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HomeMy WebLinkAboutBuilding Permit #489 - 36 SAMUEL WAY 3/17/2009Permit NO: Date Issued: +A I r% A "r 1.-% 11-11 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION /Yo� f IMPORTANT: Ap Print PROPERTY OWNER'�-' ' t•�� -.Print Historic.District PARCEL — ONING"DISTRICT: MAP NO: 2 M achine Shop V, Yes me fives ,�� TYPE OF IMPROVEMENT PROPOSED USE Residential. Non- Residential New Building One family Addition Two or more family lndustrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well -r, Floodpla'i n Wetlands, Wat had -.District, Wat6r/Sewer-, DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print PrintClearly) OWNER: Name: �j� Phone: -"`)-7C Address: 71: CONTRACfQR marne:-- Phone`fJ7?,> -)�-26 6,IoZP� _Q V, Address. 0 / A, Supervisor's Construction']Lic6. s -e- Exp. Date F II.H6m6.l4pr6,v6m.e-nt,Li,G-ense: Exo. 'Date: e, Phone: f-) -70 ---:�>-71 /ARC NGINEER-:��lr'�- Address: Reg. No. 4 FEE SCHEDULE: BULDING PERMIT. MOO PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. r:�:. 7 2� Total Project Cost: $ FEE:$ 6- Check No.: Receipt N o.: 7 NOTE: Persons contracting with ynrq� po ,, j#eq d contractors do not have accessAtheffif9rantyfund 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 G4--/ 11;V THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED. PLANNING & DEVELOPMENT /, ©" COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Commeni Water & Sewer Connection/signature & Dat DPW Town Engineer: Signature: FIRE DEPARTMENT Temp,DOM, p 'Located at,124>MaimStreet`: Fire .Department signature/date C';0MMFNTS s Num''m ail 3-13-I /� I I A A CONSERVATION Reviewed on Signature COMMENTS OC2 ��Z/ G4--/ 11;V /Z&. HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Commeni Water & Sewer Connection/signature & Dat DPW Town Engineer: Signature: FIRE DEPARTMENT Temp,DOM, p 'Located at,124>MaimStreet`: Fire .Department signature/date C';0MMFNTS s Num''m ail 3-13-I /� I I A A 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 y 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 o 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 G fly? U�f�iJ"' rf `• Location J r No. Date /% b TOWN OF NORTH ANDOVER o • Certificate of Occupancy $ 160 Building/Frame.Permit Fee $ '& Foundation Permit Fee $ /9U Other Permit Fee $ TOTAL Check # t 2187 6 Building Inspector 9 El O 7 1`-'-� 4 0 p V p w y a C/)w ° U a :3 u: U Cd x EpEi� W :3 p a m C w a O w W a p w y cn ii x p cx cn u. z w co z cn 0�1 ca p cn c o : m C ;;C O i-+ O i C N O C g O :vV .CL C dR R tC O O cc Ea COMc CD 0 CL S: H E c Co :cam cm� ts cm N A co Nip c �J c V m * ecv C � o \0 a CLc ci y O o '� Z • c � o c N O C = O O 3 � O a.- ol-o r.+ H O • r W C 4: •H �dt ea C 7 +' W •� v 'd , C cim m C*a m= O� _ CA OM= N = H t �0+ d r=... m a y t 0 coCA C O ID co 00 o` c �C N co t O Z O 5 CDF. ®II co 0 co L 0 V Z °o CL. O H ® C 0 cm i O y 0 .0 �� m cc 0 0 CL ~ CD a3 0 ® 0 cc O CLL- CL M C Q c � c Cev L -� •a o ar CO2 Q CL �..� h 0 C c c !O 0. cm uj c U) U) W W W Edgewood Retirement Community, Inc. -575 Osgood St. North Andover, MA 01845 TOWN OF NORTH ANDOVER Check Date: 03/12/2009 Invoice Description Date Gross Amount Discount Net Amount Paid 03/12/2009 /'l 03/12/2009 $18.089.55 $0.00 $18,089.55 Detach at Perforation Before Depositing Check Grand Totals 518, 08,9,55 $0, 00 518, 089.55 Page .l of 1 Check No. 10008 �Check�bateA 03/12/2009 SIG C�ecl%Arnounl�' ��; $` *""18,089.55 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 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 42 0.290 12 Door: Glass 58 0.290 17 Ceiling: Flat Ceiling or Scissor Truss 1725 38.0 0.0 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 usinphe applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be Do eater t an 125% of the design load as specified in Sections 7 CMR 1310 and J4.4. Name Title Sig r Date Project Notes A3(e UUnit B S r-�Je� t� -T 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 BOARD OF BUILDING REOULATIONS I- License: CONSTRUCTION SUPERVISOR Numtie�C 094621 - Birth a-7aDa1970 f41-7 0D010 Tr. no: 94621 i ; 4 ic OkiCORY E FISF�ER /f 30 JORpAN STREET =��..z%%i G- BEVERLY; MA 0191577 j Commissioner Im AC-98D-CERTIFfCATh OF LIABILITY INSURANCCI DATE (MM/DDmYY) OP ID B 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 _- Phone: 781-665-2775 Fax:781-665-0295 INSURED Windover Construction, Inc. Attn Karen Cochand 13 Elm Street Manchester MA 01944 COVERAGES INSURERS AFFORDING COVERAGE NAIC # INSURER A: A8 en Specialty Iris. CO. INSURER B: United specialty Insurance co. INSURER C: OneBeacon Insurance Group INSURER D: American Internat'i Companies INSURER E: ua I to ntLUw 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 PAIn CI ANA LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MWEXPDIY1 LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MAGE OCCUR GL000574-01 01/01/07 01/01/09 EACH OCCURRENCE S 1 "Oh , 000 PREMISES Eaaccurence) 550,000 MED EXP (Any one person) $ EXCLUDED PERSONAL INJURY S 1,000 000 GENERAL AGGREGATE $ 2 000 000 1 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY X JECT LOC PRODUCTS -COMP/OPAGG 32,000 On AUTOMOBILE LIABILITY ANYAU70 COMBINED SINGLE LIMB (Eeaccident) $1,000,000 ALL OWNED AUTOS C X X SCHEDULED AUTOS HIRED AUTOS FB1E07908 - 04/01/08 04/01/09 - BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) 4 GARAGE LIABILITY ANY AUTO - AUTO ONLY - EA ACCIDENT 4 OTHER THAN EAACC AUTO ONLY: AGG 4 4 EXCESSNMBRELLALLABILITY B X OCCUR EICLAIMSMADE CXA4GS708 09/25/08 01/01/09 EACH OCCURRENCE 45000000 AGGREGATE 45000000 4 DEDUCTIBLE 4 X RETENTION $ 4 WORKERS COMPENSATION AND D EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? WC6967012 Q3 /20/08 03/20/09 X TORY LIMITS ER EA. EACH ACCIDENT s500,00O E.L. DISEASE -FA EMPLOYEE $500 000 If yes, describe under SPECIAL PROVISIONS below OTHER E.LDISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES / FYCI uSinus: enncn 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 GtK I It-IGA 1 E MULUER CANCELLATION EDGEW-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR7FXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 Edgewood Retirement Community NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILUREInc 575 Osgood Street IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT N. Andover MA 01845 REPRESENTATIVES, A E © ACORD CORPORATION 1988