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HomeMy WebLinkAboutBuilding Permit #174-14 - 36 EVERGREEN DRIVE 8/23/2013 r � ORT of a H q BUILDING PERMIT 3a a6�r`eD ^6,aao0 TOWN OF NORTH ANDOVERo APPLICATION FOR PLAN EXAMINATIOKL « - �r � 1 _ e � Permit NO: Date Received �ZJ '� ,> « pqo gal— Date aw Date Issued: �9SSACHU ` IMPORTANT:A licant must complete all items on this page LOCATION �6 ,'Ev!nMu) Dry p, ' Print PROPERTY OWNER I� E' C Print MAP NO: _PARCEL: ZONING DISTRICT: Historic District yes no .Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg X Others: S St'law 11Demolition 11Other kk"o' r ❑ Septic ❑Well ❑ Floodplain ❑Wetlands El Watershed District ❑Water/Sewer ... 1tS�a-11 So I oyr I*f W chr C44-or 8 i Identification Please Type or Print Clearly) . OWNER: Name: ovrber+ M!aAt r Phone: ("lk 6?' 3QI Address: rie+11 t)nve- CONTRACTOR Name: U1 S36%33 Phone: ,&-V(e- bike Address: 6°7 `1 AW 1 v rpt ) AlAr tA33-.-.2 Supervisor's Construction License: �0f Exp. Date: > 3� 1 Home Improvement License: f bo �� Exp. Date: i I�. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. i Total Project Cost: $ y FEE: $ a 7 h)Check No.: �' Receipt No.: , _ NOTE: Persons contracting with unregistered contractors do not have acRssIto the guaran nd Signature of Agent/Owner S gnature of contractor X. ,,- �.t�,7:,s�.�'�+5..�4.r� ��tY�,.•,,,yF. - _ ..�. _'y; r •-�..n. �+in .,. 1 LocationILL �p c_-'/Q�2 !Lu-°rJL '�✓ No. /7L - IT Date Z x TOWN OF NORTH ANDOVER e � Certificate of Occupancy $ Building/Frame Permit Fee $ cF9' Foundation Permit Fee $ Other Permit Fee $ { r TOTAL $ I Check# ttt � 2-6775 Building Inspector C 1 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE:0F1-SEWERAGE.Di5bSAL Public Sewer ❑ Tanning/MassageBody Art ❑. . Swimming Pools ❑ Well ❑. Tobacco.Sales _❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ a THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments e s Conservation Decision: Comments 1 Water & Sewer Connectionisignature& Date Driveway Permit DPW T Ivo Engineer: Signature: Located 384 Osgood Street FIRE DEPARTIIIY�aI�T - Temp Dumpster on site yes no Located bt,124{Mair Street Fire Depgrtmetit.signatuedldate' �< i , •� ,y r t - j COMMENTS I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions._ Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A-F and G min.$100-$1000 fine NOTES and DATA— (For department use i M I I F ® Notified for pickup - Date I Doe.Building Permit Revised 2010 Building Department The foh:3wing is-'a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits a Building Permit Application o 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 a Building pp Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o 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) o 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 a Two,,Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cask if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apn,,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application i Doc: Doc.Building permit Revised 2012 i i RTINI Nr IL. RA c . ve" 'o 0 . � 4 �A�E h , ver, Mass, 2 A- COCMICKIWICK 79 A�"OAT EO - - S V BOARD OF HEALTH Food/Kitchen Septic System THIS CERTIFIES THATPERMIT. AA6.0.. BUILDING INSPECTOR . Foundation has permission to erect .......................... buildings on .... ...02....4me..... .!�:�. � . .......a��,►. . ......... .. Rough to be occupied as .... . .....�1�.... C/....... .. .. .. .�...................... C ey provided that the person accepting this permit shall in every respect conform to the terms of the application nal 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR N RTS Rough Service ...... .... ........ . ............................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost 7,425.00 m $ - $ 89.10 Plumbing Fee $ 11.14 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 11.14 Total fees collected $ 211.38 36 Evergreen Drive 174-14 on 8/23/2013 Solar Hot Water Heater r NORTH . ve- W' ' d . o - No. 114— �-t - - h ver, Mass pCOCHICNIWICK S V BOARD OF HEALTH Food/Kitchen PERIT LD Septic System THIS CERTIFIES THAT A.&0, BUILDING INSPECTOR ............ .... ............... -< .� - ............................ ............... rq Foundation has permission to erect .......................... buildings on .... .... ..... .'!�' g! ... ......�V . . Rough to be occupied as ...... ...... ... . ....................... ................... .. .. ..................... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR N RTS Rough Service ...... .... ........ . ........................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE orm The Commonwealth of Massachusetts F Pdhi FT Department of Industrial Accidents ki p Office of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information I' (�` �� Please Print Legibly Name(Business/Organization/Individual): � �51 /a' � uti+ltr ,lam' y Qaf tr j&V(e Dkt Address: 1,7 T11Fa City/State/Zip: 4)QKb%1('!4 Phone#: K Are you an employer?Check the appropriate box: Type of project(required): LX I am a employer with 4. E] 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. E]Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance. 9. E]Building addition required.] 5. E] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL insurance required.]t c. 152, §1(4),and we have no i2.0 Roof repairs ` p employees.[No workers' 13. Other �11�al�� 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. lContractors 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 the policy and job site information. deA4 fInsurance Company Name: t�velEff �I\ 16F!j CC)r%k00.11 Policy#or Self-ins.Lic.#: G a '� _871MOC f Expiration Date: Job Site Address: FVM rte_A ��. City/State/Zip: NANd tVl±.rlM 0 � Attach a copy of the workers' comp nsation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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 aims and- e� ties ofperjury that the in ormation provided above is true and correct Si ature:1. Date: Phone#: `V( 1_3 C Official use only. Do not write in this area,to be completed by city or town q f j�iciaL 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#• NEW ENGUND SJLAR h6twater HOME I SCHOOL 1 BUSINESS BUYER'S RIGHT TO CANCEL Proposal D0054. 8/12/13 If this agreement was solicited at or near your residence and you do not want the goods or services, you may cancel it by mailing a notice to the seller_ If you cancel, the seller may not keep any part of your cash down payment You must say, in the cancellation notice,that you do not want the goods or services and mail it before midnight of the 3rd business day after you signed this contract to the address at the bottom of this form. Total Amount$7,425 Due prior to start of project$3,713 Balance upon completion $3,712 The homeowner: 'Y ees that he/she and has read this agreement and any addenda and the terms, specifications and conditions are satisfactory. Represents and warrants that helshe is the owner or authorized agent of the Construction Address. You are authorized to work as specified and aym t wil a made as outlined above. Homeowner's signature of acceptance Date _ C` Contractor's signature of acceptance Date t 3 i This contract may be withdrawn if not accepted by the Contractor within 60 days. i neshw.com A SOUTH SHORE SUS TA/NABLEBUSINESS 677 Temple St.Duxbury,Ma 02332 Phone-'7815368633 Fax.-8153018678 bnucaet?aneshw.com Ma.H/CIAwnse 160430 rr® osal Status: active Date: 8/12/13 QUOTE:D0054 Expiration [late: S 00")VI L A R 9115/13 h Uter HOME SCHOOL BUSINESS TO Herbert Meyer 36 Evergreen Drive N.Andover, MA 01845 978-685-3019 Salesperson ; Job - Delivery Date Payment TOM Dave 2 Wagner collectors,80 gallon solar domestic hot water system TBD 50%down,balance j tt upon completionDescrilAon + — Qty- UrnT Prick- Install riceInstall solar domestic hot water collector,indirect heating loop,storage and all associated $7,425 I controls and hardware. Existing hot water heater to serve as back-up. 2 Wagner EURO C20 AR flat plate solar collector array Kinspan Tribune single coil 80 gallon stainless steel tank W/electric element i Copper or stainless steel solar lineset withl8mm UV proof insulation and sensor wire Resol BS Plus'solar controller ' Wilo Star 32F primary pump � I Zilmet drainback tank Propylene glycol heat exchange loop Potable anti scald valve ( $7,425 Kingspan provides an 20 year warranty on the tank, Wagner providesan 11 year warranty on the collectors, NESHWprovides a 10 year warranty on the solar/ineset, and NESHW 1 provides a 5yearlabor and balance of system'evmponentsIff ngs warranty ! Total $7,425 {f neshw.com A SOUTHSHORESUSTA/NABLEBUS/NESS 677 Temple St.Duxbury,Ma 02332 Phone.'7815368633 Fara 8153018678 bruce@fteshw.com Ma.H/Clicense 160450 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor i &2 Family License: CSFA-101264 , BRUCE D DIIM 677 TEMPLE STREET DUXBURY MA M332. Expiration Commissioner 05/23/2014 Aw Office of Consumer Affairs&Business Regulation fHOME IMPROVEMENT CONTRACTOR Registration:sr tE0450 Type: Expiration:-7-12W01-4 DBA VBRCE DIBR CE DIKE ALTERNATWE ENERGY BRUCE DIKE EL ._ i 677 TEMPLE ST DUXBURY,MA 02332=z R t;h Undersecretary Rightfax N3-2 8/20/2013 10: 15: 01 AM PAGE 2/002 Fax Server i gang CERTIFICATE OF LIABILITY INSURANCE E TE(MIWDDmrYY► FICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 WANED,subject to he terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsemen s. PRODUCER CONTACT NAME: MICHAUD ROWE AND RUSCAK PHONE FAX P O BOX 188 (ATC,No,Ext): (ATC,No): E-MAL NORTH ANDOVER,MA 01845 ADDRESS: 29Y5D INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS INDEMNITY CO NEW ENGLAND SOLAR HO WATER INC INSURER B: INSURER C: INSURER D: 677 TEMPLE ST INSURER E: DUXBURY,MA 02332 INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: HIS S TO MW%7=T THE POLICIESOrIUMME LISTED BELOW HAVESEEN 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 HBREN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY ORP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER ""DIYYYY) (MKMIAYYYY) LIMITS GENERAL LIABILITY CH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE $ CLAIMS MADE [--IOCCUREMISES Ea occurrence) ED EXP(Arty one person) $ RSONAL&ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PER ENERAL AGGREGATE $ POLICY PROJECT a LOC ODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT fEa accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS ODILY INJURY $ NON-0WNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) I UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY YM UB 587566W�-12 12I03l2012 12/032013 LIMITS ANY PROPERITOR1PARTNEWDCECUTNE MN OFFICERIMEMBER EXCLUDED? N/A E L EACH ACCIDENT $ 500,000 _ j (Mandatory In NM EL DISEASE-EA EMPLOYEE $ 500,000 If Yes' Oe under EL DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONSILOCATIONSNEIUCLESlRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE_ CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BUILDING DEPARTMENT BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 1600 OSGOOD ST AUTHORIZED REPRE NTOVVEE �y NORTH ANDOVER,MA 01845 f ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORA-717DR. Tkll rights reserved. NEWEN-1 OP ID:JY CERTIFICATE OF LIABILITY INSURANCE °A 08119113 Y' 08/19/13 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 WANED,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 endomemen s. PRODUCER Phone:978 688 8829 NAAONACT MME. Michaud,Rowe And Ruscak Ins. Fax:978 557 2130 PHONE Fax P.O.Box 188 AH No Ext: A1C No North Andover,MA 01845 E4eAIL Michaud,Rowe 8r Ruscak ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Harleysville Worcester Ins Co. 26182 INSURED New England Solar Hot Waterinc INSURER B:Travelers Insurance Company Bruce Dike INSURER C:Commerce Insurance Company 34754 677 Temple St Duxbury,MA 02332 INSURER 0: INSURER E: 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. INSR I TYPE OF INSURANCE -AWL SUB POLICY EFF POLICY EXP LTR POLICY NUMBER MMDIYYYY) (MMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY SPP42517H 09/11/12 09/11/13 D AGE TO RENTED PREMISES a occurrence $ 100,00 CLAIMS-MADEa OCCUR MED EXP(Any one person) $ 5,0 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY PRO-_ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaacad. $ 1,000,00 C ANY AUTO BBCM55 08/21/12 08/21/13 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOSX AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Peraccident $ $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 2,000,00 A EXCESS LIAB CLAIMS-MADE CMB92125K 06114113 06114/14 AGGREGATE $ 2,000,00 DED I X I RETENTION$ 0 $ WORKERS COMPENSATIONC STATU OTH- AND EMPLOYERS LIABILITY TOWRY L NUTS I I ER B ANY PROPRIETOR/PARTNERIEXECUTIVE YIN TO BE ISSUED BY E.L.EACH ACCIDENT MI $ OFFICEREMBER EXCLUDED? ❑ NIA A (Mandatory in NH) TRAVELERS EL DISEASE-EA EMPLOYE4$ II yyes,dWbe under DESCRIFTT10 OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) i CERTIFICATE HOLDER CANCELLATION NORTH13 j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood Street ACCORDANCE WITH THE POLICY PROVISIONS. i North Andover,MA 01845 AUTHORIZED REPRESENTATIVE! ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i TECHNICAL INFORMATION Wagner&Co EURO Solar Collector Type C20/C22 EPDM rubber seal 7 with vulcanised comer joints Anodised `r aluminium � Highly transparent casing safety glass Selective coating Comers without heat bridges �s Ultrasound fused copper absorber A f 60mm insulation CE Aluminium back .F 3F p. J Figure 1 The EURO C20IC22-powerful,versatile and rapidly installed Advantages High Efficiency through Perfect Details Adaptable Arrangements and Installations Thanks to its highly selective vaccuum coated flat plate ab- O On-Roof Installation sorber,a 60 mm back insulation and the seamless side insu- The collectors can be installed above the roof surface lation,the EURO solar collector is characterized byvery low with rafter brackets or mounting rails,either horizontally heat losses.In addition it is equipped with highlytranspar- or vertically(horizontal preferred). Even during the in- entsolar glass.The EURO C20 AR variation additionally fea- stallation, the roofing remains almost completely un- tures sunarc® anti reflection glass increasing the solar yield harmed.We offer roof-anchors and rafter brackets for al- by an additional 6-10%thanks to intelligent nano-technol- most every roofing type.Upto 4 EURO collectors can be ogy based upon the moth-eye effect. connected in series.The connection hoses with pre-as- sembled insulation also significantly simplifythe on-roof High-Quality Materials pipeworks. Distribution pipes on the roof are not re- Anodised aluminium profiles,aluminium back,high-trans- quired. parency safety glass cover,weather resistant EPDM rubber O In-Roof Installation seals with vulcanised corner joints and ultrasound-fused, The attractive in-roof installation is possible for roofs heat-resistant copper absorber ensure safe operation for with a minimum pitch of 27%and any tile cover.In this decades. case the collectors are installed vertically,with the con- nections pointing upwards.The aluminium and corru- Excellent Price/Performance Ratio gated lead flashing can be joint without solder. Tested quality according to European norm EN 12975 and O Free Standing Installation the CE label.Repeated awards from the Independent Insti- The free standing set up allows horizontal or vertical in- tute for Consumer's Goods Testing"Stiftung Warentest". stallation with adjustable inclination.Concrete slabs or gravel covered aluminium trays can be used as founda- Simple and Fast Installation tion. Tried and tested installation kits, photo-instructions and weldless connections to the solar circuit. Solar Thermal/Solar Collectors EN-EURO-C20-C22-TI-0701-11201000 1.Technical Data Feature EURO C20 AR EURO C20 HTF EURO C22 AR EURO C22 HTF Total area/aperture area 2.61/2.39 m2 2.24/2.02 m2 Size WxHxD 2151x1215x110mm 1930x1160x110mm r1a=85.4% no=81.8% TI.=85.4% %=81.8% Efficiency(DIN 4757-4) ki=3.37 W/m?K k,=3.47 W/m2K kj=3.37 W/m2K ki=3.47 W/m2K k2=0.0104 W/m2K2 kz=0.0101 W/m2K2 k2=0.0104 W/m2K2 k2=0.0101 W/m2K2 Incident angle modifier kdir=97% kd;r=94% kd;,=97% kd;,=94% kdiff=94% kd fr=88% kdiff=94% kd rr=88% Annual collector yield 546 kWh/mea 509 kWh/mea 546 kWh/mea 509 kWh/mea (ITW 5 m2*) Collector housing 60mm back insulated and frame insulated aluminium casing;specific heat capacity 4.7 kJ/(m2K) 4 mm solar safety 4 mm solar 4 mm solar safety 4 mm solar Glass cover glass with sunarc®- glass with sunarc®- antireflex-coating safety glass antireflex-coating safety glass Transmission x=96% i=91% r=96% 2=91% Absorber Heat conducting sheet and pipes made out of copper,max.pressure 10 bar Absorber coating Highly selective vacuum coating,a=95%,E=5% Absorber capacity 1.3 litre 1.1 litre Conductor fluid DC20(Propylenglycol with inhibitors),mixing ratio according to requirements Working pressure Max.10bar Idle temperature 232*C 227°C T232°C 227*C (according to DIN 4757-3) Sensortube 6 mm internal diameter Connections 1/2"male CE lable TUV certificate 0036,EC type test(Module B)in accordance with EU direction 97/23/EC Max.allowed pressure/suction forces 2.25 kN/m2(take wind and snow loads into account!Consider static capacity of roof!) Inclination range 10-85°for on-roof and free standing setup,27-85°for roof integration Weight 48 kg 43 kg *Calculated for 4 person household at Wiirzburg/Germany with 3001 solar cylinder and 5 m2 collector area. Table 1 Technical Data EURO C20/C22 Pressure losses(mbar) Pressure losses(mbar) 200 200 180 180 4 EURO in series 160 - ------ .... 160 140 140 J� 4 EURC in series J� ------------ —------- ---- ---4'- G 120 a 120 7 100 � O 100 80 3 EURC in serie 0' 80 32 ---•- ...... .... �� 3 EUR in series 60 60 : Q 40 O 42 40 C22 2 EURC in serie 2 EURC in series 20 20 4----- 0 0 0 50 100 150 200 250 300 0 50 100 150 200 250 300 Flow rate(litre/h) Flow rate(litre/h) Figure 2 Pressure loss EURO C20 in relation to the volume flow and Figure 3 Pressure loss EURO C22 in relation to the volume flow and and the number of collectors connected in-row; and the number of collectors connected in-row; Volume flow v=301/m2h;heat transfer medium:40%glycol,60%Water Volume flow v=301/m2h;heat transfer medium:40%91ycol,60%Water at 30°C;examples with v=301/m 2h;pressure losses do not account for at 30°C;examples with v=301/m2h;pressure losses do not account for connections and connection pipes connections and connection pipes 2 EN-EURO-C20-C22-TI-0701-11201000 , 1 M 84.7" I En Co EURO C20 AR-M o G SECUSOL G G G G G G a U U C7 G G u I G o i I � H (1)Flange with sacrificial anode; (2)V2"venting socket Dimensions of cylinders are without insulation. Figure 4 Dimensions of EURO C20 M8 solar collector and SECUSOL 350 solar cylinder(for dimensions see table 2) (1)Flange with sacrificial anode i 6 US-XXX-SECUSOL-TI-MA-1 00621-1121 R800 Installation of the rails C> P 1 • 1 � 2 • 2 1 17 Nm 30 Nm 0 Already conned the rails O while still on the ground Figure 13 Overview ofrail installation (1)Rail with two collector clamps; (2)Rail with single collector clamp(not in case of only one collector or two collectors side by side) Table 9 Segment Length(inch) For the side by side installation of two collectors the four ; supporting rails of type 1 (see figure 13)must be aligned EURO C20 AR M8 EURO C22 AR M10 at the given distance(see figures 5 and 6). A min. 63"(1600mm) min.59"(1500mm) B 39-51"(1000-1300mm) 35-47"(900-1200mm) C 3/4"-7.B"(20-200mm) 3/4"-7.8"(20-200mm) US-XXX_SECUSOL_TI-MA-100621-1121 R800 1s • 2. Horizontal Installation 2 1 7 4 3 Figure 5 Basic set for on-roof installation(collectors are not included in delivery) 2.1 Scope of Supply Table 1 Figure no. I Components:Basic Set for On-Roof Installation I Quantity 1 I Roof bracket (6) I 2 2 I Collector supporting rail 49.5 inch(1257 mm),incl.2 collector clamps 12 3 I Collector supporting rail 48.2 inch(1223 mm),incl.1 collector clamp 2 4 Collector supporting rail connector 2 6 Collector connection hose for solar circuit,35.4 inch(900 mm)length 2 7 Gasket 1h" 6 8 Adapter fitting'h"-to copper pipe 2 9 I Wire Strap 1 The included collector holders are not required for horizontal installation (4) Not included in set;choose according to roofing type. z Required quantity depends on structural load calculation. EN-XXX_EURO TRIC-A_MA-11216A00_MA-100119-11216A00 50 Installation manual for roof bracket Al pro on a Composition Shingle Roof Wagner&Co No need to remove any shingles if you can locate the rafters.Tools Required: Drill,socket drive for lag bolt,tape measure,stud finder, chalk line,caulking gun etc. 1. Locate the rafters and snap horizontal and vertical lines to mark the installation position for each roof bracket. 2. Center the roof bracket over the rafter. 3. Drill a pilot hole for the lag bolt. 4. Caulk hole to prevent moisture entering the roof structure 5. Insert the lag bolt with neoprene-bonded washer and Tric A clamp to the roof braket.Do not tighten the clamp at this point of installation. 6. Attach rubber rings to TRIC A rail connectors after connecting.Those rubber rings prevent damage to the roof structure(see next page for details). 7. Attach TRIC A rails to the roof brackets and tighten to approximately 97 Ibf in to ensure a watertight seal. 4x® 4x OO 4x 4x O ` ° 4x Scope of delivery(from upper left):4 rubber grommets,4 washers, Locate rafters,properly place flashing and base plate,mark 4 collector clamps,4 base plates+flashing,4 hex wood screws. position,drill pilot hole. a e Caulk hole to ensure water tightness. Attach clamp with screw and washer as shown above. DO NOT TIGHTEN YET! 72 Plot pian, 36 Evargreern Dr,, bTth Andover , MA ABI Proposed solar Riot wearer co'ilectof location(Mush mounteld to roof; 1211 WAgnar,C- Ile rs(flush m,ou ife-d to hoof) Existifixivordl on, pitch nom, SPF Raftzr pitch Rafter sham� jr Noah endaver and savvy load 55 PSP .doped roof snow load'per:+ -CE.Ch, 1 381. PS)F ��6� ������5"p���,,req'd, maximum pewmissabliep swan Ci rAefrreeican 'ood Counclil Maaclr -Um $parr CakulatoK,R/180 deff eotivr)