HomeMy WebLinkAboutBuilding Permit #604 - 16 ICEHOUSE ROAD 3/28/2006 Of NORTH 1
OL
p TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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Permit NO: O Date Received:
•
7 Date Issued:
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IMPORTANT: Applicant must complete all items on this page
LOCATION-1 6 Q4 G Nim l`l Me
Pri
PROPERTY OWNER Atz�ww's LI- (,
Print
MAP NO.: /a yC PARCEL: ZONING DISTRICT:__LL CCS•�d$�
' TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
,KNew Building ;,One family
❑ Addition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units:
❑ Repair,replacement ❑Assessory Bldg ❑Commercial
❑Demolition
❑ Moving(relocation) ❑ Other ❑ Others:
❑Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
S FR �ar C.�e& C" FC&,AU 5V 0JCAJe-
Identification Please Type or Print Clearly)
OWNER: Name: 1%n.ffi0b1 4(_ Phone: -6 T7-24 3.5_�
GAN
ature
Address: ° t r G . J
CONTRACTOR Name:ia�� �,e� ye,l Phone:977-447-Z63r
Address: Ill a_(64 M e ld RdJ i 0 .4m"p-r 'M'A
Supervisor's Construction License: U 94' l Exp. Date:
Home Improvement License: &24 Exp. Date:
ARCHITECT/ENGINEER t z)4 ' Name: Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$10.00 PER$1 00.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost :$7VW 6LA x I ZS /om x10.00=FEE:$ )0 • _ fi N oa
t S�
Check No.: Receipt No.: ` 37 6S
Page 1 of 4
TYPE OF SEWARGE DISPOSAL
Public Sewer wn Simmi
Tanning/Massage/Body Art ❑ g
Pools El
Tobacco Sales Food Pa
Well F1 � gl' ales ❑
❑ Permanent Dumpster on Site ❑ - .
Private(septic tank,etc. grirt rtegr ation to
ec
NOTE: Persons contracting with unregistered co frac ors do not have access to the guaranty f d
Signature of Agent/Owner Signature of Contractor
Plans Submitted awns Waived ❑ Certified Plot Plan ❑ amped 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
DATE REJECTED DATE APPROVED
CONSERVATION ❑ - ❑ ,
COMMENTS
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
Temp.Dumpster on site" yes_no_ Fire Department signature/date
Building Permit Approved and Issued by: .00U."4, &.4ow,
Page 2 of 4
Building Setback ( N I A ch. 406 (>ie rM*;�
Front Yard Side Yard Rear Yard
Required Provided Required Provides Required Provided
►�1 N 1A NIS
DIMENSION
Number of Stories: �Z Total square feet of floor area,based on Exterior dimensions.
Total land area, sq. ft.: 36.2
NOTES and DATA— For department use)
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Page 3 of 4
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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 DEPARTMENT:BPFORM05
i
Page 4 of 4
Location
No. Date � Ll`�j
�oRTM TOWN OF NORTH ANDOVER
f w
9
IX
°;4 • ,
Certificate of Occupancy $ t` ';4 AD
�'�S''^°•Eta Building/Frame Permit Fee $ f 10+
CMUS
Foundation Permit Fee $ t '
r
Other Permit Fee $
TOTAL $ -
Check #
Building Inspector
V40RTM
® of _. Andover
No. 604/
= _
37`5 ., .
dower, Mass.,
COCHIC ME WICK
ADRATE D P"V -`C7
S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
THIS CERTIFIES THAT... ftet+c,�. .� :; � I 5. !!C Foundation
BUILDING INSPECTOR
........ ...................... nda
has permission to erect........................................ build' gs onC ...�. �. �01,(�',...RQ .....�Vklt'}. 7 Rough
to be occupied as..S. !'..... .....D . ..��,y.,�. ...... �...... ...IrM .�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 o
Buildings in the Town of North Andover. *fit�I k&l* y p &p1p'sv Q 33 'o1r�� PLUMBING INSPECTOR
� � 31
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION 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.
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verifythat all necessary ssary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements"
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT M li .G" . (nUi)S LLC PHONE 18`�87-Z 635
LOCATION: Assessor's Map Number PARCEL 3 f
SUBDIVISION l� f� � �oC /�n� LOT (S)
STREETG@,I�6rj$Q I�pQ6l ST_ NUMBER_
USE ONLY********
RECO NDATIONS OF TO GENTS:
r
CONtERVATION ADMINIST'RATO DATE APPROVED
DATE REJECTED
COMMENTS AA�
. 11 gh _ G`'!rr
J e I
A
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS Gh . �Q Q
FOOD IN ECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR-,HEALTH DATE APPROVED
DATE REJECTED
! COMMENTS O 1j S a W E R
PUBLIC WORKS - SEWERIWATER CONNECTION G� !✓ ZG
DRIV AY P IT
FIRE DEPARTMEN '
RECEIVED BY BUILDING INSPECTOR
----.__.DATE_._
Revised 9197 jm
Permit Number
MECcheck Compliance Deport Checked By/Date
Massachusetts Energy Code
MECcheck.Software Version 3.3 Release lb
Data filename:Untitled
TITLE: The Portsmouth at Meetinghouse Commons
CITY:North Andover
STATE: Massachusetts
HDD:6322
CONSTRUCTION TYPE: 1 or 2 Family,Detached
HEATING SYSTEM TYPE:Other(Non-Electric Resistance)
DATE:02/23/06
DATE OF PLANS:2/07/06
PROJECT INFORMATION:
Meetinghouse Commons
North Andover,MA 01845
COMPANY INFORMATION:
Meetinghouse Commons LLC
COMPLIANCE: Passes
Maximum UA=477
Your Home=447
6.3%Better Than Code
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 1628 0.0 30.0 50
Wall 1: Wood Frame, 16"o.c. 2356 0.0 13.0 186
Window 1:Vinyl Frame,Double Pane with Low-E 379 0.340 129
Door 1: Solid 35 0.340 12
Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 1628 0.0 19.0 70
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 requirements uirements in MECcheck Version 3.3 Release lb and to comply with the
q
mandatory requirements listed in the MECcheck Inspection 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 eq ' ent selected to heat or cool the building shall be no greater
than 125%of the design load as specified in Sections OCMR 1310 and J4.4. n
Builder/Designer Date
J -
MECcheck Inspection Checklist.
Massachusetts Energy Code
MECcheck Software Version 3.3 Release lb
DATE:02/23/06
TITLE:The Portsmouth at Meetinghouse Commons
Bldg. J
Dept. J
Use J
J
J Ceilings:
[ ] J
1. Ceiling 1: Flat Ceiling or Scissor Truss,R-30.0 continuous insulation
J Comments:
(
J Above-Grade Walls:
[ ] J 1. Wall ]:Wood Frame, 16"o.c.,R-13.0 continuous insulation
J
Comments:
i
J Windows:
( ] J 1. Window 1:Vinyl Frame,Double Pane with Low-E,U-factor:0.340
J For windows without labeled U-factors,describe features:
J ##Panes Frame Type Thermal Break?[ ]Yes( ]No
J Comments:
J
J Doors:
[ ] J 1. Door 1: Solid,U-factor:0.340
J Comments:
J
J Floors:
j ] J 1. Floor 1: All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 continuous insulation
J Comments:
i
J Heating and Cooling Equipment:
[ ) J 1. Furnace 1:Forced Hot Air,90 AFUE or higher
J Make and Model Number
[ ] J 2. Air Conditioner 1:Electric Central Air, 10 SEER or higher
J Make and Model Number
i Air Leakage:
[ ] J Joints,penetrations,and all other such openings in the building envelope that are sources of air
J leakage must be sealed.
[ ) J When installed in the building envelope,recessed lighting fixtures
J shall meet one of the following requirements:
J 1. Type 1C rated,manufactured with no penetrations between the inside of the recessed fixture
i and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space.
J 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944
J L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture
J shall have been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled.
J
J Vapor Retarder:
( ] J Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors.
J
J Materials Identification:
[ J J Materials and equipment must be identified so that compliance can be determined.
( ] J Manufacturer manuals for all installed heating and cooling equipment and service water heating
J equipment must be provided.
[ ) Insulation R-values,glazing U-factors,and heating equipment efficiency must.be clearly marked on
J the building plans or specifications.
Duct Insulation:
[ ) 1 Ducts shall be insulated per Table J4.4.7.1.
Duct Construction:
[ j All accessible joints,seams,and connections of supply and return ductwork located outside
j 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.
[ ] The HVAC system must provide a means for balancing air and water systems.
Temperature Controls:
[ ] 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.
Heating and Cooling Equipment Sizing:
output[
Rated ou ut capacity of the heating/cooling system is not greater than 125%of the design load as] �
specified in Sections 780CMR 1310 and J4.4.
Circulating Hot Water Systems:
[ ] Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
I
All heated swimming pools must have an on/off heater switch and require a cover unless over 20%l 1 b
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
[ ] HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the
levels in Table 2.
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Table I: 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
Ding System Types Range F 2"Runouts i"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)
`- s ✓<e t�Janvreoouuecr,� o�'�/�oaac/zuaeaa
{ ` BOARD OF BUILDING REGULATIONS
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`License: CONSTRUCTION SUPERVISOR
k" Number CS. 055417
it Birthdate 04/0511960 Expires-1.0512006 Tr.no: 21033
Restricted t�� -
THOMAS.D Z` A.O i- -
921 CARTERFIELD RD45
w
N"ANDOVER, 'MA 01845 Acting C *misver
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
w,
`IINii fir,
Boston,MA 02111
www.mass.gov/dia
I Workers' Compensation Insurance Affidavit: Builders/Contractors/Clectricians/Plumbers
Applicant-Information Please Print Legibly
Name (Business/Organization/Individual):
Address: 2 I
City/State/Zip: & Phone
J�-, ��,,r, ,,ll Df -'
��
Are you an employer?Check the appropriate box:
Type of project(required):
1.❑ 1 am a employer with 4. ❑ i am a general contractor and 1
2.'�employees(full and/or part-time).* have hired the sub-contractors 6. New construction
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.
[No workers'com insurance 5. 9. Building addition
p. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
3.F_1 I 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
insurance required.] t employees. [No workers' 12.E] Roof repairs
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.
/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 forth 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 covera rification.
i
I do hereby certify under th ains and pe alties perjury that the information provided bove is true and correct.
Signature:
Date:
Phone#: 35�
Official use only. Do not write in this area,to be completed by city or town ofcial.
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#:
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MLLTINGH005L COMMONS AT 5moLAv,- rAKM
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rtsmoutk at Meetingkouse Commons
Andover, MA 16 lcehouse Road (Unit 17)
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NOTES:
GLA, FF: 1768 sf
GLA, SF: 636 sf
Tke ror-tsmouLk aEeeEingkouse Commons,
_ - -- -- -- -_ — - - Garage: .- 484 sf
Tot. GLA+ Gar. 2888 sf ��`��' �ndove`' '4
Front Porch: 148 sf 'o" Date_ O2IQ7 _z_-----.--
Deck: 144 Sf Mcctingkouse Commons LLC, Nortk Andover, MA
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NOTES:
GLA, FF: 1768 sf
GLA, SF: 636 sf
_ ___. Tke �'or-tsmoutk at Meetingkouse Commons,
- - -Garage': 484 sf
Tot. GLA+ Gar. 2888 sf Noh� /�ncover, /�
Front Porch: 148 sf ScaEe. 1/8" = k'O" ate_ 02/07/2006
Deck: 144 sf M eetin-kouse Commons LLC, Nortk AnJover, MA
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orth Andover, MA
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WINDOW & DOOR SCHEDULE
Interior Doors, 2-8 X 6-8 unless specified 34 V2 X 82 %2
D-1 Entry Door, Twin Sidelights 681/2X 83
D-2 Entry Door 381/2X 83
D-3 Slider w/transom 72 X 96 1/4
D-4 Slider 72 X 82 /2
D-5 Entry Door, Single Sidelight 531/2X 83
A Double-hung single 341/4X 65 1/4
B Double-hung twin mull 68 X 65 1/4
C Double-hung triple mull 101 1/2 X 65 1/4
{ I ,
D Double-hung single 34 1/4 X 57 1/4
i E Double-hung twin mull 68 X 57 1/4
1 F Double-hung triple mull 101 1/2 X 571/4
I -
G Double-hung single 22 1/4 X 65 1/4
- a 34 1/4 X 53 1/4
H Double hung single
I Double-hung twin mull 68 X 53 1/4
L Double-hung w/transom 34 1/4 X 79
M Glider 60 1/4 X 42 1/4
N Double-hung twin mull w/transom 68 X 79
,
P Transom 34 1/4 X 30 1/4
Q Transom twin mull 68 X 30 1/4
S Double-hung 30 1/4 X 49 1/4
T Double-hung triple mull w/transom 101 %2 X 79
U Double-hung twin mull 68 X 49 1/4 .
Rod' N` X Round stationary 24 X 24
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