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Building Permit #108-13 - 401 STEVENS STREET 8/8/2012
NORTH BUILDING PERMIT of 6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Arev 9SSAC14US, Date Issued: I. IMPORTANT:Applicant must complete all items on this page 4 11... A "4 'e 111t ......... nt, MachinE�-Sho p TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential lew Buildingi5ne family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other L Floodplainean . it e- werc DESCRIPTION OF WORK TO BE PREFORMED: 9� f " t e / /' A"I V17' IIdenMcation PI se ype or Print Clearly) OWNER: Name--/,�"? Irl z.14�.9 Phone: fZE122/-1127-!5�, Address: 7, CONTRACT® 'iPhon -- A p" _x ion License �S Yom s�l, E .,PPrvL truct 1ZJi It"; jj Home�ImprovemAe 611ficense— p ARCHITECT/ENGINEER Phone: 9Zy--el3e) Address: _Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ S/F, FEE: Check No.: Receipt No.: NOTE: Persons contracting wit unregist ed contractors do not have access to thpl�kuarantyfund nregis ign nr Signature ofA6e Signature --u-re '00" Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL i u lic Sew Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT S COMMENTS 04 ki OLN'/AW CONSERVATION Reviewed onb' Si nature �- COMMENTS 2�2- 7 HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes PlanningBoard Decision: Comments Conservation Decision: Comments Z ; "rp–V-114 Water & Sewer Connection/Signature &D e f a Zanit I DPW Town Engineer: Signature 1r c cQ ar / ocated A Os ood- treet st •-•--. ... S . , 1;Rr- ) w ^Y' RJ ..y.'`C"4a 1. FIRE DEPARTMENT:`;Temp Dumpster.on site yej x�. x }, } nog ' � � ` '`= Locat d a't124 Main Streetfi' rf ' " . t A*"`=*'' ~Fire Department signature/d`ater cw.,.'fi ''S' �r - - :., r',•k 4 `-. ,;.;- _ w +r-` r Cit E r r .,�, µt'.'C. w.•r-- COMMENTS . _ m +. •..... s,..... a..a '.`_...... +C. ..,xr`� .7.a �...};,..,::.. .,4::+:..�.ti.. ..+S::G:.:, ..+: z"3y._:.s,. Y I 1 Dimension Number of Stories: v? Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: �7�9 ELECTRICAL: Movement of Meter location, mast or service drop requires � p q 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 I i ❑ Notified for pickup - Date I Doc.Building Permit Revised 2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL u lic SewTanning/MassageBody Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 09/vl COMMENTS l 1 Old/ l CONSERVATION Reviewed on zz Signature - /& COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Consdrvation Decision: Comments I T Water & Sewer Connection/Signature &D e f a Ze—r'mit 1ZDPW Town Engineer: Signaturey/ Aail� 1����Zjz� zz��, oca ed 84 Os ood treet te' ' ♦r' t !yt. '✓ ♦tk'{r> r .y ..r E;, 1C wi y r r �....y7..y-•. t,t."Y'� FIRE'DEPARTMENT,=Temp Dumpster on site yes :'� a # *rano *,+.`"."�.` '.�,2.,+t—}-- :+i.S"� _s '�rt''l"� .� Y � v : i�,.;i,I•J:'�� "v ,. *r +,, -i �.�.^'*..ems*'<., *' - L`ocated zF-kb-bepaitment'signature%date., x _ COMMENTS 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 ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ 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) rad Building Permit Application j w/ Certified Proposed Plot Plan w/ Photo of H.I.C. And C.S.L. Licenses w/Workers Comp Affidavit e' Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract a,"'Mass check Energy Compliance Report ra�ngineering 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:INSPECTIONAL;SERVICES DEPARTMENTMFORM07 Revised 2.2008 Enter construction cost for fee cal- North Andover Fee Cakulation Construction Cost 318 00.00 m $ - $ 3,816.00 Plumbing Fee $ 477.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 477.00 Total fees collected $ 4,870.00 411 Stevens Street 108-13 on 8/8/12 New Home FORTH TOwn o _ ndover to No. * t M ver, Mass, A—y1 COC AMIC„ew¢w 7� �4ATE O S U 4v�wm* LTH �e S She 11 THIS CERTIFIES THAT .�� �� � �„ . P� T PERMIT T LD .......1....�f.................................. .:.....�......�.... _-� D�Imo,Sv/'yC/&V,/ s �� ®s'&�a�� �✓ nation' q /&/,/ has permission to erect ..:....................... buildings on .. ..............................................o ....................... - r r to be occupied as � � � �� .. � �`... a� ,� r!:?!/'®.................... cnU�h.. � °� . C,. ............ .......................... .......... ..... .......... . im provided that the person accepting this permit shall in every respect confo m to the terms oft a application , al -�.- on file In this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and — 1 Construction of Buildings in the Town of North Andover. VN' L-&((PLUMBIN(: INSPECTOR ROU ` _��✓ _ r VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION RTS u Xrvi t� -s � far ............:...s ...... .: ........................ � x,116 13 r......BUILDING INSPECTOR Final GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final .�� . z)9 No. Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner `^ StreetNo. Smoke Det. .3-2 g—/ SEE REVERSE SIDE 4 1 Oi NORTH 32���. n .`•OpL i ,sgACNUSf� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 108-13 on 8/8/2012 Date: April 23, 2013 THIS CERTIFIES THAT THE BUILDING LOCATED ON 411 Stevens Street MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Tom Patenaude Homes,Inc. P.O. Box 483 North Andover,MA 01845 Building Insp ctor Fee: PrePaid Receipt: 25591 Check : 103 i �ORTFj -own of . 0 In No. It AL o h ver, Mass, / COCNIC Nl WIC�t �1' Ago" 6 �s.4s��+rE o ►Pa,��(y U A LTH PERMIT T LD S St n � 000dOpp — THIS CERTIFIES THAT ........ � � dle1� 94t . d : GNSP CTO . .' . J .... ...o :..................................... nd has permission to erect ..:.......... . buildings on ............ .................................................................... 4 �� ss°ar:✓ctiJ°� �� l�8� & CdrZi .. £f�° ' J v to be occupied as ............ ... ........................:........ .....'.................. ........ chim provided that the person accepting this permit shall in every respect confoo the•terms oft e.application 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. RO Yom, Final �^�. PERMIT EXPIRES IN 6 MONTHS �1 ELECTRICAL INSPECTOR UNLESS CONSTRUCTION RTS � - AL FFinal ��AW-4' 130 '„� .................................:..s ...... .r .................. .. Z.1.�....1w —13 BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough r0o,�7 'L;0 o , Display in a Conspicuous Place on the Premises — Do Not Remove Fina' � �,� �'L►� p Y . p /3 No. Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. �- Smoke Det. J SEE REVERSE SIDE ORTH Town .oft 1, Andover. No. CK ver> Mass f 2 O ICOCKIC"I Wy�. f A04ATED / �S s LU) YZA A LTH 4. PERMIT . T L .D 5T,�� Id o U D G INS; CTO THIS CERTIFIES THAT ........f...�. .....................� :.. � . . ��. '6��®�.�' .................................. ndatiori di; ✓ 'fry.. has permission to erect ... buildings on . .. e tobe occupied as ............ ...: ................. �2). ..... ......... cnney..... n......... provided that the person accepting this permit shall in every respect confo m to the'terms of the application i aim G on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and u �, Construction of Buildings in the Town of North Andover, PLUMBING INSPECTOR ' VIOLATION of the Zoning or Building Regulations Voids this Permit. Final1-7 ] l. v IN 6 MONTHS PERMIYII'1r EXPIRES ELECTRICAL INSPECTOR UNLESS CONSTRUCTION RTS 5FRin `'fir 'r° 'ILP................. .... . ,g,,a1 ..... .................... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building R1c,,g 7 r°' Premises - Do Not Remove Final ' L,9 Display in a Conspicuous Place on the , e No Lathing or Dry Wall To Be Done FIRE DEPARTMENT --� Until Inspected and Approved by the Building Inspector. Burner Street No. O Smoke Det. Z g- SEE REVERSE SIDE Y 50 Washington Street Suite 3000 Westborough, MA 01581 t 508.836.9500 Conner ation f 508.870.5975 Services Group www.csgrp.com IECC 2009 402.4.2.1 Testing option Blower Door Testing Pass Fail Date of test: i 2y 1 r Street Address: S�Q� tvn e Total conditioned floor area: 2.e Total conditioned volume: �v S Source of area and volume calculations: Builder Rater Other HERS Rater: F r C. liJ I P Signature: ' Builder: r lel Builder Contact: Tested Air Leakage Requirement: 7 Air Changes per hour at 50 pascals (ACH50) or less Measurement: `` ACH50: 7i 7� Conservation Services Group © 2012 NORTH O ED to q�O O OG _ " APPLICATION FORCERTIFICATE OF OCCUP ANCY/INSPECTION �9SS•aCHusBUILDING PERMIT# ADDRES S/LOCATION OF PROPERTY:- ;Lz/l/ L:5 Map li Parcel L Lot Number SUBDIVISION: DATE REQUESTED FILED/READY FOR INSPECTION:- CLOSING DATE ON PROPERTY:_ FIVE (5)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRANC. A REINSPECTION FEE OF TWENTY DOLLARS ($20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. APPLICANT SIGNATURE Permit Issued to: Address:Zjf -eztie ROUTING / A TOWN ENGINEER, SITE PLAN— RIVE-WAY REVIEW 1h CO NSERVATION PLANNING DPW-WATER METER .SEWER CONNECTION C�l� DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCYANSPECTION REQUEST DPW --, SIGNATURE File:Application for OC form revised Jan 2007/2011 N36 39, 4" I NsB. 0 N c�T 2 01 LOT 3B 29,789 S.F. a 0 29.2' 54.0' 1 rn EXISTINGPO w FOUNDATION o 51 5, 16.0' 38.0' Cd to � P� TOP FND. v co =192.841 R=360.00' L=50.49' `S22'19'09"W 7.31' 2-1 5l STEVENS STREET P:\1 0\1 0-23\DWG\CERT3B.DWG I HEREBY CERTIFY THAT THE LOCATION OF THE STRUCTURE SHOWN ON THIS PLAN WAS DETERMINED BY A FIELD SURVEY, THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE NORTH ANDOVER ZONING REGULATIONS AND THAT IT IS NOT LOCATED IN A FLOOD PLAIN. REG. PROF. LAND SURVEYOR CERTIFICATION PLAN STN OF MA�cSq�y, LOT 3B STEVENS STREET NORTH ANDOVER, MASS. oma° PED R Prepared for a n d over GOODWIIJ NATALIE KINDRED & No.48133 9 �`J MATHEW S CHIEF consultants o,F RFG�Sj�P�o s NA SCALE: 1 =40 in c. Lis NQ 9/27/2012 TOWN MAP NO.96 LOT NO.78 1 East River Place, Methuen, Mass. Taj Engineering Consulting Engineers 7 Montview Road Chelmsford,MA 01824 T: 978-430-4585 tajengg@aol.com To Whom It May Concern November 29, 2012 Reference: Single Family Dwelling 411 Stevens Street,North Andover, MA 01845 LVL Connections & Structural Inspection At the request of Kindred Homes, Inc. we have inspected the structural framing and connections of the LVL beams for the building located at the above referenced address. We found the installed LVL connections per the standard technical practice and procedures and per the recommended specifications. Please do not hesitate to call with any b A ,'° or clarifications. Sincerely, Taj Engineering 41 3 Todd L. T. Hedly, PE Associate _, E 077 �G' lL/L Vii' J7• �1h✓ ifi� V'� �G:%f%WC,'fLL�:FC•�"L:! �'Ua�� L rZLCcs li 'GC2 C��d 2 CGl2 U'U� • / r 2 �iGCv:4�Z�GG rF=7(rev.1105) CER T J7=�Cr 1 r GF COMP IA E ECTI Ck or Tamm AA()-,7 This Cee ies that the prapeq lac;ftted at has been equipped with approved smake detectors, and car monoxide alarms and was found to be in comp((ance with Massachusetts General Law, Chapter 143 Seciians 26F, 26Fya and 527 CMR 31 et seq. Inspedion/Testina completed an: -j 9 _ ins��ccr Fee Paid; Head of Fre Department: Nota:This ceriiiicata expires si,ny (60) days aiicf date of Issuer SELLER'S caPY N36 9,04" I 66.10# E tis8. Z tip F , \ 4F X00 �0 LOT 313 29,789 S.F. a 0 29.2' 54.0' rn EXISTING N 0", w o FOUNDATION o 515, 16.0 38.0' Lo I (0oi TOP FND. J =192.8 R=360.00' L=50.49' `S22'19'09"W 67.69'' 7.31' S21'51'53"W STEVENS STREET P:\1 0\1 0-23\DWG\CERT3B.DWG I HEREBY CERTIFY THAT THE LOCATION OF THE STRUCTURE SHOWN ON THIS PLAN WAS DETERMINED BY A FIELD SURVEY, THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF- THE NORTH ANDOVER ZONING REGULATIONS AND THAT IT IS NOT LOCATED IN A FLOOD PLAIN. REG. PROF. LAND SURVEYOR CERTIFICATION PLAN LOT 3B STEVENS STREET O���P�HOFMgs69cy, NORTH ANDOVER, MASS. PETDER , Prepared for an dover GOODWIN CD NATALIE KINDRED & con su I to n is No.48133 MATHEW SCHIFF • 9��F 9F�lSTEP``� J, SCALE: 1 "=40' 9/27/2012 In C' ss��NAL LANOS�Q TOWN MAP NO.96 LOT NO.78 1 East River Place, Methuen, Mass. t%ORTy own o Andover , Q y 1n No. I - o LAN! h ver, Mass, �1�f ltl 2— COC NIC Nl WICK y�. �•9 A°RArEI> S U BOARD OF HEALTH Food/Kitchen PERMIT -T LD Septic System THIS CERTIFIES THAT .......1.0.. 1.....�u. `:`.9v�:1.�: �L� a ! :..................................... BUILDING INSPECTOR �fE�� has permission to erect ...... buildings on .. .� / Foundation Rough to be occupied as ............ ... .............................T...y .........../ -n.................. Chimney provided that the person accepting this permit shall in eve respect confozio the terms of thea licationp p p g p ry ppp 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 CONSTRUCTION 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 Bk 12774 Pg12 #755 140 Academy Road Map 96,Parcel 33 - Land Disturbance Pennit August 2,2011 p) A pre-construction meeting must be held with the developer, their construction employees, Planning Department and Building Department (and other applicable departments) to discuss scheduling of inspections to be conducted on the project and the construction schedule. 4) PRIOR TO THE ISSUANCE OF A RUILDING PERMIT a) A Plot Plan for the lot in question must be submitted to include the following: a. Location of the structure b. Location of the driveway .c. Location of all water.and sewer Iines d. Any grading called for on the lot e. Location of drainage,utility and other easements, 1. Location of landscaping b) All appropriate erosion control measures for the lot shall be in place. c) All catch basins shall be protected and maintained with hay bales to prevent siltation into the drain line during construction. :d) ' Ile lot in question shall be staked in the field. The location of any major departures from the plan must be shown. �'e) Lot numbers,visible from all roadways must be posted on all lots. 5) PRIOR TO THE RELEASE OF THE PERFORMANCE BOND: a)' The applicant is required to install a final pavement overlay on Stevens Street, starting at the last cross trench near Great Pond Road, extending to the existing sewer manhole in Stevens Street, approximately 300'northeast of the northern most point of lot 6. This work must be inspected and approved by the Department of Public Works. b) The applicant shall submit an as-built plan stamped by a Registered Professional Engineer in Massachusetts that shows all construction, including storm water mitigation trenches and other pertinent site features. This as-built plan shall be submitted to the Town Planner for approval.The applicant must submit a certification from the design engineer that the site was constructed as shown on the approved plan. e) All activity,exclusive of maintenance required in perpetuity, permitted by the Land Disturbance Permit must be completed within two years of permit issuance.Extensions of time can be granted by the Planning Board upon formal written request by the applicant, in accordance with Section 160.5.M of Town of North Andover Bylaws,Chapter 160,Stormwater Management and Erosion Control Bylaw. i d) The Planning Board will issue a Certificate of Completion upon receipt and approval of final reports and documentation as outlined in the Regulations and/or upon otherwise determining that all work of the permit has been satisfactorily completed in accordance with the Stormwater Bylaw. The Certificate of Completion shall be recorded at the Essex North District Registry of 4 6 I REScheck Software Version 4.4. 3 Compliance Certificate Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Single Family Building Orientation: Bldg.faces 225 deg.from North Conditioned Floor Area: 2544 ft2 Glazing Area Percentage: 12% Heating Degree Days: 6322 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 411 Steven st Powder Hill Development Corp Eric Kline North Andover,MA PO Box 131 J&J Heating and Air Conditioning Boxford,MA 01921 17 Arlington st Dracut me,MA 01826 Compliance:1.8%Better Than Code Ceiling 1:Flat Ceiling or Scissor Truss 1064 38.0 0.0 32 Ceiling 2:Cathedral Ceiling 416 38.0 0.0 11 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1064 30.0 0.0 35 Wall 1:Wood Frame,16"o.c. 800 21.0 0.0 35 Orientation:Front Window 1:Vinyl Frame:Double Pane with Low-E 165 0.280 46 SHGC:0.22 Orientation:Front Door 1:Solid 21 0.300 6 Orientation:Front Wall 2:Wood Frame,16"o.c. 568 21.0 0.0 31 Orientation:Right Side Window 2:Vinyl Frame:Double Pane with Low-E 30 0.280 8 SHGC:0.22 Orientation:Right Side Wall 3:Wood Frame,16"o.c. 800 21.0 0.0 38 Orientation:Back Window 3:Vinyl Frame:Double Pane with Low-E 99 0.280 28 SHGC:0.22 Orientation:Back Door 2:Glass 26 0.300 8 SHGC:0.27 Orientation:Back Wall 4:Wood Frame,16"o.c. 448 21.0 0.0 26 Orientation:Left Side Furnace 1:Forced Hot Air 95 AFUE Air Conditioner 1:Electric Central Air 13 SEER 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 20091ECC requirements in REScheck Version 4.4.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date i Project Title: - ..._ Report date:07/26/12 Data filename: Untitled.rck Page 1 of 4 REScheck Software Version 4.4.3 Inspection Checklist Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Single Family Building Orientation: Bldg.faces 225 deg.from North Conditioned Floor Area: 2544 ft2 Glazing Area Percentage: 12% Heating Degree Days: 6322 Climate Zone: 5 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: ❑ Ceiling 2:Cathedral Ceiling,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-21.0 cavity insulation Comments: ❑ Wall 2:Wood Frame,16"o.c.,R-21.0 cavity insulation Comments: ❑ Wail 3:Wood Frame,16"o.c.,R-21.0 cavity insulation Comments: ❑ Wall 4:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.280 For windows without labeled LI-factors.describe features: #Panes_Frame Type Thermal Break?_Yes_No Comments: ❑ Window 2:Vinyl Frame:Double Pane with Low-E,U-factor:0.280 For windows without labeled LI-factors,describe features: #Panes_Frame Type Thermal Break?_Yes-No Comments: ❑ Window 3:Vinyl Frame:Double Pane with Low-E,U-factor:0.280 For windows without labeled U-factors,describe features: #Panes_Frame Type Thermal Break?_Yes_No Comments: Doors: ❑ Door 1:Solid,U-factor:0.300 Comments: ❑ Door 2:Glass,U-factor:0.300 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Project Title: W Report date: 07/26112 Data filename: Untitled.rck Page 2 of 4 I Floor insulation is installed in permanent contact with the underside of the subfloor decking. Heating and Cooling Equipment: ❑ Furnace 1:Forced Hot Air:95 AFUE or higher Make and Model Number: ❑ Air Conditioner 1:Electric Central Air:13 SEER or higher Make and Model Number: 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 iambs 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. p Wood-burning fireplaces have gasketed doors and outdoor combustion air. ❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. 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 50 pascals 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 wails:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (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. (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. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. ❑ Materials and equipment are identified so that compliance can be determined. 0 Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. Duct insulation: ❑ All ducts not completely inside 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 181A 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 203.5 cfm(8 cfm per 100 ft2 of conditioned floor area). (2)Postoonstruction total leakage test(including air handler enclosure):Less than or equal to 305.3 cfm(12 cfm per 100 ft2 of conditioned floor area). (3)Rough-in total leakage test with air handler installed:Less than or equal to 152.6 cfm(6 cfm per 100 ft2 of conditioned floor area). Project Title: Report date: 07/26/12 Data filename: Untitled.rck Page 3 of 4 (4)Rough-in total leakage test without air handler installed:Less than or equal to 101.8 cfm(4 drn per 100 ft2 of conditioned floor area). Temperature Controls: At least one programmable thermostat is installed to control the primary heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle. O Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: C] Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. L3 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: 0 Circulating service hot water pipes are insulated to R-2. C] 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: Lj HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: E3 Heated swimming pools have an on/off heater switch. 0 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. C1 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. Other Requirements: Li 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: C] 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) Project Title: Report date: 07/26/12 Data filename:Untitied.rck Page 4 of 4 2009 IECC Energy Efficiency certificate Ceiling!Roof 38.00 Wali 21.00 Floor/Foundation 3n.nn Ductwork(unconditioned spaces): Window 0.28 0.22 Door 0.30 0.27 Forced Hot Air Furnace Electric Central Air Conditioner Water Heater: Name: Date: Comments: s �BoiseCascade Quadruple 1-314" x 9-112" VERSA-LAM® 2.0 3100 SP Floor Beam1FB01 BC CALC®3.0 Design Report-US 1 span I No cantilevers 10/12 slope Wednesday,July 25,2012 Build 517 File Name: BC CALC Project Job Name: Description: FB01 Address: Specifier: City, State,Zip: , Designer: Customer: Company: Code reports: ESR-1040 Misc: -------------------- -- i :._... v, .:.. •.r yr .. .. ' 12-06-00 BO B1 LL 4,000 lbs LL 4,000 lbs DL 1,617 lbs OL 1,617 lbs Total of Horizontal Design Spans=12-06-00 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115%a 133% 125% 1 Standard Load Unf.Area (psf) L 00-00-00 12-06-00 40 15 16-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 17,553 ft-ibs 62.9% 100% 1 1 - Internal Completeness and accuracy of input must End Shear 4,840 lbs 36.3% 100% 1 1 - Left be verified by anyone who would rely on Total Load Defl. U304 (0.494") 79.0% 1 1 output as evidence of suitability for Live Load Defl. U427 (0.351") 84.4% 1 1 particular application.Output here based Max Defl. 0.494" 49.4% 1 on building code-accepted design properties and analysis methods. Span/Depth 15.8 n/a 1 Installation of BOISE engineered wood products must be in accordance with Notes current Installation Guide and applicable Design meets Code minimum (0240)Total load deflection criteria. building codes.To obtain installation Guide Design meets Code minimum(U360) Live load deflection criteria. or ask questions,please call (800)232-0788 before installation. Design meets arbitrary(1")Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". BC CALC@,BC FRAMER(D,AJS-, Minimum bearing length for B1 is 1-1/2". ALLJOIST®,BC RIM BOARD?",BCI&, Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+ BOISE GLULAMT'" SIMPLE FRAMING 1/2 intermediate bearing SYSTEMS,VERSA-LAM@,VERSA-RIM PLUS©,VERSA-RIM@, VERSA-STRANDS),VERSA-STUDS)are Connection Diagram trademarks of Boise Cascade Vbbod 1 b d . •. Products L.L.C. I _ a 1 �... c i a minimum=2" c=5-1/2" b minimum=2-1/2"d =24" Beams 7 inches wide will be assumed to be either top-loaded only,or equally loaded from each side. Bolts are assumed to be Grade A307 or Grade 2 or higher. Member has no side loads. Connectors are: 1/2 in.Staggered Through Bolt Page 1 of 1 1►]Boise Cascade Triple 1-3/4" x 11-718" VERSA-LAM® 2.0 3100 SP Floor Beam1FB01 BC CALC@ 3.0 Design Report-US 1 span I No cantilevers 10112 slope Wednesday,July 25,2012 Build 517 File Name: BC CALC Project Job Name:�1`%N / t Description: FB01 Address: Specifier: City, State,Zip: , Designer: Customer; Company: Code reports: ESR-1040 Misc: .� - _ . BO B1 LL 3,120 lbs LL 3,120 ibs DL 1,180 lbs DL 1,ISO lbs Total of Horizontal Design Spans=16-00-00 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% 1 Standard Load Unf.Area(psf) L 00-00-00 16-00-00 30 10 13-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos.Moment 17,202 ft-lbs 53.9% 100% 1 1 -Internal Completeness and accuracy of input must End Shear 3,729 lbs 31.5% 100% 1 1 -Left be verified by anyone who would rely on Total Load Defl. U355(0,541") 67.6% 1 1 output as evidence of suitability for Live Load Defl. U489 (0.392") 98.1% 1 1 particular application.Output here based 0 on building code-accepted design Max Defl. 0.541' 54.1% 1 1 properties and analysis methods. Span/Depth 16,2 n/a 1 Installation of BOISE engineered wood products must be in accordance with Notes current Installation Guide and applicable Design meets Code minimum(0240)Total load deflection criteria. building codes.To obtain Installation Guide or ask questions,please call Design meets User specified (L/480) Live load deflection criteria. (800)232-0788 before installation. Design meets arbitrary(1") Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". BC CALC®,BC FRAMER@,AJS"m, Minimum bearing length for B1 is 1-1/2". ALLJOISTO,BC RIM BOARDTM,BCI@, Entered/Displayed Horizontal Span Length(s) =Clear Span+ 1/2 min. end bearing + BOISE GLULAMT" SIMPLE FRAMING 1/2 intermediate bearing SYSTEM@,VERSA-LAMS,VERSA-RIM PLUS@),VERSA-RIM@, VERSA-STRAND@,VERSA-STUDO are Connection Diagram trademarks of Boise Cascade Mod ►�b .-y d- -.� Products L.L.C. r-.. i a I f.... — 1— 'T- r c e -' I i a minimum=2" c=6-7/8" b minimum=3" d=24" e minimum =3" Nailing schedule applies to both sides of the member. Member has no side loads. Connectors are: 16d Sinker Nails Page 1 of 1 ^ Boise Cascade Triple 1.3/4,' x 9-1/2" VERSA-LAM@ 2,0 3100 SP Floor BearriXF1301 8CCALCO 3.ODesign Report'US 1span| Nocantilevers 1082slope Wednesday,July 25.2O12 Build 517 File Name: BCCALCPn�aot Job Name: ^�/^m^'�^`��� DaxohpUon: F8O1 Address: Specifier: City, State,Zip: . Designer: Customer: Company: Cndnra d EOR1040 0)i ---------- BO __- on o1 DL8nlbs DL98lbs Total of Horizontal Design Spans 14-00-00 u"v Dead Snow Wind Roof Live Txb. Load Summary Tag Description Load Typ Ref. Start End 100% 90% 115% 133% 125% ^^ Disclosure rno. wmm*nz x+*n'/os 1.8m yom 1 'Internal Completeness and accuracy ufinput must End Shear 86 lbs 1.0% 80% 1 'Lwft beverified uyanyone who would rely vn Total Load Defl. L/10,383(0.016") 2�3�� 1 output aaevidence mauimmluvfor L�eLoad De0. L0 �" n1a particular application. code-accepted design MaxDofl. 0.016° 1.6% 1 ~^properties and analysis methods. ~~=m Spon/Depth 177 n/a 1Installation of BOISE engineered wood products must be in accordance with Notes current Installation Guide and applicable building �eToobminm��|�mnmums Design— meets— ---' minimum'-- `--�-'Total load deflection- -- --- orask questions,please call Des'=' ^~�~~'~'~~' deflection criteria. (8OO232-0788before installation. Minimum bearing length for BO is 1-1/2". Minimum bearing length 1 e1'1/2'. ecoALC@, BCFRAMsR0,AJSru. Entered/Displayed Horizontal Span LengtbhA =Clear Span+ 1/2min.end bearing + aLLJcxSTO.oCRIM ooARoTm. eoxm' 1/2intermediate beahng BOISE GLuL^M`=.SIMPLE FRAMING GYGTsM6.VsRDa-Lxw@.VERSA-RIM Connection Diagram pLUSO.vEn8x'R|M(b. VERaA-STRAN0m.VERSA-STUDS are 3~10 -~' r~--o ~` trademarks orBoise Cascade Mod — ,— p,udummLL.C. � | � « � o minhnum=2" u=4-1/2" bminimum=3' d=24^ aminimum=3" Nailing schedule applies hobotbaidemofdhemembor Member has noside loads. Connectors are: 1GdSinker Nails Page,1of1 Boise Cascade Quadruple 1-314" x 11-718" VERSA-LAM® 2.0 3'100 SP Floor Beam1FB01 BBCCALC®3,0 Design Report- US 1 span{ No cantilevers 10/12 slope Wednesday,July 25, 2012 Build 517 File Name: BC CALC Project Job Name: /"r//')111 C) Description: FB01 Address: Specifier: City, State,Zip: , Designer: Customer: Company: Code reports: ESR-1040 Misc: 4: J. 15-00-00 _...__.__.................. BO B1 LL 4,200 lbs LL 4,200 lbs DL 1,751 lbs DL 1,751 lbs Total of Horizontal Design Spans=15-00-00 Live Dead Snow Wind Roof Live Trib, Load Summary Tag Description Load Type Ref, Start End 100% 90% 115% 133% 125% 1 Standard Load Unf_Area (psf) L 00-00-00 15-00-00 40 15 14-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 22,314 ft-lbs 52.4% 100% 1 1 - Internal Completeness and accuracy of input must End Shear 5,108 lbs 32.3% 100% 1 1 -Left be verified by anyone who would rely on Total Load Defl. U389 (0.463") 61.7% 1 1 output as evidence of suitability for Live Load Defl. U551 (0.327") 87.1% 1 1 particular application.Output here based Max Defl. 0.463" 46.3% 1 1 on building code-accepted design properties and analysis methods. Span/Depth 15.2 n/a 1 Installation of BOISE engineered wood products must be in accordance with Notes current Installation Guide and applicable Design meets Code minimum(U240)Total load deflection criteria. building codes.To obtain installation Guide Design meets User specified (L/480) Live load deflection criteria. or ask questions,please call Design meets arbitrary(1")Maximum load deflection criteria. (800)232-0788 before installation. Minimum bearing length for BO is 1-112". BC CALC®,BC FRAMER®,AJSTh7 Minimum bearing length for B1 is 1-1/2". ALUOISTO,BC RIM BOARDTM,BCI®, Entered/Displayed Horizontal Span Length(s) =Clear Span+ 112 min.end bearing + BOISE GLULAM- SIMPLE FRAMING 1/2 intermediate bearing SYSTEMS,VERSA-LAMS,VERSA-RIM PLUS&,VERSA-RIMS, VERSA-STRANDS,VERSA-STUDO are Connection Diagram trademarks of Boise Cascade ftod T b -• d •- Products L.L.C. c 1 a minimum=2" c=7-7/8" b minimum=2-112"d=24" Beams 7 inches wide will be assumed to be either top-loaded only,or equally loaded from each side. Bolts are assumed to be Grade A307 or Grade 2 or higher. Member has no side loads. Connectors are: 112 in. Staggered Through Bolt Page 1 of 1 , T anuucomo�� Quadruple 1-3'4" x 1 1-7/8 , V-FS8.LAM@2^0 3100 ~ P yKor Beam0~ 1~301 ` BCCALCO3.ODesign Report'US 1span INocanb|exerm!012slope Wednesday,July 25.2012 Build 517 File Name: BCCALCProject Job Name: Description: F801 Address: Specifier: Cih/, State,Zip: . Designer: Customer: Company: Code BR-1040 Misc: ~ 15-09-00 � BO | LL 4,095 lbs LL 4,095 lbs oIL\72olbs oL1.72olbs | Total � of Horizontal Design Spans 15-0�9-00 � Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% 1 Standard Load Unf.Area(psf]i L 00-00-00 15-09-00 40 15 13-00-00 Controls Summary value %Allowable Duration Case Span Disclosure Pos. Moment 22.086 ft-lbs, 53.8% 100% 1 l '|ntema| Completeness End Shear 5,030 lbs 31.3% 100% 1 1 'Left be verified by anyone who would rely on Total Load De8. L1361 (0.523") 66.596 1 1 output a,evidence msuitability for Live Load DoO. U513 (0.369") 93.6% 1 1 pa�cw|orapp|icmionOutputo h d pted design MexOefl. 0523^ 52.3% 1 1 -n---�"----- Span/Depth 15.9 n/a 1 Installation vfBOISE engineered wood products must Ueinaccordance with Notes current Installation Guide and applicable building codes.To obtain Installation Guide ~^~'u'' '''^e'~ Code minimum^ ^ `L'^`~/Total `~~~~~^~`^'~''`''^~''~' mask questions,please call Design meets User specified(U48O) Live load deflection criteria. (8O0232-0788before installation. Design meets arbitrary (i") Maximum load deflection nhterio� MinimumboahnQ/engthforBO\o1'1/2" BC Cx���.BCFRAMER®.xJn`". Minimumbeahng{engthfor81io1-1/2" ALu0Gn0.oCRIM BOARD TM,oCmy. Entered/Displayed|oyedHorizonba|SpanLongth(o)=O\earSpan+1{2min end BOISE GLVL8M-.S|MpLE FRAMING -' 8vuTsM0vsnS*'��MO'vepa*nIM i/2inbennediotebeohn0 ' PLU�&.VRGA'R|M0. veRSx'STR8NDID.vERSA-GTUD@are Connection Diagram trademarks vfBoise Cascade vmou b-^ -° -dPmductsLLC. Y a / a minimum=2' u=7'708" bminimum=2'1/2^d=24" Beams 7 inches wide will be assumed to be either top-loaded only,or equally loaded from each side. Bolts are assumed toboGrade A3O7orGrade 2nrhigher, Member has noside loads. Connectors are: 1/2in. Staggered Through Bolt Page of TOWN OF NORTH ANDOVER MASSACHUSETTS NORTH ANDOVER. OLD CENTER HISTORIC DISTRICT COMMISSION October 6.2C 10 TO NNI-10M tI'MIGHT CONCERN: Please be advised that the land owned by Robert Stevens consisting of 5 buildable lots on Stevens is not in the hi%-tor.ical District and therefore doe-,not need commission approval, Any questions please call me at 978 685 5000, Sincerely, Georue H. Schruender,Jr. Chainnan North Andover Old Center Historical District Commission Massachusetts-Department of Public Safety Board otOudding-.RegWations,and Standards Cois4truction Supeni.rff License:CS-005693 DAVID A IQNDiED` 65 EAST INDIA ROW#36H- BOSTON* 02110 =. s Expiration Commissioner 01113/2014 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 U1. www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): nC, Address: � ox City/State/Zip:-/fi , Phone#: Are ygu an employer?Check the appropriate box: Type of project(required): 1. I am a employer with O 4. ❑ I 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 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] I employees. [No workers' 1311 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I 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 their workers'comp,policy information. f am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: s �' Policy#or Self-ins.Lic.#://C C S'oo�to2/�/��� ��ra Expiration Date:T7//3 Job Site Address:_�6��� 51x7/ y lrns City/State/Zip:4/,,41 Attach a copy of the workers' compensation 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. 1 do hereby cert' nrler the pa' s and pens erj tlz t the information provided above is true and correct. Si nature: Date: 3 l 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 dwellinghouse having not more than three apartments and who resides therein or the occupant of the g p � P 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 shall 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' compensation 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 Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www,mass.gov/dia DATE WWM/YYM CERTIFICATE OF LIABILITY INSURANCE 7/20/2012 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(fes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder In lieu of such endoreemengs). PRODUCER NAME: M P Roberts Insurance Agency Inc PHONE (A/C No Ext: 978-683-8073 mac,No):978-683-3147 1060 Osgood StreetADDREss: sandi@mprobertsinsurance.com North Andover Ma 01845 INSURER(S) AFFORDING COVERAGE NAICN INSURER A: ESSEX INSURANCE CO INSURED RED TAIL DEVELOPMENTCORP A/O NORTHEAST INSURER B: ASSOCIATED EMPLOYERS INS CO DEVELOPERS LLC A/O KINDRED HOMES INC INSURER C: P.O. BOX 483 INSURER D: NORTH ANDOVER, MA 01845 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. LTR TYPE OF INSURANCEPOLICY NUMBER (MM/DD/Y" (MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 50,000 CLAIMS-MADE W OCCUR MED EXP(Any one person) $ EXCLUDED A 3DG4119 7/22/117/22/12/ PERSONAL&ADV INJURY $ 1,000,000 3DJ8068 7/22/1 7/221 GENERAL AGGREGATE $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ EXCLUDED POLICY PRI LOC $ AUTOMOBILE LIABILITY QCMUINEU SINGLE LIMIT a accident $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROP DAMAGE $ HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I I RET $ WORKERS COMPENSATION VVC AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ' ANY PROPRIETORPARTNER/EXECUTIVE N/A WCC50085210120118/1/11 8/1/12 E.L.EACH ACCIDENT $ 500,000 B OrFIC(Mandatory atIn H)EMBER ExctuoED? ❑ WCC5008521012012 /1/12 8/1/13 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (AttachACORD 101,Addftlonal Remarks Schedule,if morespaoeis required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES-BE CANCELLED BEFORE NORTH ANDOVER, MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP VE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD Date . A7 • (iUFO TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . e.). j!. . 'tel r has permission to perform . . . . .f. .- ?�� .,. /.. . . . . . . . . . . . wiring in the building of . !11?af-D. .lZ�/l'j S. . . . . . . . . . . . . . . at . . . -�TEri��?! S _ �• �• � . . . . . . . . . . , orth Andover, Mass. 0U /aoi7 ELECTRICAL INSPECTO. Check# MY 11016 Commonwealth of Massachusetts Official Use O Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] leave blank e APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ::Z131 , 17 City or Town of or� A q&l V e r To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) LI i I S -I-,e 11 t?n S } 0—OA- 3 0) Owner or Tenant K j n j 4-A Ro rh SPS a `rsV C_ Telephone No. C4 7Y-Q&6 - 7(®Li I Owner's Address -90. k ,K /-/93 A10 r I,\ A,d v;r y- AA ofr t l s Is this permit in conjunction with a building permit? Yes ❑ No Ll (Check Appropriate Box) w Purpose of Building - tm/ &Cj v;C e— Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service JDO Amps Volts Overhead ED"' Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ' l l S��e v e•1 h.i 51ree-F- , -eu1np 5erv�c-e- Com letion of the follawin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ n- ❑ o.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o."61 Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat No.of SelU.Contained Totals: Number Tons K Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ unicipa ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water Kms, 0.0 No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Devices or firing: No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov age is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) /j P 206-045 Al2 /z (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: (Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete- FIRM NAME: )a rr _ 0 XP-I(Q�f�y LIC.NO.: /On 17 Licensee: eq, Q 14,gttcx-g&,/ Signature '� _�-�/C,l� _ LIC.NO.: C� 3cf (If applicable enter "exempt"in the lice se number line.) Bus.TeL No.: W--7X.7-cs7ct 0 Address: `'t S,kver- G ra,i( 0 a 'I--,I- yy A/ I+ h3U'-1 ct Alt.TeL No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ ,w t3 1 r r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington kvi. h on Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): C (`, -/ Address: Q, J.,Or &00 L( sca ,Pan City/State/Zip: G 7 Phone#: Are you an employer?Check the appropriate box: Typeyf project(required): 1.❑ I am a employer with 4. [] I am a general contractor and I �tnployees(full and/or part-time). have hired the sub-contractors 6. New construction 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' 9. ❑Building addition [No workers' comp. insurance comp.insurance. required.] 5. ] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LQ Plumbing repairs or additions • myself. [No workers' comp. right of exemption per MGL 12.❑goof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13. ` Other "Rr1- SC."" C'e 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 the policy and job site information. ,,,, II Insurance Company Name: ,� P t t (O b41-4-5 _ Policy#or Self-ins.Lic.#: d (p �I o Expiration Date: /.S// Job Site Address: ES l2y-M S SLVAMaU e►'- City/State/Zip: (D Attach a copy of the workers'compensation 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�und�er the pains andpenalties of perjury that the information provided above is true and correct Signature: ` % �"` Y Date: l 3I I l Z Phone#: q 7r r -2 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#: f I 1 6 4 Date.�1. .'.lf.t"% .. . ... .. NpR,M TOWN OF NORTH ANDOVER FOSGp PERMIT FOR MECHANICAL INSTALLATION SAC14USES ' h This certifies that . :..�.� `:a, , .�.G, �. . . . . . . . . . . . . . . . . . . . . �.. • has permission for mechanical installation . . . .i . in the buildings of . . . . . . . . . . . . . . . . . . . . at . . . .4. . . . t-!'jv' 0'.1.� .. _�. .�:.1. . . . . . . . , North Andover, Mass. Fee. � rx... . . . Lic. No.)� ?. . . . . Of) . . . . . . . . . . . . . . . . . . . . . (i GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer i . Commonwealth of Massachusetts Sheet Metal Permit Date: (OIL Permit# )(A IT 6.0 Estimated Job Cost: $ q4-b-b Permit Fee: $ l b Plans Submitted: YES NO Plans Reviewed: YES NO Business License# 196 Applicant License# 15, CQ f� Business Information: Property Owner/Job Location Information: Name.: JU Heating & Air Conditioning,. Name: i<thdrec( - 4-nmLS (I�C Inc. Street: 17 Arlington St. Street: City/Town: Dracut, MA 01826 City/Town: AY\A ko` Telephone: 978-454-8197 Telephone: _. nuo i - 1314 Photo I.D. required/Copy of Photo I.D.attached: YES NO J-1/M-1-unrestricted license Staff 1Ws$► J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft./2-stories or less Residential: 1-2 family 4. Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. 14,' over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC 0jC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: TOr , 7INSURANCIE COVERAGE: nt liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes® No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy ® Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this boxo,I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit Issued for this application will be In compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to Insulation installation:YES NO Prowess Inspections Date Comments Final Inspection Date Comments Type of License: By ❑Master Title ❑Master-Restricted Cityrrown ❑Joumeyperson Signature o 'censee Permit# ❑Joumeyperson-Restricted License Number. Fee$ ❑ Check at www.mass.nov/dpl Inspector Signature of Permit Approval ACORQ CERTIFICATE OF LIABILITY INSURANCEDATE(MWDDIYYY`n 09/13/2012 PRODUCER 978.887.4900 FAX 978.887.2404 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Edward F. Sennott Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 16 South Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 457 Topsfield, MA 01983 INSURERS AFFORDING COVERAGE NAIC# INSURED 1&3 Heating & Air Conditioning, Inc. INSURER A: Great American Alliance Ins Co 17 Arlington Street INSURERS: Safety Insurance Company 39454 Dracut, MA 01826 INSURERC: A.I.M. Mutual Insurance Co. 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 DD' POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DD LIMITS GENERAL LIABILITY PAC6418906-05 06/01/2012 06/01/2013 EACH OCCURRENCE $ 1'000'00(000 00 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,00( CLAIMS MADE a OCCUR MED EXP(Any one person) $ 10,00( A X PERSONAL&ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00C POLICY PRO JECT171 LOC AUTOMOBILE LIABILITY 2434550 06/01/2012 06/01/2013 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY B X SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY UMB6418958-03 06/01/2012 06/01/2013 EACH OCCURRENCE $ 2,000,000 X OCCUR F�CLAIMS MADE AGGREGATE $ 2,000,00 A $ I EDEDUCTIBLE RETENTION $ $ WORKERS EMPLOY RS'COMPENSATION ILII 8006553012012 08/01/2012 TORY LIMITS ER Al AND EMPLOYERS'LIABILITY Y/N / /2012 06/02/2013 X C OFFICERIMEMBER EXCLUDED?AY ECUTIVE❑ E.L.EACH ACCIDENT $ 1,000,00C (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00( If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00( OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Evidence Of Insurance AUTHORIZED REPRESENTATIVE Peter Sennott LAR � �`G' - ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I i t COMMONWEA OF MASSACHUSETTS j AS'A BUSINESS 15SUES THE ABOVE LaCENSE T0: EAl2T7 T ,AYOTTE t J J - 'NEA T3"NG.' zAIR ,CONb, IONING m 17 AF LGTO S�REET DaACt1 T MA--Q18Zb 131 196 01/19/14 95273,` J I �A�`�SrtA�CH�S�EkT�JS p � — .. -:"�-131F' f �9$ENU -Otl 9ER.r tly�Jrf�;� a, 11 I' ��fYeer '�'-3x1 � ,,A�1•: I; Ll a83LONG.dR /�. _ �DRACUT;MA 0180•/I -� ��`�,• � / ., oso4,1 a vot�s1Oo6 I COMMONWEALTH OF MASSACHUSETTS SHEET MMA... WORKEO� � . m AS_ A MASTER ! NR�STRI�TED _ �� ISSUE'S THE ABOVE LICENSE TO:` ERIC LINE 17 , I.NGTON ST D:RACUT MA 0186 1,566 05/28/14 i I I Load Short Form Job: 411 Stevens st ~ - wrightSoft® Date: Oct 22,2012 Entire House By: J&J Heating and Air Condtioning Inc. 17 Arlington st,Dracut,MA 01826 Phone:978 454 8197 Fax 978 454 8615 Email:office@Dheatac.com Web:hheatac.com NIII MAKINNNIM on 0 0 0 For: Kindred Homes Inc RO box 483, North Andover, Ma 01845 Htg Clg Infiltration Outside db(°F) 12 88 Method Simplified Inside db(°F) 68 75 Construction quality Tight Design TD (°F) 56 13 Fireplaces 1 (Average) Daily range - L Inside humidity (%) 50 50 Moisture difference(gr/Ib) 43 28 HEATING EQUIPMENT COOLING EQUIPMENT Make Goodman Mfg. Make Goodman Mfg. Trade GOODMAN Trade GOODMAN, JANITROL,AMANA DISTI... Model GMH950905CX** Cond GSX130483A* AHRI ref 4005335 Coil CA*F4860*6D* AHRI ref 4945866 Efficiency 95AFUE Efficiency 11.0 EER, 13 SEER Heating input 92000 MBtuh Sensible cooling 36800 Btuh Heating output 88000 Btuh Latent cooling 9200 Btuh Temperature rise 52 OF Total cooling 46000 Btuh Actual air flow 1533 cfm Actual air flow 1533 cfm Air flow factor 0.029 cfm/Btuh Air flow factor 0.044 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.90 ROOM NAME Area Htg load Clg load HtgAVF CIgAVF (ft2) (Btuh) (Btuh) cfm cfm Laundry 72 2217 2265 64 99 1/2 bath 54 1319 1405 38 62 Living room 182 4766 4052 137 177 Foyer 168 3080 2244 88 98 Dining room 196 4117 3209 118 141 Eating Area 224 4865 3373 140 148 Kitchen 196 3796 3030 109 133 family 494 8135 4189 233 183 W.I.0 98 2449 592 70 26 Mater bedroom 206 4310 3357 124 147 Master bedroom 90 1680 504 48 22 BAth 2 90 1680 504 48 22 bedroom2 188 4232 2146 121 94 bedroom3# 196 4293 2605 123 114 bedroom4 138 1856 1380 53 60 hall 86 653 152 19 7 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2012-Oct-22 13:23:06 wrightsoft' Right-Suite®Universal 2012 12.0.13 RSU05790 �CA Page 1 ...Documents\Wrightsoft HVAC\421 stevens St Kindred homes inc.rop Calc=MJ8 Front Door faces: Entire House d 2678 53449 35009 1533 1533 Other equip loads 4946 2389 Equip. @ 0.93 RSM 34631 Latent cooling 4375 TOTALS 2678 58394 39005 1533 1533 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. . wrightsoft' Right-Sufte®Universal 2012 12.0.13 RSU05790 2012-Oct-22 13:23:06 ACCAPage 2 ...Documents\Wrightsoft HVAC\421 stevens St Kindred homes inc.rup Cad=M,18 Front Door faces: Building Analysis Job: 411 Stevensst wrightsoft® g y Date: Oct 22,2012 Entire House E�y: J&J Heating and Air Condtioning Inc. 17 Arlington st,Dracut,MA 01826 Phone:978 454 8197 Fax 978 454 8615 Email:office@Bheatac.com Web:bheatac.com For: Kindred Homes Inc P.0 box 483, North Andover, Ma 01845 0 e • o • Location: Indoor: Heating Cooling Boston Logan Int'I AP, MA, US Indoor temperature(°F) 68 75 Elevation: 30 ft Design TD (°F) 56 13 Latitude: 42°N Relative humidity (%) 50 50 Outdoor: Heating Cooling Moisture difference(gr/Ib) 42.7 27.8 Dry bulb(°F) 12 88 Infiltration: Wety ran eF F) - 72 ( L ) Method Simplified Construction quality Tiht Wind speed(mph) 15.0 7.5 Fireplaces 1 ?Average) Component Btuh/ft' Btuh % of load Walls 3.6 8679 14.9 ` Glazing 16.7 6131 10.5 Doors 21.7 911 1.6 Ceilings 10.2 16166 27.7 Floors 4.7 7512 12.9 Infiltration 3.7 10407 17.8 Ducts 3643 6.2 Piping 0 0 Humidification 4946 8.5 Ventilation 0 0 Adjustments 0 Total 58394 100.0 Component Btuh/ft' Btuh % of load Walls 1.0 2388 6.4 Glazing 16.6 6093 16.3 Doors 10.3 434 1.2 Ceilings 9.2 14538 38.9 Floors 1.1 1702 4.6 Infiltration 0.8 2125 5.7 - - - - Ducts 2279 6.1 - Ventilation 0 0 Internal gains 5450 14.6 Blower 2389 6.4 , Adjustments 0 Total 37398 100.0 Latent Cooling Load =4375 Btuh Overall U-value= 0.153 Btuh/ft2-°F Data entries checked. wrightsoft' 2012-Oct-2213:23:06 Right-Suite®Universal 2012 12.0.13 RSU05790 Page 1 ..Documents\Wrightsoft HVAC1421 stevens St Kindred homes inc.rup Calc=MJ8 Front Door faces: - wrightsoft® Component Constructions Job: 411 Stevens st p Date: Oct 22,2012 Entire House By: J&J Heating and Air Condtioning Inc. 17 Arlington st,Dracut,MA 01826 Phone:978 454 8197 Fax.978 454 8615 Email:office@y'heatac.com Web:hheatac.com For: Kindred Homes Inc P.0 box 483, North Andover, Ma 01845 a es o 0 j Location: Indoor: Heating Cooling Boston Logan Int'I AP, MA, US Indoor temperature(°F) 68 75 Elevation: 30 ft Design TD (°F) 56 13 Latitude: 42°N Relative humidity (%) 50 50 Outdoor: Heating Cooling Moisture difference(gr/Ib) 42.7 27.8 Dry bulb(OF) 12 88 Infiltration: Daily range(°F) - 15 ( L ) Method Simplified Wet bulb( F) - 72 Construction quality Tight Wind speed(mph) 15.0 7.5 Fireplaces 1 (Average) Construction descriptions Or Area U-value Insul R Htg HTM Loss Clg HTM Gain ft' BWhff--°F ft'-°FBtuh BWhAV Bbuh Btuhff Btuh Walls 12F-Osw:Frm wall,vnl ext,1/2"wood shth,r-21 cav ins,1/2" n 736 0.065 21.0 3.61 2661 0.99 732 gypsum board int fnsh,2"x6"wood frm a 564 0.065 21.0 3.61 2040 0.99 561 s 702 0.065 21.0 3.61 2537 0.99 698 w 399 0.065 21.0 3.61 1441 0.99 397 all 2401 0.065 21.0 3.61 8679 0.99 2388 Partitions (none) Windows 2 glazing,clr outr,air gas,wd frm mat,clr innr,1/4"gap,1/8"thk:2 n 113 0.300 0 16.7 1881 8.94 1007 glazing,clr outr,air gas,wd frm mat,cir innr,1/4"gap,1/8"thk a 16 0.300 0 16.7 260 29.1 454 s 176 0.300 0 16.7 2936 15.6 2742 w 63 0.300 0 16.7 1055 29.1 1841 all 368 0.300 0 16.7 6131 16.4 6045 Doors 11 DO:Door,wd sc type n 42 0.390 0 21.7 911 10.3 434 Ceilings 16B-38ad:Attic ceiling,asphalt shingles roof mat,r-38 ceil ins, 1/2" 494 0.026 38.0 1.45 714 1.30 642 gypsum board int fnsh C part ceiling,:C part ceiling,hrd wd fir fnsh,frm fir,10"thkns,1/2" 1092 0.255 1.0 14.2 15452 12.7 13896 gypsum board int fnsh Floors 19A-Obswp:Part floor,hrd wd fir fnsh,frm fir,10"thkns 1092 0.295 0 6.16 6728 1.40 1525 19A-30bswp:Part floor,hrd wd flr fnsh,r-30 ins,frm fir,10"thkns, 494 0.034 30.0 1.59 784 0.36 178 5/8"gypsum board int fnsh - wrightsoft• Right-Suite®Universal 2012 12.0.13 RSU05790 2012-0ct-22 13:23:06 -4CCK Page 1 ...Documents\Wrightsoft HVAC\421 Stevens St Kindred homes inc.rup Calc=MJ8 Front Door faces: Project Summa Job: 411 Stevens st wrightsoft® Date: Oct 22,2012 Enure House By: J&J Heating and Air Condtioning Inc. 17 Arlington st,Dracut,MA 01826 Phone:978 454 8197 Fax 978 454 8615 Email:office@jjheatac.com Web:jjheatac.com � • 0 0 For: Kindred Homes Inc P.0 box 483, North Andover, Ma 01845 Notes: Y, Weather: Boston Logan Int'I AP, MA, US Winter Design Conditions Summer Design Conditions Outside db 12 OF Outside db 88 OF Inside db 68 OF Inside db 75 OF Design TD 56 OF Design TD 13 OF Daily range L Relative humidity 50 % Moisture difference 28 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 49806 Btuh Structure 32730 Btuh Ducts 3643 Btuh Ducts 2279 Btuh Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh Humidification 4946 Btuh Blower 2389 Btuh Piping 0 Btuh Equipment load 58394 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 34631 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Tight Fireplaces 1 (Average) Structure 3893 Btuh Ducts 482 Btuh Heating Coolin Central vent (0 cfm) 0 Btuh Area(ft') 2678 2639 Equipment latent load 4375 Btuh Volume(ft3) 24286 24286 Air changes/hour 0.20 0.08 Equipment total load 39005 Btuh Equiv.AVF (cfm) 170 153 Req. total capacity at 0.80 SHR 3.6 ton Heating Equipment Summary Cooling Equipment Summary Make Goodman Mfg. Make Goodman Mfg. Trade GOODMAN Trade GOODMAN, JANITROL,AMANA DISTI... Model GMH950905CX** Cond GSX130483A* AHRI ref 4005335 Coil CA*F4860*6D* AHRI ref 4945866 Efficiency 95AFUE Efficiency 11.0 EER, 13 SEER Heating input 92000 MBtuh Sensible cooling 36800 Btuh Heating output 88000 Btuh Latent cooling 9200 Btuh Temperature rise 52 OF Total cooling 46000 Btuh Actual air flow 1533 cfm Actual air flow 1533 cfm Air flow factor 0.029 cfm/Btuh Air flow factor 0.044 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.90 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. ,o Wrl htsoft® 2012-Oct-2213:23:06 ��� 9 Right-Suite®Universal 2012 12.0.13 RSU05790 ..Documents\Wrightsoft HVAC\421 stevens St Kindred homes inc.rup Calc=MJ8 Front Door faces: Page 1