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Home My WebLink AboutBuilding Permit #31479 - 95 LYONS WAY 1/27/2017 Location q ��/ �`� fJ✓Viti f No. .—31 y Date / 7 7 . TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee $ _ TOTAL $ Check# :Ai 17 z", 31479 61/Building Inspector ■ NORTH ANDOVER '► � �0,,dATIM_&F ICATION FOR PLAN EXAMINATION Permit NO: f 7 Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page Print tPR0PERTY 01NMNE ..e:.`-) - a00YeEr01d Structure :yes no •P,rint �"` Y STRICT !Stoic Duct dyes �- �=< N ZONING q �N = FARCEL:' �Y � chine Sho r.1/il alai ge � yes :no u o v G t. TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ New Building III family ❑Two or more family ❑ Industrial *,Addition ❑ Commercial ❑Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other . _#4 <, 5 �:, °r. ' '• ® WatershedrDistnctc - D Flood Iain Wetlands 91:Septic- �€VUellr „v I,P1-� p Wate[/Sewe[:, DESCRIP ION OF WORK T�B� PERF ORMED: r` l S dentification Please Type or Print Clearly) Phone: �' / /0� OWNER: Name: % �-� 9J, ons W a Address: It -.f <•�g if -y M 1 i tf *' CONTRACTOR NaNY Me t _ 21 lhohei - �:Kys-M.� °nrc{ VL�tsr+ (r� / `J V r '+ s lAd,ddre� ss vA fi ....((as L iM# rSVT _� .� � y , ExpDate /' 'c U/ j `�,,n Supervisor=s,Constructton License + i.1W-21 is -merit Horne Improvement License .�k - R ARCHITECT/ENGINEER/_0Wre17C.#- V- �Uy Phone: A.ddress:_0 8 7d f-w Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. gyTotal Project Cost: $ ,7 00 -0 C) FEE: $ I It Check No.: Receipt No.: NOTE: Persons cont acting wf-dh unregisterecontractors do not have access to the guaran .. _-Si �atu:re::of:.cotitrac ;signature.of.Ag_entl.Ow_ner��:.�..:.. ._:..; . . _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan 11 Stamped P s ❑ Building Department `rine fol?owing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofifg, 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 A-ddition 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/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 40TE: 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) o Copy of Contract o Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all CEiscs if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the app%-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be- subm:tted with the building application Doc: Doc_Buhding Permit Revised 2012 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OF.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 DATE REJECTED DATE APPROVED PLANTING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS k2Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Toiv;� }Engineer: Signature: Located 384 Osgood Street FIRE ®EPARTMElT - Temp Dumpster on site yes no Located at-124 Mair,'Street Fire Departmefit sik hatureldate COMMENTS Dimension I 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.$10041000 fine li NOTES and DATA— (For department use) ` I LJ Notified for pickup - Date - = I Doc.Building Permit Revised 2010 b II b � FRONT-LINE FIRE PROTECTION, LLC Proposal 95 LVOM Wray Andow,Ma fmaoufftr .� - 7wvqZ**Wsv ft- 26i v mw �r �i�irrrrt y r(. a .. 4; .a FRONNE T-LI Q 7 FRW a w • Y q K m I ,. s. k: �: RESIDENTIAL SPRINKLER SYSTEM MODIFICATION FOR SINGLE-FAMILY BUILDING AT 95 Lyons Way, North Andover, MA 01845 FIRE PROTECTION DESIGN NARRATIVE LA ENCE V SG --RO PROTECT N y No.3891 Designed By: .0 9�a�s F ss� �L Front-Line Fire Protection,LLC INTRODUCTION AND BUILDING DESCRIPTION The purpose of this Fire Protection Design Narrative is to describe the proposed residential wet-pipe automatic sprinkler system modification in conjunction with the renovation of the 3-story building located at 95 Lyons Way,North Andover. The Building has three levels above grade. This building is constructed of combustible materials throughout and meets the criteria of Construction Type V according to 780 CMR. Sprinkler system will be installed throughout the building with an aggregate area of 8100ft2. Any concealed combustible spaces shall remain in accessible. Such spaces are not permitted to be used for storage of any kind. CODE REVIEW/HAZARD CLASSIFICATION The Massachusetts State Building Code (780 CMR)classifies this building as Type R-2 construction(Section 310.1). Section 903.2.8 (780 CMR, 8`h Edition)requires buildings of Use Group R to be provided with an automatic sprinkler system designed and installed in accordance with 780 CMR 903.3. Exception 1 (Section 903.2.8, 780 CMR) States that Buildings other than R-1 Occupancies and R-2 Dormitories,having no more than three dwelling units shall be permitted to have an automatic fire suppression system installed in accordance with 780 CMR 903.3.1.3,provided that every automatic sprinkler system shall have at least one automatic water supply source in accordance with NFPA 13D where the minimum quantity of stored water shall equal the water demand rate times 20 minutes. Section 903.3.1.3 (780 CMR) states that Where allowed, automatic sprinkler systems shall be installed throughout in accordance with NFPA 13D. Per these referenced code sections,the sprinkler system for this building has been designed in accordance with the requirements of NFPA 13D (2013 Edition). The system shall assume the hydraulically most demanding sprinklers in a single compartment up to two (2)residential sprinklers operating at the flow and pressures specified by the manufacturer(defined in the hydraulic calculation section). 1 SPRINKLER SYSTEM DESCRIPTION The building has been protected by existing fire sprinklers system which ties into thy, domestic water supply,to accommodate the expansion of the building, new sprinklers will be installed and connected to the existing piping. All residential pendent sprinklers shall be GL 4906 sprinklers with a K-Factor of 4.9. These sprinklers require a minimum flow of 13 GPM and a minimum pressure of 7 PSI and have an associated maximum spacing limitation of 16'x16. Residential sidewall sprinkler shall be GL 4431 with a K-Factor of 4.4. These sprinklers require a minimum flow of 15 GPM and a minimum pressure of 11.6 PSI for 14 X 14 coverage. NOTE: Per the requirements of the Massachusetts State Fire Marshal, all sprinkler \ contractors installing CPVC piping for automatic sprinkler systems shall be certified by a CPVC representative HYDRAULIC CALCULATIONS There is no new hydraulic remote area created in the system due to the system modification, no hydraulic calculation should be required. 2 Commonwealth of Massachusetts Department of Public SafetY Ucense:SC 210048 Sprinkler Contractor r CHARUE RODGERS ' 4 ALDERSGA M WAY NORTH READIMG MA 41866 — (' ,I Expiration:-^^ �`-I 611l512a18 Commissioner The Commonwealth of Massa.chusetts f Department of IndustrialAccidents I Congress Street, Suite 100 Boston,MA 021142017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNMING AUTHORITY. A licant Information 1 Please Print Ledb Name(Business/Organization/Individual):rnn�-kjnc L1C re- /z)feetoo, k-e e, Address: "Osw,& a o 9 City/State/Zip: n. allClau-eri HA. OdYS-Phone#: C/7 • (o55' 700oZ Are yon an employer?Check the appropriate box: Type of project(required): 1.�qI am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 4.F]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13.F]Roof repairs These sub-contractors have employees and have workers'comp.instuance.$ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other _r� 152,§1(4),and we have no,employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i 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 workeis'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:Gn nS . L/ u�7� Policy#or Self-ins.Lie.#: 0 l U qS7 —U Expiration Date: a Job Site Address: 1?5 ky n s oC// City/State/Zip: /7• Qx)clovar, H,4 Attach a copy of the workers' c .mpensation 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 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. Ido hereby certify under th pains andpcnalties of perjury that the information provided above is true and correct. Signature: Date: "o��0 /' Phone#: - 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'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 fbi 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' compensatiod'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. 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 ACo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDD/YYYY) 01/26/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Chris Gregory Gregory Insurance Agency,Ltd a/CONN Ext: (978)356-0491 ac No; (978)356 5227 Po Box 625 E-MAIL �g 9 ry ADDRESS: Chris re o insurance.com INSURER(S)AFFORDING COVERAGE NAIC# Ipswich MA 01938 INSURERA: CITATION INSURANCE COMPANY 40274 INSURED INSURER B: Admiral FRONTLINE FIRE PROTECTION INSURER C: Liberty Mutual 1820 Turnpike Street#209 INSURER D: INSURER E: North Andover MA 01845-6483 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IND WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 �/ DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 50000 MED EXP(Any one person) $ 5000 B CA000026269-01 01/26/2017 01/26/2018 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 LOC PRODUCTS-COMP/OP AGG $ 2000000 POLICY XX JECT RX OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS BBQC41 09/25/2016 09/25/2017 BODILY INJURY(Per accident) $ 1XX X HIREDAUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 B X EXCESS LIAB CLAIMS-MADE GX000000302-01 01/26/2017 01/26/2018 AGGREGATE $ 4,000,000 DED RETENTION$ $ WORKERS COMPENSATION I SPER OTH- AND EMPLOYERS'LIABILITY YIN TATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1000000 C OFFICER/MEMBER EXCLUDED? F---1N/A 804579-01 02/15/2017 02/15/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Sprinkler System Installation:Service,Repair&Inspection CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE North Andover MA EA";_ ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD `4 RESIDENTIAL SPRINKLER SYSTEM MODIFICATION FOR SINGLE-FAMILY BUILDING AT 95 Lyons Way, North Andover, MA 01845 FIRE PROTECTION DESIGN NARRATIVE LA 86 CE V SG o� -RO PROTECT N y No.3891 Designed B A9 s`�a�s EAS° Front-Line Fire Protection,LLC INTRODUCTION AND BUILDING DESCRIPTION The purpose of this Fire Protection Design Narrative is to describe the proposed residential wet-pipe automatic sprinkler system modification in conjunction with the renovation of the 3-story building located at 95 Lyons Way,North Andover. The Building has three levels above grade. This building is constructed of combustible materials throughout and meets the criteria of Construction Type V according to 780 CMR. Sprinkler system will be installed throughout the building with an aggregate area of 8100ft2. Any concealed combustible spaces shall remain in accessible. Such spaces are not permitted to be used for storage of any kind. CODE REVIEW/HAZARD CLASSIFICATION The Massachusetts State Building Code (780 CMR) classifies this building as Type R-2 construction(Section 310.1). Section 903.2.8 (780 CMR, 8`h Edition)requires buildings of Use Group R to be provided with an automatic sprinkler system designed and installed in accordance with 780 CMR 903.3. Exception 1 (Section 903.2.8, 780 CMR)States that Buildings other than R-1 Occupancies and R-2 Dormitories, having no more than three dwelling units shall be permitted to have an automatic fire suppression system installed in accordance with 780 CMR 903.3.1.3,provided that every automatic sprinkler system shall have at least one automatic water supply source in accordance with NFPA 13D where the minimum quantity of stored water shall equal the water demand rate times 20 minutes. Section 903.3.1.3 (780 CMR) states that Where allowed,automatic sprinkler systems shall be installed throughout in accordance with NFPA 13D. Per these referenced code sections,the sprinkler system for this building has been designed in accordance with the requirements of NFPA 13D (2013 Edition). The system shall assume the hydraulically most demanding sprinklers in a single compartment up to two(2)residential sprinklers operating at the flow and pressures specified by the manufacturer(defined in the hydraulic calculation section). 1 . SPRINKLER SYSTEM DESCRIPTION The building has been protected by existing fire sprinklers system which ties into the domestic water supply,to accommodate the expansion of the building,new sprinklers will be installed and connected to the existing piping. All residential pendent sprinklers shall be GL 4906 sprinklers with a K-Factor of 4.9. These sprinklers require a minimum flow of 13 GPM and a minimum pressure of 7 PSI and have an associated maximum spacing limitation of 16'x16. Residential sidewall sprinkler shall be GL 4431 with a K-Factor of 4.4. These sprinklers require a minimum flow of 15 GPM and a minimum pressure of 11.6 PSI for 14 X 14 coverage. NOTE: Per the requirements of the Massachusetts State Fire Marshal, all sprinkler contractors installing CPVC piping for automatic sprinkler systems shall be certified by a CPVC representative HYDRAULIC CALCULATIONS There is no new hydraulic remote area created in the system due to the system modification, no hydraulic calculation should be required. 2