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HomeMy WebLinkAboutBuilding Permit #759-13 - 50 MAYFLOWER DRIVE 5/14/2013TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Issued: IMPORTANT:A LOCATION i PROPERTWOWNER, e+! Print, 100,Year�Old,8tructure' yes:. i MAP `NO: 4_PARCEL:ZONING IDIS 'RIGT Ve Mistonc,District, yes Machine�Shop Villade , yes Date Received int must complete all items on this Pint''. TYPE OF IMPROVEMENT PROPOSED USE Resid ntial Non- Residential Wlqew Building ne family ❑ Addition ❑ Two or more family ❑Industrial ❑ Alteration No. of units: ❑Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other .� o Well ❑IFloodplain. N WetlandsWatershed-District, eter/Se\ker . _ . OWNER: Address: /d DESCR PTIUN UI- VVUKfK I u tst rtmruruvir-u 1 v`? 0 e 7 Q,� �/fCd,Q00 /`1,y,1. 114c tid* T on ioe'eAiv,' in Please Type or Print Clearly) r :n hone: 979-693-3163 CONTRACTOR Name: C. C.CG-o og Phone: - Address: hone: Address: &i ��� �/!���4-G �•rgH �: �a i�.�ctoyeE', �Lt Supervisor's Construction License: CS -07530. - Exp:. Date: >a/!f,. - Home .Improvement License -.— p. Date:_ ARCHITECT/ENGINEER �► Ac -CT's 2�4• Phone: 7,R Address: S9o+�4`n s�Qre�, �ec9cfi�G-� Vb1� Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 79 6 I -Q FEE: $ 4/-/ 6 '/ Check No.: oqq Receipt No.: X& .5f 7 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund .Signature of Agent/Ovv �T t ,-,signature of contractor l Plans Submitted ❑ P ns Waived ❑ Certified Plot Plan 0 Stamped Plans 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 0 Private (septic tank, etc. ❑ Permanent Dumpster on Site El. THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF: U FORM . DATE REJECTED PLANNING & DEVELOPMENT ❑ COMMEN CONSERVATION COMMENTS HEALTH COMMENTS DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Water & Sewer Conneoti 1i);}'W Towp- Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMt 17NT - Temp Dumpster on site yes no Located at'124 MainStreet Fire Depa'ilrnerit signatureldate COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Dieter location, mast or service Top requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A -F and G min.$100-$1000 fine Doc.Building Permit Revised 2010 Building Department The following is a list of the required forms to be filled out for the appropriate.permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products ROTE: 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 app: al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm;tted with the building application Doe: Doc.Bui?rfiing Permit Revised 2012 LocationneJ No. Check /' 26387 Date iy = TOWN OF NORTH ANDOVER Certificate of Occupancy $ /00 Building/Frame Permit Fee • ° a Foundation Permit Fee $ -r. Other Permit Fee_, TOTAL $' Building Inspector i 5gzj"� >'29 -Mayflower Drive North Andover, MA 01845 * � + 5 Stars Plus Confirmed Uniform Energy Rating System Energy Efficient 1 Star 1 Star Plus 2 Stars 2 Stars Plus 1 3 Stars 3 Stars Plus 4 Stars 4 Stars Plus 5 Stars 5 Stars Plus 500-401 400-301 300-251 250.201 1 200.151 j 150-101 100-91 1 90-86 85.71 70 or Less HERS Index: 59 General Information Conditioned Area: 2633 sq. ft. HouseType: Single-family detached Conditioned Volume: 23945 cubic ft Foundation: Unconditioned basement Bedrooms: 3 Mechanical Systems Features Heating: Fuel -fired air distribution, Propane, 95.0AFUE. Cooling: Air conditioner, Electric, 13.0 SEER. Water Heating: Conventional, Propane, 0.70 EF, 40.0 Gal. Duct Leakage to Outside: 128.00 CFM25. Ventilation System: Exhaust Only: 61 cfm, 9.0 watts. Programmable Thermostat: Heating: Yes Cooling: Yes Building Shell Features Ceiling Flat: R-30, R-38 Slab: None Sealed Attic: NA Exposed Floor: R-30 Vaulted Ceiling: R-27 Window Type: U:0.30, SHGC:0.29 Above Grade Wails: R-21, R-15 Infiltration Rate: Htg: 1287 CIg: 1287 CFM50 Foundation Walls: R-0.0 Method: Blower doortest Lights and Appliance Features Percent Interior Lighting: 95.00 Range/Oven Fuel: Propane Percent Garage Lighting: 100.00 Clothes Dryer Fuel: Electric Refrigerator (kWh/yr): 459.00 Clothes Dryer EF: 3.01 Dishwasher Energy Factor. 0.78 Ceiling Fan (cfmNVatt): 0.00 The Home Energy Rating Standard Disclosure for this home is availablefrom the rating provider. REM/Rate - Residential Energy Analysis and Rating Software v14.3 This information does not constitute anywaranty of energy cost or savings. ©1985-2013 Architectural Energy Corporation, Boulder, Colorado. ,4�-,/ 7 p4/1=.4cvvijt° be, nl d C4 -1-13m Registry ID: 935076970 Rating Number: Certified Energy Rater: Michael A. Browne Rating Date: 12-18-13 Rating Ordered For: Key Lime, Inc- Ben Osgood Estimated Annual Energy Cost Confirmed Use MMBtu Cost Percent Heating 71.1 $2355 56% Cooling 2.8 $145 3% Hot Water 19.5 $642 15% Lights/Appliances 21.3 $1047 25% Photovoltaics -0.0 $-0 -0% Service Charges $0 0% Total 114.8 $4188 100% This home meets or exceeds the minimum criteria for all of the following: IECC Air Sealing Mandatory Requirement- Infiltration < 7AC 2009 IECC Duct Leakage Mandatory Requirement* 2014 MA Residential New Construction - Tier 1* MA Base Code HERS Rating Performance requirement* MA Stretch Code HERS Rating Performance requirement* * Compliance with criteria forthis program is determined by the rater. Advanced Building Analysis, LLC 2 Woodlawn St Amesbury, MA 01913 www.advancedbuildinganalysis.com /�,llCertified Energy Rater K It RESNET HERS Index Certificate HERS* Index More Energy 150 { 140 Existing 130 Homes 120 110 Standard +oo New Home so so >o =Home ao 59 so 40 20 Zero EnergyU3010 Homeu Less Energy 20 Mayflower Drive North Andover, MA01845 Rater: Michael Browne Registry ID: 935076970 Annual Estimates`: Electric(kWh): 6511 Propane(G al I ons): 1014 CO2 emissions(Tons):9 Energy Savings ($)": 4182 'Based on standard operating conditions "'Based on U- S. DOE designation of a HERS Index of 130 as the Typical Existing Home' Advanced Building Analysis, LLC 2 Woodlawn St Amesbury, MA 01913 www.advancedbuildinganalysis.com This home has been inspected and performance tested in cE l�® accordance with Chapter 3 0/ J/V the RESNET standards. www resnelms 4 RESNET HOME ENERGY RATING Standard Disclosure For home located at: 20 Mayflower Drive City: NorthAndover State: MA 1. VThe Rater or the Rater's employer is receiving a fee for providing the rating on this home. 2.0 In addition to the rating, the Rater or Rater's employer has also provided the following consulting services for this home: A. Mechanical system design B. Moisture control or indoor air quality consulting C. Performance testing and/or commissioning other than required for the rating itself D. Training for sales or construction personnel 11 E. Other (specify below) 3. 0 The Rater or Rater's employer is: ❑ A. The seller of this home or their agent 1-1 B. The mortgagor for some portion of the financed payments on this home F1C. An employee, contractor or consultant of the electric and/or natural gas utility serving this home 4. D The Rater or Rater's employer is a supplier or installer of products, which may include: HVAC systems Thermal insulation systems Air sealing of envelope or duct systems Windows or window shading systems Energy efficient appliances Construction (builder, developer, construction contractor, etc.) Other (specify below): Installed in this home by: F] Rater FI Employer ❑ Rater 1-1 Employer ❑ Rater F-1 Employer 1-1 Rater 1-1 Employer ❑ Rater F1 Employer ❑ Rater [—� Employer Rater 1-1 Employer OR Is in the business of: F1 Rater 1-1 Employer 1-1 Rater ❑ Employer ❑ Rater El Employer Rater Employer Rater Employer Rater Employer Rater 11 Employer I attest that the above information is true and correct to the best of my knowledge. As a Rater or Rating Provider I abide by the rating quality control provisions of the Mortgage Industry National Home Energy Rating Standard as set forth by the Residential Energy Services Network (RESNET). The national rating quality control provisions of the rating standard are contained in Chapter One 4.C.8 of the standard and are posted at http://www.natresnet.org/accred/Standards.pdf. This home may have been verified under the provisions of Chapter Six, Section 603, "Technical Requirements for Sampling" of the Standard. Michael A. Browne Rater's Printed Name Rater's Signathre 3992602 Certification # February 06, 2014 Date RESNET Form 0300-2 E ol Z e d rre�n M1 O O Cc w O • \ , Z LLJ \ 0 d �r 0.0 W �! LLL. 6 Z . Q N�V `f�,py�,y, Z ed �'� Z L N W �0• �j V t � • .Or O t i C� E cp N LLI LLI Cl) u O -i 1ui Ll. -�dd77��yy Y, v Q v a c 7 LL c 7 `` ai s. u 7 e t ° °7 L z O + Y L O1 O d�+'C. .�+ _ LL N d' U LL W LL to .0 .O \� f w LL F; V (d N Ln d rre�n M1 O O Cc w O • yJ _� Z V1 .F� � � Q 0 d �r 0.0 w " r �y j . Q Cl) L N Y � Y p. �0• d t � • .Or O t i C� E cp � o zo Q' N Cl) —0 O ti .ti O E ier O .�a z O N 0 ��I = c ,W,ww Q vI .E CL v O O � F O � OM a .5-0 r CD 'O CLV w O 1.i. AWCOA Z 0 4>)O a ..`� as Cl) i O E w- C� � � o zo Q' N Cl) —0 Ll. � LLJ � d�+'C. .�+ _ cH C CO to .0 .O LLJ -i F; V C O! O C C Q = L m Lc i-- N 4) V m C uj W LL N '0— O O O N C u O s =i V E L 0 -o v V O s O O -a_ am ca CL as +L+ •� N F- N to .0 O = w C. O V ti .ti O E ier O .�a z O N 0 ��I = c ,W,ww Q vI .E CL v O O � F O � OM a .5-0 r CD 'O CLV w O 1.i. AWCOA Z 0 Co Cl) i O C� v � U Cl) Ll. � LLJ � cH C CO LLJ LLJ -i ti .ti O E ier O .�a z O N 0 ��I = c ,W,ww Q vI .E CL v O O � F O � OM a .5-0 r CD 'O CLV w M` �O17�e#L 49 "CHU" CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 759-13 on 5/14/2013 Date: November 7, 2013 THIS CERTIFIES THAT THE BUILDING LOCATED ON 50 Mayflower Drive_ MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Fee: Prepaid $100.00 Receipt: 26387 Check: 5849 Key Lime Inc. 10 Hepatica Drive North Andover, MA 01845 Rzf-�X..' Buil ing Inspector V NORTH '1 .� hQ V i � � J ^O4n. �V 1g f Ss'"CR�S�t CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 759-13 on 5/14/2013 Date: November 7, 2013 THIS CERTIFIES THAT THE BUILDING LOCATED ON 50 Mayflower Drive_ MAY BE OCCUPIED ASas single family home home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Fee: Prepaid $100.00 Receipt: 26387 Cheek: 5849 Key Lime Inc. 10 Hepatica Drive North Andover, MA 01845 Inspector 0 t VED !6 N t APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION BUILDING PERMIT # ��SSACHUS��� ADDRESS/LOCATION OF PROPERTY: _5V,ifVt'�o�✓i.�� Map Parcel Lot Number. SUBDIVISION: v max' " 61'7'874'w' DATE REQUESTED FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: 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. . c, Permit IssWd to: Address: TOWN ENGINEER, XCONSERVATION X PLANNING APPLICANT SIGNATURE H4 # eq/ ROUTING SITE PLAN — DRIVE -WAY REVIEW O �taw,' Nts DPW -WATER METER SEWER CONNECTION It 3 DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST SIGNATURE File: Application for OC form revised Jan 2007/2011 ,'. k\ kA 01 `J n E o z O o � = s U)o U) Q � s s � � � 0 C. CL t Q ®� .CL c Z 0 CLN 0. 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X LLJ v/ C G �w LLI —j n. z i F O: w v 0 r -M-1 W a LU CA 19 LLL UA 19 �w�p Yt 100 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 379,625.00 m $ - $ 4,555.50 Plumbing Fee $ 569.44 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 569.44 Total fees collected $ 5,794.38 50 Mayflower Drive 759-13 on 5/14/2013 New Single Family Home i i o 00 V 1 Z W Vl —au) / 00 W M • o >w cd W Cl)c � 2 �1 �v� v 1•� W 0 t V 00 V i 00 001 2,06 �. 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Co CO v+ ~ate z� OCO a Z F- U) LLI X Z o LU O W S W J az m � 0 _ .0 m t O Z 0 r- 0 O I 0-, w v O E W 0 0 0 z N 0 = I CD .E m m i 0 v D O O Q CL CL Ea 0 v J 0 'a = 0 0 rz 0 CL V U) ca _ i i Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS -075302 BENJAMIN C OSGbOD 69 OLD VH.LAGE LANE NO ANDOVER NIA 01845 Expiration Commissioner 12/04/2014 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company 64 Third Avenue, Burlington, Massachusetts 01803 NCCi NO 40959 (800) 876-2765 POLICY NO. NZOK�] PRIOR NO. ITEM 1. The insured Mail Address: Key Lime Inc 10 Hepatica Drive Street No. North Andover Town or City MA 01845 County State Zip Code FEIN xxxxx1218 ❑Individual []Partnership ®Corporation ❑Joint Venture []Association ❑Other Other workplaces not shown above: 2. The policy period is from QBL1512012 to 09/1512013 12:01 a.m, standard time at the Insured's mailing address, 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here; MA B. Employers Liability Insurance: Part Two of the policy applies to work In each state listed in item 3.A. The llmits of our liability under PartTwo are: Bodily Injuryby,Accldent $ 1.000.000 each accident Bodlly Injury by Disease $ 1.000.000 policy limit `BodilyJhjury,by Disease $ 1,000.000 each employee C. Other States Insurance; Coverage Replaoed By Endorsenr ent WC,20 03 06A D. This policy inc?udes these endorsements and schedules: SEE SCHEDUt:E' 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating plans. All information required below Is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per $100 Estimated No. Total Annual Of Annual 14 Remuneration Remuneration Premium INTRA 285896 SEE E TENSION OF INFORIVIATIC N PAGE Minimum premium $ 600.00 As indicated interim adjustments ofremium shall be made: ElAnnually ❑ Semi Annually & Quarterly ❑ Monthly Total Estimated Annual Premium $ 4,470.00 Deposit Premium $ 1,160.00 MA Assessment Chg. $4,026.02 x 4.2000% n n $1$9.00 This policy, including all endorsements, is hereby countersigned by 07/10/2012 Authofted Signature Date GOV STATE GOV CLASS KIN I] AUDIT PLACING OFFICE CLAIM OFFICE NAME CHECK- SAFETY .GROUP - MA 5645 14 505 WC 00 00 01 A (7-11) Includes copyrighted malarial of the National Count@ on Compensation Insurance, used with its permission. M P Roberts Insurance Agency Inc, 1060 Osgood Street North Andover, MA 01845