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Building Permit #485 - 21 CAROLINE WAY 3/17/2009
Permit NO:. Date Issued BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION /7 b IMPORTANT: Applica 4V PROPERTY OWNER Date Received —L must complete all items on this Print - MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes I 4y • O * .. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Adrittlzin Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone�� 7Z� J5j1::5�O Address: CONTRACTOR Name: Address C376 42 Supervisor's Construction License: i._� t Exp. Date:! i Z010 Home Improvement Date: /ARCHITECT/ NGINEER 11� � � Phone: -,5© Address: CCy7'==' Reg. No. 4301 FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ C151 2�q FEE: $ cz�� Check No.:Receipt No.: NOTE: Persons contracting with u t red contractors do not have access o h and If Ep a %06:M7M Location �G ro / Y fG y No. f Date 7 ,.ORTq TOWN OF NORTH ANDOVER i • OL Certificate of Occupancy $ �� ;'•�° .t�', Building/Frame Permit Fee $ G Foundation Permit Fee $ J00. " Other Permit Fee $ TOTAL $ 5 �, Check 111no 1 21 8/' 0 dl 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed o HEALTH Reviewed on Signature CON%UIENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comment Water & Sewer Connection/si nature & e 1 DriveWay Permi� VAj' DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT Temp DA pste on site yes no Located at 124 Main Street 11 Fire Department signature/date COMMENTS ,cans Submitted Plans Waived TYPE OF SEWERAGE DISPOSAL Public Sewer Well Private (septic tank, etc. Certified Plot Plan Tanning/Massage/Body Art Tobacco Sales Permanent Dumpster on Site Stamped Plans Swimming Pools Food Packaging/Sales THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 6`I COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Reviewed o -X, --/- 5: 2-- Y, _�'2 - Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer Connection/S DPW Town Engineer: Comments Comm :Located at 124 MainStreet:; g "Fj�e Department signature/date.: °CQMME°NTS �: - N Located 384 Osgood Street 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 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) ❑ 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 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 a 4 O z O U b wn u . i O a G G ° w � a O v am CD i ii � O w mV ° rc s p ° c w a ro Cl) i o J) : C' N 0 vca � E 0 o VIts "m ®:hm Of c C Coo !rpmco-3 Q �S 4.!- O F7§ �Z m C ;F O C O CZ CD i m c N O _ rc 0 � 3 O 0 6_0.1 C.3 •CZ W � �„_..m C, C 0 0 , m C CLS O �"' •bl :L V.� V CA CO) E a C' m c _ �_�a.-m o O _' A ts oo. N E C c 0 � u cm CD N 0 om 3 N :IN m : C' N 0 vca � E 0 o VIts "m ®:hm Of c C Coo !rpmco-3 Q �S 4.!- O F7§ E CLCD CAM N O a N C O co cocr c m `o cm C C N m Z 0 Z 0 cz 9 C2 CD L 0 CD 0. O h A C CD Qs i O ;0 co H � � m cc C3 w CL a� m � L cc ® d a- CM< col c o c cv Q 'a CD C CD C. y c C 0 C C cc CLH D LLI 0 U) W W C9 W U) �Z C:02 C O CZ H m em C _ `m 0 � 3 0 yw0+ W ® �„_..m ig 0 C N •� CLS O �"' •bl V V.� V CA _N C' 4D O -0 a N _ �_�a.-m IS O E CLCD CAM N O a N C O co cocr c m `o cm C C N m Z 0 Z 0 cz 9 C2 CD L 0 CD 0. O h A C CD Qs i O ;0 co H � � m cc C3 w CL a� m � L cc ® d a- CM< col c o c cv Q 'a CD C CD C. y c C 0 C C cc CLH D LLI 0 U) W W C9 W U) REScheck Software Version 4.1.4 Compliance Certificate Project Title: Edgewood Retirement Community Report Date: 08/21/08 Data filename: F:\DSA Project Files\Edgewood 0706\04. MA Energy Code Check\0706 Unit E.rck Energy Code: Massachusetts Energy Code 1684 21.0 0.0 Location: North Andover, Massachusetts 91 Construction Type: 1 or 2 Family, Detached 58 0.290 Heating Type: Other (Non -Electric Resistance) 47 Glazing Area Percentage: 21% Heating Degree Days: 6322 Construction Site: Owner/Agent: Designer/Contractor: 575 Osgood Street Dewing & Schmid North Andover, MA 01845 30 Monument Square Suite 200B Concord, MA 01742 Compliance: 0.0% Better Than Code Maximum UA: 344 Your UA: 344 Basement: Solid Concrete or Masonry Wall height: 7.5' Depth below grade: 7.5' Insulation depth: 7.5' First Floor: Wood Frame, 16" o.c. Windows: Wood Frame:Double Pane with Low -E Door: Solid Door: Glass Ceiling: Flat Ceiling or Scissor Truss 1671 0.0 10.0 94 1684 21.0 0.0 71 303 0.300 91 84 0.290 24 58 0.290 17 1577 38.0 0.0 47 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 REScheck Version 4.1.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determine using the applicable Standard Design Conditions found in the ode. The HVAC equipment selected to heat or cool the building sh no than 125% of the design load as specified in Sections 7 CMR 1310 and J4.4. 1 1 4 COO C, 1(16r M�;' Project Notes: Unit E -4 Z) (/\lebc 1fd WA Project Title: Edgewood Retirement Community Report date: 08/21/08 Data filename: F:\DSA Project Files\Edgewood 0706\04. MA Energy Code Check\0706 Unit E.rck Page 1 of 1 CORY,,E' FISNEf; 30 J©RDAN STFtE f G" BEVERLY MA 0191 Comml$srbrier E' I a O�✓U(�7�Jd�Lll6P.�6 i. � y 2 1 :✓'� V.O%%%/%%%O%%!U%GCGLLI/! BOARD OF BUILDING REGULATIONS •A License CONSTRUCTION SUPERVISOR Numbet CS 094621 z . t3'irth-d eT �1970 474 E crus. 0 X01 210 Tr. no: 94621 —k ` t Re�str e, CORY,,E' FISNEf; 30 J©RDAN STFtE f G" BEVERLY MA 0191 Comml$srbrier E' I a FM 4 Al'= RDCERTIFICATh OF LIA131LITY INSURANCC� OP IDB DATE(MMlDD/YYYY) PRODUCER WINDO-4 11 0 3 08 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IN THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McLaughlin Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 828 Lynn Fells Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Melrose MA 02176 EACH OCCURRENCE 161,000 OOO Phone: 781-665-2775 Fax:781-665-0295 INSURERS AFFORDING COVERAGE NAIC # INSURED CLAIMS MADE OCCUR INSURER A: Aspen Specialty Ins. Co. INSURER B: United specialty insurance Co. Windover Construction, Inc. INSURER C: OneBeacon Insurance Group Attn Karen Cochand Elm Street uwINSURER D: Arican Internat'l companies Manchester MA 0I944 INSURER E: HE�] rnvconr_re EACH OCCURRENCE 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 RESPECTTO 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, IN LTR =11TYPE OF INSURANCE POLICY NUMBER 1ZIjCT15FFrCTIW DATE MM/DD/YY POLICY EXPIRATION DATE (MWDDfyyl LIMITS GENERAL LIABILITY EACH OCCURRENCE 161,000 OOO A X COMMERCIAL GENERAL LIABILITY GL000574-01 01/01/0.7 01/01/09 PREMISES Eeoccurencs) $50,000 CLAIMS MADE OCCUR MED EXP (Any one person) $ EXCLUDED $ EXCESSNMBRELLALIABILITY PERSONAL BADV INJURY $ 1 000,000 GENERAL AGGREGATE $Z OOO,OOO B X OCCUR D CLAIMSMADE GEN'L AGGREGATE LIMIT APPLIES PER: EACH OCCURRENCE PRODUCTS-COMP/OPAGG S2,000 OOO POLICY X jE�T LOC 09/25/08 01/01/09 AUTOMOBILE LIABILITY ANY AUTO $ COMBINED SINGLE LIMIT (Es accident) $1,000,000 DEDUCTIBLE ALL OWNED AUTOS C X SCHEDULED AUTOS FBIE07908 04/01/08 04/01/09 BODILY INJURY $ (Per person) X HIRED AUTOS $ X X NON BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY $ (Per accident) ZUKIPT1oN OF DPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Edgewood Retirement Community Renovation and Expansion, North Andover, MA Bank of America, N.A., their subsidiaries, affiliates and parent companies; and their repective officers,directors, trustees, managers, members and employees are Additional Insured on all policies abover (except for WC & employers liability) for liability arising out of the operations .of Windover 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. ACORD 25 (2001/08)1--©ACORD CORPORATION 1988 AUTOONLY-EAACCIDENT $ HANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSNMBRELLALIABILITY B X OCCUR D CLAIMSMADE EACH OCCURRENCE $5000000 CXA4GS708 09/25/08 01/01/09 AGGREGATE $ 5000000 $ ` DEDUCTIBLE $ X RETENTION $ $ WORKERS COMPENSATION AND X TORY D EMPLOYERS'LIABILITY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE WC6967012 03 /20/08 03/20/09 E.LEACHACCIDENT $500 000 OFFICERIMEMBER EXCLUDED? If yes, desrrtbeunder E.L. DISEASE - EA EMPLOYEE $SOD,000 SPECIAL PROVISIONS below nTucn E.LDISEASE -POLICY LIMIT $500.000 ZUKIPT1oN OF DPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Edgewood Retirement Community Renovation and Expansion, North Andover, MA Bank of America, N.A., their subsidiaries, affiliates and parent companies; and their repective officers,directors, trustees, managers, members and employees are Additional Insured on all policies abover (except for WC & employers liability) for liability arising out of the operations .of Windover 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. ACORD 25 (2001/08)1--©ACORD CORPORATION 1988