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HomeMy WebLinkAboutMiscellaneous - 1518 GREAT POND ROAD 4/30/2018 / 1518 GREAT POND ROAD 2101062.0-0027-0000.0 I I IF i I Date.....—.t.... 9 �aORTp TOWN OF NORTH ANDOVER PERMIT FOR WIRING ;�Ss�cNusE� This certifies that ............T�,/���L...... ���Ti�/�........................ has permission to perform .................................... �'.r�................. .... �. wiring in the building ofd ................ .... ............................................... �` � .' ,North Andover,Mass. ........ .......... ........... ELECTRICALINsPE&roR Check # � 88 � U Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. CZ BOARD OF FIRE PREVENTION REGULATIONS [ROccupancy and Fee Checked ev. 1/07] (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 PM7flV DX OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform e ectrical work described below. Location(Street&Number) Owner or Tenant P.^ j CUs. �+ Telephone No.4v--- Owner's Address Is this permit in conjunction with a building permit? Yes Purpose of Building ❑ NO ❑ (Check Appropriate Box) g- ��O/Sl"�°l l' Utility Authorization No. Existing Service Amps / Volts Overhead Und d ---- h ❑ ;;r' ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �T Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp. (Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Ge rators KVA No.of Luminaires Swimming Pool Above rnIn-d.e ❑ o,o mergency ig g Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of etection and Initiating Devices No.of Ranges No.of Air Cond. otal Tons No.of Alerting Devices Rof ste Disposers Heat Pump Number ons _ KW _ No.of Se1f-Contained EETotals: Detection/Ale rtin Devices hwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other ers Heating Appliances KW Security Systems:* No.of waterNo.of No.of Devices or Equivalent Heaters KW Si s Ballasts . Data Wining: No.of Devices or Equivalent Total HP Tel No.Hydromassage Bathtubs No.of Motors ecommunications Wiring:ng: OTHER: of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: 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 pains and pen s o p jury,thatthe info�n tion this application is true and complete. FIRM NAME: e G �G ✓t G �H LIG NO.: aT� Licensee: ' s .y! Signature (If applicable, enter"exempt"i the license numbeA line.) LIC.NO.: Address: s �S' vv,� Bus.TeL No.: - —7 *Per M.G.L c. 147,s. 57-61,security work requires Departm t of Public Safety"S"License: Alt TelLicNo 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 agent Owner/Agent Signature Telephone No. PERMIT FEE. $ � ` '�. v �� °� �- � ��� x The Commonwealth of Massachusetts Z ! Department of Industrial Accidents Office of Investigations tU 600 Washing ton Street Via 1 Boston, MA 02111 www.massgov1dia . Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/plumbers Applicant Information Piease,Print Legibly Name(Business/Organization/individual): n t Address: / p�i► �� City/State/Zip: C Phone#: .�' e 3 g� 33 Are y an employer?Check the appropriate box: L I am a em to er with 4, Type°f Pre1�t(regniret�: P Y �,�_ ❑ I am a general contractor and I - 6 New.ec'construction employees(full and/or paft-time)* have hired the sub-contractors 2.❑ I am a.sole proprietor or partner- listed on the attached sheet x 7• ❑Remodeling q ship and have no employees These sub-contractors have 8. Q Demolition working for me.in any capacity. workers' comp.insurance. [No workers'comp. insurance 5. 9• ❑Building addition � p ❑ We are a corporation and its required.) Electrical red-] officers have exercised their repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MOL I I-[I Plumbing repairs or additions myself. [No•workers'comp, C. 152, §I(4),'and we have no 12. Roof insurance required.]t ❑ repairs q ] .employees. [No workers' comp, insurance required_] I3.❑.Other 'Any applicant that checks bm e#I must also fill out the section below showing their workers'compensation policy information, r Homeowners who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating ;Cotrtractors that check this box must rcarin such. attached an addi' g n• tonal sheet showing.the trema of the subcontractors and their worker'pomp•policy information. I am an employer that is providing:workerscompensation insurance for my employees: information.. Below is the policy and job site Insurance Company Name: ' Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: l�� ���q JL �� Q 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 pat and p nalties of p rjury that the information provided above is true and correct. Si tore: q Date: a Phone#: FF, nly. Do not write in this area,to be completed by city or town ofc; Town: Permit/License# ority(circle one): ealth 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector .Other Contact Person• Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or traistee of an individual,partnership,association or other legal entity,employing employees. 'However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not: because of sucb employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or locai 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 riot produced acceptable evidence of compiiance with the insurance coverage required." Additionally, MGL chapter I52, §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 r 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 numberlisted 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permitAicense applications in any given year,need only submit one affidavit indicating-current policy information(.if necessary)and under"Job Site Address"the applicant should write"all locations in (city or " town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for f xtur-e permits or licenses. A new affidavit must be filled out each t 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give as a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 TeL#617-7.27-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax 4617-727-774-4 www.mass.gov/dia FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT ( _/ZE / 4lD(Q�li�f c�C PHONE 97F(e7�V4 4;-'� LOCATION: Assessor's Map Number lCi� PARCEL SUBDIVISION LOT (S) STREET LS"!r "�4_ gar ! ST. NUMBER *****************************************OFFICIAL USE ONLY***************************'"******* REC MENDATIONS OF TOWN AGENTS: r CONSERVATION ADMINIS TOR DATE APPROVEDG' DATE REJECTED , COMMENTS TOMI P ANNER DATE APPROVED DATE REJECTED lO COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm �i. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOy�LISH�A OO�NE OR TWO FAMILY DWELLING x b m+ Z"I BUILDING PERMIT NUMBER. DATE ISSUED. X ic SIGNATURE: Building Commissioner/InEeEtor of Buildings Date Z SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: S/G'dl 76 Zoo Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required I Provided Required Provided sia '. 70-7 7— — o 1.7 Water Supply M.G.L.C.40.11 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public W Private ❑ Zone Outside Flood Zone ❑ Municipal X On Site Disposal System ❑ J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT t0 c District: es o M 2.1 Owner of Record r C/�67110 e11 Name(Print Address for Service: Sig atur Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Tel hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: U �j �(p b S8 5 D License Number Address (� ��t¢p� ��l O Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name /p,� ,3 f� m Registration Number r Add ss r z q < � Expiration Date xP V 'Signature Tele hone SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......Q' No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: ,ext'&,kC eY- c-- 2, SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be QgFiCIAL USE E?NI;y Completed by permit applicant 1. Building ,f (a) Building Permit Fee d�74U r Multiplier 2 Electrical f (b) Estimated Total Cost of Construction 3 Plumbing t10-0-0 Building Permit fee(a)x(b) 4 Mechanical HVAC 3 S� — 5 Fire Protection g 6i7. 6 Total 1+2+3+4+5 to y 300 , o Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT c, Lc—( tZ as Owner/Authorized Agent of subject property Hereby authorize ^v'P 4 to act on My beA�alofall ma ers relati to work au rized by t e i t appy ation. Si awner Date — Y ` SECTI N 7b OWNER/AUTHORIZE/D AGENT DECLARATION 1, �2� /7,�-/C! asAOmmir/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief / Print N Si ature offer/Agent V Dates NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHD&v EY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location f Facility) Signature of Permit Applicant �z T-' Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector u The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations Boston, Mass. 02911 5q Workers'Compensation Insurance Affidavit Name Please Print Name: Location: Ccily Aone # i am a homeowner performind all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: /9-T 1!'� ��� ! 6�C C- Address City: �Wy C/ '�G�`�2 ��j 1/JfVS Phone#: 9 7r (o i Insurance Co. /T Policv# 60C , 0 X76 J'rb ,S 6-L6-o D Company name: Address City: Phone#: t Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment as welLas.civil..penatties in the form-of-aSTOP WORK ORDER.and_a fine of($1D.0.00)_a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. i do hereby certify under the pains and penalties o that the information provided above is true and correct. Signature Date G a t-111'\11Print name jZo t'¢t- lC , -bp-, e Phone# n1 7,F 6 32,4t qt Ll Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required Licensing Board F-1 Selectman's Office Contact person: Phone#. F-� Health Department Other ACORDM CERTIFICATE OF LIABILITY INSURANCE 05/2/6%004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION M.P. ROBERTS INSURANCE AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1060 OSGOOD STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTH ANDOVER MA 01845 978-683-8073 INSURERS AFFORDING COVERAGE NAIC# INSURED CREATIVE BUILDERS INC. INSURER A: INSURER B: HANOVER INSURANCE COMPANY 58 WATER ST INSURER C: NO. ANDOVER, MA 01845 INSURER D: AMERICAN HOME ASSURANCE CO. WK 978-682-4948 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWLIPOLICY EFFECTIVE POLICY EXPIRATION LTR INS TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY .. EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence $ CLAIMSMADE CI OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ 100,000 B X HIRED AUTOS -6353714-02 05/08/03 05/08/04 gODILYINJURY X NON-OWNEDAUTOS (Peraccidenl) $ 300 000 PROPERTY DAMAGE (Peraccident) $ 100,000 GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANYAUTO EAACC $ OTHERTHAN AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR E CLAIMSMADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCSTATU- OTH- TORYLIMITS X ER EMPPROPRS'LI/PARTY C 768-05-55 03/29/04 03/29/05 E.L.EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE D OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ 500,000 Ifyes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO TOWN OF NORTH ANDOVER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN BUILDING DEPT. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 27 CHARLES STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR NORTH ANDOVER MA 01845 REPRESENTATIVES. AU,gRI REP R NTA ACORD25(2001/08) ©ACORD CORPORATION 1988 �^ ✓xc {bana"ww'eVefra. o f._ l/ a uxT uae/ta Board of Building Regulatiofis and Standards � l t HOME IMPROVEMENT CONTRACTOR DIE =� Registration: 105739 -- ! Expiration: 7/20/2004 Type: Private Corporation CREATIVE BUILDERS, INC. Robert Daigle 58 Water Street• r. �.mss ✓ N.Andover,MA 01845 Administrator ` ✓fie t�anUirwozcuea�- a`�/l/laoaac%uael�s BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 038650 Birthdate: 01/23/1946 Expire 01123/2006 Tr.no: 17408 Restricted: 00 ROBERT K DAIGLE 58 WATER ST N ANDOVER, MA 01845 Acting Ca mis oner ✓die ��anvma�wea/�i �',,��...�oelta DEPARTMENT OF PUBLIC SAFETY c License: HOISTING ENGINEER LICENSE I Number: HE 056490 Birthdate: 01/23/1946 Expires: 01/23/2006 Tr.no: 14607 Restricted: 2A ROBERT K DAIGLE 58 WATER ST N ANDOVER, MA 01845 Acting oner r CREATIVE BUILDERS, INC. 58 WATER STREET NORTH ANDOVER, MA 01845 Mr. & Mrs. Herbert Schultz, May 17, 2004 1518 Great Pond Road North Andover, MA 01845 978-682-2703- home ADDITION PROPOSAL We propose to build an addition 23' x 23' according to your plan and the following specifications. SCOPE OF WORK: • Permits • The area will be excavated for footings and foundation. If there's a substantial amount of loam, it will be stockpiled. We will backfill the perimeter of the addition with the existing material on site. Inside the foundation, we will spread sand, compacted and leveled. The concrete slab will then be poured. • The addition, fi•amed with 2x4 walls accordinyo to code, will have a cathedral ceiling and four- 3 ft. wide dormers. There will be a foot overhang on the sides and fi•ont. Plywood will be supplied and installed on the exterior walls and roof Tyvek will be installed on the exterior walls. • We will remove your French door fi•om its current location and install it in the addition. Our price also includes the installation of windows, a door and roofing. • Stucco will be installed on the exterior walls. The color will match the house. • We will install plumbing (piping materials) for the bathroom sink, tub and water closet. The plumbing fixtures will be supplied by the home owner. • A zone of heat will be installed for the addition. • Electrical work includes the following in the bathroom- a GFI outlet, a ceiling fan/light unit, and wiring for decorative lighting over the vanity. In the bedroom, the electric includes outlets to code, a hard wire smoke detector, wiring and installation for four sconces and a ceiling light and switches. Owner will provide all lighting. We will also connect the new heat zone. • The walls and ceiling will be insulated with fiberglass batts. • Sheet-rock will be hung, taped and compounded with three coats of joint compound, sanding between each coat. • 2"x4"'s will be attached to the bedroom ceiling creating a"beam effect". Schultz contract—page 2 Not included is engineering, windows/ exterior door, roofing materials, painting, plumbing fixtures, decorative lighting, flooring, vanity or interior trim. PAYMENT SCHEDULE Deposit $ 4000.00 Excavate for addition $ 2000.00 Foundation walls $ 4000.00 Backfill addition $ 1900.00 Concrete slab $ 2000.00 Frame—walls $12500.00 Addition weather tight $12500.00 Insulation $ 2000.00 Rough utilities $ 7300.00 Siding $ 5000.00 Sheetrock hung $ 3000.00 Sheetrock taped $ 2000.00 Finish utilities $ 1600.00 Completion $500.00 Total contract payments $64300.00 Partial payments may be requested during the h-aming, utilities and siding stages of work. We will haul away all excess fill, imcludingthe septic tank. We expect to complete the first phrase of work no later than 3 months after obtaining the permit. All work will be completed in a workmanlike manner according to standard practices. Changes or alterations to the plan, home, addition or any portion of the work, mandated by any code enforcement official or inspector, may or may not effect the price. Any alteration or deviation from the specifications involving extra costs will be executed only upon written Change Orders, and will be an extra charge over and above the contract. All agreements are contingent upon strikes, accidents or delays beyond our control. The homeowner will carry fire and other necessary insurance. Our workers are fully covered by workmen's compensation insurance. We are not responsible for increased prices on materials. Icceptance: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outline. Schultz contract—page 3 Date of acceptance: 3 Signature: 4aSig= mature: Aerbert Schul Carole Schultz Robert K. Daigle, President• Afiiaalzce charge of 1.5% (mznual percentage rate of I�S%) will be added to an_v amolint 30 dai-s past dare. Legal,fees will be charged if collection is necessai-v. IMEMM ` CONT. RIDGE VENT FI5ER6LA55 SHINGLES 23' LONG ENGINEERED RIDGE BEAM - 1/2" EXT. PLYWD. SHEATHING TO BE DESIGNED BY MANUFACTURER 2XIO RAFTERS 0 16" O.G. 2X10 CEILING J015T5 R=36 FI5EROLA55 BATT INSUL. 5[ 1:2 T1'PIOAL MALL SEOTION 05 -0 METAL METAL DRIP EDGE CONT. SOFFIT VENT SIDING TO BE SELECTED 8' HOU5EWRAP EQUAL TO "TYVEK" 2X10" 16" O.G. (5) PT 2XIO 1/2" EXT. PLYWD. SHEATHING 3/4" T 8 6 PLYWD. SUBFLOOR 5-1/2" STEEL LALLY COL 2X4 STUD WALL R=30 FIBER6LA55 BATT INSUL ON 24" X24" XIO" GONG. R=13 FI5ER&LAS5 BATT INSUL. FOOTING, 0 "t'-8" O.G. 2' MIN. 10" CONCRETE FOUNDATION 10"X20" CONCRETE FOOTING 4' 6" CRUSHED STONE W/ POLY VAPOR BARRIER 23' CREATIVE BUILDERS NORTH ANDOVER, MA. GOVT. 8.06E VENT FIBER6LA55 SHIN61-E5 25' LONG ENGINEERED RIDGE BEAM - 1/2" EXT. PLYWD. 5HEATHING TO BE DESIGNED BY MANUFACTURER 2X10 RAFTERS ® 16" O.G. 2X10 CEILING JOISTS R=58 FIBEROLA55 BATT INSUL. 8 F 1-2 T)TI CAL NALL SEOT IO 1/411 - 1 '-O METAL DRIP EDGE CONT. SOFFIT VENT SIDING TO BE SELECTED 8' HOUSEWRAP EQUAL TO "TYVEK" 2XIO" 161, O.G. (5) PT 2XIO 1/2" EXT. PLYWD. SHEATHING 5/4" T 4 G PLYWD. SUBFLOOR 5-1/2" STEEL LALLY COL 2X4 STUD WALL R=50 FIBER6LA55 BATT INSUL ON 24" X24" XIO" GONG. R=15 FIBER6LA5S BATT INSUL. FOOTING, ® T-6" O.G. 2' MIN. 10" CONCRETE FOUNDATION L -10"X20" GONGRET'E FOOTING 4' I b" CRUSHED STONE W/ i POLY VAPOR BARRIER 11'-611 23' CREATIVE BUILDERS NORTH ANDOVER, MA. k MAScheck COMPLIANCE REPORT I Massachusetts Energy Code I Permit # i MAScheck Software Version 2.01 I ( { I i I Checked by/Date I I I CITY: Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached I HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 6-5-2004 COMPLIANCE: PASSES Required UA = 144 Your Home = 137 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ---------------- ------------------------------------------------------------- CEILINGS 598 38.0 0.0 18 WALLS: Wood Frame, 16" O.C. 580 13.0 0.0 48 GLAZING: Windows or Doors 156 0.350 55 FLOORS: Over Unconditioned Space 529 30.0 0.0 17 HVAC EQUIPMENT: Furnace, 85.0 AFUE ------------------------------------------------------------------------------- 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 requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. �. Builder/Designer ADate _ I �% /✓ VI'4�'LAI re 17 fnr I k 1 ss 1 t � n i V i i f / 1 Ir r i f + 1 a c � � I ' i. t h .y `"""''. .:r�" (� f�'�/ti i�l�+lU'f is W/ '!i9'�� ! j�O/`� '1 k""✓"J� 1 F i S r d) b U f J 04 • � ""''�` �`' Ott' / � tL/M� /1FE7aCuC f� � •-- �.__... r.... a..-..�r � / �tr G x ,` ,�� ��?vita{� � i 6" fZ. /+/`1 GM�'`�'�. �'f- ' '� \.4 d3..x �T t v b � i OF- �fV;'�--t/EY �oc.47"ED rN r1 �Q �\j O IP7 P ,4 lV Z�OIVEZ , AdAfr:S fit=P,4�ED FLS 4 E P 8 E ?- T a V C YR R:M aI NEERINIs INC, LAalize r-p , MASS. . (� o . , .1410 zo ��•�j� � ,; , �i �yv9 �2 4343' .l kq v ,_ 04 VZ � Zi CHARLES EDVA O . 17 Scale: _,�� Date of Plan: ���5