HomeMy WebLinkAboutBuilding Permit #94 - 61 WENTWORTH AVENUE 5/1/2018 TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION 3?0�t.�•� L
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Permit NO: Date Received
Date Issued: ��SSACHuS����
IMPORTANT: Applicant must complete all items on this page
LOCATION ('02 4
Print �.
PROPERTY OWNER
Print
MAP NO.: V C-) PARCEL: ZONING DISTRICT: '-
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
flew Building 14-One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units:
f ❑Repair,replacement ❑Assessory Bldg ❑ Commercial
❑Demolition
' ❑Moving(relocation) ❑Other ❑ Others:
❑Foundation only
DESCRIPTION OF WORK-TO BEPRE FO ED n P
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Identification Please Typ or Print Clearly)
OWNER: Name: �'� �La c t Phone: k9,7
Address: t? Get-sq- n c°v r
CONTRACTOR Name: ,��� �(-o��t 1�►�� Phone: Q 7,V-kd P-
Address: ` ,�O SMR`. 0 JB�fS�
Supervisor's Construction License: (2-S n ?,,z— Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEERS e f�� � �� Name: Phone:
Address: �► 1�_�.�AS- Reg. No.
FEE SCHEDULE:BULDING PERMIT.-$12.00 PER$1000.0.0 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.`z-FZ8
Total Project Cost :$ / ® x =FEE:$
Check No.: n Receipt No.:
Page [of4 QL
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TYPE OF SEWERAGE DISPOSAL
Public Sewer Swimming Pools ❑
Tanning/Massage/Body Art ❑ g
Well ❑ Tobacco Sales ❑_ 'Food Packaging/Sales ❑ .
Permanent Dumpster on Site ❑
Private(septic tank,etc. ❑ Electric Meter location to I
project
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner 0 Signature of contractor
Plans Submitted Plans Waived ❑ Certified Plot Plan LJ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING& DEVELOPMENT ❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
COMMENTS
r
DATE REJECTED DATE APPROVED
CONSERVATIO ❑
I
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
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Zoning Board of Appeals:Variance,Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
-
Water&Sewer connection/Signature&Dat 7 Driveway Permit
Temp Dumpster on site yes—no— Fire Department signature/date
L
o
WFrontYard
back ft.)
Side Yard Rear Yard
Re ded Required ProvidesRequired Provided
Dimension
Number of Stories:
Total square feet of floor area based on Exterior dimensions.
sons.
Total land area,sq.ft.:
NOTES and DATA— For department use)
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Page 3 of 4
Doc:INSPECTIONALSERVICES DEPARTMENT:BPFORM05
Created JMC..Inn.2006
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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
❑ Floor Plan Or Proposed Interior Work
Addition Or Decks
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❑ Building Permit Application
❑ 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)
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
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:BPFORM05
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Location
No. Date 6�
�oRTM TOWN OF NORTH ANDOVER
• ; : Certificate of Occupancy $
• °mob+..r a
CMUs<� BuildinglFrame Permit Fee $
Foundation Permit Fee $ /0 U
Other Permit Fee $ t
TOTAL $ %
Check # 9/64
19335
Bu(ding Inspector
t4ORTH
Town of RAndover
0
..........
N o. C)-) ;;41A"� - - Z a
ro LAE dover, Mass., 146T CIF z W"
`7� COCMICMEWICK �t
AD"4ATED P'?,02, C
BOARD OF HEALTH
Food/Kitchen
Septic System
PERMIT . T D
/ BUILDING INSPECTOR
THIS CERTIFIES THAT....... �.... �I (,/�t..�( �'#s' �!
��... .. ...... ... .......7. .. ..... ..... .... ... .................... ...... ......... Foundation
........... .....
has permission to erect........................................ buildings on ... ..... � ( f11�' ..Avt Rough
to be occupied as �'....... � �.� .................
Chimney
f'
e
provided that the person ac ling this pe d shalt' ery resp conform to the ter of the application on file in Final
this office, and to the provisions of the Lodes and By-Laws relating to the Inspection, Iteration 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 V LESS CO V S T RV C 1 I ! STARTS Rough
Service
B6CTOR
Final
Occupancy Permit Required'to Occupy wilding 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.
NOTE: CERTIFIED PLOT PLAN
THE AVERAGE FRONT SETBACK 250
EACH SIDE OF THE LOCUS IS 24'. LOCATED IN NORTH ANDOVER, MASS. _
THIS DOES NOT INCLUDE SCALE.1"=20' DATE.-51412006
THE EXISTING#61. 6/13/2006
THE SETBACKS AREAS FOLLOWS: 8/1/2006
#63=28'. #71=11' #73=13'
#49-28' #41=32' #33=30' Scott L. Giles R.P.L.S.
Frank. S. Giles R.P.L.S.
50 De6=r Meadow Road NOTE.
North Andover, Mass. THE ZONING DIST. IS R-4.
BUILDING HEIGHT NOT TO EXCEED 35'.
135.00'
LOTS #133-#135
PLAN#0358 N.E.R.D.
DEED BOOK 2796
PAGE 4
12,843 S.F.
16'
N - DECK
14' 8' 24' -------- 52'---- -----
a) c�
PROPOSED HSE.
N FND. F.F. =101.0 PROP. BIT. CONC.
DRIVE
#61 24'
20'+ 38 .A T.O.W.=102.0
N
p
135.00'
. y
100.0
ASSUMED
WENTWORTH AVENUE
I CERTIFY THAT
THE OFFSETS OFFSETS SHOWN ARE FOR THE USE
OF THE BUILDING INSPECTOR ONLY z�
SHOWN COMPLY N
AND SUCH USE IS FOR THE
WITH THE ZONING DETERMINATION OF ZONING 3972 . o
BYLAWS
NORTH ANDD OVER CONFORMITY OR NON-CONFORMITY CisT4R���
�pt�0
WHEN BUILT WHEN CONSTRUCTED. �oyqL
fir/ Z..rol
NOTE: CERTIFIED PLOT PLAN
THE AVERAGE FRONT SETBACK 250'
EACH SIDE OF THE LOCUS IS 24'. LOCATED IN NORTH ANDOVER, MASS.
THIS DOES NOT INCLUDE SCALE:1"=20' DATE.9/6/2006
THE EXISTING#61. Scott L. Giles R.P.L.S.
THE SETBACKS AREAS FOLLOWS: Frank. S. Giles R.P.L.S.
#63=28'. #71=11' #73=13' 50 Deer Meadow Road
#49=28' #41=32' #33=30' North Andover, Mass.
NOTE:
THE ZONING DIST. IS R-4.
BUILDING HEIGHT NOT TO EXCEED 35'.
135.00'
LOTS #133-#135
N PLAN#0358 N.E.R.D.
c') DEED BOOK 2796
PAGE 4
12,843 S.F.
16'
N e�—
BULKHEAD
cn 32' -- -- 53 -- ----
O� 14' C0
cn
� W
EXIST. HSE.
N FND. PROP. BIT. CONC.
DRIVE
#61 24'
19'+ 38
N
a
135.00'
WENTWORTH AVENUE
I CERTIFY THAT
OFFSETS SHOWN ARE FOR THE USE
THE OFFSETS
OF THE BUILDING INSPECTOR ONLY
SHOWN COMPLY AND SUCH USE IS FOR THE '
WITH THE ZONING DETERMINATION OF ZONING A72
BYLAWS OF CONFORMITY OR NON-CONFORMITY
NORTH ANDOVER l ip
WHEN BUILT WHEN CONSTRUCTED.
9 G 86
Permit Number
MECcheck Compliance Report
Massachusetts Energy Code
MECcheck Software Version 3.2 Release lb Checked By/Date
TITLE: WENTWORTH
CITY:North Andover
STATE: Massachusetts
HDD: 6322
CONSTRUCTION TYPE: 1 or 2 Family,Detached
HEATING SYSTEM TYPE: Other(Non-Electric Resistance)
DATE:07/27/06
DATE OF PLANS: 05-01-06
PROJECT INFORMATION:
51 WENTWORTH ST
DRACUT,MA
COMPANY INFORMATION:
E&F
WALKER RD
MANDOVER
COMPLIANCE: Passes
Maximum UA=623
Your Home=583
6.4%Better Than Code
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1: Flat Ceiling or Scissor Truss 2100 30.0 0.0 74
Wall 1: Wood Frame, 16"o.c. 3324 19.0 0.0 158
Window 1: Vinyl Frame,Double Pane with Low-E 625 0.340 213
Door 1: Solid 42 0.550 23
Door 2: Glass 21 0.550 12
Floor 1: All-Wood Joist/Truss,Over Unconditioned Space 2190 19.0 0.0 103
Furnace 1:Forced Hot Air,85 AFUE
Air Conditioner 1: Electric Central Air, 10 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 Massachusetts Energy Code requirements in MECcheck Version 3.2 Release lb.
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 1 5%of the design load as specified in Sections 780CMR 1310 and J4.4.
Builder/Designer DateIZPAL
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MECcheck Inspection Checklist
Massachusetts Energy Code
MECcheck Software Version 3.2 Release lb
DATE: 07/27/06
TITLE: WENTWORTH
Bldg.
Dept.
Use
Ceilings:
[ J I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation
Comments:
Above-Grade Walls:
[ ] I 1. Wall 1: Wood Frame, 16"o.c.,R-19.0 cavity insulation
Comments:
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Windows:
[ ] I 1. Window 1: Vinyl Frame,Double Pane with Low-E,U-factor: 0.340
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break?[ ]Yes ( ] No
Comments:
I
Doors:
[ ] I 1. Door 1: Solid,U-factor: 0.550
Comments:
[ ] I 2. Door 2: Glass,U-factor: 0.550
#Panes Frame Type Thermal Break? ( ] Yes [ ] No
Comments:
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Floors:
[ ] I 1. Floor 1: All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation
Comments:
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Heating and Cooling Equipment:
[ ] I 1. Furnace 1: Forced Hot Air, 85 AFUE or higher
Make and Model Number
[ ] I 2. Air Conditioner 1: Electric Central Air, 10 SEER or higher
Make and Model Number
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Air Leakage:
[ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed.
[ ] When installed in the building envelope, recessed lighting fixtures
shall meet one of the following requirements:
1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture
and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space.
2. Type IC rated, in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944
L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled.
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Vapor Retarder:
[ ] I Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors.
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Materials Identification:
( ] I Materials and equipment must be identified so that compliance can be determined.
[ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be provided.
( ] I Insulation R-values,glazing U-values,and heating equipment efficiency must be clearly marked on
the building plans or specifications.
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Duct Insulation:
[ ] I Ducts shall be insulated per Table J4.4.7.1.
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Duct Construction:
[ ] I All accessible joints, seams,and connections of supply and return ductwork located outside
conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed
using mastic and fibrous backing tape installed according to the manufacturer's installation
instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted.
[ ] I The HVAC system must provide a means for balancing air and water systems.
I
Temperature Controls:
[ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to
partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided.
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Heating and Cooling Equipment Sizing:
[ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as
specified in Sections 780CMR 1310 and J4.4.
I
Circulating Hot Water Systems:
[ ] I Insulate circulating hot water pipes to the levels in Table 1.
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Swimming Pools:
( ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
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Heating and Cooling Piping Insulation:
[ ] I HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the
levels in Table 2.
f
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating Runouts Circulating Mains and Runouts
Temperature(F) Up to 1„ Up to 1.25" 1.5" to 2.0" Over 2"
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4"
Beating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0
Low Temperature 120-200 0.5 1.0 1.0 1.5
Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0
Cooling Systems
Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD(Building Department Use Only)
AR WCIP Liberty
ISSUING OFFICE 354 IV� ttual,. Workers Compensation and
INFORMATION PAGE Employers Liability Policy
ACCOUNT NO. SUB ACCT NO. Liberty Mutual Insurance Group/Beton -
1459623 0000 LIBERTY MUTUAL-FIRE INSURANCE CO. 16586
POLICY NO. TD/CD SALES OFFICE CODE SALES CODE N/R 1ST
WC2-31S-459623-055 ' XX X I WESTON 102 REPRESENTATIVE 3000 2 YEAR
ASSIGNED 1987
Item 1.Name of E &F BUILDERS INC AND SCOTTSDALE CORP
Insured FEIN 04-2881961
Address PO BOX 398
RISK ID 181179
NORTH ANDOVER,MA 01845
Status 03 CORPORATION
Other workplaces not shown above: SEE ITEM 4
Mo.Day Year Mo.Day Year
Item 2.Policy Period:From 08-16-05 to 08-16-06
12:01 AM standard time at the address of the insured as stated herein.
Item 3.Coverage
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 3A.The limits
of our liability under Part Two are:
Bodily Injury by Accident 100,000 each accident
Bodily Injury by Disease 500,000 policy limit
Bodily Injury by Disease 100,000 each employee
C. Other States Insurance: Part Three of the policy applies to the states,if any,listed here:
SEE END WC 20 03 06A
D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE
Item 4. Premium - 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 ch an e by audit.
Premium Basis Rates LINE 110
Estimated Per 5100 Estimated
Code Total Annual of RE- Annual
Classifications No. Premiums mumration Premiums
SEE EXTENSION OF INFORMATION PAGE
Minimum Premium $ 500 ( MA ) Total Estimated Annual Premium $ 712
Interim adjustment of premium shall be made: ANNUAL
This policy,including all endorsements issued therewith,is hereby countersigned by SEE ATTACHED FORM 1710
Authoraed Representative Date 08-15-05
Luc Code Term. Oper. Basis Periodic Payment Rating Basis Pol.H.G. Home State Dividend RENEWAL OF-
1, Andit NR MA WC2-315459623-054
GPO 4030 R1 Copyright 1987 National Council on Compensation Insurance WC 00 00 01 A
Commercial General Liability
RENEWAL DECLARATION
NAME AND ADDRESS OF AGENCY - INSURANCE COMPANY
Granite State Insurance Company
Norman Spencer McKernan Inc Member American International Group, Inc
1000 River Road, Suite 200 Executive Offices: 70 Pine St.
Conshohocken PA . 19428 New York NY 1,0270
AGENCY 0000052547
NAME AND MAILING ADDRESS OF INSURED POLICY NUMBER RENEWAL OF
02-LX -0313281-1/000 02-LX-0313281-0
E & F BUILDERS, INC. POLICY PERIOD
PO BOX 398 FROM: 06-29-05 TO: 06-29-06
NORTH ANDOVER MA 01845
At 12:01 A.M. standard time at the mailing address shown.
LIMITS OF INSURANCE
GENERAL AGGREGATE $ 2, 000, 000
PRODUCTS-COMPLETED OPERATIONS AGGREGATE $ 1, 000, 000
PERSONAL INJURY & ADVERTISING INJURY $ 1, 000, 000
EACH OCCURRENCE $ 1, 000, 000
DAMAGE TO PREMISES RENTED TO YOU $ 100, 000 ANY ONE PREMISES
MEDICAL EXPENSE $ 5, 000 ANY ONE PERSON
STATE- 1
LOCATION OF ALL PREMISES YOU OWN, RENT OR OCCUPY:
LOC # 1: 37 WALKER ROAD
PMS PDTS
LOC CLASSIFICATION CODE PREMIUM BASIS JtATE RATE
1 CONTRACTORS - SUBCONTRACTED WORK - IN CONNECTION WITH BUILDING 91583 TOTAL COST 400,000
CONSTRUCTION, RECONSTRUCTION, REPAIR OR ERECTION - ONE OR TWO
FAMILY DWELLINGS
1 CONTRACTORS EXECUTIVE SUPERVISORS OR EXECUTIVE SUPERINTENDENTS 91580 PAYROLL 28,600
PRODUCTS-COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT
2 VACANT LAND - OTHER THAN NOT-FOR-PROFIT 49451 EACH 2
PRODUCTS-COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT
2 REAL ESTATE DEVELOPMENT PROPERTY 47051 EACH 1
PRODUCTS-COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT
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Original
07-19-05 Page 3 of 8
�Q ✓lie eamr"'0w 0,
BOARD OF BUILDING
License: CONSTRUCTION.:
Number: CS 007732 aw
Birthdate: 09/08/1940
Expires: 09/08/2007
Restricted: 00
VERNE S FOLLANSBEE
359 RIVER RD
ANDOVER, MA 01810 —1--
Commissioner
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