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HomeMy WebLinkAboutBuilding Permit #017-2016 - 11 TYLER ROAD 7/1/2015 /�Jow 4-D a BUILDING'PERMIT of OWN OF NORTH ANDOVER'.'..:�? yy„•; :ry ' APPLICATION FOR:PLARMN EXAMINATION" �"d?al6ilk 1i Permit No#: !�7 Date.Received,,,':,;;�, °4 AA — �SSA Date Issued: CH�S�� IMPORTANT:Applicant must complete ali items on thi "page 7. LOCA ,€mac MCI, a fl t 1PROPEERTY.OWNER ' „ kr` b2 f'rnt 1001e'r 5 ' fine yes' rio r MAP s ` PAROL ZOnNINP,DISTRICT Historic nct yes" no i Village yes; TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ;9 One family .Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain 0 Wetlands ❑ Watershed District S, DESCRIPTION DESCRIPTION OF WORK TO BE PERFORME Identifica ' - Please Type or Print Clearly,::. OWNER: Name: 51Phone: Address:-// Contractor Name Phone ,§ - Ad°dress Supervisors Construction `License ' ' _ IN, p---ai y H®mehlrnproyement License, �Z Ex Daa.,r6 ARCH ITECT/ENGINEERJO � Phone:A03 E91/ 11/ V\5-6 Add ress:/-:Sy10,17G49d1JvZz'-4, 11 Reg;No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL EsnAfATEDrCOSTBASED ON$925.00 PER S.F. Total Project Cost: $ �Zl l j FEE-.: Check No.: Receipt.No '.., NOTE: Persons con ratting with unregistered.contractors do kiot:have:.access to the guaranty fund Signature of Agent/Q:wner j -. Signatiar0�... nf�racEOR 1 R I Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ��6F SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ i Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM i PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS fCONSERVATION Reviewed on Signature�j__j f i COMMENTS /�/C� G .�.- Y� ( C��t D J HEALTH Reviewed on Siqnature COMMENTS P � Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes t5 Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConneCtlOn/Sianature& Date Driveway Permit DPW Town Engineer: Signature: p p y v Located 384 Osgood Street FIRE DEP�4R� uMENT Temp ®um ster on site: es X no Locatedat 124 Main street �.- fire, Department**-- ture/date ' COMMENTS Dimension Number of Stories: Total square feet of floor area>based.omExt6dor dimensions. Total land area, sq. ft.: _ ELECTRICAL: Movement of Meter location, mastor 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) i i F I ❑ Notified for pickup Call Email Date ^_ Time _Contact.Name Doc.Building Permit Revised 2014 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 ❑ 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 of Bldg Permit Addition Or Decks ❑ Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit , ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ FI oor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products 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 ❑ 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) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products VOTE: 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 // Ze Location No. Date r . - TOWN OF NORTH ANDOVER • T MY 7G: Certificate of Occupancy $ Building/Frame Permit Fee $ �••� Foundation Permit Fee Other Permit Fee $ TOTAL $ Check# - r• - i uilding Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 121 ,150.00 m $ - $ 1,453.80 Plumbing Fee $ 181.73 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 181.73 Total fees collected $ 1,917.25 11 Tyler Road 017-2016 on 7/1/2015 Addition NORTH � E1� ic . " ve' . �p o - oh , ver, Mass, LAKE COCHICORWICK �� J�A00ATED P1" S V BOARD OF HEALTH Food/Kitchen P E L D Septic System �� BUILDING INSPECTOR THIS CERTIFIES T!erer T ..... ... . .................. .... ..................................................................................... �/ ��/C �� Foundation has permission to ........ ................ buildings on // Rough r to be occupied as ........... :Q. .�:�.........�.���... .�:fPo'.`�....��C:�::.,,P.�.�.��............................ 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 CONSTRUCTI ARTSRough 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. William McKay Construction 18 Academy Avenue Bradford, MA 01835 Phone: (978)361-6402 Email:wmc3cons@msn.com Find us on Facebook! PROPOSAL Project name: Eichler Residence 11 Tyler Rd., North Andover, MA Scope of work. Addition to Existing Residence • Excavating:To be performed by client. • Foundation: Form and pour foundation walls and basement. • Framing: Frame and sheathing on new addition%"sheathing on walls, 5/8" sheathing on roof. • Windows: Install windows(window count taken by plans). Flashing and sealant will be applied on all flanges. , yr / [t , V' IG Gf.�iL , SXR%` ? :.. ..;tf .J��u(/ /./f 'CA._Ij • Siding: Installation of vinyl siding and aluminum trim on rakes and facia.Vented material to be used on soffits. • Roofing: Installation of all GAE shingles and all flashings required. • Insulation: Insulation to be performed as per code and will meet requirements in all new areas. ��;;4 • Electrical: Performed by approved William McKay Construction Contractor. • Plumbing: Installation and material of all plumbing and fixtures excluding vanity cabinet in bathroom. • Heating: Installation of wall hung heat pumps. • Sheetrock: Installation of blueboard and plaster. • Finish: Installation of all standing and running trim needed. Installation of all cabinetry,,doors and hardware. • Flooring: Install all flooring tile and laminate floating flooring. • Paint:To be performed by client. • Spiral staircase: Install spiral staircase to loft area. , • Remodel: Make all changes and patch in to new addition. �� • Existing Foundation:Cut doorway in existing foundation to new addition to be performed by client. • Permits: Permit fees included in cost for all subcontractors.Any special permits needed will result in Extra cost. • Protection of Existing residence will be done in order not to disturb homeowner. i ** Cleanup of work will be done daily by William McKay Construction and disposed of too a dumpster we supply.Any changes needed or extra work requested will only be performed after the signature by both client and William McKay Construction on an Extra Work Order form.These forms once signed will become a part of the Proposal and Contract price." Total Cost of scope Outlined:$ 121,150.00 Material Allowance for this Project is as outlined below.Any materials that exceed these allowances made will result in an extra charge. Kitchen with laminate counters:$5,000 Flooring(including tile,carpet and laminate hardwood:$2,400 Spiral Staircase:$1,200 A deposit of$30,287 and a signed Proposal and Contract are required prior to start of this Project. Scheduling of Project will start immediately after deposit.Current plans may not be sufficient for Building Department. Please have your Architect prepare Construction Drawings. Need lot information and plans from town and stamped plans in order to pull permit. William L McKay III net Eichler W McKay Construction LLC i WILLIAM MCKAY CONSTRUCTION LLC. 18 Academy Ave Haverhill, MA 01835 # 978-361-6402 CONSTRUCTION CONTRACT This Construction Contract (hereinafter the "Contract")is hereby made on !VZ,7/1 V- by and between Janet Eichler of 11 Tyler Rd., North Andover, MA 01845 (hereinafter "Client") and W McKay Construction LLC of 18 Academy Avenue, Haverhill, MA 01835 (hereinafter "Contractor) collectively referred to herein as the "Parties". ARTICLE 1 A. Contractor shall provide the following Construction Services (the "Project"), as agreed to in a signed Proposal related to said scope. B. Client engages Contractor and Contractor agrees to provide to Client all necessary service , materials, and labor necessary for the completion of the Project including, but not limited to , all building and construction materials outlined in the signed scope. Material estimate and all necessary tools and machinery needed for Project completion. All construction materials should be new and of the highest quality, unless previously specified by the Client. fir - rss- - x%E' I ,` ' i YJ C. Contractor shall provide the construction services for the Project at the property located at 11 Tyler Rd., North Andover, MA 01845. D. The Contract shall be comprised of the following: this Construction Contract, Plans, Specifications, Addenda, Drawings, Photos, Proposal, Material estimate if applicable all signed and witnessed, all of which are attached hereto and are a part of this Contract as exhibits. ARTICLE II A. Contractor will begin work on1 16.1 to be completed by 7/, B. In the event that Client and Contractor agree on changes to the Project after this Contract is executed, the Parties will agree to new time deadlines that are reasonable in light of the modifications and that schedule change will be signed and witnessed and become a part of this Contract. ARTICLE III A. In consideration of the performance of this Contract, Client agrees to pay Contractor the sum of $121,150.00 (the "Contract Price") on the following payment schedule for the services. B. Contractor shall receive a 25% deposit before the start of the Project and then Progress payments shall be made thereafter as reflected progression of the Contractor's services continue through to completion. C. After receiving notification by Contractor of each stage of completion, Client or its designee will inspect and approve the work or request any necessary adjustments to same. Client agrees to make payments to Contractor after approving work. Payment shall only be adjusted upon the mutual consent of both Parties if due to unseen events or the parameters of the work are expended materially beyond the terms of the Contract. This Contract and associated fees will be modified accordingly in the form of Extra Work Orders which once signed and witnessed to shall become a part of this Contract. ARTICLE IV A. All changes or modifications to the work ordered by Client must be made in writing, with appropriate adjustments made to total payment and payment schedule. The approval of both Parties shall be required in the form of an Extra Work Order for substantial Project changes as these changes will effect date of completion, Project price, and notifications of these changes must be made in a timely manner. B. If these changes should require additional expense to Contractor, Contractor must make a claim for increase in payment, in writing to Client in a timely manner. Client must approve this claim for increase in writing prior to any changes to the work, Project or schedule. All such documents relating to changes to this Project must be signed and witnessed to and will become a part of this Contract. ARTICLE V A. If Contractor is delayed from completing required work due too unavoidable casualties, Client shall grant Contractor an extension for the completion of work equal to the delay. Unavoidable casualties include, but are not limited to, fire, flood or natural disasters, delayed acquisition of materials or material delivery, and negligence or non- payment on the part of the Client. B. In the event of unavoidable casualties, Contractor shall properly document both the event and the impact of the event on Project completion. Documentation shall be presented to Client in a timely manner. ARTICLE VI A. If Contractor fails to correct defective work or persistently fails to supply materials or equipment in accordance with the Contract documents, Client may order Contractor to stop the work or any portion thereof, until the cause for such order has been eliminated. i ARTICLE VII A. Free access to the work and the Project site shall be granted by Contractor to Client, the designated agents of the Client, and all necessary public authorities. B. Contractor agrees to keep the premises clean and orderly. Contractor shall remove all debris as needed during the hours of work in order to maintain work conditions free of health or safety hazards. ARTICLE VII A. Contractor shall conduct its activities in a professional manner and adhere to reasonable wishes of Client in relation to its working schedule. Additionally, Contractor's work shall adhere to and be in compliance with both the Standard Practices of the Trades and any relevant Manufacturers Specifications. B. Contractor shall protect all work adjacent to the Project site from any damage resulting from the work of Contractor and shall repair or replace any damaged work at its own expenses. Contractor shall take all precautions to protect persons from injury and unnecessary interference or inconvenience. ARTICLE IX A. Client agrees to hold harmless, indemnify and defend Contractor and each individual or entity that is an agent, affiliate, partner, officer, or stockholder of same against any and all claims, losses, liabilities, damages, and expenses, including legal fees, fines, judgments, settlement amounts all made in connection with , or arising from errors in any representation or warranty made by Client under this Contract, any breach of the Contract by Client, or any omission or negligent act or error by Client in connection with this Contract, provided by such negligent act, omission, or error was not done at the direction of Contractor. B. Contractor agrees to hold harmless, indemnify and defend Client and each individual or entity that is an agent, affiliate, partner, officer, or stockholder of same against any and all claims, losses, liabilities, damages, and expenses, including legal fees, fines, judgments, settlement amounts all made in connection with , or arising from errors in any representation or warranty made by Contractor under this Contract, any breach of the Contract by Contractor, or any omission or negligent act or error by Contractor in connection with this Contract, provided by such negligent act, omission, or error was not done at the direction of Client. ARTICLE X A. Contractor may be responsible for insurance to protect against any property damage, bodily injury, death, or other claims for damages that may result from the commission of the work, including general liability insurance and workers compensation insurance for its employees and/or subcontractors. ARTICLE XI A. Contractor will be responsible for obtaining all the necessary permits and licenses to fulfill the services specified in this Contract. ARTICLE XII A. Contractor is responsible for maintaining proper work, safety and environmental protection standards. Contractor agrees to hold Client harmless for all fines from federal, state or local agencies and regulators. Contractor will work in compliance with all standards required by EPA, OSHA and other applicable federal agencies. Contractor will be responsible for paying all fines and judgments levied by these agencies resultant from the performance of this Contract. ARTICLE XIII A. The relationship created between the Parties shall be limited to that of independent contractors. Neither party shall undertake any actions that would imply or seek to establish, any partnership , ownership, employment, joint venture, or trust relationship between the Parties, except by amendment to this Contract. IN WITNESS WHEREOF, the Parties hereto execute this Contract: CLIENT 0 Authoriz7 Signature (-a o ClcEz� ?-I� Name and Title CONTRACTOR Authorized Signature Name and Title License # 179265 ARTICLE XIV A. Any dispute or claim related to or arising from this Contract, its performance, breach, interpretation, validity, or enforceability, shall be exclusively(except as provided below) resolved by final binding arbitration before AAA American Arbitration Association utilizing AAA Commercial Arbitration Rules. B. The arbitrator shall be selected using AAA procedures. The arbitrator shall render a written decision within thirty calendar days of the hearing. The arbitrator may award attorneys' fees or punitive, incidental, consequential, treble, or other multiple or exemplary damages. C. Awards shall be final, binding, and non-appealable, with the exception of the grounds for appeal guaranteed by the Federal Arbitration Act and applicable laws. All awards may be filed with one or more courts, state, federal or foreign having jurisdiction over the party against whom such award is rendered or its property, as a basis of judgment and the issuance of execution of its collection. ARTICLE XV A. Both Parties are expressly prohibited from assigning this Contract or any rights or interest flowing therefrom. Assignment will only occur with the express written consent of both Parties. B. This Contract contains the entire agreement and understanding between the Parties and supersedes any prior or contemporaneous written or oral Contracts, representations, and warranties between them respecting the subject matter of this Contract. C. This Contract will be interpreted and enforced under the laws of the State of MA, without regard to conflict of laws. REScheck Software Version 4.6.0 Compliance Certificate Project Eichler Residence Addition Energy Code: 2012 IECC Location: North Andover, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 (6322 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 11 Tyler Road Janet Eichler Joel Silverwatch North Andover, Massachusetts, MA Owner Silverwatch Architects, LLC 01845 11 Tyler Road 155 Londonderry Road North Andover,Massachusetts, MA Windham, NH 03087 01845 603-894-4450 exntrk4gatos@verizon.net joel@silverwatch.com Complipn,6 passes using .• . Compliance: 9.0%Better Than Code Maximum UA: 100 Your UA: 91 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. Envelope Assemblies G-ross Area Glazing Cavity Cont.: or'Door UA Perimeter U-Factor Wall 1:Wood Frame, 16"o.c. 600 21.0 ° 0.0 0.057 26 Window 1:Vinyl Frame:Triple Pane 80 0.300 24 Door 1:Solid 70 0.150 11 Flat Ceiling: Flat Ceiling or Scissor Truss 96 38.0 0.0 0.030 3 Cathedral Ceiling:Cathedral Ceiling 354 30.0 0.0 0.034 12 Floor 1:All-Wood Joistlfruss:Over Unconditioned Space 450 30.0 0.0 0.033 15 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 has been designed to meet the 2012 IECC requirements in R Scheck Version 4.6.0 and to comply with the mandatory requirements listed ' the REScheck Inspection Checklist. N615e-Title Date �� 5►LVE yi No.9671 i I SALEM o NH NOW Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\UsersVoel\Desktop\CAD-DESIGN\2014 Jobs\Eichler Energy Check.rck Pagel of 8 REScheck Software Version 4.6.0 Inspection Checklist 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. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Re .ID -T 103.1, Construction drawings and DComplies 103.2 documentation demonstrate ❑Does Not [PR1)1 energy code compliance for the building envelope. CNot Observable ❑Not Applicable 103.1, Construction drawings and ❑Complies 103.2, documentation demonstrate ❑Does Not 403.7 energy code compliance for (PR3)1 lighting and mechanical systems. ❑Not Observable Systems serving multiple ❑Not Applicable dwelling units must demonstrate compliance with the IECC Commercial Provisions. 302.1, Heating and cooling equipment is Heating: Heating: ❑Complies 403.6 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not (PR2]2 on loads calculated per ACCA Cooling: Cooling: []Not Observable Manual)or other methods Btu/hr Btu/hr approved by the code official. ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\Users�oel\Desktop\CAD-DESIGN\2014 Jobs\Eichler Energy Check.rck Page 2 of 8 2012 IECC Foundation Inspection Complies? Comments/Assumptions 303.2.1 A protective covering is installed to ❑Complies [FO11]2 protect exposed exterior insulation ❑Does Not M and extends a minimum of 6 in. below grade. ❑Not Observable ❑Not Applicable 403.8 Snow-and ice-melting system controls ❑Complies [FO12]2 installed. ❑Does Not ? ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\Users\Joel\Desktop\CAD-DESIGN\2014 Jobs\Eichler Energy Check.rck Page 3 of 8 Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Re ID. 402.1.1, Door U-factor. U- U- ❑Complies See the Envelope Assemblies 402.3.4 ❑Does Not table for values. [FR1]1 ❑Not 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, ❑Not Observable 402.5 ❑Not Applicable [FR2]1 303.1.3 U-factors of fenestration products ❑Complies [FR4]1 are determined in accordance ❑Does Not with the NFRC test procedure or taken from the default table. ❑Not Observable ❑Not Applicable 402.4.1.1 Air barrier and thermal barrier ❑Complies [FR23]1 installed per manufacturer's ❑Does Not instructions. []Not Observable ❑Not Applicable 402.4.3 Fenestration that is not site built ❑Complies [FR20]1 is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440 or has infiltration rates per NERC ❑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 552.0 cfm leakage at 75 Pa. ❑Not Observable ❑Not Applicable 403.2.1 Supply ducts in attics are R- R- ❑Complies [FR12]1 insulated to>_R-8.All other ducts R- R- ❑Does Not J in unconditioned spaces or outside the building envelope are ❑Not Observable insulated to>_R-6. ❑Not Applicable 403.2.2 All joints and seams of air ducts, ❑Complies [FR13]1 air handlers,and filter boxes are ❑Does Not J sealed. ❑Not Observable ❑Not Applicable 403.2.3 Building cavities are not used as ❑Complies [FR15]3 ducts or plenums. ❑Does Not Y ❑Not Observable ❑Not Applicable 403.3 HVAC piping conveying fluids R- R- ❑Complies [FR17]2 above 105 sF or chilled fluids ❑Does Not u below 55°F are insulated to>_R- 3 ❑Not Observable ❑Not Applicable 403.3.1 Protection of insulation on HVAC ❑Complies [FR24]1 piping. ❑Does Not ❑Not Observable ❑Not Applicable 403.4.2 Hot water pipes are insulated to R-� R- ❑Complies [FR18]2 zR-3. ❑Does Not u ❑Not Observable ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3Low Impact(Tier 3) Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\Users�oel\Desktop\CAD-DESIGN\2014)obs\Eichler Energy Check.rck Page 4 of 8 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions &Re .ID 402.1.1, Ceiling insulation R-value. R- R- ❑Complies See the Envelope Assemblies 402.2.1, ❑ Wood ❑ Wood ❑Does Not table for values. 402.2.2, 402.2.6 ❑ Steel F1 Steel ❑Not Observable [Fill' ❑Not Applicable 303.1.1.1, Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions. ❑Does Not [FI211 Blown insulation marked every 300 ft2. ❑Not Observable ❑Not Applicable 402.2.3 Vented attics with air permeable ❑Complies [F122]2 insulation include baffle adjacent ❑Does Not to soffit and eave vents that extends over insulation. ❑Not Observable ❑Not Applicable 402.2.4 Attic access hatch and door R- R- ❑Complies [FI3]1 insulation >_R-value of the ❑Does Not adjacent assembly. ❑Not Observable ❑Not Applicable 402.4.1.2 Blower door test @ 50 Pa. <=5 ACH 50= ACH 50= ❑Complies [FI17I1 ach in Climate Zones 1-2, and ❑Does Not 0 <=3 ach in Climate Zones 3-8. ❑Not Observable ❑Not Applicable 403.2.2 Duct tightness test result of<=4 cfm/100 cfm/100 ❑Complies [F14]1 cfm/100 ft2 across the system or ft2 ft2 ❑Does Not <=3 cfm/100 ft2 without air ❑Not Observable handler @ 25 Pa.For rough-in tests,verification may need to ❑Not Applicable occur during Framing Inspection. 403.2.2.1 Air handler leakage designated ❑Complies [FI24]1 by manufacturer at<=2%of ❑Does Not design air flow. ❑Not Observable ❑Not Applicable 403.1.1 Programmable thermostats ❑Complies [Flg]2 installed on forced air furnaces. ❑Does Not w ❑Not Observable ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [FI10]2 on heat pumps. ❑Does Not " ❑Not Observable ❑Not Applicable 403.4.1 Circulating service hot water ❑Complies [Fill]2 systems have automatic or ❑Does Not accessible manual controls. [_-]Not Observable ❑Not Applicable 403.5.1 All mechanical ventilation system ❑Complies [F12512 fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy and air flow limits. ❑Not Observable ❑Not Applicable 404.1 75%of lamps in permanent ❑Complies [FI611 fixtures or 75%of permanent ❑Does Not J fixtures have high efficacy lamps. Does not apply to low-voltage ❑Not Observable lighting. ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\Users�oel\Desktop\CAD-DESIGN\2014 jobs\Eichler Energy Check,rck Page 7 of 8 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 404.1.1 Fuel gas lighting systems have OComplies (FI23]3 no continuous pilot light. ODoes Not ONot Observable ONot Applicable 401.3 Compliance certificate posted. OComplies [FI7]2 ❑Does Not ❑Not Observable ONot Applicable 303.3 Manufacturer manuals for OComplies [FI18]3 mechanical and water heating ODoes Not systems have been provided. ONot Observable ONot Applicable Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low imp-ac-t­—(Tie—r-3) Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\Users�oel\Desktop\CAD-DESIGN\2014 Jobs\Eichler Energy Check.rck Page 8 of 8 2012 IECC Energy Efficiency Certificate wo Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling/Roof 30.00 Ductwork(unconditioned spaces): •• .+ F '' .'�. �. _ OEM'-MOU _ Window 0.30 Door 0.15 Heating System: Cooling System: Water Heater: Name: Date: Comments Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Re .ID 403.5 Automatic or gravity dampers are ❑Complies VR 19]2 installed on all outdoor air ❑Does Not „ intakes and exhausts. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\UsersVoel\Desktop\CAD-DESIGN\2014)obs\Eichler Energy Check.rck Page 5 of 8 I Section Plans Verified Field Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & Req.ID 303.1 All installed insulation is labeled ❑Complies [IN13)2 or the installed R-values ❑Does Not a provided. ❑Not Observable ❑Not Applicable 402.1.1, Floor insulation R-value. R- R- ❑Complies See the Envelope Assemblies 402.2.6 ❑ Wood ❑ Wood ❑Does Not table for values. [IN111 ❑ Steel ❑ Steel ❑Not Observable ❑Not Applicable 303.2, Floor insulation installed per ❑Complies 402.2.7 manufacturer's instructions,and ❑Does Not [IN211 in substantial contact with the ,Ll) underside of the subfloor. ❑Not Observable []Not Applicable 402.1.1, Wall insulation R-value.If this is a R- R- ❑Complies See the Envelope Assemblies 402.2.5, mass wall with at least 1/2 of the ❑ Wood ❑ Wood ❑Does Not table for values. 402.2.6 wall insulation on the wall [IN3]1 exterior,the exterior insulation F-1 Mass E:] Mass ❑Not Observable requirement applies(FR10). ❑ Steel ❑ Steel ❑Not Applicable 303.2 Wall insulation is installed per ❑Complies [IN4)1 manufacturer's instructions. ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 111 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Eichler Residence Addition Report date: 05/20/15 Data filename: C:\Users�oel\Desktop\CAD-DESIGN\2014 Jobs\Eichler Energy Check.rck Page 6 of 8 The Commonwealth of Massachusetts Department of IndustrialAccidents a ; 1 Congress Street, Suite 100 < Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeLyibly Name(Business/Organization/Individual): Address: City/State/ZipIZW6 , , Phone Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 6_employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition 10g Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.lam a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurances 6.❑we are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those-entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.'Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: OPe/0 9 A y<a-- Expiration Date:_/��� Job Site Address: City/State/Zip: /9 A4p4W i QWJ� Attach a copy of the wor ers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ains andpenalties ofpetjuty that the information provided above is true and correct. Sig ature Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): ; 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment.be deemed to be an employer." MGL chapter 152,-§25C(6)also states that"every state or local licensing agency shah'withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub=contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may 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 Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensatiod'policy,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 sure that the affidavit is complete and printed 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 fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple.permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"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 as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia ,ac o0 CERTIFICATE OF LIABILITY INSURANCE °��'"�'°°24/ 3/24/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: M.P. Roberts Insurance Agency PHONEFAX 1060 Osgood Street E-MAIL (978) 683-8073 A/ N11: 078) 683-3147 ADDRESS: mike@mprobertsinsurance.com North Andover, MA 01845 INSURE S AFFORDING COVERAGE N_AIC_9 _ INSURER A:Merchants Mutual Insurance Co INSURED INSURER s:Atlantic Charter Insurance CO W MCKAY CONSTRUCTION LLC INSURER C; ATTN: BILL MCKAY INSURER D: 18 ACADEMY AVENUE INSURER E: HAVERHILL, MA 01835 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. IN111 ADDL SUER - — ----- POLICY EFF I POLICY EXP - - LTR TYPE OF INSURANCE POLICY NUMBER MIDDIY MMIDDIYYYY LIMITS A GENERALLIABIIJTY BOP9097489 8/14/14 8/14/15 EACH OCCURRENCE $ 1.000.000 X COMMERCIAL GENERAL LIABILITY DAM GETORENTED $ 5OO OOQ EREMISES_(Ep_wm _r CLAIMS�v1ADE OCCUR MEDEXP(Arty ore person) $ 15,000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ Z QOQ 000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY Ea BINE�DtSINGLELIMIT $ ANY AUTO BODILY INJURY(Per parson) $ ALLOWNED SCHEDULED l BODILY INJURY(Per accident) $ AUTOS AUTOS ) _ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _AUTOS Peraocident A UMBRELLALIAB OCCUR CUP9147266 12/22/14 8/14/15 EACH OCCURRENCE $ 1,000,000 EXCESSLIAB CLAIMS-MADE AGGREGATE $ 1 000 000 DED RETENTION$ $ B WORKERS COMPENSATION WCV01143500 3/29/14 3/29/15 WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ORY11MlIS ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICE RMIEMBER EXCLUDED? N!A (MandaCory in NH) E.L.DISEASE- A EMPLOYEE $ 500,000 If yyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 j DESCRIPTION OF OPERATIONS/LOCATIONS[VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space isrequred) CERTIFICATE HOLDER CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN JANET EICKLER ACCORDANCE WITH THE POLICY PROVISIONS. 11 TYLER ROAD NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE i 1 MICHAEL P ROBERTS 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: I '4� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/8/2015 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. i IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Rile L 0 NAME: Y Risk Strategies Company PHONEO. (781)986-4400 FNC No:(781)963-4420 15 Pacella Park Drive E-MAIL kl @risk-strategies.com ADDRESS: y Suite 240 INSURERS AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERANorGuard Insurance Co 31470 INSURED INSURER B: W McKay Construction LLC INSURER C 18 Academy Avenue INSURER D: INSURER E Bradford MA 01835 INSURER F: COVERAGES CERTIFICATE NUMBER-CL154892045 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 LTR TYPE OF INSURANCE A BR POLICY NUMBER MM/LIDDY EFF MM/DCD� LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE r_1OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- JFcT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea a.dent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS NON-OWNED $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATIONX WC STATU- GTH- AND EMPLOYERS'LIABILITY Y/N I LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) 634557 /29/2015 /29/2016 If yes,describe under7 E.L.DISEASE-EA EMPLOYE $ 100,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Janet Eichler ACCORDANCE WITH THE POLICY PROVISIONS. 11 Tyler Road North Andover, MA AUTHORIZED REPRESENTATIVE Michael Christian/KIL7.d ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025r5,n1nn,;im Tho Armin 1 n2mo nnri Inn^2m roniefornrl mnrlrc of Annion U'J/[.G' l(/V%/(I/!!l/[.LUG'U(.C![.V•✓['GC[,lJV.0%[.[[:I L'[LJ ! CN VME Office of Consumer Affairs&Business Regulation License or registration valid for indiretul use only IMPROVEMENT CONTRACTORbefore the expiration date. if found return to: gistration: 179265 Type: Office of Consumer Affairs and Business Regulation piration: 7/10/2016 LLC10 Park Plaza-Suite 5170 Boston,MA 02116 W. MCKAY CONSTRUCTION LLC. WILLIAM MCKAY 18 ACADEMY AVE. HAVERHILL,MA 01835 Undersecretary Not�,alid =thoutignature I I -- c fA O U f3 ( XM M U) ZI C_ 0 E - , Go_ rn c 90 -;m as v, `\ o ydj T N tj C �V QC E � m N X �, 4 's Z7CIn C � m d ao s oo �J .r