HomeMy WebLinkAboutMiscellaneous - 107 WAVERLY ROAD 4/30/2018GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT
TOWN OF NORTH ANDOVERBUILDING DEPARTMENT
This form shall be used to assist the Building Department in their determination of exemption under section
8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the
necessary information as requested below.
Permit Applicant Property address Map / Parcel
�1 &- S Lk q31-1 -K-
Applicant's Phone Number Single Family Two Family
I the undersigned applicant for the above property attest that the attached building permit for which this form is completed
does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw. I also understand providing this form does not
absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building
permit. Further I understand that my interpretation of the exemption status is subject to review by the Building Department and is only
officially accepted when the building permit is issued.
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building.
permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark.
This is an application for a building permit for the enlargement, restoration or reconstruction of a dwelling in existence as
of the effective date ofthis bylaw, provided that no additional residential unit is created.
The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw.
This application is for dwelling units for low and or moderate income families or individuals, where all of the conditions
of 8.7.6 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens
through a properly executed and recorded deed restriction running with the land. For purposes of this section "senior" shall mean
persons over the age of 55.
This application is part of a development project which voluntarily agreed to a minimum 40 % permanent reduction in
density (buildable lots) below the density permitted under zoning and feasible given the environmental conditions of the tract, with the
surplus land equal to at least tan buildable acres and permanently designated as open space or farmland. The land to be preserved shall
be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other
similar mechanism approved by the planning board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent
parcel on the effective date of this Section 8.7 and shall receive a onetime exemption from the Planned Growth Rate and
Development Scheduling provisions for thepurpose of constructing one single family dwelling unit on the parcel.
This application represents a lot which is ready for a building permit ( all other permits from all other boards and
commissions have been received and the project is in compliance with those permits), and the Development Schedule does not
accommodate issuing a building permit in that year. One building permit will be issued per year per Development until such time as
the development schedule accommodates issuing building permits. Applicant must submit an approved FORM U with this
EXEMPTION.
PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A
DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS.
BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED
BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE.
FURTHER 1 UNDERSTAND THT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE
CHECKDIG OFF OF A ABO XE TION WHICH DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR
NO OUN/DS FOR FU AL 1' THE BUILDING DEPARTMENT TO ISSUE A BUILDING P RIvIIT.
ci 0
APPLICANTS SIGNATURE DATE I
THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION
August 13, 2003
TO: BUILDING INSPECTOR
TOWN OF NORTH ANDOVER
FROM: FRANK S. GILES, P.L.S.
RE: WILLIAM FAHEY
107-121 WAVERLY ROAD
NORTH ANDOVER, MA 01845
To Whom it May Concern:
The front setback to the structure on either side of 107-121 Waverly Road, have been measured and
determined to be an average of fifteen (15) feet. The plan submitted for 107-121 Waverly Road shows the
proposed setback of eighteen (18) feet. Therefore, fulfilling the zoning requirement.
Please feel free to call us for any questions you may have!
Sincerely,
Frank S. Giles, P.L.S..
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sC1T C. r,ILES, P L S
FRANK S GMA. PLS -
50 DEERMEADOW ROAD
NORTH ANDOVER, MA 01845
www.FtanlcGile9Survey@"fti. aom
TEL.. (978) 683-2645 (978) 683.3924
SURVEYING
LAND PLANNING CONSULTING
August 13, 2003
TO: BUILDING INSPECTOR
TOWN OF NORTH ANDOVER
FROM: FRANK S. GILES, P.L.S.
RE: WILLIAM FAHEY
107-121 WAVERLY ROAD
NORTH ANDOVER, MA 01845
To Whom it May Concern:
The front setback to the structure on either side of 107-121 Waverly Road, have been measured and
determined to be an average of fifteen (15) feet. The plan submitted for 107-121 Waverly Road shows the
proposed setback of eighteen (18) feet. Therefore, fulfilling the zoning requirement.
Please feel free to call us for any questions you may have!
Sincerely,
Frank S. Giles, P.L.S..
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North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c 11, S1150 A._
The debris will be disposed of in:
(Location of Facility)
41b-�
KC
of Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through.the Office of the Building Inspector
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Name
Name: t r
_ovation:
Iity , ��rt Flo _ cu j
I am a homeowner performing all work myself.
Please Print
19 Y%`1 N3
I am a sole proprietor and have no one working in any capacity
F-1 I am an employer providing workers' compensation for rry employees working on this job.
Company name:
Ireff, =M
City: Phone #:
Insurance. Co. Policy #
Company name:
Address
CML Phone*
Faille to secure coverage as required. under Section 25A or MGL 152 can lead to the imposition cf criminal
i nsonment_as weH-as_c�il P �:a hne up:to $1.500.00
andfor one
years' mp p�enakies�nsheiamn �?SJP]N9WCDRDERand afiae�f (SS11 MM��agr�gaiast
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby cWW
4
ofperjmy that Me kgbrmatprovided above a true and coned.
,q
Print name Phone.#
Official use only do not write in this area to be completed by city or town dWar
City or Town PePrnitilicensir>4..
Building. Dept
[]Check I immediate response is required p Licensing Board
p Selectman's Office
Contact person: Phone A E] Health Department
Ei Other
i
4
Permit Number
REScheck Compliance Certificate Checked By/Date
Massachusetts Energy Code
REScheckSoftware Version 3.5 Release 1
Data filename: C:\My Documents\HomeworksUob Files\2002\Fahey.rck
TITLE: Fahey House
CITY: Andover
STATE: Massachusetts
HDD: 6322
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non -Electric Resistance)
DATE: 07/18/03
DATE OF PLANS: 7/14/2003
PROJECT INFORMATION:
New Residence for:
William & Heather Fahey
107 Waverly Road
North Andover, MA 01845
COMPANY INFORMATION:
David W. Brown
d/b/a Homeworks Residential Design Service
31 Glenwood Road
Andover, MA 01810-6250
978-470-0454
COMPLIANCE: Passes
Maximum UA = 603
Your Home UA = 587
2.7% Better Than Code (UA)
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R -Value R -Value U -Factor UA
Wall 1: Wood Frame, 16" o.c.
3687
15.0
0.0
242
Window 1: Wood Frame:Double Pane with Low -E
496
0.370 184
Door 1: Solid
51
0.560 29
Floor 1: All -Wood Joist/Truss:Over Unconditioned Space
2072
30.0
0.0
68
Floor 2: All -Wood Joist/Truss:Over Outside Air
24
30.0
0.0
1
Ceiling l: Flat Ceiling or Scissor Truss
2108
38.0
0.0
63
Boiler 1: Other (Except Gas -Fired Steam), 80 AFUE
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 Massachusetts
I
Energy Code requirements in RES checkVersion 3.5 Release 1 (formerly MECchecl and to comply with the mandatory
requirements listed in the RES checkInspection 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 MA
Builder/Designer z W , �� Datejmalv)
REScheck Inspection Checklist
Massachusetts Energy Code
REScheckSoftware Version 3.5 Release 1
DATE: 07/18/03
TITLE: Fahey House
Bldg.
Dept.
Use
Ceilings:
[ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-38.0 cavity insulation
I Comments:
Above -Grade Walls:
1. Wall l: Wood Frame, 16" o.c., R-15.0 cavity insulation
Comments:
Windows:
1. Window 1: Wood Frame:Double Pane with Low -E, U -factor: 0.370
For windows without labeled U -factors, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
Doors:
1. Door 1: Solid, U -factor: 0.560
Comments:
Floors:
1. Floor 1: All -Wood Joist/Truss:Over Unconditioned Space, R-30.0 cavity insulation
Comments:
2. Floor 2: All -Wood Joist/Truss:Over Outside Air, R-30.0 cavity insulation
Comments:
Heating and Cooling Equipment:
1. Boiler 1: Other (Except Gas -Fired Steam), 80 AFUE 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 and glazing U -factors must be clearly marked on the building plans or specifications
Duct Insulation:
Ducts shall be insulated per Table J4.4.7.1.
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 OF or chilled fluids below 55 OF 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 1„ 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.
NOTES TO FIELD (Building Department Use Only)
Fluid Temp.
Insulation Thickness in Inches by
Pipe Sizes
Piping 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
Stearn 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)
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F®RM 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_ 1 l (3r 0 -PHONE 6n
LOCATION: Assessor's Map Number PARCEL
SUBDIVISION
LOT (S)
STREET Q,Wer(W �� ST. NUMBER
FICIAL USE ONLY
RE MMENDATIO OWN AGENTS:
NSERVATION ADMINIS ATOR DATE APPROVED
DATE REJECTED
COMMENTS s
TO` R DATE APPROVED
DATE REJECTED
COMMENTS Q�03
FOOD INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR -HEALTH DATE APPROVED.
DATE -REJECTED
COMMENTS
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT Al
RECEIVED BY BUILDING INSPECTOR DATE _
Revised 9\97 ;m
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