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HomeMy WebLinkAboutBuilding Permit # 11/14/2016 SyORT}.� BUILDING PERMIT 0,41 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION b .h �N 6 Rq cocriT.0 1. Permit No#. Date Received p��C SPR` 5 �SSgKUs�-c Date Issued: 11 IMPORTANT: Applicant xz�ust complete all itez�n.s on this page s � s F �Prmt f � Prsnt earStruc#ure yes no MAP —PARCEL ZONING DISTRICT H[stor[c D[strct yes - Macme.Shap 1FiIlage yeS TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building 9-0ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑,Sept�e ElUIle11 ❑ Floodplain 0 Wetlands ❑ Watershed I7[str[ct 11laterlSernier N DESCRIPTION OF WORK T BE PERFORMED: Ae 35 S, - oo Identification- Please Type or Print Clearly OWNER: Name: W Phone: Address: I` S AA-7u- cs �At 3-0 Contractor Name. Phone; Erria[I. . Address: SU.pervisor's Construdon'Licbnse Exp: Date Home Improvement L[cense: Exp.' Date . ARCH ITECTIENGINFER— AJ Phone: Address: Reg. No. FEE SCHEDULE:SULD1fVG PERMIT:$92.00 PER$1000.00 of THE TOTAL ESTIMATED COST BASED ON$925.00 PER S,E. 44 Total Project Cost: $_ _-. �I - FEE. $ Check No.: _Receipt NOTE: Persons contraeting with unregistered Contractors do not have access to the guaranty fund Signature of Agenwyvner CJ Signature of contractor ¢ t%ORTH owe. of No. W_W-6 W. , , LAKE h ver, Mass, Q Z L OLNEC rilwILR � S U BOARD OF HEALTH Food/Kitchen PERNUT T LD Septic System Now THIS CERTIFIES THAT .�.................. ,.. BUILDING INSPECTOR ........... .r ...... ....,. .a has permission to erect ...................... buildings on .li#1... .S.aw /...Yzie„ Foundation WASNOW Rough to be occupied .................................................... Chimney provided that the person accepting this permit shall in #Very 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST ION S T Rough Service Oq .. ......... .... Final BUILDING IN C R GAS INSPECTOR Occupaya Permit Required to Occupr 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. Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Poals ❑ well ❑ Tobacco Sates ❑ Food Packaging/Sales ❑ i Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN'OF!* - U FORM PLANNING & DEVELOPMENT Reviewed On j Signature_ -jf COMMENTS zo CONSERVATION Reviewed on 11 Si nature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Oand of Appeals: Variance, Petition No: Zoning Decision receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connectionl5i nature & pate Drivewa Permit DPW Town Engineer: Signature: that Located 384 Osgood Street must be DEPARTMENT Temp Dumpsfer ort site yes no �t:124 Main 5,treet Doc;BuildingmentsjgnaturWdate poRTy TOWN OF NORTH ANDOVER L``xo 0 OFFICE OF BUILDING DEPARTMENT 1 1600 Osgood Street,Building 20, Suite 2035 * '4oRAr..rF` y North Andover,Massachusetts 01845 �SS.1CH�35Ei Donald Belanger Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: .JOB LOCATION: S u4V0 141 ` 1 o a Number Street Address Map/Lot HOMEOWNER 11�ee— -�Y Lo u �Yo Gvi F 3 ky Name Home Ph ne Work Phone PRESENT MAILING ADDRESS Id �!I 1U04+-Gr PAJ c O Vtom oil U City Town State Zip Code The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two family dwellings and to allow such homeowners to engage an individual for hire who does not possess a license, ro�vided that the owner acts as supervisor. 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 dwelling, attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 CMR Section I I0.R5.1.2) The undersigned"homeowner"assumes responsibility for compliance with State Building Code and other applicable p codes,by-laws,rules and regulations. V A The undersigned"homeowner"certifies that he/she understrthNorth Andover Building Department minimum inspection procedures and requirements that ly ith said procedures and requirements. HOMEOWNERS SIGNATURE .APPROVAL OF BUILDING OFFICIAL Revised 8.2015 Forma Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I' i! 1O1 SUTTON MILL ROAD l2 21 IEEE. tua E) E Nigh FROV.T IEUV,AT ZorJ 109 SUTTON HILL RoAD NoRTq AMDoVER, MA Z KE Ll- (-SUI. 15. 20 t ale �:..��� y, ,•t � f �:_., 1 � � — .-' -- i LE EH 4NN z c p• a)zYN t1L �ta7.i.YhII73 i38� i I �To�y� 0 c x !Ebe ° N h Yrov�aae c�wo°oaaa i, i %K�f! 0 ' � [,.�.: YtQCli9Q'J9 yjLS1�Y`t d i r•iSY<I � r S •.ewx`�orer't a �`m _ � hatv�l ''• - s D tS"� ns �th�vi �^h e`g d-h fl`8 w'H `OI �• o-ha O" vl e.yy n.g o-y� o`� b'ff v-4 v-t, °'Z a-Lt d•Z o-b M WMA syw4 No 9�b lin0a w o y �n s N+a �8do3 1�+oauvnvr �� 3g�h�W 9 ZiY�-Z {} r 'bQd �t H i a G o,t ; y Y c KllviY'i tragUl-A XAla X Or d C Irr w Ll * r ;, O arsino] V! F� S9xhlibQ £Byhhlr Nyr Ga !Cox hhaL.OI LVd I1f53Q I (eZ11�'S�141 O^ell Nei 1d Zl Cn 101 SUTTON HILL ROAD I I to-o Ick-6 2$-6 -a S-o 2-� • •. j' id i - Q s i f AL L Caj�?n Scoo PZZ Np • i y, C - ��9Q` A 6-6 6- �# i I e I ;W `T k kxs�sar 4io i } L_ _ - ____t nae 30�nwI � I l1 F .(/GWFC 9op/kS k `�ut+�ikac,Yrl ` t-b 1-6 I'i-o t2ro tb-o 101 SVTT0}J 1+1LL RbhD NoRT4 AU:�AVE0., MA TKZ tLG r-OUNDA-rkpM PLAM XAuE, i18" l`0" JULY 20140 y P�lfts'r fi�.aaR FRAM£ lQ ► v t � �o s �}arya LvE.O o wv tiL© Iq D ! ' EE E f J-1 4-a x wS 1vtj A ali e 3uo7'6S'- 2G tk TSrELaJGire -r ZKM relk 4x-9S vatoet 131T,3tae�E uartsu VE.�46](SK21R1� 2%LOj tZ. �b1�5[ei!►JE El�Vt�,v*�]EyS, [Tr43 Ai,vu,.muwnr„v , cKx1's.st4 DFS;- 5l, — "- ' — cgynw mftk�,t C CTTA%C?,tc KrS `8" 2 a io C7vv) I a "` I1sTEAtoR..naoQ.i Zrgq W �D� �F7F \$a Moir"" TRIK J' 51c1kbAA MeuiR J 2x� Csw7r.AOTNf �Kmcs+Rvr SeeraoaaIZ Cr PI u' a s p5fW 0 0 CD z T — a a Co rr 491 KI) alyweK!} zz� (4124 0 µ typ, SYt 5�G L1L13' a fa4.-4 •7ZI/4x03 ^114x �'+ 114x$3 496 0 Caurx+w �'m77rY' 4�' 0 p x5 K57 0 1 P cx muuu�Y 1fCN�15 APINdo�{iSSY FAM14V lig. u {, , r 4`3" .... 4xq 4{.rmum PDR. �1 �� 6•ata`ir s 2»aAtL GARflC,� �� Mv»ndp►+� r-OYU, 0101 woo X r: 0 1 o, W PoRCNIL 4 4(-.a 00 Wks 4dix 83 4•a 2a 4-a 2w V-o 6-6 k-a` P-og_0 _r 6-0 A -0 t"6 3-0.�+ 8-0 114 x 10 21 Zrd .� . aM M Hwy �y V.Y.— YY. .3 1`4. Py7 0 M11'STtPw Me W rlml 14 W mtl 00 l3Bacwc�law� cleacwo+�, 301V.ze 44.0 44.0 q gg1�4>kS 91hr4x5"i Permit Listing Report Date Range.Issued between 0I101I2016 And 111071'2016by Permit TypePIG Printer!Pn: Ion Nov P7,2P16 SQL Statement:(Street like"SUTTON HILL ROAD"OR Work Location like"SUTTON HILL ROAD*")and([Type of Permit]="Building") Permit Type Address(Work Location) District Zoning Owner Work Category Est.Cost Proposed Use Details Map/Block/Lot Permit No Online Permit No Permit Status Date Issued Contractor(Phone#) Work Description Fees Paid Check# Building 211 SUTTON HILL ROAD ANGELA LUKENS Residential Alteration $6300.00 060.0./0079,1 1047-2016 Expired Apr-I 1-2016 Richard Fluet(978)685-7010 Install 2 c channels added to beam in garage $76.00 1615 (97 SUTTON HILL ROAD) TKZ Inc. FOUNDATION $12,500.00 (.` 108-2017 OPEN Au.-03-2016 TKZ Inc.(978)687-2635 FOUNDATION ONLY 5150.00 2122 101 SUTTON HILL ROAD WATSON REALTY TRUST ELIZABETH FOUNDATION $12,500.00 B 4VATSON,TR 060.A/00081 109-2017 OPEN Aug-03-2016 TKZ Inc.(978)687-2635 FOUNDATION ONLY 5150.00 2122 110 SUTTON HILL ROAD TKZ Inc. Demolition $15,000.00 097.0/0064/ 1214-2016 OPEN May-20-2016 Thomas Zahariko(978)687-2635 Demo of Existing Structure $180.00 1984 101 SUTTON HILL ROAD WATSON REALTY TRUST ELIZABETH Shell Only 5245,450.00 B WATSON,TR 060-k/0008//0008/ 358-2017 OPEN Oct-13-2016 TKZ Inc.(97 8)687-2635 Shell Only $2,943.00 2200 (97 SUTTON HILL ROAD) TKZ LLC Single Family Dwelling 5175,400.00 Il 358-2017 OPEN Oct-11-2016 Thomas Zahariko(978)687-2635 SFR Frame Structure-Shell Only $2,104.80 2191 GeoTMSG-2016 Des Lauriers Municipal Solutions,Inc. Page I of 2 REScheck Software Version 4.6.2 Compliance Certificate Project Energy Code: 2012 IECC Location: North Andover, Massachusetts Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 4,465 ft2 Glazing Area 19% Climate Zone: 5 (6322 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 101 Sutton Hill Road North Andover, MA Compliance: 4.2%Better Than Code Maximum UA: 529 Your UA: 507 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. Ea_vg_1 wee-A.552mb-L,ea Ceiling 1: Flat Ceiling or Scissor Truss 1,569 38.0 0.0 0.030 47 Ceiling 2:Cathedral Ceiling 1,117 38.0 0.0 0,027 30 Wall 1: Wood Frame, 1611 D.C. 3,350 21.0 0.0 0,057 151 Window 1:Vinyl/Fiberglass Frame:Double Pane with Low-E 540 0.280 151 Window 2:Vinyl/Fiberglass Frame-.Double Pane with Low-E 100 0.280 28 Door 1: Solid 24 0.200 5 Door 2: Solid 20 0.200 4 Door 3: Solid 18 0,450 8 Floor 1:All-Wood joist/Truss:Over Unconditioned Space 2,509 30.0 0.0 0.033 83 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 Jhas Aen designed to meet the 2012 IECC requirements in REScheck Version 4.6.2 and to comply with the mandatory requirements liste I the REScheck I pection Checklist. -1EERS Rater#4583495 11-4-16 'T Tom Barnes, I Name-Title Si Date Project Title: Report date: 11/04/16 Data filename: C:\Users\Barnes360\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page I of 8 Sutton Hill.rck REScheck Software Version 4.6.2 Inspection Checklist C�J( Energy Code: 2012 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. ---------- Bastian Pre-linspection/131 n R Plans Verified Complies? Comments/Assumptions Value Value--'id 1'1erI`fi'ed] a eview Fie 103.1, :Construction drawings and ElComplies ' 103.2 documentation demonstrate ElDoes Not [PR1]1 energy code compliance for the E]Not Observable 41IJ/11 building envelope, UNot Applicable 103.1, Construction drawings and ElComplies 103.2, documentation demonstrate EDoes Not 403.7 energy code compliance for �[]Not Observable [PR3]1 lighting and mechanical systems. 'Systems serving multiple ONot Applicable dwelling units must demonstrate compliance with the I ECC 'Commercial Provisions. H eatl n g: ❑ElCom pl I e s 302.1, ;Heating and cooling equipment Is Heating: 403.6 sized per ACCA Manual S based BtU/hr Btu/hr 'E]Does Not [PR2]2 on loads calculated per ACCA Cooling: Cooling: ;171Not Observable V9 Manual J or other methods Btu/hr Btulhr tlNot Applicable approved by the code official. ........... Additional Comments/Assumptions: Ili --J­j-TC6w impact(Tier 3) High Medium impact(Tier 2) -------------- ....... Project Title: Report date: 11/04/16 Data filename: C:\Users\Barnes360\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page 2 of 8 Sutton Hill.rck Section # Foundation Inspection Compliesi Comments/Assumptions & CCe�IC� 03,2.1 A protective covering is Installed to ❑Complies [F011]2 protect exposed exterior Insulation ❑Does Not and extends a minimum of 6 in. below ;❑Not Observable grade. �❑Not Applicable 403.8 Snow-and ice-melting system controls ❑Complies [FO12]2 installed. ❑Does Not 14 ;❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier1)^ 2_TMedium Impact(Tier 2}TMmn „3 Low Impact(Tier 3) Project Title: Report date: 11/04/16 Data filename: C:\Users\Barnes360\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page 3 of 8 Sutton Hill,rck ectiun g g s Plans b luefied Field MJ lu Verlfied],­_ _._.. p F3Complies? _.... _...... ...-orfs � ,]Framing/ Boll tl-Irr Inspection C�arrr lies? Comments/�lssum ti_._w.__, 402.1,1, Door U-factor. U U- ;❑Complles See the Envelope Assemblies 402,3,4 ❑Does Not table for values. [FR1I1 nNot Observable ;❑Not Applicable 402.1.1, Glazing U-factor(area-weighted U- U- ❑Complies see the Envelope Assemblies 402.3,1, ;average), ❑Does Not table For values. 402.3.3, 402.3.6, �i '❑Not Observable I 402.5 ❑Not Applicable [FR2]1 r�;, 303.1.3Wmmmry U-factors of fenestration products ❑Complies [FR4]1 are determined in accordance ❑Does Not ;with the NFRC test procedure or ❑Not Observable ;taken from the default table. ❑Not Applicable ; 402.4.1.1 iAir barrier and thermal barrier ❑Compiles [FR23]1 installed per manufacturer's %❑Does Not Instructions. []Not Observable ❑Not 0Applicable .4.3 Fe Fenestration labeled as meeting ❑❑Do mpNat [ R2i ... _... _ _.-_...,.... ,. lies AAMA/W DMA/CSA 101/1.5.2/A440 or has infiltration rates per NFRC ; ❑Not Observable 400 that do not exceed code [Not Applicable limits. _ 402.4.4 IC-rated recessed lighting fixtures '©Complies [FR16]2 sealed at housing/interior finish ❑Does Not and labeled to indicate s2.0 cfm ❑Not Observable leakage at 75 Pa. ;❑Not Applicable 403.2.1 ,Supply ducts In attics mare _.. . ............... -403.2.1 ._.. . RM...... ❑Carnplies [FR12]1 Insulated to zR-8.All other ductsR R_ ❑Does Not In unconditioned spaces or ❑Not ObservableI :outside the building envelope are insulated to �R-�6. i❑Not Applicable 403.2.2 All joints and seams of air ducts, ❑Complles [FR13]1 air handlers,and filter boxes are ;❑Does Not :sealed. ;❑Not Observable ; ❑Not Applicable 403.2.3 Building cavities are not used as ,❑Complies ]3 ducts or plenums. iMDoes Not ❑Not Observable ❑Not Applicable 403.3 HVAC piping conveying fluids R- R- ❑Complies [FR17]2 above 105 QF or chilled fluids ❑Does Not below 55 QF are insulated to �-R- ❑Nat Observable 3. !nNot Applicable 403,3,1 Protection of insulation on HVAC ,❑Complies [FR24]1 j piping. ❑Does Not ,❑'Not Observable '❑Not Applica ble 403.4.z 'Hot water pipes are Insulated to R- ❑Does Not R ❑Com Iles [FR18] >R-3. r i❑Not Observable ,❑Not Applicable �..1.�High Impact(Tier 1) µm 2 Medium Impact(Tier 2� 3 LowµImpact(Tier 3) m Project Title: Report date: 11/04/16 Data filename, C:\Users\8arnes360\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page 4 of 8 Sutton Hill.rck Veri coon 3 p I lansV 1e-rfied Field luefiec4 Ii+as7 oarn ants/Assumfriirsns gamin /itcau h-in ins ecf�on� Comp �a �c� .lid�, .,..._,.,�,., ......_.._ ,_,_.,_,,,...,....,,am. ..,...._,_�_,.._,__.,......._.,. ... 403,5 Automatic or gravity dampers areClComplies [ R19]2 i Instalied on a 1 outdoor air E]Does Not r intakes and exhausts. ®Not observable CINot Applicable Additional Comments/Assumptions: I I i i i I ff 1 High impact(Tier 7) 7 Medium Impact(Tier 2) N 3 Low Impact(Tier 3) Project Title: Report date: 11/04/16 Data filename: C:\Users\Barnes360\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page 5 of 8 Sutton Will.rck Sectiorn Plans VlueVerified Field' ie Value Complies?insulation _._pe._.. C+om tions & Ite 11) _.._..�.._. .._....._ .....__.,....__.,.....,,,., .._.. s rnents/Asuw�p 303.1 `All installedinInspection InsulationIsIabeEed. _-......��...�._ ❑Complies . [IN13)2 or the installed R-values ❑Does Not provided. ❑Not ObservableVV .f ❑Not Applicable 402.1.1, Floor insulation R-value. ,....°"° _..._. - n_. ❑C...w....____.__...__.._.w___ee the___. ..._._.m_...._.m._.. lies .._..M � OmplieS ;See the Envelope Assemblies 402.2.6 F Wood Wood ❑Does Not table for values. [IN1]1 ❑ Steel ❑ Steel �❑Not Observable ❑Not Applicable 303.2, Floor insulation installed per ❑Complies 402.2.7 'manufacturer's instructions, and FlDoes Not [IN2]1 In substantial contact with the ❑Not Observable underside of the subfloor. _❑Not Applicable 402.1.1 Wall insulation R-value.xIf this Is a R Wood .� Wood mm_ ❑Complies_... See t� blie�_..m.._ See the Envelope Assemblies 402.2.5 mass wall with at least /2 of the (_ '❑Does Not table for values. 402.2.6 wall Insulation on the wall j❑ Mass j❑ Mass ❑Not Observable [IN3)1 exterior,the exterior Insulation Steel ❑ Steel [Not Applicable requirement applies(FR10). 303.2 Wall insulation is Installed per !❑Complies [IN4]1 manufacturer's instructions. ❑Does Not s❑Not Observable ❑Not Applicable Additional Comments/Assumptions: I i 11HIgl7 Impact(Ties l) mm 2 Medium Vmpact(Tier 2) NM3mm 4aw Impact(Tier 3) Project Title: Report date: 11/04/16 Data filename: C:\Users\Barnes360\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page 6 of 8 Sutton Hill.rck .._...,�,� _.._____........_.._.._.._ Plans Vain Complies?_Fiol�lueVerfio..,�. _.................._,...._._ ........_.w.. m..M _..� action _ d p ..__ ? Comments/Assumptions �... # Find Inspection provisions Com lio ew<1 ID 402.1.1, �',Celling insulation R-value. R- R- IOComplies See the Envelope Assemblies 402.2.1, i ❑ Wood j❑ Wood ❑Does Not :table for values. 402.2.2, Steel ;❑ Steel ;[]Not Observable �l 402,2.6 �EINot Applicable j [Fill' _.-_....___.__.._._..._. . .._... p _.._.___._.___. . ___..__._.._...._..,.... . 303.1.1.1, Ceiling Insulation Installed per _..m.. .M_ OComplles 303,2 manufacturer's Instructions. ODoes Not [F12]1 Blown insulation marked every ;17INot Observable r,;;; 300 ftz. ,ONot Applicable 402.2.3 Vented attics with air permeable __._.._. ... .w ,. _ 'OComplies [FI22]2 Insulation include baffle adjacent ODoes Not to soffit and eave vents that ❑Not Observable extends over insulation. .ONot Applicable 402.2.4 Attic access hatch and door R- R OCornplies [F13]1 Insulation >R-value of the ❑Does Not 1 adjacent assembly. ❑Nat Observable r �ElNot Applicable 402.4,1.2 Blower door test @ 50 Pa.W<.5__. ACH 50 ACH 50 ❑Comp_m._m.__ = = Iles [F117]1 ach in Climate Zones 1-2,and ODoes Not liyo, ;<=3 ach In Climate Zones 3-8. ; ❑Not Observable 403.2.2 Duct tightness ................._____.__ _._ .,,__.._..___...,......_ ___.. .._._. ._�_____.__..... ONat A Hess test result of<=_ O 4 cfm/100 cfm/100 Comppplicable lies [F14]1 cfm/100 ft2 across the system or ft2 ft2 ❑Does Not <=3 cfm/100 ft2 without air ❑Nat Observable handler @ 25 Pa, For rough-in tests,verification may need to �ONat Applicable !occur during Framing Inspection. 403.2.2.1 'Air handler leakage designated OComplies [F124]1 by manufacturer at <=2%of iODoes Not design air flow. '[)Not Observable i CINot Applicable 403.1.1 Programmable thermostats OComplies [FI9]2 installed on forced air furnaces. ;ODoes Not ❑Nat Observable :nNot Applicable 4 .1.2 Heat pump thermostat Installed OCompiles 03 [F110]2 on heat pumps. ODoes Not 'QNot Observable ONot Applicable 403.4.1 Circulating service hat water OComplies [FI 11]2 systems have automatic or ODoes Not �� ;accessible manual controls. ❑Not Observable ON_ot Applicable .�.._ j 403.5.1 All mechanical ventilation system OComplles...... [F125]2 ;fans not part of tested and listed ODoes Not HVAC equipment meet efficacy and air flaw limits. ❑Not Observable ;ONot Applicable ermanent [�6]1 75%of fixtures permanent ,❑Do.._ .__... ________..._ _....._.,...._..__..__ ....... i ° es Not Ak fixtures have high efficacy lamps.; =QNot Observable Does not apply to law-voltage ONot Applicable lighting' _ I I_.... pact(Tier 1)mm M 2 Medium Impact(Tier 2) _._... 3 rµLaw Impact(Tier 3} 1 Highim _..w _. . Project Title: Report date: 11/04/16 Data filename: C:\Users\Barnes860\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page 7 of 8 Sutton Hill.rck I .....�»..,..,,,rte........... ....................m._._......,....,...,..,_....,...__.___._...,,_....,....W.....,.,..._......_....,.._.._...�......,,. ..,..,.... .._,�., _..._. .,.......,.._. ,,...,.,___......_.._.:... ��.,,.....,......._...„......_..,...�_.._...__..._, .,....�.._....,..,.......,.. i. sectionIanVal lufiec� o=ieiV lueied _ p p s .4.1.1 "Fuel as lighting� .�s stems have ' a .C�n�me�ts/A`s�"urv�..9;ia�n ., � r�n�i inspection [�rovis�crns cpm ri s� 40 9 Y a ❑Complies [FI23]3 no continuous pilot light. ❑Does Not ❑Not Observable i❑Not Applicable 401.3 Compliance certificate posted. ❑Compiles [F17]2 ❑Does Not �vk( ❑Nat Observable i ❑Not Applicable 303.._. .._,:._ .. ......�...w�,,....__.. ..w___._._�_..__�.__ w.......�.. _..�.. �:,...._.._.m .�_ �m...,..�.�. ..__......�.....�.._.,. .�n___ ..,.....__ ...... .�..._.... .._____ 3 Manufacturer manuals for ❑Complies [FI18]3 mechanical and water heating '❑Does Not systems have been provided. []Not Observable ;❑Not Applicable Additional Comments/Assumptions: 1 „High impact(Tier 1)A __ 2Medium Impact(Tier: 3 Low Impact(Tier 3j_ ._...� Project Title: Report date: 11/04/16 Data filename: C:\Users\Barnes360\Dropbox\Reschecks\Peter Loughman North Andover- 2 houses\101 Page 8 of 8 Sutton Hili.rck i C2012 IECC Enei,,gy Efficiency Certificate MMEMEMOMMEMMEM2EM Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): Window 0.28 Door 0.20 Heating System: Cooling System: Water Heater: Name: Date: Comments Ae Commonwealth of Massachusetts Departme�xt ofrndastrzalAecrdents h . 1 Congress Street,,S`Oe 100 Boston,MA 02114 2017 i�^qct -WWw mass.gov/dia syy ' Workers,compensation/insurance Aflitdavit:Bail.dexs/CantractorslElectx'icia:aslk'Xnm.bers. To BBE 5 LE13 WITH TE&-pUR C'TTING.AUTRORrM please prjnt be 'bl A ' ticant 7n formation Name(tusinessfOtganiz atioiifin 1i-vidual): Address: AA City/Statelzip: Tv , ;: .:. .. : _xA=; Are you an employer$Checl�the appropriate box: Type:of prrojeet()'et�uired); em Io acs full and/or part-thna).� 7. � ev�'donstrirctioro 1,❑lam a employer with P y � 2.❑ aln a sole proprietor or parhrership and have no employecs working for me in 8, ❑Rerun dating any capacity.No workers'comp,insurance required.] 9. ❑Demolition 3.[]l am a homeowner doing all work myself.[Ro workers'comp.insurance required.]t 10❑Building addition f coutzactozstoconductallworkonmyproperty. Iwill 11.t-1 E]ectllC31-PPaiSS oradditiws ¢.14I I am a homeowner and will be hiring !� J YY""��ensure that all contractors either bave workers'compensation insurance or are sola ��—�_pbg repairs or additions proprietors with no employees. .TL1 5❑lama general contractor and T havo hired the sub-eontractozs listed on the attached sheat. 13%[!Roof xepai_xs These suh-contractors have employees andhave workers'comp.insurance.$ 14. Other b.OWe are aoorpozatign and its•oiiicers have exarcisedtheir right of exermption per MOL o. 13 2,§1(4),and we have no empio'Yeas.[7o workers'comp.insurance required.] n ORGY Y applicant that ch�oks irbi� 1 davit indicalhngthey are doingout the lallvvork andthen hire outside ow showing their workers' contrae ors must submit new af�rdavitindicating such "i IHom�eowmers who submit•this a . . fcontractors that check thiq h ve employees,they must additionalshectshowing the rovide their workers'of the policy number.and state whether of potthose entities ave employees. 7fthe sub-cin -Tam an employer Ha at is pro vidingworkers'compensation insurancefor•my employees. Below is theparity aradyob site information, Insurance Company Name: Expixatiou DOe' Policy#or Self ins.Lac.#:. A N of U A-A- M � .u, t r• . � , ,Cityl5tate/Zip: . Job Site A�ddxess: ) f �Y Attach a copy of tateWQVJ-1ers' compensationpolicy deciaratioxzpage{shavingthepolicy�beaafinea to$1,500 00 .� allure to secure coverage as required under MOL penalties xn§he form of criminal25A is a TOP WORK ORDER and a Eno o�p to $250.00 a and/or orae-year imprisonment'as we11 as civil p day against the violator.A copy of this statement may be forwarded to the Office of Lnvestigations of the IDI&for insurance coverage verlfication. do hereby cern oder ae airxs a rl penalties of perjury tlxat ilia information pr�ovidecl above is tree and Corr-Oct roc Date: Si aturo: A P1one#: Official use only. Do riot write in ilzis area,to he completed by city or to ri official Permit/License# City or Town: Issuing Authority(circle one) a 1.Board of):�ealth 2.Building Aepaxtrn.ent 3.CitylTown Clerk 4.EleetricaY inspector 5.pXnnxbizxg nspec ax• b.Other Phone#: Contact:Person: