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HomeMy WebLinkAboutBuilding Permit #685-15 - 91 FULLER ROAD 3/2/2015BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#/zj2-i Date Received Date Issued: / IMPORTANT: Applicant must complete all items on this page I rATIO PROPERTY OWNER MAP PARCEL: ty f' Print 100 Year Structure yes no -N ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Reside ial Non- Residential ❑ New Building ne family - ❑ Addition ❑ Two or more family ❑ Industrial N'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well: ❑ Floodplain ❑ Wetlands ❑: Watershed District ❑ Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: a Identification - Please Type or Print Clearly OWNER: Name: Ellis Phone: �oaa�"� C/1 l - 11IRIct Address: .� P�' Contractor Name:J�e&0 Phone: Address: R Supervisor's Construction License: C r1f :z Exp. Date. 7/7 l C-- Home Improvement License: I Jr 3 -9 -5- , Exp. Date: / f ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000 OO OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ %J ` oylro Oro FEE: $ /" Check No.: Receipt No.: NOTE: Persons contracting withregistered contractors do not have access to thew ranty fund Signature of Agent/O — signature of contractor-' Location �/ j�iil/ 9/. Check # c)%%JS, j,SC Date 5f /' — TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $— Building Inspector Plans Submitted ❑ 11f. Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYP>✓ 6F SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On COMMENTS Signature_ CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT Temp Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS Locatea :JM Usgooa Street no 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) �"YI/�)6 ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Dimension Number of Stories Total land area, sq. ft.: Total square feet of floor area, based on --Exterior dimensions. 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 A1nT1=C .nnA 1lATA _ /Fr%r riannrfmpnf imp --1 very t ❑ Notified for pickup Call Email I 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 ❑ Floor Plan Or Proposed Interior Work ❑ 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 ❑ 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 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 ❑ 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 ❑ 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: Building Permit Revised 2014 �17oiv5- Muk 4L-71- ��/w, PROFESSIONAL STRUCTURAL ENGINEERING P.O. BOX 958 DESIGN SERVICES E. HAMPSTEAD, NH 03826 (603) 329-5540 FAX (603) 329-6406 RESIDENTIAL • COMMERCIAL • INDUSTRIAL March 3, 2015 Mr. Aaron Scarpello AMS Home improvements 2 Magnolia Ave Salem, New Hampshire 03079 RE: Client requested On-site Inspection, Evaluation & Structural Engineering Certification of Installed Main Level Wall Replacement Structural Support Beam as Constructed for direct compliance to the Massachusetts State Building 86' Edition for renovation in progress at 91 Fuller Road, North Andover, MA Dear Aaron, As per your request, on Tuesday, March 3, 2015, I have physically inspected & reviewed the design specifications for the Wall Replacement Main Support Structural Beam for the renovation project in progress at 91 Fuller Road, North Andover, MA. As based on my Evaluation, the Gang Lam: 4-13/4" x 9 '/4" LVL is adequate as specified for construction (with the required completion of the thru bolting) & is in direct compliance to the Massachusetts State Building Code 8d' Edition for the required design loading. MOCCIA Sal v J. Moccia PE S STRUCTURAL � No. 33237 Regi Structural En ' „ �t President, Hampstead Consu�^�ti� cc: North Andover Building Dept. P-O.WXl" a "MOMPA NIH am mu"m 32MM I)n-lr,.Ntl) IT R jjRAL wra vzpka,14 Is =JQ rollcvST JOD ebbe ALo&&t4NT 1p-4�h., $UNIT 114) hTX hS ciactu -Sir DATR. k= "envlota 1; Y17- 0 Am -It I— v I.Y lecr- J I low AL E X 0 A PwLa -M No. jog cimcm 'By -VATZ. cu 4AY q , vb Za ----------- c 3f�% no(:Nfl; 'LM*. = 4,616— -* Vj rl ala A 110 1 E KqA%WrPA A 4 0 3 M Rxxte 3294M "Utc? 14 <41p-� DESIGNED RT DATI.ELA /1-73 i C#ICtU ST nT .1 so JOB MU lo�-. m Vcatc, %4 --------------- OL x5v Zounw- is TWOQIIDC- -240-k 6 C.. S -1 A( 4 (- rt or e4 �-rk- RS01 tA-L k I PWPV4,xo IZ k Jr A % A-tj W k -1 �-u� e 0 EEO JO 2 LL 0 o cc Co O LL N V) u Q V) at CL Z Z J m c v 7 LLL t � = c U LL cc LLI N z z m J d s 3 K LL cc LU N z v J W s =$ d' U _ N to LL oC O a Ln z N i L = d' cu LL z LLI oot a CL W 5 LL ` i co z a+ CU O (U CO n C� _O O � O e .Q W .u+ L � E * c= r S E 4. 1 � ai < as 2 c �� o Cc * Q N � O L m �- > c °'`�a� O �CD -0 0 0 N o c � _ Q c E o O CL =o co An O r w m 3 c r.L m ,� O .� .N tm O C co _ F- d Q L L iC O U) 4) V m 4) N Y LL. 'O LLJ *C;N C O _ 'u—)M . + Z ui N U V ncn m N J F- t . Q. 0 V �! o a. Z Z m N OCl) Cfl Z U W x Z W V �w CL Z LS v C) t _% CL • Q ®BoisecascaQuadruple 1-3/4" x 9-1/4" VERSA -LAM® 2.0 3100 SP Floor Beam\ ... kitchen ceiling Dry 11 span I No cantilevers 10/12 slope Wednesday, February 18, 2015 BC TALC® Design Report Build 3272 File Name: AMS Home Improvement Job Name: Ellis Description: Designslkitchen ceiling Address: 91 Fuller Rd Specifier: City, State, Zip: North Andover, MA Designer: Kimberly Hankey Customer: AMS Home Improvement Company: Cyr Lumber Co,39 Rockingham Rd, Windham, NH Code reports: ESR -1040 Misc: 12-07-00 BO B1 Total Horizontal Product Length = 12-07-00 Reaction Summary (Down / Uplift) ( Ibs ) Bearing Live Dead Snow Wind Roof Live BO, 3-1/2" 4,260/0 2,333/0 B1, 3-1/2" 4,450/0 2,523/0 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125% 1 bathroom Unf. Area (Ib/ft^2) L 08-03-08 12-07-00 40 20 06-06-00 2 bedroom Unf. Area (Ib/ft^2) L 08-03-08 12-07-00 30 10 06-06-00 3 bedroom Unf. Area (Ib/ft^2) L 00-00-00 08-03-08 30 10 13-00-00 4 ceiling Unf. Area (lb/ft^2) L 00-00-00 12-07-00 20 10 14-00-00 5 wall Unf. Lin. (Ib/ft) L 00-00-00 12-07-00 75 n/a Controls Summary Value % Allowable Duration Case Location Pos. Moment 19,538 ft -lbs 73.6% 100% 1 06-04-07 End Shear 5,737 lbs 46.6% 100% 1 01-00-12 Total Load Defl. U259 (0.561") 92.6% n/a 1 06-03-02 Live Load Defl. U403 (0.361") 89.4% n/a 2 06-03-02 Max Defl. 0.561" 56.1% n/a 1 06-03-02 Span / Depth 15.7 n/a n/a 0 00-00-00 % Allow % Allow Bearing Supports Dim. (L x W) Value Support Member Material BO Wall/Plate 3-1/2" x 7" 6,593 lbs n/a 35.9% Unspecified B1 Wall/Plate 3-1/2" x 7" 6,974 lbs n/a 38% Unspecified Notes Design meets Code minimum (U240) Total load deflection criteria Design meets Code minimum (U360) Live load deflection criteria. Design meets arbitrary (1") Maximum total load deflection criteria. Calculations assume Member is Fully Braced. Design based on Dry Service Condition. Deflections less than 1/8" were ignored in the results. Page 1 of 2 ®BoiseCascaQuadruple 1-3/4" x 9-1/4" VERSA -LAM® 2.0 3100 SP Floor Beaml...kitchen ceiling 1111113-- Dry I 1 span I No cantilevers 10/12 slope Wednesday, February 18, 2015 BC CALL® Design Report Build 3272 File Name: AMS Home Improvement Job Name: Ellis Description: Designs\kitchen ceiling Address: 91 Fuller Rd Specifier: City, State, Zip: North Andover, MA Designer: Kimberly Hankey Customer: AMS Home Improvement Company: Cyr Lumber Co,39 Rockingham Rd, Windham, NH Code reports: ESR -1040 Misc: Connection Diagram Disclosure Completeness and accuracy of input must b d be verified by anyone who would rely on a output as evidence of suitability for • • • particular application. Output here based c on building code -accepted design •� • properties and analysis methods. Installation of BOISE engineered wood • products must be in accordance with current Installation Guide and applicable building codes. To obtain Installation Guide a minimum = 2" C = 2-518" or ask questions, please call (800)232-0788 before installation.\n\nBC b minimum = 2-1/2"d = 12" CALCO, BC FRAMERS, AJS-, ALLJOIST®, BC RIM BOARD-, BCI®, Calculated Side Load = 520.0 Ib/ft BOISE GLULAM- SIMPLE FRAMING SYSTEM®, VERSA -LAME), VERSA -RIM Beams 7 inches wide will be assumed to be either top -loaded only, or equally loaded from PLUS®, VERSA -RIM®, each side. VERSA -STRANDS, VERSA -STUDS are Bolts are assumed to be Grade A307 or Grade 2 or higher. trademarks of Boise Cascade wood Connectors are: 1/2 in. Staggered Through Bolt Products L.L.C. Page 2 of 2 CNC r Sp '6* �- > J ) I —0 (L OZ W3030 8O FQ NA E3 CL= cr fJ M CL (D CA in e. cr fD a= t') Q v. .W2430R fMIR.DOOR VZZ L 9CA lose cn 0 61 V Cil 4 J ) I —0 0 =ELX Ir a :3- M (D CLO W3030 8O FQ E3 CL= cr BMWD2734 SLS36R M CL (D .W2430R fMIR.DOOR VZZ L 9CA lose cn 0 61 V Cil 4 The Commonwealth of Massachusetts Department of Industrial Accidents a d I Congress Street, Suite 100 Boston, MA 02114-2017 Name (Br Address: www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. City/State/Zip: J -V P w_&& Are you an employer? Check the appropriate box: Phone #: GU 3 2_S2- © 5!2/ 1.el a employer with employees (full and/or part-time).* 2. a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.# 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. emodeling 9. ❑ Demolition 10 ❑ Building addition 11.❑ Electrical repairs or additions 12. ❑ Plumbing repairs or additions 13. ❑ Roof repairs 14. ❑ Other *Any applicant that checks box 41 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 and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. 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 MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un • to pains and penalties of perjury that the information provided above is true and correct. Signature: —7 �� Date: -3 / //,7 -- Phone #: 6 o- /J 5�e 6 3 S/ 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 #: ~Ie� 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 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 bum leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia Massachus ��� Board of efts - I)eRartment uof Buildi g Re9u(ationsof Public Safety r Ss Constr n LicenseUpenasor 1 & 2 Famil Standards CSFA-096462 I , AARON M SC '�.� 2 MAGNO ��. LIA AitE SALE11s Ng 030 Y { Commissioner Expiration 07/07/2016 li Office or Co sio' sxo�U Y— -- — - 1.. HOIyIE 1 °sumIrA�rr. & B si Reg►strafio`n OVEMEN= ONr� ess Re� . Expiration: 153859 — CTOR 1/18/2017 p8 TYpe j AA ON M. SCARPELLO Fi0 A if AARON SCARPED ;# ME �ROVEMENT 2MAGNOLIA AVE,.; SALEM, MA 03078 Under secretary r'