HomeMy WebLinkAboutMiscellaneous - Exception (514)awr
TOWN OF NORTH ANDOVER
• BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER: DATE ISSUED:
SIGNATURE:
Building Commissioner/I for of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
a
10 Sfiipg S -F
1b7b
kin
Map Number Parcel Number
1.3 Zoning Information:
1.4 Property Dimensions:
?.3A
Zoning District Proposed Use
,
Lot Area s -Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
Required Provide Required Provided
Re red Provided
3
f
1.7 WaterS ly M.G.L.C.40. 54) 1.5. Flood Zone Information:
� Zone Outside Flood
L-8 Sewerage Disposal System: c
-11
Public Private ❑ Zone V/
Municipal 0 On Site Disposal System VI
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Name (Prin Address for Service:
57� SGS 5377
Signatory
Telephone
_,z
2.2 Owner ofRecord:
Name Print Address for Service:
Signature Tel hone
SE ION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Not Applicable - -
Licensed Construction Supervisor:
License Number
Address
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor r
Not Applicable
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
00
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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
`1T8-Zt„t-S3?
ARPLICANT � PHONE ��-�1 C)
LOCATION: Assessor's Map Number 4 D - y1 PARCEL L
SUBDIVISION LOT (S) d
STREET
ST. NUMBER �d
USE ONLY ******
RECO ENDAT ONS
F TOl
CONSERVATION AD INIS ATC
COMMENTS
PLANK R
COMMENTS SW/,/
FOOD
UMWJ
AGENTS:
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE -REJECTED
COMMENTS_. -r j� �ror
Uil� P
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PUBLIC WORks - SEWER/WATER CONNECTIONS
DRIVE . Y PERMIT
FIRE DEPARTMENT - 3
O
RECEIVED BY BUILDING INSPECTOR
Revised 9197 im
DATE
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 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 bellow.
1 t 1'rt t m5 -fairs i2ec;�_ Jta
Permit plicant Property address Map / Parcel
5)9 2(s -s.377
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 1 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 fora building permit for the enlargement, restoration or reconstruction of a dwelling in
existence as of the effective date of this 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 ten 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 7idjacent parcel on the effective date of this Section 8.7 and 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 parcel.
This application represents a lot which is ready fora 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 I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE
CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR
NOT IS GROUNDS FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT.
APPLICANTS SIGNATURE
DATE
THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION
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rRUCTUR£ SHOWN CONFORMS TO
IREM£NTS OF THE LOCAL
I EFFECT WHEN CONSTRUCTED.
CONSIDER ANY OTHER
NTS, WETLANDS.EASEMENTS,
SED BY THE CLIENT FOR ANY
TLINED ABOVE,EXCEPT WITH THE
IANSEN do SERGI INC.
THE COPYRIGHTED PROPERTY
AND ANY UNAUTHORIZED USE
NO RESPONSIBILITY
OR ANY INFOR—
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191
DWG. NO.: 02045004
g28.9'
Location
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Date
5
No.
NORTH
TOWN OF NORTH ANDOVER
? • • ow
F
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Certificate
♦
i
of Occupancy $
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Buildin /Frame Permit Fee $
9
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
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Check #_
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Building Inspector
0
rRUCTUR£ SHOWN CONFORMS TO
IREM£NTS OF THE LOCAL
I EFFECT WHEN CONSTRUCTED.
CONSIDER ANY OTHER
NTS, WETLANDS.EASEMENTS,
SED BY THE CLIENT FOR ANY
TLINED ABOVE,EXCEPT WITH THE
IANSEN do SERGI INC.
THE COPYRIGHTED PROPERTY
AND ANY UNAUTHORIZED USE
NO RESPONSIBILITY
OR ANY INFOR—
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191
DWG. NO.: 02045004
I I
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code Permit #
MAScheck Software Version 2.01
. I I
I Checked by/Date
I I
CITY: Andover
STATE: Massachusetts
HDD: 6322
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non -Electric Resistance)
DATE: 4-30-2004
DATE OF PLANS: 04/30/04
TITLE: WILLIS
COMPLIANCE: PASSES
Required UA = 501
Your Home = 417
Area or Cavity Cont.
Glazing/Door
Perimeter R -Value R -Value
----------------------------------------------------------------------------
U -Value
UA
CEILINGS 1384 30.0 0.0
49,
WALLS: Wood Frame, 16" O.C. 1988 19.0 0.0
120
GLAZING: Windows or Doors 501
0.340
170
DOORS 93
0.360
33
FLOORS: Over Unconditioned Space 1384 30.0 0.0
45
HVAC EQUIPMENT: Furnace, 92.0 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 requirements of the Massachusetts Energy
Code.
The heating load for this building, and the cooling load if appropriate,
has been determined us� g the applicable Standard Design Conditions found
in the Code. The HVA,i quipment selected to heat or cool the
building
shall be no greater n of esign load as specified
,
in
Sections 780CMR 131 n J4. .
Builder/Designer t�
0 J ` DateQ6f_
MASche.ck INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2.01
WILLIS
DATE: 4-30-2004
CEILINGS:
1. R -3d
Comments/Location
WALLS:
1. Wood Frame, 16" O.C., R-19
Comments/Location
WINDOWS AND GLASS DOORS:
1. U -value: 0.34
For windows without labeled U -values, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
DOORS:
1. U -value: 0.36
Comments/Location
FLOORS:
1. Over Unconditioned Space, R-30
Comments/Location
HVAC EQUIPMENT:
1. Furnace, 92.0 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 cfm (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
I. be determined. Manufacturer manuals for all installed heating
I and cooling equipment and service water heating equipment must be
I provided. Insulation R -values, glazing U -values, and heating
I equipment efficiency must be clearly marked on the building plans
I 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 20% of the heating energy is from
1 non-depletable sources.
I
Pool pumps
require a
time clock.
I HVAC PIPING INSULATION:
I HVAC piping conveying fluids
above
120 F or chilled
fluids
► below 55 F must be insulated
I
to the
following
levels
(in.):
PIPE
SIZES
(in.)
I HEATING SYSTEMS:
TEMP (F)
2" RUNOUTS
0-1"
1.25-2"
I Low pressure/temp.
201-250
1.0
1.5
1.5
► Low temperature
120-200
0.5
1.0
1.0
I Steam condensate
any
1.0
1.0
1.5
I COOLING SYSTEMS:
I Chilled water or
40-55
0.5
0.5
0.75
I refrigerant
below 40
1.0
1.0
1.5
2.5-4"
2.0
1.5
2.0
1.0
1.5
1
[ ] I CIRCULATING HOT WATER SYSTEMS:
I 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" I 0-1.25" 1.5-2.0" 2.0+"
170-180 0.5 I 1.0 1.5 2.0
140-160 0.5 I 0.5 1.0 1.5
4 . `
I, 100-130 0.5 I 0.5 0.5 1.0
•I
-NOTES TO FIELD (Building Department Use Only) -------------------------
I
6
THE COMMONWEALTH OF MASSACHUSETTS
DEPARTMENTOFPUBIICS MY
BOAROOFFIREPREVEMONRBGULA77ONS527CAR 12.00
Office Use only
Permit No. �1 i TO 1-1
Occupancy & Fees Checked 64Z
"—I'
APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
e
Location (Street & Number) 'D 5T 11 S 5T_
r
Owner or Tenant J1(\
Owner's Address
Is this permit in conjunction with a building
\ ipermit: Yes ® No (Check Appropriate Box)
Purpose of Building e W t"0 V1\-�Z— Utility Authorization No. 7�
Existing Service AmpsVolts Overhead 1-3 Underground No. of Meters
New Service 00 Amps i / Volts Overhead =Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool AboveBelow
Generators
KVA
round
round
No. of Emergency Lighting Battery Units
No. of Receptacle Outlets
No. of Oil Burners
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municipal
Other
No. of Dryers
Heating Devices KW
Connections �
No. of Water Heaters KW
No. of No. of
Si ns
Bailasis
J No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER; 1� " OAK— () o lM�
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(Please check one) Owner Agent
Telephone No. PERMIT FEE
signature of Owner or Agent