HomeMy WebLinkAboutBuilding Permit #371 - 67 CORTLAND DRIVE 11/6/2006 TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION OF tT�a° 06t9tiO
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Permit NO: Date Received 'f (� 0 ? e
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Date Issued: "As ACHUs
IMPORTANT: Applicant must complete all items on this page
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LOCATION Crt"J` L ( 3U Hee
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PROPERTY OWNER/"-e IC.
Print
MAP NO.:�PARCEL:4�13 ZONING DISTRICT: (�
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ j
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building ;KOne family
Addition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units:
❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial
❑ Demolition
❑ Moving(relocation) ❑ Other ❑ Others:
❑ Foundation only
DESCRIPTION OFWORK TO B PREFO ED
5 �R ►� � � FAQ., �tn'- ,
Identification Please Type or Print Clearly)
OWNER: Name: I !12 Phone: 2'F
Phone: - 3
Address: ZI l
CONTRACTOR Name: Phonea7F d87-z
Address: i`� -lizilel
Supervisor's Construction License: Exp. Date: y���d
Home Improvement License:_ // Exp. Date:
ARCHITECT/ENGINEER AName: Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost :$ 1519 S F -Y I Z!�r1o( ) x m 12-bV FEE:$ 2 a 7 '7 • } Ivo V bTN
--13 I 00 r-16
Check No.: 0 Receipt No.: 3e)7
Page I of 4
Location i � '�- ��n� / 71/ • ' •��
No. / Date
MORTq TOWN OF NORTH ANDOVER
F 9
t Certificate of Occupancy $ A)
Building/Frame Permit Fee $ "? -
J4CMU5
Foundation Permit Fee $ D U
Other Permit Fee $ 1
TOTAL $
Check #
Building Inspector
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
❑ Permanent Dumpster on Site ❑
Private(septic tank,etc. Electric Meter location to
project
NOTE: Persons contracting withunr gistered cont ctors do not have access to the guaranty fun
Signature of Agent/Owner Signature of contractor
Plans Submitted Tans Waived ❑ Certified Plot Plan ElStamped Plans ElTHE FOLLOWING SECTIONS FOR OFFICE USE ONL
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT F1 F1
❑Water ShGSpeciamit
❑ Site Plan
❑ Ter
COMMENTS
DATh REJE TED DATE APPROVED
CONSERVATION JA ❑
COMMENTS
rE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer connection/Signature& Date Drivewav Permit
Temp Dumpster on site yes—no— Fire Department signature/date
Building Setback Ti*Side
(� . qb$ r �
Front Yard Yard Rear Yard
eqqiKed Provided Required Provides Re red Provided
Dimension
Number of Stories: CIL Total square feet of floor area,based on Exterior dimensions. -{ 1 x
Total land area,sq. ft.: _,b.7, .4 t
NOTES and DATA—(For department use)
Page 3 of 4
Doc:INSPECTIONAL SERVICES DEPAR7'MENT:BPFORM05
Created JMC.Jan.2006
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
❑ 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
Paoe 4 of 4
V40 ikAndover
TO" Of : t _
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CS LAKE o '� dover, Mass.,
T
I� COC MIC HE WICK V
AERATED PPa`
�`T BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT....M ......... 111101
....... ......I� .. ............. ........ Foundation
has permission to erect........................................ buildings on6.�... '�rrl.�►. ... .!.......�L140 Rough
to be occupied as....*3. �.........D&..k..4.L.4r ........ •od�................................................... Chimney
provided that the person accepting this permit shall in every respect con orm 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
3a414s PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRU �CZ
S Rough
........... ....... ....... Service
BUILDING .................R
Final
Occupancy Permit Required to Omipy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal
No Lathing or Dry Wall To BeDone FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having Jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements_
*****************************APPLICANT FILLS OUT THIS SECTION°"**********************
APPLICANT M 1 h �p�s LLC. PHONE - s 87-7
LOCATION: Assessor's Map Number /��C PARCEL 3 f
SUBDIVISION 11 to drjo(,�P- ra)17)M 7r S LOT (S) 3 0
STREET CC)VTl� 1>(NVK-1 5T. NUMBERY
USE ONLY ******* **
CO �AD
OF TOW �EN�TS-
_.TRC ERVATION MINIATOR DATE APPROVED
DATE REJECTED
COMMENTS +
N/A
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENT'S
1�
FOOD/IN ECTOR-HEALTH DATE APPROVED
j DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS O N S"a W E P
PUBLIC WORKS - SEWER/WATER CONNECTIONS
T
DRIVEWAY PERMIT
FIRE DEPARTMENT Cv!/" -✓'f�91. 024,,
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
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C=R 0M T �A�V P t 1 bll Tke Hampton at Meetingkouse Commons,
Nortk AnJover, MA O 1 s45 nit #30
I'O" Date: 09/0112005 S�eet I
Mcctin kouse Commons LLC, Nortk AnJover, MA
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mpton at Meetingkouse Commons,
Andover, MA o l845 nit #3Qi/S" = 1'0" ate: 09/0 1/2005 Sheet Z
'�— Meetinghouse Commons LLC, NoA An over, MA
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WINDOW & DOOR SCHEDULE
Interior Doors, 2-8 X 6-8 unless specified 34 1/2 X 82 1/2
D-1 Entry Door,Twin Sidelights 68 '/2 X 83
D-2 Entry Door 381/2X 83
D-3 Slider w/transom 72 X 96 1/a
o D-4 Slider 72 X 82 1/2
N D-5 Entry Door, Single Sidelight 531/2X 83
r
A Double-hung single 34 1/4 X 65 1/4
B Double-hung twin mull 68 X 65 1/4
C Double-hung triple mull 1011/2X 65 1/4
a
D Double-hung single 341/4X 57 '/4
E Double-hung twin mull 68 X 57 1/4
F Double-hung triple mull 101 1/2 X 57 1/4
v G Double-hung single 221 4 X 65 1/4
H Double-hung single 34 1/4X 53 1/4
t
1 Double-hung twin mull 68 X 53 1/4
k L Double-hung w/transom 341/4X 79
M Glider 60 1/4 X 42 1/4
N Double-hung twin mull w/transom 68 X 79
2 tK
. P Awning 341/4X 24 1/4
Q Awning twin mull 68 X 24 1/4
S Double-hung
301/4X 49 1/4
T Double-hung triple mull w/transom 101 1/2 X 79
U Double-hung twin mull 68 X 49 '/4
X Round stationary 24 X 24
The Hampton at Meetinghouse Commons,
Nortk Andover, MA 01 845 Unit # Q
Scale: i/&" = i'o" Date: OV0 i/Z005 j�,eet 5
Meetinghouse Commons LLC, Nortk Andover, MA
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TYPICAL SECT low DF;P\�•L-
ERe Ham�ton at MCCting�iouse Commons,
Nord, Andover, MA 01 8` 5 nit # 0
jcatc: varies Date: OV0112005 j�eet 6
Meetingkouse Commons LLC, Nortf Andover, MA
BOARD OF BUILDING REGULATIONS
6$'" License: CONSTRUCTION SUPERVISOR
Number: CS 055417
Birthdate: 0410511960
Exores:04105/2006 Tr.no: 21033
Restricted: 00
THOMAS D zAHORUIKO
121 CARTERFIELD RD
N ANDOVER, MA 01845 Acting L; mis oner
�N The Commonwealth of Massachusetts
{ I Department of Industrial Accidents
Office of limestigations
i; 600 Washington Street
\� = Boston, MA 02111
www.mass.baov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
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Name (Busincss!Organization/Individual):
Address: Z I Jv, ,✓�
City/State/Zip:
,�z P.r ✓�l a6M Phone #: Cl 6"S� 7_Z45 f
Are you an employer?Cheek the appropriate box:
1.❑ 1 am a employer with 4. ElI am a general contractor and l Type of project(required):
employees(full and/or part-time).* have hired the sub-contractors 6. New construction
1 am a sole proprietor or partner- listed on the attached sheet. * 7. ❑ 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.❑ Electrical repairs or additions
D.❑ I am a homeowner doing all work right of exemption per MGL 1 I.[:] 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'
comp. insurance required.] 1'•❑ Other
*Any applicant that checks box R I must also fill out the section below showing their workers'compensation policy information.
'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 and their workers'comp.policy information.
I aur 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 covera rification.
1 do hereby certify tinder th airs and pe allies perjury that the information provided above is true arid correct.
Si nature: Z
Date:
Phone
Official use only. Do not write in this area,to be completed by city or town ofcia(.
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
b.Other
Contact Person: Phone#:
c
Permit Number
MECcheck Compliance Report Checked By/Date
Massachusetts Energy Code
MECcheck Software Version 3.3 Release lb
Data filename:Untitled
TITLE:The Hampton at Meetinghouse Commons
CITY:North Andover
STATE:Massachusetts
HDD:6322
CONSTRUCTION TYPE: 1 or 2 Family,Detached
HEATING SYSTEM TYPE:Other(Non-Electric Resistance)
DATE:03/24/06
DATE OF PLANS:09/01/05
PROJECT INFORMATION:
Meetinghouse Commons
North Andover,MA
COMPANY INFORMATION:
Meetinghouse Commons LLC
North Andover,MA
COMPLIANCE: Passes
Maximum UA=296
Your Home=271
8.4%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 998 0.0 30.0 31
Wall 1: Wood Frame, 16"o.c. 1467 0.0 13.0 118
Window 1:Vinyl Frame,Double Pane with Low-E 198 0.340 67
Door 1: Solid 35 0.340 12
Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 998 0.0 19.0 43
Furnace 1:Forced Hot Air,90 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 TVMsaaulmetts Energy Code requirements m WC-cVc—k Version 3.3 Release 115 and to comply withe
mandatory requirements listed in the MECcheck Inspection Checklist.
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
MECcheck Inspection Checklist
Massachusetts Energy Code
MECcheck Software Version 3.3 Release lb
DATE:03/24/06
TITLE:The Hampton at Meetinghouse Commons
Bldg. {
Dept.
Use
{
{ Ceilings:
[ ] { 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 continuous insulation
Comments:
Above-Grade Walls:
[ ] 1. Wall ]:Wood Frame, 16"o.c.,R-13.0 continuous insulation
� Comments: �
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:
{ Doors:
[ ] { 1. Door 1:Solid,U-factor:0.340
{ Comments:
{
Floors:
[ ] 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 continuous insulation
{ Comments:
Heating and Cooling Equipment:
[ ] 1. Furnace 1:Forced Hot Air,90 AFUE or higher
Make and Model Number
[ ] { 2. Air Conditioner 1:Electric Central Air, 10 SEER or higher
Make and Model Number
{ 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 cfin(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.
Vapor Retarder.{
[ ] { Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors.
{
{ Materials Identification:
[ ] Materials and equipment must be identified so that compliance can be determined.
[ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be provided.
[ ] Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on
the building plans or specifications.
Duct Insulation:
[ ] Ducts shall be insulated per Table J4.4.7.I.
Duct Construction:
[ ] 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.
[ ] ( The HVAC system must provide a means for balancing air and water systems.
Temperature Controls:
[ ] 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.
Heating and Cooling Equipment Sizing:
[ ] 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.
Circulating Hot Water Systems:
[ ] Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
[ ] 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.
Heating and Cooling Piping Insulation:
[ ] HVAC piping conveying fluids above 120 V or chilled fluids below 55°F must be insulated to the
levels in Table 2.
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 I" 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
)ming System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4"
Heating 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)