Loading...
HomeMy WebLinkAboutBuilding Permit #535-2017 - 103 SUTTON HILL ROAD 11/17/2016 VS ii t%ORTy BUILDING PERMIT 2o�zLF .6�4 TOWN OF NORTH ANDOVER o -` APPLICATION FOR.PLAN EXAMINATION '' `- * i 011 o Permit No#: / Date Received 1 �— i ?'�?" poRaTen ay e' RSSACHUS�� Date Issued: — 01-f MORTANT:Applicant must complete all items on this page it PuROPERTY°®WNER -'Print f1 DOYear Structure i - MA}.; i �_'S. Pi;4RC.E`L.. a"'T�`,}+�:'_� �:>7ZON�`IN_,Gt•DL I'S+sTR•x��ICW� SY"Y` ;i;H~Misat.cihty yeyes ortc® c, inSoUt no o' TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 4 New Building if One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ` ❑ Demolition ❑ Other Septic `oWell V 0 Floodplain El Wetlands M Watershed Disfnct. .�h . El Weier/%e pt :.}w.i. '...d$waG.Lc ..mow-.+-.,. -..-.• a -..__+—w..i.+t wl-wa--�. •...-. .. 1� .y 1' y, DESCRIPTION OF WORK TO DE PERFORMED: n + Identification- Please Type or Print Clearly• w OWNER: Name: _ Z LLC Phone: - t Address: l bZ I'\),J �hbyezr; . M 4 a Contractor e7%67ii,4P, Zh4m!741�P Address: _ .. . _ Supervisor s ConstructtonL>icense _4 s Exp Date ' •� 4 xe.� .. . 37 i _ ,4 - Horne.lrnprovement License F _ J Exp Date - , ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE;BULDING PERMIT.•$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.2Q PER S.F. t- .Total Project Cost: $ 3LV)jam_ FEE: $y�1o0 CI6 y l$0 Check No.: 22q!? Receipt No,, NOTE: Persons contr eting with unregistered c ractors do not have.access to the guaranty f d Signature of_Agent/Owner Signature of contractor'' J i f Plans Sub, Plans Waived Certified Plot Plan k� Stamped Plans ❑ s -'F-bF 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 Gl Signature_ —04 COMMENTS ar) a CONSERVATION Reviewed on l Signature COMMENTS F EALTH Reviewed on Si COMMENTS `� Gly � Zoning Board of Appeals: _ Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments 1 Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature• ILA-, gin1 /7/1(42 g Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street / Fire Department signature/date _�� COMMENTS AL L)':5 t Call. \, NOR Ty 1 -imension Number of Stories: 2 Total square feet of fl - oorarea, based on- Exterior dimensions.���_ Total land area, sq. ft.: 2 S 3 Z ELECTRICAL: Movement of Meter location, mast or service .,.. } Electrical Inspector Yes droprequires approval of � Ido ®ANGER Z®NE LITERATURE: Yes i MGL Chapter 166 Section 21A—F and G min.$1oo-$1000 fine No NOTES and DATA — (For department use) 1 1 I 2-BLO SIC- X 1 � 610 I Z t� K e -bile, 1 i ❑ Notified for pickup r Call Email ate Time Contact Name n l Doc.Building permit Revised 2014 ,` r Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. r Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance ance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkle Hydraulic Calculations (If Applicable) r Plan And 1 Mass check Energy Compliance Report (If Applicable) pp ) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from -Fire Departmentrior to p issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned Hydraulic Calculations (If Applicable) ) to Include Sprinkler Plan And I ❑ COPY of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products I! 40TE: All dumpster permits require sign off from Fire Departmentrior to issuance suance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decisionfrom the Board of Appeals 'R that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One co a ` �j must be submitted with the building application py nd proof of recording < Doc:Building Permit Revised 2014 COMMENTS 7v�,�-5-r.� - Location 1 0 3 S u T to N No. .53 d-0/-7 _ Date /1' l 71 [a( 7 • • TOWN OF NORTH ANDOVER � ! Certificate of Occupancy $ I Building/Frame Permit Fee $`/Oro Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 441 F0• &0 :•r Check# ,1 vBuilding Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 340,000.00 m $ - $ 4,080.00 Plumbing Fee $ 510.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 510.00 Total fees collected $ 5,200.00 103 Sutton Hill Road 535-2017 on 11/17/2016 single family home I i, V%ORTF Town of t _ 6 ndover - No. 0 - `AKa h ver, Mass, �1 COC NKNlWKK 1 /0 �9S RATEO U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System WMW;r THIS CERTIFIES THAT .. S....� ......`..... �.� BUILDING INSPECTOR . . has permission to erect buildings on ../.V.;y ., Foundation ������ Rough to be occupied as p' ... .... .. . .77�...pN- AhO................r�.. ................. Chimney 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TION __ __ fI Rough a&—. Service -rj ..... ........ .. Final BUILDING I CT 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. Y , � q BUILDING PERMIT o �NOR%0RrNti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 4 IL Permit No#: "� Date Received0 k M1. �gSSACHU`����� Date Issued: l"( 1 } LWORTANT:Applicant must complete all items on this page •.. $" .�G i.3 S �.' 7'4 S •�•i' fr �_t„ -., .-F 3,r 'S,3 :."yt '+, - ,,, ._,.. ! .4_ag,�,: f ,. ,,. ti,. " ff� L "T� •.�y. ♦Yfd"='�. ,sLOCA}fl®N �; .. yyt .t.-'4 -"s.3" 1 Ct ''t��.Fis �,'�.,r a S r.�ra -. -' r,�. f ri^�{�wt �,£'.Pnnt, ��. ct3„ 7r r ,�r .� .e.�. -�..�, fi '"S ,., h y L e :car s;;i`L, •a c ,:.S.Si"]µ PROPERTY OWNER,�y ,ts 4 ,*�:;y. „`" gym''., ^-, '� "' ,sem 'L u zryr 3•, ,,Pnnt .,, �, AOWYea�r Sfructurex �" r.may' es nog" MAP`S C� PARCEL �w..j� ZO(V1NG D1STFt1CTtHisto is Dist ict� es " x TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building )5 One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �❑ Septics�<❑;V 6 I ` ❑ Flo_odplain 0. etlands1_-ffW;ft4sh-e0dxJ§tri& „� fi-t a s� 4.i. .• xa t`�` - a! DESCRIPTION OF WORK TO BE PERFORMED: I �0 ua.�l Ydegtificafion- Please Type or Print Clearly OWNER: Name: T KZ AX Phone:C(7HR-�Q� Address: q ► givil SLi l2 zD A J kkA d I iq AX Zi z a y ",•. ContractorN rney f tPhone Ea�Ix+ \.C' •«.2, y . 1 , �„"r -Y'+� 'Se1.x!^`: - serer �rt al cm 77 71 FAd�tlress� r � c�. �2lJ:lf ,.,�3�C .� �l•:�� - �� � .Y -..n. .. I II as Ya ".` TZ"i +�.,�•. vac .s. ye,.. Supennsor's,ConstructlonLicense � � : Dat i !M', 3a HoLz a.-.,mel.M_ �mpTo�.�e'menf a ARCH ITECTIENGINEER Phone.: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. . Total Project Cost: $ 1 Z.T S Q�j. � v�M-6 JAW oozy) FEE: $ 1 S O , 01) Check No.: 2.,6 Receipt No.: NOTE: Persons contracting with unregist&ed co ractors do not have access to the guaranty u d Slgnatu_re of Agent%0wner Signature ofacontractoi^, Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/ Art ❑ Swimming Pools ❑ Massa e/Bod g Y Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ r' Private(septic tank,etc. ❑ permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY P INTERDE ARTME NTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed OnSignature_ o-� COMMENTS( �� �j71da n �U �0�yy 10 )PT Li CONSERVATION Reviewed on Si nature 4 _ LA, COMMENTS ��-, .�,,. ?�-� 0L HEALTH - - Reviewed on 0 ` ( 1 Si n COMMENTS Zoning Board of Appeals:Variance,-Petition No: Zoning Decision/receipt submitted yes�— Planning Board Decision: Comments Conservation Decision: Comments �- Water & Sewer Connection/si nature& Date Drivewav Permit DPW Town Engineer: Signatur<�, i /0-13~I b Located 384 Osgood Street FIRE DEl'AR ENT 4r, F,siteri r 4r t .: no -s.._.k�'`- �,:v, -a` r F 7vf .6-- t-y.s-+ r-.r-.-""*gS�•._r— �c F} tedat 124f11aa� Streetj - - n , , -;t e• t� ; Fire Department s� fpAtureldate �, , ;, =e_ = . r � r t 7 NORTH Town of t tAndover soh ver, Mass, 6 coc.ucnew¢w ��' �as RATIE 1►4p�,�5 U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT ..... d1/N A;S.....d!...Z...!w.. .. ..r..w.l....... ...................................... BUILDING INSPECTOR has permission to erect .......................... buildings on Foundation Rough to be occupied as A w L y ..........................................h4 v...................................................................................... Chimney 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 i PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ATS 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. l Plans Submitted Plans Waived ❑ Certified Plot Plan 1 ] Stamped Plans ❑ -TY PB'OF SEWERAGE DISPOSAL Public Sewer Tanning/MassageBody 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 a U FORM PLANNING & DEVELOPMENT Reviewed OnIvLok Signature_ COMMENTS 1/Q� cn I CONSERVATION Reviewed on — Si nature COMMENTS HEALTH Reviewed on Si �1 COMMENTS V Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes as E Planning Board Decision: Comments Conservation Decision: Comments Wafer & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT = Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date _ �; - 4 COMMENTS zk)F fph -imension Number of Stories: Total square feet of floor area, based on Exterior dimensions.��f(� 12-ELTotal land area, sq. ft.: 2 S , 312- ELECTRICAL: ECTRICAL: Movement of Meter location, mast or service drop_requires approval of Electrical Inspector Yes No ®ANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) C05 7 3SZ y t;� rik o_ ❑ Notified for pickup Call Email _ ate Time Contact Name Doc.Building Permit Revised 2014 #156-#172 CHESTNUT STREET #132 CHESTNUT STREET "GREY ROCK CONDOMINIUM" TAX MAP 60 LOT 71 N/F ROBERT & SHERRY MARCONI TAX MAP 60A LOT 22 284.96' N21'46'30"W j 31.1' LOT 2 25,312 SF.* b °� C.B.A. = 100% .01 f '60 WATERSHED BOUNDARY ?8 cpHcRF,Fr v ?4p 12 HEATH CIRCLE N LOT'1 LINE TAKEN FROM TOWN , p• p OF NORTH ANDOVER GIS p O4npN N/F GAFFNY REALTY TR. \ 93� N 7s0 a sTAX MAP 60A LOT 17 \ (V 2.0, \ R=60.00' L= 52. 2�3 SHED TO 52" BE RAZED PINNACLE WAY 5 "`i \ (50 RIGHT OF WAY) ZONING INFORMATION: � LOT 3 ZONING DISTRICT.• R3 - I CERTIFY THAT THE FOUNDATION SHOWN WAS LOCATED BY AN INSTRUMENT SURVEY ON 11/4/18 AND THE LOCATION COMPLIES FOUNDATION AS—BUILT Fo NTH THE ZONING SETBACK REQUIREMENTS. 103 SUTTON HILL ROAD \ OF NORTH ANDOVER, MA PREPARED BY, Z a Fl SULLIVAN ENGINEERING GROUP, LLC \ j X38915 P.O. BOX 2004 WOBURN, MA 01888 _ (781) 854-8644 DATE. 11/6/16 SCALE. 1"=20' ®rine Energy Rating Certificate Property HERS CLEAResult' Rating Type: Projected Rating Certified Energy Rater: Peter Virchick 10 Great Lake Lane Rating Date: 7/25/16 Rating Number: North Andover,MA 01845 Registry ID: Projected Rating: Based c)n Plans - Field Confirmation Required. Estimated Annual Energy Cost Use MMBtu Cost Percent HERS Index: 53 Heating 38.5 $1753 45% General Information cooling 11.1 $180 5% Conditioned Area 3291 sq. ft. House Type Single-family detached Hot Water 5.3 $426 11% Conditioned Volume 28046 cubic ft. Foundation Slab Lights/Appliances 28.7 $1383 36% Bedrooms 4 Photovoltaics -0.0 $-0 -0% Service Charges $137 4% Mechanical Systems Features Total 83.7 $3880 100% Heating: Fuel-fired air distribution, Propane, 96.1 AFUE. Heating: Fuel fired air distribution, Propane, 96.1 AFUE. Criteria Cooling: Air conditioner, Electric, 13.0 SEER. This home meets or exceeds the minimum criteria for the following: Duct Leakage to Outside 98.73 CFM25. Massachusetts Stretch Energy Code" Ventilation System Exhaust Only: 56 cfm, 11.0 watts. " Compliance is determined by the rater. Programmable Thermostat Heat=Yes; Cool=Yes Building Shell Features Ceiling Flat R-44.4 Slab R-9.0 Edge, R-18.0 Under Sealed Attic NA Exposed Floor NA Vaulted Ceiling R-39.5 Window Type U-Value: 0.290, SHGC: 0.300 Above Grade Walls R-21.0 Infiltration Rate Htg: 3.00 Clg: 3.00 ACH50 Foundation Walls NA Method Blower door test Conservation Services Group 50 Washington St Lights and Appliance Features Suite 3000 Percent Interior Lighting 80.00 Range/Oven Fuel Electric Westborough,MA 01581 Percent Garage Lighting 0.00 Clothes Dryer Fuel Electric 508-636-9500 Refrigerator (kWh/yr) 691 Clothes Dryer EF 3.01 www.csgrp.com Dishwasher Energy Factor 0.46 Ceiling Fan (cfm/Watt) 0.00 Certified Energy Rater: � ' y REM/Rate- Residential Energy Analysis and Rating Software v14.6.3 This information does not constitute any warranty of energy cost or savings. © 1985-2016 Noresco, Boulder, Colorado. The Home Energy Rating Standard Disclosure for this home is available from the rating provider. s+Po•o Verizon LTE -IU.UU AIVI Sent from my Pad P _ CERTIFICATE OF LIABILITY INSURANCE � DATE R.,„6/21/ 6/23%1.6_; THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ARIEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER)$),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADD)TIONAL)NSURED,Die policy(ies)must be endorsed” If SUBROGAIION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this conificate does not center rights to the ' certificate holder in lieu of such endorsement(s). PRODUCER CONT NArr-_: Saadi Munroe M.P. Roberts Insurance Agency PF[Or1E" . (978) 683-8073 FIArc.0: (979) 683-314'7 _ 1060 Osgood Street E:.;aL g aDaaFss:_ sand_i_Crmprobertsinsurance.com______.____-� -._- North Andover, MA 01845 INSU)LrRj�FFORDIN(a COVERAGE _- NAIC- tNSURERA:Essex Insurance Co .. ISURED INSuRERil:Associated Emplovers Insurance TKZ, LLC INSURERC;. - c/o TOM ZAHORUIKO It,*URERD_.-__ 78 GREAT POND ROAD 11.5URER E:. NORTH A-NDOVER, IIA 01895 1fSURER F: COVERAGES �CERTIFICATENUTABER- REVISION NUMBER: --ft IIS)S TO CFRTIFV THAT THE POLICIES OF INSURANCE LISTED BELOA.,HAVE BEEN ISSUED TO T41E-INSIJRED NAA" FD ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING A14Y RFOUIREM-ENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VJ)TI-I RESPECT TOVJHY.;H 7111.5 CERTIFICATE MAY BE ISSUED OR MAY PERTAW,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED NCRF-94 IS SUBJECT TO ALL TIIL TERtJS. EXCLUSIONS AND CONATIONS OF SUCH POLICIES.LIMTS SHOV V tAAY HAVE BEEN REDUCED BY PAID CLAMS. INSR; 'ACOL``SUBR POLICY EFF POUGY IXP UL7TS ., LTR! TYPE OF INSURArtCE1NSRI ldJDi POU LY h"Jr'BF1t ilLtltfJpIY YYY) tP.7r.�D(7'YYYYj _ E GEIERALLIA91UTY 3DX4936 7/13/15; 7/13/16;EA(;HL`CCUW2ENC[ _ _ 5 1,000,000 DAVAGE 10 HFti TE15 - X`fcr. Frtcca.ceu.IZALLt l!.ITv iIT7LtaUES(Ea arLrr^cr 50,000 C471Atg {AUE X i OCCUR EST;Am rurcr>m; 5,000 1 V:F1)URY 1.ERsora 1 000 000 i Gf NFRAL AGCr.0 C.ATI! :i 2,.000,000 i 6FN'LAGGRc:,\Te 1.1Tui APPI.t SPFiR i IPRODUC.r:S: i X!POLICY PROF LO' _. _. AUTO:..ORiLE L1ARIUTY I t:OXtH�i n titaGt r t.ttAti t - ?IKrO:LY;N.iNRY if", " ANYAUIO ALLUWN-0 SCIILU13LLU i ROD:CY iN.li1RY±Pii::R:r:her.;tj t.UTpS AUTOS f -PROPL UrY(W AGE NOtJ-0",33(D :IIREO AUTOS Amos - {Pr:atrst�rolj . _V U63RELLA UAB pu"l1R - CAM H"t-CONRL NCf,. EXCESSLIAO —CLAKAS-.`.UWY.4 DLI: RETENT10N3 - Vtr SIA10- Wil. B 'VJORKERS COMPENSATION 1 FiCC5005006517-2014A, 10/I/15. 10/1/16_g..t]RY LWIFS. ., Lf? AND EMPLOYERS'LIABILITY 1,000,000 AtIYPROPRIEICR.S'ARTNEILL-i(rCUtiJ•_' YIN�' ; F! Fi,�„ti ACCt(# IT 3 ' 17=fICE Rdlz13NN)EXI:{.t.t7f.O� {.ttai rt lS!St7S1:J:.RIt'Ii:YfF'�S 1,000,000 (tta,clnbry to NH) t � - - Uycs.desa�rmnntcr EL.DISEASE-POLICY LIMIT 1,000,000 ULSCt2IP t 1UN D�UP8 RAI i 1 DESCRIPTTONOFOPERATTONSILCCATIONSIVEtOCLES(Altach ACORD iOl,Addiition.d Renurl:s Schedule,U nn re SIuce is rcgtirtd) i I CERTIFICATE HOLDER CANCELLATION t SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN i T0Y7N OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. j BUILDING DEPT AUTHOR Y/ EPF!Eset7aYr1600 OSGOOD STREET r. 01845NORTH ANDOVER, *� (D l i 1988-2010 ACORD CORPORATION. All rights reserved. ACOR0 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-mail: i NOTICE , _ � K NOTICE TO T EMPLOYEES Y\ � EMPLOYEES 3�� gagv The Commonwealth ®f Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114-2017 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22, & 30, this will give you notice that I(we) have provided payment to our injured employees under the above mentioned chapter by insuring with: Associated Employers Insurance Company NAME OF INSURANCE COMPANY P_O. Box 4070 Burlington, MA 01803-0970 ADDRESS OF UNISURANCE CONIPANY WCC-500-5006517-2016A 10/01/2016 - 10/01/2017 POLICY NUMBER EFFECTIVE DATES 1060 Osgood Street M P Roberts Insurance Agency North Andover, MA 01845 (978)683-8073 NAME OF INSURANCE AGENT ADDRESS PHONE TKZ LLC 4 High Street#201 North Andover, MA 01845 EMPLOYER ADDRESS 08/04/2016 DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY HOSPITAL ADDRESS TO RE POSTED BY EMPLOYER Massachusetts Department of Public Safety ' Board of Building Regulations and Standards License: CS-055417 g Cora :rtcr:ioia ��::;.�:r•on�,o,• �. ,{ G THOMAS D ZAHORUIKO 4 HIGH STREET SUITE 201 NORTH ANDOVER MA 01845 C,�— Expiration: Commissioner 04/05/2018 Sutton Hill 11-4-16 MeyBjeam 103 Sutton Hill Rd.N.Andover 10:26am loft CS Beam�11.1b.1 kmBeam? e4.11.26.1 Materials Database 1516 Member Data Description: Member Type: Beam Application: Floor GARAGE HEADER Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code.- IBC/IRC Live Load: 40 PLF Deflection Criteria: L/360 live, L/240 total 1.000" max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 12.2 PLF Filename: Beam3 Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Additional Uniform(PSF) Top 0' 0.00" 24 0.00" 0' 8.00" 40 10 Live Additional Tapered(PLF) Top 0' 0.00" 24 0.00" 0 80 80 0 Live Additional Uniform(PSF) Top 0' 0.00" 24 0.00" 1' 8.00" 55 15 Snow 1200 1200 2400 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF Plate(425psi) 18.000" 1.500" 1101# — 2 12' 0.000" Wall SPF Plate(425psi) 21.000" 1.500" 3206# -- 3 24' 0.000" Wall SPF Plate(425psi) 18.000" 1.500" 1020# -- Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Live Snow Dead 1 376# 424# 501# 2 1410# 1211# 1241# 3 611# 424# 244# Design spans 19 6.875' 19 6.875' Product: 2.0 RigidLam LVL 1-3/4 x 9-1/4 3 ply PASSES DESIGN CHECKS 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 24124 23896.# 10% 5.66' Odd Spans D+0.75(L+S) Negative Moment 33904 238964 14% 12' Total Load D+0.75(L+S) Shear 14314 107971 13% 11.47 Total Load D+0.75(L+S) Max.Reaction 32064 46856.# 6% 12' Total Load D+0.75(L+S) TL Deflection 0.0613" 0.5286" L/999+ 6.18' Odd Spans D+0.75(L+S) LL Deflection 0.0463" 0.3524" L/999+ 17.82' Even Spans 0.75(L+S) Control: Negative Moment DOLS: Live=1000/o Snovr1150/o Roof=125a/o Wind=1601/o Design assumes a repetitive member use increase in bending stress: 4% All product names are trademarks of their respective owners Copyright(C)2013 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing is defined aswhen the member,fioorioist,beam or girde5 shown on this drawing meets applicable design criteria for Loads,Loading Conditions,and Spans listed on this sheet.The desion must be reviewed by a ouslified desioner ordesion orofessional as mouired for aooroval.This design assumes oroducl installation accordino to the manufacturers soecifications. 102 SUTTON HILL 11-7-16 IXeyBegtip N.Andover,M.A. 8:48am loft CS Beam 4.11.26.1 lanBedin&tgme 4.1126.1 Materials Database 1516 Member Data Description: Member Type: Beam Application: Floor Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: IBC1IRC Live Load: 40 PLF Deflection Criteria: U360 live, U240 total 1.000" max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 14.8 PLF Filename: Beaml Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Additional Uniform(PSF) Top 0' 0.00" AY 0.00" 14' 0.00" 30 10 Live Additional Uniform(PLF) Top a 0.00" 20' 0.00" 0 65 Live 8 0 0 8 0 0 4 0 0 Q O © 01 2000 Bearings and Reactions Input Nin Gravity Gravity Location Type Material Length Required Reaction Uplift 1 a 0.000" Wall SPF Plate(425psi) 3.500" 1.500" 2249# -- 2 8' 0.000" Wall SPF Plate(425psi) 3.500" 2.859" 6379# -- 3 16' 0.000" Wall SPF Plate(425psi) 3.500" 2.216" 4944# — 4 20' 0.000" Wall SPF Plate(425psi) 3.500" 1.500" 1173# -328# Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Live Dead 1 1558# 692# 2 4272# 2107# 3 3458# 1486# 4 962# 211# Design spans 7 9.375" 8' 0.000" 3' 9.375" Product: 2.0 RigidLam LVL 1-3/4 x 11-1/4 3 ply PASSES DESIGN CHECKS 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. Review gravity uplift reaction force of 328lbs at bearing 4 and ensure that the structure can resist appropriately. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 36604 29994.# 12% 3.33' Odd Spans D+L Negative Moment 48024 29994.# 16% 8' Adjacent 1 D+L Shear 2654.# 11419.# 23% 7.22' Adjacent 1 D+L Max.Reaction 63794 8646.# 73% 8' Adjacent 1 D+L TL Deflection 0.0281" 0.3891" U999+ 3.72' Odd Spans D+L LL Deflection 0.0210" 0.2594" U999+ 3.72' Odd Spans L Control: Max. Reaction DOLS: Live=100% Snow--115% Roof=1250/o Wind=1600/o Design assumes a repetitive member use increase in bending stress: 4% All product names are trademarks of their respective owners Copyright(C)2013 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing isdefined aswhen the member,fiocrioist,beam orgirde4 shown on thisdrawing meetsapplicable design criteria for Loads,Loading Conditions,and Spans listed on this sheet.The deson must be reviewed by a oualified designer or desan professional asreouired for aooroval.Thisdesion assumes oroduct installation acconlina to the manufacturer s soecifications Sutton Hill 11-4-16 MeyBegap 103 Sutton Hill Rd.N.Andover 10:17am loft CS Beam 4.11.26.1 ' 1miBeamengine 4.11.26.1 Materials Database 1516 Member Data Description: Member Type: Beam Application: Floor Top Lateral Bracing: Continuous Bottom Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: IBC/IRC Live Load: 40 PLF Deflection Criteria: U360 live, U240 total 1.000" max. LL Dead Load: 10 PLF Deck Connection: Nailed Member Weight: 12.2 PLF Filename: Beaml Other Loads Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Additional Uniform(PSF) Top a 0.00" 10' 0.00" a &M, 30 10 Live Additional Uniform(PLF) Top a 0.00" 10' 0.W, 0 80 Live Additional Uniform(PSF) Top 0' 0.00" 10' 0.00" 0' 8.00" 20 10 Live Additional Tapered(PLF) Top 0' 0.00" 10' 0.W, 0 80 80 0 Live Additional Uniform(PSF) Top a 0.00" 10 0.W, 1' &W, 55 15 Snow 1000 O � 1000 Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 0' 0.000" Wall SPF Plate(425psi) N/A 1.500" 1714# — 2 10' 0.000" Wall SPF Plate(425psi) N/A 1.500" 167811 — Maximum Load Case Reactions Used for applying point loads(or line loads)to carrying members Live Snow Dead 1 503# 465# 987# 2 646# 465# 844# Design spans 10' 1.750" Product: 2.0 RigidLam LVL 1-314 x 9-114 3 ply PASSES DESIGN CHECKS Connect members with 2 rows of 16d common nails at 12.0"oc NOTE:Nails must be applied from both sides Minimum 1.50"bearing required at bearing#1 Minimum 1.50"bearing required at bearing#2 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 37811 20780.# 18% 5 Total Load D+L Shear 1264.# 93894 13% 9.5T Total Load D+L TL Deflection 0.1151" 0.5073" U999+ 4.99 Total Load D+0.75(L+S) _LL Deflection 0.0529" 0.3382" U999+ 5.01' Total Load 0.75(L+S) Control: TL Deflection DOLS: Live-=10D% Snow=1150/o Roof=125% Wind=160% Design assumes a repetitive member use increase in bending stress: 4% Allroduct namesare trademarks of their respective owners P � Copyright(C)2013 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. "Passing isdefined aswhen the member,floorioist,beam or girft shown on this drawing meetsapplicable design criteria for Loads,Loading Conditions,and Spanslisted on thissheet.The deson must be reviewed by a qualified desioner or deson professional as reouired for approval.This design assumes product installation according to the manufacturers specifications 103 .SUTTOM 1iIUL ROAD 4 1111 Jill , O M to 4 �II f I --- f rv� FRONT 6LeVAT1onl .ia3 Su-rToW RILL ROX'b No?,TN PNDOVP-�,. ASA T K.-- LLC. - LSI awir�aia xv�a � . 3-o i2-o i2-a7 go(® it-0 -lo to-2 WON x 57 3°htx4y wt� 67 r a 0 � � M O O � t Pat€iiJl1S R.o6?� 'P LOIA SAX -o �b-0 a w ga`l+�a�6S clolq �3 OD ® K t5`C1�ti�9 rf- O [ Q5 K O _ � r fl �� sA O 3QVL xfa ltta RA�t ��t�tt3� 3►�i(yx c N - PbRC1� .31AINx6S e ve N 4-(o (p-0 R-16 't-o 8-0 4,-o t-9 I i 1- 24—® ---- ----�,.—. p is LLCOWPICTE 3000 psi. 0 a 3 0 �O'ax A®°j QG I 1 d-� cl 26-0 a4ao _o .©3 SATOliLL?NO AD .� o0 . i � r AIN �LUSR RNA 3 i I � �y 2xl20161,oC. s o so—o � Piss l.•S'dS'TS® I6's OC, III ® a CJ lev� lLk-® (46•o SEtO Nb @cc Cr r 10 Zxt2®ib"0G- ff`0 1 J. � �lulu I � to•o I I . e N a lb—ID L 8>tt'`1S�deo�a C7 t + I e � �a '+ i ' + � �S[trt�ay r�hfc 4fi• t + a e + t ! ► f gat t/° IL rQ Ile j4 c�a - c 365.Mrd•a^[a�s �� le-----—""a4s W!21SAs d i x �4,+ t/ �9cit21 i.,�1�xSas 4-1—1 I w cld-t t i ! '74 h I ; � $xz Oak tcr3do�Q- 'tit se gt�-4f3 h�S tC C���'7f1 aDai14pa. Q-e I x 0-8 cr j e N r ea� a 0-b I i