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HomeMy WebLinkAboutBuilding Permit #157-14 - 325 BOSTON STREET 8/16/2013 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
Date Issued: 4 �G
IMPORTANT:Applicant must complete all items on this page
LOCATION 30� O SQ ��5 Ie_��_ F
w - A
QfihV
fF?ROPERTY 01NNER s �-v?-
J aPrint R G100 Y a Old Structure yes E
EMAP NO ' PARCEL_.I 3(10rZO.NING4DISTRICT Historic
"District eyes
`" =Machine Shop V lla,ge yes° n
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
ew Building ne family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Qemolition ❑ Other
.;Septic `❑,Well st ` ° '^ t Floodplain ®Wetlandst „ .UVatersled�District
. - .- a r
DESCRIPTION OF WORK TO BE PERFORMED:
0N� SCw c-' A 3 boo SF .s/JV) kQ- FAV-% �
Identification Please Type or Print Clearly)
OWNER: Name:_ Phone: 77 PA1707?
Address: `6' 1RkP-v-,- V VkA 0f 9
���a'�� s+F''.G'"" }`�S^Y r�"4-a�.+�' i'k`+J x( � 1 '�''" ,' �•/ �� l v�_U�� t�i k
'CONTRACTOR Name � � ►� �o S� on �.
Ad tl re s s= =I�-e.weJC.Y1 - �°.''U R- S T-
Supervisor'sfConstructionLlcense _Ol(� 7 b_ Exp
Hoinetilm rovement:Llcerise _,:_ Ex DP f,__ -_:�. --
_ ate
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: $ � �00 FEE: $
/
Check No.: � Receipt No.: -2 6�1
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
Signature of Age nt/Owne Sig nature of;contract ` Y
w
Plans Submitted N Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
rLocation —�� 1' Gi of
No.
�7 7 `/S' Date / /
TOWN OF NORTH ANDOVER
.:. U,
r ; • 5�,� d6yd •
f 1,
• r _ Certificate of Occupancy $
Building/Frame Permit Fee $
4
Foundation Permit Fee '00
Other Permit Fee $
k'.. . TOTAL $
Check# Z�2 7`
26.79
. wilding Inspector
r I
i
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE--OF SEWER-AGE.DISPOSAL
Public Sewer ❑ Tanning/MassageBodyArt ❑. . .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 on I 1-15 Si nature
,—".
COMMENTS ��
HEALTH Reviewed on / Signature
COMMENTS
?oning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Si nat G' Gam` Drivewa Permit
DPW Tovv : Engineer: Signature:
Loc ed 384 Osgood Street
FIRE DEPARTIV ENT - Temp Dumpster on site yes no
Located-at 124 Mair Street
Fire Department signature/date- _
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.: 43 Sip
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
B Notified for pickup - Date
i
Doe.Building Permit Revised 2010
-Building Department
The fohowing isa.list of the required-forms to be filled out for the appropriate permit to be obtained.
Roofivg, 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)
v/ uilding Permit Application
�Certified Prop osed Plot Plan
Photo of H.I.C. And C.S.L. Licenses
m/Workers Comp Affidavit
m./ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
d Copy of Contract
❑ Mass check Energy Compliance Report
a/ 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 apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submAted with the building application
Doc: Doc.Builjing Permit Revised 2012
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CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 157-14 on 8/16/2013 Date: December 20, 2013
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 325 Boston Street
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: Steve Franciosa
8 Newell Farm Drive
West Newbury,MA 01985
Building Inspector
Fee: Prepaid$100.00
Receipt: 26749
Check : 1041
� Naery q '
O ZLEy
6 O
A
APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION
t4e4 x
Argo#I � BUILDING PERMIT #
ADDRESS/LOCATION OF PROPERTY: 3 Z 5 -jo S/©YJ S1' 401rl�J X1744WIA
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 ($20.00) WILL BE CHARGED IF THE STRUCTURE
DOES NOT MEET ALL APPLICABLE CODES.
APPLICANT SIGNATURE
Permit Issued to:
Address: ��w �� —�A,(L;�n �e—. �e3�— ��12,��. �'1�' Gkc1�_5
ROUTING
TOWN ENGINEER; SITE PLA -D E-WAY REVIEW N ®k 1v`-If 12- 26 -13
CONSERVATION
PLANNING n/ A
—DPW-WATER METER
.SEWER CONNECTION
_p-t:G--
DPW MUST INDICATE THAT THE WAT METER HAS BEEN INSTALLED PRIOR TO
SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST
DPW �(� � �- 12! y�l 3
SIGNATURE
File:Application for OC form revised Jan 2007/2011
• � -"yam,
•
i
is
•'bP��ATED �ti
PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CERTIFICATE OF
COMPLIANCE
As of: 12/12/13
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Complete Repair and Construction of an
On-Site Sewage Disposal System
By: Bill Hall
At:
325 Boston Street
Map 1.07D Lot 136
North Andover, MA 01845
r T 'suan e of this ceic to Shall no be construed as a guarantee that the system will function satisfactorily.
Mf 4
M' ichele Grant
Public Health Agent
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorlhandover.com
cqq
D
ME
1181 Elm Street,Suite 205 GDS AssoClBt@$, Inc. Phone:603.656.0336
Manchester,NH 03101 Engineers and Consultants Fax:603.656.0301
Building Air Infiltration Test Results (Blower Door)
Builder Name: Franciosa Construction (Name on Building Permit)
Property Address: 325 Boston St City/Town: North Andover State: MA
Test Conditions:
Indoor Temp: 65 "F Outdoor Temp: 25 °F Wind Conditions: None (speed/direction,if known)
Building Volume: 23+472 (cubic feet) Conditioned Floor Area: 2,934 (square feet)
Number of Bedrooms: 4 Average Ceiling Height: 8
Building Type: ®Single Family ❑ Multi-family.s If'Multi.-family,what test approach was used:
W
❑ hole-building ❑ Individual Unit, #units in building
Blower Door Fan was mounted to: 0 Front Door ❑ Side Door ❑ Back Door
❑ Other(describe)
Test was performed under: ® Depressurization ❑ Pressurization
Flow Ring Used: ❑ Open ® A-Ring ❑ B-Ring ❑ C-Ring
Baseline Pressure: (Pa) Building Pressure: (Pa) Fan Pressure: 50 (Pa)
Recorded Flow: 1444 (CFM50) Note:CFM50=cubic feet per minute at test pressure of 50 pascals
Calculated Air Change per Hour at 50 pascals: 3.7 (ACH50) Calculated as follows: (CFMs0x60)
Building Vol
In order to verify compliance with the Section 402.4.2.1 of International Energy Conservation Code(IECC 2009)and the
International Residential Code(IRC 2009)a home of this size of 23,472 cubic feet
(conditioned volume)must have an air infiltration rate of no greater than 7 ACH50 or 2738 CFMso
Therefore,this home: ® Complies with the air infiltration requirement within Section 402.4.2.1 of the IECC 2009
❑ Does Not Comply with the air infiltration requirement within Section 402.4.2.1 of the IECC 2009
Air Infiltration noted at the following locations:
Technician Name:TOM Pfau
Date:December 18, 1013 Time: 10:30
GDS Associates-Home Energy Ratings of New England is a RESNET-accredited Home Energy Rating Provider and is a registered EPA ENERGY STAR Partner.
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T'I� �`--o II I FIFE COVERED WTH 3/d'6T0\E
1 1 SEE"INIERfOR BWEAF2 wAll DETAIL"THS FAGS ( I ^' t �-I o ,ve L�, i ( g��'" �P;C(MATING To��N-
SeGflo N
- I2' � P1TCH SLAB TO CR.WN 4"
+t�� ( I SLAB SHALL BE 9500 M CChL"Fa--TE AT
14- 18 DAYS MR UTH MER MBBR Ib LES.
i I FER CIHIC YARD IN MX
I
ALL 15E rraTl�n ( t=
CSA E � m I I ,aha
Nf7 5 � 2'-6°
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4"GLAUF_R TWAN B r__ / - --
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12'
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ALL SIDES;-EA E47,M?
SLS O \ �'�'�'LONG.SLAB—.I 14'
" I __ f •1` 1 1 -I.•7../I �1 Q�L7� .. Id'COW-FOLD VATION WALL MW
2r3. I �• ______-' .',, ! v- 1. I��SX04 COW TOP Md3 BCMM.TYP.
SEE S 10 '�I.l)r/N'7 TFi(7)04 CONT,.BO[TQy I I �
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GARAGE R2AMFY, I "-
-- -- — -- _ -� 4------ I --- --
Sheet 10 not require( a 2' J
this job
Dan LG 2.28.12
°. Feb 28, 2012
lay 14' ---}— lo' 14'
GSE Job 12-C'5
o T4J� PLUG 3lzl�cb l ht,L( y, ' I -
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.4 MACINNIS .
58 RECENT AVE. NORTH ANDOVER, MA,
BRADFORD, MA. 01835
K1,�G 6 OAK PROf:'ERTIES,
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(978)374--8719
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58 REQ AVE, NORTH ANDOVER, MA,
BRADFORD, MA. 01835 OAK
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MARTHA MAC-MiS
58 REGENT AVE. NORTH ANDOVt=-R, MA.
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1978)374-8-M K'Nr/�'J OAK HR0PEI 1.I E5,
1
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305 B06TO�l ROAD
58 RF-CZNT AVE. NORTH ANDOVER, MA.
BRADFORD, MA. 0I83 Y c c Z
(978)374-8719 KINGOAK PR I�TIfE�7, -�
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CONT. RIDGE VENC
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2X12 RIDGE=BOARD
FIBERGLASS Si INGLES
HEADERS: 1/2" EXT'. PLYUJD °..i-IEA141NG s A
10 12 2X8 COLLAR TIES. 32" Cr- �, :_ r :
(3):2X6 AND PLYED. FILLEi3- MAX SPAN = 41-411SLOPE CUT - NAIL WITH (5) 12d
(3) 2X8 AND PLYWD:FILLEF;6- MAX SPAN =
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1/2 PLYWD, SHEATHIN
NAI G
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8d.NAILS 9:0 O.0
PERIMETER R=38 BLOWN 1141NSULATION i .�n
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12 O.C. FIELD cP of eum a Ht
FLOOR SHEATHING
3/4" T 4 G
$� NAIL JOd 6" O.C. 13 RISERS o 8.25' EA
AT PERIMETER12 TREADS m 10.75' EA,
12" O.C. IN FIELD 4' IMPSON H2,5A HURRICANE CLIP Q�
GLUE END OF EACH RAF mR, TYP CONT. NTL, DRIP EDGE
RAPIERS- 2X10® 16" O.C. 8 CONT. SCREENED SOFFIT VENT
PLYWD. SHEATHN!4 - 1/2" NAL ed
6" O.C.PERIMMER -
12" O:C,.FIELD ? 3/4" T4G PLYWD.
21 SUeFLR.
14 RISERS® 7.7" EA, VINYL SIDING
13 TREADS 0 10 Ira" EA 1/2" EXT, PLYWD, SHEATHING
$� 2X6 S-tUD WALL eO (, O, C.
sEE levor Ahp f Lyun o R=21 FIBERGLASS INSUL. .
BHEAWW3 DETAW O•E�rJr - ... -
! 41 R=30 MERGL ASS IN9J 1/2" GYP, WALLBD., WALLS 4 CLOS: TTP.
4-{OuSEWRAP Ecb.IAL TO ".T.YVEiC"
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13 RISERS ® a!' EA.
12 TREADS 9D 10.75" EA.
g
- 10" CONT, CONC. PND,
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10"X20" CONT. CONC. FTG-.
TYPICAL WALL SECTION 4" CONC. sL -
6" GRl�VEW1L W/
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1/4"d'-0
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MARTHA MACINNIS '
58 REGENT AVE. I�{ 11r AWGIVER,
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VARAWN BY: M5451CN A
MARTHA MACINNIS Ge6nas Structural Erwgi--Irq
58 REGENT AVE Daniel L.Gelinas,P.E. --�� `-''
BRADFORD, MA. 0I835 579A North End Blvd. N� '�'H A� '}�OV R1 MA,,
(978J374$719 Salisbury,MA 01952-1733 SECTION AT VAULTED CouNG
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MARTHA MACIMIS 305 1306TO5TR� I-}- a
5S REGENT A NORTH ANDOVER MA
BRADFORD, MA.A 01835
(978)37719 KING'S OAK PROPERTIES, LCC
10 12 1
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. II
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305 506TOR ROAD
DRAWN BY; 1 ` �
rlARTNA MA-ANNIS NORTH A�Y EIR, MA'
58 REGENT AVE
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ti OF A44
02� MIC 9�yG
BOSTON STREET
0 b.31 �
4 v
F Sl%
y SURVVO
I CERTIFY THAT THE AMARYSTR TUR SHOWNCONFORMS
FOUNDA TION L OCA TION TO THE HORIZONTAL SETBACK RE IRE EN OF THE LOCAL
APPL/CABLEZON/NGBY-LAWS/NE EC WHENN CONSTRUCTED.
(THIS CERTIFICATION DOES NOT ERANYOTHER
RESTRICTIONS SUCH AS COVENANTS,WETLANDS EASEMENTS,
ORDERS OF CONDIT/ONS,ETC.)THIS DRAWING SHALL NOT BE
USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THA
CLIENT, FRANCIOSA BUILDERS
OUTLINED ABOVE,EXGIINC.CEPT U THEYMOREN ISDR4WI NOF
CHR/S77NVSEN&SERGI INC.FURTHERMORE THIS DRAWING/S
THIS CERTIFICATION IS MADEAND LIMITED TO THEABOVE CLIENT THE COPYRIGHTED PROPERTY OFCHRISTIANSEN&SERGI INC
.
AND ANY UNAUTHORIZED USE IS PROH/BITED.CHRISTIANSEN&
LOCATION:325 BOSTON ST.,NO.ANDOVER,MA. SERGITAKE$NO RESPONSIBILITY FOR THE UNAUTHORIZED USE
OF THIS DRAWING OR ANY INFOR MA TION CONTAINED HEREON.
DATE: 9/9/13 SCALE: 1"=40'
PROFESSIONAL ENGINEERS& LAND SURVEYORS
CHRIS TIANSEN & SERGI, INC.
160 SUMMER STREET, HAVERHILL, MASSACHUSETTS 01830
WWW.CSI-ENGR.COM TEL. 978-373-0310 FAX 978-372-3960
D WG.NO.:11076.001.007
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
$ 3793500.00 m
$ - $ 4,554.00
Plumbing Fee $ 569.25
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 569.25
Total fees collected $ 5,792.50
c
325 Boston Street
157-14 on 8/16/2013
Single Family Home
NORTFf
own of
t EAndover
,. _ 0
151-- Iqy
h , ver, Mass,
COC MIC Nl WICN
S V
BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT .........;5.7.0.<i".l�f... ...��.?��::,�'�t.........................................................................
BUILDING INSPECTOR
' Foundation
has permission to erect buildings on .. ..., .,?.cSrr...5 ..............................
..........................
�f Rough
to be occupied as ............4T.r��s^! £:1 �' : ... .<t.Y. /.f..fC: ?°:✓!1i.1.., .................................. Chimney
provided that the person accepting this permit shall in every respect conform to tM terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS Rough
Service
.............. ...... „,.. ........................ Final
BUILDING INSPECTOR
a GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
SEE REVERSE SIDE
CREScheck Software Version 4.4.3
NJ( Compliance Certificate
Energy Code: 2009 IECC
Location: North Andover,Massachusetts
Construction Type: Single Family
Glazing Area Percentage: 14%
Heating Degree Days: 6322
Climate Zone: 5
Construction Site: Owner/Agent: Designer/Contractor:
North Andover,MA OW
MR REM
. .
Compliance:6.7%Better Than Code Maximum UA:401 Your UA:374
The%Better or Worse Than Code index reflects how close to compliance the house is based on code trade-off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
AssemblyGross Cavity' Cont. Glazing UA
or or D••
Perimeter U-Factor
Ceiling 1:Flat Ceiling or Scissor Truss 1448 38.0 0.0 43
Wall 1:Wood Frame,16"D.C. 3008 21.0 0.0 145
Window 1:Vinyl Frame:Double Pane with Low-E 352 0.300 106
Door 1:Solid 40 0.190 8
Door 2:Glass 80 0.300 24
Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1448 30.0 0.0 48
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 2009 IECC requirements in
REScheck Version 4.4.3 and to comply with the mandatory requirements listed in the REScheck Ins ion Checklist.
17
0 to
Name-Title finature Da
Project Title: Report date: 07/10/13
Data filename: Untitled.rck Page 1 of 4
2009 IECC Energy
Efficiency Certificate
Ceiling/Roof 38.00
Wall 21.00
Floor/Foundation 30.00
Ductwork(unconditioned spaces): V.0
Window 0.30 0.70
Door 0.30 0.70
Heating System:
Cooling System: 70
Water Heater: SO
Name: o VV- Date: 7 t t,
Comments:
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYYYYJ
�[0 0512212013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI:
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE;
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE(
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject ti
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to th,
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Lar Cowan
Cowan Insurance Agency,Inc. t.DNF 978 372-f45f FAx 978 521.4669
359 Main Street EMAIL ADDRESS, larry@cowaninsurance.com
Haverhill MA 01830 INSURERS AFFORDING COVERAGE NAIC#
71asuRER a:Endmance Insurance CamVia%xy.
INSURED INSURER B:
Franciosa Construction Inc. INSURER C:
9 Newell Farm Drive INSURER D:
West Newbury MA 01985 INSURE E:
INSURER IF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER101
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM:
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
rA
TYPE OF INSURANCE (,IDOt(SUBR pOLI Y NUMBER ( POUCY EYYY
FF 1 POIDDTYYYYI LICY EXP LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY i I DAMAGE TO RENTED $100,000
CLAIMS-MADE OCCUR TBA 05122)2013 �05i20i2014 MED EXP An one erson $5000
PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $1,000,000
X POLICY PRO- LOC $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY f
ANY AUTO BODILY INJURY(Per person) $
AALL UTOS OWNED SCHEDULED i BODILY INJURY(Per accident) $
NUTOS ED PROPERTY DAMAGE $
HIRED AUTOS AUTOS $
I
UMBRELLA LIAB OCCUR ' EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE I AGGREGATE $_
DED I I RETENTIONS $
WORKERS COMPENSATION WC STA-IU- OTH-
AND EMPLOYERS'LIABILITY
"Ry
i FR
ANY PROPRIETOR/PARTNER/EXECUTIVE0 N!A I E.L.EACH ACCIDENT $ _
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If ,describe under E L OfSEASE-POLICY LIMIT S
DesI I N OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
Residential general contractor.
CERTIFICATE HOLDER CANCELLATION
BE
City of Gloucester THE SHOULDANYOF EXPIRA IONH DATE VTHEREOF,DESCRIBED
NOTICE)ES WILL CBECDEL VE EDO I
Building Inspector ACCORDANCE WITH THE POLICY PROVISIONS.
22 Poplar Street
Gloucester,MA 01930 AUT4iORtZEDREPRESENTATIVE
Fax:(978)282-3036
©1988-2010 ACORD CORPORATION. All rights resery
ACORD 26(2010106) The ACORD name and logo are registered marks of ACORD
S�SILED)��
•
E copy
North Andover Health Department
Community Development Division
August 7, 2013
Stephen Franciosa
8 Newell Farm Drive
West Newbury, MA 01985
Re: Subsurface Sewage Disposal System Plan for (Lot 13)325 Boston Street, Map 107D,
Lot 136
Dear Mr. Franciosa:
The proposed wastewater system design plan for the above site dated July 23, 2013 with a final
revision dated August 5, 2013, received on August 6, 2013 has been approved.
The design has been approved for use in the construction of a new upgraded onsite septic system,
designed for a new 4-bedroom (maximum 9-room) home. This plan is good for 3-years from the
date of approval. During this time, a licensed septic system installer must obtain a permit and
complete this work, and a Certificate of Compliance be endorsed by the installer, designer and
the Town of North Andover or the plan approval will be voided.
This approval is also subject to the following conditions:
1. Prior to the issuance of the Disposal Works Installers Permit, the applicant must
submit a foundation as-built at the same scale as the approved plan.
2. Prior to the issuance of the Disposal Works Installer's Permit,the applicant must
submit the floor plans of the home showing no greater than four bedrooms or a total
of nine rooms.
3. If site conditions are found in the field to be different from those indicated on the
design plan and/or soil evaluation,the originally issued Disposal System Construction
Permit is void, installation shall stop, and the applicant shall reapply for a new
Disposal Systems Construction Permit (3 10 CMR 15.0200)).
4. It is the responsibility of the applicant and/or the applicant's septic system designer,
septic system installer or other representative to ensure that all other state and
municipal requirements are met. These may include review by the Conservation
Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
`J)25 Boston Street (Lot 13) August 7, 2013
and/or Electrical Inspector. The issuance of a Disposal System Construction Permit
shall not construe and/or imply compliance with-any of the aforementioned
requirements.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to install a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincerely,
Sursan Y. Sawyer, S/RS
Public Health Director
Encl. N Andover Installer's list
cc: Phil Christiansen, P.E.
File
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36 ,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
i
AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIWYY(
04/01/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
NORTH ANDOVER INSURANCE AGENCY, INC. PHONE
No, .,): (978) 686-2266 FAX
No):(978) 686-6410
M.J. FOSTER INSURANCE SERVICES
E-MAIL cfernandez@nafins.com
PRODUCER
163 MAIN STREET CUSTOMER ID RILL HALL INC
NORTH ANDOVER MA 01845-2508 INSURER(S)AFFORDING COVERAGE NAICA
INSURED INSURER A :HANOVER INSURANCE CO. 31534
BILL HALL, INC. INSURER B
4 VIVIANA STREET INSURER C
INSURER D
INSURER E
METHUEN MA 01844— INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE D S R POLICY EFF POLICY EXP LIMITS
LTR INSR WVD POLICY NUMBER (MMIDDIYYYY( (POLICY
A GENERAL LIABILITY ZBN9162587 6/11/2012 6/11/2013 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TOR NTE
/ / / / PREMISES Ea occurrence $ 100,000
CLAIMS-MADE 1XI OCCUR / / / / MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS-COMRIOP AGG $ 2,000,000
POLICY F1 E O- LOC / / / / $
A AUTOMOBILE LIABILITY 306899 6/11/2012 6/11/2013 COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED AUTOS BODILY INJURY(Per accident) $
X SCHEDULED AUTOS
X Peaccider nt)PERTY DAMAGE $
HIRED AUTOS (
X NON-OWNED AUTOS / / / / $
$
A X UMBRELLA LIAR __PX OCCUR UHN9175864 6/11/2012 6/11/2013 EACH OCCURRENCE $ 5,000,000
EXCESS UAB CLAIMS-MADE / / / / AGGREGATE $ 5,000,000
DEDUCTIBLE / / / / $
RETENTION $ / / / / $
A WORKERS COMPENSATION WHN8326066 6/11/2012 6/11/2013 WC STATU- OTH-
AND EMPLOYERS' LIABILITY TORY LTS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE Y,N / / / / IMIE.L.EACH ACCIDENT $ 500,_900
OFFICER/MEMBER EXCLUDED? ❑ N(A
(Mandatory in NH) / / / / E.L.DISEASE-EA EMPLOYEd$ 500,000
If yes,describe under
DESCRIPTION OF OPERATIONS below / / / / E.L.DISEASE-POLICY LIMIT I$ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required(
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
STEVE FRANCIOSA
8 NEWELL FARM DRIVE AUTHORIZED REPRESENTATIVE
WEST NEWBURY MA 01985-
ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved.
INS025(200909) The ACORD name and logo are registered marks of ACORD
i
�1
DATE(MMfDD
ACCPRV CERTIFICATE OF LIABILITY INSURANCE 4/5/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT I•V@tt@ Fanaras
Infantine Insurance -(603)669-0704 603-669-6831
P. 0. Box 5125 E-MA'L atte@infantine.com
INSURERIS)AFFORDING COVERAGE NAICI
Manchester NH 03108 itisugragA.Merchants Mutual -23329
INSURED 1msuHw3aAivsEP_Qrt Ins=ance Co
N W S Northern Wall System LLC 1101181111 C'
17 Devco Drive INSURER r2l
INSURER E
Manchester NH 03103 INSURER F,
COVERAGES CERTIFICATE NUMBER:2013/2014 Master REVISION NUMBER:
THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS-
)� TYPE OF INSURANCE D L UBR - PPQHQXW11UR9P I,OLICY EFF PIILICY Fite. LIMITS
GENERAL LIABILITY EA H RR
_.NE 1,000,000
X COMMERCIAL GENERAL LIABILITY -1_ '- 500,000
A CLAIMS-MADE F_x1 OCCUR SOP1046872 /22/2013 /22/2014 MED EXP(Any one erson 15,000
PERSONAL&ADV INJURY 1,000,000
GENERAL AGGREGATE 2,000,000
EN'LAGGRE TE LIMIT APPLIES PER- PRODUCTS- P/OP 2,000,000
X POLICY JPFA LO $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per aaident) $
AUTOS AUTOS
NON-OWNED PROPERTY AMAGE $
HIRED AUTOS AUTOS I.
UMBRELLALIABOCCUR EACH OCCURRENCE
EXCESS LIAR LAIM -MADE AGGREGATE
B WORKERS COMPENSATION }( WC S X
AND EMPLOYERS'LIABILITY Y I N
ANY PROPRIETORIPARTNER/EXECUTIVE E.L EACH ACCIDENT $ 15 91000
OFFICER/MEMBER EXCLUDED? NIA 0288300458502 /23/2013 /23/2014
(Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 500,000
If es,desca under : NH
OF OPERATION'below E.L DISEA E-P LI Y LIMIT
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
various work throughout the policy term.
CERTIFICATE H DER _ __ ___ ______. ___- - _ __CANCELLATION-
glenn—ritter@hotmail.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Sea Salt Builders LLC ACCORDANCE WITH THE POLICY PROVISIONS.
8 Newell Farm Rd
W. Newbury, NA 01985 AUTHORIZED REPRESENTATIVE
Jim Harrison/BYM ^�"""r `
ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved.
INS025(20100e)01 The ACORD name and logo are registered marks of ACORD
9 Massachusetts -De
Board of Butdin Partment of Public Safety.
9 Regulations and Standards
CMistruct1(oil .Super-%isur
License: CS-010578
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F-R'kNCIOS,A .
8
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W NEWgi,MA 01985
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12/18/2013
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DATE: MAY 30, 2013 DWG. NO.: 13011004
PROPOSED FOUNDATION
DIMENSIONS FOR 858 CHRISTIANSEN
JOHNSON STREET, PROFESSIONAL ENGINEERS S ERGI
NORTH ANDOVER MASS. LAND SURVEY
0 SUMMER STR OET RS PH:978-373-0310
HAVERHILL,MASS.01830 FAX:978-372-3960