HomeMy WebLinkAboutBuilding Permit #020-15 - 1027 GREAT POND ROAD 7/7/2014 •.;A of N°oT a 1ti�
BUILDING PERMIT 3r 4°:�_ .:.~ .'6 0W_
TOWN OF NORTH ANDOVER ° ' p
PPLICATION FOR PLAN EXAMINATION
Permit NO: A Date Received LA.4
�-•� �4SSACMUS���
Date Issued: I
IMPORTANT:Applicant must complete all items on this page
LOCATION fes ' C3"P j AID
Print
PROPERTY OWNE . 5 ycs?g-.4
MAP NO. �fC3 PARCEL: JQ ZONING Dlint
Pr
STRICT: Historic.District yes ,, no
Machine Shop Village : yes no
TYPE OF IMPROVEMENT PROPOSED USE
Res'dential Non- Residential
New Building VOne family
Addition u Two or more family i i Industrial
Alteration No. of units: F1 Commercial
- Repair, replacement 11 Assessory Bldg n Others:
= Demolition ❑ Other
C Septic ' = Well ❑ FloodplainEl Wetlands p Watershed' istrict
❑Water/Sewer J
-TIV c L 0 5 6— p 104404 C•�a r X'`r3
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
9 79- 7Y 1411
�0-�/t m�'�"lnlLp' � �9��=►��� �" P3
Address:
CONTRACTOR Name :�'r 7r Phone: j' ti�I
Address
Supervisor's Construction License: Exp. Date:
.Home Improvement License: Exp Date:
ARCHITECT/ENGINEER- /t`4FA r& Be 1s r6 A? Phone:_77P` 10,7 - ISIS
Address: Reg. No.
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. t/
Total Project Cost: $ 21 00w,- FEE: $
Check No.: X227 Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have acQss to 'we ruarmutyfund
r
L ignature of Agent/0wner '. ature of contracto
101,
7i
d
� 10R
BUILDING PERMIT 0* rTF/tAoR
TOWN OF NORTH ANDOVER
o
APPLICATION FOR PLAN EXAMINATION
Permit No#: Date Received
gSSACHUs�t
Date Issued:
IMPORTANT: Applicant must complete all items on this page
-- ----- ---��, - vL=— �.
LOCATIONS ---
Pnnt -
PROPERTY OWNER_
_ t
Print 100 Year Structure yes no
_PARCEL ZONING D,ISTRICt° __.Histo.r Strict yes,r" ono
_-
Machine Slop Village yes: trio
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
q Septic ❑1Nell. ❑ Floodplain []Wetlantls.- Y ❑ Watershed�Distnct.
.Wate_ - Sewers _ -
DESCRIPTION OF WORK TO BE PERFORMED:
I
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
ContractName I _ ~
ori Phone
Address: .
pennsor's'Constructign Liicense A — µ _ ,Exp. v-
_ - � _
- -
--
IS
i -
Home�fmprovement:License _ __ _, _� Exp Date`.
_ �.
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Receipt No.: j
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
V41r,
�tu�e of;Agent/Ownee__ _:-.
Signature of contactor:= __re_
C' ,a
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
J9
CONSERVATION Reviewed on -21-71 )qq Signature ��,Lk
COMMENTS
HEALTH Reviewed on Signature
r 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 Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPAR�TMEN�
T Tempt®umpstertonrsite. yes
Located at 124iMain;Stree_f - "
s 3 <:
f irelDepartment ignature/date _ — _ __
COMMENTS .
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— (For department use)
C
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i
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❑ Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014
f
1
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
1
❑ Building Permit Application
o Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
o Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
Li Certified Surveyed Plot Plan
. Y
o Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
Li Mass check Energy Compliance Report (If Applicable)
o g En in 9 p Bering Affidavits for Engineered products
s
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
o Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
L, Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering g g Affldavlts for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doc:Building Permit Revised 2014
�I
Location f aQ297
Cy`- lav n�I �d
No.c:lcv A;— Date / f
i
'.: o • TOWN OF NORTH ANDOVER
Certificate of Occupancy $ i
Building/Frame Permit Fee $ {
- Foundation Permit Fee $
Other Permit Fee $
�k
' TOTAL $
Y
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Check#
2748
Building Inspector
Emerson o li
22B Bridge St., Chelmsford, MA 01824
978-256-4177
June 13, 2014
Tina Sylvester
Great Pond Road
North Andover, MA
This estimate is to build a 14'x12'6" enclosed porch. The following items are included in
this estimate:
1. Remove an existing deck.
2. Install five (5) concrete sonotubes.
3. Frame the floor, walls and roof.
4. Frame for a 3'x6'6" exterior door and two storm windows on the back wall,
and 4 storm windows on each side wall.
5. Install stairs off the back door and railings on both sides.
6. Install PVC trim boards around the perimeter of the roof and around the door.
7. Install ice &water shield and matching architectural shingles on the roof.
8. Install red cedar shingles on the 3 sides of the porch.
9. Electrical work will include installation of recepticals inside, one (1) ceiling
light and two (2) outside lights. (Estimate does not include light fixtures.)
10. Install a fiberglass exterior door, storm door and ten (10) aluminum storm
windows.
11. Install crushed stone under the deck.
12.Dispose of debris.
Material & Labor:
$20,000.
($600 allowance for door & storm door)
This estimate does not include insulatingthe
floor, walls or,/beilmg. It also does not
include drywall on walls and ceiling, interior casing and baseboard.
r ;
Tina Sylvester Date Stej&n B. E erson Date
N� :This proposal may be withdrawn
by us if not accepted within 90 days.
All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Any alteration
or deviation from above specifications involving extra cost will be executed only upon written orders,and will become an extra charge over and
above the estimate.All agreements contingent upon strikes,accidents or delay beyond our control.Owner to carry fire,tornado and necessary
insurance.Our workers are fully covered by Workman's Compensation Insurance.
®Boise Cascade Double 2 x 10 SPF #2 Floor Beam1F1306
Dry 2 spans No cantilevers 10112 slope Tuesday, June 17, 2014
BC CALCO Design Report- US
Build 2627 File Name: 0614-EB04 Emerson N.Andover,e , MA
Job Name: Description: double joist @ edge(2 sides)
Address: Great Pond Rd Specifier: HBB
City, State, Zip: N.Andover, MA Designer:
Customer: Company: CLC
Code reports: NLGA Misc:
w. .a ?aKA
BO 06-03-00 06-03-00
61 B2
Total Horizontal Product Length= 12-06-00
Reaction Summary(Down/Uplift) (Ibs)
Bearing Live Dead Snow Wind Roof Live
B0, 3-1/2" 153/20 66/0
B1, 3-1/2" 401 /0 198/0
B2, 3-1/2" 153/20 66/0
k Live Dead Snow Wind Roof Live Trib.
Load Summary
Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125%
1 Standard Load Unf. Area (Ib/ft^2) L 00-00-00 12-06-00 40 15 01-04-00
Disclosure
Controls Summary Value %Allowable Duration Case Location Completeness and accuracy of input must
Pos. Moment 251 ft-lbs 7.3% 100% 2 02-08-13 be verified by anyone who would rely on
Neg. Moment -361 ft-lbs 10.5% 100% 1 06-03-00 output as evidence of suitability for
End Shear 134 lbs 5.3% 100% 2 01-00-12 particular application.Output here based
Cont. Shear 227 lbs 9.1% 100% 1 07-02-00 on building code-accepted design
properties and analysis methods.
Total Load Defl. L/999 (0.005") n/a n/a 2 03-00-00 Installation of BOISE engineered wood
Live Load Defl. L/999 (0.004") n/a n/a 5 03-00-14 products must be in accordance with
Total Neg. Defl. L/999 (-0.001") n/a n/a 3 04-08-13 current Installation Guide and applicable
Max Defl. 0.005" n/a n/a 2 03-00-00 building codes.To obtain Installation Guide
or ask questions,please call
Span/Depth 7.8 n/a n/a 0 00-00-00 (800)232-0788 before installation.\n\nBC
CALCO,BC FRAMER@,AJSTM,
%Allow %Allow ALLJOISTO,BC RIM BOARD TM BCI@,
Bearing Supports Dim.(L x W) Value Support Member Material BOISE GLULAM-,SIMPLE FRAMING
BO Wall/Plate 3-1/2"x 3" 218 lbs n/a 4.9% Unspecified SYSTEM@,VERSA-LAM@,VERSA-RIM
PLUS@,VERSA-RIM@,
B1 Wall/Plate 3-1/2"x 3" 600 lbs n/a 13.4% Unspecified VERSA-STRANDO,VERSA-STUD@ are
B2 Wall/Plate 3-1/2"x 3" 218 lbs n/a 4.9% Unspecified trademarks of Boise Cascade Wood
Products L.L.C.
Notes
Design meets Code minimum (L/240)Total load deflection criteria.
Design meets Code minimum (L/360) Live load deflection criteria.
Design meets arbitrary(1") Maximum total load deflection criteria. E.-
Calculations assume Member is Fully Braced. ` ED AAxk
Design based on Dry Service Condition. ��,� .�E GROG
The analysis of solid sawn wood members is in accordance with the NDS and is limited to the ��
output shown above. All other support and design for these products, including but not NO,30539
limited to notching, connections, installation, and engineer/architect certification is the 0ACTON
is SACT 6SETTS
responsibility of the project's design professional of record.
Deflections less than 1/8"were,ignored in the results.
i
For Concord Lu>snber Corp.
Page 1 of 1
®Boise Cascade Single 2 x 10 SPF #2 Joist1J01
Dry 1 span lNo cantilevers s 0/12 sloe Tuesday, n
p y, Ju e 17, 2014
BC CALCO Design Report- US 16 OCS I Repetitive I Glued &nailed construction
Build 2627 File Name: 0614-EB04 Emerson N.Andover, MA
Job Name: Description: floor joist
Address: Great Pond Rd Specifier: HBB
City, State, Zip: N.Andover, MA Designer:
Customer: Company: CLC
Code reports: NLGA Misc:
I
�.�,.�" ».. ,- ,.J.��.....,....n..,2—,_.....::tom .�........,.�, ...,... .� ,.....,.,..�_.,.a_i_ _�.....:.,s a..,......_..� ....x>,._ .......�.�,..- ve,.'�...._ _..,....._.�..x.,.<..�,._,a..�.t,..... Fa`i&' ...x `.
BO 12-06-00
B1
Total Horizontal Product Length= 12-06-00
Reaction Summary(Down/ Uplift) (lbs)
Bearing Live Dead Snow Wind Roof Live
BO, 2-1/2" 333/0 125/0
B1, 2-1/2" 333/0 125/0
Live Dead Snow Wind Roof Live OCS
Load Summary
Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125%
1 Standard Load Unf. Area (Ib/ft112) L 00-00-00 12-06-00 40 15 16
Disclosure
Controls Summary Value %Allowable Duration Case Location Completeness and accuracy of input must
Pos. Moment 1,366 ft-lbs 69.2% 100% 1 06-03-00 be verified by anyone who would rely on
End Shear 387 lbs 31% 100% 1 00-11-12 output as evidence of suitability for
Total Load Defl. L/554 (0.265") 43.4% n/a 1 06-03-00 particular application.Output here based
Live Load Deft L/761 (0.192") 63.1% n/a 2 06-03-00 on building code-accepted design
properties and analysis methods.
Max Defl. 0.265" 26.5% n/a 1 06-03-00 Installation of BOISE engineered wood
Span/Depth 15.8 n/a n/a 0 00-00-00 products must be in accordance with
current Installation Guide and applicable
%Allow %Allow building codes.To obtain Installation Guide
Bearing Supports Dim.(L x W) Value Support Member Material or ask questions,please call
(800)232-0788 before installation.\n\nBC
BO Wall/Plate 2-1/2" x 1-1/2" 458 lbs n/a 28.8% Unspecified CALCO,BC FRAMER@,AJSTm,
B1 Wall/Plate 2-1/2" x 1-1/2" 458 lbs n/a 28.8% Unspecified ALLJOISTO,BC RIM BOARD TM BCI®,
BOISE GLULAMM,SIMPLE FRAMING
Notes SYSTEM@,VERSA-LAM@,VERSA-RIM
PLUS@,VERSA-RIM@,
Design meets Code minimum (L/240)Total load deflection criteria. VERSA-STRANDS,VERSA-STUD@ are
Design meets User specified (L/480) Live load deflection criteria. trademarks of Boise Cascade Wood
Design meets arbitrary(1") Maximum total load deflection criteria. Products L.L.C.
Calculations assume Member is Fully Braced.
Composite EI value based on 23/32"thick OSB sheathing glued and nailed to member.
Design based on Dry Service Condition.
The analysis of solid sawn wood members is in accordance with the NDS and is limited to the
output shown above. All other support and design for these products, including but not ����
limited to notching, connections, installation, and engineer/architect certification is the QED q
responsibility of the project's design professional of record. ��`�i— RCyK4
Deflections less than 1/8"were ignored in the results. ��� ��GE. GROL TFC
N0.3G539 N
p CTON �-
i4A CH ETTS
!7F N%F'�`�
For Conan di er Corp.
Page 1 of 1
�
oise Cascade Single 2 x 10 SPF #2 r\RO1 �
Cry 1 span I No cantilevers 13/12 slope Monday, June 30. 3014 �
BC CALCODesign Report' UG 18OCSNon-Repetitive
Build 2627 File Name: 0814-EB04 Emerson N.Andover, MA
u\RO1
Job Name: Description: eogni �
Address: Great Pond Rd Specifier: HBB �
City, State, Zip: N.Andover, [NA Designer:
Customer: Company: CLC
Code reports: NLGA Mioo:
12
12-06-00
Total Horizontal Product Length= 12-06-00
Reaction Summary (Down /Uplift) (|bs)
Bearing Live Dead Snow Wind Roof Live �
B1. 2'1/2" 97/0 313/0
Live Dead Snow Wind Roof Live OCS
Load Summary
Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125%
1 Standard Load Un[ Area (|bdt^2) L 00-00-00 12'08'00 15 SU 12
Oiscimswpm
Controls SCompleteness and accuracy ufinput must
� Poo. Moment 1.220#,|bo 61.8% 11596 4 08'03'00 beverified byanyone who would rely on
End Shear 305 |bo 27.596 11596 4 00'02'08 output aoevidence o,suitability for
particular application.Ou�u�honabooed
Total Load DmO. L/602 (0.251") 29.9% n/a 4 06'03'00 onbui|ding -code-accepteddeoign
Live Load DmM. L/788 (0.192") 30.596 n/a S 06'03-00 properties and analysis methods.
N1oxOaO. O.251" 25.196 n/a 4 06-03'00 Installation ofBOISE engineered wood
Span/Depth 15.8 n/a n/a 0 00'00'00 products must boinaccordance with
current Installation Guide and applicable
-
Allow %AUmw buildingcodes.
or ask �� � U
�
Bearing � (800)232-0788 before lla8n.\n\n8C
pv vvumr/au, 2'/'2 x /'/'2409wu n/a 25./m unupeuxuu caLCO.eCpRAMER0/AJOn°.
B1 Wall/Plate 2'1/2" x14C2" 408 |bo n/a 25796 Unspecified ALLJ08TO.BCRIM BOARD n°.8Ck0.
BOISE GLULAMTM.SIMPLE FRAMING
Moriz.Length Product Length SYSTEM@.vERG8'LAM@.VERSA-RIM
Slope d Cut Lth Slope Fascia Depth PLUS@.vEnGA-R|M@.
VERGA'OTRAwDm.vEnGA'8TUDOare
Plumb Hanger"'""'. top plate 3/12 9-1/2" 12'06-0" '^'""-'^ trademarks ofBoise Cascade Wood
pmductsLLC.
Notes
Design meets Code minimum (L/180)Total load deflection criteria.
Design meets Code minimum (L/240) Live load deflection criteria.
Design meets arbitrary(1'') Maximum total load deflection criteria.
Calculations assume Member ioFully Braced.
Design based onDry SemiooCondition.
�="'`
The analysis of solid sawn wood members is in accordance with the NDS and is limited to the
output shown above. All other support and design for these products, including but not
limited to notching, connections, installation, and engineer/architect certification is the
responsibility ofthe project's design professional ofrecord. -
Deflections less than 1/8"were ignored in the nmnu|ta.
�
Page 1 of 1
For Concord Lumber Corp,
1&3olse Cascade Single 2 x 8 SPF #2 RafteAR01
Dry 1 span I No cantilevers 13/12 slope Monday, June 30, 2014
BC CALCO Design Report- US 12 OCS Non-Repetitive
Build 2627 File Name: 0614-EB04 Emerson N.Andover, MA
Job Name: Description: Designs\RO1
Address: Great Pond Rd Specifier: HBB
City, State, Zip: N.Andover, MA Designer:
Customer: Company: CLC
Code reports: NLGA Misc:
�3
12
l'
12-06-00
BO B1
Total Horizontal Product Length= 12-06-00
Reaction Summary(Down/ Uplift) (lbs)
Bearing Live Dead Snow Wind Roof Live
BO, 2-1/2" 97/0 313/0
B1, 2-1/2" 97/0 313/0
Live Dead Snow Wind Roof Live OCs
Load Summary
Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125%
1 Standard Load Unf. Area (Ib/ft12) L 00-00-00 12-06-00 15 50 12
Controls Summary Value %Allowable Duration Case Location DisclosureCompleteness and accuracy of input must
0
Pos. Moment 1,220 ft-lbs 92.2% 115% 4 06-03-00 be verified by anyone who would rely on
End Shear 395 lbs 35.1% 115% 4 00-02-08 output as evidence of suitability for
Total Load Defl. U290 (0.521") 62.1% n/a 4 06-03-00 particular application.Output here based
0 on building code-accepted design
Live Load Defl. L/379 (0.398') 63.3% n/a 5 06-03-00 properties and analysis methods.
Max Defl. 0.521" 52.1% n/a 4 06-03-00 Installation of BOISE engineered wood
Span/ Depth 20.2 n/a n/a 0 00-00-00 products must be in accordance with
current Installation Guide and applicable
%Allow %Allow building codes.To obtain Installation Guide
BearingSU or ask questions,please call
Supports Dim.(L x W) Value Support Member Material (800)232-0788 before installation.\n\nBC
BO Wall/Plate 2-1/2" x 1-1/2" 409 lbs n/a 25.7% Unspecified CALCO,BC FRAMER@,AJSTM,
B1 Wall/Plate 2-1/2" x 1-1/2" 409 lbs n/a 25.7% Unspecified ALLJOISTO,BC RIM BOARD TM,BCI®,
BOISE GLULAMT"',SIMPLE FRAMING
Horiz.Length Product Length SYSTEMO,VERSA-LAMO,VERSA-RIM
Slope and Cut Length Slope Fascia Depth PLUSO,VERSA-RIM®,
Plumb Cut with Hanger to dbl. top plate 3/12 7-1/2" 12-06-00 13-00-07 VERSA-STRANDO,VERSA-STUD®are
trademarks of Boise Cascade Wood
Products L.L.C.
Notes
Design meets Code minimum (L/180)Total load deflection criteria.
Design meets Code minimum (U240) Live load deflection criteria.
Design meets arbitrary (1") Maximum total load deflection criteria.
Calculations assume Member is Fully Braced.
Design based on Dry Service Condition. -
The analysis of solid sawn wood members is in accordance with the NDS and is limited to the An
output shown above. All other support and design for these products, including but not GRp F�
limited to notching, connections, installation, and engineer/architect certification is the 1P
responsibility of the project's design professional of record. NO,30539
Deflections less than 1/8"were ignored in the results. 0 ACTON
r ACH 'ETTS
oG
q( QF
For Co er Corp.
Page 1 of 1
Boise Cascade Triple 2 x 8 SPF #2 Floor Beam1171301
Dry 2 spans No cantilevers 10/12 slope Monday, June 30, 2014
BC CALCO Design Report-US
Build 2627 File Name: 0614-EB04 Emerson N.Andover, MA
Job Name: Description: roof beam @ end
Address: Great Pond Rd Specifier: HBB
City, State, Zip: N.Andover, MA Designer:
Customer: Company: CLC
Code reports: NLGA Misc:
VVVSSSIII 07-00-00 07-00-00 ISI
BO B1 B2
Total Horizontal Product Length=14-00-00
Reaction Summary(Down /Uplift) (lbs)
Bearing Live Dead Snow Wind Roof Live
BO, 3-1/2" 405/0 1,378/0
B1, 3-1/2" 1,238/0 3,914/0
B2, 3-1/2" 405/0 1,378/0
Live Dead Snow Wind Roof Live Trib.
Load Summary
Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125%
1 Standard Load Unf. Area (Ib/ft^2) L 00-00-00 14-00-00 15 50 09-03-00
Disclosure
Controls Summary Value %Allowable Duration Case Location Completeness and accuracy of input must
Pos. Moment 2,219 ft-lbs 55.9% 115% 1 02-11-01 be verified by anyone who would rely on
Neg. Moment -3,488 ft-lbs 87.9% 115% 3 07-00-00 output as evidence of suitability for
End Shear 1,238 lbs 36.7% 115% 1 00=10-12 particular application.Output here based
on building code-accepted design
Cont. Shear 2,119 lbs 62.8% 115% 3 07-09-00 properties and analysis methods.
Total Load Defl. L/999 (0.075") n/a n/a 1 03-02-13 Installation of BOISE engineered wood
Live Load Defl. L/999 (0.061") n/a n/a 4 03-03-08 products must be in accordance with
Total Neg. Defl. L/999 (-0.004") n/a n/a 2 06-04-03 current Installation Guide and applicable
building codes.To obtain Installation Guide
Max Defl. 0.075" n/a n/a 1 03-02-13 or ask questions,please call
Span/Depth 11.2 n/a n/a 0 00-00-00 (800)232-0788 before installation.
%Allow %Allow BC CALCO,BC FRAMER@,AJS-,
Bearing Supports Dim.(L x W) Value Support Member Material ALLJOISTO,BC RIM BOARD- BCI@,
BO Wall/Plate 3-1/2"x 4-1/2" 1,783 lbs n/a 26.6% Unspecified SYOSTEM@ISE ,v RSASLAMO,VERSA-RIM
B1 Wall/Plate 3-1/2"x 4-1/2" 5,152 lbs n/a 77% Unspecified PLUS@,VERSA-RIM@,
B2 Wall/Plate 3-1/2"x 4-1/2" 1,783 lbs n/a 26.6% Unspecified VERSA-STRANDO,VERSA-STUD@ are
trademarks of Boise Cascade Wood
Notes Products L.L.C.
Design meets Code minimum (L/240)Total load deflection criteria.
Design meets Code minimum (L/360) Live load deflection criteria.
Design meets arbitrary(1") Maximum total load deflection criteria.
Calculations assume Member is Fully Braced.
Design based on Dry Service Condition.
The analysis of solid sawn wood members is in accordance with the NDS and is limited to the
output shown above. All other support and design for these products, including but not w0 S 01�0�FOA
limited to notching, connections, installation, and engineer/architect certification is the 4,
NO.3n.�5
a9 �
responsibility of the project's design professional of record. ACTON
Deflections less than 1/8"were ignored in the results. SSACF 'ETTs Uj
�o s�
gP
5
<Ty OF b\P
For Concord Lumber Corp.
Page 1 of 1
N e Commonwealth ofMaswh.nsetts
Department of XndastriglAcczd'ents
Office of.Investigations
600 Washington Street
.Boston,HAVIX.X
www.mass gov/ctia
Wo rkexs'Compensation Insurance Affidavit:Bum tiers/Contractors/ElectriciansfPl*�erio
t�.pp�[can$Information Please Print Leg—My
Tame(Businesslorganizationlfn&Idual): -C,a&,ne— &7!�
Address: r
City/Statel p: � .. � d Phone 4: 10,
.Are you an employer?Check the appropriate box: Tyne of project(required):
1.❑ 1 am a employer with 4. 1 am a general contractor and l 6. New c6nstraction
employees(fa11 and/or part time).* have likedthe sub-contractors
2,® 1 am a sola proprietor or partner listed on the attached sheet: 7• Remodeling
ship and•haveno•employees These.sub-contractors have 8. ❑Demolition
working forme in any capacity. workers'comp.insurance. 9, Building addition
Wo workers'comp.insurance 5. ❑We are a corporation and its 10,❑Electrical repairs or additions
required.] officers have exercised.their I
3.E1 X am a homeowner doing all work right of exemption per MGL 11.[(Plumbing repairs or additions
Myself [Vbworkers'comp. c.152,§l(4),andwehaveno 1 ,[]Eoofxeairs
insurancerequixed.]i employees.[Noworkexs' 13.[]Other •
comp.insurance required.]
xAny applicantthat checks box#I must also fill out the section bel6w showing heir workers'compensationpolicy information.
I Homeowners who submit This affidavit indicating they 9" doing A worts 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 ofthe sub.-contractors and their workers'comp.policy information.
r arra an empfoyer tbat is providing workers'eompeiisation insuranco fbr fny en�ployeer Below is the vaZicy anct ja i site
information.
Insurance Comp myhlame%
Policy#or Self ins.Lic.#: Expiration Data:
rob Site Address: &2.22 Z/",°r2 sL •tylState/Zip:
Attach a copy of tete workers'coznpensatlonpollcy declaration page(showing-the policy number and expiratioa date).
Yallure to secure coverage as requixed.under Section25A.ofMGL o.152 can lead to the imposition of criminal penalties of
fine up to$1,50 0.0 0 and/ox one-year haprisonment,as well as civil penalties in the form of a STOP WORK ORDER.and a fine
` e violator. Be advised that a co of this statementma be,forwarded to the Office o£
da against Y
of up to$250.00 a copy p Yg
Investigations of tho DIA for ibsurance coverage verification,
.ado tier eby ceft1gy 2eiiains and penalties qfpVury that tree information provided above is tree and eorreet. -
Si ature• Date:
Phone#•
Official use only. Do not write in Mis area,to be coYnpleted by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health.2.BuildingZDepartment 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbi ng luspector
6.Other
f •
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for th.ei employees.
Pursuant to this statute,an employee is defined as"...every person irithe service of another under any contract ofhixe,
express or implied,oral or wxitten:'
Aa emtploye is defined as"an individual,partnership,association,corporation or other legal entity,or any two or mole
ofthe foregohig engaged in a joint enterprise,and including the legal representatives of a deceased emplayez,.or the
xedeivex ortrustee ofan individual,partnership,association or other legal entity,employing employees. pTowever the
owner of a dwelling house having notmore•than three apartments and who resides therein,,or the occupant ofthe
dwelling house of another who employs persons to do maintenance,construction ox xepair worts on such dwelling house
or on the grounds or building appurtenant thereto shallnot because of such employment be deemed to be an employer."
MOL chapter 152,§25C(6)also states that"every state or local Reensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth.fox any
applicant who has not produced.acceptable evidence of compliance with theinsurance coverage required:'
Additionally,MGL chapter 152,§25C(7)states"Neither the commmonwealth nox any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence of compliance with,the insurance
requirements ofthis chapter have beenpresented to the contracting authority."
• I
Applicants
Please fill out the workers'compensation affidavit completely,by checlang the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),addresses)andphonenumber(s)along with theircertificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members oxpartners,arenofrequiredto canyworkers'compensationinsurance. If an LLCorLLPdoes have
employees,apolicy1sxequired. Be advised thatlhls affidavitmay be,submitted to the Department of Industrial
Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Depaxtm.ent of I
Industrial Accidents. Should you have any questions regarding the law or if you are xequired to obtain,a workers'
compensationpoEGy.,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be,suxe thatthe affidavit is complete andpxinted legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be-sure to ED in the permit/Rcenso number which'will be,used as a reference number, Th addition,m applicant
thatmust submitmultiple permit/license applications in any givenyoar,need only submit one affidavit indicating cutrent
Policy information(if necessary)and under"Job Site Address"the applicant shouldwxite"all locations in (city or
toWn).".A.copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant aspxoofthat avalidaffidavit•ison:Mo:orfutuxepermitsorlicenses. Anewaffidavitmtistbefiffedouteach
year.Where a home owner or citizen is obtaining a license ox permit not related to any business or commercial ventuxe
(i.e.a dog license orpermit to burn leaves etc.)saidperson is NOT required to complete this affidavit. j
The Office of investigations would like to thank you in advance for your cooperation and should you have any questions, f
please do not hesitate to give us a call.
The Department's address,telephone anal fax number:
Tha CQ on�Mt o assac7�v P e
Dapa eut Off dusGTial AccldeWs
Of oo of111RVQWgA#o)1xa •
B QAQn,MA 02111
TO,0 61M-2'�4900 Qx406 ox 1-87-7,MASSAM _
Revised 5-26-05 Falb � �
wwvwagovlcha
1 Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Supemisor
License: CS-019489
STEPHEN B EMEJkSON
22B BRIDGE ST
CHELMSFORD IRA 0 82tt'
Expiration
Commissioner 12/10/2015
,,�a.,, ��G (poa77�I7�oa2cueCt�L�a�U/�4aJdacfSccJe��iJ
= \ Office of Consumer Affairs&Business Regulation
_ i OME IMPROVEMENT CONTRACTOR
registration: 142551 Type:
Expiration: 4/8/2016, DBA I
EMERSON REMODELING . 1
� I
STEPHEN EMERSON i
22B BRIDGE STREET
i
i
CHELMSFORD, MA 01824 Undersecretary
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COCNICNlWICM V
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BOARD OF HEALTH
Food/Kitchen
PERMIT L D Septic System
THIS CERTIFIES THAT ...0..��I�:1!1.4........... ..... lveskk......................
BUILDING INSPECTOR
Foundation
has.permission to erect .
{ � ................... buildings on ..101...... . .......... ...... ............. ......... �.
�� � Rough
p �. �........3.� 111�'t�l �....... w� ChimneyUh
It
to be occupied as .. .. .
...,................
provided that the person accepting this permit shall in 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 EXPIRES IN 6 ONT ELECTRICAL INSPECTOR
® • UNLESS CONSTRUCT S TS Rough
Service
......... ..................... ...............
Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy 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.