Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Building Permit #610-12 - 5 BOSTON HILL ROAD 2/22/2012
'6.So3glgg Permit No: 0 ✓ I -- Date Date Issued:l• 14 L TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ORTANT:A Date Received must complete all items on this _LOCATION 9 /jos to✓i 141W A9oc )off & A AmG o u er Print` _ MAP NO: JO -7C -PARCEL: 'C Print 'VPic a�2N ZONING DISM/N 1C.Historic District yes Machine Shop Village yes 100 year-old structure yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial epair, replacement ❑ / ssessory Bldg Others: (3 Demolition WOthe ¢.:U C acs :t K J' 3""u-"'� _ R "c`'�' � S.X" `,z�+ i.i �•E 'Y'x)'s+'J.a� � :� � � 'Yj 1. � > p d' . tubi'�Y'�Y i 'i C.'J F x ersheFDrsirict � � N � "5 `'t' s �"�-.rte-'C.s- � � t, ��r.. "� x.`+ t�,, ,r'f �-,T��'�., � � ���'rs "'� 'O' ,t: �+•..[g .G' �. .,Ya-�''' 1,?ad,e 17ea& (klentificatioxi Please Type or Print Clearly) OWNER: Name:_ a �7 u w^ Phone 2 3 9/ 7 Address: ) / / IFQa d / l.& -t1) " %1'7/ 7o f Y -V CONTRACTOR Name: �7o e, j u C"-Ae -t, w) L. Phone: 6 / % 231 / Address: oaQz/ Supervisor's Construction License: /2" Exp. Date: 6/2 c) Home Improvement License: Exp. Date: ARCHITECT/ENGINEER n, -e A16wM JL,, Phone: 9785Siss � C141 -Z C Address: 166o 4S ao )o `1 eg. No. �0 -? FEE SCHEDULE: SULDING PERMIT: $12.00 PER $1000.00 OF rHE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: 6 6 ,5, Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty firtid Location No. D a t e TOWN OF NORTH ANDOVER Certificate of Occupancy $- Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL $ Check # // 6 6 <' 25038 BuVifig Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body 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 ❑ �� COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date 1 t uUl a`( 0 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use U Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi 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 o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract a 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 o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit In all 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 inust be submitted with the building application Doe: Doe.Building Permit Revised 2008mi Hudson Design Groupozrl uc 10 February 22, 2012 Planning Board Town of N. Andover 1600 Osgood Street N. Andover, MA 01845 Re: Cost of Construction Memo Wireless Telecommunication Site for Sprint Site # BS03XC188 5 Boston Hill Road N. Andover, MA Dear Members of the Planning Board: Hudson Design Group LLC prepared the plans for the Sprint telecommunications facility at the above -referenced address. Based on my knowledge, information and belief the estimated construction costs for this site will not exceed $ 15,000. If you have an contact our offi, further information, please do not hesitate to p: 978.557.5553 f: 978.336.5586 a: 1600 Osgood Street, Building 20 North, Suite 2-101, N. Andover, MA 01845 husyst 151 2011 Spi-iiiT (Spum-Nextel) I Robbins ?wad NiA 01886 RE. J,:!LL-c for PRIlinmin G. FaMUIVI -, i�t-Ixwjj 101 RL)Lld; N07-11 Au�m c-, X11A -j'C# Wlnlj-ft !j N-I:Ly Covxv-r- oif rccord 'for Ot! I, rL,)perty I cic at cd �i on To"vii (I 'Arid(( . aid Cor, -419 -Msk id Nc.m.-ork Building A i , acki","Ms btreby awhorize.s �'SpTirit ,- I1 -Y Pr LLC Mid ti-icir.mgrras w A apphcaOom and appeals 4conc--mijig jht,.,virckN,, commiLmii:a1ion,� facitil"Cl locavd ;it 5 BO-florl Iliff R(ma, witi) th.- Toxim ai'Ncynh ARLIOWrin order tc, ohlaia u3c PCE111114 to, IDS101 additional wircJc�njWjjjj!1ic-UL!0t1 anirmia.; zuui Yl',UC6 LiPmcm 011 t1j,',1 11 -0;I -11Y S imocre- ly, G, Favrium Tole: (TWIN . v (a copy of thk letter shall Itavc CjjjL- S. -In -le effeet aS ui-t originad) r, rr i, '.e in i 61ffV ?tti'?C�U A WRAL SIS � For DIAS01 z BOSTON HILL 5 Boston Hill Roark Norih Andover. MA 01845 Antennas PACUnied tococricrote cmc tuvc; Equipment Supported on i1wie Secerd Floor Prepared for: %�� U -L UP, n L Dosign Group, SCOPE OF WOM Hudson Design Group LLC (HD13) has been authori ed by Sprint to conduct a evaluation of the structure Fupporfing the proposed Sprint equ,iprnent lace-Ited In the areas depicted in the attOr-hed HDG Construction Drawings dated December 119, 2011. This report represents this office's findings, conclusions and recommendations' pertoinirhg to the support of Sprint's Proposed equipment, This office conducted an on-site visual survey of the ObOve area on August 30, 20) 1, Attendees indluded Pierre G-agnon �"HDG-Sr, Field Technician). CONCLUSION SUMMARY. Buildirig Plans were not available and could not be obtained flor our use. A limited visual survey cif the structure was completed in or near the areas of the Proposed Work. Equipment Room: Kased on our evaluation, we ha've detert-ni-ned that, in generni, structural designs- to sutpport the proposed Sprint Equip -hent w0hin or near the Proposed LocatiOn can be cornpif"ted and components installed ,A/ith NO STR -_OAL UPGRADES REggI.RED to the existing structure, Antenna Support frames: Based on our evaluation, we have determine -d that., in general, structural designs to support the proposed Sprint Antennas iMhin or, rip -or the Proposed Location can be completed and components installed with NO STRUCTURAL UPGRADES REQUIRED to the existing antenna Support frames. The existing pipes are not capable of accommodating tho proposed antenna/RRH Installolion due to the larger antenna size along with proposed RRH units. HOG recommends attaching new support pipes to the existing antenna pipes as showri in the affoched construction drawings to accommodate the proposed Installation of larger antennas and RRH units. Reference the attached HHG drawings for the equipment location. A summary of the proposed support types and attachment locations are as Vows: (1) New APXV91418-£-A20 (1600 MHz) RFS antennas (Alpha Sector) (Wt. = 26 lbs/eoch).........Supported by the existing an.•te.nno support frames secured to the existing reinforced concrete structure. (1) Now APXVNt18-C-A20 (1600 MHz) RFS antennas (Beta sector) (Wf. = 26 lbs!eoch) ......_Supported by the existing antenna support homes secured to the existing reinforced concrete structure, (1) New APXV9ERRI8-C-A20 (SM/1900 MHz) RFS antennas (Alpha Sector) (Wt. = 63 lbs/each)......... Supported by the existing antenna support frames secured to the existing reinforced concrete structure. (1) New APXVSPPIB-G-A20 (800/1900 MHz) RFS antennas (Beta sector) (fit. = 57 lbs/each)......... Supporied by the existing antenn,; support frames secured to the existing reinforced concrete structure. (1) Now APXV4N13-c-A20 (1500 MHz) RFS antennas (Gamma Sector) (Wt. = 26 lbs/each)......... Supported by the existing antenna support frames secured to the existing reinforced concrete structure. (1) New P40-16-XLPP-RR-A (800/1960 MHz) RFS antennas (Gamma Sector) (Wt. = 53 lbs/each)... ...... Supported by the existing antenna support frames secured to the existing reinforced concrete structure. (3) FIJ-RRH-2x$0-800 (1 per sector) (Vitt. = 50 lbs/each)......... Supported by the existing antenno sup ra frames secured to the existing reinforced concrete structure. (3) FD-RRH-4x40.19110 (1 per sector) (Wt. = 50 lbs/each)......... Supported by the existing <antenna support frames secured to the existing reinforced concrete structure. (3) 1604 MHz RRH (1 per sector) (Wt. = 50 lbs/each)......... Supported by the existing antenna support frames secured to the existing reinforced concrete structure. (2) 60EGv2 Battery Sock -up Cabinet (Wt. = 1625 lbs.) ,........Supported by the existing reinforced concrete wattle slab. (1) Alcatel -Lucent 9928 Outdoor Cabinet (tuft. = 1390 lbs.) ,........Supported by the exisfing reinfc�r -ed concrete waffle slab. H u ca" 0 0 ni DeWcp 0- roupuc Referenced documenfs are attached. DESIGN CRITERIA: 1. Massachusetts Stat,- Building code, 8th edition and ASCE 7-05, Mlinimurn Design Loads for Buildings and Other Structures. Wind Analysis, Reference Wind Speed: 110 MPH (780CMki? 10.04.10) Category, C (ASCE 7-05 Table 1.1) G,vst Effect Factor (G): 0. 85 (ASCE 7-05 6,5.81 Force Coefficient (J1: Varies (ASCE 7-05 Fig. 6-21 F = qz * G * Cf ' Ai: Reference ASCE 7-0.51 Equation 6-28 Snovv Loading: Basic kGround Snow Load, 55 psf (7/80CMR 1604.10) Rat Roof 5 -now Load: 38.5 psf (780C.M.R 11604,10) 2. EIA/TIA -222- G Structural Standards for Steel Antenno Towers and Antenna Supporting Structures County: Essex Wind 'Load: 110 mph 3. Approximate height above grade to the center of the antennas: 89'+/- & 59.2' u, d, o, 0 n, D,c,,sign Groupuc EXISTING FLOOR SUPPORT SYSTEM CONSTRUCTION: T 1he floor system consists of a reinforced concrete waffle slab system supported by a s f - ys.e.n of reinforced concrete beams, coluryms and bearing walls. ANTENNA SUPPORT RECOMMENDATIONS: The new antennas ate proposed to t)e mounted on new mounting pipes supported on the existing antenna support frame secured to the existing reinforced concrete structure, RRH SUPPORT RECOMMENDATIONS: The new RRH's are pfoposed to be supported by the existing antenna support frames secured to the existing reinforced concrete structure. EQUIPMENT SUPPORT RECOMMENDATIONS: 1-11)(3 recommends that the Alcatel -Lucent 9928 Outdoor Cabinet and Battery Back-up Cabinets be supported by the existing reinforced waffle slab. NQtg�: 1 , Remove the existing OBU60C, and Mod Cell Cabinets to accomi-nodate the new equipment cabinets. 2. Reference the attached HDG drawings for all equipment locations_ 3, All detail requirements will be designed and furnished in the construction drawings. 4. Mount all equipment per manufacturer's specifications. 5. HDG could riot verify the -antenna support ottochmenlis to the reinforced concrete building structure of the time of our site visit. HDG ossumes the pipe mast diameter at the Alpha sector is (4S' O.D.) 4" Schedule 40 pipe. Contractor is to not:ffy HDG if pipe diameter differs from what is assumed, further analysis may be regaled. 6. HDG is under the assumDtlon that the antenna support mounts were constructed properly and adequately attached to, the' building structure. 0q, (D ,, Dotign Groupc ANTENNA LOCATIONS: Photo 1: Sample photo showing the existing Alpha sector antennas, L Dcsi,gn Group -,c Photo 2: Sample photo showing the existing Beta sector antenna. Photo 3: Sample photo showing the existing Gcimma sector antennas, ul, DesIgn Groupuc EXISTING EQUIPMENT; Photo 4; Sample photo Showing the location where the new equpmenit cabinets are proposed to be installed. lu c-, -,o umign C-lou ae Proposed DravvIngs w 4 4� y�� 9 yLLIT • Y, { [� 21 C: 1 14 CC), h 00 F�f �S n 119 t It it i! iTl € R < # N?fyy�y PRIORY t( '$ R �$ '� 6' s' � - sz #�a� °4 N 1?4 A : 19 414 $x'$ A&1111554 4�yt P� -{� ���a � F`s P 'I'M � RC se �ygri �x�Y 7 � 33k f J g* 4 y f' qac . ¢ Sir kn ,r 9, g� visa &: t,x 3#� � � aha b���.# [ "' s" A $,y5i.F2 DFy ���grgF3 ya&4 6 s [ vfsW�7 I' RlgpA Ab 9C��.� i� ,F"A •. Fr � ��j _Y e� 1� N � �� A� � F $�a S � � � � 3 � � � � R ! Ravi s � 10 pr w k 4 F R > .i�'' S i° $ faR OF �S r ij _R 6s�; s2 $ 3rd a ka$ �= s ?it fa b g g 5 a � z a 4 v t qq O _o R � £s �. 4 9 � R R cif 3is yyn '$� 1i ��.� Os .ref_ ��8 � �pr �i �'d L. s R AY s 'Hul,ri k a "¢ a; gg E"yits K� a3 gg ¢z 5# !q$ k z r �g 4� Zell Y �'�1 f b F' R � '`• f 6 �€5�2. Jig k a A k I t€mss"pogj lei Fa t• 1R $€ me }} ��s z es . fit- . #g d y p ,d Miamy -=Q��a # ��#_ x, ,� i4v 4 g8 s.R '#^ �# w 3 r • F3 9r py S D i� ig x��� �qIB FL° ?�[ XRGY#R 7� 'TRy' r3. tj > 4r b v' K i Rz x e fi g ryyry ;gig;�:d' RQ 9¢:t q5 843 LI x a ev 111 . aw 8A u w r .R. s qW,Tr gl�§ f 8 II 4p 9� 4 N, ��Y� Iva ii a =� ro ik 10 C FFi i+iYw Y� LI b �t 4 Sa r'� ii3 �A '. ! ,. s { Im C�) j f�`... �x 53 c� x xr Mill �t a�V g 1I t��t j ! l�� �f x13811 3 Fi ! �g�C'.lTS. Myra Sa r'� ii3 �A '. ! ,. s { is 49 6:�+g i� S i_ a�= 111 Ll, r { 7 4 H_21j < y �_ � �T� ��� � E .e �t7 12� S 1 F1'✓ � �ti a ��� HAI' f Agin & J 2 ! 4i A u N r { 7 4 H_21j < y �_ .�.: f 7K :'L� - A' � �T� ��� � E .e �t7 12� S 1 Fs R.P HAI' f Agin .�.: f 7K :'L� - A' � �T� ��� � E .e �t7 12� (� rK 3 HAI' f Agin �n�rve- � cu 0:1 -4- I U1.J¢i V 00 Y II cu 0:1 -4- I U1.J¢i V 00 LF, ........... . ..... La fes" -iD ell ILL -j L-4.1— WIVVIR-1-5 ��Q. 4f 114:- 4 'I h' 000 ell Z kl 'C47 (f-') (*1 1 3y (f-') (*1 Alt AVI EFA,. ia 16> 471 _1 its r7= 11041; I� ofto EN 14 4 10 645 �k 888 #��M R � it . x �a9 w� 1 y a aS HEr Pr 4 k f 34 cn - 22 yr '' 0` a z L q" ii lie _J,.j{ iaif Ma sn a zr ., Rif Ln i1SF qy g r7= 11041; I� ofto EN 14 4 10 645 �k 888 #��M R � it . x �a9 w� 1 y a aS HEr Pr 4 k f 34 cn - 22 yr '' 0` a z L q" ii lie _J,.j{ Antenna Support Calculations Date:.---- Project ip�(t7f"s'EiB: Designee! By:_„_, Checked By: 16.5.2 Velocity Pressure Coeff, Kx= 2.01 (z/z,).53:2 {ft} zd= 700 (ft) Kzmin :5 Kz 5 2.01 Table 2-4 Exposure 29 a l(min 0,43 8 1zw ft 7 o.7CJ 0.90 C 900 ft 9.5 0.85 1 D 700 ft 11.5 1.03 1.10 2„.6.6.4 Topograp k Factor: Fable 2-5 Topo. Category Kt f 2 3 4 0,43 1..25 0.53 2 0,72 1.5� Krr= (1+(K,, Ktf Kh)] z Kit= e WJH) Doolen Croup l(n= #DIWOI Kt,= #DIV/Dl K,.= p (from Table 2-4) (tr Categoa 1 then K� _ Qj. K4= 0 (from Table 2-5) f= 0 (from Table 2-5) ategary- 1 z= 59.2 H= Q (Ht. of the crest above surrounding terrain) K,t= ILOO Cote: Project Name: Project Nuntt?e€:.._ Designed By: Checke-J BY: 2.6.7 Gust Effect factors ..6,7.1 Se!LSuDDorting Lattice Structures Gh =1.0 Latticed Structures > 600 ft Gh = 0.85 Latticed Structures 450 ft or less Gh = OSS + 0.15 fh/150 - 3,0] h= lit. of structure h 89 Gh= 0,48 2, 6.7, 2 Guyed Masts 2.&.7.3 Pole Structures G?�= 0.85 Gh= 1.1 1. b.7 4 Structures Supporred on Utter Structures (Cantilivered tubular or latticed spines, pate, structures on buildings !tit.: width ratio 9 S j Gh= 1,35 Gh= 1.35 Date: Project Name: Project Numk?er:.._. - Designed 6y: Checked By: �. 9.0..E i n tie, i'hkkn ,ss: t 2.12 KEZ = [7-/33j' 01.10:5 1A K - ' 1.05 D €9� Cwmupuc fr�a Calculating the weight of ice, the cross-sectional area of ice shall be determined by: AQ _ -n*t,:*f,D, + t j Dc= 72 (in) Largest Dim of Member A;, = 493.74 2.6.9 Design Wind Load: F= gz*Gh*(EPA's) riz= 4.44256*Kz*K,t*Kat*Vmaxt Kz= 1.348 Kz2= 1 qz= 3&49 Ke 4.95 `•d;Y,ox= 110 Table 2«2 Structure Type tticed structures with triangular, uare or rectangular cross sections Tubular pole structures, latticed structures with other cross sections, appurtenances_ 1Alind ie—ctlon Probability Factor, Kd 0.85 0.95 O ate: Project tonne: Designed By:, Checked By. Determine Cf.• If lattice Structure See Manual if Tubular Pole Structure, Use Corrected Value from "fable 2.7 Below C Round 18 Sued 16 Sided 12 Sided 8 Sided mph.ft 2.02 11.4 1..93 "32 1.2 1..2 1.2 1.2 1.2 (Subcritica111) 32 to 64 38,4/Cl" 25.8/0.&85 12.6jc'.6' 2.99/% 2£1 1,2 (Transitional) > 64 0.6 0.65 03 1 1.2 (Supercritical) Op = Outside Diameter or Ou' to Out: C= 46.55 Aaourtenances Item No.1 Item No.2 Item No 3 Item No.4 Item No.S He aht 72 72 1.9.7 24.5 25.2 0,37 feet Cf= 1..2 Depth Flat -Are 7 4.00 7 4,00 10 1,78 11.8 2.02 11.4 1..93 N Farce Per Ataourtenance 249.43 (lbs) 249,43 (lbs) 1.10.90 fibs) 125.70 (lbs) 1213.€14 (lbs) TOTAL FORCE (IFA) 855.513 (Lbs) Date: Project Nome: Project Number: Designed 6y: Checked By: 2.6.5,2 Velocity Pressure Coeff: 1,404 Kzmin S Kz 5 2.01 Table 2-4 Z= 89 (ft) €= 700 (ft) 11.5 Exposure 2s tz f 2 3 4 B 1200 ft 7 O3 70 0.901 C 900 ft 9.5 0.85 a D 700 ft L11.5 1.03 1.10 2,6.6.4 Tp o ra hic Factor: Table 2-5 Topo. Category Kt f 2 3 4 0.43 :..2a 0.5? 2 0,72 1.5 K,t= (1+(K,, K, Kh);' Y j,� � {t'z/N} iti ICA= #DIWO! K,= #DMO! Kx"= 0 (from Table 2-4) !f Cctego!Y I then K', al. 01 KF- 0 (from Table 2-5) f= 0 ( from Table 2-5) Category- I x= 89 N= 0 (Ht. of the crest above surrounding terrain) I Dote: Project flC€me1 Rrojec,1 Biu nt�er:. _. Designed By: Checked y: 2.6.7 Gust Effect Factors 2,.6, 7.1 Self Supporting Lot k Structures Gh =1.0 Latticed Structures > 600 ft Gh = 0.85 Latticed Structures 450 ft or fess Gh =0.85+€3.15 [hJ15G-10 fj- 89 2.6.7.2 Guyed Masts 2.6.7.3 Pole Structures h= ht. of structure Gh= 0.489 Gh= 0.85 Gh= 1.1 4 r J u IK Q�OJ t. rte-= 2.6.74 Structures 5umorted on Other Structures (Cantilivered tubular or latticed wines, pole, structures an buildings tht.. width ratio > 5) Gh�- 1.35 Gh= 1.35 Date: Project Ncmie: Pro;eel NUMber:__._._...._ Designed By, Checked Bv: . 2.6.8 Design Ice Thickness: t = 2,Vt1I*[*Ki,*(K,0.35 2.21 ` V [z/33f�.�c s 1,4 4 . y 1.10 :tJtM fir+ i,. f D�-'Ulgn C—TC'pi�c Calculating the weight of ice, the cross-sectional area of ice shalt be determined by: A_. = n*tIDC + t,,j Dc= 72 (in) largest Dingy of Member A,, = 514.90 2.6.9 Design Wind load: F= gz*Gh*(EPA's) q,= 0.00256*tt,*K t*Kd*Vmax2 K_= 1.404 Kztw 1 t 41.32 Kd= 0,95 Vm3,= 110 Table 2-2 Structure Type Wind Direction Probability Factor, Kd Latticed structures with triangular, _ square or rectangular crass sections 0.85 Tubular pole structures, latticed structures with other cross sections, 0.95 appurtenances. Date: Projecf Name, project Nurnber: Designed By: Checked Bu: Dejermine Cf. If fa.tice St. ucture See Manual If Tubular Pale Structure, Use Corrected Value from Table 2.7 Below C Round 18 Sided 16 Sided 12 Sided 8 Sided mph.ft j8iidth <32 1.2 1.2 1.2 ? .z 1.2 I (Subcritical) Item Nx.1. to 64 38.4/fA ,6JCte67nry 2 016332 25.8/:nTGGcr 12 .991C 1.2 , (Transitional.) F > 64 0.6 0.65 x,75 1 1..2 6supercritical) 8 �vawrrrrrrrrierrwwrwrrrrrir�. Dip = uuis;de %iarneier or OW, to CA 037 feet C= 48.23 Cf- 1.2 Aepurtenances Height j8iidth _De_pth Flat Area Force PerAApnurtenaace Item Nx.1. 72 8 7 4,00 267.76 ;ins} Item No.2 72 8 7 4.00 267.76 figs) �- Item No..3 13.7 13 10 1,78 119.05 Obs) Item No.4 24.6 11.8 11.8 2,02 1.34.94 V Item No.S 25.2 11 1.2.4 1.53 128.86 (lbs) - rs; CrT ! F ?RCE QFA - 918.37 (lb 2__J s-. 07, ition: Alpha Sector Fide ttast (Antenm SLpQ.ct" =rye( -Loaded t=ruth-Spo- Boom > intr,-matior jai Prr?d`jg 1-'0Cje(AISC 13th Ed ASD)I 4 Sfd. X 1 3,0 FT (S t 311 ASTM A53•GP.3 art Adeg1X-1'e Bye 10.4% Tr4np factor. Gatlecticn Live Load -0.08 IN1118,10 1.36 IN UI -70 T0tat Load •0.0 IN 1055 i Al` 1N Lt66 Live Deflection C.rite€ie: LI) 20 Tufai Lood Defe Ction Criteria: 1;120 REA0147t#s A, $ Liv'e', L od- 0 ib 2142 it: Dead i ocid •42 11:3 M4 It) Totel Load -A,, lb 2,5216 b E Uplift (1.5 P.3) .T 113 kb 0 Ib Beam,g Length U0 in 0.A6 in Spelt Length 5 it 8 ft Unbraced LeNtl1-lop 0 ft iT f' Ur vocea tan fhboticm. 5 ft 3 #t I � Ptpf:1 atd.- ASrixR.B trope ftr -5703 rt -to Over rfght Smart of span 2 (Center Span) Stec' Yi skid Strength: Fy m. 35 m M04utu; of Fastictty. E µ 29003 ksi tube 5*e yeCfion (X Acis} dx = 4.S In %tbe Sted Section 'ry A ist: dy - 4,; in Tuba Seel Wal Mckne�s: * - 0 ;21 In Are„r: A= t a l i12 r*orrieni of 1W, tia (X AxS;: Ix 6.82 inn Secfon r.;C�dulLs (X Axis): Sx = 5,031 iO3 Via, fic Section moaLxus' z - 4.03 tn3 oesign rmperties per AMC tali} Editn stect Murlucrl: Flan o Bockiing R aLo: FEF = 20.36 Allowable Range BUCkring Ratio: AFSR - 58 AllowE.7c"•in Fk-ing-a Buc^'�ng POSO non-Cornpa& AFBR_NC 22�:.3f Ncmind Flt>xurd Shengfh w/ -%Yety Factor: Mn - 707; ft -ib C f-8- t Snev BL -,l Og Stress Coefficient Eqn. G5.2Cr; Fcr 2' k5i ikomnal Shear Streriyth Wf Sofa;� f actou t`n c 18--674 tb ControRtng Morner* -5703 rt -to Over rfght Smart of span 2 (Center Span) Creclad by comb nn O9 dace! Icat(s and live tookjs on spon(s) 2,3 Ccnfrolom Shear: -1168 lb M ight supporl of span 2 (Gefil€Tr Span# Crerrted by Coml;rr'na19 as da rd load$ and five food.-, ort spon(s Comparlsons With required sec fano ? flu t>sioment of ins-ftfa (cefl--fEvn): 6 i3 into 6.82 ifl4 moment: -57013 :`t -Ib 7373 tt-tb Shear •' 1s8 rt) 1861? ;tor ;oti'Ch;'tE. Cr�i F: gied 9ib-SS7-SS53 Ext. 231 StruCdc Verjan e.0.108.0 �. : Un?farrn five Load 0 plf 0 pif Unifom} Cow Lcad 0 olf 0 pif Bacup S'elt We;gr,t 11 011 11 Ptf Ictal Uniform _Can!: 11 calf if a 4..103 Numbe-' ane UVe Load 107 4 fb vFdd LOW 0 Ib Location 511 U119l2t31':. ti:11•17 f° of-• 1' ;.r:a jjis't`- . , r�.rfLa�...� .} n -i_ ti s+ �{ "`'l�i;� �: - �.- e r • 37�.d� '�.'• �.. � i r" 4.., r 2 � — § e : \ o Q ��$ �t 2aU f7ƒ u _ ® � w E _. I # / . } U ) k z \ j r� ) ibƒ 2 \ \g\ \ � . `_..._ The Commonwealth of Massachusetts Department of Industrial Accidents ` Office othwes6ganens '<w 600 Washington Street, 7th Floor Boston, Mass. 02111 Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors Applicant information: Please PRINT legibly name: Centerline Communications address: 960 Turnpike Street, Suite 28 city Canton state: MA Zip• 02021 phone # 781-799-6409 I am a homeommer performing all work myself. Project Type: ❑ New Construction I am a sole proprietor and have no one working in any capacity. ❑ Building Addition E3 1 am an employer providing workers' compensation for my employees working on this job. company name: Centerline Communications address: 960 Turnpike Street, Suite 28 city: Canton phone # 781-799-6409 insurance co. Acadia Insurance Company Policy # WC202000261301 ❑ I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name• address: City:phone #• insurance co. policy # company name: address: city phone #• insurance co. policy # Attach additional sheet if necessary Failure to secure coverage as required under Section 25A of A1G1. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. ! do lierebjcertify under the porins and pe ragies of perjury that fire information provided above is true and correct. 9 — Z2-- b Print name 0 S h L, -A © Elm A -^J Phone # � ��"— X23 fl' 60 official use only do not write in this area to be completed by city or town official city or town: permitAicense # ❑Building Department ❑Licensing Board C3check if immediate response is required Selectmen's Office contact Health Department (m,sed Sept. 203)rson: phone #• ❑Other "0. OG14R PCKjr1A4 ACORDIn, CERTIFICATE OF LIABILITY INSURANCE X2;28/20�l "' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sullivan Insurance Group, Inc. 10 Chestnut Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 1010 POLICY NUMBER orcesW, MA—U68=2004 INSURERS AFFORDING COVERAGE NAIC # INSURED Centerline Communications LLC 960 Turnpike Street Suite 28 INSURER A: First Mercury Insurance Company INSURER B: Acadia insurance Company INSURER c: Travelers Canton, MA 02021 INSURER D: INSURER E: EACH OCCURRENCE S1000000 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDO POLICY EXPIRATION DATE M DD/Y LIMITS GENERAL LIABILITY FNMA003302 01101/12 01/01/13 EACH OCCURRENCE S1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES (Ea occurr-encei S501000 CLAIMS MADE 7 OCCUR MED EXP (Any one person) S PERSONAL & ADV INJURY S1,000,000 X BI/PD Ded:5,000 GENERAL AGGREGATE S2 00O 000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG s2,000,000 POLICY PRO. LOC C AUTOMOBILE LIABILITY BA3965P845 01/01/12 01/01113 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S1 000,000 BODILY INJURY $ ALL OWNED AUTOS X SCHEDULED AUTOS (Per person) BODILY INJURY S X HIREDAUTOS X NON -OWNED AUTOS (Per accident) X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S ANY AUTO AUTO ONLY: AGG S A EXCESSIUMBRELLA LIABILITY CUMA000504 01/01/12 01/01113 EACH OCCURRENCE s6,000,000 X OCCUR ❑ CLAIMS MADE AGGREGATE s6,000,000 S S DEDUCTIBLE S X RETENTION S10000 B WORKERS COMPENSATION AND WC202000261302 01!08112 01/08113 TH- X WC STATU- OER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT S7 000,000 ANY PROPRIETORlPARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 51,000,000 C OTHER Leased or QT660309OB870 04/26/11 04/26/12 $100,000 rental equip DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ACORD 25 (2001/08)1 of 2 #S170318/M169701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3f) 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 AUTHORIZED REPRESENTATIVE� JJs 0 ACORD CORPORATION 1988 If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25S (2001108) 2 of 2 #S170318/M168701 W N Dyto Ch q q 0 N0 0 O z - J) y y Azi ;u M O O z z c ymy m m AmF< vmrzz OOarp -4;0 mXD c C 0 z r 1�Zr0 mZm�x Oc-4gm m m m m -Di m m m C30T M0,00 olyz O O 2 � < fmA � Zl >r 0z 00 OmmC Z � m no Comm 0�5mz m m 0 0 m --I � M w w M>09 m M;,OM-ZZ Z F- OXOZ O4m mm Oc p W �z 3 < m zrn m w oo �mnm m��m my yo AyZ -1 -1 mo 0 w aN a m �N w 00 w X X D> c -n 0 2 M� O z O m D 2 m A A O co o m D O z 0 U) --i Z-{-< A -i "10 zc� D i� 'D r W4 n ;y'7 ZZ = W NOmx �m D �O /� 0K0 0°0 C, m OF co 45cn z�m �m,� <<p� YJ GOyZ aµ ri? a°O..) O 0i=-- _ Oprn<n 00<v (1) (t) mA0 0 w -1 m mr J 0rm--1M Mo Ozz� Ommmz rn Am µ z ;0 �0-4- AT 3y O<OD Z D� D 3g U) CO CD 0- x tanto z /T��Vp r + Z� mr-OZ M;uM-4 mZ -n D v ■■ 00ZO Am z O p �O CZiX cmi0 m -q r ZmO� -4Z=2 mm r D Orn AD D Or 0r - m0 m�mz >� z Z 0 mm �C C 3D 3O ic CO -- <��' �m o p 0 �� Nn n Dr yr D C) tnim0 mo z z �0 mD D z1 Z'v 0u AmG)N y O DC Z1 <� j0 A� v zz p n m y 0 m 0 ca � p y0 zomo c A T m -1 [A o2mo z S ,-zl z m mm Nmzz O K �0 -q�° z -yyn mzC�2-1000Z -1g,D KCl) -�(n < Z Z� 2G)zz XFX000 -0 C,) mCmi)0 5-1122 .Zml -a-1 z 0tZn00 y w�D�00 omO0C0 �TWm Dmm--4 O z o zM nz =1 0°zz0p ApWp-a-I�T. aAZr 2oz z O �v<W 17)V<OAoT n)$mmG�C n�'i �0 o O _A Z -010Ln 1 m°iA 'iz moOn�O rnD0z a D o mA -10m C5 Cm0 n'mgm0z pmo'i C m �mv om-40 �° p0,C. < Z N C O V 0 o � m 0 Cl) A W N m Om mm Xz Z X, Om mm m G) T z X rn 0 /�/ y Dm m Dao al r T G) 0 -1 m 0 C/) v o 0 Dz i 1 D o 0 1 N O O O m 0 D aT mn z z mm Cl)i D m <y Cl) Cl) Z O m D D o O `^ m y to ma, - �0 0 Cl)V, v w z m 0° rn Z O (/� C m D m z'z p r o f., v m W z r D O TI a = v m fp 0 D z m g F- * BOSTON ST o� X Ap s� n Trn—m ��rn O D Z Z yr -J 00 T m A >m n z O o a D z m y y5 �o r D c m z ry O r �m 0 D m M ^m 00 z ? V � 1 D 0 000m 3 0Oz m mD Z PST = m° z DZ � ai D D D n 1 m AD m 00 C omo w N Z O 0 m m Z*Z 0 G) -C7 m p z o=m z m -1nm H m 00 =1 Spy D y m m f°zm U) _+ v v y ?cm z z z mi 00j A' qv m Dov c Z {00 v O0m 1� z Cl) OM 22 i mal0 { O { m G)mm O M -1 O � -� z O r m z y v o00 0 SCC Omz z z N y Dz mo D D D D m 0 m m m m 0N N Om A S <m 40 ZONINGm 2 M8 v z Do C,0 El to x 9� a i —1 =pv, O Wy 9 0 O D y zo aC f1 Cl) —� frrl v 8 M 0,- 0" r i <� m o y �- �.t g gZg z xzC) K �� Ns �O � �Fm rm 0c) ?-P /� �� o b C�� C, r � F�� 5��� � (D a g al -� N u rl Z Z to 2p C � Z � ass W O � Z Z 2p � W O W D= vZ n � � 0 �m D� rD �yON J H1MON 3nru EP N mOD q ao D n O O w z 00 A 2 9A l D z Z z X D O X rn z D z m O p C y C 6 m z O W c O � U m W m N zv� m 0 W� pm oo Wz azo A=te Z N S2 Q �� Sm (X); m ;u (1) Z D z Z z X D O X rn z D z m O p C y C 6 m z O W c O � U m W m N zv� m O� W� pm oo Wz azo A=te Z N S2 Q �� Sm (X); m ;u (1) r 00 �9 0 o f Oo �v S z'n cn N ff� m, 1�r� O O z==C z �_� Z Is m m Z�s m y Am C 0 z ozo zz "•) c z Max � �,z 8 O N o D y W c O p F+S G m N oN tD O J O] A Z m m Z y N S2 Q I m z 9 o $ S z'n Ir b ON� _ ? 7c R yyZ M 0 o y� Zc�� O� DS m r Z p�O S m Z c CI A <m W N O Vi rn vZ O o N LD v A N C 0o < pA C. Ap mA Ff H� fi- cn N ff� m, 1�r� O O z==C z �_� Z Is m m Z�s m y Am C 0 z ozo zz "•) c z Max � �,z 8 O N o D y W n z D F+S G p oN tD O J O] Z m� W 9 130 $ S z'n cn N ff� m, 1�r� O O z==C z �_� Z Is m m Z�s m y Am C 0 z ozo zz "•) c z Max � �,z 8 O N o D y n z D ,Do Z D� ,Do Z 130 z'n 00 M 0 O� DS vZ v 0o < mA 0 m F -D B• Ra� �x 3fW1 o �p w -n i m g I > I > N J v� � I u O u V >T mmy G + o II X — " ox - w z S m NO ZV PM 1 g oz ZE jell 1 11;o S vNm v>m X � > z CC (e7� eC•i!(�87C�Ij � v+ �T z X X ME z M, c� O D C a 01 6 0 { y,$ " R' Q u fZZ g'J a AA V 1-Z�O _ SO Z'. NK 0N m+�g o A w _ i 3 W�v z Z N oo s x a r N zz m zm D ZZ �� O C w m o r I I --� -- _-- Nim>n�z�o z a Z �Zr*iZ D'D00 O ' N-+Zo c�=cnzo cOmcm�Oz �OMjNDDr rcc�o- �zo Dn�Z'Um00 x� WN m" � M DOOOOm-im ti z A0 A� g �t*70��pCX m 00 0� =i (n�D�0:C1—si OI Z mn mp ZZ mC: Fm o m� o> w Am O " - V/ N :U 8 a O D 5 Ado n N �p0 O O O Z �N �1 Z c� n "-Z O o°� OOL �) 3@ D Q fl oom O O m D m m N O N �— rr �i� rL � Z Z M,(nm J 0 8$� ^ C4- r.+ !o� �� FFA Z ' 99 X 8� rr r N w o�p � o I `O o � 0 J Oo 0 N D p ZO D o 0 � Z � O z p S S O� a� a `O o � 0 0 0 N D p ZO D o 0 � Z � O z O� a� a W n mf a o v vZ � ao O ZZ ZO � Z � O O� a� vZ ao �m D� rD ;m 3. 3m T O p o O � yy �CCj O CA O D 'm D O z ❑ ❑ ro� Z X Z X 2 X Z Z Z Z Z Z O N I 1 �z I I v v v1 --o Ilk �J ® ® ❑ C� a ❑1 m O X V) y o Z O y O E m ji Z R 3 A �Z Z� O O � ^� z Y O orl� 2'C Z oZµryr� h' yp µ ryyy� µ M o Ay �7e LjLji m A O 70D O RI z� A m ;♦ ; m u m a� .. �Ooz a Z;A nt0/1 tnOm ��� �m cZiz ti gig 751 C m m �R In�Dn�DZ 0 �D IZ mzmz Dov —1 cv NOr�� r*i00 C�-cn-I-I-<-- -IZCc2U?ZO �OmCx�OD DOmgNDDr Dc7 Z� O Z08, �� u) m �m o��c� n c =g 0 Nozz8mc po OT m En r � � � � ,Y`✓�q� zSo o= C a - oN O vN 8 c] o D y A�8 nC n oom m p m o Z v r r z 'a D o Xcrn • -i ASA 3 nm o 3o N is � m O V to 0 Z N z Z_ O r O � Gp O S � m O 0 Z N z Z_ O O � �O z WO >=> + m D fart O C vZ av O Z Z_ O Z� �O WO � � vZ av M m� rD 72' 17.25' �D r ZD 3 ym N c C F z M D =A m = Zx -i m O A Z c C z o Z D — O o v DI= I o o o — D ?o --- L J w - - omo \;23, a _.,yam. CD f z �_ Z C z p�m� I ♦03 0 A A w I 24.6" x p = 1 Z O 2 v 4 Z D 80' N 0 m w �< D z m yN --- of n zz M r og A D w �.� s Z N m H o + z A p D G ari D i W 25.2 w m m w c a n 7� AP i rZjl z Z Z L O v m r. 19.7" 36'f 39" m =m V1 N w v y 18'CO) n c v O o x OD v .� .� o ® ®i '±1 Z �a / / M ® w w 0 m m A O -{ co 0 2 > p m� u p O - o 'n z m O N W t0 O a a X ZZ -i D= p O n 2 D CEJ X Z � SS �S o ACP 00 WCD cn 0 opm O� Om � 00 D � mZo Zz Xc � 3r� m 4. m D A to r � O y r � O U � c4i t9i � S Hx O " -I v v O �J �= m o � N O � � f�. cO��a O � Dr ADZ +- L Z t0 _ N : Z'� NZ Z D (r s � N D O " D� 7 o D � � O �J �= m o � N O � � f�. cO��a O � D OZ zz �D +- L \ D i O ` N : m� D� 7 o D � O O � N m C ^ z Cl) �= m o � �o � � f�. cO��a O � �< +- L � u 1,C: -7f1 n ZZ N " o o m C:: 7 o D � O O � N m C ^ z Cl) z � z o rte-' m � r �' � � F d �_ � � f�. cO��a � _>- ice +- L � u 1,C: -7f1 w iv U) 'o 0 D N co G) 0 T N 0 0 0 0 ;D0C,U zim c c 0 0 n z Oc m m m -mlr,cm Xmmoo z-0mm -j ;o ,mm, Z 1 -OI ° G) D D c MMF< To -n ZZ OOD- C� �DAy7 c C z 0 K K 1 Z r0 w Z m A D OC D- N m Do O m m m m p fmn m A D 1 D O CE77 2 --{{t G rn Cn X>OK mm;1�-4 oToo Om�c z G7 'D .. O p000 m oo°m-I -Im(1,fn pa°� •Am. op.. D <m2S 0-IDa mm>Z0�� owo 0 z zA-n cn cn -1 a) ;u W z < m zN m m Ncn zrr mm OND mm OC O m �A D r= N Om O L7 �oinm 2'n < Dmm0 A�12 11 �2r O t�h o�; .0 r m �O m w �mDm M: K O to -i mwzmM�c 00 m° -mi D ow -' GD) x 2 -NI oO x DaCm o20� OzOm DZ. m> �G) m can NA ~ m DO z w Om2 i> DDAO OKO m� u r ocn n m 02 r m NzI-M Dmm� zmmog /1 OmZ wµ �A �� 0 v_� O� r Cl) Omy1-i Oi00<ro cntnSc YI mX0 cA µ m mA �l mr-im O�zD 00mz rn �m µ _' AD rn �o�9 ,�°0 05 a °5 ap --I --I OD<m �m . 0 0 i of-� '- ° rn °° (n (n Z T A op? mmmz mo DD_ `" O 'A0Z0 ciAO m-1 °zmO� --gzm2 mm r- 0--j P. o=i my v 00 00 0 O m O m z D p z Z 0 m m A D D m D °m0fn oA ° O O Cn mn n Dr Dr orr- i �pN o� z; J }' H1a0N anal 80 T r oZ O W 5ro m \ i 100 J� // c ♦ w / \ t /ve56 ♦m ,/ ti m / 441 o� 1 cot \ X A Q ti' 0 4 A\ O K mo -- rm v�=ma ♦ 2p II /'' soyz ♦� '� jj i ozZ ` AC�wn z II i r \ \ oOm° °�♦ 11 Oy !C 1 O \ \110 + 40 /// Nr CA 00 \ v0 100 *# o O \ All °� .00 F2 v �0�0041 CDO Z O O A z ro w SII W Mo rg _ O p� O M Z �Zo z W z rrl A=U z m ggr-m Sm Z � I ZO D 00 SII � D z O ro w W Mo rg _ O p� O M Z �Zo z W z rrl A=U z m ggr-m Sm v v Doi C? ZO A 00 C � D m 2 � N � c 6 r r m m 00 1 I D Om N O - a= c V1 Cn o Q M M -< 0O 70 m <� z O ro w W Mo rg _ O p� O M Z �Zo z W z rrl A=U Z c 0 M z O ro w W Mo rg _ O -En -i N p� O M Z �Zo z W z rrl A=U 3 c 0 M ggr-m Sm �m Doi r ZO oD 00 � D D 9 VD N w mz y O ) � yoy N Z m { 5 m ZOR Z 5 0 O f TO z 9;$ z 59 0 QQm O N N C 0 AO N mOm N >O N ZZ Z vc): �ZA �o c N kOi 0 z0 us0 W"O vvZ ZA9�pppp o, N Z mN 0 m (^� V, a m Z O m U) O X m z�- �io A 8 �oo cm T.CQ 7 0 0 0 ro w Mo rg � d V D) �oZ ZZ C � Z O ZO D 9 Z � 00 QQm O N N C 0 AO N mOm N >O N ZZ Z vc): �ZA �o c N kOi 0 z0 us0 W"O vvZ ZA9�pppp o, N Z mN 0 m (^� V, a m Z O m U) O X m z�- �io A 8 �oo cm T.CQ 7 0 0 0 Mo rg �. ZZ ZO z -n 00 mM O - a= Q Z ao 0O 70 m <� rD CA 1) ♦ N m > iC 9 T Ny z� P oP D Tl I O z C M v� m D O z ❑ ❑ 7— 0 am am ~0 Z Z Z Z Z N I D� D� Dc, Z N m 0 ❑ X C� P 1 Z g 0 0 0 �Em m A i 1 Z 0 c �po 0 C - HC 3J -g{ L4y �8�.8 Dpi 3111 X o Z m O t��T II pig o�O _Z X m O mcZ7 II � I N4 47 T �O N O N t! m m X_ mm m A O� ZC 9 !N 19 v.a ;0�L9c v 19 C ? m OD > SF iY Q P µ �8 � z µ" µ o o Z 9 c�a y L A _ y HF � Tvj�' o z3 foo D nf�/1v�iN� g z _C An z Z �m z m ri �o �o CD �� �R. -+m�0-<zDo O MCzmz D -UCG p �0r- U� c?�-00 -iZc�=tnzo C O W c�� O D DOm�cnyDr r-C:0Z5' XZZ-I acs z-om o �m0ooOXx �0go zzor�ic 00 o m cn r A z _ 9� �^ =m OMI I y V, O _ D o cfl C F— Dmm �� ZO z 'AA C) �F_ z Z G= c Q �A ��o _ D m2a D X C F� V mew N O arm 2 m m z Doi � �A L3Sc N � N W m 'r moa Z Z =N= 0 0 o Zp c a a z D W v 0 00 8 � D m >x � m 'r moa Z Z =N= p Zp D f*1 v 0 00 W� z m >x m+ D � o = m a 'r O Z Z Zp Z� 00 W� vZ av m i%j r n :EJ x t O M M N m nZ .6£ :F.9£ .09 om xg �4F N2 s � o� U IT J w m D N Z N t c - m J N O Q Q _ ON 0. M M N N W N ir d 9LUS a CI Z Od O Z Z y m2 0 2 3 m O �U U F W Z Z U 3 0° 5 F� 3�2 IJ 2 3w UU � S S F- tODNf27 n r 3m .09 om xg �4F N2 s � o� U IT J w m D 0 0 2 Z N zz •�� CC� `� ,tel I Z J w m D 0 0 2 Z N zz r d 0 N O Q Q _ ON 0. o=w zM U, xN ¢U S W N ir d 9LUS a CI Z Od N m 08 y m2 0 2 3 m m U F W Z Z = 3 0° 5 F� 3�2 IJ 2 � n r Z J w m ^ 0 0 2 Z N zz r d 0 N O Q Q _ ON 0. o=w zM U, xN ¢U S W N ir d 9LUS a CI Z Od N m 08 y m2 0 2 3 m ZN U F W F �j0 Z = 3 0° 5 F� Z N � m ^ Q \ Z Z N r d 0 ZZ O w Q Q o=w zM Q U ¢U S W CI Z Od N m 08 y m2 3 d N S W U F W F �j0 Z = 3 a 0 I -z3 Io< 3�2 Z N h cq M m Z ZN wZ r d 0 2 O w Q Q o=w zM w� ¢U S W CI Z Od N m 08 y m2 m O w .6-(D co p Z = 3 a 0 I -z3 Io< IJ 2 a x Q Q Q w W Z J 'Q W o G Q �w Z R ID W W Z x OfN v :w T N K LL } J z0 Z 6 y w tea W � �0. U as + N � V1 J Z Off ff C� C N n 0 0 l K co p 0 a00 0 d 0 J w X o=w zM w� aoo W CI Z Od N m U (n y m2 m m� O Z a x Q Q Q w W Z J 'Q W o G Q �w Z R ID W W Z x OfN v :w T N K LL } J z0 Z 6 y w tea W � �0. U as + N � V1 J Z Off ff C� C N n 0 0 l K co p ti ONINOZ •� J 0o Noma c WT �j j • MNAM D v Q Z Z Z M�0 L �o 55 Cl)� f.. OL ca Cl)0 C/) co Q z Z X O W a Ca U �J W W a W o _ s co z L a 5 w F - w z z a a o WI LL % ¢ a 0 w w W O O z LLI 2 ~ U ¢ ¢ Q �r Ji a X OW U� } F- m ow (.)5: Lu N.8' F -m < co OW zfr Him Z LuW° ¢ UVU Qa. wJ0 W<� Oz �0 F W a �=aW a ¢W� Q Qa0 CO Ooh a Z O a�� mz jr I-q- =Zw 0 W U aQ IIra a z30 Z OWO Jw= 00m LL J LU X00 z o z N a o W � O z vi30 zF 1 W U�W i° 10c yon oZ �.a SR W O = o sza O ° •� J 0o Noma c WT �j j • MNAM D v Q Z Z Z M�0 L �o 55 Cl)� f.. OL ca Cl)0 C/) co Q z Z X O W a Ca U �J W W a W o _ s co z L a 5 w F - w z z a a o WI LL % ¢ a 0 w w W O O z LLI 2 ~ U ¢ ¢ Q �r Ji a X OW U� } F- m ow (.)5: Lu N.8' F -m < co OW zfr Him Z LuW° ¢ UVU Qa. wJ0 W<� Oz �0 F W a �=aW a ¢W� Q Qa0 CO Ooh a Z O a�� mz jr I-q- =Zw 0 W U aQ IIra a z30 Z OWO Jw= 00m LL J LU X00 z o z N a o W � O z * v!i voi gU W U�W U �? w O mrnm 2aiO M C Z. p z z �F �� O z Qaz �¢ �z z 0 O� UJ o aW w oaCL U) m LLaZ K Qa � J O J a N J F ctop O p o wa°¢° OJjOoo OKaj��o ¢ Z Ow OpJ'm�^ C7m2W��i NO F_,o.Q lj?of am YF'F-m�� QpO�vhiM �F LIJ F = Qm2,0 3] JOQo ZOo0. ¢c°m > h?to ¢ JIr W J f -Z ¢W (� l�pN=�x�_ z ¢ 3 H w O � Z W j O o O F - Z U U p� F = m m o l LL LU Zul o z z N U W Q.s a� ~ O ~ N W � O z z O d * v!i voi gU W U�W W p Iii r mrnm 2aiO M C Z. p i� 11 ¢� �� O z Qaz 0 �z z Z -;;t m m0 WW z�� U) m LLaZ 00 a w O JOO ¢ IUL W W w O w Z � O � o U W Ir F- ui ate. x l< � Q Z t - -Z LU p O Z X am CO J _J 0 LLJ O i- mro = Sp w O U z O¢ cr o coF W Q o m O mp � a m m Z w LU Zul o z z N U W Q.s a� ~ O ~ N W � O ° z z O d Lll 1" z o z z N U W Q.s a� O J wZ �° CO Z O w v rn4 W) 0 w 2 ¢ LLiU F - g U w O Z' 0 ozaag ° F ¢�1 a 2LL pwz a ZZIU 0w ¢ Z �E`iZIF pW0 o Z3c~i¢ Oa IrOZ!1- W J2 � ir o w az0'Q O a-ZWuj of O o W� °F>� JO U0, 000 92Oo z to u�y v~12jx ZLL VOO W °WC- 2 3zzxwd 1wU~ C�oa>> aJ�. ~v~wo �Waz Jw ¢ Ic? WO81=0 JQO LLO=Z 1'vlF,ly F m W UV O S¢¢ W ¢¢NO ¢¢OZ O¢NW z°w3a "`¢w°o Za 1O OO�m WOOU �nSF¢O ��Waz 0OUj tq <' goo F -t -2a W OZ�U =aZ OOWWX W�Jir m w O m W q (V b v rn4 * v!i voi gU W U�W U) Iii r mrnm 2aiO M C Z. p i� 11 ¢� �� O z Z -;;t m m0 WW z�� U) m LLaZ 2 w F J= ¢ W W w O w O j U W Ir F- O O ate. x � � Q Z t - -Z LU p U X am w 2 ¢ LLiU F - g U w O Z' 0 ozaag ° F ¢�1 a 2LL pwz a ZZIU 0w ¢ Z �E`iZIF pW0 o Z3c~i¢ Oa IrOZ!1- W J2 � ir o w az0'Q O a-ZWuj of O o W� °F>� JO U0, 000 92Oo z to u�y v~12jx ZLL VOO W °WC- 2 3zzxwd 1wU~ C�oa>> aJ�. ~v~wo �Waz Jw ¢ Ic? WO81=0 JQO LLO=Z 1'vlF,ly F m W UV O S¢¢ W ¢¢NO ¢¢OZ O¢NW z°w3a "`¢w°o Za 1O OO�m WOOU �nSF¢O ��Waz 0OUj tq <' goo F -t -2a W OZ�U =aZ OOWWX W�Jir m w O m W q (V 0Ci 'Vo W D ai o p a C e 0 s V 3 N0 o = o �LL g � O GJ cg C O bw U TRUE 3 ` a W °1 g NORTH a�z \n m oro n I I 41I U �\ .0 Vy, t„•G• I r N 'Vo W W OUW ii a .9� _"m 0 Z g° M o �i�w o a OD 0 LU aZ o Q c; N Z UaW ir b- � M m� U ON o C H -20 ZU zZ ` OZO Ura rN U� W K_ N� Zmmaob, *;!o0� //••�� �..L �iOF Z Q U Q z tE-0o4 Z Z Z 'a o W W N6 <o& '�� v, ZO W : W L •- i Q N O bw U TRUE 3 ` a W °1 g NORTH a�z \n m oro n I I 41I U �\ .0 Vy, t„•G• I r N W a c; LLJ C H CL lo - 13 z Kwo W a L LLI � aIa a O2 'ayoi LLJ j< N O bw U TRUE 3 ` a W °1 g NORTH a�z \n m oro n I I 41I U �\ .0 Vy, t„•G• I r N B• S s 4�C �x u o D at N I $ I qD I If I u+ W+ wr m x I Am Oz i �� w w m s A NO' �0 az�m� m y Z rm'm ZR pN m if p 8 T m OZ CCCC ff��11 GCtl Y' G z .{ O .Z7 "N€i� v� m Omm x Z �y N Li = Z z m c c, O n m _ om 0 c 0 �t f�11 P w v > O� C) zt -.4 - — s pp H-0 zr SQ S*u 0 -0 O X-10 n�Nr1 tAOfA mG 8 ON mfz �a K r Xi m m cZ `Z Zb m R 0 r m C x m N A O r. _ _ 3•��t o z i T cz r o L J ln�DC�WD�D Z D-ir'1>O�ZDO IO 0 Z f m Z m Z D T O - q c_ Ct N �cN�Ov�izp m Zc�2- cO�c.Zm7V�OD D0m�NDDr rcn0- mZ �� mo0 xrl oN �g w DKOZ��Nlm zczi a)00mmm� z �mC7X;u m 000 of vZei tn�D�pZ7--I z om aA ZZ mC c v 'm m U) � r W z w n X m ��9 > O _ v= Mcn pp J l 8i D Cl) O xm O 9 0 ^� O D S �o n C n s co < JO O Z toi» y cn � °�° ? z cn z CD CL F d v D p �Zv z m O z ^< r u� �fTl� �m 2m m a� o C o0 1 Z aA r oo `� z o 0 r °° v m U r N N o � O J 00 0 N z Zp � �� o c�5 mo 0 N g fO o � o0 zZ 0 o Zp � �� o mo 0 Z m 0 a= Z N � �+I O D C C .. z� ao v� 0 zZ Zp L! O 0 a= vZ ao 70 m O� rD J � Xp 00 �Qiov' ir!Ox�UW� OLJ N�ofOOZ a Li a. ZLu o Lu5 O� OZc/l2�OC90 I l-a�0V) C) OCL Z �O Z Q�Qy-OprW� -- -----L-7 9r � m 0wig Ct FO W Z 2 W mm Q'+ L Z n p N a 4 �fDD 4411 i o O pF 4 pp � 04.7 W O b - O N le ` 700 �^F7LZ F- W wgg ll: o a�� c� z N X IW\\ NQ � ❑ ❑ =Z "Q I I En F N W Z Z W Q W Q N z I ❑� W`J I 12 88 aeras g �m �x F a O oat w 7 a it m ❑ 03 cou oR� Z 2a 6zo Z Q ,�� t C) J � Xp 00 �Qiov' ir!Ox�UW� OLJ N�ofOOZ a Li a. ZLu o Lu5 O� OZc/l2�OC90 I l-a�0V) C) OCL Z �O Z Q�Qy-OprW� -- -----L-7 9r � m 0wig Ct FO W Z 2 W mm Q'+ L Z n p N a 4 �fDD 4411 i o O pF 4 pp � 04.7 W O b - O N le ` 700 �^F7LZ F- W wgg ll: o a�� c� z N X IW\\ NQ � ❑ ❑ =Z "Q I I En F N W Z Z W Q W Q N z I ❑� W`J I 12 88 aeras g �m �x F a O oat w 7 a it m ❑ c� w K W o LL nz ON OO Z np 5& = ) m \ r � 7 , Z � 2 � 4'j �} � J0 �% * � \ �( OCL /IL % -«» ¢ 6~ ^ � G / 7 » e� ©� � 9 / M � ) m \ r � 7 , Z � 2 � 2/ �} � � � /IL ¢ P, 7 » / M � // a ! /§ § 0 /2@ Ix �® z o z w // \ Of 0< NN.�� §0 37 � ) m \ r � 7 , Z � � 2/ �} m m 4 m CA m m y .0 CD a Z CD O ar d fl. .0 O o v cCDD CL %< CD ..:. c v to CD 0 CA .0 CD 0 CO) d O CO) 'v. O y O C7 CD O CD CD a, FA- CD CO) v 0 0 CD 0 CD C o w _ O —• y o Q' N i a 0: O y ..� _CLCm m O ycia0 m z ?o N o� O1 ,D.r m N T1 ... CL CD nim y C� o m N p . O m. m �CO a to -0 _ . A O 0 n o Z 4c. NCD oo � m N C-' Cr1 aum ''^^ c ? Vl m m m N X00 n o w H=i �. c* w n C W C f� o,� n �1 CL N C co • cn 0. N PL n m m m o� O Dom Coy to O � � � ��►. z N •+ . . , CD bd C; CDca CDc wo a El �0 CD d M 9 a r0o ., �. M N oGa O y0 w �• oda x � r. a= ac x ro r y �- R. C7 �. c/) O . x y r N omi 0 0 c '10242 Date ..... ��7 ?, 2, // ..................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING g5' Alc'�41'6,� jie. This certifies that ........... ............................ ............................ has permission to perform ..... Z5�0011 .... 5�� ............................... wiring in the building of ....... 7- .................................................. ..... &5 at ...................... ....... D ................................. North Andover, Mass. I"JI "I �1"U I "v; Fee..'�� ................ Lic. No. la ............. ................. KrRICAL �INSP�ECTORi Check # Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. _ 10 2512_ a._. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank 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: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersignedives notice of his or her intention to perform the electrical work described below. Location (Street & Number) X� 7 0 J A // kac.C/ Owner or Tenant -r— -o o 4, (t Telephone No. Owner's Address 10 Ca •w., enc a 114y Nn -4r M/I Is this permit in conjunction si with a/ building permit? Yes ElNo [:1(Check Appropriate Box) Purpose of Building (fe tl 6amz T� tat,- Utility Authorization No. // V 9 9/ 9 2 Existing Service 1,100 Amps / Z o 12- Yo Volts Overhead ❑ Undgrd ❑ No. of Meters New Service ?°p Amps Volts Overhead ❑ Undgrd ❑ No. of Meters ' Number of Feeders and Ampacity Location and Nature of Posed Electrical Work: liP9n,A,� f -em vc L � t C 41'14a/117 Completion of the following table may be waived by the In ector o Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ rnd. rnd. o. o mergency tg ting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons ... ... . .. ... KW ............... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Estimated Value of Electrical Work: lot d o e Attach additional detail if desired, or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: I ci` 2��I Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the�ains andyenalties of perjury, that the information on this application is true and complete. FIRM NAME: 3 P �4./ /'S %F✓fit ec t X—C LIC. NO.: Licensee:Cfefvall /"t q r° 14 ,/ Signature 1*4_ " LIC. NO.: C� - fa �6 (If applicable, enter "exempt" in the licgnse numblingg.) Bus. Tel. No.: 5108 -?c/-!r yt7o Address: g6 7'P�e tfi^�G� 4117 4, 1Z 4 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. 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 Owner/Agent Signature Telephone No. PERMIT FEE: $ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www. mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name (Business/Organization/Individual): 510 la/" 4 Te �t C Address: 5�1� rQ,,?^ie. 511-,,,e_ City/State/Zip: it, -J( It �� 0219 9 Phone #: Jd -�`t'S �%�? D Are you an employer? Check the appropriate box: LEI ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors !. ❑ I am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance 5. ❑ required.] 3. ❑ 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] t workers' comp. insurance. We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. El Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other *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. TContractors 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: /Nv /C &C-ok Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: 90 t �,, /4. /( ep. J 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 certify under the pains an'dpenaallltties of p rjury that the information provided above is true and correct. Signature:z �u-o� �-- Date: 65T 2 Z 29th �-o�- 3ys y3,;;�o 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 #: