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Building Permit #494 - 39 Martin Street 12/20/2011
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: vL— Date Received Date Issued: _ r,� EVIPORTANT• Applicant must comRlete all items on this nage 0 ILI Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes 100 year-old structure yes TYPE OF IMPROVEMENT PROPOSED USE N New Building ❑ Addition ❑ Alteration ❑ Repair, replacement ❑ Demolition Residential R*One family ❑ Two or more family No. of units: ❑ Assessory Bldg ❑ Other vvemu ` F1°°dP gin L, lands �• DES ION F W RK TOB PERFO "l (Id OWNER: Name: , n Please Type or Print Clearly) Non- Residential 0 Industrial 0 Commercial 0 Others: .r , .•-, D Watershed istnct Address:_ZV IVJgj6b,�o CONTRACTOR Name: ! - g. —� y Phone:F– 9� � � Address: � ��� hiC�(r fa �^ '1 0�AC u /'I ASS. Supervisor's Construction License: Home Improvement License: Exp. Date: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT: $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access= he guarantatfund 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: Doc.Building Permit Revised 2008mi 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 APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Boa, -;d of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Bot-�rd Decision: Conservation Decision: Comm Comme Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site Located at 124 Main Street Fire Department signature/date COMMENTS Located 384 Osgood Street yes no 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.$10041000 fine Doc:.Building Permit Revised 20117une/mi Location 27 Aftj,07 Ae- No. � i o�,.,3 Date J1) '�"—�/ NORTH TOWN OF NORTH ANDOVER f Ad L s A Certificate of Occupancy $ CMUs ��' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # IJ 24901 Building Inspector rA 0 s? O d 0) Q 00 c C a ym� o x ~ rO� N mCIO W C U> H v co100 : U w H w ao' w w U a wCd cn w x E cla w z w v w� o z, cn Q x 0 CO O d 0) Q R U 0 O v O O CD L O 5 Z °o 0. O y G C O cm C' .� y CD., O m cc CD CL �� CD Ci L o a CL CM< C O O CJCA J •a C Z CD CL C3 h O C .c c W LLI U) 19 W 19 W LLIN O� o CLO c C a ym� o ~ rO� N mCIO W C Cc =�Z LL N O t0 O C O ac E CJ 2 c . _ CW.3 o CODtoR- R U 0 O v O O CD L O 5 Z °o 0. O y G C O cm C' .� y CD., O m cc CD CL �� CD Ci L o a CL CM< C O O CJCA J •a C Z CD CL C3 h O C .c c W LLI U) 19 W 19 W LLIN i. '`.. •'7 i E+F construction North Andover Maa J' wvn ��+ I Vol I iN�l OLUI W 1855 Bridge st. Dracut Ma. 01826 ' (978) 459-3672 (978)423-0286 (978) 441-0040 First floor: 40,000 btu furnace 96+ °!o eff j --2 tons of a/c condenser and coil air cl C%E eaner .� steam humidifier Second floor: 45,000 btu furnace % effo� �9f 1.5 tons of a/c condenser and coil air cleaner We will supply and install ductwork supply and return all grills, registers,drains,ref lines necessary for @ system. Note ductwork for @ system is equal to enegry star all ductwork is sealed and insulated per code total price 13,850.00 / U ��i� 60 ACRD` CERTIFICATE OF LIABILITY INSURANCE 1211 TE MM/DD/YVYY) PRODUCER Cowan Insurance Agency, Inc. 359 Main Street Haverhill MA 01830 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Desired Temperature, Inc. 1855 Bridge Street Dracut MA 01826 INSURER A: Employers Mutual Casualty Company INSURER B: Technology Insurance Company INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OFINSURANCELISTED 'BELOW HAVE BEEN ISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPCRIODINDICATED. 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 BYTHE POLICIES DESCRIBEDHEREIN ISSUBJECTTOALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY NUMBER POLICY EFFECTIVE TEIMMID)IYYYYL POLICYEXPIRATION DAT LIMITS Phone: Fax: (978)685-7362 GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 A X COMMERCIAL GENERAL LIABILITY 3D27294 08103111 08103112 CLAIMS MADE Fx_1 OCCUR MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 x Blanket additional insured GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOC A AUTOMOBILE LIABILITY ANY AUTO 3Z27294 08103111 08103112 COMBINED SINGLE LIMIT $ Ea accident) BODILY INJURY (Per person) $ 100'000 X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ 300,000 (Per accident) X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ 100,000 (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV© TWC3284503 08103111 08103112 WC STATU- OTH- E.L. EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYER $ 100,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS HVAC Contractor. All parties as required by contract are listed as additional insureds on the general liability insurance policy. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rignts reserves. The ACORD name and logo are registered marks of ACORD SHOULDANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Follensbee-E & F Construction DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN PO BOX 398 - - - -- - - '' - %1OTICE TO?HE CERTIE!CA.TE HOLDER NAMED T6 THE LEFT, BUT FAILURE TO DO SO SHALL. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR North Andover, MA 01845 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Phone: Fax: (978)685-7362 ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rignts reserves. The ACORD name and logo are registered marks of ACORD fA API of NH Duct Design Load Short Form Entire House A. P. I. OF NEW HAMPSHIRE Project Infom rm tion For: SCOTT FOLLANSBEE, DESIRED TEMP NORTH ANDOVER, Ma Job: Date: Aug 30, 2011 By: HEATING EQUIPMENT Make Rheem Trade RHEEM, RUUD Model RGRM-06(E,N)MAES AHRI ref no.4356280 Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 95AFUE 11.6 EER, 15 SEER D • e e Btuh Htg Cig Infiltration Outside db (°F) -1 94 Method Simplified Inside db (°F) 68 70 Construction quality Average Design TD (°F) 69 24 Fireplaces 0 Daily range - M Inside humidity (%) 50 50 Moisture difference (gr/Ib) 47 57 HEATING EQUIPMENT Make Rheem Trade RHEEM, RUUD Model RGRM-06(E,N)MAES AHRI ref no.4356280 Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 95AFUE 11.6 EER, 15 SEER 60000 Btuh 58000 Btuh 48 OF 1100 cfm 0.034 cfm/Btuh 0 in H2O COOLING EQUIPMENT Make Rheem Trade RHEEM RASL SERIES Cond RASL-036JEC Coil RCFL-H*3617+RGRM-06?MAE? AHRI ref no.4050961 Efficiency 11.6 EER, 15 SEER Htg load (Btuh) Sensible cooling 23100 Btuh Latent cooling 9900 Btuh Total cooling 33000 Btuh Actual air flow 1100 cfm Air flow factor 0.048 cfm/Btuh Static pressure 0 in H2O Load sensible heat ratio 0.84 42 ROOM NAME n/41 Area (ft2) Htg load (Btuh) Cig load (Btuh) Htg AVF (cfm) Cig AVF (cfm) mstr bdrm 234 3766 2570 128 123 mstr bath 104 2511 1321 86 63 wic 91 1233 885 42 42 greatrm 320 3921 3850 134 184 foyer 169 1861 868 63 41 break/kit 378 2470 2526 84 120 study 80 961 1048 33 50 dining rm 182 2527 1695 86 81 storage 208 2694 2403 92 115 bdrmi 245 4761 2647 162 126 bdrm2 258 2395 1733 82 83 bath2 60 210 126 7 6 II ' 96 2967 1393 101 66 ope a Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. wrightsoft* Right -Suite® Universal 8.0.16 RSU11815 ACCA ...nts\Wrightsoft HVAC\Template\desired temp scott follansbee.rup Calc = MA Front Door faces: 2011 -Aug -30 14:22:59 Page 1 Entire House 2525 32276 23067 1100 1100 Other equip loads 0 0 Equip. @ 0.99 RSM 22836 Latent cooling 4431 TnTA I C 7r7G 41-W17a 13713nQ 14M i i nn V 1llLV LJLJ VLL, V LlLW ..VV 1 1 Vu Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. t ' wri htSoft° 2011 -Aug -30 14:age 2 9 Right -Suited Universa18.0.16 RSU1i815 Page 2 ACCK ...nts\Wrightsoft HVAC\TemplateWesired temp scoff follansbee.rup Calc = MJ8 Front Door faces: