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Home My WebLink AboutBuilding Permit #831-11 - 25 EMPIRE DRIVE 6/8/2011v? / - // Permit NO: 4 .2 Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received ANT: Applicant must complete all items on this PIP-tt- OgtuE- r5�-Y 12 �. ) I -LC Print MAPNOP�C PARCEI.&/J?, ZONING DISTRICT.:7: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential )!�New Building 9 One family El Addition 0 Two or more family 0 Industrial —0 Alteration No. of units: 0 Commercial 0 Repair, replacemBnt 0 Assessory Bldg El Others: 11 Demolition 11 Other El S-eptic OW011 am El Flood- -1 0 Wetlaindg 0 W-VatoirshpaDistribt. N9CRIPTION OF WORK TO BE A+U C2 AS Identification Please Type or Print Clearly) 162'. OWNER: N Address: e Pox S Ploy -phoneq CONTRACTOR Name: I 9--M -3) Address:qH (3KIC591 r0NQ UrWe X-)Q)�T-GEU .44- t! - 0 14 e I Supervisor's Construction License: 02-93/ Exp. Date: - F/3/ //7, qg2_ q I Home Improvement License: Yxp. Date: ARCH ITECT/ENGINEER/-,MrVQ (()qnpU 9% Phone:1766-352 — FS I g- Address:/1:9-�. AA A Gw9elujA) M A DI F 3 3 Reg. No-:�'- FEE SCHEDULE: BULDINGPERMIT.- $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F. Total Project Cost: $ ol7zllo O -Z> FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to theguaranlyfund 0 - -.8i - _ 71 1 flown -0- 1�k7 9 Mon ig -,.aqdr0.bf-.bohteaC't6-.* 5 tion 2-1—L I/ >;,Fl,, Date A - TOWN OF NORTH ANDOVER 40 Certificate of Occupancy C Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL $ Check # AMAIding Inspector Plans Submitted 11 Plans Waived 11 Certified Plot Plan 11 Stamped Plans 11 TYPE OF SEWEPAGE DISPOSAL c El Public S;w�er El Tanning/Massage/Body Art El Swimming Pools ell. - F�Ve El Tobacco Sales El Food Packaging/Sales El Private (septic'tank� etc. El Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT DATE REJECTED 11 DATEAPPROVED El COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments C-anservation Decision: Commen Water & Sewer Connection/Siq n a6r�eJaa�t4 DPW Town Engineer: - emp )wrf- FIRE DEPARTNMNT T D -pAer on site yeq Located at 124 Main Street Fire Department signature/date Lt COA4MENTS � T ,No= Located 384 Osgood Street ,—, no /--, �'?— I ( 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 WKIP: I ITFRATURE: Yes No. MGL Chapter 166 Section 21 A —F and (3 min.$100-$1000 fine 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 a Building Permit Application Ei Certified Surveyed Plot Plan • Workers Comp Affidavit • Photo Copy of H.I.C. And C.S.L. Licenses • Copy Of Contract • Flo or/Crossection/E levation 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) ci Building Permit Application u Certified Proposed Plot Plan Ei Photo of H.I.C. And C.S.L. Licenses a Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ci 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 Tin 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 triust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi ,,ORYN US CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 831-12 on 6/8/2011 Date: July 24, 2012 THIS CERTIFIES THAT Orchard Village, LLC THE BUILDING LOCATED ON 25 Empire Drive — Lot #26 MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Orchard Village, LLC 277 Washington Street Groveland, MA 01834 Building Inspector Fee: $100.00 Receipt: 24229 Cheek: 2075 6.7, -0 fe- - , APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION BUILDING PERMIT # 9'31 cmus ADDRESS/LOCATION OF PROPERTY: Map. Id 7 Parcel If7'_11 2-"' Lot Number- 0 Z SUBDIVISION: DATE REQUESTED FILED/READY FOR INSPECTION:. 12-,z 11-2, CLOSING DATE ON PROPERTY: —;�7 / .M / / Z_ 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:D9Cfi4t_V UiLL)4G& e -4c Address:z2J7 WASPIIK�,o -rou AJ 12 A4 A o 17 Sy" ROUTING TOWN ENGINEER., SITE PLAN — PMVE-WAY REVIEW�y_ & -2/10/1c-) CONSERVATION PLANNING DPW-WATERMETER SEWER CONNECTION 0 Ck " El/-" '1/t Iq I I! DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW File: Application for OC forin revised Jan 2007/2011 SIGNATtfRE 1�/ 0-,// �-__ (U ;�o 0 A�o 0 - 0 FM4 0 0 z IN, 4k yly �Lu 0 A C, \,t.\ C, C., cm ZW U) cc CD =.C2 C', c t5 PL4 rm wz,. 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LU U) ui U) 19 LU ui 19 LLI ul CO) MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 6-8-2011 DATE OF PLANS: 8/8/09 TITLE: The Waverly PROJECT INFORMATION: Orchard Village Lot 26, #25 Empire Drive N.Andover, MA 01845 COMPANYINFORMATION: Orchard Village, LLC Messina Development Co., Inc. COMPLIANCE: PASSES Required UA = 592 Your Home = 336 Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 1232 38.0 0.0 37 WALLS: Wood Frame, 16" O.C. 2773 20.0 0.0 164 BSMT: Conc. 8.0' ht/7.0' bg/0.0' insul 0 0.0 0.0 0 GLAZING: Windows or Doors 283 0.350 99 DOORS 70 0.000 0 FLOORS:.Over Unconditioned Space 1105 30.0 0.0 36 HVAC EQUIPMENT: Furnace, 96.0 AFUE HVAC EQUIPMENT: Air Conditioner, 13.0 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 requirements of the Massachusetts Energy Code. 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 equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 The Waverly DATE: 6-8-2011 Bldg. Dept. Use CEILINGS: 1. R-38 Comments/Location WALLS: 1. Wood Frame, 16" O.C., R-20 Comments/Location BASEMENT WALLS: 1. Conc. 8.0' ht/7.0' bg/0.0' insul, R-0 (uninsulated) Comments/Location WINDOWS AND GLASS DOORS: 1. U -value: 0.35 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? Yes No Comments/Location DOORS: 1. U -value: 0 Comments/Location FLOORS: 1. Over Unconditioned Space, R-30 Comments/Location HVAC EQUIPMENT: 1. Furnace, 96.0 AFUE or higher Make and Model Number 2. Air Conditioner, 13.0 SEER or higher Make and Model Number AIR LEAK -AGE: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unc ' onditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R -values, glazing U -values, and heating and cooling equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: Ducts shall be insulated per Table J4.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside 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. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): CIRCULATING HOT WATER SYSTEMS: I Insulate circulating,hot water pipes to the following levels (in.): PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F)-: RUNOUTS 0-1" 1 0-1.2511 1.5-2.011 2.0+11 PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: I Insulate circulating,hot water pipes to the following levels (in.): PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F)-: RUNOUTS 0-1" 1 0-1.2511 1.5-2.011 2.0+11 170-180 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 NOTES TO FIELD (Building Department Use Only) ------------------------- The Commonwealth ofMassachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston, AM, 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians['Plumbers Applicant Informatio Pl' e Print LeLyibl Name (Business/Organizatio0ndividual):- LL- A 6, -- Address: b )r- k tf-e City/State/Z Phone Are you an employer? Check the appropriate box: LEI am a employer with . — . 4. El I am a general co�tractor and I mployees (full and/or part-time).* 2. " a sole have hired the sub -contractors listed _am proprietor or partner- on the attached shget. h lip and have no employees These sub -contractors have Working for me in any capacity. workers' comp. insurance [NO workers' comp. insurance 5. El We ake a corporation and its required.) 3. 1 am a homeowner doing officers have exercised their all work right of exemption per MGL myself [No workers, comp. c. 152, § 10), and we have no insurance required.] t employees. [No workers' COMP. insurance required.] *Any applicant that checks box # I must also fill out the section below sho - : I Type of project (required): 6. E] New construction 7. El Remodeling 8. El liemolition 9. E] Building addition 10. El Electrical repairs or additions ll-E]Plumbing r*epairs or additions 12.0 Roof repairs l3F1 Other ng e r woik, compensation poiicy 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. Iam an eMployeriliatisprovidingw'orkersp compensation inSUranceformy employees. Below is thepolicy andjob site information. Insurance Company Name: Policy # or Self -ins. Lic. Job Site Address: Expiration Date: City/State/Zin: 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 finprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine I of up to $250.00 a day against the violator. Be advis eid that a copy of this statement may be forwarded to the Off ce of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenallies ofperjury that the information provided above is true and correct. '�� A , A , A — Yk ? —?& -Z— Official use only. Do not write in this area, to be completed by city or town offl"cial City or Town: Permit/License suing Authority (circle one): L Board of Health 2. Building Department 3. CJtY/Town Clerk 6. Other Contact Person: V// 4. Electrical Inspector 5. Plumbing Inspector Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers I to provide workers' compensation for their employees. Pursuant to this statute, an employee is*defined as "...every person in the service of another under any contract of hire, express or implied, or�l or written." An employer is defiried as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint ente ise, and including the I legal representatives of a deceased employer, or the rpri receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' ' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLQ or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of lidustrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any q�iestions regqding the law or if you are required to obtain a workers' compensation policy; please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriatiD line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will beused as a referencdnumber. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in ' —(City or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affiddvit. I The Office of Investigations would like to thank you'in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth ofIN/irassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. W 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 wwwmass.eov/dia LOT27 , os �11 276' EX.FND. EL.=272.7' N, 16.4' LOT25 EMPIRE DR. FOUNDA TION LOCA TION CLIENT ORCHARD VILLAGE, LLC THIS CER77Ffr-4T70N IS MADEANDLIMUED To 77JEABOVECUENT L OCA TION. #25 EMPIRE DRI VE, NOR TH A NDO VER, MA. DATE -7613111 SCALEII�--30' LOT26 279' \1 vA0F4tq6, ICH 0 J. z 2 SER I m 0 No.33191 sslo I CERTIFY THAT THE PRIMARYSTRUCTURESHOWN CONFORMS To THE HORIZONTAL SETBACKREQUIREMEN7S OF THELOCAL APPLICABLEZONINGBY-LAWSINEFFECTKIHFJVCONS7RUCTED (THIScER77F,cA77oNDoEsNorcoNsiDERAmyoTHER RES7RIC-1701VSSLICHASCOW-A�,WEnAAfDS,EASEMEAfM ORDERS OF =77ONS; TC' 7711S DRAWING SHALL NOTBE US BY T I 'T 0 ED HTCL F fAlY PURPOSE OTHER THAN THAT OUTLINED ABOVEE)(CEPr K07TH THE WRITTEN PERMISSION OF CHRIS77ANSEN & SERGI INC FURTHERMORE THIS DRAWNG IS THE COPYRIGHTED PROPERTYOF CHRIS77ANSEN & SERGI INC AND ANY UN4UTHoRjZEO USE IS pRoHjBnrD CHRIS77ANSEIV & SERGI TAKES NO RESPONSIBILITY FOR 7 -HE UNAUlH0RL7E0 USE OF77YIS DR4WfNG ORANYINFOR- MAI -70N CONTAINED HEREON PROFESSIONAL ENGINEERS & LAND SURVEyORS CHRIS TIA NSEN & SERGI. INC. y 160 SUMMER STREET, HAVERHILL, MASSACHUSETTS 01830 WWW CSI-ENGR COM TEL. 978-373-03 10 FAX 978-372-3960 DWG.NO.:06029.001.047