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HomeMy WebLinkAboutBuilding Permit #909-15 - 550 BOXFORD STREET 5/12/2015 NORTH BUILDING PERMIT OF LED - qtit ik646 V `` � TOWN OF NORTH ANDOVER � PPLICATION FOR PLAN EXAMINATION '' p �-A o „ 1. Permit No#: b�—I L5 Date Received no ,/ �gSSgcHusE��S Date Issued: t I7 IMPORTANT Applicant must complete all items on this page LOCATIOIVa' J , y OXRD9D 5���'F -,D � (� t'•4 x Print PROF?ERTYOWNER /TCJI'I/I��' �--L _ _ ;Print 00 Year Structure; MAP .,PARCEL':,ZONING DISTRICT _Historic ®istnct yes:.* no �> Machine,Shop'Village yes- no TYPE OF IMPROVEMENT PROPOSED USE Res i ntial Non- Residential ew Building ArOne family ❑Addition ❑Two or more family ❑ Industrial- ❑Alteration No. of units: ❑ Commercial ❑Repair, replacement ❑Assessory Bldg ❑ Others: _❑Demolition ❑ Other ❑_ Septc 111e1I E` ❑4Floodplai_nWetlands Watershed?sDi tract; © _ °Wager/�evue� DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly 8bra a5� OWNER: Name: S �c-1©xmS' L�1..G Phone: q)8 6/e3go t 17 Address: U N -4 �-- '� ` e3 t�8 Contractor Ng me' ��t ..,� ] Phone '.�►c . Email: i LeA'tb_ ►: MaxAeb..,-t-0 Ad d- ':- � 'Ex ;Supervisor s.Construction"License . p D__ „ II: Home I'rnprovementLicen"se Exp._sDate.. ARCHITECT/ENGINEER IQ g12q _ Deti p, E Phone:6779-352-73 j . Address;���il?�IilJ�� �=oy�'f otnJN MA--O� Reg. No.' -77LJ FEE SCHEDULE.BOLDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 317 — FEE: $ Check No.: Receipt No.: 20 1 ko_5 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund .4. - Location 550 4 /7� LA Z No. #� Date 6112-11'5— TOWN 12 /'5—TOWN OF NORTH ANDOVER Certificate of Occupancy $ dv Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ ` TOTAL $ 406 Check# i Building Inspector Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimm'ng Pools ❑ Well Y. Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS f'2,' 60&11 k ff&ClA2-d - ' 40T ! i 1-Or 2 CM�il-ed of ITYn •+�csZ. �110 - d%Sit1� > CONSERVATION Reviewed on Si nature COMMENTS Uo .Qrapo � troy ,, CCS` 1�cz�nn , 4'�Q 1 o . c v o c�p s �-�{- c� l e���o� Cork ca\ c� HEALTH Reviewed on ,6.'4 'o�) �✓ Si nature COMMENTS (�S Zoning Board of Appeals:Variance, Petition No: AJ14 Zoning Decision/receipt submitted yes e 4 Planning Board Decision: Comments Conservation Decision: Comme 4- —1 Water&Sewer Con nection/si natu n I Drivewa Perm' (m DPW Town Engineer: Signature: � Located 38 Osgo d Street FIRE DEP�IRxMMENiffi, pmp rl),r on sift y' es no Located at 1x24 Main Street' - Fire Departmen -qi,g ature r Dimension Number of Stories: Total square feet of floor area, based on Exterior dirnerlsions.a )OaP Total land area, sq. ft.: 9 0 .� 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) i Wu l Notified for pickup icku Call Email Date Time Contact Name Doc.Building Permit 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 4 Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: 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 OTE: 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 OTE: 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 i i Doe:Building Permit Revised 2014 I Registry ID: 107928201 Rating Number: oose Certified Energy Rater: Eric Wilder l - Rating Date: 1/7/2016 Lot 2 550 Boxford St. Rating Ordered For: Unknown North Andover,MA 01845 Estimated Annual Energy Cost i Confirmed 5 Stars Plus Use MMBtu Cost Percent Confirmed Heating 62.8 $1571 50% Uniform Energy Rating System Energy Efficient Cooling 2.2 $91 3% Hot Water 14.9 $365 12% 1 Star 1 Star Plus 2 Stars 2 Stars Plus 3 Stars 3 Stars Pius 4 Stars 4 Stars Plus 5 Stars 5 Stars Plus Lights/Appliances 25.1 $993 31% 500-401 400-301 300-251 250-201 200-151 150-101 100-91 90-86 85-71 70 or Less photovoltaics -0.0 $-0 -0% HERS Index: 46 Service Charges $136 4% General Information ] Total 105.0 $3156 100% Conditioned Area: 3139 sq.ft. HouseType: Single-family detached --- ---- ---- -— -- --- -- Conditioned Volume: 27047 cubic ft. Foundation: Unconditioned basement - - - -- -- - - —- - -- Bedrooms: 4 This home meets or exceeds the minimum r_-.M- _..---.- ._. ..._.--.- _- . . _. criteria for all of the following: echanical Systems Features Heating: Fuel-fired air distribution,Propane,96.0AFUE. Cooling: Air conditioner,Electric,13.0 SEER. Water Heating: Instant water heater,Propane,0.97 EF,0.0 Gal. Duct Leakage to Outside: 79.16 CFM25. Ventilation System: Exhaust Only:70 cfm,21.0 watts. Programmable Thermostat: Heating:Yes Cooling:Yes Building Shell Features Ceiling Flat: R-41.5 Slab: None Sealed Attic: NA Exposed Floor: R-30.0 Vaulted Ceiling: R-35.0 Window Type: U-Value:0.300,SHGC:0.280 Above Grade Walls: R-21.0 Infiltration Rate: Htg:2.16 CIg:,2.16 ACH50 Foundation Walls: R-0.0 Method: Blower door test I Lights and Appliance Features TITLE Percent Interior Lighting: 100.00 Range/Oven Fuel: Propane Company Percent Garage Lighting: 100.00 Clothes Dryer Fuel: Electric Address Refrigerator(kWh/yr): 550.00 Clothes Dryer EF: 3.01 City,State,Zip Dishwasher(kWh/yr): 256.00 Ceiling Fan(cfm/Watt): 0.00 Phone# The Home Energy Rating Standard Disclosure for this home is available from the rating provider. Fax# ` 1 REM/Rate-Residential Energy Analysis and Rating Software v14.6 W This information does not constitute any warranty of energy cost or savings. ©1985-2015 Noresco,Boulder,Colorado. I F 9 CERTIFICATE OF USE & OCCUPANCY 'OWN OF NORTH ANDOVER Building Permit Number 909-15 on 5/12/2015 Date: January 8 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 550 Boxford Street—Lot 2 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: S&L Homes LLC 10 Middlesex Avenue i Wilmington,MA 01887 I I f CGS Building Inspector Fee: PrePaid$100.00 j Receipt: 29729 Cheek : 1127 i I I I Of NoerH q ., Eo r6s N O S APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION �9SsCH"CH "°E��y ]BUILDING PERMIT # A ADDRESS/LOCATION OF PROPERTY: J� map—L65-0-- Parcel a-a Lot Number SUBDIVISION:_ 44A P(VrR t- Lo, DATE REQUESTED FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: FIVE(S)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED 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: S `C L -44q, �_5 Address: 1tQ t-lt.C_cUt s ev AY2 . tj I- 0 (St I ROUTING TOWN ENGINEER, SITE PLAN—DRIVE-WAY REVIEW ►���,� CONSERVATION 01, PLANNING [ �� 6l��� �r!� ��X I u� DPW-WATER METER ❑ SEWER CONNECTION ❑ �/ -l'U, DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST 7 DPW SIGNATURE File:Application for OC form revised Jan 2007/2011 µoRTH Town � z 96C4� za ,,,K, h ver, Mass, 21 05 coc�/�c.I&WICK ��• p0RAT E 0 PPP _j ,`�(5 S U BOARD OF HEALTH Or PERMI _ Foo She .r • iiy�� �rf _:.,, THIS CERTIFIES THAT .......... . .�........ ,5.. .` ,,, „ ,,, ,,, ............. = BUILDING INSPECTOR' has permission to erect ................ ...... Idings o .. _D .., a a...... T..... oundation Rough to be occupied as ................... 4r........ . .�.. .. ....... .................................................... Chimney provided that the person accepting permit shall in p p p. g p a eve respect conform to the terms of the application final on file in 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. P MBING N�SgP ACVol Rough �_c W lot VIOLATION of the Zoning or Building Regulations Voids this Permit. Final C� FoL1,41� PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough �',,• Service e .................... ...,...:.:... ........................................... BUILDING INSPECTOR !� GASINS ECTO Occupancy Permit Required to Occupy Buildinm Roug Display in a Conspicuous Place on the Premises — Do Not Remove Final Vs fes- f No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Buhr Street No. ' Smoke Det.P{ CLEAResult 50 Washington Street, Suite 3000 Westborough, MA 01581 IECC 2012 402.4.2.1 Testing option Blower Door Testing oPas / Fail Date of test: /� 77-14:z, Street Address: d Total conditioned floor area: Total conditioned volume: 271 ��7 Source of area and volume calculations: PL'q-V S Builder ✓ Rater Other HERS Rater: CLEAResult, Certification Number: p t /L{-Z Signature: �� — Builder: S � D✓hes Builder Contact: Tested Air Leakage Requirement:3 Air Changes per hour at 50 pascals(ACH50)or less Measurement: ACH50: 2, 00 0 CLEAResult © 2015 'CLEAResult 50 Washington Street Westborough, MA 01581 IECC 2012 & MA Stretch Energy Code Duct Tightness Verification oPassFail Date: ! �Z� l ['�O Permit No.: Street Address: 15,50 jp>CA Total conditioned floor area: " 112-.101 Source of Area Calculation: V-3 S HERS Rater: iC , BCW Certification Number: v Signature: Builder: Builder Contact: I HVAC Contractor: Do` c 2012 IECC-New Construction Post-construction test ❑ Total Leak2ge-4 cfm/100 ft2 maximum allowed Testing result: cfm/100 ft2 Rough-in test-Total leakage Air Handler Installed? El"Yes Cf M/100 ft2 maximum allowed ❑ No—3 cfm/100 ft2 maximum allowed Testing result: 2. 5 cfm/100 ft2 MA Stretch Energy Code—401.3 Prescriptive Option for Residential Additions and 401.5 Prescriptive Option for Alterations,Renovations or Repairs Applies to all systems except those in which the air handler and all ducts are located within conditioned space ❑ Leakage to outdoors-4 cfm/100 ft2 maximum allowed Testing result: cfm/100 ft2 Results apply to the system as tested on the date above. Compliance is void if any changes are made to the duct system. CLEAResult Copyright 2015 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 3175000.00 m $ - $ 3,804.00 Plumbing Fee $ 475.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 475.50 Total fees collected $ 4,855.00 550 Boxford Street 909-15 on 5/12/2015 Single Family Home 296.0' LOT Z w EXISTING FOUNDATION TOF EL.=130.9' 100'BUFFER 4(3 or J. 1 / N \rn SERGI �O No.33 1 �O �9or-3SI��P I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL EB CK FCTWFN°RUFOUNDATION LOCATION APPLICABLE ZONING -LAWS N EFFECT CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER LLC RESTRICTIONS SUCH AS COVENANTS.WETLANDS,EASEMENTS. CLIENT: S & L HOMES ,LLC ORDERS OF CONDITIONS,ETC.)THIS DRAWING SHALL NOT BE USED THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE,EXCEPT WITH THE WRITTEN PERMISSION OF CHRISTIANSEN LOCATION:NORTH ANDOVER,MA. &SERGI INC.FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN&SERGI INC_AND ANY DATE: 7127115 SCALE: 1"=80' UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN&SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFORMATION CONTAINED HEREON. PROFESSIONAL ENGINEERS & LAND SURVEYORS CHRISTIANSEN & SERGI, INC. 160 SUMMER STREET, HAVERHILL,MASSACHUSETTS 01830 WWW.CSI-ENGR.COM TEL.978-373-0310 FAX.978-372-3960 DWG.NO.:14036.001.017 W o A N t�vvCf' ;tea 50 Washington Street Suite 3000 Westborough,MA 01581 t 508.836.9500 Conner ation f 508.870.5975 Services Group www.csgrp.com IECC 2012 & MA Stretch Energy Code Duct Tightness Verification �I�� ass Fail Date: � /s Permit No.: Street Address: L�jT 2 R Total conditioned floor area: Z S� ' Source of Area Calculation: PL 00, S HERS Rater: Certification Number: c Signature: Builder: Builder Contact: , l HVAC Contractor: 2012 IECC-New Construction Post-construction test ❑ Total Leakage-4 cfm/100 ft2 maximum allowed Testing result: cfm/100 ft2 Rough-in test-Total leakage Air Handler IInstalled?M Yes-4 cfm/100 ft2 maximum allowed ❑ No—3 cfm/100 ft2 maximum allowed Testing result: 3,,0 cfm/100 ft2 MA Stretch Energy Code—401.3 Prescriptive Option for Residential Additions and 401.5 Prescriptive Option for Alterations,Renovations or Repairs Applies to all systems except those in which the air handler and all ducts are located within conditioned space ❑ Leakage to outdoors-4 cfm/100 ft2 maximum allowed Testing result: cfm/100 ft2 Results apply to the system as tested on the date above.Compliance is void if any changes are made to the duct system. Q� o IL � C LAWRENCE H.OGDEN,P.E. n 198 EAST MAIN STREET GEORGETOWN,MA 01833 978-35248318 fax 978—352-2858 cell:978-592-5921 September 15,2015 Mr.William Lumbard Comfort Realty Inc. 1.4 Bemis Circle Tewksbury,Ma.01876 RE: Lot 2 Boxford Street,North Andover,Ma.. Dear Mr.Lumbard As you requested I conducted a site visit 9/2115 and met with you to review the installation of the Engineered Materials consisting of LVLs,beams utilized in the framing of the above project.. The Lvls are shown on plans prepared by JMA Architects,Inc. dated June 7,2015 with the framing plans sheets F-1,F-2 certified by me June 17,2015. I can certify that to the best of my knowledge the LVLs members and associated details utilized in the framing as shown on the drawings are installed properly and meet the loading conditions of the 8th Edition of the Massachusetts State Building Code for 1&2 Family Residences. This certification is based on what I could visibly see at the time of this vist when the framming was complete. The purpose of this site vist was to form an opinion and comfort level that the construction appears to be in compliance with the drawings.This certification should not be construed as a thourough detailed inspection of the construction and framing. At the time of this site visit I noted certain items that reguared remedial or additional work see attached sheets S-1,S-2 dated 9/7/15.I revisited the site 9/11/15 and to the best of my knowledge this work was properly completed. Nothing in this certification relieves the Licensed Construction Supervisor of the responsibility for construction of this project per Section 110.85.2,and sub section I I O.R5.2.15 or of the Massachusetts Residential Code 780 CMR 51,or the proper execution of the details and framing requirements of the drawings,including but not limited to materials,blocking, manufacturers installation requirements and nailing schedules or other requirements of the code. Should you have any questions please do not hesitate to call. 04F Yours truly, La ence H. Ogden P.E. Structural 27765 �� is 15"4,9 L.Or Z BOXFORO STPeEr duokN Atuvouep- -t.440 •91T(1S S 80tLpeR ISILL LVM QA-RD 970 265 8532 4AU.s Ulf JMR ARC41TCG.?S 617 jeols fZ?,hMIA)& F-t DETAILS AiuD POTF�, P- CFRTtpteD 6�IpjiS.. C)1 ?-11. r°tt u4Srr TMF- FOLLt7Wide- WOO-#, 4UEE93 710 84o COM PLeCrCp C REPAIR -P i � G��AG•F ado �ra.a�fa�- 5�� �ErR�. ����,r- ��� � i�. 5xt ratoR S A �n XS AT ODEA-0,V�_ 5 Jrvn Its e ;�. T A , Ott t r "ro P 6fi wA t-t 'r0 e1 I;.Q At4D STUDS ear TVD, !� '�> OA-) eVP�E ,.� tItStvR•C. A°LL LVLS AkE BCRr-WF'D TO 6-ET-W E.2 pER ;-23) 4W P-7- 3) 9&TAtL A, 34P-FT P~ 1 5HDk-4 Z vVS COA)TINvDUr BTM 'FIA-Tm- TO TOP PL,4TI- 'NE MIZAW'Fo. DID A)Or. T10 TldtS f�pD 51M psoAl L- STR• Z4 $riz4pS DA., ItverPF i L5T4 24- 12. ( p ii 4) C-010TZACTOR. To u E RI r-.,, S t M p.50ju -M?_Z e TR A-p,, A 64OWN ON R,4I5E D FL&TE RAFTER. -N;zij$'r 54ser 4`-t RE PLAe-p` tr- n��cF�S►��r 5) CC )Till,:.Llf f-12 r` -to I A?SOR F 13 Loe-I-,r Aje, SET Wt E FrL< P A Prt` P A°5 SROW fru WA" 3RACilUr OETA14: A-AP tfi1 PLACE /4`r ALL 6) TgIb A bORME1L otop-k THM RAM!+_ RODM AT Tt.( l- Fp-otir €s,JA-L.tom. W %THotjr CoAatout'wc- "Ir- E7l-J&INEEQ, QF peeoRQ 'rH t PRAmWe. 1 $ 4 IVA-D6QUfkT'E REP Rt R AS 5+4ownj A!5 N 5—Z. A C!4 r D ?1 -r °+F- PRAMEIk S U13 ST IT V 7't V 3 -2010 t^oR To E✓ I-#E AV E R -56t Qwu 4-r -T-M r_ ST'vi?Y I N P CAC t: o f L vy S lfas.,ns ± TI4(s 15 Ac-cePTA9Lc stjR.£ " ,r4 Rtr- 7--Z,-,.',:. J AC-kS e4:t f 1.4, s uPP OR°r tnrc, -n4E W e^V E.z Lawrence H. Ogden P.E. 198 East Main St Georgetown, MA 01833 5 E E 5-2. A rTA,C.o4 E V 976 3 S 2 8 318 I L4Fc� q 7 iS LVL 5'Tr>p-� Ar f'o Ir i. i a FLAT' 1 LVL ON"F0 ,. a 7.3 11-1-7Sx Wl RvWS w t STA.: r P.E F 5 ISLE R lb o d eat —' s? c 5Cc r i O ra ito 94 Ttx*4 L s EAt�- 8 j Q$7WL rAsTr" M,4 2 Roy,jS t -� L eSa !C die % t ,0 arDD 5ctwps�.0 NVZ p-3 BF°Ais� - 3 �Zx ip 52 T � Z-2� p � O �'qc,1� Z G- tali Nc�T' 'G�L.as,k , � #�.�~►�t-± n�?� Lawrence H. Ogden P.E. 198 East Main St Georgetown, MA 01833 979 i North Andover Health Department UfllmunitY and Economic Development Division June.21,2015 S&L:Hames LLC William Lombard 14 Middleton Ave,Suite 1 Wilmington,MA.01887 Re: Subsurface Sewage Disposal System Plan,for 602 Boxford Street—Lot 2 (Map 105C,.Lot 22) Deal:Mr.Lombard, The proposed wastewater system design plan.for the above site dated June 9,201.5 with.a final. revision date of June 23,201.5 and received on Tune 23,2015 has been approved.. The design has'been approved for use in the construction of a new on-site septic system fora 4- bedroom(max 9-room)home utilizing Quick 4 High Capacity Infiltrator Chamber system.This. design plan approval is valid until June 23,20 18. During this time,a licensed septic systemm installermust obtain a permit and complete this work, and a,.Tnstallation.Certification be endorsed by the installer,designer and the Town of North Andover. This approval is also subject to the following conditions: 1. Prior to the issuance of the Disposal Works Installers Permit, the applicant must submit.a foundation as-built at the same.scale as the approved plan 2. Prior to the issuance of the Disposal Works Installer's Permit,the applicant must. submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms or a total of 9 rooms. 3> If site conditions are found in the field to be different from those.indicated on the design plan and/or soil evaluation,the originally issued.Disposal System Construction Permit is void,installation shall stop;and the applicant shall reapply for anew Disposal.Systems Construction Permit(3 10 CMR 15,020(1)): :Page 1 of 2 Forth Andover Health Department, 1,600 Osgood.Street,Suite 2035 North Andover,MA 01845 Phone-.978,588,9540 Pay: 978.688,8470 I 802 Boxf6rid Street Lot 2 June 231 2015 4. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system.installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission,Zoning Board,Planning Board,Building Inspector,Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a-wastewater treatment and dispersal system wbich.Willi be in compliance with all regulations and assure protection of public health and the environment of. North Andover. Sincerely, tUJJ-&,---A' Michele Grant V Health Inspector 'Encl. Installers list OC16 Philip Christiansen,P.E. File Page 2 of 2 North Andover Health Depmfinent, 1600 Osgood Streell Suite 2035, North Andover,:MA 0.1845 Phone:9.78.689.9540 Fax: 978,689,8476 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 3179000.00 m $ - $ 100.00 Plumbing Fee $ 475.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 475.50 Total fees collected $ 1,151.00 550 Boxford Street Lot 2 909-15 on 5/13/15 Single Family Home F NORT#j Town of E ,, ndover 0 - 0 Ah ver, Mass, 122.6I5 coc»�c»ew.c« 1' s 96ci- U BOARD OF HEALTH Food/Kitchen PERMILD Septic System TJ THIS CERTIFIES THAT BUILDING INSPECTOR ...�� N ...' .. ...� ., Foundation has permission to erect .....:.................... Idings o Ir/A������////���� •. Rough tobe occupied as ...........�..... .. ........ m!.-.. ....... -.................................................... Chimney provided that the person accepting his permit shall in eve respect conform to the terms of the application Final on file in 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 CONSTRUCTIONS ARTS Rough Service ............. ...... yrG,-t '...X-2--.1................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA.02111 UJP www.mass.gov/ilia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizatiorAndividual): L &mes LG Address-"/DD 6K 11P City/State/Zip: 491#yorkAj A44 OfflF7 Phone#: ffF-4/9-,.; )t ►re you an employer?Check the appropriate box: Type of project(required): ❑ I am a 4 employer with . ❑ I am a general contractor and I 6. Ovew construction employees(full and/or part-time).* have hired the sub-contractors ElI am a sole proprietor or partner- listed on the attached sheet.t ?• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. XWe are a corporation and its required.] officers have exercised their 10.F1 Electrical repairs or additions ❑ I am a homeowner doing all work right of exemption per MGL ILEI Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.0 Roof repairs insurance required.]uiemployees.[No workers' q ] 1311Other comp.insurance required.] ty applicant that checks box R must also fill out the section below showing their workers'compensation policy information. :)meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ntractors that check this box must attached an additional sheet all the name of the sub-contractors and their workers'comp.policy information. w itn employer that is providing workers'compensation insurance for my employees. Below is the policy and job site grmation. urance Company Name: icy#or Self-ins.Lid.#: Expiration Date: Site Address: City/State/Zip: ach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). lure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 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 1p to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of estigations of the DIA for insurance coverage verification. Iterebyj certify under the pains and penal- s of perjury that the information provided above is true and correct. iature: W Date: neo: le^Z6r= )fficlal trse only. Do not write in this area,to be completer)by city or town official. ;ity or Town: Permit/License# ssuing Authority(circle one): .Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Other �,,...6.,..t T)....-...-. lot,.,,, 34. 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 j oint 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 for 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 burn leaves etc.)said person is NOT required to complete this affidavit. rhe Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, Tease do not hesitate to give us a call. 'he Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or. 1-877-MASSAFE Rqy fE Al 7-797_7749 - Orne LFne-rgy Rating cerdlilcat.22 Property HERS Unknown Rating Type: Projected Rating Certified Energy Rater: Eric Wilder Lot 2 550 Boxford St. Rating Date: 5/5/2015 Rating Number: North Andover,MA 01845 Registry ID: Projected Rating: Based on Plans - Field Confirmation Required. Estimated Annual Energy Cost HERS Index' S3 use MMBtu Cost Percent Heating 32.8 $1485 49% General information Cooling 6.3 $89 3% Conditioned Area 2537 sq.ft. House Type Single-family detached Hot Water 8.1 $432 14% Conditioned Volume 20352 cubic ft. Foundation Unconditioned basement Lights/Appliances 22.5 $885 29% Bedrooms 4 Photovoltaics -0.0 $-0 -0% Service Charges $136 4% Mechanical Systems Features Total 69.7 $3026 100% Heating: Fuel-fired air distribution,Propane,96.0 AFUE. Cooling: Air conditioner,Electric,13.0 SEER. Criteria Water Heating: Instant water heater,Propane,0-82 EF,0.0 Gal. This home meets or exceeds the minimum criteria for the following: Duct Leakage to Outside 98.00 CFM25. Ventilation System Exhaust Only:55 cfm,21.0 watts. Programmable Thermostat Heat=Yes;Cool=Yes Fuilding Shell Features Ceiling Flat R-50.0 Stab None Seated Attic NA Exposed Floor R-30.0 Vaulted Ceiling NA Window Type U-Value:0.320,SHGC:0.300 Above Grade Walls R-21.0 Infiltration Rate Htg:3.00 Clg:3.00 ACH50 l Foundation Watts R-0.0 Method Blower door test Eric Wilder Conservation Services Group Lights and Appliance Features 50 Washington St. Percent Interior Lighting 100.00 Range/Oven Fuel Propane Westborough,MA 01581 Percent Garage Lighting 100.00 Clothes Dryer Fuel Electric 508-836-9500 Refrigerator(kWh/yr) 550 Clothes Dryer EF 3.01 2003-017 Dishwasher(kWh/yr) 256 Ceiling Fan(cfm/Watt) 0.00 9901142 REM/Rate-Residential Energy Analysis and Rating Software 04.6.1 V This information does not constitute any warranty of energy cost or savings.0 1985-2015 Noresco,Boulder,Colorado. The Home Energy Rating Standard Disclosure for this home is available from the rating provider. I Massachusetts-Department o�Public Safety Board of Building Regulations and Standards n___ cV11SL{i5futli.au�Zi visOr ;- License:CS-076124 ti6TIS , Alt william H Lumbars A Bemis Circle '= Tewksbury MA 6187 < J .-wig", Expiration 02/18/2017 commissioner