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Home My WebLink AboutBuilding Permit #384-2011 - 63 EMPIRE DRIVE 11/4/2010 BUILDING PERMIT r10RTy TOWN OF NORTH ANDOVER A+ TOWN APPLICATION FOR PLAN EXAMINATION ° Permit N0: Date Received Date Issued: /4MPORRTAANNT: w SSACHUS�� Applicant must complete all items on this pa '�-��,'t r R:u .1 o �( '•.t r L �1 -4-' � �I�i x'•.o. s "},µ_' "^+F;`YA-- �a 4 a re�� t'I .K ,^ .� ^:�".� K`''•-t«n..v, .,'r '4„rte,"fes,*4'cTS47 4*0 �eMa? J 2 5; `i?- �f � _Fi' np I+ 5' "s}' ter a a .•e '( r'; .. el'- - 7;�.-s�g, _..r..s h y .,.r"•''-u4-o- - i+-JK rte^,. r 0_1 �� +t tm• 9 A-•YY� 3� �,�v"i.'S'.�31��.Jrxo?51rT�•',.��yT'.,t�'�. R SY: �i„t� xa �-^t.�- ai�,r y:ys-r �� .i y � a;.��.+CJ 3' _�,r a�p.� ,.__a,. ...:.3'.e. -�•i. 'i l r-d. .., - .a�c:r s7 �1�cli 1, 3=Y= Ye-F' kW u Y7 '°� y.•ca. is a �-^,-A7".J.,.�r�-15,��.'G1r�YF. _ i� � .rtd/u7N��.G-i�t F'�, ��il�t .•�� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne famil Addition Two or more family '� Alteration Industrial No. of units: Commercial Repair, replacement Assessory Bldg _ i Others: Demolition Other L x'�- rahr' a17, r_..,_.. �E��`s.-- S 3�r A��za;��f hA� ".��-.'� ,�:;t` rr�.' �3.'°-5��n;}�r's j -si .€� f-r--��•�i• ...._. .�... vhL:�, .:+.amu �,..� 'F_:�.s7�'+ .h_.•;�� .__.- � 1�'q� `1a'��,y"`�'',,�'-�'.. mG DESCRIPTION OF WORK T BE PREFORMED. {z Identification PIease Type or Print Clearly) OWNER: Name (� f— GCC Phone �l7 311�� Address r ve Fi Jp _^Ea ��era -i'T ��a�C °!•a""'o-� .,j�"T�,Y".''- �G�^��rk�� ¢� � a"`us�"4�'�S. "(ra�J.,y��`"�lr+s, �;�"r�s2. t� r.:�.t-N.m -ri•��.r ` ^r�.r { Y1'" t �� '...�,. z„ � '+y"� �a r dr"2�' � t-�-• ��rc r 2•r �,�`-?"�,y��7�:� iM �.-Tl �. ��'-��L•+�{�� Mg,� JR•e -Fanflr t r r a�aT,Y t,•�.�f � -sig u-�y-jr�5r�.tk'�"� ,d 'ynw�{a.?6� t E _ .:..nTr�f�•w•'e6,; •'y."a4y ��q Y1p� fled. .t 7�,+.?v"Gd�" 3t' ""'-�l ^�.ia"S� �al. •rL`.Ne,lr�t f g, rig$ J.'�r `�.laoii�-s, rel �, • A , II - n ray�r•,M ��s5'=' ��r �; �.a}k• �`�a,�r-"";-•n�.. �-s`s- `�-Y""�4�d-!"'�r`ur,tr'`r7yx�_+�^y"��"7�j'�+,��y*„7�w�p�.,,�t`r�`,�'�.t1¢��I x •^�}'s..s.y,r.?-”O:M1?.•r,i SOW=� 92,SnF''Fr�`e-w'y��,,„s+4x',-a.,'�•.�,��y,`s"'�f,Sa4'Pu Nom, ',�cr J1�. '.e...-�cte'r.'at.f��=.(Y..s,;,� +��v�<'..-.'at''omJ� �7,., =y?.��^x..^+,x�.,��^.2;^fI�de"'y,,�=•�r"rd'345'"sc�t��a�£.ra�s:�a,x�: ,•r � 4r ARCHITECT/ENGINEER Phone: Address�9 Reg. No. 7-7 4.5 FEE SCHEDULE:BOLDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$123.00 PER S.F. Total Project Cost: $ 3 0� ,�j �,j° FEE: $_ r 0,6 Check No.: c/U Receipt No.: �✓ �. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund atu`r� enfil�aruner t� 5agnaturefco i=actor 4 _ ' r Location o?/a,/'F 1)11✓t No. a d// Date 1 f NORTH TOWN OF NORTH ANDOVER 3? •. • O /0 9 ° Certificate of Occupancy $ J U An,'S<�' Building/Frame/Frame Permit Fee $ U s,�cMusE 9 Foundation Permit Fee $ /OD — Other Permit Fee $ ' TOTAL Check #//G y 236 ;; All Building Inspector Plans Submittte Plans Waived Certified Plot:Plan C Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Se Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales i gmglSales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on 2 v Si nature COMMENTS S III L T 1 HEALTH Reviewed on Signature COMMENTS l I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision_: Comments AI A dl—Z--1Q Water $ Sewer Connection/Si nature& D Dnvewa Permit DPW Town Engineer: Signature: Located 384 Osgood Street L-ocaterit �1a�n S#re�f x k q s F�r 3aepJiarila�e - S 4 4 '-1 L 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) i ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 i 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 1 NO ❑ Engineering Affidavits for Engineered products TE. All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 1 j Addition Or.-Decks " j ❑ Building Permit Application I ❑ Certified Surveyed Plot Plan II ❑ 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) ❑ 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 ❑ Certi jed Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit j ❑ 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 (VOTE: 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 I must be submitted with the building application Doc:Building Permit Revised 2008 `OT22 LOT23 10.3' 1 i EX.FND. T.O.F.=281.1' �_ rn I 28"0 LOT 24 ico �I 10� -,N OF� S9 2 MICHAEL nZ O� J.2 SERGI U No.3319 o 'D FOUNDA TION L OCA TION I CER77FYTHAT THE PRIMARYSTRUCIURESH CONFORMS TO THEHORIZONTALSETBACKREOU/REMENTSOFTHELOCAL CLIENT ORCHARD VILLAGE, LLC APau�n�TlONDOESNOTCCONSIDERANYWS INEFFECT WHEN�ER CONSTRUCTED RESTRICTIONS SUCHAS COVENANTS,WETL4NDS,EASEMENTS THIS CERTIFlCAT10N 1S MADEAND LIMITED TO 7HEABOVE CLIENT ORDERS OFCONDITIONS ETC)THIS DRAWING SHALL NOT BE LOCATION:NORTH ANDOVER MA. USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE EM PT WITH THE WRITTEN PERMISSION OF DATE., 11/15/10 SCALE.-l!--20' CHRIS714NSEN&SERGI INC.FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OFCHRISTIANSEN&SERGI INC. AND ANY UNAUTHORIZED USE ISPROMB/TFDD.CHRISTIANSEN& SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORLZED USE OF THIS DRAWING ORANY INFOR-MA77ON 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.:06029.001.047 oNwTM 1 F ants� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 384-2011 Date:April 22,2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 63 Empire Drive, Unit 23 North Andover MA MA 0l 845 Orchard Village LLC MAY BE OCCUPIED AS single-familv IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Orchard Village,LLC 44 Great Pond Drive Boxford,MA 01921 Building Inspector Fee: 100.00 previously paid Receipt: 23655 /oZ elo / 6 ,cla 7 �y X73 � S X04 r � � ORTH TONM of � Andover y 1 No. A4 tl Q LAKE O dover, Mass., , IALIO COCMICMEWICK 7,pSDRATED 1 S BOARD OF HEALTH Food/Kitchen Septic System .PERM IT T f l THIS CERTIFIES THAT........... / �� h BUILDING INSPECT .......... fU/'1Ce0'C� // ./.��.��............ ....... ..............................D................................. Foundation has permission to erect..............:......................... buildings on ...... .. ....! '!.1:�.�... ....... /�t.R!��`................... Rough tobe occupied as.................... 1 ... r�..l..F....... ��.'�!p'1.././ ..................................................................... Chimney provided that the person accepting this permit shall in every respect can 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 TARTS Rough ............ .............................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy 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. I I MAScheck COMPLIANCE REPORT Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 Release 2 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: 11-1-2010 DATE OF PLANS: 08/08/09 TITLE: The Brentwood PROJECT INFORMATION: Orchard Village Empire Drive COMPANY INFORMATION: Messina Development Company, Inc. COMPLIANCE: PASSES Required UA = 574 Your Home = 319 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ----------------------------------- -------------------------------------------- CEILINGS 841 38.0 0.0 25 WALLS: Wood Frame, 16" O.C. 2729 21.0 0.0 156 BSMT: Conc. 8.0' ht/8 .0' bg/8.0' insul 0 0.0 0.0 0 GLAZING: Windows br Doors 239 0.320 76 DOORS z 69 0.310 21 FLOORS: Over Unconditianed Space 1240 30.0 . 0.0 41 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 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date d Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 The Brentwood DATE: 11-1-2010 Bldg. ) Dept. ► Use I 1 CEILINGS: [ ] I 1. R-38 Comments/Location I WALLS: [ ] I 1. Wood Frame, 16" O.C. , R-21 i Comments/Location I 1 BASEMENT WALLS: [ ] 1 1. Conc. 8.0' ht/8.0' bg/8.0' insul, R-0 (uninsulated) I Comments/Location I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.32 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I DOORS: [ ] i 1. U-value: 0.31 I Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-30 I Comments/Location I I HVAC EQUIPMENT: [ ] I 1. Furnace, 96.0 AFUE or higher I Make and Model Number [ l 1 2. Air Conditioner, 13.0 SEER or higher I Make and Model Number I AIR LEAKAGE: [ l 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 I 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 I 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 DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or 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 I and/or cooling input to each zone or floor shall be provided. I HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I SWIMMING POOLS: [ ] I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I 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 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: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I 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 I PIPE SIZES (in. ) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS 1 HEATED WATER TEMP (F) : RUNOUTS 0-1" 1 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 1 100-130 0.5 i 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only) ------------------------- The Commonwealth of Massachusetts i Department of Industrial Accidents Office of Investigations 600 Washington Street ;wa Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print'Legibly Name(Business/Organization/Individual):DA:Z&m 14ZZA6s- LLc Address:2/N �,l/D ,Op/(/E! �Pic P_P M A - 0 I U21 City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. X New construction employees(full and/or part-time).* have hired the sub-contractors 2.. I am a sole proprietor or partner- listed on the attached sheet. E] 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. ❑ 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 myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors arid 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 form 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature- E&OA �� Date: Phone#: �- 7 --3/612 Official use only. Do not write in this area,to be completed by city or town official, 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-contractor(s)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 pennit/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 pen-nits 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. 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 Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia