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HomeMy WebLinkAboutBuilding Permit #546-2016 - 39-67 Saunders Street 11/2/2015ivJvz:-R // 5- -15— Permit Date Issued: LOCATION BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION IMPORTANT: Applicant must c I , 61 6avvider5 5 PROPERTY OWNER bt-0,4tre + Date Received all items on this Lt c - ' Print 100 Year Structure MAP PARCEL: ZONING DISTRICT: Historic District Machine Shop Village NORTH w- OFD 1 16 6grC ,P 1• 7A A�RA7EU �PP��S yes no yes no yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ❑ One family [I Addition XTwo or more family 11 Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer DESCRIPTION OF WUKK I U tit rtK1-UK1V1tu: w4i-4A ►yes �6-h' ave �✓''�"I �i`� ��& fe�,kk, � � OWNER: Name: WradS-K'4.L' Address: Contractor Name: la Email: w"IL t e -f- e GD Address IF it; 1►n M0Y-0VG+V -leas Type or Print Clearly V � t,(,(- Phone: �SSr S Phone: 0)510 -461 °2Vq- T Supervisor's Construction License: C�- las 181 Exp. Date: 1� I Home Improvement License: �� Exp. Date: ARCHITECT/ENGINEER � V La �l� S�. AK06, ```L Phone: Address:[ 51 v, &w OA- 0 AQ Reg. No. � FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. �--r:.-� ' Total Project Cost: $ FEE: $ _ �} Check No.:&,q Receipt No.- NOTE: Persons contractingit unregistered contractors do not have access to the guaranty fund IA A 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. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On (©1zi NS Signature_ 0 5(cC P�rMir CI`(� �Cjl� PIV COMMENTS els dei � dated i -G-2.0 - A. 5�i�ei ��•3, l CONSERVATION Reviewed o CO TS C\ �� 5 w HEALTH CO Reviewed N nature re Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer Connectio DPW Town Engineer: Signature: FIRE ,DEPARoTMENIT TempApurr Lodatedlit .124'IMdAtStt6bt Oi'reiDepartment.signature/date CC)MMENTS - Comments Co OK / -- Located 84 O: Street Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. '�; 13 6 x 3 Total land area, sq. ft.: ��, qg� 4F ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine Wk NOTES and DATA — (For department use) 0 Iia ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 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 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/Cross Section/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 TOTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products IOTE: 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 Revised 2014 Location J.9 -7 S6 Date //hl� ? No. Check # // TOWN OF NORTH AND61ER Certificate of Occupancy $ Building/Frame Permit Fee ®o Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /'Building Inspector J!) -b/ z>aunaers mreet ib Kesiaentlal Apartments Address I IBuilding I I Electical I I Plumbing/Gas I Notes 39 Rough Final 411 Rough Final 43 Rough Final 451 Roug Final 47 Rough Final 49 Rough Final 511 Rou€ Final 531 Roug Final 55 Rough Final 57 Rough Final 591 Roug Final 611 Rough Final 63 Rough Final 65 Rough Final 671 Roug Final w- Debms, Maura From: Deems, Maura Sent: Monday, December 28, 2015 12:23 PM To: 'mark@verdecodesigns.com' Subject: 39-67 Saunders Street Attachments: 201512281224.pdf Mark, Please see attached sheet I created for inspections at 39-67 Saunders Street. I am hoping that you can attach this sheet to the back of the building permit card so that the units can be easily signed off by the inspectors. Please let me know that you have done this so that I can let all the inspectors know that it is there. Thank you, Maura Deems Building Department Assistant Town of North Andover -----Original Message ----- From: noreply@townofnorthanfover.com [mailto:noreply@townofnorthanfover.com) Sent: Monday, December 28, 2015 12:25 PM To: Deems, Maura Subject: Message from "CommDev-Ricoh" This E-mail was sent from "CommDev-Ricoh" (Aficio MP C4502). Scan Date: 12.28.2015 12:24:35 (-0500) Queries to: noreply@townofnorthanfover.com 0 :5y -b/ ,)aunaers mreet ib Kesiaentiai Apartments Final Rough Final 451Rough Final Final 531 R Final 571Rough Final 611Rough Final 651Rough Deems, Maura From: Deems, Maura Sent: Monday, December 28, 2015 2:43 PM To: 'Mark Yanowitz' Subject: RE: 39-67 Saunders Street Thank you. Should help to minimize confusion and keep the inspections organized. Maura From: Mark Yanowitz[mailto:mark(cbverdecodesigns.com] Sent: Monday, December 28, 2015 2:39 PM To: Deems, Maura Subject: Re: 39-67 Saunders Street Thanks Maura! I have printed the form and will attach it to the permit tomorrow! Cheers, Mark Mark Yanowitz, LEER AP, Associate AIA, ucsL Verdeco Designs, LLC 978-409-2217 markgverdecodesigns.com On Dec 28, 2015, at 12:23 PM, Deems, Maura <MDeems@townofnorthandover.com> wrote: <201512281224.pdf> CD 0 Z CD o Cr Q �. O O v CD CLc cD O CD �- o C• CD U) CD O Ow. n 0 U) CCD rF CD CD .w O 0 CD i0 CD 0 V� < 0 :3 " < °1 = =� .� Cl) D-1 c O. � n CD m O 0 0. C) 3 N O rta m o, o N m 00 vi 0 N <D 0 : m S O Q O R C O O O O rt to to N Q O O O N �� � � n .D c7 S. co o0cn CD to "a : n z CD ha Cr rt O D CD co) CL • � cn n = < CL O — Q. — cn n <(n=\ o `° c N (D yCL CD �� CD ' O i .a C) �•�� '� CO) -1- w+ O v �.� vat 03 0 ;! y DSO O O =rCD cD G -h D CD O CL O O � O \ .lt O. B ;rr0-r (D ,N' O c I 3 (D m Z j N O O N Z m T O V1 O n. (D 7p O C 3 m D Z f1 0 T :3O al C cm S C W z M 0 T Na n S 3 (D G � O O aq S T O C O C D G1 LA m O N (D 'O f1 Ln h 3 T O O \ n =3 O p 2 Dm 2 1 J v Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 11926,000.00 m $ - $ 23,112.00 Plumbing Fee $ 2,889.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 2,889.00 Total fees collected $ 28,990.00 39-67 Saunders Street 546-2016 on 11/2/2015 15 Apartments Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 11926,000.00 m $ - $ 23,112.00 Plumbing Fee $ 2,889.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 2,889.00 Total fees collected $ 28,990.00 39-67 Saunders Street 546-2016 on 11/2/2015 15 Apartments j D- LaGrasse & Associates, Inc. Architects, Engineers & Land Planners November 2, 2015 North Andover Board of Health North Andover Town Hall 1600 Osgood Street, North Andover, Ma 01845 Re: Bradstreet on Main Attn. Susan Sawyer, Architects Joseph D. LaGrasse, AIA Thomas E Galvin, AIA Juliann E. Hoch, RA Please accept this memo as my Affidavit as an amendment to my Building Permit Architectural Affidavit given to the Building Department for the issuance of a Building Permit. I have never had to submit a special one to the Board of Health and do not have any special forms. The 15 DU building under construction shall comply with the requirements of the Department of Public Health Human Habitation Code MGL 105 CMR 410.000. Exception: When completed, the building will be in compliance with the occupancy requirements, however I cannot certify that the continued operational maintenance of the building under the habitation code will be continued. _ . ► ui . . Signed: V' ikc. Joseph D r.D ARC,%,TF g p, La O to `9 053 r No' R m o MP sa AIA �� �i oFACTH OF Joseph D LaGrasse and Associates, 1 Elm Square, Andover, Massachusetts, 01810 One Elm Square T 978.470.3675 Andover, MA 01810 F 978.470.3670 www.lagrassearchitects.com 1420 Celebration Blvd. Celebration, FL 34747 AA26001333 D. Robert Nicetta, Building Commissioner lvvvIII "r III" IN litt11\11VVr.11 OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North. Andover, Massachusetts 01845 Telephone (978) 688-95454 Fax (978)688-9542 CONTROL CONSTRUCTION - SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 I, Jot, >✓V� I L a 6fe"t �� e Y CERTIFY THAT THE BUILDING CONSTRUCTED AT ?q-61 Saari def S `a+ DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHI REGIS I NOTE: ENGINEER "WET STAMP" MUST BE AFFIXED TO THIS FORM Control Construction Form revised 11. 15.2004 BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Generated by REScheck-Web Software Compliance Certificate Project 39-67 Saunders St., N. Andover Energy Code: Location: Construction Type: Project Type: Conditioned Floor Area Glazing Area Climate Zone: Permit Date: Permit Number: 2012 IECC Essex County, Massachusetts Multi -family New Construction 15,408 ft2 16% 5 (6499 HDD) Construction Site: Owner/Agent: Designer/Contractor: 39-67 Saunders St Willard Perkins Mark Yanowitz North Andover, Massachusetts Bradstreet Partners, LLC Verdeco Designs LLC 01845 28 Andover St 1 Elm Square Andover, Massachusetts 01845 Andover, Massachusetts 01810 (978)475-5400 978-409-2217 wperkins@hearthstonerealty.com mark@verdecodesigns.com Compliance:trade-off Compliance: 16.6% Better Than Code Maximum UA: 1411 Your UA: 1177 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. Envelope Assemblies Ceiling: Flat or Scissor Truss 15,408 0.0 49.0 0.020 308 Wall: Wood Frame, 16in. o.c. 7,830 20.0 5.0 0.044 287 Window: Vinyl Frame, 2 Pane w/ Low -E 1,215 0.300 365 Door: Solid 63 0.200 13 Door: Glass 21 0.300 6 Floor: Unheated Slab -On -Grade 290 10.0 0.684 198 Insulation depth: 4.0' 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 2012 IECC requirements in REScheck Version 5..5.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. A"yucyv'J� , MNGIttj 1 � � f'p ko 116/ Name - Title I I Si aur Dat Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Pagel of 8 REScheck Software Version 5.5.0 Inspection Checklist Energy Code: 2012 IECC Requirements: 100.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section # Pre-Inspection/Plan Review Plans Verified Value Field Verified ValueComplies? Comments/Assumptions & Req.lD 103.1, Construction drawings and ❑Complies Requirement will be met. 103.2 documentation demonstrate ❑Does Not [PR111 energy code compliance for the ❑Not Observable ;� building envelope. ❑Not Applicable 103.1, Construction drawings and ❑Complies Requirement will be met. 103.2, documentation demonstrate ❑Does Not 403.7 energy code compliance for []Not Observable [PR3]1 lighting and mechanical systems. u; Systems serving multiple ❑Not Applicable dwelling units must demonstrate compliance with the IECC Commercial Provisions. 302.1, Heating and cooling equipment is Heating: Heating: ❑Complies Requirement will be met. 403.6 sized per ACCA Manual S based Btu/hr— Btu/hr ❑Does Not [PR2]2 on loads calculated per ACCA Cooling: Cooling: ❑Not Observable w Manual J or other methods Btu/hr Btu/hr ❑Not Applicable approved by the code official. Additional Comments/Assumptions: 11 High Impact (Tier 1) 12 1 Medium Impact (Tier 2) 13 1 Low Impact (Tier 3) Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Page 2 of E Section # Foundation Inspection Plans Verified Value Field Verified Value Complies? I Comments/Assumptions & Req.ID 402.1.1 Slab edge insulation R -value. R- R- ❑Complies See the Envelope Assemblies [FO1]1 ❑ Unheated ❑ Unheated []Does Not table for values. Heated E] Heated []Not Observable ❑Not Applicable 303.2, Slab edge insulation installed per ❑Complies Requirement will be met. 402.2.9 manufacturer's instructions. ❑Does Not [F02]1 []Not Observable Its ❑Not Applicable 402.1.1 Slab edge insulation ft ft ❑Complies See the Envelope Assemblies [F03]1 depth/length. _ _ [-]Does Not table for values. []Not Observable ❑Not Applicable 303.2.1 A protective covering is installed ❑Complies Requirement will be met. [FO11]2 to protect exposed exterior ❑Does Not insulation and extends a ❑Not Observable minimum of 6 in. below grade. ❑Not Applicable 403.8 Snow- and ice -melting system ❑Complies Exception: null. [FO12]2 controls installed. ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 111 High Impact (Tier 1) 12 1 Medium Impact (Tier 2) 13 1 Low Impact (Tier 3) Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Page 3 of 8 Section # Framing / Rough -In Inspection Plans Verified Value Field Verified Value Complies? Comments/Assumptions & Req.ID 402.1.1, Door U -factor. U-_ U-_ ❑Complies See the Envelope Assemblies 402.3.4 ❑Does Not table for values. [FR1]1 ❑Not Observable ❑Not Applicable 402.1.1, Glazing U -factor (area -weighted U-_ U-_ ❑Complies See the Envelope Assemblies 402.3.1, average). []Does Not table for values. 402.3.3, []Not402.3.6, Not Observable 402.5 ❑Not Applicable [FR2]1 303.1.3 U -factors of fenestration products ❑Complies Requirement will be met. [FR4]1 are determined in accordance ❑Does Not with the NFRC test procedure or ❑Not Observable taken from the default table. ❑Not Applicable 402.4.1.1 Air barrier and thermal barrier ❑Complies Requirement will be met. [FR23]1 installed per manufacturer's ❑Does Not instructions. ❑Not Observable ❑Not Applicable 402.4.3 Fenestration that is not site built ❑Complies Requirement will be met. [FR20]1 is listed and labeled as meeting ❑Does Not AAMA /WDMA/CSA 101/I.S.2/A440 []Not Observable or has infiltration rates per NFRC ❑Not Applicable 400 that do not exceed code limits. 402.4.4 IC -rated recessed lighting fixtures ❑Complies Requirement will be met. [FR16]2 sealed at housing/interior finish ❑Does Not N - and labeled to indicate <_2.0 cfm ❑Not Observable leakage at 75 Pa. []Not Applicable 403.2.1 Supply ducts in attics are R-_ R-_ ❑Complies Exception: null. [FR12]1 insulated to >_R-8. All other ducts R- R- ❑Does Not in unconditioned spaces or []Not Observable outside the building envelope are ❑Not Applicable insulated to >_11-6. 403.2.2 All joints and seams of air ducts, ❑Complies Requirement will be met. [FR13]1 air handlers, and filter boxes are ❑Does Not sealed. ❑Not Observable ❑Not Applicable 403.2.3 Building cavities are not used as ❑Complies Requirement will be met. [FR15]3 ducts or plenums. ❑Does Not []Not Observable ❑Not Applicable 403.3 HVAC piping conveying fluids R-_ R-_ ❑Complies Requirement will be met. [FR17]2 above 105 °F or chilled fluids ❑Does Not 14 below 55 °F are insulated to >_R- ❑ Not Observable 3 ❑Not Applicable 403.3.1 Protection of insulation on HVAC ❑Complies Requirement will be met. [FR24]1 piping. ❑Does Not ❑Not Observable ❑Not Applicable 403.4.2 Hot water pipes are insulated to R- R-_ ❑Complies Requirement will be met. [FR18]2 >_R-3. ❑Does Not a ❑Not Observable ❑Not Applicable 11 High Impact (Tier 1) 2 1 Medium Impact (Tier 2) 3 1 Low Impact (Tier 3) Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Page 4 of 8 Section # I Framing / Rough -In Inspection & Req.ID 403.5 Automatic or gravity dampers are (FR19]2 installed on all outdoor air intakes and exhausts. Additional Comments/Assumptions: Plans Verified Field Verified Complies? Value I Value []Complies ❑Does Not ❑Not Observable ❑Not Applicable Comments/Assumptions Requirement will be met. 11 High Impact (Tier 1) 2 1 Medium Impact (Tier 2) 3 1 Low Impact (Tier 3) Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Page 5 of 8 Section # Insulation Inspection Plans Verified Value Field Verified Value Complies? Comments/Assumptions & Req.ID 303.1 All installed insulation is labeled ❑Complies Requirement will be met. [IN13]2 or the installed R -values ❑Does Not u provided. ❑Not Observable ❑Not Applicable 402.1.1, Wall insulation R -value. If this is a R- R- ❑Complies See the Envelope Assemblies 402.2.5, mass wall with at least 1/2 of the ❑ Wood ❑ Wood []Does Not table for values. 402.2.6 [IN3]1 wall insulation on the wall exterior, the exterior insulation F] Mass Mass ❑Not Observable 1�0 requirement applies (FR10). ❑ Steel ❑ Steel ❑Not Applicable 303.2 Wall insulation is installed per ❑Complies Requirement will be met. [IN4]' manufacturer's instructions. ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 11 High Impact (Tier 1) 2 1 Medium Impact (Tier 2) 3 1 Low Impact (Tier 3) Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Page 6 of 8 Section # Final Inspection Provisions Plans Verified Value Field Verified Value Complies? Comments/Assumptions & Req.ID 402.1.1, Ceiling insulation R -value. R- R- ❑Complies See the Envelope Assemblies 402.2.1, ❑ Wood ❑ Wood DDoes Not table for values. 402.2.2, 402.2.6 ❑Steel E] Steel ❑Not Observable [FI1]1 ❑Not Applicable 303.1.1.1, Ceiling insulation installed per ❑Complies Requirement will be met. 303.2 manufacturer's instructions. DDoes Not [F12]1 Blown insulation marked every ❑Not Observable 300 ft2. ❑Not Applicable 402.2.3 Vented attics with air permeable ❑Complies Requirement will be met. [FI22]2 insulation include baffle adjacent DDoes Not to soffit and eave vents that []Not Observable extends over insulation. ❑Not Applicable 402.2.4 Attic access hatch and door R-_ R- ❑Complies Requirement will be met. [F13]1 insulation >_R -value of the DDoes Not 31 adjacent assembly. ❑Not Observable ❑Not Applicable 402.4.1.2 Blower door test @ 50 Pa. <=5 ACH 50 =_ ACH 50 =_ ❑Complies Requirement will be met. [FI1711 ach in Climate Zones 1-2, and DDoes Not Yu, <=3 ach in Climate Zones 3-8. ❑Not Observable ❑Not Applicable 403.2.2 Duct tightness test result of <=4 _ cfm/100 _ cfm/100 ❑Complies Requirement will be met. [FI4]1 cfm/100 ft2 across the system or ft2 ft2 DDoes Not W <=3 cfm/100 ft2 without air ❑Not Observable handler @ 25 Pa. For rough -in ❑Not Applicable tests, verification may need to occur during Framing Inspection. 403.2.2.1 Air handler leakage designated ❑Complies Requirement will be met. [FI24]1 by manufacturer at <=2% of DDoes Not design air flow. ❑Not Observable ❑Not Applicable 403.1.1 Programmable thermostats ❑Complies Exception: null. [Fl9]2 installed on forced air furnaces. ❑Does Not 14 ❑Not Observable ❑Not Applicable 403.1.2 Heat pump thermostat installed [Complies Requirement will be met. [Fl 10]2 on heat pumps. DDoes Not ❑Not Observable ❑Not Applicable 403.4.1 Circulating service hot water ❑Complies Exception: null. [Fill], systems have automatic or DDoes Not accessible manual controls. [-]Not Observable ❑Not Applicable 403.5.1 All mechanical ventilation system ❑Complies Requirement will be met. [FI25]2 fans not part of tested and listed DDoes Not HVAC equipment meet efficacy []Not Observable and air flow limits. ❑Not Applicable 404.1 75% of lamps in permanent ❑Complies Requirement will be met. [FI611 fixtures or 75% of permanent DDoes Not fixtures have high efficacy lamps. ❑Not Observable Does not apply to low -voltage ❑Not Applicable lighting. 111 High Impact (Tier 1) 12 1 Medium Impact (Tier 2) 13 1 Low Impact (Tier 3) Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Page 7 of 8 Section # Final Inspection Provisions Plans Verified Value Field Verified Value Complies? Comments/Assumptions & Req.ID 404.1.1 Fuel gas lighting systems have ❑Complies Exception: null. [FI23]3 no continuous pilot light. ❑Does Not []Not Observable ❑Not Applicable 401.3 Compliance certificate posted. ❑Complies Requirement will be met. [FI7]2 ❑Does Not []Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies Requirement will be met. [FI18]3 mechanical and water heating ❑Does Not systems have been provided. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 111 High Impact (Tier 1) 2 1 Medium Impact (Tier 2) 3 1 Low Impact (Tier 3) Project Title: 39-67 Saunders St., N. Andover Report date: 10/28/15 Data filename: Page 8 of 8 4 . . f 2012 IECC Energy Efficiency Certificate Above -Grade Wall Below -Grade Wall Floor Ceiling / Roof Ductwork (unconditioned spaces): Window Door Heating System: ►VA;kr� nvc-"IfSS Cooling System: Yy ` `"' 5Q l' 43 Water Heater: A, C, 5y`"' j1P►u So 25.00 0.00 10.00 49.00 0.30 0.20 i2.S A� Lommenis verdeco DESIGNS One Elm Square, Andover, MA 01810 • 978-409-2217 • www.verdecodesigns.com November 2, 2015 TO: Gerry Brown, Town of North Andover Building Department RE: Building permit application for 39-67 Saunders Street This memo is to acknowledge that we are proceeding on a design -build basis for certain systems related to work defined in the above permit application and will provide additional design information and affidavits for the following: • Plumbing systems • Mechanical systems • Electrical systems • Fire Sprinkler & Protection systems • Health Department requirements including resident intercom system rk Yanowitz Managing Partner Verdeco Designs, LLC A� O CERTIFICATE OF LIABILITY INSURANCE 9�8�2oi5 ) 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(les) 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 MTM Insurance Associates 1320 Osgood Street North Andover MA 01845 CONTACT Lisa London NAME: PHONE (978)681-5700 FAX 978)681-5777 AIC No AARLESS'lisal@mt:minsure.com INSURERS AFFORDING COVERAGE NAIC # INSURERAAtain Specialty Insurance INSURED Verdeco Designs 1 Elm Square Andover MA 01810 INSURERB:Safety Insurance Company 9454 INSURERC: INSURER D : INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER:15-16 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A }i COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx] OCCUR IP159979002 /17/2015 /17/2016 DAMAGE TO RENTED 100 , 000 PREMISES Ea occurrence) $ MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITYOMB NEDidentSINGLE LIMIT 1,000,000 (Ea aANY BODILY INJURY (Per person) $ B AUTO ALL OWNED SCHEDULED AUTOS AUTOS 5057753 /17/2015 /17/2016 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION NC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) This certificate of insurance represents coverage currently in effect and may or may not be in compliance with any written contract. CERTIFICATE HOLDER CANCELLATION Town of North Andover 1600 Osgood St. N Andover, MA 01845 ACORD 25 (2010105) IN3n95 r9n1nnsi m SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Laorenza/STEPH � �- ©1988-2010 ACORD CORPORATION. All rights reserved. The Arnon nnmu ..,I I- nrn renic4ururl moire of A(,npn CERTIFICATE OF LIABILITY INSURANCE 7/15/2015 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(les) of the policy, certain policies may require an endorsement. A statement on this c must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions artificate does not confer rights to the certificate holder in lieu of such endorsements(s) PRODUCER CONTACT NAME. MTM Insurance Associates, LLC (A/HC, No Ext): (978) 681-5700 FAX No.:) 1320 Osgood Street North Andover, MA 01845 ADDRESS: PRODUCER _ CUSTOMER ID 4, INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Atlantic Charter Insurance Company VDAC 44326 INSURER B: Verdeco Designs, LLC INSURER C: One Elm Square INSURER D: Andover, MA 01810 INSURER E: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR TYPE OF INSURANCE ADDL SURR INSR WVD POLICY NUMBER POLICY EFFECTIVE DATE(MWDD/YY) POLICY EXPIRATION DATE(MM/DDNY) LIMITS (In Thousand ) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑ OCCUR ❑ ❑ DAMAGE TO RENTED PREMISES (Ea ocwnence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PROJECT ❑ LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea Accident) BODILY INJURY person) $ ALL OWNED AUTOS(Per F-1 El SCHEDULED AUTOS HIRED AUTOS NON-OWNDED AUTOS BODILY INJURY $ (Ea Accident) PROPERTY DAMAGE $ (Ea Accident) /UMBRELLA ❑ OCCUR LIABILITY EACH OCCURRENCE $ EXCESS LIAB ❑ CLAIMS MADE El El AGGREGATE $ DEDUCTIBLE RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? Fy� Mandatory in NH N/A WCV00951304 Policy Coverage State: MA 03/04/2015 03/04/2016 X STATUTORY LIMITS OTHER EACH ACCIDENT $ 1,000,000 DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below DISEASE -EACH EMPLOYEE $ 1,000,000 OTHER ❑ ❑ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES (Attach ACORD 101, Additional Remarks Schedule, ifmore space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of North Andover 1600 Osgood Street North Andover, MA 01845 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 12 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ACORD 25 (2009109) UTHORIZED REPRESENTATIVE Page 1 of 1 CERTIFICATE HOLDER COPY ©1988-2009 ACORD CORPORATION. All rights reserved. Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -105187 Construction Supervisor MARK J YANOWIT.Z � ONE ELM SQUARE ANDOVER MA 01810+ Expiration: ' Commissioner 07/11/2017 The Commonwealth of Massqehusetts . Department of IndustrialAccidents 1 Congress Street, Suite 100 Y Boston, MA 02114-2017 www mass.gov/dia yY� Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name (Business/Organization/Individual): Address: City/State/Zip: V Arief MPF Phone #: 0 151 Are you an employer? Check the appropriate box: Type of project (required): 1111 am.a. employer with employees (full and/or part-time).* 7. New construction 2. Q I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity. [No workers' comp. insurance required.] 9. El Demolition 3.F] I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 10 F1 Building addition 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole 11. [] Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.� I am a general contractor and I have hired the sub -contractors listed on the attached sheet. 13.0 Roof repairs These sub -contractors have employees and have workers' comp. insirance.t 6. Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Q Other 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. i Homeowners who submit Ibis affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ?Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors fiave employees, ley must provide their workeis' comp. policy number. ' X am an employer that is providing workers' compensation insurance for my employees.' Below is the policy and job site information. ` Insurance Company Name: Policy# or Self -ins. Lie. #: UVCV O 0 If 5 130 � Expiration Date: 3 "t lb Job Site Address: 'ala' 0 SavMaerS 64 City/State/Zip: N • % PAP d t (5 4 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration. date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Signature: Date: Official use only. Do not write in this area, to be completed by city or town official.. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract 41ire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or ocher 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, §25C(6) 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, MGL chapter 152, §25C(7) states "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- out -the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and -phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance: If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents foi• confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit 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. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials 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 permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA. 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia