HomeMy WebLinkAboutBuilding Permit # 7/1/2015 i
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BUILDING PERMIT �a®ry'•`n�
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
qp c«.:•i....
Date Issued:
�" ACHU`��4�y a
IMPORTANT: Applicant must complete all items on this page
LOCATION /32 Q S4--aC)/. 'i ",,/0/-' VC
Print
PROPERTY OWNER 3A A) A7d A1 �^
,11a Cf a u[ 7 rcj
Print
MAP NO: PARCEL: /7 ZONING DISTRICT: Historic District es no
Machine Shop Village yes o
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building 2-One family
RAddition ❑ Two or more family ❑ Industrial
❑ Alteration No, of units: ❑ Commercial
U-Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain E Wetlands ❑ Watershed District
El Water/Sewer
Ze/ o("e ex,:ah"4 /3e,,'%l
s<'�Cc.v Ica�U e� �M t!a'7`,t�v L•�Cf;(' /®'�.�,�,,.o rs�x � yrC l�v��/4
Identification Please Type or Print Clearly)
OWNER: Name: 7c)I,\.U/-P0�,,,0 Crag,6,- d Phone: mss'-oQ76G
Address: /3 9 O-S 46®d 15-¢ V�Q' ®/ 3�" —
CONTRACTOR Name: Phone:
Address:
bc
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER 4
Total Project Cost: $__.��/� FEE: $
Check No.: I F Receipt No.: id Z
NOTE: Persons contr cling with unregistered ontractors do not have access to the guaranty fiend
S,'nature of Agent/Owner Signature of contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Starnped-'flans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dwnpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m U FORM
PLANNING DEVELOPMENT Reviewed On i5 Signature
COMMENTS____
CONSERVATION Reviewed on Si nature
1
COMMENTS
LTH Reviewed on Signature
A
I
7COMMS TS
i
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
(C,
Waf ,r& Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature: .
Located 384 Osgood Street
FIRE DEPARTMENT Temp DumOster ob-site yes ;no,, r. dw
Located at`1124 Main Street ;,;
Fire Departmntaignatu�re/date
COMMENTS
itORTEIi
Town of :7" ndover
h ver Mass I
Y
% LAKE >
COCHIC«lw.cK
�®A04A7ED
S U
BOARD OF HEALTH
PER.MIT T D Food/Kitchen
Septic System
THIS CERTIFIES THAT ...... ® ^� ®v"1fJ`� .-.'i�z-el BUILDING INSPECTOR
. ....................................................................................................
05n.�. 5'J.... Foundation
...has permission to erect .......................... buildings on . ........ ..................................
�i �a Rough
to be occupied as er� we.....\. 7 ' - ...... Chimney
............. ....... .�. .. ..................... ..... "�............................
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
IT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
LESS CONSTRUCTIOlf A Rough
Service
................................................................................ Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required t® Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
NORTH ANDOVER OLDE CENTER HISTORIC
DISTRICT COMMISSION
Certificate of Appropriateness
This Certificate of Appropriateness is issued this
Thirty day of April 2015 to John & Donna Crawford for
139 Osgood Street in accordance with Chapter 40C of the
General Laws of the Commonwealth of Massachusetts as
amended and the by-laws of the North Andover Olde
Center Historic District Commission.
This will allow for windows to replace screen in porch
porch with the plans and narrative approved at this
meeting.
George H. Schruender, Jr. Chairman
Kath yska
David Mermelstein
Martha Larson
Les '-e Fraziel
�y Az '
R r L son
M 1_4ard S r
Michael Lenihan
Q 110Rrh TOWN OF NORTH ANDOVER
3�6s`;`.o " OFFICE OF
° p BUILDING DEPARTMENT
�o J 1600 Osgood Street Building 20, Suite 2-36
North Andover, Massachusetts 01845
P� t,
9SSACNUS��
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:6/18/2015
JOB LOCATION: 139 Osgood St
Number Street Address Ma /Lot
HOMEOWNER John Crawford (978)258-8780 (978)273-4674
Name Home Phone Work Phone
PRESENT MAILING ADDRESS 139 Osgood St
North Andover MA 01845
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less
and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the
owner acts as supervisor). State Building (Code Section 108.3.5.1)
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be
considered a homeowner.
The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other
Applicable codes,by-laws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE 61M415-
APPROVAL
!APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
The Commonwealth of Massa chusetts
Department oflndustrialAccidents
7 . a 1 Congress Street, Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERAUTTING AUTHORITY.
Applicant Information ii ( �^ Please Print Le 'bl
Name(Business/Organization/Individual): �.J6 N\n1
Address: U3(� ���,�,r,�r 'S1
City/State/Zip: /V�r p�s e-� Phone#: 7 '���— �0
Are you an employer?Check the appropriate box: Type of project(required):
1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction
IF]I am a sole proprietor or partnership and have no employees working for me in g. ❑Remodeling
any capacity.[No workers'comp.insurance required.]
9. El Demolition
3. am a homeowner doing all work myself.[No workers'comp.insurance required.]t
10 [t�uilding addition
4. lam
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 11.❑Electrical repairs or additions
proprietors with no employees.
• 12.F1 Plumbing repairs or additions
5. 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet.
❑ 13.E]Roof repairs
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. 14.E]Other
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.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors 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-coniraclors have employees,tliey must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurancefor my employees.' Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lia#: 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 herebycertify r•t ��nd�penalflfpeijuiy that the information provided above is true and correct.
Signature- Date: /S
Phone#:
' g) S V r
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#:
Generated by REScheck-Web Software
CertificateCompliance
Project 139 Osgood St
Energy Code: 2009 IECC
Location: Essex County, Massachusetts
Construction Type: Single-family
Project Type: Addition
Climate Zone: 5
Permit Date:
Permit Number:
Construction Site: Owner/Agent: Designer/Contractor:
Compliance: 1.7%Better Than Code Maximum UA: 58 Your UA: 57
The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
Envelope Assemblies
Ceiling: Flat or Scissor Truss 131 38.0 0.0 0.030 4
Wall: Wood Frame, 161n. o.c. 126 19.0 0.0 0.060 4
Window:Wood Frame, 2 Pane w/Low-E 53 0.300 16
Wall: Wood Frame, 16in,D.C. 112 19.0 0.0 0.060 4
Window:Wood Frame, 2 Pane w/Low-E 33 0.300 10
Door: Glass 15 0.350 5
Crawl:Solid Concrete or Masonry 118 0.0 6.0 0.120 11
Wall height: 5.2'
Depth below grade: 3.0'
Insulation depth:4.8'
Floor:All-Wood joist/Truss Over Uncond. Space 131 38.0 0.0 0.026 3
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 2009 IECC requirements in
REScheck Version 5.5.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Name-Title Signature Date
Project Notes:
addition and renovation of kitchen
Project Title: 139 Osgood St Report date: 06/09/15
Data filename: Page 1 of 7
QUOTE NBR CUST NBR CUSTOMER P ENTEREDDATE ORDERED ORDER TYPE
3814674 1060462 6/30/2015 Quote Not Ordered Cash
ORDERED BY STATUS SHIP VIA DELIVERY AREA
JOHN None Whse Pickup SALEM WAREHOUSE
CLERK JOB NAME COUPON
gmh -Gaye Hicks OWN HOME
LINE# DESCRIPTION QTY UNIT PRIC XTENDED
12000-1 Majesty DH,Unit Size 30 x 67.25,RO 30.5 x67.75,EXTENDED 1 $763.30 $763.30
LEADTIME
Half Screen,Virtually Invisible Mesh,Screen Shipping Separate=No
Overall Glass Thickness=11/16",Double Glazed,Double Low E,
Argon Filled,DSB,Tempered,Custom Annealed IG=No,IG MFG
=HY
Window Label=Harvey,Single,White,Routed j
Unit 1:U-Factor=0.32,SHGC=0.34,VT=0.38,AL-,NFRC CPD
Number=HII M 26 00273 00002,Custom/Call Size Option=
Custom Size,New Construction -
Unit 1 Lower Glass, 1 Upper Glass:NFRC CPD Number=HE M 26
.-fi035-
00273 00002
Primed Pine,Base Color=White,Jamb Liner Color=White /
Sim Div Lite,Colonial,White,Interior Finish=Primed,4W3H ;
6 9/16",4 Side Field Applied
Applied Nail Fin
Overall Rough Opening Width=30.5,Overall Rough Opening
Height=67.75
Room Location: TEMP
LINE# DESCRIPTION QTY UNIT PRICE EXTENDED,
13000-1 Majesty DH Sash Only Top Only,Unit Size 32 x 60.25,RO 32.25 x 1 $330.38 $330.38
60.5,EXTENDED LEADTIME
Unit 1 Lower:Overall Glass Thickness=11/16",Double Glazed,
Double Low E,Argon Filled,DSB,Tempered,Custom Annealed IG
=No,Custom Temp IG,IG MFG=GD 1 9
Unit 1 Upper:Overall Glass Thickness=11/16",Double Glazed, o 8
Double Low E,Argon Filled,DSB,Tempered,Custom Annealed IG
=No,IG MFG=HY
Window Label=Harvey, Single,White,Routed
Unit 1:NFRC CPD Number=HII M 26 00273 00002,Sash Only,
Custom/Call Size Option=Custom Size,Replacement Part Location 32 -.
AO-3221
=Top Only,Reason Remade=Charge Order,Replacement
Unit 1 Lower Glass:NFRC CPD Number=HII M 26 00198 00001
Unit 1 Upper Glass:NFRC CPD Number=HII M 26 00273 00002
Primed Pine,Base Color=White,Jamb Liner Color=White
Unit 1 Bottom:None
Unit 1 Top: Sim Div Lite,Colonial,Match Frame,Interior Finish=
Primed,4W3H
Overall Rough Opening Width=32.25,Overall Rough Opening
Height=60.5
Room Location: TOPITEMP
Page 2 Of 5
QUOTE NBR CUST NBR CUSTOMER P ENTERED DATE ORDERED -ORDER TYPE
3814674 1060462 1 6/30/2015 Quote Not Ordered I Cash
ORDERED BY STATUS SHIP VIA DELIVERY AREA
JOHN None Whse Pickup SALEM WAREHOUSE
CLERK JOB NAME COUPON
gmh -Gaye Hicks OWN HOME
LINE# DESCRIPTION QTY UNIT PRICE EXTENDED'
14000-1 Majesty DH Sash Only Bottom Only,Unit Size 32 x 60.25,RO 1 $330.38 $330.38
32.25 x 60.5,EXTENDED LEADTIME
Unit 1 Lower:Overall Glass Thickness=11/16",Double Glazed,
Double Low E,Argon Filled,DSB,Tempered,Custom Annealed IG
=No,IG MFG=HY
Unit 1 Upper: Overall Glass Thickness=11/16",Double Glazed, o s
Double Low E,Argon Filled,DSB,Tempered,Custom Annealed IG
=No,Custom Temp IG,IG MFG=GD
Window Label=Harvey, Single,White,Routed
Unit 1:NFRC CPD Number=HII M 26 00273 00002,Sash Only,
Custom/Call Size Option=Custom Size,Replacement Part Location ----- ---
RO.327 -+
=Bottom Only,Reason Remade=Charge Order,Replacement
Unit 1 Lower Glass:NFRC CPD Number=HII M 26 00273 00002
Unit 1 Upper Glass:NFRC CPD Number=HII M 26 00198 00001
Primed Pine,Base Color=White,Jamb Liner Color=White
Unit 1 Bottom:Sim Div Lite,Colonial,Match Frame,Interior Finish
=Primed,4W3H
Unit 1 Top:None
Overall Rough Opening Width=32.25,Overall Rough Opening
Height=60.5
Room Location: BOT/rBMP
LINE# DESCRIPTION QTY -UNIT PRICE EXTENDED
15000-1 Majesty Awning,Unit Size 37.75 x 15,RO 38.25 x 15.5 3 $444.63 $1,333.89
Overall Glass Thickness=7/8"Insulated,Triple Glazed,Double Low
E,Krypton Filled,Custom Annealed IG=No,IG MFG=HY
Energy Star
Unit 1:U-Factor=0.27,SHGC=0.22,VT=0.37,AL-,NFRC CPD T T
Number=HII M 24 00393 00001,Custom/Call Size Option=
Custom Size,New Construction,Fixed Vent 110 1
Unit 1 Glass:NFRC CPD Number=HII M 24 00393 00001
37 75 --
Primed Pine,Base Color=White ao-�75
Window Label=Harvey
Sim Div Lite,Colonial,Match Frame,Interior Finish=Primed,
4W1H
6 9/16",4 Side Field Applied
Applied Nail Fin
Overall Rough Opening Width=38.25,Overall Rough Opening
Height= 15.5
Room Location:
Paae 3 Of 5
HARVEYManufacturin
ACKNOWLEDGEMENT
AN Iff. BUILDING PRODUCTS
Harvey Industries,Inc.
1400 Main Street.Waltham,MA 02451-1689 Dealer Quote
(781)899-3500 harveybp.com Summary
BILL TO: SHIP TO: Salem
413 Raymond Road
SALEM,NH 03079-9283
Phone:(603)893-1611 Fax:(603)893-8196
CRAWFORD DESIGN CRAWFORD DESIGN 111111111
II IIII �RN
� ���I�1)111111
139 OSGOOD ST 139 OSGOOD ST
NORTH ANDOVER,MA 01845-0000
NORTH ANDOVER, MA 01845-0000
Phone: 978-2734674 Fax: 0 Phone: 978-2734674 Fax: 0
QUOTE NRR CUST NBR CUSTOMERPI ENTERED: DATEORDERET ORDER TYPE 1
3814674 1060462 1 6/30/2015 Quote Not Ordered I Cash
ORDERED BY STATUS SHIP VIA DELIVERY AREA
JOHN None Whse Pickup SALEM WAREHOUSE
CLERK JOB NAME COUPON
gmh -Gaye Hicks OWN HOME
LINE# DESCRIPTION QTY UNIT PRICE EXTENDED
10000-1 Majesty DH,Unit Size 37.75 x 67.25,RO 38.25 x 67.75 3 $705.17 $2,115.52
Half Screen,Virtually Invisible Mesh,Screen Shipping Separate=No
Overall Glass Thickness= 11/16",Double Glazed,Double Low E, —
Argon Filled,Custom Annealed IG=No,IG MFG=HY -
Window Label=Harvey,Double Locks,White,Routed
Unit 1:U-Factor=0.3,SHGC=0.24,VT=0.4 1,AL-,NFRC CPD
Number=HII M 26 00213 00002,Custom/Call Size Option=
Custom Size,New Construction
Unit 1 Lower Glass, 1 Upper Glass:NFRC CPD Number=HH M 26 —
00213 00002
Energy Star
Primed Pine,Base Color=White,Jamb Liner Color=White
Sim Div Lite,Colonial,White,Interior Finish=Primed,4W3H
6 9/16",4 Side Field Applied
Applied Nail Fin
Overall Rough Opening Width=38.25,Overall Rough Opening
Height=67.75
Room Location: None Assigned
LINE# DESCRIPTION QTY UNIT PRICE EXTENDED
11000-1 Majesty DH,Unit Size 30 x 67.25,RO 30.5 x 67.75 1 $678.67 $678.67
Half Screen,Virtually Invisible Mesh,Screen Shipping Separate=No
Overall Glass Thickness= 11/16",Double Glazed,Double Low E,
Argon Filled,Custom Annealed IG=No,IG MFG=HY —1—'-�-
Window Label=Harvey,Single,White,Routed
Unit 1:U-Factor=0.3,SHGC=0.24,VT=0.4 1,AL-,NFRC CPD
Number=HII M 26 00213 00002,Custom/Call Size Option=
Custom Size,New Construction —
Unit 1 Lower Glass, 1 Upper Glass:NFRC CPD Number=HII M 26
00213 00002 1
Energy Star
Primed Pine,Base Color=White,Jamb Liner Color=White
Sim Div Lite,Colonial,White,Interior Finish=Primed,4W3H
6 9/16",4 Side Field Applied
Applied Nail Fin
Overall Rough Opening Width=30.5,Overall Rough Opening
Height=67.75
Room Location: None Assigned
Page 1 Of 5