HomeMy WebLinkAboutBuilding Permit #605-12 - 24 DARTMOUTH STREET 2/21/2012BUILDING PERMIT OF NORT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION '
Permit NO:
Date Received A
DRArED N�
Date Issued: 2 �/ �2 AC US
IMPORTANT: Applicant must complete all items on this page
LOCATION
"Pnnta, -
PROPERTYrOWNER ;�(y/
lw.•/ 1 + 4 i, k i,.Y+,.S A k .� ft
�MAPff210 PARCEL ,.3 ZONING -DISTRICT`" Histone D�stnct: `
1, 7ayes tno
TYPE OF IMPROVEMENT PROPOSED USE
• Residential Non- Residential
Ne ing One famil
Additio Two or more fami ^ Industrial
A teration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Se ti� c Well L Floodplain Wetlands WatershedDrstrict
Y
'f4 ate r/Newer _ _ _ - .1 t. _ - 5. - - •}k i 4`` {.
DESCRIPTION OFWORK TO BE PREFORMED: _
Q
—tam I I � I�e�rn �ff
Identification Please Type or Print Clearly)
OWNER: Name:_ ::5c- z�—' -o Phone:
Address:
r
CQONTRACT,OR ,Name ��� -'
Ph one
aaAd.drkess:_77-
-•..c -'
t.
ri
5.
{ d
SuvpEr,�isors ConstuctionLicense
-
-x
Dater
Ho.merinprovement'License -
s
-Exp_;
ARCH ITECT/ENGINEER_LC�Aj�fi
=��'� � Phone: 7
Address:%%I► �c� ��PS(' j( S� NO,
0,AV Reg. No.
FEE SCHEDULE; BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total project
Cost: $
FEE:
Check No.: \� �//C�
Receipt
No.: _2
NOTE: Persons contracting with
AuF istered contractors do not have access to the guaranty fund
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO:
Issued: 2 �'/��
IMPORTANT: Applic,
L, Q
PROI
A OWN -REMAP ''
RCELQ
-i.4L
Date Received
IAORTIi
O ,.[Lao
0
.ire o IX
SSAC US
t must complete all items on this page
nnt
IN^�DISTRICT'.
yes lno
at. gb
o,
YP- no.
TYPE OF IMPROVEMENT I PROPOSED USE
N!'ew
�ing
ditio_
�u'L'u
e r �at io n
Repair, replacement
Demolition
Residential
One family
T—vm''— rmore refa TJ�
No. of units:
Assessory Bldg
Other
Non- Residential
Industrial
Commercial
Others:
Se t 0 JJA
t -0 (Y - I vVetlandois
P--qin
-... - q),
lj
atbil7sif 0�r-
DESCRIPTION OF WORK TO BE PROF—ORMED.
— )q � UA' -1-t +0
)MM I I \-/ Rom e-
46 '
714.
Identification Please Type or Print Clearly)
OWNER: Name:
='eix
X9'6 -
/'Z9
lone:
Address:
-V
b N -T RA CTT 0
R-
ress;..
isu6v:pb O'Ks-'Qgl4y! I rue ibn-.4!qqnsq-,
a e%
.. ...........................
pTqYqrn I
ARCHITECT/ENGINEER ,e�(A� fi— .�jve�C�l
Phone:
Address: S jC S NO, Rpri NIr)
FEE SCHEDULE.BULDING PERMIT. $JZ00PER $J00o.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00PER S.F.
Total Project Cost: FEE:
11 2(
Check No.: wo Receipt No.:
NOTE: Persons contracting with u
" ff rVistered contractors do not have access to the guarantyfund
,� L SY
Location be, " �,5tf 0 L, -//,
No.— 6, - Date lAfl"
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $-
TOTAL $
q
Check
25031 Building Inspector
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Culic 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
COMMENTS
Signature,
HEALTH Reviewed on Signature
COMMENTS 5 Z
t. Zoning Board of Appeals: Variance, Petition No: V -- oning Decision/receipt submitted yes
Planning Board Decision: N Comments
Conservation Decision: - Comments
Water & Sewer Connection/Si natur ate Drivewav Permit
� �j�G to v Olt_ ScTG
DPW Town Engineer: Signature:
Lo ated 384 Osgood Street
FIRE DEPARTMENT Temp Dumpster un site :yes no
Located
at'124�Main Street '•• ,� r�,• ",�
hT
Fire:Departmentsignatute/date F _
COMMENTSz _
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
ublic 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
COMMENTS
L,
4O - Signature,
HEALTH Reviewed on Signature
COMMENTS 5 Z
, Zoning Board of Appeals: Variance, Petition No: oning Decision/receipt submitted yes
Planning Board Decision: N A- Comments
Conservation Decision:L Comment
Water & Sewer Con nection/si natur ate Driveway Permit
y,j;G S
DPW Town Engineer: Signature:
FIRE:DEPARTMENT Temp Dumpste n site y_es no ._ =
;:Locafed of 124 Main Street ; r% ,
FiDepai-tments
reJgnature/date.
_ F -me r -
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land. area, sq. ft.: ' 000 _
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 2010
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.: I S ou)
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 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
❑ -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 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 Revised 2008
NO eTM 1
M,SSACHUSEtr
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 605-2012 Date: August 15, 2012
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 24 Dartmouth Street
MAY BE OCCUPIED AS One Unit of a two family IN ACCORDANCE WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER
REGULATIONS AS MAY APPLY. ZBA# 2010- 009a ZBA 1010- 006b
Certificate Issued to:
Fee: $100.00
Receipt: 25031
Check No # : 12410
Jeffco Inc
PO Box 802
Andover Ma 01830
Building Inspector
CDAEDA
Advanced Building Analysis
Duct Leakage Test Form for MA Code Compliance
Name:
MJ Mechanical
Address:
39 Lazarus Way
City, State Zip:
Salem, NH 03079
Phone:
603-698-5772
E-mail:
MJMechanical(a)-comcast.net
Location
Type of test 0 Total/ 0 To Olutoe.
Approx. Floor Area Served ' - 2.50 0
CFM Leakage at 25 pa t 96o `'I if
Approx % leakage for single system*
Location
Type of test 0 Total/ 0 To Outside
Approx. Floor Area Served
CFM Leakage at 25 pa
Approx % leakage for single system*
of test 0 Total/ 0 To Outside
►x. Floor Area Served
Leakage at 25 pa
>x % leakage for single system*
Address: 1160 Great Pond Rd. Brooks
City, State Zip: N. Andover, MA
Test Date 8/10/2012
Test Time 115 i !� �
Point of Construction� Rough 0 incl
of test 0 Total/ O To Outside
►x. Floor Area Served
Leakage at 25 pa
►x % leakage for single system*
of test O Total 0 To Outside
)x. Floor Area Served
Leakage at 25 pa
)x % leakage for single system*
Combined Results
Total Conditioned floor area .Z 5 0 v
Sq. Ft.
Leakage limit 0 6% 08%
P,12%
Leakage limit 300
cfm@25
Combined Leakage"*..
cfm@25
20091ECC Compliance Pass
O Fail
use only.
** Total combined duct leakage is required for 20091EEC Compliance.
test
Tester's Signature ,/ ` Date
HERS Rater Name: Dan Clark
HERS Rater Company: Advanced Building Analysis, LLC
HERS Rater Provider: Energy Raters of Massachusetts
i
CFM / 100 Limits 2009 IECC = Code
MA NH
SF of Hom 4
0.04
ENTER
1
6
0.06 6% Total midpoint
6% LTO Final
8
0.08 8% LTO final
12
0. 12 12% total leakage final
a <4 LTO
0.04 0.04 final ES
4 cfm /_100 sf
<6 Total
0.06 0.06 midpoint Code/final MA NH
6 cfm / 100 sf
<8 LTO
0.08 0.08 final Code
8 cfm / 100 sf
<12 Total Leakage
0.12 0.12 final Code
12 cfm / 100 sf
RESULTS
CFM25 '0(100)
80 0.01.
8000
90, 0.01
9000 '
140 0.01 ,
14000 ,
200 • 0.01
20000
Final Results 0 0.01
100
APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
BUILDING PERMIT #
ADDRESS/LOCATION OF PROPERTY: cl LO/�` Cv I. ac h�tjr � S'�-
Map Parcel Lot Number.
SUBDIVISION:
DATE REQUESTED FILED/READY FOR INSPECTION:
CLOSING DATE ON PROPERTY:
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A
REINSPECTION FEE OF TWENTY DOLLARS ($20.00) WILL BE CHARGED IF THE STRUCTURE
DOES NOT MEET ALL APPLICABLE CODES.
APPLICANT SIGNATURE
Permit Issued to:
Address:
ROUTING
TOWN ENGINEER, SITE PLAN —DE-WAY REVIEW 9� R N/
CONSERVATION
PLANNING ❑
DPW-WATERMETER
SEWER CONNECTION 1-7.,
DPWMUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO
SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST
DPW
SIGNATURE
File: Application for OC form revised Jan 2007/2011
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Massachusetts - Department of Public Saretl
Board of Building ReAiulations and Standards
Construction Supervisor License
License: CS 31830
DOUGLAS J AHERN
PO BOX 802 u
ANDOVER, MA 01810
Expiration: 9/21/2013
('ummissionrr
Tr#: 1609