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Home My WebLink AboutBuilding Permit #065-2012 - 48 EMPIRE DRIVE 7/26/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO.-- V l�J �0 2 Date Received Date Issued: 7 :26 1,1 ORTANT:Applicant must complete all items on this page LOCATION 4 ` / / Pr' t PROPERTY OWNER ('=J�CN-A�P (.LL AG C SLC Print MAP NO:10X PARCEL{ ZONING DISTRICT' .I Historic District yes o Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial ❑ Repair, replacement ❑Assessory Bldg 0 Others: ❑ Demolition ❑ Other OS ptic' �, 4 `D�Floodpla'inl fpWetlands '0 Waters_heciDstr"ict;- ❑Well v DESCRIPTION OF WORK TO BE PERFORMED: EA M i LY well I NTI ?gib n ? Ili 1-f�S 25+611 (j/4 9-9C -h J A+.eY( ewes, ' Identification Please Type or Print Clearly) OWNER: Name: T L - LL(_ Phone(77Z- -,3/94 Address: N n S&U afi ti D m CONTRACTOR Name: 'ea��/l C�g N 6 Phone:777 AddressTa W ,�� &Laa lu 0 M 94 e) f Supervisor's Construction License: Exp. Date: YJ 3 j Home Improvement License: �j`7 W 2 Exp. Date: Zh ARCHITECT/ENGINEER AddressN UEReg. No. al-776 S FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ cV G el 12 <" FEE: $ r) S'0 Check No.: a2Receipt No.: '? y y 2 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund - ent/Owner,:: i nature of`contracfor Si nature:"of A __ _ Location �d �-- No. 06 12 Date MORTh TOWN OF NORTH ANDOVER 3�p•,t`•o •,h0 /p. A i • ; Certificate of Occupancy $ ♦ i s,CMusttBuilding/Frame Permit Fee $ 6 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check # 24i4tj / Building Inspector c� /Ir 1 Location No. Date 14o RT: TOWN OF NORTH ANDOVER L ► A 9 Certificate of Occupancy $ sA-S<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ /a D * U. TOTAL $ Check # 167,24609 Pt ilding Inspector Plans Submitted V Plans Waived ❑ Certified Plot Plan L4Y Stamped Plans TYPE OF SEWERAGEDISPOSALL Public Sewer Ltd' Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT El n COMMENTS CONSERVATION Reviewed one] Si nature e-U- COMMENTS I _ 1 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes t .Planning Board Decision: Comments � I Conservation Decision: Comments c LIA! lWater & Sewer Connection/Sl natur &D DrivPermit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp D ster o site yes no Located at 124 Main Street Fire Department signature/date (9 ' 4 COMMENTS ' I 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.$100-$1000 fine NOTES and DATA— For department use 0 Notified for pickup - Date Doc:.Building Permit Revised 2008 Building Department I 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 Cnmp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work rk ❑ 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/E levation Plan Of Proposed Work With Sprinkler Plan And Hydraulic,y aulic.Calculations ( f 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 DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit ri all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording rust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi oN•eTM 1 h �?s�;r. 1••OCb . �SSACHUS�t ' CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 065-2012 Date:November 9, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 48 Empire Drive, Lot 11, North Andover, MA 01845 Orchard Village, LLC MAY BE OCCUPIED AS single -family dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Bob Messina 277 Washington Street Groveland,MA 01834 Building Inspector Fee: $100.00 Receipt: 24809 ++�cxuit CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number _065720-11 - ..Date:November 9, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON _48 Empire Drive; Lot 1.1,_North Andover; MA -01-845 Orchard Vitlage,LLC MAY RE OCCUPIED-AS- single ff mffdwelling IN-ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate to: Bob-Messina- 277 Washington Street Groveland,MA 01834 Building inspector Pee: $100.00 Rcceipt: 24809 NORTH q � •fit ,flD ib tiO O a • o � APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION BUILDING PERMIT # ADDRESS/LOCATION OF PROPERTY: 8wllec b g iug- Map 167C Parcel a-0 2- Lot Number -4// SUBDIVISION: 0 t2C 1 f_V &Lg6i5- DATE REQUESTED FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: VA/ FIVE(5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A REINSPECTION FEE OF TWENTY DOLLARS ($20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. APPLICANT SIGNATURE Permit Issued to: 1?CN A 9 0 l! ILL M e-E Z-6 C, Address:� 17 11U Tt& -tCpor-tAwo AAA d173 ROUTING TOWN ENGINEER, SITE PLA —DRIVE-WAY REVIEW CONSERVATION ; PLANNING A$ DPW-WATER METER I✓1 01� 1 vGt/ SEWER CONNECTION CY n� I CT DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST �f DPW SIGNATURE File:Application for OC form revised Jan 2007/2011 NORT►y 0 Andover' dover, Mass., 71 r-/// T O LAKE �. .+� COCMICMEWICK 7 S°RATED p.Y�` �'� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ` LD VGBUI INSPECTOR THIS CERTIFIES THAT.................. ✓'7 .�", ... 0.1.�4�e.F.... �C. .... . .................. ...... (Foundation has permission to erect........................................ buildings on ....ZIP.. ,, �.t"�... ..�'�!��................................ Roux to be occupied as �:?v..�.. ,Lti- C. ne'fv provided that the person accepting this permit shall in everfrespect conform to terms of the application on file in Final. this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. BING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �Rou Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTION T TS °ugh 7-1'Y--Jr .. rvice 04'S, UILDISPECTOR Occupancy Permit Required to Occupy Building / sPECTIO 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. Bur r Street No. - SEE REVERSE SIDE smok`erDi A/L� / r1ORTH TONM oAndover. 00 ry_ o lover, Mass. ;?Z;2 t,i COCMICEWICK 11. IT �P�\�°�,� 'PERMIT T '9 �� BOARD OF HEALTH DFood/Kitchen Septic System DING INSPECTOR // BUIL THIS CERTIFIES THAT....................��✓�� . ..,� ./l. /�4 '�..Q.9��............ . ............... . .... ..... Foundation has permission to erect...................................... buildings on fle... ! l ....i � !>e, '................................ Rough to be occupied as.................. a.s fv..�. ....,.5<..;�►�r. A-..../ G'��rX.' .............".......................................... Chimney h' provided that the person accepting this permit shall in ever respect conform to re terms of the application on file in Final, this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T TS Rough Service UILSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry wall To Be Done FIR_E.DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. I I MAScheck COMPLIANCE REPORT Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 Release 2 I i I I Checked by/Date I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 7-18-2011 DATE OF PLANS: 7/30/09 TITLE: The Willow PROJECT INFORMATION: Orchard Village, Lot 11, #48 Empire Drive COMPANY INFORMATION: Orchard Village, LLC COMPLIANCE: PASSES Required UA = 450 Your Home = 233 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------=------------------------ CEILINGS 1258 38.0 0.0 38 WALLS: Wood Frame, 16" O.C. 2115 21.0 0.0 121 BSMT: Conc. 8 .0' ht/7.0' bg/0.0' insul 0 0.0 0.0 0 GLAZING: Windows or Doors 140 0.350 49 DOORS 79 0.000 0 FLOORS: Over Unconditioned Space 768 30.0 0.0 25 HVAC EQUIPMENT: Furnace, 96.0 AFUE HVAC EQUIPMENT: Air Conditioner, 13.0 SEER ._ ------------------------------------------------------------------------------- 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 requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 The Willow DATE: 7-18-2011 Bldg. 1 Dept. 1 Use I I CEILINGS: ( ] I 1. R-38 I Comments/Location I WALLS: I ] I 1. Wood Frame, 16" O.C. , R-21 I Comments/Location I BASEMENT WALLS: [ ] I 1. Conc. 8 .0' ht/7.0' bg/0.0' insul, R-0 (uninsulated) I Comments/Location I I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.35 I For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I DOORS: [ ] ► 1. U-value: 0 I Comments/Location I FLOORS: [ ] I 1. Over Unconditioned Space, R-30 I Comments/Location I HVAC EQUIPMENT: [ ] I 1. Furnace, 96.0 AFUE or higher I Make and Model Number [ ] I 2. Air Conditioner, 13.0 SEER or higher I Make and Model Number I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 1 2 . Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating and I cooling equipment efficiency must be clearly marked on the building I plans or specifications. I I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not i permitted. The HVAC system must provide a means for balancing I air and water systems. I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual i or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is I not greater than 1250 of the design load as specified i in Sections 780CMR 1310 -and J4.4. I I SWIMMING POOLS: L ] I All heated swimming pools must have an on/off heater switch and I require a cover unless over 200 of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I HVAC PIPING INSULATION: [ ] I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in. ) : I PIPE SIZES (in. ) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1. 0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 I I CIRCULATING HOT WATER SYSTEMS: [ ] I Insulate circulating hot water pipes to the following levels (in. ) : I PIPE SIZES (in. ) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS i HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 1 170-180 0.5 1 1.0 1.5 2 .0 1 140-160 0.5 1 0.5 1.0 1.5 I 100-130 0.5 1 0.5 0.5 1.0 I ----NOTES TO FIELD (Building .Department Use Only) ------------------------- The Commonwealth oflMassachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston MA 02111 " www.massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information . Please Prinf Legibly Name(Business/Organization/Individual) ARD VOLL-An-it ZLC Address:;47-7 A5P 9J"r A)2tge e+ City/State/Zip.6&UQ1WQ .A -01$'3q Phone##:17P 71' Are you ai i employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction mployees(full and/or part-time).* have hired the sub-contractors 2. I airy a sole proprietor or partner- listed on the attached sheet. �• ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for mein any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL - 11.❑Plumbing repairs or additions inyself.[No workers'comp. c. 152, §1(4),and we have no 12.❑Roofrepairs " insurance required.]i employees.[No workers' comp.insurance required.] 13.0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors acid their workers'comp.policy information. I 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.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the fonn of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance*coverage verification. Ido hereby ce under the pains and penalties of perjury tliat the information provided above/is true and cor'rect.' -Signature: lra Phone#: Official use only. Do not write in.this area,to be completed by city or town offtciaL 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 of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other 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)naine(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 cavy 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 for confinnation of insurance coverage. AIso 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 hasprovided 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 pennit/lieense 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 pen-nit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Tnvestiptions 600 WmMngton Street Boston,MA 02111 Tel.#617-727-4.900 ext 406 or 1-877-MA.SSAFE Revised 5-26-05 Fax##617-727-7749 Www.mass.gov#dia