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HomeMy WebLinkAboutBuilding Permit # 3/2/2017 N BUILDING PERMIT cc)`,,a•o TOWN OF NORTH ANDOV ° *00 APPLICATION F . N EXAMINAT Permit N®: / ' ' Date Received a I—:��. Date Issued: IMPORTANT. Applicant Must comlite all ite2ns on this pa e LOCATION: Print PROPER7 DI NER Print MAI"'NO: PARCEL...: ON. LNG. DIST. I T � Historic l�istrs e r�cr achine Shop Village TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition :` Two or more family - Industrial ::,' PIteration No. of units: C_ Commercial 1 Repair, replacement - Assessory Bldg _ ethers; Demolition I.; Other Septi l 0?well: i Fl aodplaif 13 Wetlands. 0 Watershed District waterlSew r Ci�7J ' -A' l 0 L Identification Please Type or Print Clearly) 44 MINER: Name: VV r �-1 Phone: -J - t Address: 1'7 5VA 57 50 t tet - ' 14 Oa I L-( 3 CONT -( 3 NT T Name 5c? Phone: 777 Address: T . Supeisys Construction Licerrw Exp, mate. 4 � to Home Improvement License Exp. Date. � t f � ARCH ITECTIENGINEER 1—Ac iiZ. Phone: � � � � �o� Address: t 1: f� '�4 4-� L5A s/'t(VL) Reg. No.__t'1� FEE SCHEDULE, [PLDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIM SED ON$925.00 PER S.F. Total Project east: l FEE: Check No.: 7Receipt No.: NOTE: Persons contracting withn ist red reontrractors do not have access o th guaranty d Signature of Agentl ne Signature of contractor g4®RT#y Town of 2 :; _ g ndover . No. 7 ver, MaiL ssAb COCMIC"1%WEn 41. U BOARD OF HEALTH PERMIT T D Food/Kitchen MR , Septic System THIS CERTIFIES THAT ,...,! .. ...oft4...�t11.. w�,,,���`, BUILDING INSPECTOR . .. ....... ......... .........�....�.,.,.. � .. Foundation has permission to erect .......................... buildings on ..14t4;4* . � ..... .. ......... Rough g to be occupied as ....5eft...... ....4shl .&W. .......... ..�..,. ....... Chimney provided that the person accepting this permitin every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EEAINONTHELECTRICAL INSPECT-011 Rough GService Y . ...J.....,.. BUILDING. INSPECTOR� Fina[ CAS INSPECTOR ®ccs2ancy Permit a Wred t® Occupy Buildin 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. 1 E H StructUr-al Consulting 1:L Pony brcwk Lana Lexington,[,IA 02,421 PHONE ] 978,40 E921 E.Ak-1 rr; r,rrrrri.•r~IN(3 Ela iric.@EAHstrur„, uralcot November 22"d,2016 To: Solect Energy 89 Hayden Rowe Street Hopkinton, MA 01748 Subject: Structural Certification for Installation of Solar Panels RCG, LLC 50 High Street North Andover, MA 01845 To whom it may concern; A design check for the subject buildings was done on the existing roofing and framing systems for the installation of solar panels over the roof. From the site inspections,the existing roof support structures were observed as follows: The roof consists of EPDM roofing over 6-in rigid insulation on nominal 3-in tongue and groove wood decking. The wood decking is supported by true dimensioned 7"x15" old growth wood rafters at 10'-0" o.c.. The rafters have a span of 22'-0” and are framed into 7"x15"old growth wood beams. The wood beams are supported by 7"x7"wood posts at 15'-0" o.c.. The roof has a 5-degree pitch. The existing roof framing systems are judged to be adequate to withstand the loadings imposed by the installation of the solar panels. No reinforcement is necessary. The existing roof framing system can withstand an additional 8 psf solar ballast load. I further certify that all applicable loads required by IBC 2009 with Massachusetts amendments were applied to the solar ballast system and analyzed. The applicable loads are indicated in the load combination table and the summation of maximum loads indicated on permit plan,which is part of this submittal package. Furthermore, I was informed that the installation crews have been thoroughly trained to install the solar panels based on the specific roof installation instructions developed by the manufacturer for the ballast system and for the inter connections. Finally, I accept the certifications indicated by the solar panel manufacturer for the ability of the panels to withstand high wind and snow loads. Vk OF ELAINI A. iry HUANG Sincerely, CMI Elaine A. Huang, P.E. o Structural Engineer s � NAt 1 EAI-] Structural Consulting P7, 1.1. f'r,nybroc Lane 1 Lexington, 1'w A 02,1 1 u���.AH c' m cat.ti-.'rimarw I apb .r r r h1 krtlr:�tar,�k.k.rr�1 Project: RCG LLC Client: Soled Energy l Location: 50 High Street,North Andover,AVIA 01845 Date: 11/22/2016 Engineer: Elaine A Huang,PE Load and Load Combination: Dead Load:(wood roof) 3" Nominal T&G =8 psf(ASCE-7 Table C3-1) EPDM = 1 psf(ASCE-7 Table C3-1) Insulation =3 psf(6 inch of polyiso) Solar Panels=8 psf(Given by Product Catalog) Total Dead Load =8+ 1+3+8=20 psf Snow Load: Ground Snow Load, PO: Town of North Andover, MA=50 psf(Mass Building Code,780 CMR, 81h Ed.) Flat Roof snow load= Pf=0.7 Ce Ct I pg=0.7 x 1.0 x 1.0 x 1.0 x 50 psf=35 psf (ASCE-7, Eq.7-1) Ce=exposure factor= 1.0, (ASCE-7,Table 7-2),Terrain C, Partially Exposed Ct=thermal factor=1.0(ASCE-7,Table 7-3) 1 = importance factor= 1.0(ASCE-7,Table 7-4), occupancy category II Wind Speed: Basic Wind Speed: Town of North Andover, MA= 100 mph (Mass Building Code, 780 CMR,8th Ed.) Wind Pressure: Q,=0.00256 Kz Kzt Cnet V2(IBC Equation 16-35) Kz=0.81 (50' building) (IBC refers to ASCE-7) K,t= 1.0(IBC refers to ASCE-7) C„Pt=0.41 or-1.17(Components and Cladding,zone 2) (IBC Table1609.6.2) V= 100 mph (Mass building code 8th ed.) Therefore, q,=0.00256 x 0.81 x 1.0 x 0.41 or-1.17 x 1002=8.50 psf and-24.3 psf(uplift) (IBC Equation 16-35) Seismic Load Ss=0.33 (Mass Building Code 81h ed.Table 1604.11) S1=0.075 (Mass Building Cade 8't'ed.Table 1601.11) Spectral Response Acceleration coefficients: 2 1 EAH Stri..ictural C011SUltirIg 1.1. L'onybrook Lane 11 Lc�xi gton, MA 02421, PHONE M78.40(58921, ;il" CAH 01,,3r4 vLi4criv4n EI nT�o�ti�('�Hstiir.rrttrr�l„�: art"� Sens= Fa Ss= 1.6 x 0.33 =0.528(IBC Equation 16-37) Smi= F„S, =2.4 x 0.075=0.180 (IBC Equation 16-38) Design Spectral Response Acceleration Parameters: SDs= 2/3 x Sins=2/3 x 0.528=0.352 (IBC Equation 16-39) SDI=2/3 x SMi=2/3 x 0.180=0.120(IBC Equation 16-40) According to IBC Table 1613.3.5 (1) and (2),the seismic design category is"B" and the calculation can be finished by using ASCE-7 equivalent force procedure. The importance factor, I,for this building is 1.0. The response modification coefficient, R, is 3.25 according to ASCE-7. TL=6 sec(ASCE Fig 22-15) T=Ct hnx=0.028 x 500.0=0.64 sec(ASCE-7 Equation 12.8-7) The seismic response coefficient, C$, is C,=SDs I/R=0.352 x 1.0/3.25=0.108 The maximum value of C,=SDII/(TR) =0.120 x 1.0/(0.64 x 3.25) =0.0577 The minimum value of C,=0.01 Therefore, C,=0.0577 IEBC Section 707.5 states that the lateral resisting frame structural elements need not comply with Section 807.4 if the alteration does not increase the demand-capacity ratio by more than 10%. In this case,the panels'weight,8 psf, is extremely small compared to floor live load (60 psf/floor for assembly area, 100 psf for storage) and building dead load. Therefore, seismic design should not be considered. Load Combination(ASM(18C 2009 Ch16)wood deck D+S=55 psf (Eq 16-10) 0.61)+W=-12 psf(Eq 16-13) D+0.75 (0.6W)+0.75S=50 psf(Eq 16-14) Roof Structures The roof consists of EPDM roofing over 6-in rigid insulation on nominal 3-in tongue and groove wood decking. The wood decking is supported by true dimensioned 7"x15"old growth wood rafters at 10'-0” 3 "I If EAH Structural C01-ISu16119 11 Pcrrrybrraok Lane Lexington, (,lA 02421 PHOPIE 1,978,406.8921 E-ZAt1 C1UNSLAL."1"IN01 Elaine(, EAHstructursLcorn o.c.. The rafters have a span of 22'-0"and are framed into 7'x15" old growth wood beams. The wood beams are supported by TV"wood posts at 15'-0"o.c.. The roof has a 5-degree pitch. Structural Analysis and Calculation According to AWC Wood Sontruction Data,3-in nominal tongue and groove decking with simple span layup can stand 68 psf uniform load (1,000,000 psi Young's Modulous, conservatively assumed). Therefore,the decking is adequate to support an uniform load of 55 psf. Table 4. Three and Four inch Nominal Thickness - Allowable Roof Lund Limited by Deflection - Simple Span Layup Maduiunrrt Detlecti4n Allowable Uniforn7l Distributed Total Roof Loatf°` sf Elasticity,psf Unit 3 inch nominal thickness S pi rt,ft. 4 inch nominal thickness',Span,ft. 8 9 10 11 12 13 14 15 16 8 9 10 11 12 13 14 15 16 17 18 19 20 U160 63 44 32 24 19 15 '12 t0 6 174 '122 69 67 51 40 32 6 2 18 t 13 11 700000 U240 47 33 24 18 14 11 9 7 6 130 91 67 50 39 30 24 20 16 14 it 10 8 600000 U160 72 51 37 28 21 17 13 11 9 198 139 102 76 59 46 37 30 25 21 17 15 13 U240 41 36 28 21 16 13 10 8 7 149 105 76 57 44 35 28 23 19 16 13 11 10 960000 U160 8157 42 31 24 19 15 12 10 223 157 114 86 66 52 42 34 28 23 20 17 14 U240 61 43 31 23 18 14 11 9 6 '167 118 66 64 50 39 31 25 21 17 15 13 11 1000000 U180 90 64 46 35 27 21 17 t4 11 248 174 127 95 74 58 46 38 31 26 22 19 16 U240 68 48 35 26 20 16 13 10 8 186 131 95 72 55 43 35 28 23 19 16 14 12 1100000 U160 99 70 51 38 29 23 19 15 12 273 192 140 105 81 64 51 41 34 28 24 20 U 11240 75 52 38 2.9 22 17 14 11 9 205 144 105 79 61 48 38 31 26 21 18 15 13 1200000 U160 109 76 56 42 32 25 20 16 14 298 209 152 115 88 69 56 45 37 31 26 22 19 U240 81 57 42 31 24 19 15 12 10 223 157 114 86 66 52 42 34 28 23 20 17 14 1300000 U180 118 83 60 45 35 27 22 '18 15 323 227 165 124 96 75 60 49 40 34 28 24 21 U240 88 62 45 34 26 21 16 13 11 242 170 124 93 72 56 45 37 30 25 21 18 15 1400000 U160 127 69 65 49 38 30 24 t9 t6 347 244 178 134 '103 81 65 53 43 36 30 26 22 U240 95 67 49 37 28 22 18 14 12 261 183 133 100 71 61 49 40 33 27 23 19 t7 1500000 U160 136 95 69 52 40 32 25 2t 17 372 261 191 143 110 87 69 56 47 39 33 28 24 L7240 102 71 52 39 30 24 19 15 t3 279 196 143 107 83 65 52 42 35 29 25 21 18 1600004 U180 145 102 74 56 43 34 27 22 18 397 279 203 153 118 93 74 60 50 41 35 30 25 U240 109 76 56 42 32 25 20 16 14 298 209 152 115 88 69 56 45 37 31 26 22 19 Ell 0400U180 154 108 79 59 46 36 29 23 19 422 296 216 162 125 98 79 64 53 44 37 31 27 U240 115 81 59 44 34 27 22 17 14 316 222 162 122 94 74 59 48 40 33 28 24 20 0000 I U180 163 114 83 63 48 38 30 25 20 447 314 229 172 132 104 83 68 56 47 39 33 29 U240 1 122 86 63 47 36 28 23 19 15 1335 235 172 129 99 78 83 51 42 35 29 25 21 Wood Rafters 7x15 Member Size=7"x15" Spacing= 10.0'O.C. Span Length =22,0'approximately w=55 psf x 120 in/(12 in/ft) =550 lbs/ft 4 r EAH StRICtUral C011SUltlrlg L exington, NIA 02421, PHONE L978AO6,8921 A1.4 I oto raa trt.°t°Mt t Cmlvur7� ;ME�fi trcaca��i l r rn Check moment capacity of Rafters: M =0,125wL'=0,125 x 550 lbs/ft x(22.0 ft)'=33275 lbs-ft S= bdZ/6 =262,5 in3 M/S=33275 lbs-ft x 12 (in/ft)/262.5 in3= 1521 psi Ft,= 1500 psi (conservatively assumed for old growth)x 1.15 (Ca)x 1.15 (CR)= 1984 psi,ok Check shear capacity of Rafters: V=5wL/8=5 x 550 lbs/ft x 22 ft/8=7562 lbs Vn,,x=3V/2A= [3 (7562 lbs)]/[2 (105 inz)] = 108 psi F„= 150 psi (conservatively assumed for old growth), OK Check deflection of Rafters: Atot,i=5wL4/384EI = (5 x 0.550 K/ft x 224 ft'x 123 in3/ft3)/(384 x 1400 Ksi x 1969 in4) = 1,05" L/240=22.00'x(12 in/ft)/240= 1,10 in,OK Wood Beams 7x15 Member Size=7"x15" Spacing= 22.0'O.C. Span Length =15.0' approximately P=55 psf x 22 ft x 10 ft= 12100 lbs Check moment capacity of Rafters: M = Pa= 12100 lbs x(2.5 ft) =30250 lbs-ft S= bd2/6=262.5 in3 M/S=30250 lbs-ft x 12 (in/ft)/262.5 in3= 1383 psi 5 r FLAN StructLIral Consr116119 11 Ponybrook Lane Lexington, A 02421 0� �l ('HONE 1 9'/8.406.8921, EAFI G; rer, ti °r�ry K. I �uiw� hl tr�.i gar al ��rr� Fb= 1500 psi (conservatively assumed for old growth)x 1.15 (Co)x 1.15 (CR)= 1984 psi,ok Check shear capacity of Rafters: V= P= 12100 lbs Vrnax= 3V/2A= [3 (12100 lbs)]/[2 (105 in2)] = 172 psi F„= 180 psi (conservatively assumed for old growth), OK Check deflection of Rafters: Atotal= Pa/24E1 (31-2—42) =0.514 in L/240= 15.00'x(12 in/ft)/240=0.750 in, OK 6 NORrN O toown of North Andover Machine Shop Village Neighborhood Conservation District Commission Af; � 1600 Osgood Street North Atxdovcr, MA 011345 i XCLUSION From Certificate to Alter w Certain alterations are excluded,from review by the Machine Shop Village Neighborhood Conservation District Colmnission in accordance with the Bylaw. Applicants for exempt projects n2ust,fill out the form below and submit to the Commission Chahpenson(contact itzfo below), � Date: /z/Z Contact Name lie Address: i ... ' N,, rrV GI Project Address: 41.50 9h Cf Project Description(attach additional pages,if needed): Exclusion From Review Requested" or: C� 1. Interior Alterations existing conditions including materials, design and dimensions. U 2. Storm windows and doors,screen windows and doors. LJ 9.replacement of existing substitute doors,substitute siding or substitute EJ 3.removal,replacement or installation of windows with new materials that are i gutters and downspouts. substantially similar to the existing condition, Cl 4.removal,replacement or installation of window and door shutters. 0 10,Replacement of original fabric of windows or doors with substitute Ll 5.Accessory buildings of less than 100 windows or doors that maintain the square feet of floor area, architectural integrity with respect to form,fit and function of the original Ll 6,removal of substitute siding. windows or doors, 7.Alterations riot visible from a public ® 11,reconstruction,substantially similar in way. exterior design,of a building,damaged or destroyed by fire,storm or other disaster, 0 S. Ordinary maintenance:and repair of provided such reconstruction is begun architectural futures that snatch the within one year thereafter. 1 MSVt DC Page 1 Current Chair;u7 I{ennessy,77�hn Street,l�rc tt at rbwi� �r��{i�,r��.ccrrri, ~� 1 peu,g0 TF+1+ w.w Towt-i of Nordi Andover �y Machinehop Village Neighborhood Conrsetvtttityt�District Commission t 1600 C`)%ood Street North Attc ovc.r,Mrd 019,15 S$niF�aasw For Items 9,10 or 11,provide the toll,owing documentation: Photos%drawings orf existinl,doors, windows ar-sidt`nS, as applicable -Description/Catalog Cuts o pi-opnsed inaterriGals to be rrsed fcv doors, windows or sidling —Plan and elevation of reconsu•nction far Item l I Determination: This project is deternainetd to be X exempt 0 not exempt from review by the Machine Shap Village Neighborhood Conservation District Commission. Projects that rue^not txeattp)must complete then Application fir,C'e,tif't`ccale to Alter,available from the Ruilding Department and be reviewed by the Commission. Detennination made bv: Signature Lizetta M. FennessV Neighborhood Caraservation District C"onrrnission 12/20/16 Date ._.. iidL''W'F"1i91''+KP'.».119PL4"u".„ ...� VYIU �aruwitiuuwatquivmu�umiwmuyrtmmemdwoiumummwummuuwww�uu;FFrmyC""�,"''7V. ,^It MSV NCDC Page 2 Current C:;hairt Liz Fennessy,77 Mtn Strcct, Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8"'edition of the Massachusetts State Building Code, 780 CMR, Section 107 1 HIGH STREET, BUILDING 36(RCG WEST MILL NA LLC) Project Title: Date: 1/12/17 Property Address: 1 HIGH STREET, BUILDING 36(RCG WEST MILL NA LLC) ---------F- Project: Check one or both as applicable: 0 New construction Existing Constructio Project description: _I?Fstall-589-"go—Far—li-an—er!§'"dff-bii—st-thg roo—f to generate lb6.1—KW power, no struttural amendments necessary per rue ura I ELAINE HUANG ------------------MA Registration Number:49029 'Expiration date: 6/20/1.8-___,ama i-egistei-ed de.yign profesvional, and I have prepared or directly supervised the preparation,of all design plans, C0111plItatiOrls and specifications concerning: Architectural Structural Mechanical Fire Protection Flectrical Other for the above named project and that to the best of my knowledge,information,and belief such plans,co putations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted I a engineering practices for the proposed project. I understand and agree that I (or my designee)shall perfo-in the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this codealid the design concept,shop drawings,samples and other ubinittals by the t contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being perforrned in a manner consistent with he approved construction documents and this code. Nothing in this docur.rient relieves the contractor of its responsibility regarding the provisions of 780 CM )Vhen required by the building official,I shall submit field/progress reports(see item 3.)together with p rtinent comments,in a form acceptable to the building official. 11 11ui*,M A's4 cy Upon completion of the work,I shall submit to the i bild' g official a'Final Construction Control 1 1. P,mAs N- i? ; Enter in the space to the right a"wet"or signat electronic signature and seal: date: SS 0% Phone number:978-406-8921 Email: ELAINE@EAHSTRUCT Biiildiiig Official Use Only Building Oflicial Name: Pcrniit Pilo.: Date: Version 06112013 Appendix 2 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required for this. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents' Mark"x"where plicable IVo. Item Submitted Incosn fete Not Re aired 1 Architectural 2 Poundation 3 1 Structural 4 Fire Suppression 5 Fire Alainma re uire re eaters 6 HVAC 7 Electrical 8 Plumbin include local connections 9 Gas(Natural,Pro ane,Medical or other 10 Surveyed Site flan(Utilities,Wetland,etc. 11 5 ecifications 12 Structural Deer Review 13 Structural Tests&Inspections Pro am 14 'Fire Protection Narrative Re ort 15 Ids ,n Building 5urve /]nvesti anon 16 Energy Conservation Report 17 Ardutectural Access Review 521 CIvLI? 18 Workers Compensation Insurance 19 Hazardous Material N iti ation Documentation 20 Other S ec• 21 Other Specify)' 22 Other S ec• 'Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction.Work started prior to approval may be subjected to triple the original permit fee. Registered Professional. Contact Information _ ; Regisrr$,+ion Numbe° - Nam�fp •�istrant) -- - �— Telephone No. e-mail address Street Address Ci Town state dip Discipline Expiration Date ty/ Name(Registrant) Telephone No. e-mail address Reb' hation.Number Street ddress Discipline Expirati41at � Ci Town State Zi Name(Registrant) Telephone No. e-mail address Registration Number Street AddressTown State Zip Discipline Expiration Date The Cominonive altdt �1f���dr�Sflefirrs'c�rttF #- Df-Taa'traleiit of hid ustHal Accidents Ofj tee uj Iid estrg atioll5 600 HI(I,ahiliRgton Sti-eet Bostom, )VIA 02111 ' ` iE/iviv.il;rdrss.��Tvvlc�icf NVor-kers' Compensadon 0sur•ance Affidavit: Builders/Colltr•,,ictor-s/Electg•icia;iis/Plirnibei-s Iicm i a� 'r�r rxratiorr Tease Print 1Le ib)v amc (C3tlsint ss;Us,trli�atic�tl:indiviiitttll j: L C: � t�,�j-L r SS p VE - Address: n C City/State/zip: ki: C 1 � ' �• J, q E) r � .>�l�orac .r. ��- �. � �.= Are you an employer?C:hecic the applropt"iate box. 1.R l am a ,mployer with 50+ 4. ❑ 1 am a general eontractor and I Type of project(required): employees (full and;'or trt-iilnc). have hired the sub-contractors 6. ❑ New construction 2•❑ I an, a sole ryptutor or partner- listed on the Attached sheet. 7. ❑ Remodeling ship and haN'e no ettlployees These sub-contractom hmT g El Drarnolitinn nrclt4;it g for me in any capacity. employees and have workers, (No workers' comp. insl.trat)Ce comp. insurance.= 9. ❑ Building ciddition required.] ''tic: ar•t a Corporation and its 1L1•❑ Elechical rept m or addition, 3.❑ 1 ant a hottleowner doing all tc-orlc officers have exercised their 1 l.❑ Plunlbirlg thyself. [?4o worker's' comp, right oCeNcnlption per•'NIGi= repairs or additions 12 ❑ Roof rcp�tirs insuratacc required j '' c. 152, §1(4)1 and we have no Etuplo}'et's, [No workers' I I JR Othei-SOLAR ARRAY 401111), itnsul'ance required.] "Any app€icanl than checks but=€ mart as no mo the section hc€ow"Musing their wrkem'emnpen ation police hiormnaon. 1€omcowlmrs who,ubmit IhiS a;ftdavi!indicating they:are doing all wwk and then€tire ulsiLie uOntract els angst sut�mit a neu aftida�i!ir�clicutin_s h. Contr.=etora that dc :this nn. u 1 \must anwhed n ht€doo,s€ m S1mwing the name of the sub-Comoctors and Strut"Outer or no!nose emiocs€avo e:llpruYcia• ]f the sub-rontmctors have nnployca&[hey mot]tray ide their to kel-z'ettmn.p0hey number. am an em plk(ger that is11rovitfi lg wol-ke"S'L•(1mpeTsatioll insi1-ante fOl'my elllple t)%tes. Below iS Me poligll and job:Sit[, (1T f�rl1"111r1T`d(11T. insurance Company Name:- 1 `-:� l,' Poli0y P, ar sclff�iris. l_it'. !'- U (_• C' L( �� - G:' [� - ' j Date: :?_C ,� . t � �• 1={� ----- _. [ � ExpirationExpiration ' ! •role Site Address;__� � Grp S Tfe�s�G �� N A�'�U�. Cst�+.`StatciZip; Attach 2 COPY Of the workers' cotnpenstttiou policy [lcclaration page (sholving the:park}: rtunri5er €and eel3iratinn date). Failure to st clue eover�ge €,ti T•equired tinder Section 25A oftV[GL c. 152 call lead to tllc irltlaositinrt of criminal penalties oe) rime tip to S 1,500.00 andior one-;rear impt'isonment, as well as civil penalties it) the form of a STOP WORK ORDER and a fine Of up to 5250.00 a duty ra�tttirlst the violator, Be advised that:a copy o€'this statenlctlt€nay be forwarded to the Di:licc of Investigations of the DIA fur insurance covet'ttge veriticatiotl. 1(lo herehj,c"e1 aA, 1117rler t ti reins x1111 penah%r)f pe1j1r1;1,!lull flat irlfvT'rlultiun provided tlhnt+e is tl Ire volti cart ect" Phone A 508-579-1083 U d 11 i dfffcirrl use arrlt. Do Ira,"'rile ill 111is a1'f!a� to he caltrprnterl bl viot al tnrrfrl official. Litz• or Town: Pet tttii/I icensc Issuing Authorlo'(ell-Cie carte): — -----�._� 1. Board of Health 2. BulkUng Departnieut 3. 001TOMm CAW 4. Electdco ltlspector 5, f'lulTtbhg Inspector G. Other Contact 1 etim: Phone 4: I SOLEINC-01 CFERGUS N ,4co�zoM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 03/01/2017 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 have ADDITIONAL INSURED provisions or 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 C TACT Provider Group AICC.N,Et):(781)444-0347 FAX No):(781)444-8961 160 Gould Street,Suite 122 Needham,MA 02494 e- A .need hamr providerig.com INSURERJS)AFFORDING COVERAGE NAIC 9 INSURERA:Landmark American Insurance Co INSURED INSURER B:OhioSecUrl Insurance Company 24082 Solect,Inc.,Clean Energy Installs LLC,Solect Energy Dev INSURERC:RSUI Indemnily Company LLC 89 Hayden Rowe St.Suite E INSURER D:Hartford Hopkinton,MA 01748 INSURER E; 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 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 AODp SUBR WVD POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,QU0,000 CLAIMS-MADE [X] OCCUR LHA110983 01109/2017 01/09/2018 DAEMA13ETO RENTED $ 54,000 MED EXP(Any oneperson) PERSONAL&ADV INJURY 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑jpeT F-1 LOC PRODUCTS-COMPIOPAGG 2'000,000 X I OTHER:Deductible: $5000 $ B AUTOMOBILE LIABILITY (CEOM.,, SINGLE LIMIT 1000,000 ANY AUTO BASS6258949 0910412016 09/0412017 BODILY INJURY Perperson) $ OWNED X SCHEDULED BODILY INJURY Per accident $ AURTOS ONLY AUTOpSWN X AUTOS ONLY X AlO1T08 ONLY PPOracEcRdent..— $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,000 EXCESSLIAB CLAIMS-MADE NHA078225 0110912017 01109/2018 AGGREGATE $ 6,000,000 DED RETENTION$ D WORKERS COMPENSATION PER OTH- AND EMPLOYERS,LIABILITY YIN 6S60UB-OG04294-8-16 05/16/2016 05/16/2017 1,000,000 AANFYICRROPNIRII^TBOERRIEXGLUERIEDEO?ECUTIVE ❑ NIA E.L.FJ�CHACCIDENT (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1'000'000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE 9 o ACORD 25(2016103) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Ca C,dJM di Fe�Na°A�^��/fi/AJ I✓ " Pwegu.rr', M��� aenircm:yantte 11e ertu ve vvt° V tapalfu:. tt'nt . Office of Cnnsumer rlffuirs&Business Regulation o IOME IMPROVEMENT CONTRACTOR Board Of 80cfing Regulations and Standards � egistration: 182158 /p. Type: l x p.,ration:_ 6/1/2617- License: CS-108049 individual BRIAN MCPHAIL BRL4,N MCPHAIL /i Af�Jf 22 FRENCH STREET- BRIAN MCPHAIL !� Billerica MA 01821 �1 i 22 FRENCH STREET d BILLERICA, MA01821 `, Undersecretary r N . t.arar'v�cetvaa�„¢a'� p�;q�vu�tlf�hv'v ., 7/0912018,. trr jO✓,+w4w;wN1Y,ylwN f.✓r� r,. w R au„{;mi y' tM q,rNrr�t�r w'yr":i""`�J`+ �y 9f�s�wr C 5.8Jafmtrowl of tat 4„tCCutxA,,xW Salety ararw Heawn m mmisirat:Gon t 100114AIN 41 411"".. ti favus;a rr.aashy wrr WW'lV s 0-h4m orcupallonal safety end 8°4eak f"mWngl Courtw 1,)n i Caat*ucli tSat e tt lth