HomeMy WebLinkAboutBuilding Permit #680 - 291 APPLETON STREET 3/28/2012Permit NO
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
�p Date Received
DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
ARCHITECT/ENGINEER Phone:
Address:
Reg. No
FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ 0-00 FEE: $
Check No.: Receipt No.: 1 ��
NOTE: Persons contracting with unregistered contractors do not have access to th ,wanty fund
129 Date. --� - d f. -?:�� -
0* "ORTN TOWN OF NORTH ANDOVER
PERMIT FOR MECHANICAL INSTALLATION
This certifies that..r:-7:—//7.. e'V<�1111C'z .......... ........
has permission for mechanical installation
in the buildings of ...........................................
at ... Q)�? K -Z J —North Andover, Mass.
�7
Fee. -5-.K ... Lic. No. .. ........
GASINSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art EI
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales El
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
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
I HEALTH ❑ ❑
COMMENTS
I
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Driveway Permit
Located at 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 2007
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
o 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
o Workers Comp Affidavit
o 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
o 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
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The Commonwealth of Massachusetts
Department of Industrial Accidents
y F MCIIfh?W5t/F9Uaas
a= r 600 Washin-ton Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit: Building/Plumbinh/Electrical Contractors
flame: Eka 61 K 14C L✓ aiP
address: 5_1 2
city state: ziz 0(9.7— phone# 1 22 '352`76o�f
I am a -homeowner performing all work myself. Project Type: U New Construction
I am a sole proprietor and have no one working in any capacity. ❑ Building; Addition
I am an employer providing workers' compensation for my employees work ng on this job.
any na
dress:
city:
_— phone 9:
insurance co
I am a soleproprietor, neral contractor, or homeowner (circle one) and have hired the contractors -listed below who
Lave the following workers' compensation polices:
company Dame: r°% ht�_ �0LVARp qazW_—"'(O r .G
address: 5 G ti-
city: 61RCV X190 4 01L A- O o g_B phone 9: -1;?
insurance co. 55 oliev #
company name: AJRT( 0 A. A I��Q:�e�O3� � /�I.� ��i�E���(� �✓ri?
��j�y
address:
/
t�.GBt�G jam J'� e10113(�_I1( J�
city: 13A_A®r—oK'O A&4 phone #: —3 7r
insurance co. licy J#
FaUure to secure coverage as required under Section 25A of IvIGL 152 can lead to the impositlon ofcriminal penalties of a fine tip to ,51,500.00 and/or
Doe years' imprtsonmeut as weU as c1vU penalties In the form o(a STOP WORK ORDER and a fine o(SI00.00 a day against ma 1 understand that a
copy of this statement tray be forwarded to the Ofrlce o! Investigatloos of the DW [or coverage veriticatlon.
I do hereby certify under the pains andpenalties of perjury that the information provided above is true and correct
Signature.'7�rsj-//�— 131--r-is-Y�. * Date
Print parne 159AAik— UQ_4.1 AAO Phone # i 3 5-2-760'K
0'K
official use only . do not write In this area to be completed by city or town official
city or town: permi"cepse p ❑Building Deparrment
❑Lleensing Board
C1check if Immediate response V required ❑Selectmen's Office
contact person: phone p; ❑Hoalth Department
❑Other
(-4 Scpt �OCl1) .
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employ=. As quoted from the "law", an employee is defined as every person in the service of another under any contract
of hire, express or implied, oral or written.
An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the 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 section 25 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, 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation. Please
supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted
to the Department of industrial Accidents for confirmation of insurance coverage. Also be sure to sign -and date the
affidavit. The affidavit shoWd be returned to the city or town that the application for the pe=t or license is being
requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are
required to obtain a workers' compensation policy, please call the Department at the number listed below.
City or Towns
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 pernut/license number which will be used as a reference number. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you 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 Of Massachusetts
Department of Industrial Accidents
offts 81 by"Stleadons
600 Washington Street
Boston, Ma. 02111
fax #: (617) 727-7749
phone #: (617) 727-4900 ext. 406
COMMONWEALTH OF MASSACHUSETTS
-SHEET METAL WORKERS -
As A M'ASTER- NIZESTRICTED
�
ISSUES THE ABOVE LICENSE TO!
ERIC L AZUL
123%R GLEN STREET
M A -L DE N MA 0214,8-1105
6963 05128/12 9823-94
Commonwealth of Massachusetts
Sheet Metal Permit
Date:
a /,:� 0 L�-
Estimated Job Cost: $ OCA
Plans Submitted: YES /NO
Business License #
An
Business Information 3 (_00
Name: C, (IF7
� Z V4 / Street: j �✓ S .
�q /�.�
City/Town: 9,,� 9NDO ve f2
Telephone: Z?l a Y 1 71 l3
Photo I.D. required / Copy of Photo I.D. attached
J-1 / M -1 -unrestricted license
Permit #
Permit Fee: $
Plans Reviewed: YES NO
Applicant License # & (60 3
Property Owner / Job Location Information:
Name:
Street: f AAP le 4z;ti S-�-
City/Town: An(D d k m /-
Telephone:
YES V1 NO
Staff Initial
J-2 / M -2 -restricted to dwellings 3 -stories or less and commercial up to 10,000 sq. ft. / 2 -stories or less
Residential: 1-2 family / Multi -family Condo / Townhouses
Other
Commercial: Office Retail Industrial Educational
Institutional) Other
Square Footage: under 10,000 sq. ft. V/70 -ver 10,000 sq. ft. Number of Stories:
Sheet metalwork be completed: New Work: t/ Renovation:
HVAC Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney / Vents Air Balancing
Provide detailed description of work to be done:
F
RANCE COVERAGE:
a current liabili insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes ❑ No ❑
have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box❑, I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation: YES NO
Date
Date
By
Title
City/Town
Permit #
Fee $
Inspector Signature of Permit Approval
Progress Inspections
Comments
Final Inspection
Type of License:
❑ Master
❑ Master -Restricted
❑Journeyperson
❑Journeyperson-Restricted
Comments
Signature of Licensee
License Number:
Check at www.mass.gov/dpl
Page 1 Residential Heat Loss and Heat Gain Calculation
3/21/2012
In accordance with ACCA Manual J
Report Prepared By:
E.L.A. Mechanical
For: Frank Howard
291 Appleton
North Andover, Ma
Design Conditions: North Andover
Indoor:
Outdoor:
Summer temperature: 72
Summer temperature:
90
Winter temperature: 70
Winter temperature:
9
Relative humidity: 55
Summer grains of moisture:
88
Daily temperature range:Medium
Building Component Sensible
Latent
Total
Total
Gain
Gain
Heat Gain
Heat Loss
(BTUH)
(BTUH)
(BTUH)
(BTUH)
Whole House 805 sq.ft. 16,494
1,314
17,808
28,547
(1.5 tons)
Main Floor 16,494
1,314
17,808
28,547
Family Room 805 sq.ft. 16,494
1,314
17,808
28,547
Infiltration 1,594
1,314
2,908
12,226
-Tightness: Avg.; WinterACH: 1.13; SummerACH:.5
Duct 785
0
785
2,595
- Supply above 120; Exposed to outdoor ambient; R-8
Floor 805 sq.ft. 565
0
565
2,553
- Over garage or open crawl space; Hardwood or tile; R-19 (4 - 6.5 inch)
E Wall 228 sq.ft. 295
0
295
834
- Wood frame, with sheathing, siding or brick; R-19 5 1/2 in.; none
Window 48 sq.ft. 3,418
0
3,418
1,613
- Double pane; Wood frame; Clear glass
- No inside shading; Coating: None (clear glass); No outside shading.
S Wall 375 sq.ft. 486
0
486
1,372
Page 2 Frank Howard
Building Component Sensible
Gain
(BTUH)
Latent
Gain
(BTUH)
Total
Heat Gain
(BTUH)
3/21/2012
Total
Heat Loss
(BTUH)
- Wood frame, with sheathing, siding or brick; R-19 5 1/2 in.;
none
Window 45 sq.ft. 1,674
0
1,674
1,512
- Double pane; Wood frame; Clear glass
- No inside shading; Coating: None (clear glass); No outside shading.
W Wall 195 sq.ft. 253
0
253
714
- Wood frame, with sheathing, siding or brick; R-19 5 1/2 in.;
none
Window 81 sq.ft. 5,767
0
5,767
2,722
- Double pane; Wood frame; Clear glass
- No inside shading; Coating: None (clear glass); No outside shading.
Ceiling 805 sq.ft. 1,657
0
1,657
2,406
- Roof -Ceiling combination; R-19 batts (2 X 8 rafters); Dark
Whole House 805 sq.ft. 16,494
1,314
17,808
28,547
(1.5 tons )
HVAC -Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101
Load calculations are estimates only, actual loads may vary due to weather and construction differences.
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