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Home My WebLink AboutBuilding Permit #210-13 - 401 STEVENS STREET 9/17/2012 LoT /V BUILDING PERMIT of "°pT" TOWN OF NORTH ANDOVER a? ��t.- ` ,6.6 APPLICATION FOR PLAN EXAMINATION o Permit NO: Co M r Date Received 9 • '' �` Date Issued: 7 �gSSACHUs��q� IMPORTANT: Applicant must complete all items on this page LOCATION �bIv �. 4. s . Print — — PROPERTYC?WNER-* Print MAP.-?1,0 PARCEL, ZONING-DISTRICT,-3 Historic District yes o . Machine Shop,Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential � ewB uilding ne family dition or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic 1Nell Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFO MED: Identification Plea a Type or Print Clearly) OWNER: Name:_::Z-' o��G�� Z� Phone: �7� ''!r Address: A6 ZzC 5� AlaveO Z/-151- Col CONTRACTOR Name , ,. P �� e .`fie-5,1� 'Phone: ... Address: __ 1. 5X1 ' u ' Supervisot's-Construction License: .0/ 4/- Expl. Da#e: / . Dome Improyernent License: :Exp Date:. ARCH ITECT/ENGINEER_ �R-;- S::pH✓ Phone: Address: 11�eloWf 14V ow SS' Reg. No. - Ll� --z FEE SCHEDULE.BULDING PERMIT;$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. ' Total Project Cost: $_ FEE: $ Check No.: /O y'O " Receipt No.: NOTE: Persons contracting wit unregistered egastered contractors do not have access to the guaranty fund Signature of Agent/Owner _ ��m n Signature of contractor, _ ' 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 11'7 A� .--- COMMENTS L,,q��'6h o CONSERVATION Reviewed on Si nature COMMENTS (V�A 1�� -+I-- HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments �� --/7-1 �'- Water & Sewer Connection/Si nature 8�o Drivewa Permit DPW Town Engineer: Signature: ►� � s� Located 384 Osgood Street FIRE-DEPARTMENT --Temp Dumpster on-site, yes no Located;at 124 Main,Sti�eet _ Fire Department signature/date COMMENTS- Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 3 � 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 21 A—F and G min.s100-s1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 i 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 /7 COMMENTS 4 b h AA boel Le&[l o fe-C&LI CONSERVATION Reviewed on Signature:::],",_�� COMMENTS I� a J� �I HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments 7-/7-/2- Water & Sewer Connection/signature& D Drivewav Permit DPW Town Engineer: Signature: _ o� Jacc,eSS Located 384 Osgood Street FIRE DEPARTMENT Temp Dumpster on site . yes no Located at 124 Main--Street Fire Department signature/date - COMMENTS J Building Department The followingis a list of the required form q s to be filled out for theappropriate ermi p t to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application P ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or.C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work r ❑ 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: 9 All dumpster permits require sign off from Fire Department artment riot to issuance of Bldg 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 2008 � NORTI� T!own of 2 n over No. t h h ver, Mass ° COCNIC HlWKN %, �•9 A°R�rEo �P�`,�q5 S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT �-X ,�'.................. BUILDING INSPECTOR s6,U Foundation has permission to erect .......................... buildings on .. .......:.............4`�^. .... ................ o Rough to be occupied as .................... . ..�..&��11' .�.. . .l.F t:.....Ow. .. ......:.............................I............. Chimney provided that the person accepting this permit shall in every respect con rm to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws r ting to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T RTS - Rough Service .............. ....... ... .. : .. .. ..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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 b! y •� Ik N•! N � N. N �W I \ 4 i 2 o� CP.N cfl. a � 2 N� I Lois �L Nc3� J � I Cl: LOT 4 1 35,630 S.F. 566.3 24 F 89 2 Z � 8 LA V11, �. \� 1 N 1E ,3 TOP FN D. 2� 05 Nj/ � -189.6 0 2�o � o`b 21'� 28 3 3 0 68 Noy �� N66, so• o • N h/ hN I HEREBY CERTIFY THAT THE LOCATION OF THE STRUCTURE SHOWN ON THIS PLAN WAS DETERMINED BY A FIELD SURVEY, THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE NORTH ANDOVER ZONING REG LATI::ONNS AND THAT IT IS NOT LOCATED IN A FLOOD PLAIN. REG. PROF. LAND SURVEYOR CERTIFICATION PLAN ss9cy LOT 4 STEVENS STREET oFMg NORTH ANDOVER, MASS. andover �� PETER DG + Prepared for " GOODWIN consultants No.48133 TOM PATENAUDE HOMES INC 9 0� SCALE: 1"=40' September 27, 2012 inc. �'Fss�9FO/STER�� NAC LANA TOWN MAP NO.96 LOT NO.79 P:\10\10-23\DWG\CERT4.DWG 1 East River Place, Methuen, Mass. 167 Date . . . . .. .. .. pf , NpRTM TOWN OF NORTH ANDOVER FOS " p� PERMIT FOR MECHANICAL INSTALLATION SACHUSEtt � _ _ . . . .This certifies that . 1 . . e. . . . ' has permission for mechanical installation . ./-,6//t-7--. . . . . . . . . . . h in the buildings of7/1t�'�., yC,l�i.r� . . . . . . . . . . . . . . atM . .CSV . . '4k T7. . . . . . . .. North Andover, Mass. Fee le Lic. No.. . . . /��A . . . . . . . . . . � —. . . . �G GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Sheet Metal Permit rn Date: /2 Permit# VG Estimated Job Cost: $ );��J a Permit Fee: $ Plans Submitted: YES VINO Plans Reviewed: YES NO Business License# �/ to �� Applicant License# Property Owner/Job ocation Information: Business Information: p riY Name: Name: �.. Street. �, Street: JQ.� City/Town: _ City/Town:ff Telephone. Telephone: ;/K / 9� Photo I.D. required/Copy of Photo I.D. attached: YES NO Staff Initial �-1 - estricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq.ft./2-stories or less Residential: 1-2 family__,/ Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other 000 s . ft. V/ over 10 000 s . ft. Number of Stories: Square Footage: under 10, q q --� Sheet metalwork t be completed: New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed descri ion of work to be done: INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes❑ No❑ If you have checked Yes,indicate the ype of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner Agent ❑ Signd'ture of Owner,or Owner's Agent By checking this boxE1,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES t, /NO Prol?ress Inspections Date Comments Final Inspection Date Comments Type of License: By ❑Master Title ❑Master-Restricted tel/ Cityrrown ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: /1 4 4 3 Fee$ ❑ Check at vvww.mass.govldpl Inspector Signature of Permit Approval ` e i API of NH Component Constructions Date. 5.87.10.8.1.12 � Duct Design ah T By:DESIRED TEMP DRACUT,Ma For. TOM PATENAUDE HOMES INC, DESIRED TEMP LOTI STEVENS ST, NORTH ANDOVER, Ma Location: Indoor: Heating Cooling Lawrence Muni MA US Indoor temperature( )°F 70 75 P Elevation: 151 ft Design TD °F 67 9 Latitude: 430N Relative humidity(%) 30 50 Outdoor: Heating Cooling Moisture difference(gr/Ib) 27:7 30.3 j Dry bulb(°F) 3 84 Infiltration: Daily range(°F) - 18 ( M ) Method Simplified Wet bulb(°F) - 71 Construction quality Tight Wind speed(mph) 15.0 7.5 Fireplaces 1 (Tight) t Construction descriptions Or Area U-value Insul R Htg HTM Loss Cig HTM Gain ft BuW--°F ft'-°F/Bt th BUM Btuh BfttA2 Btuh Walls 12F-Osw:Frm wall,wd ext,3/8"wood shth,r-21 cav ins,1/2"gypsum n 264 0.065 21.0 4.37 1153 0.65 171 board int fnsh,2"W'wood frm a 384 0.065 21.0 4.37 1676 0.65 248 s 264 0.065 21.0 4.37 1153 0.65 171 sw 14 0.065 21.0 4.37 62 0.65 9 w 353 0.065 21.0 4.37 1542 0.65 228 nw 14 0.065 21.0 4.37 62 0.65 9 all 1293 0.065 21.0 4.37 5648 0.65 836 Partitions (none) Windows 4A5-2ow:2 glazing,dr low-e outr,argon gas,wd frm mat,dr innr,1/2" n 24 0.470 0 31.6 758 10.0 241 gap,1/4"thk a 60 0.470 0 31.6 1905 33.2 2002 e 42 0.470 0 31.6 1327 33.2 1394 S 24 0.470 0 31.6 758 17.8 427 sw 11 0.470 0 31.6 358 29.1 330 w 76 0.470 0 31.6 2400 33.2 2523 nw 11 0.470 0 31.6 358 23.1 261 all 249 0.470 0 31.6 7863 28.8 7179 Doors 11 E0:Door,wd sc type,wd strm w 21 0.260 0 17.5 367 5.50 115 Ceilings C part ceiling,:C part ceiling,hrd wd fir fnsh,frm fir,8"thkns,1/2" 14 0.255 1.0 17.2 240 11.4 160 gypsum board int fnsh Floors 19A-19bswp:Part floor,hrd wd fir fish,r-19 ins,frm fir,8"thkns 20 0.049 19.0 2.58 52 0.34 7 A:- + wrightsoft® Right-Suite®universal 201212.0.13 RSU11815 2012-Oct-10 06:34:02Page 1 ...slpaul\DocumentsUESIREDTEMP\DESIREDTEMPLOT5NANDOVER.rup Calc=W8 faces:N Building Analysis Job: 5.87.10.8.1.12 API of NH ah 1 Bye: By:Design DESIRED TEMP DRACLM Me For. TOM PATENAUDE HOMES INC DESIRED TEMP LOT 5 STEVENS ST., NORTH ANDOVER, Ma Location: Indoor: Heating Cooling Lawrence Muni, MA, US Indoor temperature(°F) 70 75 Elevation: 151 ft Design TD (°F) 67 9 Latitude: 430N Relative humidity(%) 30 50 Outdoor: Heating Cooling Moisture difference(gr/Ib) 27.7 30.3 Dry bulb(°F) 3 84 Infiltration: Daily range ff) - 18 ( M ) Method Simplified Wet bulb(° ) - 71 Construction quality Tiht Wind speed(mph) 15.0 7.5 Fireplaces 1 Tight) n E Component Btuh/ft' Btuh % of load Walls 4.4 5648 34.9 Glazing 31.6 7863 48.5 Doors 17.5 367 2.3 Ceilings 17.2 240 1.5 Floors 2.6 52 0.3 Infiltration 1.3 2034 12.6 Ducts 0 0 Piping 0 0 Humidification 0 0 Ventilation 0 0 Adjustments 0 Total 16204 100.0 Component Btuh/ft2 Btuh % of load r Walls 0.6 836 8.3 �R Glazing 28.8 7179 71.0 Doors 5.5 115 1.1 Ceilings 11.4 160 1.6 x Floors 0.3 7 0.1 Infiltration 0.1 143 1.4 Ducts 0 0 Ventilation 0 0 Internal gains 1670 16.5 Blower 0 0 Adjustments 0 Total 10110 100.0 oma,a Latent Cooling Load= 505 Btuh Overall U-value= 0.132 Btuh/W°F Data entries checked. A- A wrightsoft' Right-Suite®Universal 201212.0.13 RSU11815 2012-Oct-10 06:34:02 ...s aul\Doaments\DESI D = Page 1 tQ RE TEMPIDESIREDTEMPLOTSNANDOVER.rup Calc MJ8 faces:N J API of NH Building Analysis Date: .87.10.8.1.12 Duct Design ah 2 By: DESIRED TEMP DRACM Me For. TOM PATENAUDE HOMES INC DESIRED TEMP LOT 5 STEVENS ST, NORTH ANDOVER, Ma Location: Indoor: Heating Cooling Lawrence Muni, MA, US Indoor temperature(°F) 70 75 Elevation: 151 ft Design TD (°F) 67 9 Latitude: 430N Relative humidity(%) 30 50 Outdoor: Heating Cooling Moisture difference(gr/Ib) 27.7 30.3 Dry bulb(°F) 3 84 Infiltration: 0 t Daily range( F) - 18 ( M ) Method Simplified Wet bulb(°F) - 71 Construction quality Ti ht Wind speed(mph) 15.0 7.5 Fireplaces 1 'Fight) Component Btuh/ft2 Btuh % of load Walls 4.4 10386 46.2 Glazing 31.6 5484 24.4 Doors 0 0 0 Ceilings 2.2 3273 14.6 Floors 0 0 0 _ Infiltration 1.3 3320 14.8 Ducts 0 0 Piping 0 0 Humidification 0 0 h'b= Ventilation 0 0 Adjustments 0 Total 22464 100.0 Component Btuh/ft2 Btuh % of load Walls 0.6 1538 12.8 Glazing 35.6 6186 51.5 Doors 0 0 0 '0- Ceilings 0Ceilings 1.4 2175 18.1 Floors 0 0 0 Infiltration 0.1 234 2.0 Ducts 0 0 — Ventilation 0 0 Intemal gains 1870 15.6 Blower 0 0 Adjustments 0 , Total 12003 100.0 Latent Cooling Load= 1499 Btuh Overall U value= 0.070 Btuh/ft22F Data entries checked. C + wrightsoft' Right-Sufte®Universal 2012 12.0.13 RSU11815 2012-Oct-10 06:34:02 Page 2 ...s\pauRDocumenLs\DESIREDTEMP\DESIREDTEMPL075NANDOVER.rup Calc=MJ8 faces:N i ah 2 2083 22464 12003 793 793 Other equip loads 0 0 Equip. @ 0.89 RSM 10658 Latent cooling 1499 TOTALS 2083 22464 12157 793 793 1 Calculations approved byACCA to meet all requirements of Manual J 8th Ed. . wrightsoft, Right-Suite®Universal 2012 12.0.13RSU11815 2012-0d-10 06:34:02 /�.Ck Page 3 ...slpaullDocumenlslDESIREDTEMPIDESIREDTEMPLOTSNANDOVER.rup Calc=MJ8 faces:N 11/07/2012 10:16 19785214669 COWAN INSURANCE PAGE 01/01 i CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYW) 1117112 RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cowan Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 359 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Haverhill M_A 01830 INSURERS AFFORDING COVERAGE NAIL INS # URED Desired Temperature,Inc. INSURER A; Em Io ers Mutual Casual Company 1855 Bridge Street INSURER e: Technology Insurance Company INSURER C: _ •r••.• Dracut MA 01828 INSURER D: COVERAGES INSURER E: —` THEPOLICIESOFINSURANCELISTEDBELOW HAVE BEEN ISSLIEDTOTHE INSUREDNAMEDABOVE FORTHEPOLICYPERIOD 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 INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHE TERMS,EXCLUSIONSAND CONDITIONSOFSUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, _ INSR W00' _ POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION — LIMITS GENERAL LIABILITY EACH OCCURRENCE___ a 1000 000 A X _COMMERCIAL,GENERAL LIABILITY 3D27294 08103112 08!03113 DAMAGE TO RENTED P8EM)S S IEe o=encaI S 100,000 CLAIMS MADE X OCCUR MED EXP(Anyone _ $5,000 x Blanket additional insured person) - PERsoNAL&nD_v_iNJyRY $1000 000 GENERAL AGGREGATE 2 000,000 GEN L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s 2,000,000 x PRO. _ POLICY LOC AUTOMOBILE LIABILITY A ANY AUTO 3227284 COMBINED SINGLE LIMIT a 08103112 08103113 (En accidnnl) ALL OWNED AUTOS JL_ SCHEDULED AUTOS BODILY INJURY g 100,000 (Per person) k HIRED AUTOS XN BODILYINJURY $00,000 ON-OWNED AUTOS (Par accidenl) PROPERTY DAMAGE (Per accident) 8 100,OD0 GARAGE LIABILITY ANY AUTOO AUTO ONLY-EA ACCIDENT S .. _ OTHER THAN _EAACC $ AUTO ONLY: AGG S EXCESS/UMBRELLA L,IADILITY EACH OCC URRF,NGE $ OCCUR 71 CLAIMS MADE - AGGREGATE g DEDUCTIBLE RETENTION $ _ $ WORKERS COMPENSATION $ M AND EMPLOYERS'LIABILITY x I WC STATU- OTH- B ANY PROPRIETOR/PARTNER/EXECUTIV Y/N TWC3284503 09103112 08103113 MITS EF.L_..- OFFICER/MEMBER EXCLUDED? E.L.EACH,ACCIDENT ¢ 00 000 - (Mandatory In NM) _ If yee,deseribr,under E.L.DISEASE-EA EMPLOYEES 100,000 ^ ECIAL PR V ONS below OTHER E,l,.DISEASE•POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEMICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 978 688 9542 HVAC Contractor. All Parties as required by contract are listed as additional insureds on the general liabliftY insurance policy. CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION EOF,THB ISSUING INSURER WILL ENDEAVOR TO MAIL 30 Building Department DATE THERDAYS WRITTEN 1600 Osgood St NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT,OUT FAILURE TO DO$O SMALL North Andover,MA 01845 IMP ISLIGATION (LI Y KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE AU RIZED R EBENTATIVe Fax: 978 fi88.9542 ACORD 2.5(2009101) X198 - CORPORATION. All rights reserved. The ACORD name and logo are r istered'marks 6 MONWEALTH OF MASSACHUSETTS '`'. SHEET METAL WORDS AS2 A.MASTER-UNRESTRICTED, ISSUES THE ABOVE LICENSE TO: a GEfi'4�._D: A TELLIER � { r 1555 BRIDGE STLo Q� ; DRACUT MA 0182672644 ; 116.63 01/28/13 9479 � a NORTH OE4t�2o "I O 3.ii be � OL o /- t h ACHUS�t9 CONSERVATION DEPARTMENT Community Development Division NEGATIVE DETERMINATION OF APPLICABILITY SPECIAL CONDITIONS Columbia Gas — Gas Utility Line Installation on Stevens (to serve new homes), North Andover At the October 10, 2012 public hearing the North Andover Conservation Commission (NACC) voted to issue a Negative Determination of Applicability filed to install gas pipeline within the existing roadway on Stevens Street within the Buffer Zone to Bordering Vegetated Wetland. Work shall comply with the following: Applicant: Columbia Gas of Massachusetts 55 Marston Street Lawrence,MA 01841-2312 Representative: Shaw Environment&Infrasture Gary Jacob 100 Technology Center Dr. Stoughton,MA 02072 Record Documents: Request for Determination of Applicability,received September 24, 2012 Prepared by Gary Jacob of Shaw Record Plan: Maps &Aerial Photographs—Figures 1-3 (Dated: 9/17 &9/18/12) Appendix 1 (Dated August 2012) &Appendix 2 Prepared by Shaw Wetland Delineation: Delineation Confirmation not requested as part of this filing.Wetland locations were approximated by Shaw from other filings and online sources. This was acceptable to the NACC due to location of all work within existing roadway. Construction Conditions for liras Main Improvements: ❖ All work will be conducted in accordance with the above referenced documents and plans. 1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web:http://www.townofnorthandover.com/Pages/NAndoverMA_Conservation/index � 4 ❖ Prior to the commencement of work, erosion controls will be installed as detailed in Appendix 2 referenced herein. Dewatering,if required shall be done through a filter bag as outlined in Section 1.2 No. 6 of Appendix 2. ❖ The Conservation Department will be contacted prior to the start of work to inspect the installed erosion controls. Excess materials and construction debris shall be properly disposed of off-site and no stockpiled material shall be stored overnight within the 100-foot Buffer Zone. Trenches shall be backfilled daily as outlined in Appendix 2. ❖ All catch basins shall be protected with silt sacks during construction. Post Construction Conditions for Gas Main Improvements• ❖ Immediately following completion of the work and prior to the removal of erosion controls, any disturbed areas will be permanently stabilized against erosion by loaming and seeding and other approved methods. ❖ Upon stabilization the Conservation Department will conduct a final inspection to confirm the restoration of prior site conditions and the removal of all erosion controls. 1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web:http://www.townofnorthandover.com/Pages/NAndoverMA_Conservation/index Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: When filling out From: forms on the North Andover computer, use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Columbia Gas of Masschusetts return key. Name Name Marston Street Ma � Mailing Address Mailing Address Lawrence MA 01841- City/Town State 2312 City/Town State Zip Code 1. Title and Date(or Revised Date if applicable) of Final Plans and Other Documents. Map, Plan &Aerial Photographs- Figures 1-3 9/17 &18/2012 Title Date Appendix 1 &2 August 2012 Title Date Title Date 2. Date Request Filed: 9/24/12 B. Determination Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): Installation of natural gas utility line within the Buffer Zone to Bordering Vegetated Wetland. Project Location: Stevens Street Extension North Andover Street Address City/Town N/A Work limited to existing roadway Assessors Map/Plat Number Parcel/Lot Number wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 1 of 5 e Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands r WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) or Order of Resource Area Delineation (issued following submittal of Simplified Review ANRAD) has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s)is an area subject to protection under the Act. Removing,filling,dredging,or altering of the area requires the filing of a Notice of Intent. ❑ 2a.The boundary delineations of the following resource areas described on the referenced plan(s)are confirmed as accurate.Therefore,the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s)and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone). ❑ 5. The area and/or work described on referenced plan(s) and document(s) is subject to review and approval by: Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 2 of 5 3 i Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department.Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of Intent. ® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions (if any). See attached conditions ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 3 of 5 o Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. North Andover Wetlands Protection Bylaw Chapter 178 Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on [`'r by certified mail, return receipt requested on j6'/'41_4 Date Date This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office(see hftp://www.mass.gov/dep/about/region.findyour.htm and the property owner(if different from the applicant). Signatures: f Date wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 4 of 5 Massachusetts Department of Environmental Protection ILIBureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office (see http://www.mass.gov/dep/about/region.findyour.htm)to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 5 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information Important: When filling out 1. Person or party making request(if appropriate, name the citizen group's representative): forms on the computer, use Name only the tab key to move your cursor- Mailing Address do not use the return key. City/Town State Zip Code Phone Number Fax Number(if applicable) Project Location rertsn Mailing Address City/Town State Zip Code 2. Applicant(as shown on Notice of Intent(Form 3), Abbreviated Notice of Resource Area Delineation (Form 4A); or Request for Determination of Applicability (Form 1)): Name Mailing Address CitylTown State Zip Code Phone Number Fax Number(if applicable) 3. DEP File Number: B. Instructions 1. When the Departmental action request is for(check one): ❑ Superseding Order of Conditions ($100 for individual single family homes with associated structures; $200 for all other projects) ❑ Superseding Determination of Applicability($100) ❑ Superseding Order of Resource Area Delineation ($100) Send this form and check or money order for the appropriate amount, payable to the Commonwealth of Massachusetts to: Department of Environmental Protection Box 4062 Boston, MA 02211 wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Pagel of 2 Massachusetts Department of Environmental Protection p ton Bureau of Resource Protection - Wetlands Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed. To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office (see http://www.mass.gov/dep�/�about/re-gion/findyour.htm). 4. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 2 of 2 1 1 I I I f I t i i j I I i f f I L I I If I