HomeMy WebLinkAboutBuilding Permit #262-13 - 16 FAULKNER ROAD 10/3/2012 TOWN OF,NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued: �7
IMPORTANT:Applicant must complete all items on this page
LOCATION I� raul kav RoaA
Print + 0u► W5 Lud iy)
PROPERTY OWNER 1S2 d
Print 100 Year Old Structu yes n
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes3no
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building )KOne family
XAddition ❑Two or more family ❑ Industrial
❑Alteration No. of units: 0 Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
Water/Sewer
DESCRIPTION OFORK TO BE PERFORMED:
lodmtn -- new uvx -jDA tr 2 COP" y IZ b6A k'
Identification Please Type or Print Clearly)
OWNER: Name: F-J& jdm ly l Phone: 6R41
y��� `7 �
Address: 6 FaUikner' ?d
CONTRACTOR Name: Dou leis Lud in Phone: Gq
Address: 16 PAulkyier RoaA
Supervisor's Construction License: h0ft 0 WMeY' Exp. Date:
Home Improvement License: boft Owne,r Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BOLDING PERMIT:$12.00 9IR 0. 'OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $
� FEE: $
Check No.: '��� Receipt No.: 7;--
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
I `
Signature of Agent/Owner ignature of contractor
Plans Submitted ❑ , la Waived ❑ ertified Plot Plan ❑ Stamped Plans ❑
Location t (-j
No. Date �v
• - TOWN OF NORTH ANDOVER
0 ��'l 11,J)16��
•
Certificate of Occupancy $
Building/Frame Permit Fee $��
4 Foundation Permit Fee $
^` Other Permit Fee $
TOTAL
Check# 35%
L
25778 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 ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
d.
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION Reviewed on D Si nature 6
COMMENTS pa '
HEALTH Reviewed on Z Si natu /
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
DPW 'Town Engineer: signature: II
Located 384 Os ood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Departinerit 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 Motor location, mast or service drop requires approval of
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
"'j
El Notified for pickup - Date
i
Doc.Building Permit Revised 2010
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
o Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o 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)
o Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ 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
❑ 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: Doc.Building Permit Revised 2012
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
$ 97,625.00 m
$ - $ 1,171.50
Plumbing Fee $ 146.44
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 146.44
Total fees collected $ 1,564.38
16 Faulkner Road
262-13 on 10/3/12
New Foundation for 2 car garage
1/2 bath, kitchen extension, mudroom
TOWN OF NORTH ANDOVER
�= 6z`° `' ° OFFICE OF
J BUILDING DEPARTMENT
Osgood Street Building 20, Smote 2-36
"�ssA��sc�s North Andover,Massachusetts 01845
Gerald A.Brown
Inspector of Buildings Telephone(97g)688-9545
HOMEOWNER"LICENSE EXE1VIpTION Fax (978) 688-9542
BUIDING PERMIT APPLICATION
Please print
DATE: O 3 2ajZ
JOB LOCATION: dove '
Number Street Address °� M A
Map/Lot
UOMEOWNER O>; 4d c ►'1 t� (O�' 2
Name 0 Home Phone
Work Phone
PRESENT MAILING ADDRESS G �
City Ta a S fwt�
Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units-Or le r
to allow such homeov11 ers to en aye an irc' ss and
g b ividual for hire who does not possess a i cense,provided that the owner
acts as supervisor). State Building (Code Section 108.3.5.7)
DEFINITION OF HOMEOWNER
Person(s)who Qwns a parcel of land on which he/she resides or int
considered a homeowner. s to reside,on which there is,or is intended to
be,a one or two family structures. A person who constructs mor th .one home Ina two-yearperiod shall not be
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 Andover Building Department
minimum inspection procedures and requirements and that he/she will comply with,said procedures and
requirements,
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
OARD OF APPEALS 688-9541 CONSERVATION 688-9530
HEALTH 688-9540 PLANNING 688-9535
tAORTH
Town of EAndover
No. -
� Z - h
o h ver, Mass, .z.
COCN1Cnl WICII
O-VATE /'PP,`,�5
S U
BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT ................................................................... BUILDING INSPECTOR
has permission to erect buildings on �C Foundation
.......................... ................ ...........................` ..........................
to be occupied as ..... CI• ". j.. ..... .... -. ;.. .. .�.. :... .....IT.r.7`cilu ...... .F/.r.. �--
Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application .
p p p g 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
UNLESS CONSTRUCTION ST TS Rough
....................... Service
...........:........... ...... .. Final
BUILCING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building 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 Det.
SEE REVERSE SIDE
s
,- Rr Schech Sof'zwr:e Version 66.3
Compliance Certificate
1
Project Title: Ludgin Residence
Energy Code: 2009 IECC
Location: North Andover,Massachusetts
Construction Type: Single Family
Project Type: Addition/Alteration
Heating Degree Days: 6322
Climate Zone: 5
Construction Site: Owner/Agent: Designer/Contractor:
16 Faulkner Road Douglas and Elise Ludgin Douglas Ludgin
North Andover,MA 01845 16 Faulkner Road Ludginstudio LLC
North Andover,MA 01845 16 Faulkner Road
6178694782 North Andover,MA 01845
doug@ludginstudio.com 6178694782
doug@ludginstudio.com
ompliance:Passes Am
Compliance:10.6%Better Than Code Maximum UA:47 Your UA:42
The%Better or Worse Than Code index reflects how dose to compliance the house is based on code tradeoff rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
.YPArea o
i 4 w.ar'14 a r k E 3x - 7
ROL Perimeter
Ceiling 1:Flat Ceiling or Scissor Truss 204 38.0 0.0 6
Wall 1:Wood Frame,16"o.c. 290 19.0 0.0 14
Window 1:Vinyl Frame:Double Pane with Low-E 29 0.290 8
Door 1:Solid 20 0.140 3
Crawl 1:Solid Concrete or Masonry 57 0.0 13.0 4
Wall height:3.9'
Depth below grade:3.0'
Insulation depth:2.2'
Inside below-grade depth:1.4'
Floor 1:All-Wood JoisVTruss:Over Unconditioned Space 204 30.0 0.0 7
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 2009 IECC requirements in
REScheck Version 4.4.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Name-Title Signature Date
Project Title: Ludgin Residence Report date: 09/27/12
Data filename: Untitled.rck Page 1 of 4
l rhech GgRware"' rsic.nAl�
Inspection Checklist
Energy Code: 20091ECC
Location: North Andover,Massachusetts
Construction Type: Single Family
Project Type: Addition/Alteration
Heating Degree Days: 6322
Climate Zone: 5
Ceilings:
❑ Ceiling 1:Flat Ceiling or Scissor truss,R-38.0 cavity insulation
Comments:
Above-Grade Walls:
❑ Wall 1:Wood Frame,16"o.c.,R-19.0 cavity insulation
Comments:
Windows:
❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.290
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
T
Doors:
r
e ,
❑ Door 1:Solid,U-factor.0.140
Comments:
Floors:
❑ Floor 1:All-Wood JoisVTruss:Over Unconditioned Space,R-30.0 cavity insulation
Comments:
Floor insulation is installed in permanent contact with the underside of the subfloor decking.
Crawl Space Walls:
❑ Crawl 1:Solid Concrete or Masonry,3.9'ht/3.0'bg/2.2'ext.insul/1.4'inside bg depth,R-13.0 continuous insulation
I
Comments:
Exposed earth in unvented crawl space foundations is covered with a continuous vapor retarder(less than or equal to 0.1 perm).All joints
of the vapor retarder are overlapped by 6 inches and are sealed or taped with edges extending at least 6 inches up the stem wall and
securely attached.
Air Leakage:
❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are
sources of air leakage are sealed with caulk asketed weatherstri or otherwise sealed with an air barrier material suitable film or
9 �9 � PPS
solid material.
❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between
window/door jambs and framing.
❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk
between the housing and the interior wall or ceiling covering.
❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or
damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed
to maintain insulation application.
❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air.
❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts.
Air Sealing and Insulation:
Project Title: Ludgin Residence Report date: 09/27/12
Data filename: Untitled.rck Page 2 of 4
C] Building envelope air tightness and insulition installation complies by either 1)a post rough-in blower door test result of less than 7
ACH at 50 pascals OR 2)the following items have been satisfied:
(a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or
repaired.
(b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed.
(c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier.
(d)Floors:Air barrier is installed at any exposed edge of insulation.
(e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or
sprayed/blown insulation extends behind piping and wiring.
(>) Comers,headers,narrow framing cavities,and rim joists are insulated.
(9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall.
Sunrooms:
0 Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum
skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope
requirements.
Materials Identification and Installation:
Materials and equipment are installed in aocordance with the manufacturers installation instructions.
Materials and equipment are identified so that compliance can be determined.
❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided.
Insulation R-values and glazing LI-factors are clearly marked on the building plans or specifications.
Duct Insulation:
Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are
insulated to at least R-6.
Duct Construction and Testing:
Building framing cavities are not used as supply ducts.
All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means
of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or
UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically
fastened.Crimp joints for round metal duds have a contact lap of at least 11/2 inches and are fastened with a minimum of three
equally spaced sheet-metal screws.
Exceptions:
Joint and seams covered with spray polyurethane foam.
Where a partially inaccessible dud connection exists,mechanical fasteners can be equally spaced on the exposed portion of the
joint so as to prevent a hinge effect.
Continuously welded and locking-type longitudinal joints and seams on duds operating at less than 2 in.w.g.(500 Pa).
Duct tightness test has been performed and meets one of the following test criteria:
(1)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area.
(2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2.
(3)Rough4n total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area.
(4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area.
Temperature Controls:
Lj When;the primary heating system is a forced air-fumace,at least one programmable thermostat is installed to control the primary
heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle.
Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the
compressor can meet the heating load.
Heating and Cooling Equipment Sizing:
0
Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code.
For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial
Building Mechanical and/or Service Water Heating(Sections 503 and 504).
Circulating Service Hot Water Systems:
Circulating service hot water pipes are insulated to R-2.
Circulating service hot water systems include an automatic or accessible manual switch to tum off the circulating pump when the
system is not in use.
Project Title: Ludgin Residence Report date: 09/27/12
Data filename: Untitled.rck Page 3 of 4
The' Commonwealth of Massachusefts
Department of Fire Services
Office of the State.Fire Marshal.
R.0.Box.I075 StatcRoad,Stow.NLA 01775
APPLICATION FOR PERMIT
Date:
N. Andover �'ermatNo
(City or Town.) (4Applicable) Dig Safe Numj
In accordance with the provisions of NLG-L. Chapter 10 as
pravided in Sectiea 5.27 . CMR 34 application ishereby made Start Date �(/ 7
'by
Full name.of person,Finn of Corporation)
'State clearly -Address (� Fa vtky r .N 0"'111 Nrlayer MA
purpose for (Street oc P.O.Bax City ar Town)
which
ested For permission,to locate dumpster for construction/rennvati nn ldt-mnl i i-; nn
is requested -of building.
Comments: . d u m p s t e r must be .25 ` from structure or covered when not rrn li e
_LSO—Pam 1k ner— RA
(Give location by strcct and no.,or descri a in suchmanner as to provied adequate identification of locatiea)
ol
Name of competeat•operator Cert No.• .
(lfAPPlicrble) e '-�
Darectcd g O �� l �YE�
'rli C-Applicant) '
Date of expiration 6 Z Fee$ 50 .00 Paid Doc
The Co'
. onwealth of Mass.achusetts
Departmeht of Fire Services
Office of the State Fire-Marshal
P.0.Box 1025 State Road,Stow,MA 01775 ;
PERMIT Date:
Norah Andover -Permit No
(City of Town) (LE Applicable) .Dig Safe Num er
In accordance with the provisions of 1M GL 1 4 8 Chapters Q as provided in section 9 7 7 (,,rjR 34
Start Date /T '
This Permit is granted to:
Full name of person,Firm or Corporation
Permissionto locate dumpster for construction/renovation/demolition of building
oauctidumpster must be
Restrictions:
. 25 ` from structure if unable to place with required
s:clearance dumps-ter must be covered with plywood or tarp end of 'work -day
at
(Give location by street ar no.',or3'es`cnbc suchmoaner as�to�piovii�dequabcidcn ca ion o lbcatioa)
r'
.FccPaidS 50 .00 �. .:.. Fire Chief
This Permit will expire �� —�=1 Signator t rant (Tide)
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Lod
Print Legibly
Name (Business/Organization/Individual): Q V 411 oi5 L U d Q)Y\
Address: I o Folinky)-er• Foa
City/State/Zip: Wo,-4) )k4oVCeMA oiB45Phone#: aD NA— Aq(62
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.E] I am a sole proprietor or partner- listed on the attached sheet.# Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp.insurance. 9.XBuilding addition
[No workers' comp.insurance 5. ❑ We are a corporation and its
officers have exercised their10.❑Electrical repairs or additions
3)(equired.]
am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs
insurance required.]i employees. [No workers'
comp.insurance required.] 13.❑ Other
*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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
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 certify under the pains and penalties of perjury that the information provided G�above is true and correct.
Signature: Date: `_2 _
Phone#:
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#: