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Building Permit # 9/28/2016
%AORTH OWING PERMIT 't B 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINAT!O Permit NO: Date Received Date Issued: L t5b CH Im ORTANT. Applicant must coniplate all items on this page ON, LOCATI r in t V -PROPERTY QW, stei �d G Hl�t&:' CEL ' ZQN 1, 10 "Ict" Rl �60 I ll in Sh -Ahll' PE OF IMPROVEMENT PROPOSED U' Residential Non- Residential New Building One faW, 'Addition Two or mo e, family Industrial i Alteration No. Of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other e an- s,,- Q 's tl ' d rs r trlet dmlti-lo"i�' J dwk 0/ 2 Identifleation Please Type or Print Clearly) OWNER: Name: J o d,,4 4 I)e-2,11 Phone: Si /,,5 1W(5 k?<1 A,10i:�' 4'Ck)Vt"'-J lh4 77777�77 7 7 CONTR 7-7-- 7 A ress:, A dd t tx ba' P 7 D 't ARCHITECT/ENGINEER— Phone: Address: Reg. No. FEE SCHEDULE:SULDING PERMIT. $12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 0 0 FEE: $ 6i�� Check No.: Receipt No.: Ji Permit 0' Issued: b IM 01 0 D Y e (b h NOTE: Persons contracting with unregistered contractors do not have access q the guar my nd 9 wn r tbre 6, bbritrac,or 8ighatote 6fA 'Ont/b ` 6� signa, 'f t' Plans Submitted ❑ Plans Waived ❑ C lot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DTSPS L Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private{septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ Izzoo(Q.— COMENTS )CONSERVATION ❑ ❑ - to.4-1 COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: ) Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature& Date DrivewaV Permit Located at 384 Osgood Street .l."'Q❑er f I ee` ,� ems`" ""�� °��r a � � i ^ � �/ P"•.� 8 X711 1 p,r. � ] �'. n.,Y,ry� " ^� .�' � � .,. "s ?� � ���k w rvs i 'r s p� 8 I 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 966 section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) f ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 F NORTf '9 Town of 2 6ndover 1341., J011 h ver, Mass O I. K. �. 1 P � 3 U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT .............%7*-A .....AV. ,................. ,........................... .............. ... BUILDING INSPECTOR has permission to erect JO...... �ult.L.... Foundation rh to be occupied as .. .. . . . I . Rough .. . ..VA. .. .. .. ��.... .,... �....�...... Chimney provided that the person accepting is permit shall in eve r!s ect conform tot terms of e application every p pp 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 261(olm Rauh VIOLATION of the Zoning or Building Regulations Voids this Permit. !3 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSJA1qTI0 Rough Service .. BUIL©I� PECT. Final GAS INSPECTOR ®ecu ancy hermit Required t® Occupy Buiddiu 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. 9.15-16 Allen Residence 4:06pm 1 of 2 10 Silsbee Road North Andover,MA rMember Nnp w 1521 Application: Floor Clete Member Type: ream ion:Basement Beam Top Lateral Braeing: Continuous r Bottom Lateral Bracing: Continuous Building Code: IBCARC Moisture Condition: Dry .000n max. LL Standard Load: Deflection Criteria: L1360 live, 0240 total 1 Member Weight: 13.6 PLF PLF Live Load: 40 Deck Connection: Nailed Dead Load: 10 PLF Filename: Beam? Other Dead End Category leer Loads End Width Start End start Live (Dee Side Begin 14' 6.00" 40 10 Live scription) 0" 0.00" 17 4.50" 40 Snow Additional Uniform(PSF) Tap 17' 4.50" 21' 8,00" 9110.001, 1172 613 Snow Additional Uniform(PSF) Top 8' 8.25" 1172 613 Snow $" 8.25" Point(LBS) Top 2432 783 Tap Point(LBS) To 8' 8.25" Point LBS r f 5 012 1 64 5 812 0 0 21 8 0 Min Gravity Gravity Bearings and Reactions input Length Required Reaction uplift mat 1.500" 2759# Location Type all SPF Plate(425psi) 5.500" 11189# 1 p' 0.000"° Wall Steel 4,500" 4.988' 2 8' 8.250" Wali 4.500"" 1.818" 4636# Wall Steel 4.500" 1.629" 4154# 3 14' 5.000"' Steel 1.500" 439# 1576# 4 20' 1.750" Wall SPF Plate 425 i 3.500" 5 21' 8.000" Wall Maximum Load Case Reactions U�sdtorappiongpointtoads(orline toads)tocarrying members nowDead Live of 569# 1 2190# 3461# 2 5528# 4776# 78311 3 3853# 7590 5 374# Orb 201# Design spans5' 8.750„ 5' 8,750" ' 1' 3.625" 8' 3,626' � Product: Spruce-Pine-Fir #2 2 x 12 4 pig' PAM 11730,"; DESIGN CHECKS Connect members with 2 rows of 1/2"diameter bolts at 24.0"oc Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Review gravity uplift reaction force of 1577lbs at bearing 5 and ensure that the structure can resist appropriately. p y. �llfaweble Stress Design� Loading Actual Allowable Capacity Location 10613.'# 45% 3.71' Odd Spans D+L Positive Moment 4814.'# 49% 8.89' Adjacent 1 D+L Negative Moment 31654# 10813,# Adjacent 1 D+L 31.64.# 6075.# 52% 7.86' 1 Shear 12431.# 900/4 8.69' Adjacent 1 D+0,75(L+S) Max.Reaction 11189.# 0,2767"' U999+ 4,12' Odd Spans L LL Deflection 0.0429" 0,4151" U999+ 4.12' C7dd S ons D+L TL Deflection 0.0530" Control: Max,Reaction DOLS: Live-100% Snow-115% Root=125°/4 Wind-160°! This Design i7ases$beocreas n tltivS designed•inacco dr use er s, with DB 25r. a in bending tress 15% All product names are tmdbmarusor their respective owners copy"igh1(cl 2015 by Simpson Strong•Tle company Inc.ALL RIGHTS RESERVED. on ..o.,."„n"�d"rmnd as Wnan the member,go4rJ4ttA,boom orQhde drowm on oils drawing rooeot. lspolednn acdesign nos r41,�du ofor insatl 81ion aacoNinnto aro"manufeaiurorsed c1114lmtonsot.The 9-15-16 Allen Residence 3:32pm 10 Silsbee Road 1 of 1 ,1w g y i.A ID f 1`f North Andover,MA -S Beans 4.1702 olllri is nn}lef,;, eber Data Application:Application: Floor Hemmer Type: Beam Description:front Window Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous mmmmuolumuuuuomrN Moisture Condition: Dry Building Code: IBCAR Live Load: 40 PLF Deflection Criteria: U360 live, L1240 total 1 Mem�beaWeight: 6.3 PLF Dead Load: 10 PLF Deck Connection: Nailed Filename: Beams Other Loads TO. other Dead End Start End Category Type in £nd %dth �55 15 Snow (Description) Side 0'000„ B' 0.00" a" 0.00" 10 10 Live Additional Uniform(PSF) TOPTo 0" 0.00" a' 0.001" 2' 6.00" Additional Uniform PSF aao (L sa0 Bearings and Realations Input Min Gravity Gravity Location fype Material Length Required Reaction NIA Upift 1.646' 2449# V 0.000" Wl 1 0' 0.000" Wail SSPF Plate(425psl) PF Plate 425 i N/A 1.646n 2 al Maximum Load Case Realctions Ussdlorapplying point toads(or lino loads)tocarrying mernlArD Dead Live Snow 657# 265# 1792# 2 2604 1782# 657# Design spans q 1.754" r duet: 2.0 i i L M LVL 1®3/4 x 7-1/4 2 ply Connect members with 2 rows of 16d common nails at 12.0"oc Minimum 1.65"bearing required at bearing#1 Minimum 1.65',bearing required at bearing#2 Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chard. Allowable 5iress design AIlowabie capacity Location Loading Actual 4' Total Load D+S 4987,'# 9701:# 51% 4! Load D+S Positive Moment5642.# 36% 7.6T Shear 2086.# V364 4' Total Load D+S S Deflection 4.2660" 0.4073" 4' Total Load S 0.1961" 0.271 LL Deflection 5" L498 Control: LL Deflection NOLs: Live-100% Snow-115% Roof=1251/. Wind-16C% NIP,, names aro trademDrtts of(nDlr rospDaUwD owmDrs c0pydght(C)20t5bySIM nC>t,Dng.Moconipany Inc.ALL RIGHTS RES@ft'V6h. deal nmust bolmwrodbDna QU011110 deflonarord fan omDalonaoasre a Ddaoradowa�fThsdabnedo msarmductlnalalionaDYonrdltotthDma Naotrersd�ciEalaclonDl 7ha Allen Residence 9-15-16 10 Silsbee Road 3:13pm North Andover,MA 1 of 1 "S Beam 4,17,0.2 rember % 1527 [data ��;,n.Main Ridge Member Type: BeamApplication: Roof Top Lateral Bracing: Continuous Slope: 0.00/ 12 „u ,o,u . a�m�uuuumuuummrr Bottom Lateral Bracing: Continuous Standard Load. Moisture Condition: Dry Building Code: IBC/!RC Snow Load: 50 PLF Deflection Criteria: U240 live, 0180 total 1.000" max. LL Dead Load: 15 PLF Deck Connection: Nailed Member Weight: 28.0 PLF Filename: Beam Other Loads TWO Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Additional Uniform(PSF) Top 0' 0.00" 21' 8,00" 6 6.00" 55 15 Snow Additional Tapered(PLF) Top 0' 0.00" 8" 8.26" 239 55 66 15 Snow Additional Tapered(PLF) Top 8' 8.25" 17' 4,50" 55 239 15 66 Snow Additional Uniform(PSF) Top 17' 4,50" 21' 8.00" 4" 4.13" 55 15 Snow 21 8 a 21 8 a Bearings and Reactions Input Min Gravity Gravity Location 11)pe Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF Plate(425psl) 5.500" 2.604" 7746# 2 21' 8.000" Wall SPF Plate 425 I 3.500" 2.748" 8175# Maximum Load Case reactions used for applying point loads(or cine toads)to carrying members Snow Dead 1 5840# 1906# 2 6178# 1997# Design spans 21' 0.750" Product: 2.0 RigidLam LVL 1®314 x 16 4 ply t A,33SDEMN CHECK Connect members with 2 rows of 112"diameter bolts at 24.0"oc Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Ziwabia Stress Design Actual Allowable Capacity Location Loading Positive Moment 40033.'# 89019.1# 44% 11.28' Total Load D+S Shear 70394 249011 28% 20.39 Total Load D+S Max.Reaction 61751 10412.# 78% 21.67' Total Load D+S TL Deflection 0.6732" 1.4042" U375 10.92' Total Load D+S LL Deflection 0.5074" 1.00001" U498 10.92' Total Load S Control: Max.Reaction DOLS: Uve-100%e Snow.11501. Roof=1251% Wind=160°/6 Design assumes a repetitive member use increase in bending stress: 4%6 All product names are trademadrs of their respective owners Copynpht(C)2015by Simpson Strong-TIOCompany Inc.ALL RIGHTS RESERVED. -PaWag todattnod MWIlan the member,Etacc)oia,beam or girder,sirawn on thls drawing"tsetse pppbcable dedgn cdteda for Loads,Loading Conditions,and Spans Ps1ed on thisshoel.The dad nmudbereviewedb a ualiliedde nerordod n mfeseVonaiasro uiredfora roval,Thisded names roduotinst Ila'onaocordln to Chamnnulacturora ecitictmons. Allen Residence 9-15-16 10 Silsbee Road 3:32p1n Nortb Andover,MA 1 of 2 .S Beam 417.0.2 mttfeudld 44 w�tS27u I amber Data Description:Porch Beam Member Type: Beam Application: Floor �w Top Lateral Gracing: Continuous Bottom Laterat Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: 18C/IRC Live Load: 40 PLF Deflection Criteria: U360 live, 0240 total 1.000" max, LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 9.5 PLF Filename: Beam6 Other Dada Two "rrib. Other Dead (Description) Side Begin End Width start End Start End Category Additional Uniform(PSF) Top a 0.00" 21' 4.50" 2' 6,00" 10 i0 Live Additional Uniform PSF To 0' 0.00"' 21 4.50'" 5' 6,00" 55 15 Snow 0 3314' 2 0 0 1210 4 0 2 0 0 0 4 2 $ 21 4 8 Bearings and Reactions Input Min Gravity Gravity Location 'type Material Length required reaction Uplift 1 0' 3.750" Wall SPF Plate(425psi) 3.500" 1.500" -2477# 2 2' 3.750" Wall SPF Plate(425psi) 3.500" 2.683" 5987# -- 3 15' 2.000" Wall SPF Plate(425p$l) 3.500" 2.361" 5269# -354# 4 17 2.000" Wall SPF Plate 425 sill 3.5001' 1.566" 3490 -1121# Maximum Load Case Reactions Used for apptylag point foods(crime ioadetto carrying members Live Snow Dead 1 -393# -1631# - 2 907# 4222# 1766# 3 692# 414911 1119# 4 649# 3019# 4754 Design spans 0' 3.750"(left cant) 0 UIV 12 10.250" 2 0.000" 4' 2.500"(right cant) Product: 2,0 RigidLam LVL 1.3/4 x 7-1/4 3 plySie�l�,� DESIGN CHECKS Connect members with 2 rows of 16d common nails at 12.0"oc NOTE:Fails must be applied from both skies Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Review gravity uplift reaction force of 2477lbs at bearing 1 and ensure that the structure can resist appropriately. Review gravity uplift reaction force of 355lbs at bearing 3 and ensure that the structure can resist appropriately. Review gravity uplift reaction force of 1122lbs at bearing 4 and ensure that the structure can resist appropriately. Mlowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 3597,'# 15134.'# 23% 8.74' Odd Spans D+S Negative Moment 5525.'# 15134.'# 36% 2.31' Adjacent 2 D+S Shear 2931.# 8463.# 34% 1.71' Adjacent 2 D+S Max.Reaction 59874 86461 69% 2.31' Adjacent 2 D+S TL Deflection 0.2267" 0.6427" U680 8.74' Odd Spans D+S LL Deflection 0.1601" 0.4285" U963 8.74" Odd Spans S DeftLt. 0.0029" 0.2000" 2U999+ 0' Odd Spans D+$ TL Def LL Deft.,Lt. 0.0021" 0.2000" 2U999+ 0' Odd Spans S TL Defl.,Rt. 0.1783" 0.4208"" 20566 21,38' Odd Spans D+S LL DOI,,Rt. 0.1262" 0.2806" 2U800 21,38" Odd Sp2ns S All product namos are trademarks of their respective owners CONright(C)2418 by Simpson Strong-Me Company lnc.ALL RIGHTS RESERVED. on this dod�n mustb@lr@v gvrod b a uaYVt ed d@a�nero dation root@tonal arra uHed oe� 3 meets applica tppbn alum@s droduc�inalolidoliona�@ardtnndio`the Spans and ctYrcallarrrs.I,The Allen Residence 9-15-16 ;J, 1 10 Silsbee Road 3:21pm North Andover,MA I of I CS Beam 4.17.0,2 kri6earnm0r, 1.7,1 0041 Member Data( Application: Roof description:Rear Valleys 0 Member Type: Beam 111111ill Top Lateral Bracing: Continuous Slope: 6.00/ 12 Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Snow Load: 50 PLF Deflection Criteria: U240 live, U180 total 1.000" max. LL Dead Load; 15 PLF Deck Connection: Nailed Member Weight: 8.3 PLF Filename: Beam3 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Additional Tapered(PLF) TOP 01 0,'001, 12' 6.50" 239 65 66 15 Snow Additional Tapered PLF� _Tap 0. 0.00" 12' 6,50" . 239 55 66 15 Snow rn ........ 12 6 8 12 6 a Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 01 0.0001, Wall SPF Plate(425psi) N/A 2.326" 3459# 2 12' 6.500" Wall SPF PIat6 425 i N/A 1.603" 2385# Maximum Load Case Reactions Weed for applyloo point loads for lino loado)to carrying Inarabom Snow Dead 259311 867# 2 1177211 613ft Design spans 14' 2.250" Actual Length 14'5.000" Product: 2.0 Rigidi-arn LVL 1-3/4 x 9-1/2 2 ply 0 Connect members with 2 rows of 16d common nails at 12.0"oc Minimum 2.33"bearing required at bearing#I Minimum 1.60"bearing required at bearing#2 Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. flowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 9339,'# 16104,W 57% 5.64' Total Load D+S Shear 25974 7393.# 35% -0.06 Total Load D+S TL Deflection 0.6712" 0.9457" U253 6.29 Total Load D+S LL Deflection 0.5013" 0,7093" U339 6.26 Total Load S Control: T1.Deflection DOLS: Live-100% Snow-115% Roof-125% Wincim160% All product names are tradoatoiksol their(espootive owners Copyright(0)2015 by Simpson Strong-'re company lsc.AlA.SIGHS AESERVr.11 [Bdoli"ed as when the member,floor joist,beam of g1rder,shoma aii this draMilti meals applicable doeign Criteria for 1-08dS,Lo=,,",,dJ.fion,�,.a,,d Spanslhtwd on lhissheot.Pie de'q a must be reviewed by a qigjgL�� sproyffl,'1711100 n aspirao 9999=i ca "ItAdolurees Allen Residence 9-15-16 10 Silsbee Road 3:1.6prn NorthAndover,MA I of 1 CS Bc in:t,17.0.2 kmBcafflE4 4,113.7,1 16i Jnr eraber Data � Description:Near Ridge Member Type: Beard Application: Roof � fw„t Top Lateral Bracing: Continuous Slope: 0.00! 12 Bottom Lateral Bracing: Continuous Standard Load: Moisture Cond+tion: Dry Building Code: IBCARC Snow Load: 50 PLF Deflection Criteria: U240 live, L/180 total 1.000'” max, LL Dead Load: 15 PLF Deck Connection: Nailed Member Weight: 14.8 PLF Filename: Beam2 Other Loads Type Trib. Cather Dead (Description) Side Begin End Width Start End Start End Category Additional Uniform(PSF) Top 0' 0.001, 5' 0.001' 8' 8.25" 55 15 Snow Additional Tapered(PLF) Top 5' 0.00" 15' 0.00" 239 55 66 15 Snow Additional Tapered(PLF) Top 5' 0.00 15' 0,00" 239 55 66 15 Snow 15 0 0 15 0 0 Bearings and Reactions Input Min (gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0,000" Wall SPF Plate(425psi) 5.500" 1.982" 4423## 2 15" 0.000" Wall SPF Plate(425psi) 5.50.0" 1.500" 3215# Maximum Load Case Reactions Used for applying point loads(or fine loads)to carrying mambsrs Snow Dead 1 3382# 1041# 2 2432# 783# Design spans 14' 2.750" Products 2,0 RigidLarn LVL 1-3/4 x 11-1/4 3 ply Connect members with 2 rows of 16d common nails at 12,0"oc NOTE:(Nails must be applied from both sides Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. ,Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 1424031 34493.'## 41% 6,99' Total Load D+S Shear 37781 131321 28% OA' Total Load D+S Max.Reaction 4423.# 12272.# 36% 0' Total Load D+S TL Deflection 0.4118" 0.9486" 0414 7.5' Total Load D+S LL Deflection 0.3137` 0.7115" U544 7.5' Total Load S Control LL Deflection DOLS: Live-`100% S=V-115°/6 1`1001=125% W1nd=180% Design assumes a repetitive member use Increase in bending stress: 4%e .._... All product names ane uadarnarksolthel(respectiveowners Copyright(G)2pt5 by Simpson Strong-no company Inc.ALL.RIGHTS RESERVED. "Pang is delinod as when the member,it oar joist,boam or glyda,,stravrn on Uris drawing rnaola applicable design criteda.for Loads,Loading Carxt'rtions,and Spans listed on thisshaet.The design mu WontvEo•xadbyaRualilloddadgnorordedgnpmro..melaererf it foraP(?ravpl TYSRSdot# na5EJJmes roductinstallaliaracaordlntotkeomanulaglurgr's acr ifiomlfmrs, Allen Residence 9-15- r' 10 Silsbee Road 3:24p1 North Andover,MA 1 of ku � 7 koou�o memo tiui76to ktttnaaq� arta�:rs t527 r ember Data " Description:Fridge deader % Member Type: Beam Application: Floor w ��I�° Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: iBCARC Live Load: 40 PLF Deflection Criteria: U360 live, L/240 total 1.000" max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 6,3 PLF Filename: Beam4 Other Loads Type Trib. Other Dead (Description) Side Eegin End Width Start End Start End Categor Point LBS Top 1' 0.00" 6178 1997 Sno+ aoo C17 � 0 Sao Bearings and Reactions Input Min Gravity Gravity Location 'type Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF Plate(425psl) N/A 3.639" 5412# 2 3' 0,000" Wall SPF Plate 425 sl NIA 1.892" 2814# Maximum load Case Reactions Llsod for applying point loads(or Tina loads)to carrying members Live Snow Dead 1 63# 4071# 1342# 2 631E 2107# 707# Design spans 3' 1.750" Product: 2,0 RigidLam LVL 1-3/4 x 7-1/4 2 ply C'3 fl1"GKf� Connect members with 2 rows of 16d common nails at 12.0"o0 Minimum 9.64"bearing required at bearing#1 Minimum 1.89"bearing required at bearing#2 Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. A►ilvwabie Stress Design Actual Allowable Capacity Location Loading Positive Moment 5798,'# 9701,'# 59% 1' Total Load D+S Shear 5403.# 5642,# 950/0 406' Total Load D+S TL Deflection 0.0361" 0.1573" U999+ 1.34' Total Load D+S LL Deflection 0.0271" 0,1049" 0999+ 1.34' Total Load Control: Shear _M DQLs: Live=100% Snow�1150% Roof=1251% Wind=160% Ali product namosore Iradomadssof their mspecfivo ovmers Capydght(C)2015 by Simpson Shong�ne Company Ino.ALL RIGHTS RESERVED. "Passing In Uofinod as yMon tho membor,poor joist,(warn or oinfor,shown an thio dm%rino moors appticab9e design arileda for Loads,Loading Condilions,and Spans listed on lhls shoot.fin dasi nmust bo rovitruedloa uali1leddeb ner or desi n rofe:&onal asr uired lora roval.Tbladod no�umos �mduol Installation aaaorUln to rho manufacturer'socilications. Massachusetts Nome Improvement Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Itegulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Horneo,vvner Information Contractor Information Name: Jody Allen Name: Kevin Smith Smith Construction Company Address: 10 Silsbee Road Address: 37 Linden Avenue ]North Andover,MA 01845 North Andover,MA 01845 Phone: 978-857-3946 Phone: 978-687-7064 Mailing Address if different from above: Const. Super. Lic.# CS-102589 Exp. Date: 3/5/2017 HIC Lic. # 108511 Exp. Date: 8/19/2018 The Contractor agrees to do the following work for the Homeowner: Furnish all labor, materials,and equipment necessary to construct a 504 square foot in-law suite in accordance with the attached drawings dated 9/9/2016. The following permits are required and will be secured by Proposed Start Date: 9/28/2016 the contractor as the owner's agent: Building Permit Substantial Completion Date: 1/18/2017 Electrical Permit Plumbing Permit Total Contract Price and Payment Schedule The Contractor agrees to perform the work, furnish the material and labor specified above for the total sum of: S 68,000.00 Payments will be made according to the following schedule: 15% Excavation Completed 15% Foundation and Backfill Completed 35% Frame and Roof Completed 20% Insulation and plastering Completed 10% Painting,Cabinets,Flooring Completed 5% Occupancy Permit i I Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid home Improvement Contractor Re istration, The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document, • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Horne Improvement Contractor Law, You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight ofthe third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract must be completed acid signed. One copy should go to the homeowner. The other cop should be kept by the contractor. Ho owner's i nature Contractor's n tune Date Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action) if they have a dispute with a contractor. The same right is not automatically afforded to a contractor, however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Horne Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consul er shall be required to submit to such arbitration asp rovided In Massachusetts General Laws, el a ter 14 A. Hot eowner' Signature Contracto Signature NO ICE: T ie signatures of the parties above apply only to the agreement of parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A) and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way, even by agreement. However, homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular I'. purpose. Ail enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If You have questions about your consumer/homeowner rights, contact the Consumer Information Hotline(listed below). Execution of Conti-act The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both pat-ties. Contracted work may not begin until both parties have received a fully executed copy of the contract, and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However, in instances where a contractor deems birrilherself to be financially insecure, the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds froin said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights, or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170,Boston, MA 02116 617-973-8787, 888-283-3757 or visit the OCABR website at ht1ja.//W%A,wjnaSs.j,' )v/ocabr/ .............. If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Horne Improvement Contractor Law, contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or visit the J-IIC website at liti�ll.-_fliv)vw,lllas�i.,L',o Go online to view the status of a Home Improvement Contractor's Registration: ll;,t,ll,//(-Ib.stale.ma.tms/tioi en ............. For assistance with informal mediation of disputes or to registerformal complaints against a business, call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800, 508-755-2548 or 413-734-3114 Version 2.1 - 11/22/2010 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DESPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO [Name of Seller], AT [Address of Seller's Place of Business] NOT LATER THAN MIDNIGHT OF (date). I HEREBY CANCEL THIS TRANSACTION. Date: Buyer's Signature: Town o£Noah Wflygt Wit 99-2V- 2016 112-24 ZONING soAxn o5Ciry�� I -Ubert R Ivlanxi 111,Esq.CbnirmQn tAoRTH ryryp f A!'�s �^ p Town Cleric Time Stamp 1 LUlcn I IvICIntyre,Viee-CIWIWarr o�,rro r. �•4 4D 16 AU �Cj H E E� �F 7 j D.Paul Koch Jr.] sq.Clerk �� a`.S` " "° �o� (} Douglas Ludgin Allan Cuscia KQRTH.9rsodafeMemberr Duney Alor ntha€ +. Teo «k •,+` i r' ;n rr•t • e r. j Nathan Wei❑reich S�nC1"4U 1- is Is Eo e6�dt}+that twenty(20)days L11e:candria A,Jacobs>✓sq. have elapsed-from date of decl8W.}bed without filing of an appeal.16 Sep S01(,, Date Joyoe A.Bradshaw � Town Clark Any appeal shall be filed within(20) Notice of Decision days after the date of filing of this Year 2016 notice in the office of the Town Cleric, Property at: 10 Silsbee Road(Map 20,Parcel 29) per Mass.Gen.L.ch.40A, §17 North Andover,MA 01845 NAME: Jody Allen BEARING(S):June 28,2016&August 18,2016 ADDRESS: 10 Silsbee Road, PETITION: 2016-003 North Andover Ma.01845S ecial Permit—Construct a Family Suite 3 The North Andover Board of Appeals held a public hearing at The School Administration Building,at 566 Main Street, North Andover, MA on Thursday, August 18, 2016 at 7:00 PM on the application of Jody Allem for 1 property located at 10 Silsbee Road(Map 20,Parcel 29)North Andover,MA 01845. i A Special Permit for the R-4 Zoning District is needed.The Petitioner is requesting a Special Permit to construct a Family Suite from 4.122.22 of the Zoning Bylaws in the R-4 Zoning District. Legal notices were sent to all the certified abutters provided by the Town of North Andover,Assessors Office,and were published in the Eagle-Tribune,a newspaper of general circulation in the Town of North Andover,June 14, 2016,and June 21,2016. The following regular voting members were present:Albert P.Manzi III,Ellen P.McIntyre,Doug Ludgin and Allan Cuscia. The following Associate members present:Alexandria Jacobs. Ellen McIntyre made a motion to GRANT the Special Permit from 4.122.22 of the Zoning Bylaw to allow for a Single Family Suite in the R4 Zoning District at 10 Silsbee Road (Map 20, Parcel 29) North Andover, MA 01845. Douglas Ludgin second the motion to Grant the Special Permit. All those in favor to Grant the Special Permit:Albert P.Manzi LII,Ellen P.McIntyre,Doug Ludgiu,and.Alexandria Jacobs. Opposed:Allan Cuscia Vote 4-1 The Board finds that this use, as developed by the building and site plans, will not adversely affect the neighborhood. There will be no nuisance or serious hazard to vehicles or pedestrians since there are provisions for the required off-street parking. Adequate and appropriate facilities are provided to the existing residential dwelling and will be provided for the proper operation of a-Family Suite. The Board finds that the Family Suite will not be substantially more detrimental than the existing single family dwelling to the neighborhood and that this use, to allow a Family Suite to the single family dwelling,is in harmony with the general purpose and intent of this Bylaw. ATTEST t -A True Copy' Town Clerk r .Page 1 o£2 I Site: 10 Silsbee Road(Map 20,Parcel 29)North Andover,MA 01845 The Petitioner is requesting a Special Permit to construct a Family Suite from 4.122.22 of the Zoning Bylaws in the R-4 Zoning District. Special Permit: Section 4.122.22 of the Zoning Bylaw in order to grant a single Family Suite in the R-4 Zoning District. Plans(s)and titles 1)"Plot of the Land"containing one(1)sheet. Prepared by Merrimack Engineering Services,Dated July 27,2016,66 Park Street,Andover,MA.01810 2)Allen Residence,containing six sheets;Front Elevation,First Floor Plan Second Floor Plan,Left Elevation Right Elevation,Rear Elevation,Dated 07/11/16 Voting in favor of the Albert Manzi III, Ellen P.McIntyre,Doug Ludgin and Alexandria Jacobs Special Permit: i Voting in the Negative- Allan Cuscia The Board finds that the applicant has satisfied the provisions of Section 4.122.22 of the Zoning Bylaw in order to allow for a Single Family Suite located at 10 Silsbee Road(Map 20,Parcel 29)North Andover,MA 01845 in the R- 4 Zoning District. Notes: 1. This decision shall not be in effect until a copy of this decision is recorded at the Essex County Registry of Deeds,Northern District at the applicant's expense. 2. The granting of the Special Permit as requested by the applicant does not necessarily ensure the granting of a building permit as the applicant must abide by all applicable local,state,and federal building codes and regulations,prior to the issuance of a building permit as required by the Inspector of Buildings. 3. if the rights authorized by the Special Permit are not exercised within 2 years of the date of the grant,it shall lapse,and may be re- established only after notice,and a new hearing. EIE 'J ;l Nortfi Andover Zoning toard of Appeals Al rt P.Manzi III,Esq.,Chairman Ellen P.McIntyre, Vice-Chairman Douglas Ludgin Alexandria Jacobs,Esq. 1 Decision 2016.003 '1 i 3 1 i s 3 Page 2 of 2 i '3 NOTES SA" sr 1. SITE IS SHOWN ON TOWN OF NORTH ANDOVER ASSESSORS r MAP #78 BLOCK #t LOT#2. SEE E.N.O.R-D• BOOK X1106 PAGE #250 FOR SITE DEED, AND PLAN #88138, SHEET 2 �. FOR SFTE. cNx 2. ZONE DISTRICT IS R4 (RESIDENCE 4). Q SITE NATHAN AUBRI DEMARS / LEGEND KATHRYN ELIZABETH DEMARS JOHN P. LAHOUD N/F BELGA a W, LW.F. WOOD FRAME WANG XIN A�10UD 7090p W.F,D, WOOD FRAME DWELLING ' S32'20'2fi'E -� 74'37'LDT t6 Lors�2 33'S3..E 69..96' (C� N/F NOW OR FORMERLY vo- 1 CONC. CONCRETE BH BULKHEAD 17&18 p. Q PROP. PROPOSED OR REGISTRY USE LOCUS ` `" "�Y PROP. IN-LAWoEA=!3,979 S.F. (D) DEED LIL SUITE(504 S.F.) 3 (C) CALCULATED N.T.S. CXISTING 4 o ENCLOSED Eli PDRCH (TO 63 ( o 8E RAZED} p N/F /l' _ I N 43.38' 1`17.38' (169 S.F.) ,DIMENSIONAL SUMMARY MOORADKANIAN LN' ONG I( Mil RO N� °X IJCCARDELLO W M7DDLESE1s w ZONING DISTRICT: R4 STREET 1-4 ROP. PORCH N L_ a ITEM 130 EFT. PROVIDED Z Z AXOISiTMC TO a� MIN. LOT AREA 13,479 S.F. N � WELLIN -17.3 '4 " w A Z $ MIN, LOT FRONTAGE 119.83' N/F N/F N/F DEAN } �0 2 X LOT COVERAGE 24.62X PROP. N/F X1N DEMARS LAHOUD PTROG 38.38' _Opp itwr vy z REALTY TIIUST 17.38 MAX. HEIGHT 2 STORY N M-W Q�? MIN. FRONT SETBACK 34.83' PROP. K1 C7 MIN. SIDE SETBACK 38.38' PROP. � SITE o x MIN. REAR SETBACK 35.26' PROP. in N/FC,�S, 4 q a �` m .EXISTING DWELLING AREA N A 2,047 S.F. TECHRIST 'A5 \a '� v� uT ai xy ALLEN z 4 0 Z n R o IN-LAW SUETS AREA N A 504 S.F. PROP. Z za z \X - SllggE� z APPROVED BY THE TOWN OF NORTH L=59_I4ANDOVER ZONING HOARD OF APPEALS +oAp R=409.29 L=60.69' N/F GRAY FfNNI aRE �w 2 R=4p9.0 pA11= N zea �z SILSBEE (40' WIDE) ROAD ro SH£RLOCK 4 $ n 3 HEARING q 4E OOy G�0 z� N�fi SAlfTN 2� APPROVED 4 ~ PLAN OF LAND ABUTTERS MAP 11,E SCALE. 1'-100' NORTH ANDOVER MASSACHUSETTS "I HEREBY CERTIFY THAT THE PROPERTY LINES OWNED .8Y SHOWN ON THIS PLAN ARE THE LINES DIVIDkNG 10 SILEBEE NOMINEE TRUST EXISTING OWNERSH€PS, AND THE LINES OF THE .8Y CERTIFY TO THE TOWN OF NORTH ANDOVER STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC JODY M. ALLEN, TRUSTEE THE DWELLING IS LOCATED ON THE LOT AS SHOWN." ES PRIVATE STREETS OR WAYS ALREADY AL 10 SILSBEE ROAD ESTABLISHED, AND THAT NO NEW LINES FOR DIVISION OF EXISTING OWNERSHIP OR FOR NEW NORTH ANDOVER, MASSACHUSETTS 01645 WAYS ARE SHOWN AND THIS PLAN CONFORMS TO THE RULES AND REGULA71ONS OF THE REGISTRY OF DEEDS.' DATE.- JULY 27, 2016 SCALE. 1"-20' o' 1o' zD' 44' so' MERRIMACK ENGINEERING SER UCES 66 PARK STREET 7/27/15 �1a�. "�..� ` 7/27/15 ANDOVER MASSACHUSETTS 01810 "` STEPHEN '} R.L.S. DATE PHONE., (978) 475-9555 FAX: (976) 475-1446 HEN SKI, R.L.S. DATE EMAII. MERRENG®AO&COM a��� Essex ss.!-and Gou A true copy of Land Court Document [ -- hook a PagM_..�-!- Certlflcatel.o.�-� �1� M Regtstereda at__ -- Attest; J,2e� �e��ete�of Deed& The Commonwealth of Massachusetts r Department of.IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 mm.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contiactors/E lectricians/Plurnbers. TO BE TILED WITH THE PERMITTING AUTHORITY. A licant Information 4 Please Print Leydbl. Name (Business/Organization/Individual): e v. Address: 11.� City/State/Zip: lj� � �'hone Are you an employer-?Cheelc the appropriate box: Type of project(required): 1,❑I am a employer with employees(Rill and/or part-time).* 7, E]New construction 2.E]l am a sola proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3-❑I am a homeowner doing all work myself.[No workers'camp.insurance required.)t j 10 Building addition 4.E]I am 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.❑Plumbing repairs or additions 5. am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13,❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.F-1 We are a corporation and its officers have exercised choir right of exemption per MGL c, 14.❑Other g 152,§1(4),and we have no employees.[No workers'comp.insurance required,] 6 *Any appl leant that checks box 111 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-contractors have employees,they must provide their workers'comp.policy number. I at?i an eiiiployei•that is providing~Voi'l(e)'s'eontpeitsatio)i insttra?tce foi•iity eltlployees Below is the policy and job site hi/oi?cation. AA ,, 0 ` Insurance Company Name: U itOf''► Policy#or Self-ins.Lie.#:Aiii e- V00 70 ,� �—TJ 0/� _ Expiration Date: f' j I /0 Job Site Address r Se's • City/State/Zip: v �� (�` $ Attach a copy of the wor'kers'compensation policy declaration page(showing the policy number and expiration date), Failure to secure coverage as required underMGL 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. X do hereby cot'[f rend 'eke p ins penalties ofpe►jrrry cleat cite i,tfortttatinirpiovided above is clue and correct. Si nature: Dare: Phone# Official use only. Do not IpHle In this area,to be completed by city or totVii official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person; Phone#: L DATE(€1Ct1lDDlYYYY) A `..,� CERTIFICATE OF LIABILITY INSURANCE 5,18,16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on thi s certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Armand P. Michaud Insurance Ag PHONE (978 685_2549 FMIQ NO: AX (978) 794-0822 105 Haverhill Street An�R�ss: Methuen, MA 01844 --INSURERS AFFORDING COVERAGE NAIL INSURERA;Green Mountain Insurance Co. m„ INSURED INSURER B Kevin J Smith INSURER C: Smith Construction Co. INSURER D; 63 Inglewood St INSURER E: North Andover, MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W fTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AMLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIY MMIDDIYYYY pl GENERAL LIABILITY 20004593 5/12/16 5/12/17 EACH OCCURRENCE $ 11000,000 ){ DAMAGE TO-RENTED COMMERCIAL GENERAL LIABILITY $ MISES(Ea occk CLAIMS-MADE OCCUR MED EXP(Anyone person) $ 5u,000 PERSONAL&ALN INJURY $ _ GENERAL AGGREGATF $ 2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-OOMPIOPAGG $ 2,000,,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY (Ea accIDt81NGLf LIMIT)__ IM1T $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS - NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS eraccidenl) UMBRELLA LIAB OCGUR EACH OCCURRENCE $ EXCESS LIABi CLAIMS-MADE AGGREGATE $--_ DED RETENTION$ WORKERS COMPENSATION ITO WC STATU- OTH- AND EMPLOYERS`LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE YIN N/A E.L.EACH ACG DE NT OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ Si es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additlonal Remarks Schedule,if more space Is reqsi red) re: 10 Silsbee Rd. , North Andover, MA 01845 I is CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Inspector North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Trudy Lawler ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: AC R® DATE(MMIODIYYYY) CERTIFICATE OF LIABILITY INSURANCE 05/18/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Lawler MICHAUD INSURANCE AGENCY PHON o Ex (978)685-2549 FAX,lNo; E-MADDRESS: trudylawler@michaudinsurance,com 105 HAVERHILL ST. _ INSURER(S)AFFORDING COVERAGE _ NAIC# METHUEN MA 01844 INSURERA; AIM MUTUAL INS CO 33758 INSURED INSURER B: KEVIN SMITH INSURER C: SMITH CONSTRUCTION CO INSURERD: 63 INGLEWOOD STREET INSURER E: NORTH ANDOVER MA 01845 INSURER F; COVERAGES CERTIFICATE NUMBER: 54023 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR mPOLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PIMISES Ea occurrenceL $ — ME_D EXP Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 1-1 PRO- JECT D LOC PRODUCTS-COMP/0P AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED AUTOS AUTOS NIA BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident _ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE NIA AGGREGATE $ _ DED I I RETENTION$ $ m WORKERS COMPENSATION STATUTE OTTH- AND EMPLOYERS'LIABILITY Y I N ER ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICERIMEMBEREXCLUDED7 NIA NIA NIA AWC40070334522015A 1110612015 11/06/2016 - (Mandatory In NH) €,L,DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 NIA DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees In slates other than Massachusetts If the insured hires,or has hired those employees outside of Massachusetts. This certificate of Insurance shows the policy In force on the date that this certificate was issued(unless the expiration date on the above pollcy precedes the issue date of this certificate of Insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov4wdhvorkers-mmpensationlinvestigationsl. Sole proprietor has not elected coverage. Continuation of above Named Insured:SMITH CONSTRUCTION CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street AUTHORIZED REPRESENTATIVE North Andover MA 01845 I-�'`-/ Cu- Daniel tM,Croy,CPCU,Vice President-Residual Market-WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD rYXe [('(ziN JNC»1I(�CrlllJl O/ !'cfJJac"!C(t3nlCJ Office of Consumer Affairs&Susibem Regulation HOME IMPROVEMENT CONTRACTOR Registration 108511 Type: Expiration 81 1 91201 8 DBA SMITH CONSTRUdTjp Kevin Smith 37 LINDEN AVE NORTH ANDOVER, MA 01$45 Undersecretary= i I i -'.t4 Massachusetts-Qepartirient of Public safety Board of Building Regulations andS�art rGa0 3 effi-Istruif:7on 9Fa�'iL�t'iei)F- I License: C5 102589 KEVIN 3 SNUTH�` zt Ilk 63 URGLYM66 -ST North Andover WA 0 MW Expiretinn J•'�'» •tl 0310$120 s5i Gvr+�mirsner IT 6! I I I t I i