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HomeMy WebLinkAboutMiscellaneous - Rocky Brook Road 150Location 1,�.?,313 Pt� O 1 acY j ��d��� lac No. ,5�� Date NORTV0.1 9, TOWN OF NORTH ANDOVER A _ Certificate of Occupancy $ p' y+s ",•° t�� Building/Frame Permit Fee $' 3ACMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /,5-43' , ; Check # ` 3504 Building Inspector ,Location i:. ` _ DG rr� No. Date`f�" t r r TOWN OF NORTH ANIDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ d� TOTAL $ B u i l dq'g�A stf(/eUtto/r 1' 5 6 i Div. PA)d Works - — -- -- --- - - 1 i Rl I V Fil - _ _ - 7 v r � '- I � � \ ♦ .—., - ' _ v� �• � �! ✓ � I W ice.. I is ^ _ 7 _ � ,mil � �. — _ � _ � ` D O z �. u4 W. l� Px ry - G Gtp ZZ _ Q4 J- V , lb IQ w C �V V2 Q j Q I v I � N Rl I V Fil I is - y ✓: _. _ ^ y % Y — _ / :/, �_ V .Y � ✓ ✓ _ � � !0� as O 7 QCK4 Z oG LO f I I I - z _ Ln cr, 74 7 - - =7 7 v t\ 1A c=rr I v I Q \ r� ` j ` j z i o - 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 /7 1�2,r✓e let /in e'U / PHONE_ LOCATION; Assessors Map Number PARCEL SUBDIVISION LOT (S) ; STREET 2 `�Y gee o ✓P. J ST. NUMBER JD OFFICIAL USE ONLY***' ter --*---***********•***'******'******' RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR COMMENTS 1_ /NS DATE APPROVED DATE REJECTED_ 4 Sq Te(' COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED IC SNSPECTOR-HEALTH DATE APPROVED !!% DATE REJECTED COMMENTS ysn,e=�- n^i-;.P.1� ,•���_', PUBLIC WORKS - SEWER/WATER CONNECTIONS�G— DRIVEWAY PERMIT /P fla-ktel- FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO eo ati�n T4' 019 lalljul I BUILDING Dwh-;,AffT�AEN T� I ;:,_ ✓lie �tinrmtonwea� � I� I o ./��zaeac6uaet�a i DE.AR.INENT OF PUBLIC SAFETY r CONSTRUCTION SUPERVISOR LICENSE ;{ Expires: Birthdate p Numb r r �� f CSµ j`:_b,68S693 ;81�13�28B0 81�13j1954 i,, t s i '.•i BB i Opulb A KINDRCO �i 30 Nlll POND POB%;531 1 i N ANDOVER, MA 156635 Restricted„To. 00 BB 351601 cf enclosed space (NG t C.112 S.601) IA,- Mason' y. only 1 IG - 1 6 2 family 'ik0 faife- lure to (possess a current°.editiop. of the Massachusetts State Building Code '• is cause..for`"revocation of this license. I 'If, i' ;a 4 i Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant an Building Permit (below) Address of Property for Permit (below) i`;/Ilt11eNr ,�� Map and Parcel: Purpose f.Application (check below) Phgfrt �PJu er pplicant: 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 North Andover 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 ig issued. Based an 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 of this by-law, provided that no additional residential unit is created. ByThe lot(s) were/was created prior to May 6. 1996 are exempt from the provisions of this Section 8.7 of the Zoning law. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6.care met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons 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 a part of a development project which voluntarily agreed to a minimum 40% permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space and/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. adjThis application represents a tract of land existing and not held by a Developer in common ownership with an acent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the P:Nm I. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and issions 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 supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed 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 I understand that the submittal of misleading and or inaccur aticn, or the checking off of an above item which does not comply, whether done to my know dge or ci ' grou ds for r fusal by the Building Department to issue a Building Permi . 1 Gy `/ i� 7 i ature o caner orA honzed Agent who signed the Attached Building Permit Da This form must be attached to the Building Permit upon application for such permit MAScheck COMPLIANCE REPORT Massachusetts Energy Code >check Software Version 2.0 CITY: Haverhill STATE: Massachusetts HDD: 6027 CONSTRUCTION TYPE: 1 or 2 family„ detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 8-9-1999 i DATE OF PLANS: TITLE: Permit # Checked by/Date COMPLIANCE: PASSES Required UA = 608 Your Home = 574 Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value --------------------------------- UA ---------------------------------------------- CEILINGS i 1540 30.0 0.0 54 WALLS: Wood Frame, 16" O.C. ! 2720 13.0 3.0 194 GLAZING: Windows or Doors 420 0.480 202 DOORS j 21 0.490 10 "7.00RS: Over Unconditioned Space! 1540 19.0 73 4T: 7.0' ht/6.0' bg/0.0' insul.l 170 0.0 41 HVAC EFFICIENCY: Furnace, 89.0 AFUE ---------------------------------i---------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. 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 1250 of ithe design load as specified in sections 780CMR 1310 and J4.4. Builder/Designer I Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 h TE: 8-9-1999 Bldg. Dept. Use L. ] CEILINGS: 1. R-30 Comments/Location WALLS: 1. Wood Frame, 16" Comments/Locati O.C., R-13 + R-3 n 3 WINDOWS AND GLASS DOORS: j 1. U -value: 0.48 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U -value: 0.49 Comments/Locat FLOORS: 1. Over Unconditioned Space, R-19 Comments/Location I BASEMENT WALLS: 1. 7.0' ht/6.0' bg/0.0' Comments/Location HVAC EQUIPMENT EFFICIENCY:] 1. Furnace, 89.0 AFUE or higher Make and Model Numberi THERMOSTATS: . I Adjustable thermostats required for each HVAC system. AIR LEAKAGE: ' Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air -tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: I Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION:1 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 -values, and heating A I equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: All ducts must be sealedwith mastic and fibrous backing tape. Pressure -sensitive tape may be used for fibrous ducts. 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. HVAC 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. i I MISC REQUIREMENTS: j [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building DepaIrtment Use Only) ------------------------- The Commonwealth of Massachusetts Department of Indus trialA cciden ts Office of lnvestiaadons Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Blame t' --"e vc o me "v J Please Print N ton: F7 1 am a homeowner performing all work myself. El I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Comoanv name: / ® /��yc Of A e,y l Address z a- i3a x S i City /V. AN9DUc Phone C rt� Insurance Co. 6vg7—ec'J Policv m �✓C g 6 7 0% (� Comoanv name: Insurance Co. Polio,/ Failure to secure coverace as required under Section 25A or MGL 152 can lead to the imposition cf criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as dvii penalties to ttte form of a STCP WORK ORDER and a fine of (5100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify and pains nd penalbes•o"pe7urythat the infcrmatien provided above is true and correct. Signature Date Print name �.�1 '" '«t Phone# �/n - 6-`-S F Official use only do not write in this area to be completed by dry or 'town cfncial' City or Town ❑Check if immediate response is required Contact ❑ Building Dept Licensing Board �j Selectman's Office ❑ Health Department F i Other 5� y oily dy b �3 a 7 a8 � 410 CR 2- -'Tl rr, m e C/) M m Cl) 0 L -J V1 d O y Cl) O CA Er C7 CD O CD CO)CD CD CO) O CD O CD I V3 CD �1I 49 Z o 00 0 CD 9:y < m ca y C')� :D .oao -0 �0t ® CD N d H o N cc, ..► C m d C y c odder y NCD :� O n - Ca~a o m y C� cn b r) to m o oCDCO gym ITI Z<ra H• A O b ny f +� Vol » < � CD m y ' �' z C')� :D CD N d H 2L d Q o F d C y c �1 C NCD :� O n - G � �n G w 3 d �' z 7 z o G ? 2L ,� o F ?? w g G � n - G � �n G w C� cn b r) 7n O GL ITI )NIq 0 0 c m m m a 0 I ai C)-� m n m Mn ,c : i 'n �+ C nl ?' o v m o3 boZ .: .� 0 z, �m 0 0 CL 0 I 0 Ln 0 c CL a 0 0 cr C �« a� Ln n m 0 CL C U1 n m E E 0 or U. m x Ln W I l Q 0 E a-+ 0 c 1+ 0 C?o a cD n r-9 rfl oc3 Q' 0 N 0 o 0 y IDID0 ~ 0 -0 �, 0 = cD D cr x .� cD co X e 11 3 C °-n. c� _~ c 'D ? fD M ;� d �o ~ c gr CD O r,, a `� CD c V� 9 4. 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