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Home My WebLink AboutBuilding Permit #430 - 120 STEVENS STREET 11/29/2006 AL. - TOWN OF NORTH ANDOVER NO R TF/ APPLICATION FOR PLAN EXAMINATION '° OL t A Permit NO: 0 Date ReceivedAreD + e^ Date Issued: s v ��.2s US5��5 IMPORTANT: Applicant must complete all items on this page I i LOCATION 6 ��e✓�v�s ��he�� // Prin 1 PROPERTY OWNER iVQG&k) �G�12S,(�t/��f/�1,��/�� t/�lTr�'G� Print MAP NO.: PARCEL: ZONING DISTRICT: Z TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑One family [�'Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: I` ❑ Repair, replacement ❑Assessory Bldg ❑ Commercial ❑ Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED G`� Z- �i4-�• sl �tr�fi� KNG� /""'� %may-- /,// ` Identification Please Type or Print Clearly) OWNER: Name: A4nr k ,kej ye f.,G 141 ('64 Phone: q,70 -6 b3-6VS Address: (Zor —_ „ • ti �c r CONTRACTOR Name: /V �S Phd�i"e: - S y(/Gfv ��Zr� v.lr• 978 ��7 •f . Address: 89 A �& y SI Supervisor's Construction License: b Z Exp. Date: Home Improvement License: Exp. Date: I I ARCHITECT/ENGINEERScA G 1NC Name: Phone: 6o o3 -37F-23 K7 Address: 3t TP-CG IVood _>-l Exe ! Reg. No. I FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Costt+:$0 9S FEE:$ 3, ��— i Check No.: Receipt No.: Page W4 I 1 � TYPE OF SEWERAGE DISPOSAL ,��y/ Tanning/Massage/Body Art E] Swimming Pools ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the g r# ry fund I Signature of Agent/Owner Signature of contra Plans Submitted El'- 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATIO � 6 U� COMMENTS C US A 'In DATE REJECTED DATE APPROVED HEALTH F.1 ` ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes" no Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Si nature& Date : a ZZ-DSO Driveway Permit N'� s` F Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension 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:DPFORM05 Created JMC.Jan.2006 t f 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 I ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit o 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) o Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o 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 i Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 Location Ido No. ' L) Date M�RTM TOWN OF NORTH ANDOVER f p { Certificate of Occupancy $ �'�s• °''<�' Building/Frame/Frame Permit Fee $ s�cHust 9 Foundation Permit Fee $ ------------- Other —Other Permit Fee $ r�- TOTAL $ `l Check # 19834 KN(z Building Inspector NORTH Town of Andover No. Y70 inn moo. over, Mass., 21 c0c.if-A.C. " 0RATED WARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.... .. . ...6 "00 BUILDING INSPECTOR has permission to erect........................................ buildings on/AV.....�.W.Orwofx......jarm............... Foundation ............. Rough to beoccupled a ...... Chimney provided that the person accepting t it conform to terms of the application on file in Final efba ....!��ti-Iii in 4--y--SresA#p^ec-1#c 0*^ -7h ...*e#4# - 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 3L220 PERMIT EXPIRES IN 6 AQ S Final ELECTRICAL INSPECTOR. UNLESS CONSPTRU 0 0 00� 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. Burner Street No. SEE REVERSE SIDE Smoke Det. CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE: 1"=40' DATE.5/16/2006 11/03/2006 51 40' Scott L. Giles R.P.L.S. 113.56' Frank. S. Giles R.P.L.S. 50 Deer Meadow Road LOT 3 'AN ER p, North Andover, Mass. 7 PL-A 35410-36 PARCEL 12 ASSESSORS MAP AD��IOry EXIST. NSErn FNS- = N N 8a PORCH Coco t 151.48' STEVENS STREET I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE ri OF THE OFFSETS J� OF THE BUILDING INSPECTOR ONLY / SC SHOWN COMPLY AND SUCH USE IS FOR THE y CJ v WITH THE ZONING DETERMINATION OF ZONING y t z BYLAWS CONFORMITY OR NON-CONFORMITY �gTEpEO NORTHANDOVER 1�� WHEN BUILT WHEN CONSTRUCTED. L .over 89 North Main Street A�, Kenneth M. LaRose Andover,MA 01810 7-/ ' President Aui cfiingyour home 3s if t were"anr dame Tel: 978-470-4753 Fax: 978-470-0258 www.andoverequitybuilders.com 11/21/06 Helfrich/Marchesault Garage/Interior renovations Proposal Andover Equity Builders Inc. proposes to build a two car garage .Interior alterations will include some kitchen cabinet modifications, new window replacements and roofing. Andover Equity Builders Inc. proposes to build a stuiroonn according to plans by Alfred J.Dibiaso ,Architect and structural by SCADD inc. dated 11/06/06. This proposal estimated total is $268,954.00 . The estimated total. This total may increase or decrease based on the decisions that you as the owner make.The Management fee is based on the cost plus 18%. If this proposal is accepted please sign one copy and return it to Andover Equity Builders Inc. at the abovp address. SignedJ2 6�11Date 22/2006 Signed Date /x/2006 Permit Number REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code REScheckSoftware Version 3.5 Release le Data filename: C:\Program Files\Check\REScheck\Helfrich.rck CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 11/24/06 DATE OF PLANS: 11-6-2006 PROJECT DESCRIPTION: Helfrich Residence 120 Stevens Street North Andover,MA 01845 DESIGNER/CONTRACTOR: Andover Equity Builders 89 North Main Street Andover,MA 01810 COMPLIANCE:Passes Maximum UA=292 Your Home UA=287 1.7%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Cathedral Ceiling(no attic) 1299 30.0 0.0 44 Wall 1: Wood Frame, 16" o.c. 1325 19.0 0.0 58 Window 1: Metal Frame with Thermal Break:Double Pane with Low-E 300 0.350 105 Door l: Glass 42 0.350 15 Door 2: Glass 21 0.550 12 Floor 1: All-Wood Joist/Truss:Over Unconditioned Space 1125 19.0 0.0 53 Furnace 1: Forced Hot Air, 90 AFUE Air Conditioner 1:Electric Central Air, 10 SEER COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheckVersion 3.5 Release le (formerly MECchecl and to comply with the mandatory requirements listed in the REScheckInspection Checklist. The heating load for this building,and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date REScheck Inspection Checklist Massachusetts Energy Code RES checkSoftware Version 3.5 Release le DATE: 11/24/06 Bldg. Dept. Use i Ceilings: [ ] I 1. Ceiling 1: Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: I Above-Grade Walls: [ ] I 1. Wall 1: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: I Windows: [ ] I 1. Window 1:Metal Frame with Thermal Break:Double Pane with Low-E,U-factor: 0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ] Yes [ ] No Comments: Doors: [ ] I 1. Door 1: Glass,U-factor: 0.350 Comments: [ ] I 2. Door 2: Glass,U-factor: 0.550 Comments: I I Floors: [ ] I 1. Floor 1: All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: I Heating and Cooling Equipment: [ ] I 1. Furnace 1: Forced Hot Air, 90 AFUE or higher Make and Model Number [ ] I 2. Air Conditioner 1: Electric Central Air, 10 SEER or higher Make and Model Number I Air Leakage: [ ] I Joints,penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated;in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls, and floors. I Materials Identification: [ ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] I Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] I Ducts shall be insulated per Table J4.4.7.1. I Duct Construction: [ ] I All accessible joints, seams,and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. ( Temperature Controls: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I Heating and Cooling Equipment Sizing: [ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as I specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] I Insulate circulating hot water pipes to the levels in;Table 1. I Swimming Pools: L ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) p� T1. TDdI)YIYf.0I2U/�Q�GiL d�✓I�CfWdlGGl2�d( 6 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration!-'126392 Expiration::-5/25/2008 Type Pnry'j�te Corporation ANDOVER EQUITYI+0UILDEFtS KEN LAROSE t- 53 PORTER RD ANDOVER, MA 01810 Deputy Administrator + ✓die T�ail�rizoozurea.�6 ✓�aaaa.�fivae�.6 BOARD OF BUILDINREGULATIONS 1 License: CONSTRUCTION SUPERVISOR Number:`; 012411 , Birthdate:.06/16/1958 Elpires06/1612`0!Q'8 Tr.no: 380.0 KENNETH M LARQSEt' 53 TERRD PORTER ' , ANDOVER, MA 0181:0; 4 ;y, C Commissioner The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lep-ibly Name(Business/Organization/individual): A V(,Dela/ r �V�IdGw S vhf Address: o City/State/Zip: 14 oyoev lk4 0/(_5)/0 Phone#: q7b— '�1,20-y753 Are you an employer?Check the appropriate box: Type of project(required): 1.al am a employer with �7 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 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 working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.E]Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t 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 their workers'comp.policy information. I I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: rn j Policy#or Self-ins. Lic. #: t.V C Sob 3 �f�/ UI�- dv S� Expiration Date:_ 7 �? Job Site Address: Zo 54e y, City/State/Zip: Arct'�v�s. �(/J 0/8/ -D 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 cert' nde the pains and p ties of perjury that the information provided above is true and correct. Si nature: VDate: Phone#: O — 3 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. :a Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax #617-727-7749 www.mass.gov/dia