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HomeMy WebLinkAboutBuilding Permit #461-14 - 96 DALE STREET 11/25/2013TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATI ON Permit NO: `� ( I Date Received tf 1 I Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATIOi` o� # ,D/4L Print, PROPERTY OWNER �o�'� (+��ctce� �e�enP e/1i�" Prins 100 Year Old structure yes Ano MAP NO: �PARCEL:� ZONING D.ISTRICT:Historic District yesMachine Shop Village yes TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential )(New Building )One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg 0 Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands X Watershed District Water/Sewer Islip . i _ IN IN ff*J -.A >� Identification OWNER: Name: Address: /SG nc /iii/ Phone: 97$'F527 CONTRACTOR Name: Ay -A- c- Cq-AAPhone: Address: %5( %� %i 1-3X Supervisor's Construction License: Exp. Date-.- l5 Home Improvement License: /73g'`fZ. Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: l l O b Receipt No.: `�-I lva NOTE: .Persons contracting wit unregistered contractors do not have access to th guara ty fund Signature of Agent/Owner eco filature of contractor _I -- Plans Submitted—R- Plans Waived ❑ Certified Plot Plan ,9 Stamp ansk Location f 4' 1� �� C\� 4 No. i `�' —-1 Date t 2c� �3 Check #—f ` `-� 27136 ON TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $�b Other Permit Fee $ TOTAL $ Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE:OF-:SEWERAGE D3SPOySSA.L Public Sewer 1+x Tanning/MassageMody 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 r "--PLANNING & DEVELOPMENT- ❑ 7� COMMENTS .CONSERVATION C, . Reviewed ons= HEALTH COMMENTS Reviewed on Signature r Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Commen 0 Water & Seger Connection/Signature & DPW Toiv; )Engineer: Signature: - - z. FIRE-DEPARTML=NT `Temp D pster on site Lbcated-at 124 Mair.. Street � Fire Departmerit-sigh COMMENTS Located 384 Osgood Street no 11--C -1-3I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. 'Z -Vo _ o Total land area, sq. ft.: qD 6— ELECTRICAL: Movement of Meter location, hast 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 DA I A — (For department use ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The folowing is"a. list of the required.forms to be filled out for the appropriate, permit to be obtained. Roofivg, 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 o 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 ❑ 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 apw al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Building Permit Revised 2012 J .��--�� ��.P ��� �� z�� w � �� NI s� em r L 0: O " 3 as cc � J L O O N d O > 4i, _ NVQ 'a H E c T CL W - N - o 3 � o0 L S: 0.4) cu ,o 'y N = c rL H O y V m w O d LLJW = a +�-' O O LL •� d � N C H N •O w � 4. 0 t .$ CLo0 Q W CL COZ z JcaO E Co CL Z V V W O x Z Cl) °C W c W J CL Z m `o c .E N d t O Z O O N LS • N i w •N W O W Z 0 .E i N V cc CL U) V .Q U) c V m L Q t v L N LU nim \\ —� a a M O U G x ,. L z y z Z a Q 0 ZZ v Z w O c 1> v ul aC7 o LU °c m C E tcu _ J d J LU V' rV+ T Y N \ U T ON L C _ `J L _ L (,f tto_ L to _ z N a+ N Y O O Q O N LL VI 7 0 N O O L O LL O' U LL 7 f0 O O w LL i m O O C d' (/1 LL 7 t0 O O w LL i v 3 �, E CO (n N em r L 0: O " 3 as cc � J L O O N d O > 4i, _ NVQ 'a H E c T CL W - N - o 3 � o0 L S: 0.4) cu ,o 'y N = c rL H O y V m w O d LLJW = a +�-' O O LL •� d � N C H N •O w � 4. 0 t .$ CLo0 Q W CL COZ z JcaO E Co CL Z V V W O x Z Cl) °C W c W J CL Z m `o c .E N d t O Z O O N LS • N i w •N W O W Z 0 .E i N V cc CL U) V .Q U) c V m L Q t v L N •O r em r L 0: O " 3 as cc � J L O O N d O > 4i, _ NVQ 'a H E c T CL W - N - o 3 � o0 L S: 0.4) cu ,o 'y N = c rL H O y V m w O d LLJW = a +�-' O O LL •� d � N C H N •O w � 4. 0 t .$ CLo0 Q W CL COZ z JcaO E Co CL Z V V W O x Z Cl) °C W c W J CL Z m `o c .E N d t O Z O O N LS • N i w •N W O W Z 0 .E i N V cc CL U) V .Q U) c V m The Commonwealth ofMassachusetts Department oflndustrial Accidents Ofjtce of -Investigations 600 Washington,. 6-eet >v .Foston, MA 02111 www,massgovIdaa Workers' Compensation insurance Affidavit: Builders/Contractors/Clectricians/Plumbers mlicanf Tnfnrrnni;n-n Name (Business/Organization/Individual):_ Ail`Klf- C&flS,+t-�� City/State/Zip: Are you an employer? Check the appropriate box: 1. I am a employer with /-/( • 4. V4 I am a general contractor and I employees (full and/or part-time).* 2111 am a sole proprietor or have hired the sub -contractors listed partner- on the attached sheget. ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing .officers have exercised their all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] f employees. [No workers' comp, insurance required i Type ofproject (required): 6. X New construction 7. ❑ Remodeling 8. ❑ Demblition 9. ❑ Building addition 10. ❑ EIectrical repairs or additions 1111 Plumbing repairs or additions 12.0 Roofrepairs Un Other . *Any applicant that checks box#1 must also fill out the section below showing their workers' compensation policy information. THomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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. d -am an employer that is providing workers' compensation insurancefor my employees Below is tlzepolicy and jab site information. Insurance Company Policy # or Self -ins. Lic. #: Job Site Address: E p tion Date: �- /� �� �-.� 4 City/State/Zip: �r eJ7J�� 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 ofMGL c. 152 can lead to the imposition of criminalenalties of a fine up to $1,500.00 and/or one-year p ear imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine �f up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of �Ivestigations of the D9 for insur ce coverage verification. do hereby certify under penalties ofperjury that the Information provided above is true and correct. ..�, jfrcaa[ use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License ,T Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 6. Other 4. Electrical Inspector 5. Plumbing inspector 201atact Person 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 employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency hall'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 ofpublic work until acceptable evidence of compliance with the insurance requirements ofthis 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), addresses) andphone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees ocher 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 maybe 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 Iisted 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 permithicense number which will be used as a reference number. In addition, an applicant that must submit multiple pernvt/license applications in any given year, need only submit one affidavitindicating current Policy information (ifnecessary) and under "Job Site Address" the applicant should write "all locations in jcity 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 notrelated to• any business or commercial venture (i.e. a dog license or permit to bum leaves etc) said person is NOTrequired to complete this affidavit. The Office of Investigations would no 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: 'V1, Co'-=01CWeaith offyJassacl usetts Department of Tadustrial Accidents Office of InvesUgations 600 Washington Street B oston; MA. 02111 Tel. # 617.-77-4900 ext 406 ox 1,877.MASSAFE E.evised 5-26-05 Fax # 617,727-7749 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supers icor License: C"71149 - w b JEFFREY S HORNS F s 156 BAREHII L RH V - gOXFORD MA 61921. °U - i ,I lit Expiration 05/21/2015 Commissioner HORNEA OP In- KW CERTIFICATE OF LIABILITY INSURANCE 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. DATE YY) TYPE OF INSURANCE 1 12 512 01 11!25/2013 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 Daniel J. Guarino Ins. Agency wwW.djgins.comNo 99 Rosewood Drive Suite 111 Danvers, MA 01923 �TEACT PHONE Fax Ext): (AIC. No): noDRlEss INSURERS} AFFORDING COVERAGE NAIL 0 INSURER A: Norfolk S Dedhan Mutual Fire 13706 INSURED Horne Construction Corp 156 Bearhill Rd INSURER B: EACH OCCURRENCE $ 1,000,00 Boxford, MA 01921 INsuRER c INSURER 0: INSURER E; 08/29/2013 IN URER F: PREMISES E! a NIIzu ca $ 140,00 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. TYPE OF INSURANCE POLICY NUMBER rYUUCp yyyy POLICY O YYYPY LIMITS I GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 rA COMMERCIALGENERAL LIABILITY CLAIMS -MADE FIOCCUR R0640878A 08/29/2013 08/2912014 PREMISES E! a NIIzu ca $ 140,00 MED EXP (Any one Person) $ 5,00 X I Business Owners PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 i GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,0010 $ AUTOMOBILE �1 LIABILITY ANY AUTO ALL OWNED 1 SCHEDULED AUTOS .AUTOS COMBINED SINGLE LIMIT Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident i ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE PER AC 1DENT $ Is UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED RETENTION $$L $ WORKERS COMPENSATIONJ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDE p7 IMandatoryy In NIA A I 0T _I'MY LIMITS I ER._ _ E.L. EACH ACCIDENT I $ r E.L DISEASE - EA EMPLOYEE $ under DESCRIPTION OF OPERATIONS below . E.L. DISEASE - POLICY LIMIT I $ 1 I PROPERTY 10,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attuh ACORD 101, Additional Remarks Schedule, N mors space Is required) Coverage is subject to all terms and conditions of the policy forms. TOWNNAN Town of N. Andover Building Dept 1600 Osgood St Bldg. 20 Suite 2035 North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W 1atf6-2U1U ACORO CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Q N NI MA I ' V E 00 r L v03 M O H J W LL O O co C N Y O lOi N V)m U CL {/) �JC d Z Z O m C "6 7 LL L O 5 v C E U C LL �O a Z Z J d t O C LL O C Z V W W t OD O W UtwbO In N C LL O a Z Q bD 7 0' @ C LL F- Z CW G cc Q W LLI 5 U. L L O m z (U v V1 r N 0 Cc O 2 - Q cLa Cc °�' a, �CL L N � d ` y.+ 0 ..omit 7: c a L CL ca ca > M LZ_ o = > CD cc C = V Ego T CL (n C `o - y o 0 3 � o0 CL 0L s CL '0: m 0 .� c H E� O = _ = O CL O "7 Oof d v m LUW _ 'a O O LL ' � � � N1 _ CJv W E v L V Q. O -a G1 cn N �=O I— t Z CL 0 0 O a z z :o CD /� �/ cn V/ co z V W Ccn L Lu O � U Cl) LU ►v LS North Andover MIMAP November 25, 2013 W., 7- 7/A- 01 37. -00 #V5 7'.B-OU12 70// 7, 071/ 37.B-00 5 alzo a 0 R-1 037.1BR-001 037XrO a wipro C 03TH-0075 037 R, 137. -D -M #90 -4'7 H-U06I 50 --111 3 ALA 23 #1 03TJR�/J 41 # 037/B- 15, '89 U 37,B 0 U /gl, Rail Line lntemtalm Interstate 7� Wetlands Zoning E—pt Lards X3 Buusi nnwi B s ii� I DIstri 20 1 Horizontal Datum: MA Stateplane Coordinate System. Datum NAD83. Major Roads M Bust M Busimu s 3 DIstr6kdA s 4 District AORTh Meters Data Sources: The data for this map ms produced by Merrimack Valley Planning Commission (MVPC) usIng data provided by the To%vn of Roads Ci Easements E Gerona 0 Planne, Business District Commercial Dev 0 * ,,to '.16 North Andover. Additional data provided by the Executive Office of Environmental AffairstmassGIS. The Information depicted on this map is 0 MVPC Boundary C3 Municipal Boundary Zoning O"aflay i� C.—ido do N Corrid :1du::11 Development Dist Development Dist 0 Development Dist I.- -A 111 District 49 lwl* -"M 4 for planning purposes only. It may not be adequate for legal boundary definition or regulatory Interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY E3 Adult Entertainmen 1 0 00vvr1lo" Overlay District nd 0 lndu.ti,f E Industri %t2Di 3 DI:hIct, it S District OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF C3 Historic District E3 Water Protection Residej Residei ce I District 2 District THIS INFORMATION 0 Parcels 0 R—idei ce C US ce 3 District Hydrographic Features 1 149 ft de ce 4 Distri ct Di ::Hct State— d. VZ6 Di rict �Idenflal District North Andover MIMAP November 25, 2013 037.B-0011 037.B-0001 130 MARBLERIDGE RD 037.D-0013 or 037.B-0010 Cf fj 037.B-0009 a� y� ` 96'DA-} LE S-^�T 100 DALE S 037.D-0001 ALE ST, 150 MARBLEHEAD ST 9\ � 037.B-0061 N037.B-1113 X69 \ 154' \ _ \9'' Street p ale 113 DALE ST 145 037.B-0014 91 DALE ST 037.B-0042 N037.B-1111 037.D-0041 4&- 037.B-0069 -s�� atly 037.B-0015 -- Rail Line Interstates, — Inst Interstate P Horizontal Datum: MA State lane Coordinate System, Datum NAD83, — Major Roads NORTN Meters Data Sources: The data for This map was produced by Merrimack Valley Planning Commission (MVPC) using data provided by the Town or Roads Ce Easements Ot 0 9a ? e 4++ �O North Andover. Additional data provided by the Executive Office of Environmental ABairsfMassGIS. The information depleted on this map is ❑ MVPC Boundaryw-for C3 Municipal Boundary - Trails l'-. ~— - 9 ♦ • planning purposes only. It may not be adequate for legal boundary definition or regulatory Interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY 4 i OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT ❑ Pamels .',^ +F �o �� ♦ ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF 111 Hydrographic Features Streams .J�+" n :,`�y 9SSACMUS�S THIS INFORMATION Wetlands r- Exempt Lands 1" = 85 ft "�' REScheck Software Version 4.4.4 Compliance Certificate Project Title: Lot 196/100 dale st Energy Code: Location: Construction Type: Glazing Area Percentage: Heating Degree Days: Climate Zone: Construction Site: 96 Dale st North Andover, MA 01845 2012 IECC North Andover, Massachusetts Single Family 22% 6322 6 Owner/Agent: Jeffrey Home Country Places Development Ik: 156 Bare Hill Rd Boxford, MA 01921 978-887-6709 homeconstructionl @verizon.net Compliance: Compliance: 31.3% Better Than Code Maximum UA: 435 Your UA: 299 The % Better Or Worse Than Cade index rr9kcts how close to comprsrge the horse is based on code trade-off rules. it DOES NOT provide an estimate of energy use or cost relative to a minimumaode home. Designer/Contractor: Home Construction Corp. 156 Bare Hill Rd Boxford, MA 01921 978-887-6709 Homeconstructionl @verizon.net Ceiling 1: Flat Ceiling or Scissor Truss 1500 38.0 38.0 21 Wall 1: Wood Frame, 16" o.c. 2900 21.0 21.0 55 Window 1: Vinyl Frame:Triple Pane with Low -E 600 0.300 180 Door 1: Solid 45 0.100 5 Door 2: Glass 45 0.300 14 Floor 1: All -Wood JoistrFruss:Over Unconditioned Space 1500 30.0 30.0 24 Compliance Statement. The proposed building design described here is consiste building plans, specifications, and other calculations submitted with the permit application. The proposed building ha desigilled to meet the 2012 IECC requirements in REScheck Yersion 4.4.4 and to comply with the mandatory requirements li ted in the Scheck Inspection Checklist. Name - Title Si Date Project Title: Lot 1 96/100 dale st Report date: 11/07/13 Data filename: Untitled.rck Page 1 of 5 CREScheck Software Version 4.4.4 �(J Inspection Checklist Energy Code: 2012 IECC Location: North Andover, Massachusetts Construction Type: Single Family Glazing Area Percentage: 22% Heating Degree Days: 6322 Climate Zone: 5 Ceilings: ❑ Ceiling 1: Flat Ceiling or Scissor Truss, R-38.0 cavity+ R-38.0 continuous insulation Comments: Where air permeable insulation exists in vented attics, a baffle (of solid material) is installed adjacent to soffit and eave vents. Baffles maintain an opening equal or greater than the size of the vent. The baffle extends over the top of the attic insulation. Above -Grade Walls: ❑ Wall 1: Wood Frame, 16" o.c., R-21.0 cavity + R-21.0 continuous insulation Continuous insulation specified for this above -grade wall has consistent R -value rating across full area of the wall. Comments: Windows: ❑ Window 1: Vinyl Frame:Triple Pane with Low -E, U -factor: 0.300 For windows without labeled U -factors, describe features: #Panes - Frame Type Thermal Break? - Yes _ No Comments: Doors: ❑ Door 1: Solid, U -factor: 0.100 Comments: ❑ Door 2: Glass, U -factor: 0.300 Comments: Floors: ❑ Floor 1: All -Wood JoisVTruss:Over Unconditioned Space, R-30.0 cavity + R-30.0 continuous insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Building envelope air tightness complies by a post rough -in blower door test result of less than 3 ACH at 50 pascals. ❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Wood -burning fireplaces shall have tight -fitting flue dampers and outdoor combustion air. Air Barrier, Sealing, and Insulation Installation Criteria: ❑ A continuous air barrier is installed in the building envelope including rim joists and exposed edges of insulation. Breaks or joints in the air barrier are sealed. Air permeable insulation is not used as a sealing material. ❑ Junction of foundation and wall sill plates, wall top plate and top of wall, sill plate and rim -band, and rim band and subfloor are sealed. Comers, headers, and rim joists making up the thermal envelope are insulated. ❑ Insulation in floors (including above garage and cantilevered floors) is installed to maintain permanent contact with underside of subfloor decking. Exterior insulation for framed walls is in substantial contact and continuous alignment with the air barrier. Crawl space wall insulation Installed in lieu of floor insulation is permanently attached to crawlspace walls. Inspection of log walls is in accordance with the provisions of ICC -400. ❑ Spaces between fenestration jambs and framing and skylights and framing are sealed. Batts in narrow cavities are cut to fit; or narrow cavities are filled with insulation that readily fills the available cavity space. ❑ Exposed earth in unvented crawl spaces is covered with Class I vapor retarder with overlapping joints taped. Project Title: Lot 1 96/100 dale st Report date: 11107113 Data filename: Untitied.rck Page 2 of 5 © Air sealing is installed between the garage and conditioned spaces. Exterior walls adjacent to showers and tubs are insulated and have air barrier separating the wall from the shower and tubs. Access openings, drop down stairs or knee wall doors to unconditioned attic spaces are insulated and seated. Recessed light fixtures installed in the building thermal envelope are IC rated, airtight labeled at air leakage rate <= 2.0 cfm, and sealed to the drywall with gasket or caulk. Dud shafts, utility penetrations, and flue shafts opening to exterior or unconditioned space are air sealed. LI Plumbing and Wiring: Insulation is placed between the exterior of the wall assembly and pipes. Batt insulation is cut and fitted around wiring and plumbing, or for insulation that on installation readily conforms to available space such insulation shall fill all space between wail and piping/wiring. 0 Air barrier extends behind eteetrical or communication boxes or, air seated type boxes are installed. Lj HVAC register boots that penetrate building thermal envelope are sealed to subfloor or drywall. LI Fireplace walls have air barrier and c1mre doors are gasketed. Sunrooms: L1 Sunrooms that are NOT thermally isolated from the building envelope meet the requirements applicable to the building envelope. Materials Identification and Installation: Cj Materials and equipment are installed in accordance with the manufacturer's installation instructions. L] Materials and equipment are identified so that compliance can be determined. E) Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. 0 Insulation R -values and glazing U -factors are clearly marked on the building plans or specifications. Duct Insulation: L] Supply duds in attics are insulated to a minimum of R-8. All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: L3 Building framing cavities are not used as duds or plenums. All joints and seams of air duds, air handlers, and finer boxes are substantially airtight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Tapes, mastics, and fasteners are rated UL 181A or UL 1818 and are labeled according to the duct construction. Metal duct connections with equipment and/or fittings are mechanically fastened. Crimp joints for round metal ducts have a contact lap of at least 1 1 /2 inches and are fastened with a minimum of three equally spaced sheet -metal screws. Exceptions: Joint and seams covered with air4mpermeable spray foam. Where a partially inaccessible duct connection exists, mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking -type kmgitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). All ducts and air handlers are located within conditioned space. Temperature Controls: Cj Where the primary heating system is a forced air-fumace, at least one programmable thermostat is installed to control the primary heating system and has set -points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle. Lj Heat pumps having supplementary electric -resistance heat have controls that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: 0 Equipment is sized in accordance with ACCA Manual S based on building loads calculated in accordance with ACCA Manual J or other approved heating and cooling calculation methodologies. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2012 IECC Commercial Building Mechanical and/or Service Water Heating (Sections C403 and C404). Circulating Service Hot Water Systems: Systems include an automatic or accesstble manual switch to turn off the circulating pump when the system is not in use. 0 Pipes are insulated to R3 when any one of the following appy: (a) piping serves more than one dwelling unit, (b) piping between water heater and kitchen or water heater and distribution manifold, (c) piping outside conditioned space, buried, or located under a floor stab, (d) supply and return piping in recirculation systems other than demand recirculation systems, (e) piping is > 3/4 inch nominal diameter, Project Title: Lot 1 96/100 dale st Report date: 11/07/13 Data filename: Untitled.rcik Page 3 of 5 . ..—__.w T -- r— Project Title: Lot 1 96/100 dale st Report date: 11/07/13 Data filename: Untitted.rck Page 5 of 5 HORNE CONSTRUCTION CORP. FR I �aQ4ZJ CcE RS Efficiency Certificate Ceiling / Roof 76.00 Wall 4200 Floor / Foundation 60.00 Ductwork (unconditioned spaces): Window 0.30 Door 0.10 NA Heating System: Cooling System: Water Heater: Building Air Leakage Test Results Name of Air Leakage Tester Duct Tightness Test Results Name of Duct Tester Name: — Comments: L7 -17N 156 BAREHILL ROAD, BOXFORD, MA 01921 PHONE (978)887-6709 • FAX(978)887-0760 • HORN ECONSTRUCTIONIOVER IZON.NET