The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #336 - 457 BOSTON STREET 10/27/2006 TOWN OF NORTH ANDOVER NORT1i APPLICATION FOR PLAN EXAMINATION o` o e � Permit NO: Date Received v SAArAD H Date Issued: � ' � s CUs� IMPORTANT: Applicant must complete all items on this page LOCATION�S 7 325 � Print PROPERTY OWNER (i<1 i [C�(s ^-� STT-��'► • �C✓ /2 Gly-�-S Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Resid tial Non- Residential D>gw Building ne family fd Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED �li►tiov-�— �e�Cc�t^t Scr w�.a.�• t�L�► � cx�S fvti c.� n.a.•.-� �c.�,'(-� CGU 0"1 Q G�G�•f(el L11 Ltl ,�fG a tom" �c�c.•�--Identification Please Please Type or Print Clearly) OWNER: Name: k/J C,-&-� T ,jrH.►, lz! c ,r! Phone: Address: y S 7�0 <':�t/-est • CONTRACTOR Name:�� i,c lQ,�✓l C�•.,Sfr�c. L� .��L - Phone: Address: L +'mac [ •6� S� Supervisor's Construction License:may,, 3 el I Exp. Date: Home Improvement License: 13r7 a 10 )L Exp. Date: �� 07 ARCHITECT/ENGINEER I dW Wr- 5�. V- Name: Phone: '7 81 - ff,I - X51.3 Address: 113 AlclA 1. ��f� G2YZ Reg. No. 31 U FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 1760 2 vo FEE:$ Check No.: r9 (-.,,`o --7— Receipt No.: 7 �J Page I of 4 i Location ��" ��J-v l--+ -51— No. Date v TOWN OF NORTH ANDOVER Of� `•O ,•,gyp 3? � • OL Certificate of Occupancy $ Building/Frame Permit Fee $ s�cMus Q Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # l 19 7 3u �- - Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools 11❑ Tanning/Massage/Body Art F] g Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales [IJ� Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracia"'s;�Waived unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner � Signature of contractor /14 74*4--6� Plans Submitted LY1 ❑ Certified Plot Plan S amped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS REJECTED DATE APPROVED CONSERVATIO I A COMMENTS �+ r� ��5�! f � L� '�� bf CCI Cj fi i DATE REJECTED DATE. PROVED HEALTH ❑ / �� ®� COMMENTS F FIRE DEPARTMENT - Temp Dumpster on site "yes no Fire Department signature/date-.,�%"' �� O COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments i Conservation Decision: Comments Water& Sewer connection/Signature& Date Driveway Permit Building Setback (ft.) Front Yard Side Yard Rear Yard Requireq__L Provided Required Provides Required Provided `t.5 G / 3v 3 ' / 40 ' 30 - /.29. ' Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 I J 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 E ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks wilding Permit Application � urveyed Plot Plan orkers Comp Affidavit hoto Copy of H.I.C. And C.S.L. Licenses Copy Of Contract 2 ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler l'la And Hydraulic Calculations (If Applicable) 4d"Mass check Energy Compliance Report (If Applicable) pp ) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit + ❑ Two Sets of Building Plans (One To Be Returned) to Include S Hydraulic Calculations (If Applicable) Sprinkler Plan And ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registr of Deed One copy and proof of recording must be submitted with the building application y s' Doc:INSPECTIONAL SERVICES DF.PARTMEN'rMFORM05 Page 4 of 4 10/19/2006 11:34 978-372-7183 RAM ENGINEERING PAGE 02 R.A.M. ENGINEERING ROBERT A. MASYS, P.E. 160 MAIN STREET HAVERHILL. MA 01830 TEL. 878-372-0449 FAX: 876-372-7183 October 19, 2006 Ms. Susan Sawyer North Andover Board of Health North Andover, MA. RE : 457 Boston Street, North Andover, MA. Door Ms. Sawyer, Please be advised, that at the above site, the frost wall will be 11'+I-from the septic trenches. The building will be cantilivered out approximately 3 feet. There will be no columns under this section of the building. If you have any questions, or need more information, please contact me. Ve t9dy yours, P.E. i 16119/2606 11:34 978-372-7183 RAM ENGINEERING PAGE 01 r L R . A . M . ENGINEERING 1 6 0 M' a i n S t r e e t Haverhill , Massachusetts 01830 TEL . ( 978 ) 372 - 0449 FAX : (978 ) 372 - 7183 FAX COVER SHEET DATE: l� / �?�d TO: u 15 a.0 act COMPANY: FROM: ala FAX 4t: NUMBER OF PAGES including cover sheet) , SUBJECT: CONFIDENTIALLY NOTICE... The information contained in this fax message is intended only for the personal and confidential use of the designated recipients named above, if the reader of this massage is not the intended recipient or on agent responsible for delivering it to the intended recipient, you are hereby notified that you have received in error, and that nay review, dissemination, distribution, or copying of this message is strictly prohibited. if you have received this communication in error please notify us immediately by telephone and return the original message to us by mail. Thank you, NORTH Town ofover.. O A MM&I o - LA E over, Mass., COCMIC.. ICK V 7�ADRATED P'Pa,`�� FI BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT `I4)1/4.0. ......... ` �/�. ..... .............. ....................................................... Foundation Via has permission to erect................ ...................... buildings on .., ...y...T. .......... ./7.:.... .. ............. Rough to be occupied ashslid..... ...Oriii .. ........ �. .. .A!s.t..... ....ftepte*rms a��►... ..en1....$76e� Chimney provided that the person accepting this permit shall in every respect confor to of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PE1 Nff EXPMES IN 6 MONTHS UNLESS CONSTRU TAk S ELECTRICAL INSPECTOR ......... ...................... Rough ..... ........ .. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. IF-siEEREVERSESIDE j Smoke Det. N° FD 4792 Date NoarN TOWN OF NORTH ANDOVER "�.:..:. RECEIPT SgCHUs�t /.. �This certifies that...... �... .....,.. haspaid...... .....UU................................................................... r for ..... (� Received by O �� Department ..........47. ........................................................... WHITE: Applicant CANARY:Department PINK:Treasurer The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.0.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover permit No (City of Town) (If Applicable) Dig Safe Num er In accordance with the provisions of M.G.L.l 4 8 Chapter_1Q as provided in section-521—EMR 34 Start Date This Permit is granted to: �/jo sl F z r,y'y£` Z Full name of person,Finn or Corporation Pennissionto locate dumpster for construction/renovation/demolition of building. Comments: dumpster must be . 25 ' from structure if unable to lace with re uired Restrictions:clearance dumpster must be covered with 1 wood or tarp end of work day at �._� (Give location by street and no.,or describe in such manner as to Prgvied to identification of location) FeePaids 50 .00 �r/ eee..M• Fire Chief This Permit will expirey� (Signature of offical granting permit) Offical granting permit (Title) R.A.M. ENGINEERING 0 ROBERT A. MASYS, P.E. 160 MAIN STREET HAVERHILL, MA 01830 TEL : 978-372-0449 FAX: 978-372-7183 October 23, 2006 Mr. Jeffrey Ward J. L. Ward Construction Company, INC. 50 Glidden Street Beverly, MA. 01915 RE : 457 Boston Street, North Andover, MA. Dear Mr. Ward, To build the proposed addition at the above site, it will require cantilevering a portion of the building. Attached, please find copies of the calculations for the wooden beams to be used. The requirement will be for two (2) - 14" LVL on each side of the building, and one (1) - 14" LVL at the front of the cantilever. If you have any questions, or need additional information, please contact me. l T kasy , BQr Double 1-3/4" x 14" VERSA-LAM@) 2.0 3100 SP Floor BeamT1303 3C CALCO 9.3 Design Report- US 2 spans ; Right cantilever 10112 slope Friday, October 20,200611:56 3uild 047 1 File Name. BC CALC Project Job Name: W ! /�C G-,,/C� Description: 171303 4ddress: / Specifier: ',ity, State,Zip: , Designer: ^ustomer: /� �� 1G� St Company: "ode reports: ESR-1040 ! � Misc: ' ! I 7 6 i X X ' I 1 �t .► L 'r' yr i r t r r tY r � ir: r `. s r t r r w r +r S� w •�. w w w r 1.11 ih Pill, kilo l{:�rill:: .'!•I)i(I�i '1 II R.�:' rlrGiti:"!• ,'}. i'!''.E1F11ii� ,tk -frf{ (fi'�1(,•}' Kf+. r ,'' d,l!l!1i�I��. '3 ii!li.itllf "` I til li�it!,: , kilt i. fi t'I,.,tr..l (II r i•. .'(i `'t'!II• .t t. .!{s li!Illoi sii iP i llll�11� i � :��!�1�' � d r q�Ifi�ili iQ1 I�iP ,�hl!qi(e:Cillii'� ,•IIEIt's t ,er �,' u' �.;• I,.t .p. �n ! 03.08.00 12-08-00 BO B1 LL 676 Ibs LL 1685 lbs DL 15 Ibs OL 3070 Ibs SL 2409 Ibs Total of Horizontal Design Spans= 16-04-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 12.5%_ _ Trib. 1 Standard Load Unf. Area (psf) Left 00-00-00 16-04-00 40 20 01-04-00 2. WALL Conc. Pt. (Ibs) Left 16-04-00 16-04-00 0 80 n/a 3 SECOND FLOOR JOISTS Conc. Pt. (Ibs) Left 16-04-00 16-04-00 436 218 n/a 4 WALL Conc. Pt. (Ibs) Left 16-04-00 16-04-00 0 80 n/a 5 ROOF Conc. Pt. (Ibs) Left 16-04-00 16-04-00 218 436 nla 6 WALL Unf. Lin. (plf) Left 12-08-00 16-04-00 0 80 n/a 7 SECOND FLLOR WALL Unf. Lin. (plf) Left 12-08-00 16-04-00 0 80 n/a 8 SECOND FLOOR JOISTS Unf.Area (psf) Left 00-00-00 16-04-00 40 20 01-04-00 9 ROOF Unf. Lin. (pif) Left 12-08-00 16-04-00 220 440 n/a Controls Summary value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 1373 ft-lbs 4.7% 100% 14 1 -Internal Completeness and accuracy of input must Neg. Moment -12063 ft-lbs 36.8% 115% 2 2-Left be verified by anyone who would rely on End Shear -610 Ibs .5.7% 115% 15 1 -Left output as evidence of suitability for Cont. Shear 3808 Ibs 35,6% 115% 2 2-Left particular application.Output here based Uplift 527 lbs n/a 15 1 Left on building code-accepted design p properties and analysis methods, Total Load Defl. 2xL/386 (0.22$") 62.1% 15 2-Cantilever Installation of BOISE engineered wood Live Load Defl. 2xL/617 (0.143") 58.3% 15 2-Cantilever products must be in accordance with `- ° current Installation Guide and applicable . Taal Neg. Defl. -0.111 22.1 /0 15 1 PP Max Defl. 0.228" 22.8% 15 2-Cantilever building codes.To obtain Installation Guide Span/Depth 10.9 n/a 1 or ask uestions,p lease call (800)232-0788 before Install sti n. Cautions BC CALCO,BC FRAMER@,AJST'" Uplift of 527 lbs found at span 1 -Left. ALLJOIST@,BC RIM BOARD-,Bcl@, BOISE GLULAM-,SIMPLE FRAMING SYSTEMO,VERSA-LAM@,VERSA-RIM Notes. PLUSO,VERSA-RIM@, Design meets User specified (2xL/240)Total load deflection criteria. VERSA-STRAND@,VERSA-STUDO are Design meets User specified (2xL/360) Live load deflection criteria. trademarks of Boise wood Products. Design meets arbitrary(1r') Maximum load deflection criteria. L.L. Minimum bearing length for B0 is 1-112". Of Minimum bearing length for B1 is 3". Entered/Displayed Horizontal Span Length(s)= Clear Span+ 1/2 min.end bearing+ $'� FOORT 1/2 intermediate bearing ALAN V2`'8!17 F IALE� Page 1 of 1 _ w BO/$E" Single 14" AJSTm 25 MSR Joist1J01 3C CALL®9.3 Design Report- US 2 spans I Right cantilever 0/12 slope Friday, October 20, 2006 11:49 3uild 047 16" OCS I Non-Repetitive Glued &nailed construction File Name: BC CALC Project Job Name: �� Description: J01 4ddress: 2Ga na/� Specifier: "ity, State,Zip: , y" Designer: ,ustomer: �,/SbVs f Company: -ode reports: ESR-1144 t' Misc: ,5 ,4 3 s .r yr ,Y .Ir s .► + i +i L w ._} ._� s ��L IT # • ,ir . }„ l _»' w r ti v- .� , ::. ......,: '�;rn r.,r':..'_..,:t'•`t,.i,-.'- '.. -'.. ''ss' :':, ,,)u�,,.'__.:!,:,,{,n''i.'.' .�:{',`�r'r•r-._.t.v f„ :p+i;';•r',r,1,i^• S u ;f;I i!•,Irt',it...i t';'s,.,. ,,i;., r r' ''U9,,,{'. `.wh t:f i i i i z:,1'.,';�., iia tl} r a!B, •k I ,', }, f.I ..f ';j, tt.1, r1 .�,r ..u`i,'' ,,., di:::E�i;,i...l.l+ ;. ,,..,; ,r,,,.ti,.,4., .,._,•'.. r 3. u: !;F,r. t;, ''il t6�-- i .2 pll ti.:. n! f.. e,�') ,ru r,:ir „ t J, .....t �. ._ .t.li ,....,. ), ." txl�i. ).. ,..r.. li;f ,d,. .S }}I_.i..',•L.. ,i ili,. .�'t�;od}y ..,: -;i..f, ::-": ..,...,,.tit:,:,•: ,,.c„ (.,.,,.h... ;{_ ., ,:j", ';i.!I Iii^ .!• iit ii ,1. II'. I I.. .�::. ,„ t .... - Itlliil ,. r. ,s::.. ::....... n.` ;r a :R�... :i: -'N i); •li•�: i ,.! E. ,,..,...,. -,.sc::::... ,,�: .r..., ,.tF, ., i rt.......,. : :I .'.. ..,... ._....... s __._........ r ......... .,,,-:.::�._:=-ar, .f61� ....,. .v.............:.... ... ........a,..,.. ....a ri! ._....,. ....,.._, ,t •,•,e.,_� ,:i:' ',gip •.� 'ilia ,.. ....:.,,.:...: :rc, .r...._......: r:,.. .,. :.-....,..i.,.� :,...f....... I I? 12-08.00 03.08-00 30, 1-3/4" B1,3-112” _L 338 lbs LL 1124 lbs X 0 lbs DL 1049 lbs SL 562 lbs Total of Horizontal Design Spans=16-04-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% OCs 1 Standard Load Unf.Area(psf) Left 00-00-00 16-04-00 40 20 16-' 2 WALL Conc. Pt. (Ibs) Left 16-04-00 16-04-00 0 80 n/a 3 ROOF LOAD Conc. Pt. (Ibs) Left 16-04-00 16-04-00 218 436 n/a 4 SECOND FLOOR WALL Conc. Pt. (Ibs) Left 16-04-00 16-04-00 0 80 n/a 5 SECOND FLOOR JOISTS Conc. Pt, (Ibs) Left 16-04-00 16-04-00 436 218 n/a. Controls Summary value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 640 ft-Ibs 8.5% 100% 14 1 - Internal Completeness and accuracy of input must Neg. Moment -5920 ft-lbs 68.6% 115% 15 2-Left be verified by anyone who would rely on End Reaction 314 Ibs 27.5% 100% 14 1 -Left output as evidence of suitability for Int. Reaction 2712 lbs 80.5% 115% 2 2- Left particular application.Output here based Cont. Shear 1750 lbs 84.9% 115% 2 2- Left on building code-accepted design Uplift 299 lbs n/a 15 1 -Left properties and analysis methods. p Installation of BOISE engineered wood Total Load Defl. 2xL/306 (0.288") 78.4% 15 2-Cantilever products must b6 in accordance with Live Load.Defl. 2xL1482 (0.182") 74.6% 15 2-Cantilever current Installation Guide and applicable Total Neg. Defl. -0.104" 20.7% 15 1 building codes.To obtain Installation Guide Max Defl, 0,288" 28.8% 15 2- Cantilever or ask questions,please call Span I Depth 10,9 n/a 1 (800)232-0788 before Installation. BC CALC®,BC FRAMER®,AJS'M, w Cautions ALLJOIST®,BC RIM BOARD-,BCI®, Uplift of 299 lbs found at span 1 -Left. BOISE GLULAMTM',SIMPLE FRAMING Design assumes To and Bottom flanges to be restrained at cantilever. SYSTEM®®,VERSA-LAM®,VERSA-RIM g P g PLUS®,VERSA-RIM®, Web stiffeners are always required under concentrated loads that exceed 1000 lbs. Install VERSA-STRAND®,VERSA-STUD®are the web stiffeners snug to the top of the flange. Follow the nailing schedule for intermediate. trademarks of Boise Wood Products, bearings. L.L.C. Notes Design meets User specified (2xL/240)Total load deflection criteria. Design meets User specified (2xL/360) Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Entered/Displayed Horizontal Span Length(s)=Clear Span+ 1/2 min. end bearing + 1/2 intermediate bearing Composite El value based on 23/32"thick sheathing glued and nailed to joist. h OF RCMRT ALAN 22 MASYS . v 0 y A Page 1 of 1 s ' . WS1 QUOTE CUSTOMER• MABE03 JOB NAME: ROGERS i", UOTE M 4 1 sd. *4 PO BOX s48 MOYNIHANLUMBERSHIPTO: JOfEOATS: T06BEVERLY.MA01915 467 BOSTON ST aQs 1 of . STEVE SLACK NCATH ANDOVER.MA PREPARED BY: CHECKED BY: CUSTOMER POM DANIEL EXT138 wimm. DATE ORDERED: ORDER TAKEN DELIVERY DATE: 05/3112005 �n � w -i � OQ co ROOF TRUSS DESIGNED PER 90CA/ANS198 CODE CITY OVRALL NET PITCH TYPE OVERHANG C LOADING CANTILEVER SPC PROFILE 6RG SIZE LABL LOTH SPAN ,.� PLY TOP BOT LEFT RIGHT T �°"L"" LEFT RIGHT LEFT RIGHT' w12 001 22-09-08 22.09-08 10 0 ATTIC 01-00-00 01-0D-00 P 36-10 0.10 00-00.00 00.00-00 24 a222""o MOD." .,,. p. 002 22-09.08 22-0948 10 0 GABLE 01-00-00 01-00.00 P 38-10-0-10 00-00-00 00-0o-0o24 �" ✓ e� ✓ � sn 9 00-07-0t Ob0L00 07 003 121-02-00 21-02-00 7 0 ATTIC 01-00.00 01.00-00 P 35-10-0-10 00-00-00 00.Ma() 24 � N . Z1.Otd0 00-0400 : 't z 004 1 21-02-00 21-02.00 7 0 GABLE 01.00-00 01.00.00 P 35-10-0.10 00-OD-00 00.00-00 24 e S 1 1A�� +a`K •� t`o ROOF TRUSS SUB TOTAL: 3qcl-i 5gb.�a Lb ca w o � G11 � .t ro+ Report DatalTime:8124#2006 4:61:22 PM 2r The Commonwealth of Massachusetts Department of Industrial Accidents �+$ Office of Investigations 600 Washington Street Boston, MA 02111 Mf www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �AJCAL✓d C,(�/'� rrj�/�.0 /G� -�✓►G Address: S�> a^"t- City/State/Zip: BQtted'�y /�' of 5 lS Phone#: � Are an employer?Check the appropriate box: Type of project(required): 1. I am a employer with J5 4. ❑ I am a general contractor and I 6. Wemodeling 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 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.❑ I am a homeowner doing all work right of exemption per MGL 11.E] Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. / Insurance Company Name: y�� G Policy#or Self-ins.Lic.#: 93(D �'� 3 J Expiration Date: // G Job Site Address: fZS 7 /3o,S'� Si_ Ztla- 1!4741loV44/ City/State/Zip: 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 certi u r the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: �d 6 Phone#: 97 8 9d l" -A 7 SpZ Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency 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 - ACQRt2. CERTIFICATE OF UABILITY INSURANCE 07 26 soo6 F+oaxmR TM CERiIFIGAW IS ISSUM AS A MATTER OF INFORMATION Circle Business Insurance Agency Inc ONLY AND GONERS no RKsM UPON THE CERTIRGATE I "OWER. TMS CERTWAM SES NOT AMEND, WEM! OR 1 247 Neabmy St. ALTER TIS COVEIL4M AFFORAED BY THE POUCUM BELOW. Danvers, NA 01923 978-777-7030 RriSURBt9 AFFORDING COVERAGE NAIC11 NSVRW J.L. Ward Construction Inc IdUFM& SCOTTSDALE INSWANCB CO. DvL4ll�R s: ' 50 Glidden St e a Beverly, HA 01915 0MURM 0- 1979-921-2752 SWIM e CONERAGFS THE POI OF WSURANCE USTEO BELOW HAVE BEEN ISSUED TOTW INSWED NAMED ABOVE FOR THE POLICY PERIOD INDICATEO.NOTWff"STANDING ANY f6WIFIEMENT.TERM OR CONDITION OF ANY COWW.C'T OR OTHER OOCav:NT WTTH RESPC-ar TO w1K>1 TM CERTIFICATE MAY BE ISSUED OR i WAY PERrAM,THE POPANCE AFft MW BY THE POLICIES DESOUBED 1115WN IS SUBJECT TO ALL THE TOM.EXCLUSIONS AND CONDITIONS OF SUCH I POUCIE&AGGRECATEUMOTSSHOWNMAYHWEBE&d ASOLICMISYPAPOCLAM. 01` PoUcv wime t DA WITS cep LAIMmr GACH OCCUR IDWA s 1,000 000 { g CNaMEra wLCENENALLAsam F�� s 50,000 I 0AWS� 000CW. Iti 01P(I►nyanepasan) s 5 000 ': A, CLS1274717 06/18/06 06/18/07 PvSONAk&AwwAw s 1,000,000 : I Gmpm AoomcwE is 2,000,000 MMAGGRWATE uWTAPPUES PM PRODUCTS-COMP/OPAGG is 2,000,000 X i POLICY �O LDC AWOUDOMJ VASKM I couaodmswGUEumrr I AWAVTO I f;x Au.owNW Ames tt SCtI®UL®AUrOS lIFWPWSM) T s WRWAROS eomvnmRY s Itxm4w wAUmS IFaama�,y 6 PR0FER7Y On.aOE f i I iRe�s'aonalal d,RAGEU48RM 1 AUTOOKY-EAACCKlENr s i ANYAUTO c"14mTWNU EAACC I AUMONLY: AGO s I EXCESSAINBRaIA LwBILm EOLCH OCaIRR EPM s i OO P. Ej 0AIMMAOE A09REGATE f f e�DEDUCIIBIE f RETENTION f f i woovemsO0MplimSATIONAW T ATU EMPLOYERS LABdITY F-L EACH AWOW IS I OFFICERNAMUN EILLIOEV/. I E!_1HSFJA9E-EA EIMP $ I PROM b lseear. E-LMWASE-POLCYLONT S I onl�t I OESCRVTIONOFCWMMTK)MSILwATxmivE"K.LEStE7IGLUSKNOADOEDDYENDOR$9ENT/SFECPLPROVISIONS I i 1 I 1 - 1 CERTWCATE HOLDER WW EVU-ATM MOULD ANY OF THE AsoVE DEED POuCKS BE CAmcaLm BEFORE TRE Q54RATIO TOWN OF DANVER3 DATE TNEEORFHE.TISSUNG aaSURER W&L OWSWOR To MAIL" OArs WMTMN 1 SYLVAN STREET No'm To THE LTi An uoLOeR mmw-ro TwE L3'r 6UT FMLVRE TO OO SO SHALL DANVBIitS, KA 01923 UMPOW NO 08LIOA11Or+Olt LNSIUTY OF ANY TOMO UK"TME WSURM MS AGENTS OR r= # 978-777-1025 REPPMSEHMMM I . AcoF4w 25(200 m) GACOWCORKNIAMNIM ACORD� CERTFICATE OF LIABILITY INSURANCE °/26� /06 weoplN�e TNDCM FCAIE NS N ISMASA MATFEIMF M ORMAMIN VM1 Richard i Associ ates ONLYAND ANO MONIS 1PO117NECBiTFME 491 Map10 Street HOI.D6i'7MCeRIi7CATEDGIMMOf AYMEX MOR Saito 102 ALYM THE S AFm iff imf MIGM UBAW. Danvers, MIA 01923 09KNOMAIFFORIMIGOVOMM !f4wa --- IN®II�e® J.L. Ward CaTsetructien Zeta_ NaATsea _ _ - 50 Cliddea St mac: --- Beverly, "A 01915 ummma: _— MwM.@ COY INE FOIC16S OF PURMANCE USTED BELOW NAYS BEEN ISMM 70 TME INSURED NAYCD ABOVE FOR IHE POI ICY PE MOD INDICAIM.NOTWIINSIANDING ANY MWOMOI T.MM OR COtIDIDON OF MIV CM#MACTOR OTHER DDM BNT WI/H RESPECT TO WHICH IRIS CERTrFICAIE LAY BE ISSUED OR MRv PTI'RTNN.THE INSURANCE AFFORDED 6Y THE PPOUCIES DESCRIBED HEREN 12 SUBJECT TO ALL THE TOVAS.EAGIUSIONS AND CONDI VINs OF SUCn POUCIES.AGGAEGRIE MIS SHOWN IMY HAVE SEEM R6DUCED BY PAID CWNE —.-- TVM ra.crNuweet Lam selalx uAa�lnr 40 M E �s _ —... � �caol�eaioeIrleanr E,�.�. •:s _ s i :Cuu18 WOE 1 OOCUR NmE71P(hyaneDlm" i I PHI9oNAI&ADVN txty is I GENG LAOOREGATE is O AGORmATEUMUC3 RAiPPM PRODUCTe-COMROP POLICy I we j Aflr,R10Bl.EtlABBlTY C USff&D9TWWUMR s MnAUTD i troxaoMp — SCMSPU W AUTOS !—:NRm AUTOS �_i'- - OAMArE ':S t I jGARA�UI�BKIfV 1lWTOOtLLY-EAAl7Cg13ff �'— ANrA1/TO EAACC!-i oa�ar. + --i rw AGO;$ O YNbRH1AtAlBL1TY GOCHOCCURRENCE Is -- ' OCCUR CLANSUME A00RBTil1TE - - : -- I REMNnCM s s jwOwj"C mm* x TIi A =_OMMIS' WC9305738 7/26/05 7/29/06. s 100,000 A°I"C T"E UC9305734 7/29/06 7/29/07 I owseoecwo� 100.000 F�Lum l► Nio �i s-POIICYUMR j s 500,000 ISR i awcnv�lol/aI:oR3rATMa+sieaA�IONs�velcls�esx.u3q�ISAnoEv sYea°ae�rsan�cw.weavul°as CER"M#"HMJM - CANCH tATN7N aN°uI MVGFT#W MGWUES M®FOUL UECAN:EU"eeTHEEWOUXION OAMTIMF..TfE DIWA MWRL TVMIMI 15 DATSWARIBI Md110ETOTNECBWNW EHMMIUA DMTNIUFT.BUTFALURETO008091ALL IAVMEIID0BT164 =0RlI18UffOFAUYIONO IISAGEMOR BB!'I�BITAaYA33 AIIIIUR¢® � ACOM25(20MIDBy �„M, -'-"•••T.MACCMGGNWC TMJs" Ii BOA i �1e-Pq�y„raaaaa�! o�✓uaaauc�cuaeo� � �` ✓le 'Vo„ti�wn+.lea�i a�✓�aaaadu�ael�d BOARD OF BUILDING REGULATIONS �_ Board of Building Regulations and Standards License: CONSTRUCTION SUPERVISOR HOME IMPROVEMENT CONTRACTOR Number: CS 063821 Reglstr bft 139222 at09/16/ 9a59 �2412007Birthdea ; . -:. Exprre�:`49It612008 Tr.no: 3154.0 Type- 1?tivate Corporation Restti t&f?00- J.L WARD CONSTRtl ItIN ►dC. JEFFREY L WARD JEFFREY WARD 50 GLIDDEN STREET 50 GILDDEN ST. G'1..,►.- i�✓s�"' BEVERLY, MA 01915• Commissioner BEVERLY,MA 01915 Administrator en o space —-- (MGL 0.112 S.BOL) I 1A-Masonry only License or 1 G-1&2 Family Homes registration valid for individul use on ly Failure to possess a current edition of the before the expiration date. Iffound return to: Massachusetts State Building Code Bgulations and Standards is cause for revocation of this license. Ooard of Building Rene Ashburton Plate Rm Boston,Ma.02108 1301 DIG SAFE CALL CENTER: (888)344-7233 of all without signature i Permit# Permit Date REScheck Software Version 3.7 Release 1 b Compliance Certificate Project Title: Family Room/Master Suite addition Report Date:10/02!06 Energy Code: 2000 IECC Location: North Andover,Massachusetts Construction Type: Single Family Glazing Area Percentage: 1596 Heating Degree Days: 6322 Construction Site: Owner/Agent: Designer/Contractor: 457 Boston St Will&Jenn Rogers JL Ward Construction,In.c North Andover,MA 01845 457 Boston St 50 Glidden St North Andover,MA 01845 Beverly,MA 01915 978-921-2752 Compliance:Passes Maximum UA:274 Your Home UA: 187--31-.8%Better Than .. Ceiling 1:Flat Ceiling or Scissor Truss: 787 30.0 0.0 28 Wall 1:Wood Frame,16"o.c.: 36 13.0 0.0 3 Wall 2:Wood Frame,l6"o.c.: 37 13.0 0.0 3 Wall 3:Wood Frame,16"o.c.: 127 13.0 0.0 10 Wall 4:Wood Frame,16"o.c.: 168 13.0 0.0 14 Wail 5:Wood Frame,16"o.c.: 91 13.0 0.0 7 Wall 6:Wood Frame,16"o.c.: 98 13.0 0.0 8 Wall 7:Wood Frame,16"o.c.: 150 13.0 0.0 12 Wall 8:Wood Frame,16"o.c.: 290 13.0 0.0 20 Wali 9:Wood Frame,16"o.c.: 33 13.0 0.0 3 Window:W06:Wood Frame,Double Pane with Low-E: 45 0.030 1 Wall 10:Wood Frame,16"o.c.: 20 13.0 0.0 1 Wall 11:Wood Frame,16"o.c.: 116 13.0 0.0 7 Window:W07:Wood Frame,Double Pane with Low-E: 9 0.030 0 Wall 12:Wood Frame,16"o.c.: 153 13.0 0.0 9 Wail 13:Wood Frame,16"o.c.: 116 13.0 0.0 8 Door:D09:Glass: 41 0.035 1 Wail 14:Wood Frame,16"o.c.: 31 13.0 0.0 3 Wall 15:Wood Frame,16"o.c.: 105 13.0 0.0 9 Wall 16:Wood Frame,16"o.c.: 203 13.0 0.0 7 Wall 17:Wood Frame,16"o.c.: 36 13.0 0.0 1 Window:W01:Wood Frame,Double Pane with Low-E: 66 0.030 2 Window:W03:Wood Frame,Double Pane with Low-E: 45 0.030 1 Window:W04:Wood Frame,Double Pane with Low-E: 11 0.030 0 Window:W02:Wood Frame,Double Pane with Low-E: 20 0.030 1 Window:W05:Wood Frame,Double Pane with Low-E: 9 0.030 0 Door:D04:Solid: 18 0.035 1 Door.D08:Glass: 32 0.035 1 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space: 787 30.0 0.0 26 Family Room/Master Suite addition Page 1 of 6 I Compliance Statement:Statement of Compliance: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 2000 IECC requirements in REScheck Version 3.7 Release 1 b and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. -� Bui dli? i er Company Name Date V,I�r p/vo' c i t-1' Family Room/Master Suite addition Page 2 of 6 r REScheck Software Version 3.7 Release 1 b Inspection Checklist Date: 10/02/06 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: Q Wall 1:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wall 2:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wall 3:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wall 4:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wall 5:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wall 6:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wall 7:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wall 8:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:First Floor Q Wali 9:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Q Wall 10:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Q Wail 11:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Q Wall 12:Woad Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Q Wall 13:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Q Wall 14:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Q Wall 15:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Q Wall 16:Wood Frame,16"o.c.,RA 3.0 cavity insulation Comments:Second Floor Q Wall 17:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:Second Floor Windows: Q Window:W06:Wood Frame,Double Pane with Low-E,1.1-factor 0.030 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Q Window:W07:Wood Frame,Double Pane with Low-E,U-factor.0.030 For windows without labeled U-factors,describe features: Family Room/Master Suite addition Page 3 of 6 Y #Panes . Frame Type Thermal Break? Yes No Comments: ❑ Window:W01:Wood Frame,Double Pane with low-E,U-factor:0.030 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑Window:W03:Wood Frame,Double Pane with Low-E,U-factor:0.030 For windows without labeled 1.1-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Q Window:W04:Wood Frame,Double Pane with Low-E,U-factor:0.030 For windows without labeled 1.1-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:W02:Wood Frame,Double Pane with Low-E,U-factor.0.030 For windows without labeled 1.1-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:W05:Wood Frame,Double Pane with Low-E,U-factor.0.030 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door.D09:Glass,U-factor.0.035 Comments: ❑ Door.004:Solid,U-factor.0.035 Comments: ❑ Door:DOB:Glass,U-factor:0.035 Comments: Floors: ❑ Floor 1:All-Wood Joist(Truss,Over Unconditioned Space,R-30.0 cavity insulation Comments: Air leakage: ❑Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. ❑ Recessed lights must be 1)Type IC rated,or 2)installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible materials.If non-IC rated,the fixture must be installed with a 3"clearance from insulation. Vapor Retarder: ❑ Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment must be installed in accordance with the manufacturers installation instructions. ❑ Materials and equipment must be identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. ❑ Insulation R-values and glazing U-factors must be dearly marked on the building plans or specifications. Duct Insulation: ❑ Ducts in unconditioned spaces must be insulated to R-5.Ducts outside the building must be insulated to R-6.5. Duct Construction: ❑ All joints,seams,and connections must be securely fastened with welds,gaskets,mastics(adhesives), mastic-plus-embedded-fabric,or tapes.Tapes and mastics must be rated UL 181A or UL 181 B. Exception:Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Family Room/Master Suite addition Page 4 of 6 �I Pa). Q The HVAC system must provide a means for balancing air and water systems. Temperature Controls: ❑ Thermostats are required for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Service Water Heating: ❑Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. ❑ Insulate circulating hot water pipes to the levels in Table 1. Circulating Hot Water Systems: ❑ Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: Q Ail heated swimming pools must have an on/off heater switch and require a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps require a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table 2. Family Room/Master Suite addition Page 5 of 6 Table 1:Minimum insulation Thkkness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature("F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-169 0.5 0.5 1.0 1.5 100-139 0.5 0.5 0.5 1.0 Table 2:Minimum insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness In Inches by Pipe Sizes Piping System Types Range("F) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" Heating Systems Low Pressure/Tempersture 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Family Room/Master Suite addttion Page 6 of 6 f `+ J.L.WARD CONSTRUCTION: DESIGN&REMODEUNG SOLUTIONS so Gtidd:^I15tftkkt,evmkr too 01'915 T: 978.921.2752 F: 978.921.4580 HIC: 139222MA LIC: 063821 ****PROPOSAL* 1 YEAR WARRANTY ON ALL WORKMANSHIP SUBMITTED TO: Pro osal #011106-2c DRpPOSAL Date: July 10, 2006 Will and Jennifer Rogers 457 Boston Street M A01 845 No. Andover, Page: 1 of 4 978 989-0002 Dear Will and Jenn: We respectfully submit our proposal ( NolAndover�Ma as per the design r the family room addition submitted ter suite above at 457 Boston Street are aware of master by J. L. Ward Construction Inc. Not to include the garage renovation. e the existing septic system as it relates to the new foundation. The homeowner has provided us with a septic plan. Permits and Plans: ect are not included. This proposal does not include The permititing fees for this proj ired, any additional fees are the responsibility of variances or special permit fees. If requ the Owner. Excavation&foundation: We will excavate for the new addition as follows: ilds will the new structure as per he to allow for the foundation / crawl space whichn and form and pour a 8° concrete wall 12 x 20 footing ns. We will form and pour a s required around plans. rade a q tying into the existing frost wall. We will backfill for a rough at the front and rear the foundation. Seeding by others. We will excavate for the pylons porches as per plans. Excavation Allowance: $3,750.00. Foundation Allowance: $3,770.00. Concre e floor(mud slab) Allowance: $1,250.00 Demolition: We will remove and properly dispose of the following items: existing family room, kitchen wall and rear We will remove the necessary portions of the 9 screen porch to allow for the proposed faas requiretd. Theions. To include flooring, homeowner is recaui ed interior and exterior finishesfuture oof, intefor IIs and r o save walls order t to remove the cobble stone at the existin front en m use. We will save and reuse the two existing steel doors. ts. $2 500.00. Waste Removal Allowance: $1,555.00. Demolition Co , { R Page 2 Framing: ressure treated sill plate We will frame the new addition using foam sill seal, 2x6 p topped with a 2x6 KD plate. The floor framing to consist of: BCI 6000 floor joub flooring, 10 KD, 16noc, sheathed with 3/4 tongue and groove Advantek plywood nailed and secured to the joist with constructione. Te exterior walls will be 1h2" CDX exterior grade framed using 2° X 4° KD. studs 16 oc. plywood. The roof will consist of a 2" X 10" roof rafter system for the main roof and a roof truss system at the master bedroom,2xte orfor °rade plywood. The interior h roof and walls" for will the front dormers sheathed with 5/8 CDX e 9 be laid out according to the plans and framed with 2" X 4° KD. Studs. We will frame in for and install the new windows, exterior and interior doors as per plans. We will frame the porch at the front and rear of the dwelling as per plans. We will use pressure treated lumber for the framing of the porch and steps. We will frame the garage door opening to receive a new garage door (Garage Door by Owners). We will frame the family room with no columns. Roofing: We will install Typar roof wrap to the entire surface of the new roof to include tying into the existing roof as required, install three feet of Ice and Water shield at the fascia perimeter and at the new valleys. We will install 8° aluminum drip edge to the entire perimeter of the new roof area. We will shingle the roof using three —tab roof shingles (25 yr). color to match existing, secured to the roof using galvanized roof nails. We will properly flash where the new meets the existing to insure a weather tight seal. We will also install COBRA VENT ridge vent. Windows and Exterior Doors: exterior doors as per the plans windows and doors are We will install the windows and screens and grilles, The exterior as follows: All windows are An and will have doors are Therma-Tru smooth star at the front entry and steel doors at the garage. We will reuse the existing slider and the existing triple window. We will provide a window schedule prior to start. W1Garage Doorsve and reuse he two b Owners.g steel doors. Window Allowance: $7,720.00. Exterior Door and Hardware Allowance: $1,100.00 Siding, Exterior Trim: I +/2° x 6° PFJ cedar clapboards to the We will install TYVEK house wrap and apply exterior side walls of the new addition to include any patching and weaving in to the existing, install soffet vents at the addi� Exterior rear porchwindow and steps w�ll be trimed out or trim will be primed flat stock to match existing. The ont and with pre-primed pine, the handrails and ballu foe approximately willbd y 180 ar and tl Heal ckfe'eg mate ial will be correct deck. We have estimate seemiess aluminum gutter and snow guar .Ot the existing rear shed roof. Gutter& Snow guard Allowance: ----------- I Page 3 Plumbing &Heating: We will supply and install the required pipe fitting and labor for one toilet, one tub, one shower and one vanity. We will istall the fixtures provided by the owners. We will supply and install a separate zone (if required) to the existing furnace and run approximately Ninety (90) lineal feet of base board heat to to the new addition as required and tie into the existing Forced Hot Water furnace. Heating Allowance: $4,500.00. Plumbing Allowance: $5,000.00. Fixtures by Owners. Electrical: We will supply materials and labor to install the wiring for the new addition and we will ice as per the owners request. All ceiling upgrade the existing panel to a 200 amp sery fans, chandeliers, pendants, sconces or otherwise flush mounted lighting fixtures to be supplied by the Owner and installed by us. We will supply wiring, outlets, lighting with toggle type switches to code. We will wire the new circulator and thermostat for the additional heat. We have carried an allowance for wiring to code. Electrical Allowance: $7,500.00 Insulation: We will install R-13 fiberglass insulation with vapor barrier in the walls of the new addition. We will supply R-30 fiberglass insulation in the floor. We will supply R-30 fiberglass insulation with "proper-vent"to the ceiling areas. Walls and Ceilings: We will install '/2° blueboard and skim coat piaster to the walls and ceilings of the new addition. The plaster finish will be smooth and we will blend with existing to match as closely as possible where patching or tying into existing is required. All closet areas will be a skip trowel light textured finish. Plastering Allowance: $10,244.00. Interior Doors and Trim: We will supply and install door and window casing and base board molding to the newly renovated areas we have estimated forpain nWe have estimated fot grade merials. We W'al schpage polished ly and install interior doors and hardware as per plans. brass, plymouth style knob. We will supply and install a shelf and closet pole to the closet in the master suite and the closets in the mudroom. We will supply oak treads and pine risers with skirts to the stair case and an oak hand rail(B-720). We will build a cubby area with a storage seat in the mud room. We will buid the cabinet with doors and shelving in the family room. Interior Trim Materials Allowance: $ 4,530.00. Floors: We will supply and install approximately 90 square yards of berber carpet to the master bedroom, hall and closet. We will supply and install approximately 202 square feet of the to the master bath floor and shower. Oak Flooring By Owners. Carpet Allowance: $1,980.00 Tile Allowance: $3,636.00. Page 4 Painting &Finishing: Painting of the walls, trim, doors, windows and exterior walls and trim by Owners. (Exterior of the proposed window sashes do not require painting, as they are clad with vinyl.) , Clean up: We will provide daily clean up and we will remove and properly dispose of all construction related waste leaving the home broom clean at the completion of the project. Pre-Completion Checklist: Homeowner and Contractor will review all work performed to insure that the project has been completed as specified. Any remaining details will be part of this checklist. On completion of these checklist items, the contract will be complete and final payment will be due. Any issue that arises that is not listed in the pre-completion checklist will be treated as warranty work and will not impact the final payment. TOTAL COSTS FOR ALL ITEMS LISTED ABOVE $176,200.00 PAYMENT SCHEDULE: WITH ACCEPTANCE OF CONSTRUCTION AGREEMENT $18,730.00 PRIOR TO COMMENCEMENT OF EXCAVATION $37,460.00 PRIOR TO COMMENCEMENT OF FRAMING $35,496.00 PRIOR TO COMMENCEMENT OF PLASTER $33,872.00 PRIOR TO COMMENCEMENT OF INTERIOR TRIM $33,872.00 WITH ACCEPETANCE OF PRE-COMPLETION CHECKLIST $ 7,647.00 AT COMPLETION OF CHECK-LIST ACCEPTANCE OF PROPOSAL: The enclosed prices, specifications and conditions are satisfactory and hereby accepted. J.L.Ward Inc. and Company are authorized to do the work as specified. Payment will be made as outlined above. This proposal is valid for 15 days from the date specified. Date: Z a 6 D�° Signed and Sealed: L r elnt/A�ge Si ned and Sealed: Date: g Signed and Sealed: { KOC Date: -J/I L o .*All material is guaranteed to be as specified. All work to be completed in accordance to Mass state Building Code. Any alteration or deviation from submitted specifications,involving extra cost will be executed only upon written orders; and will become an extra charge over and above this estimate.All agreements contingent upon strikes, accidents or delays beyond our control. owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurance. r ._t I of 11 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS I U9 DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Owner's Address: 457 Boston Street North Andover,MA 01845 Date of Inspection: August 4,2006 Name of Inspector: (please print) Benjamin C.Osgood,Jr.Certified Title 5 Inspector Company Name: New England Engineering Services Inc. Mailing Address: 1600 Osgood Street Building 20 Suite 2-64,North Andover,MA 01845 Telephone Number: 978-686-1768 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of the on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15340 of Title 5(3 10 CMR 15.000).The system: V Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails / Inspector's Signature:., e7!�) 4? -Date: 8`y d t The system inspection shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. 2of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ,/ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: N0 One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): Broken pipe(s)are replaced Obstruction is removed Distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): Broken pipe(s)are replaced Obstruction is removed ND explain_ I I 3of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 C. Further Evaluation is Required by the Board of Health: /b Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and (SAS) Absorption System and the (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organize compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 1 , 4of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 D. System Criteria applicable to all systems: You must indicate"yes or No"to each of the following for all inspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _F Discharge or ponding of effluent to the surface of the ground or surface waters due to an overload or clogged SAS or cesspool. mac_ Static liquid level in the distribution box above outlet invert due to an overload or clogged SAS or cesspool y_ Liquid depth in cesspool is less than 6"below invert or available volume is less than'/z day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped )c_ Any Portion of the SAS,cesspool or privy is below high ground water elevation. —')F_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply —:f— Any portion of a cesspool or privy is within a Zone 1 of a public well. r» Any portion of a cesspool or privy is within 50 feet of a private water supply well. -- Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (this system passes if the well water analysis,performed at a DEP certified laboratory for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrogen is equal to or less than 5ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) .A2[2--(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to connect the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The followin 'teria apply to large systems in addition to the criteria above) Yes No The system is within eet of a surface drinking water supply The system is within 200 feet of a ' tary to a surface ' ' g water supply The system is located in a nitrogen sensitive Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you answered"yes"to any question in S 'on E the system is considered a sigm t threat,or answered"yes"in Section D above the large system has failed. The o or operator of any large system considered a sigm t threat under Section E or failed under Section D shall upgrade the s in accordance with 310 CMR 15.304. The system owner sho contact the appropriate regional office of the Department. 5of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 Check if the following have been done You must indicate"Yes"or"no"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health ✓' Were any of the system components pumped out in the previous two weeks_? V" Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of an inspection? Were as built plans of the system obtained and examined? (If they were not available note as N/A) Vol' Was the facility or dwelling inspected for signs of sewage back up? —�/ Was the site inspected for sign of break out? Were all system components,excluding the SAS,located on site? — - Were all the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Was the facility owner(and occupants if difference from owner)provided with information on the proper maintenance of the subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] 6of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 FLOW CONDITIONS RESIDENTIAL `��- Number of bedrooms(design) Number of bedrooms(actual): DESIGN flow based in 310 CMR 15.203(for example: 110 gpd x #of bedrooms) Number of current residents: Does residence have a garbage grinder(yes or no): A'u Is laundry on a separate sewage system(yes or no): /moi i [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): Water meter readings,if available(last 2 years usage(gpd)��% L�- Sump Pump (yes or no):A!f Last date of occupancy C _. �•1 COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gPd Basis of design flow(seats/persons/sgft,etc Grease trap present(yes or no)' Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no) Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records t Source of information: Was system pumped as partof the inspection(�es or no): & If yes,volume pumped:_------gallons–How was quantity pumped determined?________—. Reason for pumping: TYPE OF SYSTEM _ Septic tank, distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attached a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: ✓N K oww Were sewage odors detected wen arriving at the site(yes or no): 1t i 7of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 BUILDING SEWER(locate on site plan) Depth below grade:_ / Materials of construction: ✓ cast iron 40 PVC other(explain) Distance from private water supply well or suction line: -3 o' Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: (locate on site plan) Depth below grade: l� Material of constraction:—,x _concrete metal fiberglass polyethylene Other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions:_ /,FLS_Q -%:5 Sludge depth: G 1 At Distance from top of sludge to bottom of outlet tee or baffle: 32 Scum thickness: / t Distance from top of scum to top of outlet tee or baffle:—/—�` Distance from bottom of scum to bottom of outlet tee or baffle /et; How were dimensions determined: s.�c K Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): irAoV% fv Cs•csa10 TEES (ti G0-bt7 Cei'��`T'td•n GREASE TRAP:JL/ (locate on site plan) Depth below grade: Materials of construction: concrete metal fiberglass polyethylene other (explain? Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of sludge to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc. i 80f11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 TIGHT OR HOLDING TANK: N.�+R- (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Materials of construction: concrete metal fiberglass polyethylene other (explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:--(21— ets equal,any evidnence of solids carryover,any evidence of leakage into or Comments(note if box is level and distribution to outl out of box,etc.): a ✓ �3 O.�Q Gv r-/ • - v/t. c7 t>tcat c No 0✓epe. r6 4 la ULA AS C1+f2Q,.yotjet— 17�bifLiS�d•'t ECl2.��}4 PUMP CHAMBER: N Yk- (locate on sire plan) Pumps in working order(yes or no) Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 9of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan excavation not required If SAS not located explain why TYPE leaching pits number leaching chambers, number leaching galleries number j 3 b 4 r ./•leaching trenches,number in length 2 'f�r`�-✓� leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology ponding,dam soil,condition of vegetation,etc) hydraulic failure.Level of g, p Comments(note condition of soil,signs of P A-QZf4 0 F� s�Ks rLc.�n &�o" ci-�•,� �"Nc�'— ai �r V Atm Ste. 0,2. v N�s� A L- �LG-E ?'t72d N CESSPOOLS:N� (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of Construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: locate on site plan) Material of construction: Dimensions: Depth of solids: Comments(note condition of soil signs of hydraulic failure,level of ponding,condition of vegetation,etc. 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supplyenters the building. g p l STA-.JCE S -T- pa TD$ T pvQcM TL7 i VELA— V RwE 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 457 Boston Street North Andover,MA 01845 Owner's Name: Jen Rogers Date of Inspection: August 4,2006 SITE EXAM Slope /�o Surface water Check cellar g%,AA Shallow wells ".Z,tj 4a Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record—If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health—explain: Checked with local excavator,installers—(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: ac v5c.5i n%4-P.r5 66 LITTLETON ROAD,WESTFORD, MA 01886 (978)692-8395 FAX(978)692-0023 1-800-649-TEST Report Number: A102029 Report Date: 8/10/06 Client: Sample Information: New England Eng. Services 457 Boston Rd 60 Beechwood Dr. N Andover MA N. Andover MA 01845 Sampled by: Client Date Received: 8/7/06 Date Sampled: 8/05/06 Certificate of Analysis Test Parameter EPA Limit Results Units Total Coliform(P) 0 0 per I00ml i Fecal Coliform/E.coli(P) Absent Absent per100ml Iron(S) 0.3 # 0.32 mg/L Manganese(S) 0.05 <0.01 mg/L Sodium See Note 54.8 mg/L Chloride(S) 250 37.9 mg/L Spec. <2 mg/L Not S Hardness p Nitrate-N(P) 10 <0.01 mg/L Nitrite-N (P) 1 <0.05 mg/L PH(S) 6.5-8.5 # 6.1 SU Legends: (P)=Primary EPA Standard,(S)=Secondary EPA Standard,#=Exceeds EPA Limit, TNTC=Too Numerous to Count, *=Background Bacteria Noted,'=Exceeds Advisory Limit Sodium Advisory Limits,Mass.=20,NH=250. This water sample as submitted is considered SAFE to drink according to EPA guidelines. However,one or more parameters exceeds secondary limits as denoted by he sig%, Massachusetts Certification#MA048 Michael P.Carlson, for Thorstensen Laboratory Inc.