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HomeMy WebLinkAboutBuilding Permit #488 - 28 SAMUEL WAY 3/17/2009Permit NO: / epa Date Issued: -311710 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received y t��c.+ �6• ryC TYPE OF IMPROVEMENT PROPOSED USE R Non- Residential New Building TYPE OF IMPROVEMENT PROPOSED USE R Non- Residential New Building One family 110 Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well- rtR Floodplain Wetlands Watershed District 3 .Water/Sawer, DESCRIPTION OF WC ��1� L -),:f --T c:)t--,( , .r �TO�BE PREFORMED' Identification Please Type or Print Clearly) OWNER: Name: Phone: 0)7 72�i r-- FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.080 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ � � , �. [ FEE: $ 5 Check No.: / ® 60 Receipt No.: (�7 NOTE: Persons contracting with unregistfrgd cityractqrs do not have access tgAe guaranty fund U F Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL jPub:hc:S:ew�er 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 -67 COMMENTS >/ CONSERVATION Reviewed on HEALTH Reviewed on Signature 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/¢y�13 �flrivewav Per i % e Located3at 124 Main°Street mF%re "De-partment,signatu!re/date COM ME=NTS T Dimension Number of Stories: i Total square feet of floor area, based on Exterior dimensions. 1040 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 Location9d 5C "� W)a `/ No. ?r J Date / 7 �aR,h TOWN OF NORTH ANDOVER 40 Certificate of Occupancy $ ida Building/Frame Permit Fee $�-7 .'I , Foundation Permit Fee $ /62 D Other Permit Fee $ TOTAL $ ®©0� Check #( R 21-874 /w Building Inspector rA W O d O,.., Gq O w - cn cn a Z w u� U w � 0 U bo G x x o W ¢ w -a04 p aG V U) G w O d O a p w G w W W W w d z cn v Q -114 O cn � LIJ zip zCL CL co M H c A CD w cm S m 0 cm c 'c N O t r O Z C) 5 0 z 0 w a T a 2 Co O 03 Z O H L .E co L CL CD s C O co Q ey y O .= CO3 C /O �s to C cc d h lig L O V co CL CIO C O CM C co O C m cc H = ev � O � O CM Qm O to O D CDZ Ci W C LU cl W W ce W CA c c m C ~ a CD ;;F O S m - o � H O O. O F - yr c ` O N LU C O v V •dam Cc E v ui d C CIO d . A R S A O ;= O � N �a CF CDL :... ca o c y CE ail GO 3 c c : CD c , .� m Co N tC E m `mo &c -C.3 � O :.c o pO, C \ .0 O� V; �1 V y Z CL co M H c A CD w cm S m 0 cm c 'c N O t r O Z C) 5 0 z 0 w a T a 2 Co O 03 Z O H L .E co L CL CD s C O co Q ey y O .= CO3 C /O �s to C cc d h lig L O V co CL CIO C O CM C co O C m cc H = ev � O � O CM Qm O to O D CDZ Ci W C LU cl W W ce W CA cc C c o d ~ a CD y� S m - 1 .2 H O O. O F - yr as LU Cc E v ui CIO d m O.p m S A i Ce .a0m CL co M H c A CD w cm S m 0 cm c 'c N O t r O Z C) 5 0 z 0 w a T a 2 Co O 03 Z O H L .E co L CL CD s C O co Q ey y O .= CO3 C /O �s to C cc d h lig L O V co CL CIO C O CM C co O C m cc H = ev � O � O CM Qm O to O D CDZ Ci W C LU cl W W ce W CA 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\0706.00 Unit B.rck Energy Code: Massachusetts Energy Code Location: North Andover, Massachusetts Construction Type: 1 or 2 Family, Detached Heating Type: Other (Non -Electric Resistance) Glazing Area Percentage: 23% 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 � � �y a s"•a � �wYtd�. ��r� ° � � 3�.1 t tet„ e 3 ,��. �p�r>rr .�Mx,S { e� *��,+.,, xr r � moi.;;; Compliance: 1.9% Better Than Code Maximum UA: 378 Your UA: 371 Basement: Solid Concrete or Masonry 1846 0.0 10.0 103 Wall height: 7.5' Depth below grade: 7.5' Insulation depth: 7.5' First Floor: Wood Frame, 16" o.c. 1854 21.0 0.0 79 Windows: Wood Frame:Double Pane with Low -E 361 0.300 108 Door: Solid Door: Glass Ceiling: Flat Ceiling or Scissor Truss 42 58 1725 38.0 0.0 0.290 12 0.290 17 52 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 determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall bn greater than 125% of the design load as specified in Sections(780CMR 1310 and J4.4. :JC - M 3 /�• 0 Name - Title 1 — Sig Date Project Notes: Unit B ?8 S,NIaEI. WAI� Project Title: Edgewood Retirement Community Report date: 08/21/08 Data filename: F:\DSA Project Files\Edgewood 0706\04. MA Energy Code Check\0706.00 Unit B.rck Page 1 of 1 4= ; BOARD OF BUILDING REGULATIONS # License CONSTRUCTION SUPERVISOR a 3 3 Number: SGS 094621 Birth a g 9)70 Ex [rs1610 Tr. no: 94621 E }. i2estrtcie _ G 0� CORYE fIStIE+2 �/ i 30 JORDAN ...ZT. �G BEVISRLY, MA 0191'3 Oommissiorier _, .. N Y1 s � � i /' DATE (MMlDD/Yl'YY) ID Ar:�RD CERTIFICATt OF LIABILITY INSURANCC PRODUCER WINDO a 11 oe 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 LTR Phone: 781-665-2775 Fax:781-665-0295 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Aspen Specialty Ins. Co. INSURER B: United specialty insurance co. Windover Construction, Inc, INSURER C: OneBeacon Insurance Grou Attn Karen Cochand ElmstreetMA INSURER D: American Intarnat�l companies Manchester nchesteteMA r 01944 INSURER E: Cf1VFGJ1rFS CLAIMS MADE FX OCCUR 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 RESPECT TO 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, lNb LTR NSR TYPE OF INSURANCE POLICY NUMBER ;:Y POLIC -EXPIRATION DATE MM/ITECTIVE DD/YY DATE MWOONY LIMITS GENERALLIA81LITY EACH OCCURRENCE $ 1,000 000 A X COMMERCIAL GENERAL LIABILITY GL000574-01 01/01/0.7 01/01/09 UAMPREMISES £toIran�a) $50,000 CLAIMS MADE FX OCCUR MED EXP (Any one person) $ EXCLUDED . PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE s 2 000, 000 GEN'LAGGREGATELIMITAPPIIESPER: PRODUCTS -COMP/OPAGG $2,000,000 POLICY X JET LOC AUTOMOBILE LIABILITY ANY AUTO COMBINEDSINGLE LIMIT $2,000,000 ALL OWNED AUTOS C X SCHEDULED AUTOS FBIE07908 BODILY INJURY $ 04/01/08 04/01/09 (Per person) X HIRED AUTOS X NON -OWNED AUTOS BODILYINJURY t6 - (Per accident) PROPERTY DAMAGE $ (Per accident) GE LUIBILITY AUTO ONLY - EA ACCIDENT S NY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ "BX SS/UMBRELLALIABILITY EACH OCCURRENCE $5000000 CCUR CLAIMSMADE CXAQGS7O8 09/25/08 O1/01/09 AGGREGATE $5000000 EDUCTIBLEETENTION It WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X TORY LIMITS ER D WC6967012 ANY PROPRIETOR/PARTNER/EXECUTNE 03 /20/08 03/20/09 E.L. EACH ACCIDENT $500 000 OFFICERIMEMBER EXCLUDED? 11 es,desrrlbeunder E.L. DISEASE - EA EMPLOYEE $500,000 SPE CIALPROVISIONS below E.LDISEASE- POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I 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 Inc NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO So SHALL 575 Osgood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR N. Andover MA 01845 REPRESENTATIVES. AUTHORIZE R NTA E ACORD 25 (2001/08) V ©ACORD CORPORATION 1988