HomeMy WebLinkAboutBuilding Permit #169 - 53 HEPATICA DRIVE 8/31/2007 OORTM
BUILDING PERMIT "0
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TOWN OF NORTH ANDOVER 0 . 0
APPLICATION FOR PLAN EXAMINATION
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Permit N0: Date Received �4ssgcHUS����
Date Issued:
IMPORTANT: Applicant must complete all items on this page
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PR7F'ER
wA ' NQ 'AR�L ZONII31ST �T �Histflric D�strtct yes
3 n
Machine Slop 1/lllage` yes no
TYPE OF IMPROVEMENT_ PROPOSED USE
Residential Non- Residential
New Building ❑ One family
❑ Addition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units: 0 Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
fSepttc "Q 1lUet ❑ Flnodsla�a� �letlands ater
❑ W hed"Distrl
'� w❑'�ate7�l��"r �!���•"4�s..a�.,HSP}��'.w'�".s"�� �,. :z .��,..•�.� . ,��4a<> �''�% o.,.� r .:.< .,�.,�, 'µ aa- .�.;4,:
DESCRIPTION OF WORK TO BE PREFORMED:
pQ ,' II cyv nn oo wl �-�i
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o�s eow ASS �e12 4�t� 9 _77
Identification Please Type or Print Clearly)
OWNER: Name: K+eq ),:",V Phone: 78 4983
-
Address
..Phone
TOR Qt\larie
CtONTRA
Superv� o 's nsftr i �6q, teen Exp.
Dete 5?
a .5NO
x, a .4
Hofne im �-oue�entk .oehse5 «.. E ;. Dat
�. �..
ry
v.a
ARCHITECT/ENGINEER Uo�" 'j'� �5 , Phone: 78�
p t, r
0 �r � ekak Y-4[ eF e LLO W4 Re No.
Address: a l I�d�c�� � g•
FEE SCHEDULE:BULDII G PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ Oy0 FEE: $ r f
Check No.: .s_ _Receipt No.: ®2 C�
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty.fund
Sgnaturef ggenf/� xb `` +gnature of ContraeN
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 El
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
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THE FOLLOWING SECTIONS FOR OFFICE USE ONLY j
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING &-DEVELOPMENT ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ . ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
i
Conservation Decision: Comments
Water& Sewer Connection/Signature & Date Driveway Permit
Located at 384 Osgood Street
FIRE DEPARTMENT Temp Durnpsteron site yes no
Located
f ' 4 M
,4Jh Street-
rre.Department s�glnaturefdate
i
Ly�IVI ll'G.NTS
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
❑ Notified for pickup - Date
......._............................................................................................................................................................................._...._................................_........
.....................;
Doc.Building Permit Revised 2007
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
U Copy of Contract
,❑ Floor Plan Or Proposed Interior Work
o 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
a Certified Surveyed Plot Plan
o Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
Li 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)
/ Building Permit Application
R( 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)
o Copy of Contract
Mass check Energy Compliance Report
o Engineering Affidavits for Engineered products
NOTE: All,dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
Location
No. 16
Date 4sz 0
NaRTM TOWN OF NORTH ANDOVER
3? SOL
� 9
Certificate of Occupancy $
o
y
Building/Frame Permit Fee $ a a
s�CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
3
Check # 7?
20555
Bu'ding I Spector
NORTH
TO Of - _over
No.
K E o� , dover, Mass.,
COC LAMIC MEWICK 1•
A-
I 9,95 RATED P,? C7
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
�� BUILDING INSPECTOR
THIS CERTIFIES THAT
........... ........�.................................................................................;............ . Foundation
has permission to erect........................................ buildings on ...
Rough
to be occupied as................. "i.../W ..... Chimney
provided that the person accepting this permit shall in every respect conform to the 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 ARTS Rough
.... . ..... .... .....................................
Service
DIN R
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 FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
Board of Building Regulations and Standards
Construction Supervisor License
0*" .
ykicehse:,CS 75302
B1rthdate51,2/411941
-ern
08 Tr# 6950
expiration 1214/20
Restriction
BENJAMIN C.OSGOOD �
69 OLD VILLAGE LANE�,5' s y. •'' ,
NO ANDOVER,MA 01845 Commissioner
i
I
------
WORKERS COMPENSATION AND EMPLOYERS LIABILITI r,4SURANCE POLICY
INFORMATION PAGE
Associated Industries of Massachusetts Mutual Insurance Company
Burlington, Massachusetts NCCI NO 26158
(800) 876-2765
POLICY NO. I AWC 7013446012006
PRIOR NO. AWC 7013446012005
ITEM
1. The Insured Keylime Inc
Mailing Address: 1538 Turnpike Street North Andover MA 01845
1
L (No. Street Town or City County State Zip Code
4.
ElIndividual ElPartnership ® Corporation ElOther FEIN 04-3311218
Other workplaces not shown above:
2. The policy period is frOm09/15/2006 to 09/15/2007 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 limits of our liability under Part Two are: Bodily Injury by Accident$ 1,000,000 each accident
Bodily injury by Disease $ 1,000,000 policylimit
Bodily Injury by Disease $ 1,000,000 each employee
C. Other States Insurance:Coverage Replaced By Endorsement WC 20 03 06A
D. This policy includes these endorsements and schedules: SEE SCHEDULE
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
Estimated Per$100 Estimated
Code Total Annual of Annual
No. Remuneration Remuneration Premium
INTRA 285896
SEE EXTENSION OF INFORI 4ATION PAGE
i
Minimum premium$ 500.00 Total Estimated Annual Premium $ 1,128.00
1� As indicated,interim adjustments of premium shall be made: Deposit Premium $ 1,160.00
® Annually, ❑ Semi Annually ❑ Quarterly ❑ Monthly
MA Assessment Chg.
$768.55 x 4.1920% $32.00
This policy,including all endorsements,is hereby countersigned by 08/03/2006
ll Authorized Signature Date
!!I GOV GOV KIND PLACING CLAIM NAME SAFETY
STATE CLASS AUDIT OFFICE OFFICE CHECK GROUP M P Roberts Insurance Agency
MA 5645 2 1705 Inc
`i WC 00 00 01 A(11-88) 1060 Osgood Street
-i North Andover,MA 01845
Includes copyrighted material of the National Council on Compensation Insurance,
i used with its permission.
i
A B
A4 A4
50'-O'
20'-O' 18'-0' 7-0' 6-0' 7-0• 7-0-
10'-0' 16-0' CANN.;
DOOR SCHEDULE 6' 7-6' 9' 3,
NJMBER TYPE MATL WIDTH 14EIGHT THICK REMARKS
DI ENTRY MTL./INSLL. 3'-0' 6'-8' 13/4 W/17 SIDELIGHT O I LINE OF 0 1 S U L L I V A N
02 SINGLE MTL./INSUL. 3'-0' 6'-8' 13/4 20 MIN RATED W/SELF-CLOSING HINGES — DECK ABOVE
D3 SINGLE WOOD 7-10' 6'-8' 13/8' - I — — — — — — — — -� — — — — — ARCHITECTS, INC.
D4 SINGLE WOOD 7-6 6'-8' 13/8 -
D5 SINGLE MTL./INSLL. 3'-0' 6'-8' 13/4 -
ARCHITECTURE DESIGN PLANNING
06 SLIDER WDJGLA 6'-0' 6-8' 13/4' - -
D7 DBL BI-FOLD WOOD (D 3•-O' 6'-8' 1 3/8' - 201 EDGLD,MAS DRIVE,SUITE 215
D8 SINGLE MTL./INSU L. 3'-0' 6'-8' 1 3/4 - I 10'CONCRETE FND. I IT DIA CONCRETE WAKEFIELD,MASSACHUSETTS 01880
WALL W/20'X10'
D9 GARAGE MTL./INSL..L. 9-O' 7-O' T METAL OVERHEAD DOOR W/I'-0'TRANSOM I I FILLED SONOTUBES
CONT.CONCRETE TO UNDISTURBED Tel:W.OS46-1667 Fax:(781)246-1683
DIO SINGLE WOOD I'-b' 6'-8' 13/8 - Q
DIV— SINGLE— WOOD--- 7-8'- --b'-8' 1.3/8- - FTG(TYPICAL) I SOIL(TYPJ I Q WWW.OSULLIVANARCHITECTS.COM
DI2 DOUBLE WOOD (2)7-0' 1 6'-8' 113/8 m _ .— _ _ - W/6X6 PT. — _ oa
COL[XVIINS v .I_. .N _ _ _ .-. _ _- These arew;nes ena speorcetrore.,e�e weperea
ror cse heioasron.�na�ce�ea...wa�maon
se�s expressly rmrtea�o U,e beneeea iocenm.
N I I I C WB n Pert.a PrPhiti lea wilftcu[Cie wriLLenin vfiae
N 10 b'-2' 6'-O" 6'-7 10LL
A40 2006 O'Sullivan Architects Inc.
I— ��—Tl
POCKET _ - - - - - — - - � O
� J - - - - - - - - - - - � M I
I . '
o
I
POCKET LIN ` I tP ETS
BEAM
I ABOVE CONC.SLAB
GENERAL NOTES e MIL.P PSI MIN) N 6
I.
GENERAL
'SASHDEM �2817BAREAWAY AS LC ��� 7 MIL.POLYETHYLENE
VAPOR BARRIER W/
A) ALL FOOTINGS SHALL BEAR ON UNDISTURBED SOIL HAVING A MINIMUM REO�D(TYPJ REIN 10/10 W.WM
I
BEARING CAPACITY OF 3,000 PSF POUNDS PER SQUARE FOOT). i I COMP OVER 6'MIN
B) TFE BOTTOM ELEVATION OF EXTERIOR FOOTINGS SHALL BE A MINIMUM — O COMP.GRAVEL-� I Old Salem Village
OF 4'-0'BELOW OUTSIDE GRADE LOWER FOOTINGS AS REQUIRED TO REACH N 10'C TE F*
GOOD BEARING. ( 2X4 WOOD WALL /20'X10'
CONT.CONCRETE
T.O.SLAB FTG.( 1CAL)
C) THOROUGHLY COMPACT THE BOTTOM OF EXCAVATIONS PRIOR TO �rEL 91'-T
FORMING FOOTINGS.
0. 10'-9' T-9' 3'-0' 14'-0' 6'-6' 6-4'
D)ALL FOUNDATION WALLS SHALLL BE BACKFILLED EVENLY ON BOTH SIDES
TO PREVENT UNBALANCED LOADINGS. 'c+ BEAM BEAM
D ALL BACKFILL USED INSIDE THE BUILDING SHALL BE WELL GRADED GRAVEL
O v) I POCKET I— f I I— P°QKET
WHICH SHALL BE T14CQOUGI-LY COMPACTED IN 8-LAYERS.ON-SITE MATERIAL O I -71 I
MAY BE USED IF ACCEPTABLE TO TI-E GEOTECI-INICAL ENGItsEER. I � .O.LLFOUND. D —A L LIQ nOF O J L _JUP p i
F) ALL CONCRETE SHALL BE PLACED IN DRY EXCAVATIONS.PUMP AWAY I L 100-0 — _ 14R ABOVE -v I— PST ( I N Route 1 1 4
11 1
GROUND WATE12 AS REQUIRED.
° — — — _ - - - - - - North Andover, MA
G) FOR CONSTRUCTION DURING WINTER,FOOTINGS AND FLOOR SLABS WILL — — — — — SAM LINE OF (D LALLY
REQUIRE PROTECTION FROM FREEZING TEMPERATURES AT THE BEARING FOUND
SURFACES UNTIL TILE BUILDING IS ENCLOSED AND HEATED. I I TO P U I I POCKET BEAM COLUMNS TO WALL EL.
ABOVE
2. CONCRETE- d I I 99'-8 EL.W-8' I Ski' IA.H.W.LALLY
C LMN WITH TOP
A) ALL CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF BOTTOM PLATE
o BELODROPW
WALL I2 9X30'X17 I I U1"l�t E Alt.
3,000 PSI AT 28 DAYS. in I I BELOW T.O.SLAB I � CONCRETE FOOTING I) I
B) MAXIMUM ALLOWABLE SLUMP OF CONCRETE SHALL NOT EXCEED 4•. I HIGH PT a MAN TYP.(SEE DETAIL)C) ALL CONCRETE WORK SHALL COMPLY WITH A.C.I.SPECIFICATIONS. I DOCK I WALL . I Foundation Plan
100'-O'
3. REINFORCING STEED I Q I I II'-7 8'-8' `t
A) ALL REINGFORCING STEEL SHALL BE ASTM A615-GRADE 60 AND SHALL BE N Z
I 4'CONC.SLAB O— I
DETAILED,FABRICATED AND INSTALLED IN ACCORDANCE WITH THE LATEST 2 BEAM BEAM
(3000 PSI MIN)W/b O POCKET POCKET
A.C.1.SPECIFICATIONS, 117
MIL.POLYETHYLENE ~O �'
VAPOR BARRIER W/ O N I — — — I
a B) WELDED WIRE FABRIC(W.W.F.)SHALL BE ASTM A-185.LAP ALL SPLICES 12' w
MINIMJM SECURELY FASTEN W.WF.IN PLACE TO PREVENT MOVEMENT DURING bX6X 10/10 W.W.M U
REINF.OVER 6•MIN. to W I I (2)LALLY J I I
n CONCRETE PLACEMENT. COMP.GRAVEL a ABOVE
$ C) ALL HORIZONTAL RODS ARE CONTINUOUS.THE LENGTH OF ALL LAP I I d I I T.O.FOU-40
COLUMNS I I p Key-Lime, nC-
aj
SPLICES SHALL BE AS REQUIRED FOR'CLASS B•TENSION SPLICES P92 THE
WALL EL 4 T.O.FOUND. M_ 1538 Turnpike St.
LATEST A.C.I.CODE REQUIREMENTS LMESS OTI-E12WISE NOTED ON THE I I I 100'-II' SHELF E_ I I North Andover,MA 01845
STRUCTURAL DRAWINGS.PROVIDE CORNER RODS AS DETAILED ON THE I I I V
CONTRACT DRAWINGS. — — — —
FOOTING NOTE&
D) PROVIDE A CLEAR COVER FROM REINFORCING STEEL TO ADJACENT I. ANY WOOD IN CONTACT W/CONC.MUST BE P.T. I I 14
w CONCRETE SURFACES AS FOLLOWS DROP WALL 12' h
BOTTOM OF FOOTING 3' 2 PROVIDE 7-10'CONCRETE POUR.(SEE SECTIONS) I I BELOW T.O.$LAB 4(LOW)S-AB I O ,O 16-6 O0 O L_
�I LOW PTs GARAGE
PIERS AND WALLS 1 I/2'(EXCEPT 7 AT n6 AND LARGER BARS) �y_4.
THESE DIMENSIONS SHALL BE CONSID62ED ACTUAL AND ARE NOT TO BE 3. TOP OF MAIN FOUNDATION WALL ASSUMED TO BE 100''0' I L DOOR — _j O
e ADJUSTED IN EITHER DIRECTION. — SCALE: 1/8"=1'-0"
4, FOOTING ELEVATIONS REPRESENT A MIN ALLOWABLE O I ;o .O.FOUI"D. I 10'CONCRETE FND.
8'CONCRETE FT�D.
DEPTH ALL FOOTINGS MUST BE PLACED ON UNDISTURBED ALL EL O I ISSUED/DRAWN BY
f0I D ALL REINFORCING RODS AND W.W.P.SHALL BE SECURED IN PROPOEI2 — — — WALL W/16'X8' WALL W/207(10'
w SOIL OR COMPACTED FILL BUT IN NO CASE LESS THAN DRIVE OUT CONT.CONCRETE ARIES
.. POSITION ON CHAIRS OR BOLSTERS AS MAts1FACTURED BY RICHMON7 SCREW THE FROST LINE DEPTH(4'-0'MIN)(CONTRACTOR TO Q Y 4' 4' CONT.CONCRETE O 7-23-07
j ANCHOR CO.OR APPORVED EQUAL EL 87-0' I FTG. FTG.(TYPICAU morswran amn.�-.,ice.
VERIFY SOIL CONDITIONS UNDER ALL FOOTINGS.) in —
REVISED/REVISED BY
3 - - - - - - - - T.O.SHELF3
o O KY-4'MO. 7 BRICK COURSES
BELOW GRADE
20'-4• 17-10• ll'-101
2
so•-0•
o
UNIT E S F. 5-25-06
W
FOUNDATION PLAN - UNITE FIRST FLOOR 18765F. JOB NO: 04022
o cafe: 1/a =1'-0° SHEET NUMBER
SECOND FLOOR 895 S.F.
C07 TOTAL• 2491 SF.
O
Y GARAGE 477 S.F.
OPT.SECOND FLOOR 1053 S.F. Al