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HomeMy WebLinkAboutBuilding Permit #483 - 35 CAROLINE WAY 3/17/2009BUILDING PERMITr.o 6� '' •6 O A TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION b Permit NO: q _ Date Received Date Issued: J111101\ IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER Ew'ro t 2Ez yz--F_ Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes; ! Machine Shop Village yes ti o) TYPE OF IMPROVEMENT PROPOSED USE Re idential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer . DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: `5_7b Address: '!:57 Cyt)C-*� �� CONTRACTOR Name:�� : c5'7 Z Address: I e—, -T t_�c.t + E -45, Tf '- i�✓!l� Supervisor's Construction License: 6 0A ee2_1 Exp, 'Date: 2 a Home Improvement Date: A�ITECTNGINEER �� I1�� -�t`7[�� Phone:f')'7 16 "37 " 7f5C�_") Address: c�r-�<z i 'j i - � 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: $ t 2 �� FEE: $ - CDC) Check No.: 100 f Z_ .-.i I Raraint Nn • " /gi eF-" I Location 3,�' &Ia y No. W /Date 7�,f NORTry TOWN OF NORTH ANDOVER • s Certificate of Occupancy $ Q li Building/Frame Permit Fee $ Foundation Permit Fee $ 0 d Other Permit Fee $ TOTAL $ Check # / 2r d 2., 863 1P Bdilding Inspector L Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public 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 PPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS A HEALTH ' COMMENTS A Reviewed on4Signature 2Z i� Reviewed on_,_ . Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Da J/Driveway Permit 1 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp :Dumpster on site yes no Located at 124,Main 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.: ELECTRICAL: Movement of Meter location_ , mast or service droprequires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NU I t5 and UA I A - ( For de ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 use 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 ER1 L rA W r� x O o O w cn 0 U as z w x w c U x O U W W a0 p w C ii O U W �' a w p w c3i �, C w p U m p w G w w v a co . cn O cn O z O `" �O w0 a a U C.7 CD O �• L _O Z CD CL O CO) D C co cm I O 'O CD h CD � C m CD 0 co C3 O � co O ® OL eyv o CL CL cm< c� O+�•+ Cc 0S C co CL V y c C C c 0. LU U) ui U) W W V9 LUW iii O :•m C ;;C O o c H o c "r o Qc R R m C � O o m E Q ID CE m o �• Q C ,wn::.. ev m y• m O a m 3_ (�� O h c C � O C O m � O O cm o m fir; �t=o cm CM Co m o V N O Z m O �.: A C C CL C C •O Q : y m C ~ CD K:5 CD N m CC Lu a ® ea = m C .... �tA .�... m .E 4.D .y o LU W � O F— cc t $ 0..=.. m O `" �O w0 a a U C.7 CD O �• L _O Z CD CL O CO) D C co cm I O 'O CD h CD � C m CD 0 co C3 O � co O ® OL eyv o CL CL cm< c� O+�•+ Cc 0S C co CL V y c C C c 0. LU U) ui U) W W V9 LUW iii IN 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 Unit E.rck Energy Code: Massachusetts Energy Code 1684 21.0 0.0 Location: North Andover, Massachusetts 91 Construction Type: 1 or 2 Family, Detached 58 0.290 Heating Type: Other (Non -Electric Resistance) 47 Glazing Area Percentage: 21% 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 Compliance: 0.0%. Better Than Code Maximum UA: 344 Your UA: 344 Basement: Solid Concrete or Masonry Wall height: 7.5' Depth below grade: 7.5' Insulation depth: 7.5' First Floor: Wood Frame, 16" o.c. Windows: Wood Frame:Double Pane with Low -E Door: Solid Door: Glass Ceiling: Flat Ceiling or Scissor Truss 1671 0.0 10.0 94 1684 21.0 0.0 71 303 0.300 91 84 0.290 24 58 0.290 17 1577 38.0 0.0 47 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 sing the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building sha n eate than 125% of the design load as specified in Sections 7 CMR 1310 and J4.4. 'IUr� Lo(z Name - Title Sig �} Date �SSoC.I�t G Project Notes: Unit E -A'� W-A`f Project Title: Edgewood Retirement Community Report date: 08/21/08 Data filename: F:\DSA Project Files\Edgewood 0706\04. MA Energy Code Check\0706 Unit E.rck Page 1 of 1 ----------- BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR l NumbeCS 094621 s er ith a0171970 p0 0 Tr. no: 94621 "Mete CORY EFISHI,R - 30 JORAN STF2E ;f G` j gjVffk.Yj. NIA 0191 ^" " Cominiss�orier P H AC -2-R- CERTIFICATE OF LIABILITY INSURANCC� OP ID B DATE(MMIDD/YYYY) WINDO-4 11/03/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE McLaughlin Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 828 Lynn Fells Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Melrose MA 02176 POLICY NUMBER Phone: 781-665-2775 Fax:781-665-0295 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: A3 en Specialty Iris. CO. Windover Construction, Inc. Attn Karen Cochand Manchester MA 01944 Elm Street Ma INSURER B: United apacialty insurance Co. INSURER C: OneBeacon Insurance -Group INSURER D: American Intarnat'l Companias INSURER E: RA�/FRAl: FS 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. INO LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MWDD 'POLICY EXPIRA DATE MWDD(YY LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY GL000574-01 CLAIMS MADE OCCUR 01/01/0.7 01/01/09 _ EACH OCCURRENCE $1,000,000 PREMISES(Eeoo=usnoe) $ 50,000 MED EXP (Any one person) $ EXCLUDED PERSONAL& ADV INJURY 31,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JEC LOC GENERAL AGGREGATE S 2 000, 000 PRODUCTS - COMP/OP AGG $2,000,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ee accident) $ 1, 0 0 0, 0 0 0 ALL OWNED AUTOS C X X SCHEDULED AUTOS FBIE07908 HIRED AUTOS 04/01/08 04/01/09 BODILY INJURY $ (Per person) X NON -OWNED AUTOS BODILY INJURY $ (Per socidenl) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY HANYAU70 AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC S AUTO ONLY: AGG $ EXCESSAIMBRELLALIABILITY B X OCCUR LAI MADE CXA4GS7O8 09/25/08 01/01/09 EACH OCCURRENCE $SOOOOOO AGGREGATE 3 5000000 Js DEDUCTIBLE $ X RETENTION $ WORKERS COMPENIs SATION AND D EMPLOYERS' LIABILITYER ANY PROPRIETORIPARTNERIEXECUTNE WC6967012 OFFICER/MEMBER EXCLUDED? 03/20/08 03/20/09 X TORY LIMITS T E.LEACHACCIDENT $5OO 000 E.L. DISEASE - EA EMPLOYEE $ 500 000 If yyes, dasorlba under SPECIALPROVISIONSbelow OTHER E.L. DISEASE -POLICY LIMIT $500 OOO DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES I rYCI ILSIMM ennan 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 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL Inc 575 Osgood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR N. Andover MA 01845 REPRESENTATNES, NE © ACORD CORPORATION 1988 .,�,'� is