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Building Permit #210-2011 - 22 ASHLAND STREET 9/10/2010
i BUILDING-PERMIT of "°oT" TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION T 7• b Permit NO: Date Received �� • p�`+�reo e�ayg5 �SSRCHU`��� Date Issued: 0k IR:VORTANT:Applicant must complete all items on this page '_:tt's -a.�;:=_;..• „>•3 .n;.:h: =- _..:.r..: _ - _ ?hCis �' },�.1.-_. h—=s�:',s—�i.',-.It��J".Si'a_-... -�..yr' �i�.i;_- .ef.'iN..X...-1_.=_'-4`--.,.:3.-.„hti-.. __ �_'.'_t5� +,`•L�.4�[�%iIS _te�e,5•-=.. .L_4'...n vsv._<7:._T" - OWN . -Y_ 'r\ - " :�,_at_.-.l}3�i•5scly. •�i�a1iT�•�•" -.1F.•�•r.+„.`ti,t�.:.�..="�: _ -k�6;v .XiG=��`:_^;E.-;•�.'�-i-�p_.�..qFi'=..._.-<--.ris'irt4:.1--.... ,.r.P�:::"^�y:'-'«_i,.yy�_...1,..::�" .'a..,.. t �i��'E+-,�_....,.Y`x'- -- - - - _� _ _ _ - _ _ - - n�i._!/.•}.N,fs�va�i h!�-.a:l:`:.,'nr5t.. .• -......-':^:...��n•._.. moi✓ .... _ _ c.? u..<Y', r:1'�=y�.l�!' _<S�T c�::'n •-id - _ �':�T_�".F tYv�-y`-•)n �� : ,-�.y ��• .�..r. :%na.- ,',.-?:''�:7 r^'•rI_. _ _ ..;".:C^-'=`.=.°' - `�ri:x:e.l r-4.:. I - ..'.h.-3,.. 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TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Buildin One family Addition wo r more fami Industrial Alteration No. of units: 0 Commercial Repair, replacement Assessory Bldg Others: f Demolition Other _ I K.-�=zsa�.u=RK%iil�-'x.:.::_n��-v:�.•-_,_">....-.. .___ _ _ _��4'.�'r"=`-+": �:- ,..u:...a w,.3„�.. - a�3Yl�_�..-UTi::.E"ri.t�?Y.'1��4�a�,.Y:'! _ ry�ti�"'�-`ni'�t:.i�-•�-.•.s_ _.aS�.ra= `%'F.`_ Y.u• :Us-,:Y' = I. ��� ������•.�,:.e`. re �`� ��--;-�'{ala'���,nP`,.. i s '��4, -�fi5'r -J'' ,'.' <3^t.e,� �8i.:',G�'a�rid='ss Via%:.w=z�r, ���• `�=.3?ti�';'�r`_--�:s---��,,�,u��'`-���'' .�: !s't; "_.' ,'�''�'�'� � r t�--�����1�d � �” �-�� .ca��' :131,U�:�=/ +t'�'�?'t ��s=--�' ' �°. �==�'�~� ,. ,, �-'°�."�y�- :at:. �e '� „r"" �'�-.o���'• c:€r�->�s-°7�„ri`y 1 ,�.J ', y"'"e'°._ �?,5.•s�-rp1-�'n�u`�i :.�..+r=j k ''�;' r-- �' �n F,•- !tF,” �r P.,�:,=�'.. t �+'�-aY .�s�' =�.''-t-`. sL h�' -ci.�.. .ia,..k.� I ,ej'.� °`_.t_ �:,.,�}�:�,•c �'�.:ea. =r "-^_ 9'r=tw.:G:..,�� ,s?�f:_�r_a''- �. �4c,.,5 .�,i ..�z:a..,�i°�`P".'�'-=a� �Chr-•�stJ�Y.{� �-'1, "`����;':�'_�".stF; ,t. .,:......_.-........._.,....... �-,:_c..,2•�..c��rn.�+�._..-.�._._._.s'F,+..e .� "f��Yxrw:YF�':,_'^�-.'.,� .w���.'+�� -- �-c:?wa4�^'S�;�iy - _`i_ _ _�_�C� - �_-_GI x<=m:J?, r.__ _` .7s-.. -.,..".•�-v _Sic.^ C” "-1'`.'.P«'r., DESCRI TiON OF WORK TO BE PREFORMED: I 005; J Identifi don� PIease a or Print le Iy) OWNER: Name: ��r- ltaV*?/— WL7� r, Phone: Address: OR t `� � . 14'r46,4 �� 1 ��:�i ja=,;moi.-'.•��t'rr- __ --�.•".rsOr'-•..:�;�whi�`��. _ ,-;;7kti ,._:w-::::cr3?•��"�'_=,h=�,:..,�n-rt-^�4:.. -i:1c.:_�a _--_ -. 4�,�. .,?/F ter.'"�;r.. - '.t ,tr'{ —_ � 'u ��..s2.3;=' t7€s` -.�.9r;e'er �:��-3:;hG.��;,,•r�n:r.� �;e.i:^•. w='-^.�`^•':: tve'�. _ -- _ s rn, .��y�r r ..ari � m x�� k.^Y 1y `^$l,_�...4�-..NY�rFa;�le�•' . _., -._�•,.-�aw�•- -�F3f'f��e_"s.'�KV� ap' w••F'�F'�ti 'i°vz;U �'=-•'F s rat� � r ,�„ Te.�¢`�� `�- - �-,r.• ez, n Jt ��� js~'�-x-� '1.f_.2� � � •P �. ..-..z�-5 '4^..".F'...a_ r E� r�T��: SEEM •�—^. .,;�:�. ��.,.- �4;,'�+-:'a'>;r'.��'"b,"'�-"-s �2i'�n5 .:. r'`n,�� �!+��? ��.'� �.''-7•���31."�_-sr•"`yµ t ?t ks� a ,� �' fir• r� -S <kvv. ' '! q. ': _ .-e -Y ^u3-t!✓6... vet. i.c' F�:'rj:�'r5._�', - '' "' r'1r�� ^Y'-� ."lr :�'� 1?-t, •-=Jrs Y"'f ';err. t ?5'� i^+r �4 cr'-•t YLY ii! I•a ,.,�-,•7r�.-gg �.5 s",�3.. c^..`t�._'rz-�"�... 7�^ S�'t;f'Z� r�x:�rvaTP V'•s..! ��'^. rl uaj -S:••-i ,i� au �"•'•T7p w,S'R���`, .y- 7��;t .:Z'7.,�-r 2t-•r�txfe�g .fir ?v-'�.,_ci,Iri`�,,�. �` r,.:,�t�-'•: rpw^ -,a �-"'�•` �'� moi' n,�ccll�:,�` c�.'_j: :ittu.lt`�F,...,jt�.�.i "- i•'f". cA.IJ+P�" 1 :d''_'•�' ;1 r' �t - 5•iL_ , Yr is "'T�`'1�,•: .I=!� .f- s,r;;:SfKy" �L STy� a'r o •,��gygy.�jQ� ,-�I$ �_ r ��, � ��ar• �`LSlE �-l5 al_" F_"1^ .vJl� `yq tL6..s` '-!"Es. ._:S aF ��..`_'-C'C��S�.F•-:����� `'�� It�,:••t ��-3�c}_� . ^• ca'a-py y�'�a,r: ,�. T��. �,�, ;r:�.�-s,..,,:n �»�'a.=�Fr3n.�_ ":='��y�`_�.:� r,�.;�i"' .,. '& :- '�„=��.}.�.�:x._ ter•- - M r'. =*`=L� .r�..��- rnSc��x... �a'�•f'r,,�,'.�a'�t...ar., _- a;,.-�.,r?2'r.•..`=n_=r_'-x-.i:. �� -'a,�-_•s'�.�-y. .<. '� _ z ....,��'Y:lzr _ ..:,:t�ai:::fai� r.�?': "?r �3+•S'�dti�N.'S..I- �.3��m si-'f`:,F '�r.qtr«:,����. >� '?����•�..:+,-a..ut,-,r' -!'�"=i.:`+�;,.�r cr �ts ��ti.. „s.:�, 1c y,� _� ' 7T"t�,`-':-t:`slr'.'e '..: :� .���_;^ .r.a r.rruatc�:�'•a�.�ys:�t.�^r-r<_g.� 4:z _:^"'� =..amu asy.. ,r: -�..,-,-_: .`��.-.v t s,- - ' w_Js ac-.,�':,su. a`'3:. - 11'x•...�"s;�w:i=�S-'G�. ��� '^'�'�`_ � =�ti¢f,�;�+cr� a�,�%i,��',r"'S��� cfi, �.- -f-•a. 4�-...n�,��•ir�:1,y�vTa:'•`.�. -.5 r ,,t�•STt.`p_'�X.�1� ..L�,�•,�q��r !�_9p✓L`����• .�� '.�+ .t'n 0a�'.-`wi:�.{1:���f�.-..d(.l�P''t, �*Y Y^�:-,,,�� S:J�• �.�5,. ffL':�.s:Y�`M fC-.:.� -C:.� ��,�Y't�r r��r�� �;5�dIJII6V,G,�':t7.r-iy'<"r.�i L'a.F^1� 'l-'�•'�[.�, D°.�'k-^• �:�:rt�.�.�!iils ^'`�ia+� X01. rte'} �"."=rgy��.-�''7'f:,.�+J''.t .� Y:i ,t�� ,._ . � � ..�� "�J e'�`,y"•-�_ .a t,-rv."� 'moi=c�:•:,."-.-v,3^i_j'� ��.:,��ic>t:l`���k;��:�'�.'r•_z'• 'Atm`-,*'f-,.�; .^`��rx .y ARCHITECT/ENGINEER- (�er tt-Grr-� J Phone: �r ��' Address.zo�; CU>jl �.Li �l 1 / !7 AN TReg. No. Q 7 l FEE SCHEDULE:BULDiNG PERMIT:$12.00 PER$1000.0 OF THE L ES (MATED COST BASED ON$125.00 PER S.F. Tota( Project Cost: $ EE; $ Check No.: j Receipt No.: NOTE: Persons contracting with unre ' tered contractors do not have access to the aauar tyfund vitn f k Location 29 2Y A&,6n,..l No. / Date t NORTIy TOWN OF NORTH ANDOVER 3?•' I�'ti o a ' Certificate of Occupancy $ s„CwBuilding/Frame Permit Fee $ J Foundation Permit Fee $ /00-- Other Permit Fee $ TOTAL $ Check # 7/ 234Lf B+ ing Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tannin Swimming Pools g/MassageBody Art 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 DATE REJECTED DATE APPROVED• PLANNING DEVELOPMENT COMMENTS ' - CONSERVATION Reviewed on Signature I ' T 0 C..l.11V MEZ1V I J EAL ZRevi�vrleo� Sic i nature q COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decisionlreceipt submitted yes Planning Baard Decision: Comments -Conservation Decision: Comments Water & Sewer Connection/Si nature& D v &� rivewa Permit AP W Town Engineer: Signatiire: � 07�' �/0 Located 384 Osgood Street r"�" + _ :ri _ ..;w•::_�,i +:^��F'.s?�.is .^•. ir .,-:.�.., -:a� ,:_'!,.._= %1•`e.'p-M.=%� - :TY7't-��:`.-•--.�i-{`i_'p: - �_]: M�.-.. _ - w�N".r .Y '=_rte'-___•.-::=..:. ate. •, :;�;,::;_,_;�. ��111a1;'�'� Ee-e• - - -��T _ ::.''-:�>t:r".�'? - - �re _ I Vie:= - •. M1•r- .V .. .....m: S .. .. i�.y....-.,,C.••+.•' :.?N}` - - - __ - _ _ .•Jt'- - - � _- __ — LVL-..� M• _ - •• ui^YE ::.ti Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. l I Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of i 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) ❑ Notified for pickup - Date I Doc.Building Permit Revised 2010 I � I 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 N.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 ❑ Certified 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 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 •-i-New Construction (Single and Two Family) ❑ Building Permit Application rl •n _t:ri i n i riFS c- d Mr-d- P� -e{u..e., r-r.�Vv %v , {WL ,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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2008 I F NORT1y TO" of ;ed - �a �� dM over fp j Y 0 LAKE 1 ass.1 1COCMICMEWICK ��• 7�S 4ATED BOARD OF HEALTH Food/Kitchen PERM 'IT T D Septic System I THIS CERTIFIES THAT '�� �1../.�N ©�f'"..�!!.�' ss. ... T``� ©s^�• ••.• ....••......................•.....• Foundation INSPECTOR �..... has permission to erect.................•...................... buildings on .. {!............................................. Rough n ............................................................................ t0 be Occupied.aS....................... .....6Vi?'T..C� f.. f ...... '1. Chimney provided that the person accepting this permit shall in every respect nform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relatin 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 CONSTRUCTION STARTS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE it I Massachusetts- Department of Public Slll'C ) Board of Building Regulations and Stand:u'da Construction Supervisor License License: CS 65021 Restricted to: 00 MICHAEL J VAREIKA 12 BEATTY LN S EASTON, MA 02375 Expiration: 8/1412011 (ummi••iuncr Tr#: 19843 I J ACORDM CERTIFICATE OF LIABILITY INSURANCE 06/14/2 0' PRODUCER (978)392-4567 FAX (978)392-9696 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION E. J. Wells Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Regency Park ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 219 Littleton Road H Ford, MA 01886 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Union Insurance (Acadia Group) Vareika Construction Co. , Inc. INSURERS: Acadia Insurance 219 Walnut Street Suite B INSURERc: Firemens Insurance Company W. Bridgewater, MA 02379 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY CPA 0092564-17 06/20/2010 06/20/2011 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 250,000 CLAIMS MADE Fj]OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICYFX jE O LOC AUTOMOBILE LIABILITY MAA 0092568-17 06/20/2010 06/20/2011 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY (Per person) $ A X SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY (Per accident) $ X NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ S,000,000 X OCCUR El CLAIMS MADE CUA0121032-16 06/20/2010 06/20/2011 AGGREGATE $ 5,000,000 B $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCA 0112029-17 06/20/2010 06/20/2011 X WCSTATU- OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ S00,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 5UU,UUU OTHER CPA0092564-17 06/20/2010 06/20/2011 $200,000 any one job site I tored Materials A $200,000 temp off premises $200,000 property in transit DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 51810 Modular duplex. Orth Andover Housing Authority is listed as an additional insured with respect to General Liability where required by written contract. 'Except 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30'' DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, North Andover Housing Authority BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 310 Greene Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. N. Andover, MA 01845 AUTHORIZED REPRESENTATIVE O (L Paul Coffey/NAM aC ACORD 25(2001108) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). M 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s),authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. I i i ACORD 25(2001/08) 1 ARCHITECT CONSTRUCTION CONTROL AFFIDAVIT Project Name: North Andover Housing Authority i Project Title: 705 Modular FamilyHousing—DHCD Project#196019 1 g i Project Location: 22-24 Ashland St. North Andover MA 01845 Scope of Project: Construction of a modular duplex house—the new 2-family home will contain (2)3 bedroom units one HC accessible Architect: Brown Lindquist Fenuccio & Raber Architects, Inc. In accordance with paragraph 116.0 of 780 CMR, the Massachusetts State Building Code, I, Richard P. Fenuccio Massachusetts Registration Number 7789 being a registered professional Architect hereby certify that all plans, computations and specifications, and changes thereto, involving subject project will be prepared by or under the direct supervision of a Massachusetts registered architect or Massachusetts registered professional engineer and bear his or her original signature and seal or by the legally recognized professional performing the work, as defined by Massachusetts General Law(M.G.L.) c. 112, §81 R. For the above named project I, or a registered professional arch itectlengineer under my cognizance, will review the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. I will review and approve the quality control procedures for all code-required controlled materials. I further certify that I will be present on the construction site at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. Pursuant to 780 CMR 116.2.3 1 will provide the results of structural tests and inspections to the building official and owner. I will submit, periodically, a progress report inept comments of the site visits and compliance of all pertinent items to the building official. I as to the satisfactory completion and the readiness of the proAi ject f occupan "00( ` 0 2 L , 778°Z " Arc i t Richard P. Fenuccio PO Date Subscribed and Sworn lo, before m his o y of "` VX70(__ 201 D, the undersigned notary public, personally appeared A/2*c /7 C-aC_ 0 Ovide to me through satisfactory evidence of identification, which is rS to be the person whose name is signed on the preceding or attached documerft, and acknowledged to me that he signed it voluntarily for its stated purpose. otary Notary Public/ Alyson�S yson Public Konkol Date tary Commission Expires Commonwealth of Memadmift Commission Expk%on Mar.10,2017 CONSTRUTION CONTROL AFFIDAVIT PROJECT: 22-24 Ashland Street,North Andover,MA LOCATION: 22-24 Ashland Street,North Andover,MA ENGINEER: Allen&Major Associates,Inc. Allen&Major Associates, Inc. (A&M) has served as the Engineer in connection with the 22-24 Ashland Street project in North Andover, MA. In this professional capacity, A&M has prepared or directly supervised the preparation of design plans, computations and specifications and to the best of our knowledge, such plans, computations and specifications meet acceptable professional practices and applicable laws and ordinances for the proposed use and occupancy. i I further certify that 1, or people under my direct supervision, shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that, in general, the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following: 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review the quality procedures for code-required controlled materials. 3. Requested engineering professional oversight of critical construction components as required during the build condition as documented in the design documents. This certificate is given by A&M based on A&M's actual knowledge and professional expertise and experience concerning the matters discussed in this affidavit. A&M has had sufficient involvement in the Project to make the statements in this certificate and has no knowledge of any inaccuracy herein. However, if there is an inaccuracy in this certificate, A&M shall not be responsible for the inaccuracy as A&M has performed their duties in good faith and with the degree of skill and care ordinarily used by engineers in similar conditions and circumstances. SIGNATURE: Timothy J.Williams,P.E. SS: On this 26th day of Ault,2010,AD before me,Laurie Twohig,a Notary Public,duly appeared Timothy J.Williams,being duly sworn, deposes and says that the above statements by him/her are true. Laurie Twohig (Notary Public) _ Allen&Major Associates- Tnc. My Commission Expires August i Name: Timothy J.Williams,P.E. Title: Project Manager Date: 08/26/10 t I, REScheck Software Version 4.3.1 Compliance Certificate Project Title: MODULAR FAMILY HOUSING Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Single Family Glazing Area Percentage: 13% Heating Degree Days: 6322 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 22-24 ASHLAND ST. NORTH ANDOVER HOUSING AUTH. BLFR ARCHITYECTS,INC NORTH ANDOVER,MA 01845 ONE MORKESKI MEADOWS 203 WILLOW ST. NORTH ANDOVER,MA 01845 SUITE A 978-682-3932 YARMOUTHPORT,MA 02675 508-362-8382 i Compliance:0.0%Better Than Code Maximum UA:425 Your UA:425 The%Better or Worse Than Code index reflects how close to compliance the house is based on code tradeoff rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. AssemblyGross Cavity Cont. Glazing UA or or D•• Perimeter U-Factor Ceiling 1:Flat Ceiling or Scissor Truss 2097 38.0 0.0 63 Wall 1:Wood Frame,16"D.C. 2760 21.0 0.0 131 Window 1:Vinyl Frame:Double Pane with Low-E 325 0.350 114 Window 2:Vinyl Frame:Double Pane with Low-E 24 0.340 8 Door 1:Solid 75 0.350 26 y Door 2:Solid 40 0.350 14 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 2097 30.0 0.0 69 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 deet the 2009 IECC requirements in REScheck Version 4.3.1 and to comply with the mandatory requirements Ii in e RES e nspeotlon C cklist. Name-Title Signature _ Date 0 AR e No, r kr YA( orl Htpt.`a MA i ,Fd Iw th, Project Title: MODULAR FAMILY HOUSING Report date:08/25/10 Data filename: Untitled.rck Page 1 of 4 REScheck Software Version 4.3.1 Inspection Checklist i Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-21.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Vinyl Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Solid,U-factor:0.350 Comments: ❑ Door 2:Solid,U-factor.0.350 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. Project Title: MODULAR FAMILY HOUSING Report date:08/25/10 Data filename: Untitled.rck Page 2 of 4 (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. j (f) Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: ❑ Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: i Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturers installation instructions. i ❑ Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. ❑ Materials and compliance can be determined.equipment ment are identified so that q P ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: ❑ Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: ❑ Building framing cavities are not used as supply ducts. ❑ All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181 A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). ❑ Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 225.4 cfm(8 cfm per 100 f:2 of conditioned floor area). (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 338.0 cfm(12 cfm per 100 ft2 of conditioned floor area)pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 169.0 cfm(6 cfm per 100 ft2 of conditioned floor area) when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 112.7 cfm(4 cfm per 100 ft2 of conditioned floor area). Heating and Cooling Equipment Sizing: ❑ Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. ❑ For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: ❑ Circulating service hot water pipes are insulated to R-2. ❑ Circulating service hot water systems include an automatic or accessible manual switch to tum off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Project Title: MODULAR FAMILY HOUSING Report date:08/25/10 Data filename: Untitled.rck Page 3 of 4 0 Heated swimming pools have an on/off heater switch. ' Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. I Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage—15 (d)50 lumens per watt for lamp wattage>15 and-40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: 0 Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement's'). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) i i I I Project Title: MODULAR FAMILY HOUSING Report date:08/25/10 Data filename: Untitled.rck Page 4 of 4 2009 IECC Energy Efficiency Certificate Ceiling/Roof 38.00 Wall 21.00 Floor/Foundation 30.00 Ductwork(unconditioned spaces): 11 1 Window 0.35 0.30 Door 0.35 NA Heating System: Cooling System: Water Heater: No TT-Tiv— Name: Date: Comments: I i I i