HomeMy WebLinkAboutBuilding Permit #343-13 - 95 OLYMPIC LANE 10/24/2012 00RTF1 BUILDING PERMIT %,,_EDI, - TOWN OF NORTH ANDOVER 3� ° 1 4 .. APPLICATION FOR PLAN EXAMINATION Permit N0: � � ` Date Received �pATED 'PP '(5 �SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION WJt Vl G: r _ r k. .Print E,RTM I CIf L. V W 1� u �� M 'K.1 rinY MAP-'NQ _ PARCEL. _ __ZQNING°DISTRICT .!Historic District yes no A Machine;ShoPYillage- ,yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One fami (TR ition Two or more family Industrial era ion No. of units: Commercial Repair, re-p cement Assessory Bldg Others: Other Septic. W611" .: Floodplain. Wetlands' WatersF ed'Disf"nct' Water/Sewer, DESCRIPTION OF WORK TO BE PREFORMED: S'�t1r2y_A2011-/ON Lo1 /'CO _ ,S(� jZ��Ny1l /y s" Tv K ri gin'FN & - EAlT� 9&r/7' . s IViA16 i&d W6' Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRAC � 0TRPhone" � . :Address: �%� L�� Stapervisor's ConstructiornLicense C '�C)�3 Exp Date: - . l I _ .�_- - Hbmn Limprovement License ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.B LDING PERMIT: 12.00 PER 1000.0 F , U U $ $ 0 O THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: FEE: $ q �— Check No.: Receipt No.: askq-v NOTE: Persons contracti w'lfiunre iferld contra tars do not have access to guar my fund Signature of Agent/Own T afore of contractory 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 A /5 fSignature ` 1 QA-- -6-Gam -COMMENTS lk �� ' r C� rye. -Gam - i HEALTH Reviewed on - 1 7Signature j COMMENTS__ Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes i Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street F]RE?DEPARTMENTr �`Temp Dumpster on site yes ���a t t ,no,,,,., r ;�p 4 t �L-ocatedtat,124rMam _ # Fire Departn ia me ','snatufire/ a dte SP Y N` C J. 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) ❑ Notified for pickup - Date I Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks /❑ Building Permit Application r❑ Certified Surveyed Plot Plan /o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ✓❑ Copy Of Contract �❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And j Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) -,❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 Sprinkler Plan And Hydraulic Calculationslicable If Applicable) PP ) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 I Revised 2.2008 Location v r1'! /e" No. 3VJ Al Dat G? •j •� t� • = TOWN OF NORTH ANDOVER � Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check _a� 25877 Building Inspector Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost 191.1096.00 m $ - $ 2,293.15 Plumbing Fee $ 286.64 Gas Fee 100 comm. $ 1:00:.00 Electrical Fee $ 286.64 Total fees collected $ 2,966.44 95 Olympic Lane 343-13 on 10/24/2012 New Two Story Addition, Reno kitchen, bath, basement, bath, siding, roofing and deck poRTk TOWN OF NORTH ANDOVER 3?°e`45Ll�`'� °o OFFICE OF } n BUILDING DEPARTMENT 400 Osgood Street North Andover,Massachusetts 01845 SACNUgt D.Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 CONTROL CONSTRUCTION— SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 Imants Dankers h HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT 95 Olympic Lane, North Andover, MA DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: L V L [TEAMS (--o i2 RCA 9— ^122 1 To o nJ Arl'D F'12ST F7"o R Af4lD CwtSENLEWr REcUVAz,00 . AUTHORIZED SIGNATURE: DATE: January 7, 2013 REGISTRATION: MA Registration No. 33689 » PIH OF cc MqS NOTE: ENGINEER WET STAMP MUST BE AFFIXED TO THIS FORM G o IMANTS N DANKERS .� STRUCTURAL No.33689 Control Construction Form revised l 1.15.2004 �Q SE I TE�� NAL BOARD BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 P Al I lvz� I ti illi j I � I j � r7I + + j # f 1 � i FVERMINSK1 R �IDENCE 95' 0U1G�-�E NQallooVER+.4A. 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E .0- a 6"O C Vapor retarder 518'CDX SHL Rim insulation in joint \ 2-2'X12'RIDGE Pressure-treated 2*sill ROOFING: \ l I. plate with gasket — -ICE 1>i WATER SHT: ` �,(� •2'X6'COLLAR TIES a d — a i 6"O-C. ..1513 FELE -_ Slope away from 8"min x wall at 6"in 10' SRiAG= a 8"HDR- { ROOF VENTING: 1/2'X12"J-BOLT SIDING: OR BETTER HIP d� SPACED 12'FROM " CONT. 60' with o nal HOUSE WRAPS T' � CORNERS, 10'P.C. � a 4 slab p VINYL RISE APART MAX. welded-wire mesh DBL.4 VI LL FROST WA G SIDING v Rigid insulation e Vapor retarder 6 MIL. • #4 rebar for crack control a A d e d ---- �� TOP OF FOUNDATION FINISH GRADE PAGE NOT 1/2"m X 12" LONG WALLS: `�1 FINISH GRADE VARIES TO SCALE 2"Xi�" 16"O.C. ` ANCHOR BOLT 112" CDX SHT_ P.T.2'X4" MUDSILL SINGLE KD. BOTTOM PLATE 4oeDOUBLE TOP PLATE FMI -FRAC M-G DETAILS _ N T- snt ' - 10" CONCRETE FOUNDATION WALL 4-7— C) _ I I NORTH own of E ndo' ver No. iL 3 _ Y CO LANE h ver, Mass, eT '43 , coc"Ic NEwlcK y1. ORATED S U BOARD OF HEALTH Food/Kitchen T LD Septic System THIS CERTIFIES THAT .....PER !jg BUILDING INSPECTOR ....................U.!�!! M!�1. .. .. ... ................ Foundation has permission to erect ........... buildings on . �. ...... .. g .. �.....�. . �.�. ........ � ...... .. Rough to be occupied as ...AAf'1^...�!!,f.....�.. .............I..ii�1..........1..�...5i. ..��!!�.. :.. . Chimney Ch' e provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final 3 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR • UNLESS CONSTRUCT T TS Rough Service ............ .... ..... .... ......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE A & D MILLWORK 42 ERIK STREET MERRIMACK,NH 03054 603-765-7020 admillwork@comcast.net FIXED PRICE AGREEMENT DATE: JULY 13, 2012 OWNER'S NAME: MR. & MRS. VERMINSKI ADDRESS: 95 OLYMPIC LANE N. ANDOVER, MA 01845 PHONE: 978-208-8711 PROJECT NUMBER: 1609 I. PARTIES This contract (hereinafter referred to as "agreement") is made and entered into on this thirteenth day of July 2012, by and between Mr. Matthew and Michelle Verminski, (hereinafter referred to as "owner"); and A & D Millwork, (hereinafter referred to as "contractor"). In consideration of the mutual promises contained herein, contractor agrees to perform the following work: II. GENERAL SCOPE OF WORK DESCRIPTION: CONSTRUCTION OF TWO STORY ADDITION, PORTICO AND SHED WITH RENOVATIONS TO THE FOLLOWING AREAS: KITCHEN, BASEMENT/FAMILY ROOM, FIRST FLOOR BATHROOM, SIDING, ROOFING, AND DECK. PREP: SEPARATE ALL OPENINGS BETWEEN WORK AREA AND REST OF HOME WITH 3 MIL. PLASTIC AND PLYWOOD. COVER FAMILY ROOM FLOOR WITH A" HARDBOARD. DEMOLITION: I EXTERIOR: REMOVE EXISTING SCREENED PORCH, EXISTING DECK AND CONCRETE SLAB.INTERIOR: REMOVE SECTION OF BASEMENT WALL TO ACCOMODATE NEW BASEMENT FLOOR PLAN. REMOVE ONE STEEL COLUMN. DEMO AND DISPOSE OF ENTIRE KITCHEN EXPOSING FRAMING. REMOVE FLOOR COVERING IN KITCHEN AND BATHROOM, EXPOSING SUBFLOOR. DEMO SEVERAL SECTIONS OF INTERIOR AND EXTERIOR KITCHEN WALLS TO ACCOMMODATE NEW FLOOR PLAN. EXCAVATION: EXCAVATE SURROUNDING GROUNDS TO ALLOW FOR FOUNDATION. RETURN TO ROUGH GRADE. FOUNDATION: POUR CONCRETE FOUNDATION AND FROST WALL AS PER PLAN. POUR CONCRETE SLABS FOR BASEMENT AND SHED MEETING MA STATE CODE. FRAMING: FRAME NEW TWO STORY ADDITION AS PER PLAN INCLUDING SHED. FRAME PORTICO AROUND FRONT ENTRY DOOR, MATCHING PHOTO SUPPLIED BY OWNER, AS CLOSE AS POSSIBLE. FRAME NEW 12 X 18-20' DECK. INSTALL STRUCTURAL BEAMS IN BASEMENT AND KITCHEN AS PER PLAN. SEE ATTACHED CUT SHEET. FRAME BASEMENT WALLS AS PER PLAN. ALL FRAMING TO MEET MA STATE CODE. ROOFING: REMOVE ALL LAYERS OF ROOFING EXPOSING SHEATHING INSTALL ICE AND WATER SHIELD ON ENTIRE ROOF. INSTALL 30 YEAR ARCHITECTURAL SHINGLE TO MEET MA STATE CODE. COLOR TBD. INSTALL "METAL SALES" -CLASSIC RIB GALVANIZED STEEL ROOFING. COLOR-BLACK. WINDOWS AND DOORS: INSTALL (1 ) NEW 72" FRENCH DOOR. (ATRIUM/ASHWORTH) INSTALL (1 ) NEW 32" FRENCH DOOR. (ATRIUM/ASHWORTH) INSTALL NEW HARVEY VINYL WINDOWS, AS PER PLAN, MATCHING EXISTING AS CLOSE AS POSSIBLE. INSTALL (1 ) NEW GARAGE DOOR TO SIZE IN SHED. INSTALL (1 ) NEW 32" DOOR BETWEEN GARAGE AND SHED. EXTERIOR: REMOVE SIDING, WINDOW TRIM, CORNER BOARDS, GARAGE AND ENTRY DOOR TRIM. REMOVE AND SAVE DOWNSPOUTS TO BE REINSTALLED. WRAP ENTIRE HOUSE, INCLUDING ADDITION WITH TYVEK HOUSEWRAP. TAPE ALL SEAMS. INSTALL SOLID PVC TRIM ON ALL WINDOWS, CORNER BOARDS, ENTRY DOORS AND PORTICO. ENTIRE ADDITION TO BE TRIMMED OUT WITH PVC TRIM. *FRONT FACING WINDOWS TO HAVE CROWN DETAIL. INSTALL CERTAINTEED FIBER CEMENT SIDING WITH 4" EXPOSURE ON ENTIRE HOUSE INCLUDING ADDITION. INSTALL 5/4 X 6" AZEK DECKING. COLOR TO BE CHOSEN FROM THE TERRA COLLECTION. INSTALL S ALL VERANDA COMPOSITE OS RAIL SYSTEM IN WHITE. INSTALL ROLL-AWAY SCREEN ON SINGLE FRENCH DOOR. INSTALL SLIDING SCREEN ON DOUBLE FRENCH DOORS. ELECTRICAL: KITCHEN: REMOVE AND REWORK EXISTING WIRING AS NEEDED. SUPPLY AND INSTALL 8-10, 5" RECESSED LIGHTS. THREE (3) PENDANTS. ONE (1 ) HANGING FIXTURE. RECEPTICALS TO CODE. SUPPLY AND INSTALL FOUR (4) UNDER CABINET LIGHTS. WIRING FOR ALL APPLIANCES AND OUTLETS. THREE (3) DIMMERS. BATHROOM: REMOVE AND REWORK WIRING FOR WASHER/DRYER CLOSET TO CODE. FAMILY ROOM: INSTALL (1 ) ELECTRICAL OUTLET IN EACH LOWER CABINET. INSTALL CONDUIT BETWEEN CABINET OUTLETS AND TV. BASEMENT: SUPPLY AND INSTALL EIGHT (8), 5" RECESSED LIGHTS. RECEPTICALS TO CODE. SUPPLY AND INSTALL LIGHTS FOR NEW MEHANICAL ROOM. ONE (1 ) NEW SMOKE DETECTOR TO BE CONNECTED WITH EXISTING SYSTEM. SHED: SUPPLY AND INSTALL ONE G.F.I. RECEPTICAL TO CODE. INSTALL ONE (1 ) LIGHT AND SWITCH. MISCELLANEOUS: ELECTRICAL PERMIT ALL DEVICES AND MATERIAL NEEDED TO COMPLETE PROJECT. PLUMBING AND HEATING: ALL ROUGH IN WORK AS NECESSARY FOR NEW KITCHEN, BATHROOM AND BASEMENT. RELOCATE GAS LINE, SINK, AND DISHWASHER, AS PER PLAN. INSTALL SECURITY DRAIN FOR WASHING MACHINE. PROVIDE NEW BASEBOARD OR TOE KICK HEAT. INSTALL NEW SINK AND FAUCET IN KITCHEN, SEE ALLOWANCES. INSTALL NEW SINK AND FAUCET IN BATHROOM. BASEMENT: PROVIDE HEAT IN EXISTING BASEMENT AND ADDITION. PLUMBING PERMIT. INSULATION: INSULATE BOTH FLOORS OF ADDITION TO MEET MASS CODE. PLASTER: INSTALL NEW BLUEBOARD AND PLASTER IN THE FOLLOWING AREAS: KITCHEN WALLS AND CEILINGS NEW BATHROOM AREA FINISHED PORTION OF BASEMENT INTERIOR TRIM: KITCHEN AND BASEMENT: INSTALL CASING ON ALL NEW DOORS AND WINDOWS. INSTALL BASEBOARD MOULDING WHERE NEEDED. MOULDINGS TO MATCH EXISTING. INSTALL DOOR INTO MECHANICAL ROOM. SIZE TBD. INSTALL TWO (2) SETS OF SLIDING DOORS FOR CLOSET. SIZE TBD. ALL TRIM AND DOORS TO BE PAINT GRADE. BUILT-INS: FABRICATE AND INSTALL CUSTOM BANQUET SEATING IN KITCHEN NOOK. DESIGN TO BE SUPPLIED BY SWI DESIGNS. FABRICATE AND INSTALL CUSTOM BUILT-IN CABINETRY, SHELVING AND MANTLE UNIT IN FAMILY ROOM. SEE ATTACHED SKETCH. FLOORING: KITCHEN: INSTALL 2 1/4" OAK HARDWOOD FLOORING. TWO COATS OF POLYURETHANE. BATHROOM: INSTALL 12" CERAMIC TILE-SQUARE PATTERN. TILE SUPPLIED BY OWNER. BASEMENT: INSTALL CORK LAMINATE FLOORING. INTERIOR PAINTING: TWO (2) COATS OF BEN. MOORE ON ALL NEW PLASTER AND ENTIRE JOB AREA-WALLS, CEILINGS, TRIM, AND BUILT-INS. CEILING WHITE ON ALL CEILINGS. ONE (1 ) STANDARD COLOR FOR EACH ROOM. CABINETS AND HARDWARE: INSTALL ALL CABINETRY, CABINET TRIM, AS PER DRAWING. ALL CABINETRY SUPPLIED BY OWNER. INSTALL HARDWARE, SUPPLIED BY OWNER, ON ALL CABINETRY. CLEAN-UP: DISPOSE OF ALL WASTE GENERATED BY JOB. CLEAN UP EACH NIGHT AND LEAVE JOB SITE IN A CLEAN "BROOM SWEPT" MANNER. ADDITIONAL SCOPE OF WORK PAGE(S) ATTACHED NO OWNER WILL CHECK SAMPLES AND/OR PICTURES BEFORE INSTALLATION OF MOULDINGS, FLOORING AND PAINT COLORS. NO CREDIT WILL BE GIVEN AFTER INSTALLATION BEGINS. LUMP SUM PRICE FOR ALL WORK ABOVE: $156,712.00 PRICING FOR CUSTOMER SUPPLIED CABINETRY $ 31 ,384.00 ESTIMATED PRICING FOR GRANITE $ 3,000.00 TOTAL: $191 ,096.00 111. GENERAL CONDITIONS FOR THE AGREEMENT ABOVE A. EXCLUSIONS THIS AGREEMENT DOES NOT INCLUDE LABOR OR MATERIALS FOR THE FOLLOWING WORK AT THIS TIME: 1 . STANDARD EXCLUSIONS: UNLESS SPECIFICALLY INCLUDED IN THE "GENERAL SCOPE OF WORK" SECTION ABOVE, THIS AGREEMENT DOES NOT INCLUDE LABOR OR MATERIALS FOR THE FOLLOWING WORK: PLANS, LEGAL FEES, ENGINEERING FEES, OR GOVERNMENTAL PERMITS AND FEES OF ANY KIND. TESTING, REMOVAL AND DISPOSAL OF ANY MATERIALS CONTAINING ASBESTOS (OR ANY OTHER HAZARDOUS MATERIAL AS DEFINED BY THE EPA). CUSTOM MILLING OF ANY WOOD FOR USE IN PROJECT. MOVING OWNER'S PROPERTY AROUND THE SITE. LABOR OR MATERIALS REQUIRED TO REPAIR OR REPLACE ANY OWNER-SUPPLIED MATERIALS. REPAIR OF CONCEALED UNDERGROUND UTILITIES NOT LOCATED ON PRINTS OR PHYSICALLY STAKED OUT BY OWNER, WHICH ARE DAMAGED DURING CONSTRUCTION. SURVEYING THAT MAY BE REQUIRED TO ESTABLISH ACCURATE PROPERTY BOUNDARIES FOR SETBACK PURPOSES (FENCES AND OLD STAKES MAY NOT BE LOCATED ON ACTUAL PROPERTY LINES). FINAL CONSTRUCTION CLEANING (CONTRACTOR WILL LEAVE SITE IN "BROOM SWEPT" CONDITION). LANDSCAPING AND IRRIGATION, PAVING, OR STREET WORK OF ANY KIND. TEMPORARY SANITATION, POWER, OR FENCING. REMOVAL OF SOILS UNDER HOUSE IN ORDER TO OBTAIN 18 INCHES (OR CODE- REQUIRED HEIGHT) OF CLEAR SPACE BETWEEN BOTTOM OF JOISTS AND SOIL. REMOVAL OF FILLED GROUND OR ROCK OR ANY OTHER MATERIALS NOT REMOVABLE BY ORDINARY HAND TOOLS (UNLESS HEAVY EQUIPMENT IS SPECIFIED IN SCOPE OF WORK SECTION ABOVE), CORRECTION OF EXISTING OUT-OF-PLUMB OR OUT-OF-LEVEL CONDITIONS IN EXISTING STRUCTURE. CORRECTION OF CONCEALED SUBSTANDARD FRAMING. REROUTING/REMOVAL OF VENTS, PIPES, DUCTS, STRUCTURAL MEMBERS, WIRING OR CONDUITS, STEEL MESH, WHICH MAY BE DISCOVERED IN THE REMOVAL OF WALLS OR THE CUTTING OF OPENINGS IN WALLS. REMOVAL AND REPLACEMENT OF EXISTING ROT OR INSECT INFESTATION. FAILURE OF SURROUNDING PART OF EXISTING STRUCTURE, DESPITE CONTRACTOR'S GOOD FAITH EFFORTS TO MINIMIZE DAMAGE, SUCH AS PLASTER OR DRYWALL CRACKING AND POPPED NAILS IN ADJACENT ROOMS OR BLOCKAGE OF PIPES OR PLUMBING FIXTURES CAUSED BY LOOSENED RUST WITHIN PIPES; CONSTRUCTION OF A CONTINUOUSLY LEVEL FOUNDATION AROUND STRUCTURE (IF LOT IS SLOPED MORE THAN 6 INCHES FROM FRONT TO BACK OR SIDE TO SIDE, CONTRACTOR WILL STEP THE FOUNDATION IN ACCORDANCE WITH THE SLOPE OF THE LOT). EXACT MATCHING OF EXISTING FINISHES, PUBLIC OR PRIVATE UTILITY CONNECTION FEES. REPAIR OF DAMAGE TO ROADWAYS, DRIVEWAYS, OR SIDEWALKS THAT COULD OCCUR WHEN CONSTRUCTION EQUIPMENT AND VEHICLES ARE BEING USED IN THE NORMAL COURSE OF CONSTRUCTION. ADDITIONAL AND/ OR JOB SPECIFIC EXCLUSIONS: ABOVE PRICE DOES NOT INCLUDE COST OF BUILDING PERMIT. TO BE PAID BY OWNER ONCE COST IS DETERMINED. B. ALLOWANCES: STAINLESS STEEL SINK: $400.00 FAUCET: $200.00 C. DATE OF WORK COMMENCEMENT AND SUBSTANTIAL COMPLETION COMMENCE WORK: LATE JULY 2012 WITHIN TWO (2) WEEKS OF BUILDING PERMIT APPROVAL. CONSTRUCTION TIME THROUGH SUBSTANTIAL COMPLETION: APPROXIMATELY 5 - 7 MONTHS, NOT INCLUDING DELAYS AND ADJUSTMENTS FOR DELAYS CAUSED BY: INCLEMENT WEATHER ADDITIONAL TIME REQUIRED FOR CHANGE ORDER WORK, AND OTHER DELAYS UNAVOIDABLE OR BEYOND THE CONTROL OF THE CONTRACTOR. D. CHANGE ORDERS: CONCEALED CONDITIONS AND ADDITIONAL WORK 1 . CONCEALED CONDITIONS: THIS AGREEMENT IS BASED SOLELY ON THE OBSERVATIONS CONTRACTOR WAS ABLE TO MAKE WITH THE STRUCTURE IN ITS CURRENT CONDITION AT THE TIME THIS AGREEMENT WAS BID. IF ADDITIONAL CONCEALED CONDITIONS ARE DISCOVERED ONCE WORK HAS COMMENCED WHICH WERE NOT VISIBLE AT THE TIME THIS PROPOSAL WAS BID, CONTRACTOR WILL STOP WORK AND POINT OUT THESE UNFORESEEN CONCEALED CONDITIONS TO OWNER SO THAT OWNER AND CONTRACTOR CAN EXECUTE A CHANGE ORDER FOR ANY ADDITIONAL WORK. I 2. DEVIATION FROM SCOPE OF WORK: ANY ALTERATION OR DEVIATION FROM THE SCOPE OF WORK REFERRED TO IN THIS AGREEMENT INVOLVING EXTRA COSTS OF MATERIALS OR LABOR (INCLUDING ANY OVERAGE ON ALLOWANCE WORK AND ANY CHANGES IN THE SCOPE OF WORK REQUIRED BY GOVERNMENTAL PLAN CHECKERS OR FIELD BUILDING INSPECTORS) WILL BE EXECUTED UPON A WRITTEN CHANGE ORDER ISSUED BY CONTRACTOR AND SHOULD BE SIGNED BY CONTRACTOR AND OWNER PRIOR TO THE COMMENCEMENT OF ADDITIONAL WORK BY THE CONTRACTOR. CONTRACTOR TO SUPERVISE, COORDINATE, AND CHARGE 25% PROFIT AND OVERHEAD ON OWNER'S SEPARATE SUBCONTRACTORS WHO ARE WORKING ON SITE AT SAME TIME AS CONTRACTOR. CONTRACTOR'S PROFIT AND OVERHEAD, AND ANY SUPERVISORY LABOR WILL NOT BE CREDITED BACK TO OWNER WITH ANY DEDUCTIVE CHANGE ORDERS (WORK DELETED FROM AGREEMENT BY OWNER) THROUGH THE CURRENT PAYMENT PERIOD. E. PAYMENT SCHEDULE AND PAYMENT TERMS 1 . PAYMENT SCHEDULE: PAYMENTS DUE UPON SUBSTANTIAL COMPLETION OF THE FOLLOWING JOB PHASES. DUE TO THE DYNAMIC NATURE OF RENOVATIING, PAYMENTS MAY NOT ALWAYS FALL IN THE ORDER THEY APPEAR BELOW. $ 2,500.00 - DUE WHEN AGREEMENT IS SIGNED. $23,000.00 - MATERIALS DEPOSIT DUE TWO (2) WEEKS PRIOR TO STARTASSUANCE OF BUILDING PERMIT. $ 79000.00 - DUE UPON COMPLETION OF EXTERIOR DEMO. (DECK AND SUNROOM $ 8,000.00 - DUE UPON COMPLETION OF EXCAVATION FOR FOUNDATION. $10,000.00 - DUE UPON POURING OF FOUNDATION. $ 8,000.00 - DUE UPON FRAMING OF BASEMENT. $12,000.00 - DUE UPON FRAMING OF ADDITION AND INTERIOR RE- WORK. $ 7,000.00 - DUE UPON FRAMING OF DECK AND SHED. $ 3,000.00 - DUE UPON ROOFING OF ADDITION. $ 8,000.00 - DUE UPON INSTALLATION OF WINDOWS AND EXTERIOR DOORS. $ 6,000.00 - DUE UPON COMPLETION OF REAR SIDING. $ 8,000.00 - DUE UPON COMPLETION OF ROUGH $ 8,000.00 - DUE UPON COMPLETION OF ROUGH ELECTRICAL. 5,000.00 - DUE UPON COMPLETION OF INSULATION. $ 6,000.00 - DUE UPON COMPLETION OF PLASTER. $ 8,000.00 - DUE UPON INSTALLATION OF KI CABINETS.CHEN CABfNET $10,000.00 -� DUE UPON COMPLETION OF INTERIOR TRIM TRIM AND BUILT-INS. $8,000.00 - DUE UPON COMPLETION OF EXTERIOR PAINTING AND TRIM. $ 9,212.00 - DUE UPON COMPLETION OF PUNCH LIST. 2. PAYMENT OF CHANGE ORDERS: PAYMENT FOR EACH CHANGE ORDER IS DUE WHEN THE WORK IS AUTHORIZED BY OWNER AND CONTRACTOR SUBMITS INVOICE. 3. ADDITIONAL PAYMENTS FOR ALLOWANCE WORK AND RELATED CREDITS: PAYMENT FOR WORK DESIGNATED IN THE AGREEMENT AS ALLOWANCE WORK HAS BEEN INITIALLY FACTORED INTO THE LUMP SUM PRICE AND PAYMENT SCHEDULE SET FORTH IN THIS EMENT. I THE ACTUAL COST OF THE ALLOWANCE WORK EXCEEDS THE ALLOWANCE AMOUNT IN THE AGREEMENT, THE DIFFERENCE BETWEEN THE COST AND THE LINE ITEM ALLOWANCE AMOUNT STATED IN THE AGREEMENT WILL BE WRITTEN UP BY CONTRACTOR AS A CHANGE ORDER SUBJECT TO CONTRACTOR'S PROFIT AND OVERHEAD AT THE RATE OF 25%. IF THE COST OF THE ALLOWANCE WORK IS LESS THAN THE ALLOWANCE LINE ITEM AMOUNT LISTED IN THE AGREEMENT, A CREDIT WILL BE ISSUED TO OWNER AFTER ALL BILLINGS RELATED TO THIS PARTICULAR LINE ITEM ALLOWANCE WORK HAVE BEEN RECEIVED BY CONTRACTOR. THIS CREDIT WILL BE APPLIED TOWARD THE FINAL PAYMENT OWING UNDER THE AGREEMENT. CONTRACTOR PROFIT AND OVERHEAD AND ANY SUPERVISORY LABOR WILL NOT BE CREDITED BACK TO OWNER FOR ALLOWANCE WORK. F. WARRANTY CONTRACTOR PROVIDES A LIMITED WARRANTY ON ALL CONTRACTOR- AND SUBCONTRACTOR-SUPPLIED LABOR AND MATERIALS USED IN THIS PROJECT FOR A PERIOD OF EIGHTEEN MONTHS FOLLOWING SUBSTANTIAL COMPLETION OF ALL WORK. NO WARRANTY IS PROVIDED BY CONTRACTOR ON ANY MATERIALS FURNISHED BY THE OWNER FOR INSTALLATION. NO WARRANTY IS PROVIDED ON ANY EXISTING MATERIALS THAT ARE MOVED AND/OR REINSTALLED BY THE CONTRACTOR WITHIN THE DWELLING (INCLUDING ANY WARRANTY THAT EXISTING/USED MATERIALS WILL NOT BE DAMAGED DURING THE REMOVAL AND REINSTALLATION PROCESS). ONE YEAR AFTER SUBSTANTIAL COMPLETION OF THE PROJECT, THE OWNER'S SOLE REMEDY (FOR MATERIALS AND LABOR) ON ALL MATERIALS THAT ARE COVERED BY A MANUFACTURER'S WARRANTY IS STRICTLY WITH THE MANUFACTURER, NOT WITH THE CONTRACTOR. REPAIR OF THE FOLLOWING ITEMS IS SPECIFICALLY EXCLUDED FROM CONTRACTOR'S WARRANTY: DAMAGES RESULTING FROM LACK OF OWNER MAINTENANCE; DAMAGES RESULTING FROM OWNER ABUSE OR ORDINARY WEAR AND TEAR; DEVIATIONS THAT ARISE SUCH AS THE MINOR CRACKING OF CONCRETE, STUCCO AND PLASTER; MINOR STRESS FRACTURES IN DRYWALL DUE TO THE CURING OF LUMBER; WARPING AND DEFLECTION OF WOOD; SHRINKING/CRACKING OF GROUTS AND CAULKING; FADING OF PAINTS AND FINISHES EXPOSED TO SUNLIGHT. THE EXPRESS WARRANTIES CONTAINED HEREIN ARE IN LIEU OF ALL OTHER WARRANTIES, EXCEPT WARRANTY OF HABITABILITY EXPRESS OR IMPLIED, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, OR FITNESS FOR A PARTICULAR USE OR PURPOSE. THIS LIMITED WARRANTY EXCLUDES CONSEQUENTIAL AND INCIDENTAL DAMAGES AND LIMITS THE DURATION OF IMPLIED WARRANTIES TO THE FULLEST EXTENT PERMISSIBLE UNDER STATE AND FEDERAL LAW. G. WORK STOPPAGE, TERMINATION OF CONTRACT FOR DEFAULT, AND INTEREST CONTRACTOR SHALL HAVE THE RIGHT TO STOP ALL WORK ON THE PROJECT AND KEEP THE JOB IDLE IF PAYMENTS ARE NOT MADE TO CONTRACTOR IN ACCORDANCE WITH THE PAYMENT SCHEDULE IN THIS AGREEMENT, OR IF OWNER REPEATEDLY FAILS OR REFUSES TO FURNISH CONTRACTOR WITH ACCESS TO THE JOB SITE AND/OR PRODUCT SELECTIONS OR INFORMATION NECESSARY FOR THE ADVANCEMENT OF CONTRACTOR'S WORK. SIMULTANEOUS WITH STOPPING WORK ON THE PROJECT, THE CONTRACTOR MUST GIVE OWNER WRITTEN NOTICE OF THE NATURE OF OWNER'S DEFAULT AND MUST ALSO GIVE THE OWNER A 14- DAY PERIOD IN WHICH TO CURE THIS DEFAULT. IF WORK IS STOPPED DUE TO ANY OF THE ABOVE REASONS (OR FOR ANY OTHER MATERIAL BREACH OF CONTRACT BY OWNER) FOR A PERIOD OF 14 DAYS, AND THE OWNER HAS FAILED TO TAKE SIGNIFICANT STEPS TO CURE HIS DEFAULT, THEN CONTRACTOR MAY, WITHOUT PREJUDICING ANY OTHER REMEDIES CONTRACTOR MAY HAVE, GIVE WRITTEN NOTICE OF TERMINATION OF THE AGREEMENT TO OWNER AND DEMAND PAYMENT FOR ALL COMPLETED WORK AND MATERIALS ORDERED THROUGH THE DATE OF WORK STOPPAGE, AND ANY OTHER LOSS SUSTAINED BY CONTRACTOR, INCLUDING CONTRACTOR'S PROFIT AND OVERHEAD AT THE RATE OF 25% ON THE BALANCE OF THE PAYMENT PERIOD UNDER THE AGREEMENT. THEREAFTER, CONTRACTOR IS RELIEVED FROM ALL OTHER CONTRACTUAL DUTIES, INCLUDING ALL PUNCH LIST AND WARRANTY WORK. H. DISPUTE RESOLUTION AND ATTORNEY'S FEES ANY CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THIS AGREEMENT INVOLVING AN AMOUNT OF LESS THAN $5,000 (OR THE MAXIMUM LIMIT OF THE COURT) MUST BE HEARD IN THE SMALL CLAIMS DIVISION OF THE MUNICIPAL COURT IN THE COUNTY WHERE THE CONTRACTOR'S OFFICE IS LOCATED. ANY CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THIS AGREEMENT WHICH IS OVER THE DOLLAR LIMIT OF THE SMALL CLAIMS COURT MUST BE SETTLED BY BINDING ARBITRATION ADMINISTERED BY THE AMERICAN ARBITRATION ASSOCIATION IN ACCORDANCE WITH THE CONSTRUCTION INDUSTRY ARBITRATION RULES. JUDGMENT UPON THE AWARD MAY BE ENTERED IN ANY COURT HAVING JURISDICTION THEREOF. THE PREVAILING PARTY IN ANY LEGAL PROCEEDING RELATED TO THIS AGREEMENT SHALL BE ENTITLED TO PAYMENT OF REASONABLE ATTORNEY'S FEES, COSTS, AND EXPENSES. THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT THE CONTRACTOR HAS A DISPUTE CONCERNING THIS CONTRACT, THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION PROVIDED IN MGL.142A. OW 'S SIGNATU CONTRACTOR'S SIGNATURE: NOTICE: THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO AGREEMENT OF THE PARTIES ALTERNATE DISPUTE RESOLUTION INITIATED BY CONTRACTOR. THE OWNER MAY INITIATE ALTERNATE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SIGNED BY THE PARTIES. I. EXPIRATION OF THIS AGREEMENT THIS AGREEMENT WILL EXPIRE 30 DAYS AFTER THE DATE AT THE TOP OF PAGE ONE OF THIS AGREEMENT IF NOT FIRST ACCEPTED IN WRITING BY OWNER. J. ENTIRE AGREEMENT THIS AGREEMENT REPRESENTS AND CONTAINS THE ENTIRE AGREEMENT BETWEEN THE PARTIES. PRIOR DISCUSSIONS OR VERBAL REPRESENTATIONS BY THE PARTIES THAT ARE NOT CONTAINED IN THIS AGREEMENT ARE NOT A PART OF THIS AGREEMENT. I HAVE READ AND UNDERSTOOD, AND I AGREE TO, ALL THE TERMS AND CONDITIONS CONTAINED IN THE AGREEMENT ABOVE. D�ATt� ONTRACTOR'S SIGNATURE DATE OWNER'S SIGNATURE i Generated by REScheck-Web Software Compliance Certificate Project Title: 95 Olympic Ave N. Andover Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6322 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: Compliance:7.4%Better Than Code Maximum UA:122 Your UA:113 The%Better or Worse Than Code index reflects how Gose to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. • • • �•• • Basement:Solid Concrete or Masonry 220 15.0 0.0 13 Wall height:7.6' Depth below grade:6.0' Insulation depth:7.6' Floor.Unheated Slab-On-Grade 42 12.0 28 Insulation depth:4.0' Floor.Unheated Slab-On-Grade 2 1.1 2 Insulation depth:0.0' Wall:Wood Frame,16in.o.c. 315 21.0 0.0 18 Wall:Wood Frame,16in.o.c. 315 21.0 0.0 12 Window:Vinyl Frame,2 Pane w/Low-E 43 0.300 13 Window:Vinyl Frame,2 Pane w/Low-E 44 0.300 13 Door:Glass 24 0.300 7 Ceiling:Flat or Scissor Truss 220 38.0 0.0 7 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. (—'4S�Hc%1 2 _ -e s�G-O&c Ju '� ;?0/,4,- Name-title Signature Date Project Notes: Kitchen Addition and Basement finishing Project Title: 95 Olympic Ave N.Andover Report date: 07/12/12 Data filename: Page 1 of 4 4 Y Generated by REScheck-Web Software Inspection Checklist Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6322 Climate Zone: 5 Ceilings: ❑ Ceiling:Flat or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall:Wood Frame,16in.o.c.,R-21.0 cavity insulation Comments: ❑ Wall:Wood Frame,16in.o.c.,R-21.0 cavity insulation Comments: Basement Walls: ❑ Basement:Solid Concrete or Masonry,7.6'ht/6.0'bg/7.6'insul,R-15.0 cavity insulation Comments: Windows: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor:0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor:0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door:Glass,U-factor:0.300 Comments: Floors: ❑ Floor:Unheated Slab-On-Grade,4.0'insulation depth,R-12.0 continuous insulation Comments: Slab insulation extends down from the top of the slab to at least 4.0 ft.OR down to at least the bottom of the slab then horizontally for a total distance of 4.0 ft. ❑ Floor:Unheated Slab-On-Grade,0.0'insulation depth,R-1.1 continuous insulation Comments: Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. Project Title: 95 Olympic Ave N.Andover Report date: 07/12/12 Data filename: Page 2 of 4 Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. Wood-burning fireplaces have gasketed doors and outdoor combustion air. Lj Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Air Sealing and Insulation: L1 Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 50 pascals OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. (f) Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight LI-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Materials Identification and Installation: Lj Materials and equipment are installed in accordance with the manufacturer's installation instructions. Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. U Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: LI Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: Lj Building framing cavities are not used as supply ducts. Lj All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). Lj Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area. (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2. (3)Rough-in total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area. (4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area. Temperature Controls: L] Where the primary heating system is a forced air-fumace,at least one programmable thermostat is installed to control the primary heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle. L1 Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the compressor can meet the heating load. Heating and Cooling Equipment Sizing: Project Title: 95 Olympic Ave N.Andover Report date: 07/12/12 Data filename: Page 3 of 4 a Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: Lj Circulating service hot water pipes are insulated to R-2. L] Circulating service hot water systems include an automatic or accessible manual switch to tum off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: Lj HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Lj Heated swimming pools have an on/off heater switch. a Pool heaters operating on natural gas or LPG have an electronic pilot light. Cj Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Lj Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage—15 (d)50 lumens per watt for lamp wattage>15 and—40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement V). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: 95 Olympic Ave N.Andover Report date: 07/12/12 Data filename: Page 4 of 4 2009 IECC [energy Efficiency Certificate Ceiling I Roof 38.00 Wall 21.00 Floor!Foundation 15.00 Ductwork(unconditioned spaces): a... WON Window 0.30 Door 0.30 NA Heating System: Cooling System: Water Heater: Name: Date: Comments: Dankers Structural Consulting,LLC Title: Vermanski Residence Job#12062 1-6 Kenney Road Engineer. Imants Dankers,P.E. Medfield,MA 02052 Project Desc,: Renovation-95 Olympic Lane,North Andover,MA 508-359-4075 Punted:16 OCT 2012,7:12AM ®oi)� Beam File:C:MSCMSC Proiects112062 VemFinsid Residence 95 Olympic Lane N Andover MAICdcs112062.ec6 ENERCALC,INC.1983-2012,Bidd:6.12.9.13,Ver.6.12.9.13 Description: Basement Center Beam B3 CODE REFERENCES Calculations per NDS 2005, IBC 2006, CBC 2007,ASCE 7-05 Load Combination Set:20061BC&ASCE7-05 Material Properties Analysis Method: Allowable Stress Design Fb-Tension 3,100.0 psi E:Modulus of Elasticrfy Load Combination 2006IBC&ASCE7-05 Fb-Compr 3,100.0 psi Ebend-xx 2,000.Oksi Fc-Pdl 3,000.0 psi Eminbend-xx 2,000.0ksi Wood Species :Boise Cascade Fc-Perp 750.0 psi Wood Grade :Versa Lam 3100 Fv 285.0 psi Ft 2,100.0 psi Density 32.210 pcf Beam Bracing : Beam is Fully Braced against lateral-torsion buckling ---..- - ... -------- ------ - ---- --- -- - -------------- ----- ----, D 0.096 L 0.24 i D(0. 04) D 0.12 L 0.36 D(0104) 04 D(O.14 L(0.6) I j f i t t 1 7x11.875 - i Span=12.50 ft Applied Loads Service loads entered.Load Factors will be applied for calculations. Beam self weight calculated and added to loads Uniform Load: D=0.010, L=0.050 ksf, Tributary Width=12.0 ft,(First Floor) Uniform Load: D=0.1040, Tributary Width=1.0 ft,(wall) Uniform Load: D=0.010, L=0.030 ksf, Tributary Width=i 2.0 ft,(Second Floor) Uniform Load: D=0.1040, Tributary Width=1.0 ft,(wall) Uniform Load: D=0.0080, L=0.020 ksf, Tributary Width=12.0 ft,(Attic) DESIGN SUMMARY Maximum Bending Stress Ratio = 0.8091 Maximum Shear Stress Ratio = 0.593 : 1 Section used for this span 7x11,875 Section used for this span 7x11.875 to:Actual 21508.91 psi fv:Actual = 168.90 psi FB:Allowable 3,100.00psi Fv:Allowable 285.00 psi Load Combination +D+L+H Load Combination +`D+L+H Location of maximum on span = 6.250ft Location of maximum on span = 11.563 ft Span#where maximum occurs = Span#1 Span#where maximum occurs = Span#1 i Maximum Deflection Max Downward L+Lr+S Deflection 0.340 in Ratio= 441 i Max Upward L+Lr+S Deflection 0.000 In Ratio= 0 <360 s Max Downward Total Deflection 0.499 in Ratio= 300 i Max Upward Total Deflection 0.000 in Ratio= 0 <240 f i Maximum Forces&Stresses for Load Combinations Load Combination Max Stress Ratios Moment Values Shear Values Segment Length Span# M V Cd C FN Ci Cr C m C t CL M fb Fb V fv Fv +D 0.00 0.00 0.00 0.00 Length=12.50 ft 1 0.258 0.189 1.00 1.00 1.00 1.00 1.00 1.00 1.00 10.99 800,82 3100.00 2.99 53.91 285.00 +D+L+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=12.50 ft 1 0.809 0.593 1.00 1.00 1.00 1.00 1.00 1.00 1.00 34.43 2,508.91 3100.00 9.36 168.90 285.00 +D+0.750Lr+0.750L+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=12.50 ft 1 0.672 0.492 1.00 1.00 1.00 1.00 1.00 1.00 1.00 28.57 2,081.89 3100.00 7.77 140.15 285.00 +M.750L+0.750S+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Dankers Structural Consulting,LLC Title: Vermanski Residence Job# 12062 46 Onney Road Engineer: Imants Dankers,P.E. Medfield,MA 02052 Project Desa.: Renovation 508-359-4075 Printed:17 OCT 2012,9:30AM Wood Beam Re:C USCIDSC ProjedMI2062 Vemimsl6 Residence 95 Olympic Lane N Andover MAIC&s112062.ec6 ENERCALC,INC.1983-2012,Bdd:6.12.9.13,Ver.6.12.9.13 EMS0.9i, " i gwalsdill Description: Basement Center Beam B3 Load Combination Max Stress Ratios Moment Values Shear Values Segment Length Span# M V C d C FN C i C r C m C t C L M fb Pb V fV F'v Length=12.50 ft 1 0.672 0.492 1.00 1.00 1.00 1.00 1.00 1.00 1.00 28.57 2,081.89 3100.00 7.77 140.15 285.00 +D+0.750Lr+0.750L+0.750W+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=12.50 ft 1 0.672 0.492 1.00 1.00 1.00 1.00 1.00 1.00 1.00 28.57 2,081.89 3100.00 7.77 140.15 285.00 +D+0.750L+0.750S+0.750W+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=12.50 ft 1 0.672 0.492 1.00 1.00 1.00 1.00 1.00 1.00 1.00 28.57 2,081.89 3100.00 7.77 140.15 285.00 +D+0.750Lr+0.750L+0.5250E+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=12.50 ft 1 0.672 0.492 1.00 1.00 1.00 1.00 1.00 1.00 1.00 28.57 2,081.89 3100.00 7.77 140.15 285.00 +D+0,750L+0.750S+0.5250E+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=12.50 ft 1 0.672 0.492 1.00 1.00 1.00 1.00 1.00 1.00 1.00 28.57 2,081.89 3100.00 7.77 140.15 285.00 Overall Maximum Deflections-Unfactored loads Load Combination Span Max.""Defl Location in Span Load Combination Max."+"Defl Location in Span D+L 1 0.4989 6.313 0.0000 0.000 Vertical Reactions-Unfactored Support notation:Far left is#1 Values in KIPS Load Combination Support 1 Support 2 Overall MAXimum 11.016 11.016 D Only 3.516 3.516 L Only 7.500 7.500 D+L 11.016 11.016 OF MgSs�cyG 0 KERS pA� a o S1RU •3T36B L Plo A�- gt��1.7 Dankers Structural Consulting,LLC Title: Vermanski Residence Job#12062 g 46 Kenney Road Engineer. Imants Dankers P.E. Medfield,MA 02052 Project Desc.; Renovation-95 Olympic Lane,North Andover,MA 508-359-4075 Printed:18 OCT 2012,7:09AM Wood Beam He:C1DSC1DSC Prolects112062 Verrninski Residence 95 Olympic Lane N Andover MA%CaW12062.ec6 ENERCALC,INC.1983-2012,Bmld:6.12.9.13,Ver.6.12.9.13 o.oa.•. _ - -- e • a e , e Description; Basement Beam B1-Exterior Wall CODE REFERENCES Calculations per NDS 2005, IBC 2006, CBC 2007,ASCE 7-05 Load Combination Set: 20061BC&ASCE7-05 Material Properties Analysis Method: Allowable Stress Design Fb-Tension 3,100.0 psi E:Modulus of Elasticity Load Combination 20061BC&ASCE7-05 Fb-Compr 3,100.0 psi Ebend-xx 2,000.Oksi Fc-Pril 3,000.0 psi Eminbend-xx 2,000.Oksi Wood Species ;Boise Cascade Fc-Perp 750.0 psi Wood Grade :Versa Lam 3100 Fv 285.0 psi Ft 2,100.0 psi Density 32.210 pcf Beam Bracing : Beam is Fully Braced against lateral-torsion buckling ---------- --- -- ---._...----------------- --- ------ - - --- --- ------- ---- ----- - --- ---- D(3.16)L(2.48) S(3.92) ! i D 0.11)L 0.44 I i F f I r } 5.25x11.875 L --- _ Span= 10.0 ft Applied Loads Service loads entered.Load Factors will be applied for calculations. Beam self weight calculated and added to loads Uniform Load: D=0.010, L=0.040 ksf, Tributary Width=11.0 ft,(First Floor Loads) Point Load: D=3.160, L=2.480, S=3.920 k(a)3.50 ft,(post load) DESIGN SUMMARY n o 'Maximum Bending Stress Ratio = 0.730 1 Maximum Shear Stress Ratio = 0.592 : 1 i Section used for this span 5.25x11.875 Section used for this span 5.25x11.875 fb:Actual = 2,263.35psi fv:Actual 168.72 psi FB:Allowable = 3,100.00psi Fv:Allowable = 285.00 psi Load Combination +0+0.750L+0.750S+H Load Combination +D+0.750L+0.750S+H E Location of maximum on span = 3.500 ft Location of maximum on span = 0.000 ft I j Span#where maximum occurs = Span#1 Span#where maximum occurs = Span#1 l Maximum Deffection Max Downward L+Lr+S Deflection 0.208 in Ratio= 576 Max Upward L+Lr+S Deflection 0.000 in Ratio= 0 <360 Max Downward Total Deflection 0.297 in Ratio= 404 Max Upward Total Deflection 0.000 In Ratio= 0 <240 I E Maximum Forces&Stresses for Load Combinations Load Combination Max Stress Ratios Moment Values Shear Values Segment Length Span# M V C d C FN C i. Cr Cm C t C L M fb Pb V fv Fv +D 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.270 0.216 1.00 1.00 1.00 1.00 1.00 1.00 1.00 8.60 836.27 3100.00 2.56 61.50 285.00 +0.+L+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 It 1 0.604 0.502 1.00 1.00 1.00 1.00 1.00 1.00 1.00 19.25 1,871.73 3100.00 5.95 143.16 285.00 +D+S+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.550 0.431 1.00 1.00 1.00 1.00 1.00 1.00 1.00 17.52 1,703.58 3100.00 5.10 122.80 285.00 +D+0.750Lr*0.750L+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.520 0.431 1.00 1.00 1.00 1.00 1.00 1.00 1.00 16.58 1,612.87 3100.00 5.10 122.74 285.00 +D+0.750L+0.7508+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.730 0.592 1.00 1.00 1.00 1.00 1.00 1.00 1.00 23.27 2,263.35 3100.00 7.01 168.72 285.00 Dankers Structural Consulting,LLC Title: Vermanski Residence Job# 12062 'r6 Kenney Road Engineer: Imants Dankers,P.E. Medfield,MA 02052 Project Desc.: Renovation 508-359-4075 Printed:16 OCT 2012 4:13PM ®®� Bea 191 File:C:IDSC1oSC Pr1ects112062 Vern insid Residence 95 Olympic Lane N AndwerMA1Cdcs112062.ec6 ENERCALC,INC.1983-201Z Bmld.6.112.9.13,Ver.8.12.9.13 Description: Second Floor B2-Existwall ataddition Load Combination Max Stress Ratios Moment Values Shear Values Segment Length Span# M V Cd C IN C i C r C m C t C L M fb Pb V fV PV +D+0.750Lr+0.750L+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.526 0.405 1.00 1.00 1.00 1.00 1.00 1.00 1.00 25.70 1,631.96 3100.00 4.84 115.31 285.00 +D+0.750L+0.750S+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.795 0.611 1.00 1.00 1.00 1.00 1.00 1.00 1.00 38.82 2,464.86 3100.00 7.31 174.16 285.00 +D*0.750Lr+0.750L+0.750W+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.526 0.405 1.00 1.00 1.00 1.00 1.00 1.00 1.00 25.70 1,631.96 3100.00 4.84 115.31 285.00 +D+0.750L+0.750S+0.750W+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.795 0.611 1.00 1.00 1.00 1.00 1.00 1.00 1.00 38.82 2,464.86 3100.00 7.31 174.16 285.00 +D+0.750Lr+0.750L+0.5250E+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.526 0.405 1.00 1.00 1.00 1.00 1.00 1.00 1.00 25.70 1,631.96 3100.00 4.84 115.31 285.00 +D+0.750L+0.750S+0.5250E+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.795 0.611 1.00 1.00 1.00 1.00 1.00 1.00 1.00 38.82 2,464.86 3100.00 7.31 174.16 285.00 Overall Maximum Deflections-Unfactored Loads Load Combination Span Max.""Defl Location in Span Load Combination Max."+"Defl Location in Span D+L+S 1 0.7983 9.006 0.0000 0.000 Veftical Reactions-Unfactored Support notation:Far left is#1 Values in KIPS Load Combination Support 1 Support 2 Overall MAXimum 10.558 10.558 D Only 3.157 3.157 L Only 3.477 3.477 S Only 3.923 3.923 L+S 7.401 7.401 D+L 6.635 6.635 D+S 7.081 7.081 D+L+S 10.558 10.558 OF MAss�cy GJ, o STRUCTUf�L v� v tyo.33669 jo�Z���� i Dankers Structural Consulting,LLC Title: Vermanski Residence Job#12062 g Kenney Road Engineer. Imants Dankers,P.E. Medfield,MA 02052 Project Desc.; Renovation-95 Olympic Lane,North Andover,MA 508-359-4075 Pdnted:18OCT 2012,7:11AM Wood Beam! File:C'DSCMSC"ects112062 VenTdnsld Residence 95 01yT*c Lane N Andover MAICdcsI12062.ec6 ENERCALC,INC.1983-2012,Bdd:6.12.9.13,Ver.6.12.9.13 o.ae. a' • Description: Second Floor B2-Exist wall at addition CODE REFERENCES Calculations per NDS 2005, IBC 2006, CBC 2007,ASCE 7-05 Load Combination Set: 20061BC&ASCE7-05 Mateda4 Properties Analysis Method: Allowable Stress Design Fb-Tension 3,100.0 psi E:Modulus of Elasticity Load Combination 20061BC&ASCE7-05 Fb-Compr 3,100.0 psi Ebend-xx 2,000.Oksi Fc-Prll 3,000.0 psi Eminbend-xx 2,000.Oksi Wood Species :Boise Cascade Fc-Perp 750.0 psi Wood Grade :Versa Lam 3100 Fv 285.0 psi Ft 2,100.0 psi Density 32.210pcf Beam Bracing : Beam is Fully Braced against lateral-torsion buckling i D 0.06 S 0.24 D 0.03 Q0.1) D 0.05 S D.2 i D 0.035 L 0.05 { D(0.06)L(0.24) t F 3.5x18 C L- -- ... - ------ ------- ------- -----------Span=17.833 ft---- -- -- - - - ----- -... -----------------' Applied Loads Service loads entered.Load Factors will be applied for calculations. Beam self weight calculated and added to loads Uniform Load: D=0.010, L=0.040 ksf, Tributary Width=6.0 ft,(Second Floor Loads) Uniform Load: D=0.0070, L=0.010 ksf, Tributary Width=5.0 ft,(addition ceiling) Uniform Load: D=0.010, S=0.040 ksf, Tributary Width=5.0 ft,(addition roof) Uniform Load: D=0.0070, L=0.020 ksf, Tributary Width=5.0 ft,(main attic) Unitorm Load: D=0.010, S=0.040 ksf, Tributary Width=6.0 ft,(main roof) Uniform Load: D=010, Tributary Width=1.0 ft,(exterior wall) DESIGN SUMMARY - o 'Maximum Bending Stress Ratio = 0.7951 Maximum Shear Stress Ratio = 0.611 : 1 Section used for this span 3,5x18 Section used for this span 3.5x18 fb:Actual = 2,464.86 psi fv:Actual = 174.16 psi FB:Allowable = 3,100.00psi Fv:Allowable = 285.00 psi s Load Combination +D+0.750L+0.750S+H Load Combination +D+0.750L+0.750S+H Location of maximum on span = 8.917 ft Location of maximum on span = 0.000 ft Span#where maximum occurs = Span#1 Span#where maximum occurs = Span#1 t Maximum Deflection i I Max Downward L+Lr+S Deflection 0.560 in Ratio= 382 Max Upward L+Lr+S Deflection 0.000 in Ratio= 0 <360 i Max Downward Total Deflection 0.798 in Ratio= 268 Max Upward Total Deflection 0.000 in Ratio= 0 <240 w I ! Maximum Forces&Stresses for Load Combinations Load Combination Max Stress Ratios Moment Values Shear Values Segment Length Span# M V C d C FN C i Cr C m C t C L M fb Fb V fv Fv +D 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.288 0.222 1.00 1.00 1.00 1.00 1.00 1.00 1.00 14.08 893.71 3100.00 2.65 63.15 285.00 +D+L+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.606 0.466 1.00 1.00 1.00 1.00 1.00 1.00 1.00 29.58 1,878.04 3100.00 5.57 132.69 285.00 j +0+S+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=17.833 ft 1 0.647 0.497 1.00 1.00 1.00 1.00 1.00 1.00 1.00 31.57 21004.24 3100.00 5.95 141.61 285.00 I Dankers Structural Consulting,LLC Title: Vermanski Residence Job# 12062 46 Kenney Road Engineer: Imants Dankers,P.E. Medfield,MA 02052 Project Desc.: Renovation 508-359-4075 ftted:17OCT 2012,9:28AM Wood Beam File:C:IDSCIDSC Proiects112062 Va rim*Residence95 Olympic Lane N Andover MAICalcs112062.ec6 ENERCALC,INC.1983-2012,Bdild:6.12.9.13,Vec6.12.9.13 e.�a. e, Description: Basement Beam B1-Exterior Wall Load Combination Max Stress Ratios Moment Values Shear Values Segment Length Span# M V C d C FN C i Cr C m C t C L M tb F'b V fv Fv +D+0.750Lr+0.750L+0.750W+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.520 0.431 1.00 1.00 1.00 1.00 1.00 1.00 1.00 16.58 1,612.87 3100.00 5.10 122.74 285.00 +D+0.750L+0.750S+0.750W+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.730 0.592 1.00 1.00 1.00 1.00 1.00 1.00 1.00 23.27 2,263.35 3100.00 7.01 168.72 285.00 +0+0.750Lr-+0.750L-+0.5250E+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.520 0.431 1.00 1.00 1.00 1.00 1.00 1.00 1.00 16.58 1,612.87 3100.00 5.10 122.74 285.00 +D+0.750L+0.750S+0.5250E+H 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.00 Length=10.0 ft 1 0.730 0.592 1.00 1.00 1.00 1.00 1.00 1.00 1.00 23.27 2,263.35 3100.00 7.01 168.72 285.00 Overall Maximum Deflections•Unfactored Loads Load Combination Span Max."-"Defl Location in Span Load Combination Max."+"Defl Location in Span D+L+S 1 0.2966 4.750 0.0000 0.000 Vortical Reactions,Unfactored Support notation:Far left is#1 Values in KIPS Load Combination Support 1 Support 2 Overall MAXimum 9.034 6.166 D Only 2.674 1.726 L Only 3.812 3.068 S Only 2.548 1.372 L+,q 6.360 4.440 D+L 6.486 4.794 D+S 5.222 3.098 D+L+S 9.034 6.166 �P���OF MAgs�cy 3a S GJ, o 4 � N p�ERS a v SZRB 3T368 L cn PROP NEW _ WALL ---lip , ! $3 i C� APAP ! G O xG CCC)sET �p NCw Ftp, 8A5,rMFAIT IO Gt J !6 o,C. f jtj oil' -- — I � 4L /1 177, 777 / 77 i R ' 1 �Of V.5 Z� C�L�►PJ� 19 <�s1,, LVL NEAo�2-1 $Z ` . . 01 5T ca j (SFS Cvt Sci Ef� �Y / i 1�►t►�(i z Z 1// ZZI/ / I r tr 59 Wit it t �5 Pit I f I I i t_. PROP NEW ' z VVA LL i JNC w i -.. -- L7 i pAf i I ' CLOSET { pEn1 nJ, 5fm0J poopNC F� (�� T -, 6 ujFLi. tG \ M \ fi. J OX C/ The Commonwealth ofMassachusetts Department oflndustria[Accidents Office of Investigation,, 600 Washington Street Boston,MA 021,11 SY www.massgov/ilia WorkersCompensation Insuralace Affidavit:Builders/Contractors/Electricians/Plumbers A licant Information �'1ease Print Le ibl Name(Business/Organization/individual): *- � Address: ' s . .City/State/Zip: 1^ 'k L(� `�Phone #: 60-3 �s Are you an employer?Check the appropriate box: 1•❑I am a employer with 4. general Type of project(required): employees(full and/or part-tim )e * ❑have hired the sub conco trac orsactor and z 6• El New construction 2.❑I am a sole proprietor or partner- listed on the attached sheget.1 7. ❑Remodeling ship and have no employees These sub-contractors have working for me in any capacity, orkers'coin , ' 8 0 Demolition p insurance. g. �ilding addition [No workers'comp,insurance 5. We are a corporation and its required,] .officers have exercised their 10•0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself [No workers'comp. c.152, §1(4),and we have no insurance required.]t employees.[No workers' 12•❑Roofrepairs comp,insurancerequired.] 13•n Other kLjTN !Any applicant that checks box#1 must also fill out the section below sho Homeowners wing their workers'compensation policy information who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicatingsuch #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. i I am an employer that is providing workers'compensation insurance or m em information. f to ee Y p y s Below zs the olfc • P y andJob site Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: 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 ofMGL c, 152 can lead to the imposition of criminalp enalties of a trte 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 certy un r the pains and enalties o er u that the in fP J �Y foYnlation provided above is true and correct, Si ature: . . Date: 'hone#- 63 6 ^ VcA-O Official use only. Do not write an this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.PIumbing Inspector 6.Other Contact Person: Phone M - 9 i 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 g p 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 apartinents 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-contractors)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(ifnecessary)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 affiddvit. 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 Coli-mmonwealtla,of Yja:ssac'a�setcs Department of l dustrial Accidents Of ce of Investigations _ 600 Washington Street Boston;M 02111 Tel.#617.727•-4904 ext 406 or 1-877-M.SSAFE Revised 5-26-05 Fax#617"727-7749 WW[?f-mass.g4v/dia Massachusetts- Department of Public Sateh Board of Building Re<�ulations and Standards Construe ion Supervisor License License: CS 74036 CHARLES R SCHULER 153 WOOD ST HOPKINTON, MA 01748 Expiration: 2/11/2013 Commissioner Tr#: 15090 .r 71 Office o. onsumer airs mess.ebu anon HOME IMPROVEMENT CONTRACTOR or_ W Registration:,.-,161236 Type:/ Expiration `1`,0%1/2012 Individual � i CH' ES R SCHIJLERJRz CHARLES SCHULER_+-y H. 153 WOOD ST i _� — " :_._. HOPKINTON,MA 01748:;;: Undersecretary a THE COMMONWEALTH OF MASSACHUSETTS Registration: 161236 Office of Consumer Affairs and Business Regulation Home Improvement Contractor Registration Program Expiration: 10/1/2012 z Z 10 Park Plaza,Suite 5170 Boston,MA 02116 Received: d APPLICATION FOR RENEWAL OF REGISTRATION Home Improvement Contractor or Subcontractor a MGL Chapter 142A,201 CMR 18 CHARLES R SCHULER JR. REQUIRED RENEWAL FEE: �.TT�T.FS ,SCHULER BanizofAmerica�� _. $100 VOID AFTER 90 DAYS Personal Mone - y Order DateQli 30-11140 Pay To The NTX „n Order Of o a;gf frid3 £ lKj1 ;. 5 � 1t Cltf 4 Not Valid Over$1000 n' Bank of America is not liable for lost or stolen Mone against loss or theft sign P / gn and complete this Mone Y Orders.For Our nrt_ t/ Sank ofAmerica,N,A. �� Lit x{11 }' 1 Y Order as soon as possible. ian Antonio,Texas Customer Copy Non-Negotiable Retain For Your Records 001641005362 Signature of Applicant Title held with Applicant Date A false answer to any question in this application constitutes grounds for suspension or revocation of the applicant's registration. CHANGE IN LAW ABOLISHES.CSL's HIC REGISTRATION.FEE EXEMPTION As of a result of a recent change in the law(Section 8.0.of Chapter 27 of the Acts of 2009),the holders of Construction Supervisor Licenses are no longer exempt from HIC registration fees. i CONSEQUENTLY,ALL CONTRACTORS INCLUDING CSLs WHO ARE RENEWING THEIR HIC REGISTRATIONS MUST PAY A RENEWAL FEE OF$100 ' =EE DL �I 1�'�o�GIA S� w w \ 0 I�, g} DRIVEWAY �'` a-(n N/F GOLINI EASEMENT W W 00 #B3 D. QQ� \ \ \ n C .,�, \ a0 AREAS: 0 cr 0 \ s \ \ 7 J LOT 33A = 51,823±S.F. 1,895±S.F. 7 2 o z 100, BUFFER \\ \ �\ `3� EXISTING AND PROPOSED BUILDING 1,740 S.F. ZONE 105 x oGG PAVEMENT AND WALKW3Y635}S F \ TOTAL IMPERVIOUS = 22 437±S.F. '� UPLAND (BUILDING) AREA = = 16.2% \ \ �s % IMPERVIOUS UPLAND AREA AR SPACE 83.8% \ (BUILDING) 50' No BUILD _ \ \_ -� o.'�, OPEN ZONE ♦ \�\ \ 7. 0 7 F.F.EL �1 SGG #1 ' arden `' s.2' \ 25' NO DISTURBANCEONE OPOSED SGG #2 ITI 1p o• Sep is O \ \ to , SG � p0 200' RIVER FRONTo�iy ecs a �° h •s. SGG #4 't o — _ gs4 ,��' .` �°•o. _ •zs'``� TCDD r SGG #5 0 105 P. = o ,Y o. CHgpll� `p LTG fR�NG 8 47t - ' E* " t40.37553 W�NO OSGG #6 O�ESS1Gyp�` NSTgLI APPROPRIATE BARRIER SGG #7 EROSION CONTROL LINE DSUSUR4� FIRM 25009CO243F 07-03-12 ZONE AE B.F.E. = 95.0 SGG #$ t \ LOT 33A SGG #9 AREA = 51,g23±S.F. UPLAND y6� #107 \a N/F WYARD PLOT PLAN PREPARED FOR NG PROPERTY OWNER(S) goROfRi MATTHEW AND MICHELLE VERMINSKI g go rEO 95 OLYMPIC LANE ,I O NORTH ANDOVER, MA 01845 G % 6 �\ \ s oP�� � P�� \\ ASSESSORS PARCEL ID: 106.8 pROpOS'ED ADDITION \ \ G SGG GG G gGMAHW#1 BO INNGDISTRICT: R1 YARD SETBACKS: PLOT PLAN OF LANA IN BOST \ NOTE: FRONT = 30.0' 40' DRAINAGE i \ ON 8R WETLANDS FLAGGED BY: SIDE = 30.0' NORTH ANDOVER, MA. EASEMENT OOt� SCOTT GODDARD, PWSREAR = 30.0' DATE: 07/11/2012 GODDARD CONSULTING, LLC. SCALE. 1"-40' \\ ATLAS LAND SURVEYING, INC. DEED BOOK 10653 PAGE 155 s s. atlas 1 surveying-corn PLAN #8368 �ooa3i• 100' 150' 508-523-4559 atlaslandslyahoo.com 0 50. LANE, NORTHBORO, MA 01532 RECORDED ® ESSEX NORTH REG. DEEDS � N/F NEW ENGLAND $ MOORE POWER COMPANY