HomeMy WebLinkAboutBuilding Permit #771-11 - Lot 19 79 Empire Drive 5/16/2011TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO:—/7/—// Date Received
Date Issued:
ORTANT: Applicant must complete all items on this page
T.nC'.ATTnN
Print
PROPERTY OWNER - ",A K 1 LLACS e:- L -L- C -
Print
MAP NO: V C PARCEL:O//ZZONING DISTRICT;. Historic District yes
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
Clew Building
One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
[D Septic f� Well "
O�Floodplain Wetlands
'� 'Wat shed D strict
_N
f.
, DESCRIPTION OF WORK TO BE PERFORMED:
I e 1 f 2%Z -
c IPA N 64 ctr. -�A-S
Nentification Please Type or Print Clearly)
OWNER: Name: Phone: .-9� �
:n' e-jb AAA 0l9z f'
CONTRACTOR Name: Phonelffn?t -3/6 2s
Address z
Supervisor's Construction License: �� dry 31 Exp. Date: Z
Home Improvement License:/ I-, C[ Exp. Date:
ARCHITECT/ENGINEER Phone:' ?3)�
Address: 179EPR fA)apoftA.,t-�MROReg. No. C Y -
FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Coat: $ -13 04L 5-00 FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
-1
Location
No. -7 7 / -
Date
TOWN OF NORTH ANDOVER
� R
lipa ; : Certificate of Occupancy $
/t% 0
JCC Building/Frame Permit Fee $ �% % O 2
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ 0 2
Check #
241 J6
Buil ing Inspector
Plans Submitted �1` Plans Waived ❑ Certified Plot Plan A Stamped Plans X
TYPE OF SEWERAGE DISPOSAL
Public Sewer A
Well ❑
Private (septic tank, etc. ❑
Tanning/Massage/Body Art ❑
Tobacco Sales ❑
Permanent Dumpster on Site ❑
Swimming Pools ❑
Food Packaging/Sales ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Co
r4 Conservation Decision: Comm
Water & Sewer Connection/sianatura&oa6�
a
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dump�bja yes.
Located at 124 Main Street
Fire Department signature/date
COMMENTS
11:�-5 —/
Located 384 Osgood Street
no _
Dimension
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.$100-$1000 fine
NOTES and DATA — (For department use
® Notified for pickup - Date
Doc:.Building Permit Revised 2008
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, 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
❑ 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
MOTE: 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
Chat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
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The Commonwealth of Massachusetts
Department of Industrial.Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
qV www.mass.gov/d'ia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Na1'ne (Business/Organization/Individual):
Address: /-/ y (n P_kE4% )'If Af1-2 1) k I Ue-
��c
City/State/Zip_S G�P�� D� �Z� Phone #: �1,
Are you an employer? Check the appropriate box:
' L ❑ I am a employer with
4. ❑ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2. I am a sole proprietor or partner-
listed on the attached sheet. 1
ship and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. ❑ We are a corporation and its
required.]
officers have exercised their
3. ❑ I am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.] i
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. K New construction.
7. ❑ Remodeling .
8. ❑ Demolition
9. [] Building addition
10.❑ Electrical repairs or additions
11. ❑ Plumbing- repairs or additions
12.❑ Roof repairs
13.❑ Other
*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.
lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and joh site
information.
Insurance Company
Policy # or Self -ins. Lie.
Job Site Address:
Expiration Date:
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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
X do hereby cerrfl u er thepains andpenaldes ofperjury that the information provided above is true and correct.
SiunafnrP//;' Fl/t 1 UID�/filif� Date:-
Official use only. Do not write in this area, to be completed by city or town official
City or Town:
Permit/License 4
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. EIectricaI Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone
,Zoy :l
7 0 0
70
--� OL�/ ��
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code
MAScheck Software Version 2.01 Release 2
CITY: North Andover
STATE: Massachusetts
HDD: 6322
CONSTRUCTION TYPE: 1 or 2
HEATING SYSTEM TYPE: Other
DATE: 5-14-2011
DATE OF PLANS: 08/08/09
TITLE: The Foxbrook lot 19
PROJECT INFORMATION:
Orchard Village
79 Empire Drive
North Andover, MA
Family, Detached
(Non -Electric Resistance)
COMPANY INFORMATION:
Messina Development Co., Inc.
COMPLIANCE: PASSES
Required UA = 574
Your Home = 567
Permit #
Checked by/Date
Area or
Cavity
Cont.
Glazing/Door
Perimeter
-------------------------------------=-----------------------------------------
R -Value
R -Value
U -Value
UA
CEILINGS 841
38.0
0.0
25
WALLS: Wood Frame, 16" O.C. 2729
21.0
0.0
156
BSMT: Conc. 8.0' ht/8.0' bg/8.0' insul 0
0.0
0.0
0
GLAZING: Windows or Doors 239
0.320
76
DOORS 69
0.310
21
FLOORS: Over Unconditioned Space 1240
0.3
0.0
289
HVAC EQUIPMENT: Furnace, 96.0 AFUE
HVAC EQUIPMENT: Air Conditioner, 13..0 SEER
-------------------------------=-----------------------------------------------
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 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 the design load as specified in
Sections 780CMR 1310 and J4.4.
Builder/Designer Date
Massachusetts Energy Code
MAScheck Software Version 2.01 Release 2
The Foxbrook lot 19
DATE: 5-14-2011
Bldg.I
Dept.I
Use I
I CEILINGS:
[ ] I 1. R-38
I Comments/Location
I
I WALLS:
[ ] I 1. Wood Frame, 16" O.C., R-21
I Comments/Location
I
BASEMENT WALLS:
[ ] I 1. Conc. 8.0' ht/8.0' bg/8.0' insul, R-0 (uninsulated)
i Comments/Location
I
I WINDOWS AND GLASS DOORS:
[ ] I 1. U -value: 0.32
I For windows without labeled U -values, describe features:
I # Panes Frame Type Thermal Break? [ ] Yes [ ] No
I Comments/Location
I
I DOORS:
[ ] I 1. U -value: 0.31
I Comments/Location
I
FLOORS:
[ ] I 1. Over Unconditioned Space, R-0.3
I Comments/Location
I
I HVAC EQUIPMENT:
[ ] I 1. Furnace, 96.0 AFUE or higher
I Make and Model Number
[ l I 2. Air Conditioner, 13.0 SEER or higher
I Make and Model Number
I
AIR LEAKAGE:
[ ] I Joints, penetrations, and all other such openings in the building
I envelope that are sources of air.leakage must be sealed. When
I installed in the building envelope, recessed lighting fixtures
I shall meet one of the following requirements:
I 1. Type IC rated, manufactured with no penetrations between the
I inside of the recessed fixture and ceiling cavity and sealed or
I gasketed to prevent air leakage into the unconditioned space.
I 2. Type IC rated, in accordance with Standard ASTM E 283, with no
I more than 2.0 cfm (0.944 L/s) air movement from the the
I conditioned space to the ceiling cavity. The lighting fixture
i shall have been tested at 75 PA or 1.57 lbs/ft2 pressure
I difference and shall be labeled.
I
I VAPOR RETARDER:
[ ] I 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, glazing U -values, and heating and
cooling equipment efficiency 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.
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.
SWIMMING POOLS:
All heated swimming pools must have an on/off heater switch and
require a cover unless over 200 of the heating energy is from
non-depletable sources. Pool pumps require a time clock.
HVAC PIPING INSULATION:
HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F must be insulated to the following levels (in.):
CIRCULATING HOT WATER SYSTEMS:
Insulate circulating hot water pipes to the following levels (in.):
PIPE SIZES (in.)
NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS
HEATED WATER TEMP (F)': RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+"
PIPE
SIZES
(in.)
HEATING SYSTEMS:
TEMP (F)
2" RUNOUTS
0-1"
1.25-2"
2.5-4"
Low pressure/temp.
201-250
1.0
1.5
1.5
2.0
Low temperature
120-200
0.5
1.0
1.0
1.5
Steam condensate
any
1.0
1.0
1.5
2.0
COOLING SYSTEMS:
Chilled water or
40-55
0.5
0.5
0.75
1.0
refrigerant
below 40
1.0
1.0
1.5
1.5
CIRCULATING HOT WATER SYSTEMS:
Insulate circulating hot water pipes to the following levels (in.):
PIPE SIZES (in.)
NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS
HEATED WATER TEMP (F)': RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+"
170-180
0.5
1.0
1.5
2.0
140-160
0.5
0.5
1.0
1.5
100-130
0.5
1 0.5
0.5
1.0
----NOTES TO FIELD (Building Department Use Only)-------------------------
�T
LOT 19
EXIST.M.
TOF-291.7
25.9'
F,yiA�RFoR
FOUN DA TION LOCA TION
CLIENT:ORCHARD VILLAGE, LLC
LOCAWN. #79 EMPIRE DRAlFNORTHANDOVERMA.
DATE.5/12l11 SCALE.12*"'
lttv
LOT 20
PROFESSIONAL ENGINEERS & LAND SURVEYORS
CHRISTIANSEN & SERGI, INC.
160 SUMMER STREET, HAVERHILL, MASSACHUSETTS 01830
WWW.M-ENMCOM TEL 978373-0E310 FAX 978372 3960
DWG.NO.:06029-00LO47