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HomeMy WebLinkAboutBuilding Permit #281 - 17 CAROLINE WAY 10/8/2009 r10RTH BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: l Date Received 9q �gSSACHUS���� Date Issued: e"4--to IMPORTANT: Applicant must complete all items on this page LOCATION OC {T:> Print + { PROPERTY OWNER . i)," k� c � C'tl'� Print MAP NO: PARCEL: ZONING DISTRICT: :Z Historic District yes h Machine Shap Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Buildinqt One family_ Addition Two or-R4efe-family Industrial Alteration No. of units: '"— Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/ ewer DESCRIPTION OF WORK TO BE PREFORMED: -T LLQ Identification Please Type or Print Clearly) OWNER: Name: `2 11-k'�� Phone: 4�7& '7Ya 41n Address: 1E:;-,7r=> CONTRACTOR Name:W 14ve�a— 4,6 Phone: 037 5 C)4 7 Address; �.- 1'✓1 _ A SupervisdrsConstruction License: 09414I Exp. Date: -7//AD1 C- P A . Exp. Date: y Home Improvement License: /A=RCHITECTENGINEER iTNLI i . Phone: - 'T f' 5 �G i Address: JCS I-tCSi�Ut`'iE J–[ Q c:04c:CJeO MA 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: $ / `G y i e a FEE: $ '� 7j 7JP2 ,38 Check No.:/ 9//(v Receipt No.: S NOTE: Persons contracting with un a 'ste contractors do not have access to the guaranty fund signature ofAgen Owner W ignature of contractor y Location 119";-4019d No. Date 0 " �aRTM TOWN OF NORTH ANDOVER 3: i • O 10. 9 t i y Certificate of Occupancy $ °� —<..... •'ate+ SACMUS t� Building/Frame Permit Fee $ 1 �Z ,�v O Foundation Permit Fee $ f� Other Permit Fee $ TOTAL f Check # a 2.2 5 7 s Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS A// � cjal P j1/1�� ujlre 5 CONSERVATION Reviewed on C/ Signature WTt V/1 COMMENT ' S ` HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submittedY es e t Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con nection/si nat a IIVAIJ611- Drivewa Permit AIA�c DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Du pster site yes no Located at 124 Main Street ;Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location mast or service drop requires approval. P q of PP Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use I D Notified for pickup - Date Doc.Building Permit Revised 2008 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 ❑ Engineering Affidavits for Engineered products 9 9 9 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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:Building Permit Application Revised 2.2008 NORTH own of over -,o _ o dover, MLAKE ass., )/d2/ COCMICMEWICK OOATED �7 E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System �6 yel�et � 4W�vAo!pt. BUILDING INSPECTOR THIS CERTIFIES THAT.......... .......... . .&........... ...... . �� ....... Foundation has permission to erect........................................ buildings on ./S-7../...7..a.egk N� ��.. ........ Rough ................. to be occupied as O M S f/�U .R a v E/b�4. ... r!! Chimney provided that the person accepting this permit shall in every respect conform to the terms of the 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S ARTS 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. Registered Architectural and Engineering Services Construction Control Affidavit Project Number; DSA Project #0706.04 Project Title: Edgewood Retirement Community Cottages Project Location: #15 & #17 Caroline Way,North Andover,MA 01845 Scope of Project: 24 Individual Cottages In accordance with Section 116.0 of the Massachusetts State Building Code I,Allen Dewing Jr., MA Registration #4301 being a registered professional engineer/architect, hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project XX Architectural Structural Mechanical Fire Protection Electrical Other (Specify) For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code. All acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals,which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required materials. 3. Be resent at intervals appropriate to the sta e of construction to become generally familiar with the pg g Y progress and quality of the work and to determine,in general,if the work is being performed in a manner consistent with the construction documents. Upon completion of the Work, I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. A zli�v� Allen D C� VEW) c� C13 ¢ No.4301 Co' 771()F tds 'P F:\DSA Project Files\Edgewood 0706\05. Project Word Documents\a. Correspondence and Transmittals\vi. Misc Registered Architectural and Engineering Services Construction Control Affidavit Project Number_ DSA Project#0706.04 / FBRA # 2007153 Project Title: Edgewood Retirement Community Cottages Project Location: #15 & #17 Caroline Way,North Andover,MA 01845 Scope of Project: 24 Individual Cottages In accordance with Section 116.0 of the Massachusetts State Building Code I, Geoffrey S. Conway,MA P.E. Registration #32753 being a registered professional engineer,hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural X Structural Mechanical Fire Protection Electrical Other (Specify) For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code. All acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples,and other submittals,which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine,in general,if the work is being performed in a manner consistent with the construction documents. Upon completion of the Work, I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. OF p/gssq oma' GEOFFREY in- Geoffre nw y,P.E. �0 S. CONWAYm �� O� STRUCTURAL � No.32753 h O GISTE�����R FSS/ONAI.�N6 F:\DSA Project Files\Edgewood 0706\05. Project Word Documents\a. Correspondence and Transmittals\vi. Misc REScheck Software Version 4.3.0 Compliance Certificate Project Title: Edgewood Retirement Community Energy Code: 2007 IECC Location: North Andover, Massachusetts Construction Type: Single Family Building Orientation: Bldg.orientation unspecified Conditioned Floor Area: 7137 f:2 Glazing Area Percentage: 9% Heating Degree Days: 6322 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 575 Osgood Street MA Dewing and Schmid Architects, Inc. North Andover,MA 01845 30 Monument Square,Suite 200B Concord,MA 01742 Compliance: Maximum UA:1130 Your UA:1002 Gross Assembly 'or D.. Perimeter U-Factor Floor 1:Slab-On-Grade:Unheated 245 10.0 168 Insulation depth:6.0' Wall 1:Wood Frame, 16"o.c. 6924 21.0 0.0 328 Orientation:Unspecified Window-Awning:Wood Frame:Double Pane with Low-E 404 0.310 125 SHGC:0.33 Orientation:Unspecified Window-Double Hung:Wood Frame:Double Pane with Low-E 235 0.300 71 SHGC:0.29 Orientation:Unspecified Door 1:Solid 525 0.290 152 Orientation:Unspecified Ceiling 1:Flat Ceiling or Scissor Truss 6307 38.0 6.0 158 Furnace 1:Forced Hot Air 95 AFUE Air Conditioner 1:Electric Central Air 13 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 de ' he 2007 IECC requirements in REScheck Version 4.3.0 and to comply with the mandatory requirements listed' t check Ins ction Checcklliist. Name-Title Si y Date Project Notes: #15&#17 Caroline Way,Unit Type"F""The Milk Barn" Project Title: Edgewood Retirement Community Report date: 08/28/09 Data filename:F:\DSA Project Files\Edgewood 0706\04.MA Energy Code Check\0706#15&#17 Carilone Way Unit F Milk REScheck Software Version 4.3.0 Compliance Certificate Project Title: Edgewood Retirement Community Energy Code: 2007 IECC Location: North Andover, Massachusetts Construction Type: Single Family Building Orientation: Bldg.orientation unspecified Conditioned Floor Area: 7137 ft2 Glazing Area Percentage: 9% Heating Degree Days: 6322 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 575 Osgood Street MA Dewing and Schmid Architects, Inc. North Andover,MA 01845 30 Monument Square,Suite 200B Concord,MA 0174.2 Compliance: Maximum UA:1130 Your UA:1002 Gross Cavity Cont. Glazing UA Area or R-Value R-Value Assembly or D.. Perimeter U-Factor Floor 1:Slab-On-Grade:Unheated 245 10.0 168 Insulation depth:6.0' Wall 1:Wood Frame, 16"o.c. 6924 21.0 0.0 328 Orientation:Unspecified Window-Awning:Wood Frame:Double Pane with Low-E 404 0.310 125 SHGC:0.33 Orientation:Unspecified Window-Double Hung:Wood Frame:Double Pane with Low-E 235 0.300 71 SHGC:0.29 Orientation:Unspecified Door 1:Solid 525 0.290 152 Orientation:Unspecified Ceiling 1:Flat Ceiling or Scissor Truss 6307 38.0 6.0 158 Furnace 1:Forced Hot Air 95 AFUE Air Conditioner 1:Electric Central Air 13 SEER Compliance Statement: The proposed building design described here is consistent with tV building plans,specifications,and other calculations submitted with the permit application.The proposed building has been d ed e t the 2007 1ECC requirements in REScheck Version 4.3.0 and to comply with the mandatory requirements liste int E heck spection Chocklist. Name-Title Si u Date Project Notes: #15&#17 Caroline Way,Unit Type"F""The Milk Barn" Project Title: Edgewood Retirement Community Report date: 08/28/09 Data filename:F:\DSA Project Files\Edgewood 0706\04.MA Energy Code Check\0706#15&#17 Carilone Way Unit F Milk I ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID $ DATE(MMIDDIYYYY) WINDO-4 S1 03/18/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE McLaughlin Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 828 Lynn Fells Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Melrose MA 02176 Phone: 781-665-2775 Fax:781-665-0295 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A United Specialty Insurance Co. INSURERB: Ohio CasualtyGroup M . Justin in Belliveau carJConstruction, Inc. INSURER C: American Internat'l companies Mr. 13 Elm Street INSURER D: Manchester MA 01944 INSURER E: � COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1NbLTR NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD/YY DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAUL A X COMMERCIAL GENERAL LIABILITY CR0946109 01/01/09 01/01/10 PREMISES Eaoccurence $50r000 CLAIMS MADE X❑OCCUR MED EXP(Any one person) $EXCLUDED PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEITL AGGREGATE LIMIT APPLIES PEP, -PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 000 000 ANY AUTO (Ea accident) � � ALL OWNED AUTOS BODILY INJURY $ $ SCHEDULED AUTOS ELA00953558225 11/01/08 11/01/09 (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT I$ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $5000000 A X I OCCUR CLAIMSMADE CXA4GS709 01/01/09 01/01/10 AGGREGATE $5000000 $ 10 DEDUCTIBLE $ RETENTION $10000 $ ATI WORKERS COMPENSATION AND X TORY LIMITS ER EMP LOYERS'LIABILITY C ANY PROPRIETOR/PARTNER/EXECUTIVE WC6967012 03/20/08 03/20/09 E.L.EACH ACCIDENT $500,000 C OFFICER/MEMBEREXCLUDED? WC009399316 03/20/09 03/20/10 E.L.DISEASE-EA EMPLOYEE $500,000 N es,describe under SPEC IAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: Edgewood Retirement Community Renovation and Expansion, North Andover, MA Edgewood Retirement Community, Inc. and Trident Building,LLC; Bank of America, N.A. their subsidiaries, affiliates and parent companies; and their respective officers, directors, trustees, managers, members,building committee members and employees are additional insureds on all policies CERTIFICATE HOLDER CANCELLATION EDGEW-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Edgewood Retirement Community NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Inc 575 Osgood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR N. Andover MA 01845 REPRESENTATIVES, -J-�[�//A ACORD 25 2001108 d + above (except for Workers Compensation and Employers Liability Coverage) for liability arising out of the operations of Windover Construction, Inc. and its subcontractors are listed for liability arising out of the operations of the Construction Manager and its Subcontractors on this project. i STT,° ✓1 BOARD OF BUILDING REGULATIONS LAcen'se CONSTRUCTION SUPERVISOR Numbe/(ftil s 094621 Birf _a e- 970 r s fess"0 ''} 0 Tr.no: 94621 I 12 x'nc�e � l;r I CORY E F1Sf�ER ' 30 JORDAN STRE'E�� "e:1 BEVERLY,. MA 0t915 C Commissioner - ..-.... -- ----._........................._.-._...._._...... _:_-......__... . .