE 8� °o Component Performance: "Manual Trade-Off" (Limited to wood or metal framed,Vildings only) Climate Zone (froth Figure 16.2.2) Zone 12 [ Zone. 13 Zone 14 Attach Trade-OffWorksheer from Appendix J, (and HVAC Trade-Off Worksheet, if applicable) 0 MAScheck Software Attach Compliance Report and Inspection Checklist printouts. (] Systems Analysis OR (] Renewable Energy Sources Attach Mass Regisured Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Wall +Ceiling Arca %la sq.ft, b. Glazing Arca' 86 ' sq.ft. c. Glazing % (ioo x b - a) to. ADDITION with GLuIng % (c.) up to 40% may use 780 CMR Table 11.1.2.3.1 below: MA MUM U-value MINLMUM R-Values Feac4cration Ce1110Wall Floor 1 liaaameot Wall SUb Perlmetar, Ncb 0.39 RJ7 I R-13 f R-19 R-10 R.10,f ft 0 "SUNROOM"addition (grtater thin 40% glazing-to-wall and ceiling gross area) Attach"Consumer Iaformation Forth" from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved l] Dcnicd l] Daze of Approval/Dcnial: Reasons) for DeniaJ: (provide additional details as needed on back side) Glazing Arca clay be either Rough O+pcning or Unit dimctuiotu. sales odiz/v: ... UL � 221 780 CMR Appcndta J Manual Trade-Off Worksheet iPer mit;; Builder Name . Date i Builder Address CnecKeo By Site Address Zone 012 1 3 4 Submitted By Phone Date PROPOSED Ceilings Skvli�nts 'and Floors over outslde Air Requ,,e0 Insulation x NO U•Vawe ' Descnp,llon R•Value U•Value Area = UA (Table J6 2 2, x Areca t : A Ceiling 30 *035 22 1; 7.8 1 , 635 'l O J 5 1�p l (Table J6.2.2a) Floor Over Outside Air 36 3 5 HA 7.8 (Table J6.2.2a) Total Area ,L,qB h VValts. Windows and Doors Requ,,eo Insulation x NvI R•Value U•Value Area = UA u•Vawe . Aiea = �A wallsDescription ftj J3 0�� ��2 ��• 1 � O� 'i � CD 357.7 (Table J6.2.2o.c.0) Windows _ • 33 �� h 2lo.q (NFRC or Taole J1.5.3a) Doors _.. (NFRC or Table J1.5.30) Sliding Glass Doors —' 2 9 9 —• '3.3 (NFRC or Taoie Jt.5.3a) I Total Area r Floors and Foundations Insulation Insulation x Arua or Req,,ec Descnpuon Depin R•Value U•Value Penmeter = VA U vawr x Area = �A Floor Over Uncondhioned (Table . Space J6.2.2e) Basement wall (fable J6.2.20 Unheated Slab n (Table J6.2.2 ) 'n' - h Heated Stab (Taole J6.2.2 ) 'n Toni Proposod UA must be loss Total Total than or equal to rotor Rvquireo UA Proposed UA Required UA Statement of Compliance: The proposed building design represented ,n inose cocumenis ,s eonsisieni .+,in inc o'do,ng olan� 1 speufit:ations. a other Calwlatr ns suomrttod with lh• permit epplicat,on Rc�► ITECr J. SAIA — A Build r es, ner Company Name Dare DRAFT (tor training purposes)