HomeMy WebLinkAboutBuilding Permit #702 - 20 DEWEY STREET 5/23/2006• TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXANtINATIUN
�s4cNus
Date Received: S
Permit N0:
Date Issued:
• • 6
ENIPORTANT: Applicant must complete all items on this
LOCATION 2-0 3'i 9-�
Print
PROPERTY OV1NER
Print R
NMAP NO.: I Q PARCEL: a-1 ZONING DISTRICT: -
TYPE AND USE OF BUILDING HISTORIC DISTRICT
TYPE OF IMPROVEMENT PROPOSED USE
Residential
New Building JbOne family
24 Addition Two or more family
- Alteration No. of units:
= Repair, replacement Assessory Bldg
h1C Demolition
Moving(relocation)-Other
Foundation onl
DESCRIPTION OF WORK TO BE PREFORMED RC P�A<< x isr
G.Y Roocl"\)& PoIZOA w I 7- _ e:x
Identification Please Type or Print Clearly)
O1&'N,ER: 'name: ay E -L
Address: 'DeLve-REc-'—
CONTR.
Address:
Al
YES 0
Non- Residential
Industrial
Commercial
Others:
,W&:Sc 2enLE
ANb A
Cg6 0y-7
Supervisor's Construction License:--- Z a- Exp.
Home Improvement License:
Date: b' dG �f._ -►.
Exp. Date:
ARCHI`t'ECT. ,NGINEERIM I PPOLr ry Name: Phone: 1�
Address: Reg. No..
FEE SCHEDL LE: BL LDI.1G PERMIT. S10.30 PER SJ100.00 OF THE TOT. IL ESTIJI.-t TED COST &&SED U,N S1'S.00 pE,R S.F.
Total Project Cost :$____ �f �/ � / x10.00= FEE: ���f
Check 'tic).:
Receipt No.:—,
Location -AD 0ek.)v4�✓��
No. Date .T ' 3
TOWN OF NORTH ANDOVER
o
a s
�e Certificate of Occupancy $
s„CwUs t� Building/Frame Permit Fee $ 4, 6,
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ L I QY, /
Check #�
19206 �rl9r !..�I',/ ✓ar94</a't
Building Inspector
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TYPE OF SENVARGE DISPOSAL
Public Seher
Well
PriNate (septic tank, etc. _
'VOTE:
Tann ingAlassage: Body .krt
Tobacco Sales
Permanent Dempster on Sitz �
SH imming Pools
4u.
F
Fes. �
ood Packaging Sales
��s
lleArie deter location to
project
Persons contracting with unregistered contractors rlo not lurve access to the guaranty fund
Signature of Agent'Owner
Plans Submitted
Plans Waived 1_''
Signature of Contractor
Certified Plot Plan
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTIvIENT,IL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
CONNINIENTS
DATE REJECTED
❑ .1
❑Water Shed Special Permit
❑ Site Plan Special Permit
Other
Stamped Plans _
DATE APPROVED
,ATE REJECTED IAPPROVED
CONSERVATION
,n
COMMENTS
l
DATE REJECTED DATE APPROVED
IIE.ILTH- l—1
CUMMENTS
Zoning Board of Appeals: 1 ariance. Petition No:
Zoning Decision! reccipt submitted ,,es
P!arinin4 Board Decision: --..--------_ Commc
C,,mscrvtticn Decision:
A',,tcr {u-. S,:ti:cr onnection si;naturc & date
e1�mp Dumpster r_n site acs_- no_— Fire Department si�,natur_.date
Building Permit Appreicd and 1SSLIud by:
Building Setback(
Front Yard
Side Yard
Rear Yard
Required
Provided
Re wired
Provides
Required
Provided
`7
Ntimber of Stories: p�2--
Total land area, sq. It.:
a Soo
Total square feet of floor area, based on Exterior dimensions.
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
.j Photo Copy Of H.I.C. And/Or C.S.L. Licenses
Copy of Contract
Floor Plan Or Proposed Interior' 1kork
Addition Or Decks
• Building Permit Application
• Surveyed Plot Plan
— ❑ Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
-- ,� Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydrae
Calculations (If Applicable)
Klass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
Building Permit Application
Certified Proposed Plot Plan
Photo of H.I.C. And C.S.L. Licenses
a Workers Comp Affidavit
Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (if Applicable)
o Copy of Contract
j Mass check Energy Compliance Report
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of
%ppeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One cop) and
proof of recording must be submitted with the building application
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ZONING BOARD OF APPEALS
Community Development Division
R E C E WEV'e' Time Stamp
TOWN CLERICS OFFICE
2006 MAY 22 P1i 4: 17
Minor Modification to Notice of Decision Year 2000
Property at 20 Dewey Street
T U! OF
NORTH ANDOVER
MASS ACE•s'US'E'T T
NAME: Joel & Emily Porten
Modification Date: 5-10-2006
ADDRESS: 20 Dewey Street
PETITION: 2000-020
The North Andover Board of Appeals held a public hearing at its regular meeting on Wednesday, May 10, 2006,
at 7:30 PM in the Senior Center, 120R Main Street, North Andover, MA upon the application of Joel & Emily
Porten, 20 Dewey Street requesting the Board to modify the June 20, 2000 Variance and Special Permit decision
2000-020 granted to Dale Cunningham for relief from the requirements of front and side setbacks and for the
extension of a pre-existing, non -conforming structure on a preexisting, non -conforming lot. The current owners,
Joel and Emily Porten, request permission to enclose the screened porch and add a bedroom above the porch.
The following voting members were present: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R
Webster, and Daniel S. Braese. The following non-voting member was present: Thomas D. Ippolito.
Upon a motion by Richard J. Byers and 2"d by David R Webster, the Board voted to GRANT the applicant's
request for a minor modification to the Variance & Special Permit decision 2000-020 in order to extend the pre-
existing, non-conformingstructure r:
Site:
20 Dewey Street [Map 10, Parcel 271, North Andover, MA 10845
Site Plan Title:
Plan of Land in North Andover, Mass., owned by Dale Cunnin gham
Date (& Revised Dates):
2/28/2000, 11/22/2005
Registered Professional
Land Surveyor
Scott L. Giles, R P. L. S. #13972, 50 Deer Meadow Road, North Andover,
Mass.
Sheet/Drawin
N. E. R D. Plan 13794
Building Plan Title
Addition & Renovations to Residence for Joel Porten, 20 Dewey Street,
North Andover, MA
By:
Timothy D. Ippolito, Registered Architect #10592, Ippolito Design
Associates, P. O. Box 116, Topsfield, Massachusetts, 01983.
Date:
November 14, 2005
Sheet/Drawin
Fl & Al -A4
Voting in favor: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R Webster, and Daniel S.
Braese.
The Board finds that the modification request is within the allowed seven (7) year modification time and that the
modification request to enclose the screened porch and add a bedroom above the porch is a minor modification
that does not change the footprint granted in June 2000. The Board finds that the applicant has satisfied the
provisions of Section 9, Paragraph 9.2 of the Zoning Bylaw that this change shall not be substantially more
detrimental than the existing structure to the neighborhood.
Town of North Andover
f Appeals,
-�;A, '� 0, L41t
E en P. McIntyre, C
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9541 Fax 978.688.9542 Web www.townofnorthandover.com
Nov 30 05 01:45p NORTH ANDOVER
NORTH REGISTRY OF
' �rJ,--E
. � !-OPY• A i TEST-
PeTME OFA `north Andover
Zoning Board of Appeals
?7 Charles Street
North Andover, Mlassachusetts 0l S15
Phcne ,'973) 633-9:41
9786889542 p.9
RECEIVED
JOYCE8RAOSHAW
TOWN CLERK
NORTH ANDOVER
1000 JUN 28 P 2: 30
any aopeals shall be tiled NOTICE OF DECISION
Within (go) days after the Year 2000
date of riling of this notice Proaerty at: 20 Dewev Street
O in the office of the Town Clerk.
Dale J. Cunningham
ADDRESS: 20 Dewev Street
Niorth Andover, MA 01$4:
1
I1N le a aonlyy at,tiw�nb, tso� vara
�►�411"Aens"�N d tdtlon, lged
3/ pail
Fax (973 ) 6SS-9542
DATE: 6i27/2000
PETMON: 020-2000
HEARING: 6/30/2000
iw?q The Board of Appeals held a regular meeting on Tuesday evening. June 20, 2000 at 7:30 PM upon the
I application Dale I Cunningham, 20 Dewev Street, North Andover, NLA.. Pensioner is requesting a
Variance from the requirements of Section 7 Paragraph 7.1, 7.2. & 7,3 for a relief of front and side
setbacks in order to enclose an existing open deck vrith screening. Petitioner is requesting a Special Permit
from Section 9. Paragraph 9.1 in order to enclose an existing open deck on a pre-existinc non -conforming �
lot. v�
The folloxving members were present:. William J. Sullivan. John Pallone. Scott Karpinski. Ellen ,tilclnrNTa.
Ge..cr;eEarley - �UL
Upon a motion made by Scott Karpinski and 2"d by John Pallone. the Board voted to GRANT a
dimensional Variance for a front setback of 11'. left side setback of 1' and right side setback of 11' and
for a Special Permit from Section 9. Paragraph 9. 1. in order to alter and enclose an existing open deck
with screening, on a pre-existing non -conforming lot, on the condition that the new proposed deck remain
the same size as the existing deck with the elevation not to exceed as shorn on the plan of land by: Scott.
L. Giles. RPLS, ;13972, So Dear Meadow Road. North Andover, NIA dated 3/20/2000. The Board rinds
that the variance granted to the petitioner is because the petitioner has satisfied the provisions of Section
10. Paragraph 10.4 of the Zoning Bylaw and that the granting of these variance will not adversely affect the
neighborhood or derogate from the intent and purpose of the Zoning Bylaw. The Board finds that the
applicant has satisfied the provision of Section 9, paragraph 9.1 of the Zoning Bylaw and that such change, extension or
alteration shall not be substantially more detrimental than the existing nonconforming structure to the neighborhood.
Voting in favor: William J. Sullivan. John Pallone. Scott Karpinski. Ellen M- dntyre, George Earley.
Furthermore, if the rights authorized by the variance are not exercised within one (t) year of the date of the grant. they shall Lapse, and
may be re•eswblished only after notice, and a new hearing. Furthermore, if a Special Perri granted under the provisions contained
herein shall be deemed to have lapsed atter a ewe (1) year peiod from the date on which the Special Permit was granted unless
substantial use or construction has commenced. they shall lapse and may be reestablished only atler notice and a new hearing.
By order of thelZaning Board of Appeals.
l�
William J. Sullivan. Chairman
l
i
.6d
PLAN OF LAND
IN
NORTH ANDOVER, MASS.
OWNED BY
DALE CUNNINGHAM
SCALE. 1"-20' CATE.2,QW600 (1 1 zZI MOOD;
0' 20' _ 40' 60'
Scott L. Giles R.P.L.S
Frank. S. Giles
50 Deer Meadow Road
North Andover, Mass.
DEWEY STREET
900' TO MARBLEHEAD STREET N 7417-00 E 50.00'
HSE. #24 4'fL I I
#20
EXIST. HSE.
FND.
(V�
T'
�i
W
YEROZOLIMSKY
NORTHANDOVER
BOARD 9F APPEALS
_d /
DATE OF FILING:
DATE OF HEARING:
DATE OF APPROVAL:
14'+1 -
DECK
L. C. PLAN 9399C
LOT 10
6500 S.F.
N ASSESSORS MAP 10
PARCEL 27
S 74-17-00 W 50.00'
QUINN
THE PROPERTY LINES SHOWN ARE THE
LINES DIVIDING EXISTING OWNERSHIPS, AND
THE LINES OF STREETS AND WAYS SHOWN
ARE THOSE OF PUBLIC OR PRIVATE STREETS
OR WAYS ALREADY ESTABLISHED, AND NO
NEW LINES FOR DIVISION OF EXISTING
OWNER IP OR NEVI/. WAYS ARE SHOWN.2,100c) .
v
NSE. #1s
ROCCA
THE ZONING DIST.
IS R4.
.............._._—_
Propo]ed14' 16'Bddi11'
Profile - Elevation
nts.
i
CUNNINGHAM
THIS IS TO CERTIFY THAT I HAVE CONFORMED
WITH THE RULES AND REGULATIONS OF THE
REGISTERS OF DEEDS IN PREPARING THIS PLAN
The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
P. 0. Box 1025 State Road, Stow, MA 01775
PERMIT Date:
North Andover Permit NO Dig Safe Number
( City of Town ) (If Applicable)
In accordance with the provisions of M.G.L.14 8 Cbapter__I_Q_ as provided in section—5 7 (' M R 34 Start Date
This Permit is granted to: O £ L o /i' -/ r�
Full name of person, Firm or Corporation
Permissionto locate dumpster for construction/renovation/demolition of building
Comments: dumpster must be 25' from structure if unable to place with required
Restrictions: clearance dumpster must be covered with plywood or tarp end of work day
at
( Give location by street ageno., or describe in such manner as to provied adequate identification of location )
Fee Paid$ 50.00 Fire Chief
This Permit will expire — ( Signature of offical granting permit) Offical granting permit ( Title )
oAI-6�
WOM♦ TWIC PFRMIT MI ICT RF rnAICPir'I Illi ICI Y P(-1CTi=n I IPr)A1 TNF PRFMICFC . ,tib
May 10 06 11:35a Jim Ryan
Ryan Drmertr, Maintenance
Quality Work
Commercial
Affordable Prices
Residential
Renovations
Full Service
Remodeling
Property Management
Doors/Windows
Decks
Repairs of all kinds
... ,.... ,... -2
2 years experience in building, roofing and home repairs
penalizing in jobs that may be too small for the big guys
May 6, 2006
978 521-5729
Porten Residence
20 Dewey St.
N. Andover, Ma.
P.1
CONTRACT
Contract for addition is as follows.,
• Remove necessary area of existing structure and discard
• Install footings and foundation in area indicated in engineered drawings
• Cut opening into existing cellar from new cellar area
• Pour and finish cellar floor to height of existing cellar
• Rough frame 2 stories on residence and all inside partitions to specifications as listed in
engineered drawings
• Insulate all areas as per Mass bldg code and engineered drawings
• Wire new addition, including all plugs and switches
• Wire for phone and cable as necessary
• Up to four can lights with trim and bulbs will be included
• Wire bathroom gfi outlet and fanlight (there is a $500 light fixture budget)
• Interior sheathing with 1/2" drywall throughout and moisture resistant board in bathroom
• Plumbing will include all lines, vents, and drains to laundry and to new bathroom
• Shower valve will be a Simmons Temptrol with an Allura trim kit and two shower heads
• Appropriate lengths hot water baseboard will be run in new addition
• A new hot water boiler will be installed to accommodate the new addition and the existing family
room (Burnham,gas fired, 96000btu, 85% efficiency, chimney vented, single zone)
• Bathroom would include midline cost water saver toilet, vanity faucet, and shower pan, outside
shower wall, and midline doors. (Ceramic tile would be an additional cost)
• Installation of vanity, vanity top, sink, and medicine cabinets and accessories would be included
(Purchasing these would come from a $1000 budget for bathroom fixtures or upgrades)
• Windows will be midline quality Paradigm vinyl, new construction, low E, Argon gas, with
specified grids, double tiltouts, dual locks and screens. (literature will be forth coming)
• Interior doors will be raised panel hollow core masonite prehung doors with brass look hardware
• Closets will be complete with closet poles and/or basic shelving. (Closet doors can be substituted
with raised panel hollow, masonite bifold doors, if so desired)
• Siding will be a wooden shake which bests matches the existing siding
• Exterior trim will be made to match existing window trim as closely possible
• Interior trim will be colonial casing (21/4'� and colonial baseboard (3'/z')
• All new interior surfaces will be oil base primed and latex custom colored to customers
specification. Bathroom wall surfaces will be painted with a mold resistant latex paint
• New exterior surfaces will be oil base primer and latex house paint to match existing colors as
closely as possible
• Seamless aluminum gutter and downspouts will be installed along new addition (No gutter is
planned at this time for dormer roofs)
• Roof will be a 30 year shingle,(match existing as closely as possible) woven into the existing roof.
Ice and water shield will be installed along all roof bottom edges, along the sides of dormers, and
the dormer roofs in their entirety. Ridge vent, and drip edge will also be installed.
May 10 06 11:35a Jim Ryan 978 521-5729 p.2
• All floors will be "flooring ready". (Any floor finishes will be discounted from a $2000 flooring
budget. If ceramic tiling is chosen, any Durock surfaces and their installation will be deducted
from the "flooring budget'
• Rear entrance door will be a fiberglass paintable door with a midline price window accent if
desired, and locking passage set and deadbolt.
• Basic landscaping and reseeding in areas around new addition are included
• General contractor is responsible for removing all debris related to specified work
• General contractor agrees to perform all work in a timely and professional fashion.
Manner of payment is as follows: $50,000 at signing of contract .... $35,000 upon signoff of rough
electrical and pluming. Final payment, $25,461, due upon completion of above specified work. Any
additional work will be paid for with 1 half before commencement of such work and final half upon
completion of such work.
Total ............................................. $110,461
The above price includes a flooring budget of $2000, a lighting budget of $500, and a bathroom fixture
budget of $1000. The balance of any of these budgets can be transferred to another budget and any
funds left in any of these budgets will be returned to home owner, or deducted from final payment.
date
James Ryan
4 New Hampshire Avenue
Bradford, MA 01835 - �330
To accept this contract, please sign below.
date
TN -55 evs�a5
May 10 06 11:35a Jim Ryan 978 521-5729 p•4
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVIS,' FR
Number: CS 079214
Birthdate: 06102/1956
,,y Expires: 06102/2007 Tr. no: 11780
Restricted: 00
JAMES RYAN
4NEW HAMPSHIRE RO
BRADFORD, MA 01835 Commissioner
May 10 06 11:35a Jim Ryan
978 521-5729 p•3
GENERAL LIABILITY
COVERAGE PART
The Providence Mutual Fire Insurance Company P.O. Box 6066 Providence, Rhode Island 02940-6066
Policy Number CPP 0055854 03
Renewal of CPP 0055854
Transaction RENEWAL
Policy Period From 05/22/2006 To 05/22/2007
12:01 A.M. Standard Time at the Named Insured's Address
Direct Bill Nine Payments
Named Insured and Address Agent
RYAN, JIM G. D/B/A - RYAN CITY INSURANCE AGENCY INC. 364
PROPERTY MAINTAINENCE RPM LLC 709 SOUTH MAIN STREET
4 NEW HAMPSHIRE AVENUE P.O. BOX 1297
BRADFORD MA 01835 HAVERHILL, MA 01831
Telephone: 97B-373-3381
Business Description Type of Business Audit Period
CARPENTRY LTCP Annual
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE
WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
LIMITS OF INSURANCE
General Aggregate Limit (Other than Products -Completed Operations) $ 1,000,000
Products - Completed Operations Aggregate Limit $ 1,000,000
Each Occurrence Limit $ 500,000
Personal and Advertising Injury Limit $ 500,000
Medical Expense Limit, any one person $ S'000
Fire Damage Limit, any one fire $ S0,000
AMENDED LIMITS OF LIABILITY
Refer to attached schedule, if any.
LOCATIONS OF ALL PREMISES YOU OWN, RENT OR OCCUPY
Refer to attached schedule.
CLASSIFICATIONS
Refer to attached schedule
TOTAL PREMIUM FOR THIS COVERAGE PART $ 2,664.00
Forms and Endorsements Applicable to this Policy
SEE ATTACHED SCHEDULE
These Declarations together with the common policy conditions, coverage part declarations, coverage part coverage
form(s) and form(s) and endorsements, if any, issued , complete the above numbered policy.
ued Date: 04/21/2006
ENERGY CONSERVATION APPLICATION FORM FOR
LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS
780 CMR Appendix J (effective 3/1/98)
Applicant Name:
Applicant Address:
Applicant Phone:
E
Site Address: g 0yff-w ''( 2Z
City/Town: i4mg;13A ,4,1120J=
Use Group:
Date of Application:
Applicant Signature:
Compliance Path (check one):
[! Prescriptive Package (Limited to 1- or 2 -family wood frame buildings heated with fossil fuels only)
Package (A through KK from Table 15.2.1b): Heating Degree Days (HDD65) from Table J5.2.Ia:
(For items d. through i., fill in all values that apply from Table 15.2.1 b:)
a. Gross Wall Area sq.ft f. Wall R -value R-
b. Glazing Area' sq.ft. g. Floor R -value R -
c. Glazing % (100 x b = a) % h. Basement wall R-
d. Glazing U -value U- i. Slab Perimeter R-
e. Ceiling R -value R- j. Heating AFUE
n Component Performance: "Manual Trade -Off" (Limited to wood or metal framed buildings only)
Climate Zone (from Figure 16.2.2) Zone 12 0 Zone 13 E] Zone 14
�.r
Attach Trade -Off Worksheet from Appendix 1, [and HVAC Trade -Off Worksheet, if applicable)
[] MAScheck Software
Attach Compliance Report and Inspection Checklist printouts.
C] Systems Analysis OR 0 Renewable Energy Sources
Attach Mass Registered Architect or Engineer Analysis
ALTERNATIVE FOR ADDITIONS ONLY:
a. Gross Wall + Ceiling Area 1027'sq.ft. b. Glazing Area'1► I(sq.ft. c. Glazing % (100.x b = a) %
4 ADDITION with Glazing % (c.) up to 40% may use 780 CMR Table J 1.1.2.3.1 below:
MAXIMUM U -value MINIMUM R -Values
Fenestration Ceiling
Wall
Floor
I Baserqent Wall
Slab Perimeter, Depth
0.39 R-37
R-13
R-19
J R-10
R-10, 4 ft
0 "SUNROOM" addition (greater than 40% glazing -to -wall and ceiling gross area)
Attach "Consumer Information Form" from 780 CMR Appendix B.
Official's Name: Official's Signature:
Application Approved E] Denied Date of Approval/Denial:
Reason(s) for Denial: (provide additional details as needed on back side)
'Glazing Area may be either Rough Opening or Unit dimensions. BBRS 06/12/98
The Commonwealth of Massachusetts
Department of Industrial: lecidents
Office of investigations
600 Washington Street
Boston, MA 02111
www. niass.gov1dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
,kpplicant Information Please Print Legibly
Vat7te Il3usincssiOr,aniialit�nilndivi�luul): R m cJ\k Q� )Nr�l
,address:
City. State/Zip: r rd l Phone #: Ct i cCi
Evan I)rcperty Maintenance
Quality Work Commercial
Affordable Prices Residential
Renovations Full Service
Remodeling Property Management
Doors/Windows
Decks Jim Ryan
Repairs of all kinds (978) 521-5729
22 years experience in building, roofing and home repairs
Specializing in jobs that may be too small for the big guys
General Contractor
Jim Ryan dba Ryan Property Maintenance
Liberty Mutual Insurance
Policy #WC2-31 S-357976-016
Framing:
AWC, LLC
Guard Insurance Co.
Policy #ALWC703063
Site work
Pentucket Companies, LLC
Commerce Insurance Co.
Policy #WCV00520801
Plumbing & heating
Steve Gigglioti & Sons
Granite State Insurance Co.
Policy #Combo ID 000479632
Wiring
Vaine Electric
Sole proprietorship working alone
AR WCIP - Libert�7
ISSUING OFFICE 354 Mutual. Workers Compensation and
INFORMATION PAGE Employers Liability Policy
ACCOUNT NO. SUB ACCT NO. Liberty Mutual Insurance (croup/Boston
1-357976 0000 LIBERTY MUTUAL FIRE INSURANCE -l' CO. Itsse
_ POLICY NO. TD/CD SALES OFFICE CODE SALES CODE N/R 1.ST
rWC2--31S-357976-016 XXX WESTON 102 REPRESENTATIVE 3000 1 YEAR
ASSIGNED 2006
Item l.. Name of JAMES G RYAN
Insured DBA RYAN PROPERTY MAINTENANCE
Address 4 NEW HAMPSHIRE AVE
FEIN 03-2481948
RISK ID 193427
BRADFORD, MA 01835
Status 01 INDIVIDUAL
Other workplaces not shown above: SEE ITEM 4
Nio. Dav Year \qo. Dav Ye:u'
Item 2. Policy Period: From 01-20-06 to 01-20-07
12:01 AM standard time at the address of the insured as stated herein.
Item 3. Coverage
A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the
states listed here:
MA
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits
of our liability under Part Two are:
Bodily Injury by Accident 500,000 each accident
Bodily Injury by Disease 500,000 policy limit
Bodily Injury by Disease 500,000 each employee
C. Oilier States Insurance: Part Three of the policy applies to the states, if any. listed here:
SEE END WC 20 03 06A
D. This policy includes these endorsements anti schedules: SEE EXTENSION OF INFORMATION PAGE
Item 4. Premium - The premium for this policy will be determined by our Manuals of Rules Classifications Rates and Rating
,.A r.i„ --I,; �t In vt+nrrvalinn antt rhanae }1V alldli-
1. 1lllll. f'1l1 1lLL V��1�U11V11 --J--' - - -
Premium Basis
Rales
--
LINE 110
Bstinuucd
Per 5100
Islimatcd
Code
Total Annual
o1 RL-.
Annual
Classifications
Premiums
muneralion
Premiums
SEE EXTENSION OF INFORMATION PAGE
Minimum Premium 500 ( MA) Total Estimated Annual rremntm r .•olto
Interim adjustment of premium shall be made: ANNUAL
This policy, including all endorsements issued therewith, is hereby countersigned by SEE ATTACHED ACHED FORM i71Q
Authorized Representative Date 02-22-06
Loc. Code Perm. OPer. audit [iasis Periodic Payurenl Raliac 13:+sis Pol. 11.G. i lone Stale Dividend NEW BUSINESS
(12-22-06 NR MA NEVV
G1104030 RI
Copyright 1987 National Council on Compensation Ipsurance
INSURED COPY
wC000001A
OCMULGEE ASSOCIATES, INC.
317 HIGH SIMFr
` !pswr-H, MASSA+CHUSEM 01938
978-356.7833
WE
UU+nULkn= POWaL bG
By DateFII® No.
�� Shoet No.
NOV. It, Cis 25*3
Sub)eci
Pc�R� �`-1�►J�, 2:D D�.bt1t=Y �T", til. �4t�tp�f�
R = til 33M„ L — 1,7.2 <5 . 10, WLR
(z) 14 )1 LvL-
U�
JOIST
V' fir+ p� U C)•#- t X75`} 30+ t } s 5A`{ 750 W'� wt v F WPM.
rev 2x to (2 !(m''
. v%— 14b7 > 10 45.4
Zv 10 0
tib 335 X2515 > Zw 10 ►�. C�.
:11.51
1'r -Le, 5� t2-
X3,3 i Aa,
X73,3
WAYl�iE
C.
KINQ
IbfyyV..lYUy lit IMM 111.1 rinlY� nn
a 46 Second Floor Framing
TJbesmw@4t$edelNuA .70ss1aegz Be2mA
User2 'lntl"ZIle%pu 3 Pee of 13/4" X 91/4" 1.9E Microllamit LVL
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS
FOR THE APPLICATION AND LOADS LISTED
I�atlUCt aiVVI.41 t w Coneeptual,
Analysis Is AN a Header (Pl Beam) Member. Tdbutery load WIdUr 20 13118"
PdMrl+ Load Group. ReOC1011 1 • Living Areas (W: 30.0 i the at 100 % durat)on,1S,0 Dead
$UPPER X
Input BwinS VardeN ReaMlons (lbs) Datep Other
lmdth Lenlgih UVa;DeadfUpIWTetal
1 Studwall
all 3•5" 2.21•
0 Stud U41/10931010M Al: 9locking 1 Ply 1 314' x 9 114" 1.0E Maotlw* LVL
Z.57 2.21• 32411169310/4934 A1; Siocidng i Ply 13/4' )( 91H" 1.9E MiraollemS LVL
-See TJ SPECIFIERS / BUILDERS GUIDE for debil(s); Al., Btol;Wng
Maximum Cosign Com w Control Locanpn
Shear (lbs) 4781 -3958 9227 Passed (43%) Rt. antl Span 1 under Floor leading
Moment(Ftd (i)(i12449
Live Loetl Defl '2449 left$ Passed (74%) MID spSn 1 under Floor loading
t) 0.203 0.2W Passed (U475) MID Span 1 under Floor loading
Total Lt,Bd Geri (in) 0.401 0.521 Passed (U312) MID
man 1 under Floor 'ceding
-Deflection CrUds: STANDARD(LLIJ480,TLU 740).
-Bmdng(Lu): AD comprasign edges (top and bWort0 mAt be breoatl at 10' 8' do umloss detailed cawv lea. Proper attachment and �s4iontng Of lateral bratlng is required to
achieve, nwrrraer stabtikV.
ADOITIONAl NOTES-
-IMPORTANT) The analysis preaentad I$ output {ran $ottware developeO by True Jdsi (TJ), TJ wtirrant$ the sizing of lay products by tit's 8offmrs ywll be accomplished in accords cm
wnh output
product dealpn t rFA and o s design vslueg, The apectflC product rrpA400n, input dealgn loads. and BMW dimannim- tWe � pm ft4 � tae aafAvem user.
Ttlia output lova not b3en !9tl . TJ Amodam
-Not e8 produ0te are nes* ewaUable. Check wMl ytur Supplier or TJ technical repr&sent*m for protlud avatlabllhy.
-THIS ANALYSIS FOR TRUSJOIST PRODUCTS ONLY' PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS.
-Aiiowsbte Stress De9ilyn mstihodotogy was used for Bulging Code UBC analyzing Ma Td Distribution product ilstvd above.
-Nola: Sea TJ SPECIFIERS / BUILDER'S GUIDES for multiple ply connection.
PROJECT IN ogwiow
Porten R80d4r0e, 20 0ax'eY St, N. Andover
IDPoito Design AMclaias
OA File 25163
Novetr-her 1 i, =or:
copyright a 1005 by Tcw Joiae, a asrel7heeueer Buainage
11i=01140 In a Yeaietered tra4am4rk of True Joint.
OPEW IN)*ORMaTION•
WAYNE C. KWG, P.E.
OCMULGEb ASSOCIATES, INC.
317 HIGH STREET
IPSWICH, MA 0193E-1242
Phone: (a78) 956.7833
Fax :(078)358.3465
OCMULGEECIIACART
— -- --,
8t FAKU.
Roof Framing
itdga Beam 8
U Z IT4LBi/11ros2:t4A4� 2 Pcs of 13/4" x 14" 1.9E MIcrollamlll LVL
PaSe1 E"°"reVefliOn`t•20'19 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS
FOR THE APPLICATION AND LOADS LISTED
iflen*er Slope: QAZ Roof Slopc*112
's
-=7
R .Q
i 17' 311$"— t
All flitrien010Hs :tsc horimtttal. PrOMIef 01186M g is Conmpt11al.
LOX03,
Artelyata is for 0 Helder (Flush Beam) Member. Tributary triad Width: l0'
Primary Load Group - Snow (psfj: 30.0 Live at 116 % duration, 15.0 Dead
rmt-C cju
SUPPORTS.
input
18ewing
Vertical Reactions Jibe)
Ply I)qo Nailing
Detail Oyler
Width
Length
livaiDeadAJdnlHTotil
6apth
Top lentge Top Flange Support wood
1 Stud wall 3,60"
2.671
2M! 1404 1 0 15978
RIA WA NJA
L1: Spgk'ng i Ply i 3/4-1 14- 1,9E Microliamt LVL
2 Microiem LVL beam 950"
Hanger
281211424/0/4=
1 14.00' NIA
He: race Wunt Hanger None
-See TJ SPECIFIERS I BUILDERS GUItm for dateH(eh L1: BlocidngAS: Face Mount Hanger
nARIAr01: 1111110800 Wang
-Tie® ConnedM
Ippolb Design Amdataa
OCMULGEE ASSOCIATES, INC,
0A r0$ 2vi83
support
Model
slope
611e10 Revetae
Top lentge Top Flange Support wood
Fax :(078)356-3466
Fila a
Offset Slope Spenipe
2 papa mount, Hanger
HHUS410
0112
0 No
NIA N/A NIA
-Nailing for Support 2: Face` 30.1 Od , Top NIA,
Member 10-10d
DESIGN CONTROLS:
Mlaxtaum
tUsign
Control
Control
Loeatton
Shear obs) 3901
.3980
10707
Pataed (31 %)
Rt end Span 1 tinder Snow loading
Moment (Ft -Lbs) 16415
16415
27877
Parsed (60%)
MID Span 1 under Snow lowng
Live Load Dell (In)
01388
0.301
Passed (UM)
MID Span 1 under $now loading
Total Lod 00f1(in)
0.981
0.842
Passed JU342)
MIC 5pan 1 under Snow loading
-Deuton Criteria: 8TANDARD01iI380,TL:L/240).
-Bradng(U): AD wmpresaion edges (top and bottom) must be braved at W 2" do unease detaiied ctherwtae. Proper atlac hment and positioning of lateral bracing Is reaulne0 to gem"
member stability.
-Detign asaunwa adequate continuous tatorai suppo4 of the eomoroeeion edge,
ADDITIONAL. NOTES,
-IMPORTANT! The analyds presontad Is output nom s0lwarl developed by Trus Jowl (TJ). TJ wenente the sting of Its products by this scaware vdti be accompaahed in aanrdarm
With TJ product design cdteria and coda accepted design valuta. The spedllo product application, Input design IONS, and Stated dimensions have been provided by the eenwere user.
1I -n8 outW has not baso reviewEal by e , J As*dltb.
-Not 00 prod1,14% are readily *Venable, Check With your Supplier or TJ technical repreaenletive for product evaiabi ly.
-THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS TH18 ANALYSIS.
-Allowable Stress Design melhodology was used for 6ultding Code USC enalyxlnq the TJ DIatr0ltttion product hated above.
-NM 50 TJ SPECIFIERS I BUILDERS GUIDES for multiple ply connection.
WAYNE
C.
KING
Me. Will
PROJECT INFORMATION:
Porten Residence. 20 Dewey St, N. Andover
OPERATOR INFORMATION:
WAYNE C. KING, P.E.
Ippolb Design Amdataa
OCMULGEE ASSOCIATES, INC,
0A r0$ 2vi83
317 HIGH STREET
November 11, ,ZOOS
IPSWICH, MA 01838-1242
Phone: (078) 368-1833
Fax :(078)356-3466
OCMULGEESTIAC.NET
00IMighc a 1005 by Trus Joist, a weyerhaeuser eaviaaae
Microllame Aad 16mvilamP are registered tradeearks of True Joist.
simpeon strong -ries COmrwctors la a rey"tared trademark of bi09W strong -Tia oaalpany, Inc.