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Miscellaneous - 176 VEST WAY 4/30/2018
K TOWN OF PERMIT FOR PLUMBING D at e!!�. NORTH ANDOVER This certifies that ... .........................771:27-: ........... has permission to perform. . plumbing in the buildings of .......................... at. ......... ,North Andover, Mass. qq 4, ......... Fee .... Lic. No.:. .... PLUMBING INSPECTOR Check # 666) MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS {� ` Date lD Z6 dS Building Location l� Owners Name�� c� 6LOV51M� O r- Permit # G to i' ` Amount 6 Type of Occupancy New1:1 d Renovation Replacement Plans Submitted Yes No FIXTURES (Print or type) 1 \ Check one: Certificate r Installing Company Name , o,On 0 n5 ❑ Corp. R Address 0''\ 01S S� 0 Partner. Ke MR oz is s Busm'� a ep one G t �.. - Sct 12 - 1'i 3 W Firm/Co. Name of Licensed Plumber. W i 1 \ c\r, \ I p � cA Ori Insurance Coverage: Indicate t4 type of insurance coverage by checking the appropriate box: Liability insurance policy10 Other type of indemnity 11 Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance signature Owner ❑ Agent I hereby certify that all of the details and information j-hae submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing wor i allation4t, ,m d under Permit Issued for this application will be in compliance with all pertinent provisions of the �s ct etts 0 i;; Code and Chapter 142 of the General Laws. Type of Plumbing License d,Zclg66 License m Master `%ED (OFFICE USE ONLY ElJourneyman f t II �G_ 180 Date.................................. NORTH '1 <�``° ;•� + TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ...4 ......................................................... v has permission to perform. ' :4-z. — ......... wiring in the building of ...��'".`.....:.......................................... at ................................ .................... . North Andover, Mass. Fee�o........ Lic. NosO/..... .`.......-�...s ..... ELec[�icu.IxsPecrox ` Check # DFAIIIJIr WOFPENE&FM Permit No. / �G ., BOAMOFFIREPREVFN7nVRBOUlMQi 527(M12O OmPwicy 3 Feta Checked APPUCATTONFOR PERMIT'TO PERFORMELEcnuCAL WORK ALL WORK To BE PE PORMBD IN ACCORDANCE WITH TIB MASSACHUSSTS MECTRICAL CODE, 527 CMR 12:00 (PLEASE PR]NT IN INK OR TYPE ALL VMRMATION) D D d2 � Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant a V 16i t! T S ,r Owner's Address AV— e Is this permit in conjunction with a building permit Yes No C3 (Check Appropriate Box) Purpose of Building �� t C ✓t �! ���� 1� n Utility Authorization No. Existing Service emwmw�Amps Volts Overhead Underground M No. of Meters New Service I Amptt....LVolts Overhead El Urdeggound C3 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work V (4-4�4A eiPfd s-iJ-d k--% No. of U{b ft Outla Na of Hot Tubs No. of Trmsbrrerrs TOW KVA Na of Uahthy PiMM Swimming Pool' Above Below Genmu n KVA No. of ReceptaeN Outbta f No. of Oil Buinen W of Eawgeary Uahtina Battery tWo Na of Switch Outlsu No. of Oes Boman FIRE ALARMS No. of Zan No. of Amass j Na of Air Cond. Total f TOM Na of Detection utd No. of Dispoule / No. of Has TOW TOW PUMP TOM KW InidsBot Dem No. of Soumdinj Devices No. of Dishwashers { Spece Ates Hea ing KW l NO. of Self CooWned DetecdodSoondlnB Devices Lmd MOweipal otim No. of Dryers Herons Devices KW D Coturecdom p No. of Water Herten KW Na Of Na of 31011 sihW6 No. Hydro Msuge Tube Na Of Moran Total HP OTHER' r hR==CbVWF P4NUMID41C IiQrmI Ihnesubdrrbdvaidpoddsaaeolre0mm 7f1�LJ C A6URANQ � BCD am ED WakIDStrtt ire ortDORagseed Sgledun&-iePtrwMdpajiay.�l fCC✓1 f ,'i �t i FEMNAMBA, tko l� or�s�rlirler�ivaiat y� ® No LJ Ifyouharedte+dedYl�,pkaadrnlelretYPedco�ta�by Dde �01a /DSL�neledvalredF�laca AW $ Pb* l Aw !�l/� en h tedcd Limmm Budna UNa - BI 3l 31,10 — AV14146 C1wMeSMJRANCEWAMRin waedntdmLim a 4kiramacomWoribs>bSmryYegilvaimtas;Ag bylbiee®ch>seibCclatlLavK ardthetrrqsigra�aetndispamit�pic�wsivmfireQirarsnt (Please check one) Owner ri Agent Signalure or Owner or Agm �., Telephone No, Pmwr FEB 09/30/2005 FRI 13211 FAX 978 657 5844 srilmington Builders I `-4 BC CA,LCO 2003 DESIGN REPORT - US ®002/002 Friday, September 30, 200513:05 Double 13/4" X 117181' VERSA LAM@ 3100 SP File Name: SC CALC Project: F801 Job Name: WSHNIER ADDITION Description: Address: 175 VEST WAY Sped ier: City, Stale. Tp: NORTH ANDOVER, MA Designer; Cuslomee Company - Code reports: ICBG 5512, MR en rAsc. 2ND FLOOR BEAM 130 81 39W lbs LL 3900 lbs LL 1958 lbs OL 1958 tbs DL Gwwal Data Load Case Version: us Imperiai Member Type: Floor Beam Number of Spans: 1 Left Cantilever. No Right Cantilever: No Slope: 0112 Tributary: 12-00.00 Live Load: 30 psf Dead Load: 10 psf Partition Load: 0 psf Duration: 100 D1Sclosure The completeness and accuracy or the input must be verified by anyone who would rely on the output as evidence of suitability for a particular appication. The output above is based upon buidmg code -accepted design properties and analysis methods. Installation of BOISE engineered wood Products must be in accordance with the current Installation Guide and Me applicable building codes. To obtain an Installation Guide or if you have any clues bm, pease can (800)232-0788 before beginning product inswislion. BC CALM BC FRAMERS. BC*, BC RIM BOARDTM. BC OSB RIM BOARD'". BOISE GLULAM'". VERSA -LAMS. VERSA -RIMS. VERSA -RIM PLUS& VERSA -STRAND"". VERSA-MDO. ALUOISTS and AJS'w are trademarks of Boise Cascade Cotporelion. Page 1 of 1 TOW Hwiaontot Length -10-00-00 Low swnmary Load Case $pan Location Moment 14646 ft4t&s 68.8% 100% 2 1- Internal Neg. Moment 0 ft -lbs NO 100% ID Description Load Type Ref. Start End Type Value Trio. Dur. S Standard Load Unf. Area Left 00-00-00 IM -00 Live 30 psi 12-00-00 100% Notes Design meets Code minimum (L/240) Tolai load deflection criteria. Dead 10 psi 12-00-00 90% 1 Unt Area Left 00 -MOO 10-00-00 Roof live 35 psf 1240-00 115% Winimum bearing length for 81 is 2'. Dead 15 psf 1240-M 90% 2 Unf. Lin. Left 00-00.00 1OW40 Live 0 pir rva 9wo Dead 80 plf r/a 9095 Controls Summary Control Type Value %Allowable Duration Load Case $pan Location Moment 14646 ft4t&s 68.8% 100% 2 1- Internal Neg. Moment 0 ft -lbs NO 100% End Shear 4699 IU 56.5% 1000A 2 1 -Left Tota( Lead Dell. U445 (0.27-) 54.0% 2 1 Live Load Deft. U66a (0.18") 71.9% 2 1 Max Oetl. 0.27- 27.0% 2 1 Notes Design meets Code minimum (L/240) Tolai load deflection criteria. Design rn99% User Specified (1/480) Live load dellec Wn critarrd. Design melts arbitrary (1') Ma>omum load ddlection criteria. minimum bearing length for 80 is 2". Winimum bearing length for 81 is 2'. Entwed/Displayed Ho0ronto Span Length(s) = Clear Span + 112 min. end bearing + 12 intermediate bearing Connection Diagram Member has no side loads. Connectors are. 16d Sinus' Nails a=2' b=3' c = 7-7l8" d =12" +�- T::�% -�- ?.G era k � ConsAruc;Vaol T -d ESE30-EL2-TBL rid ves+ via. pjeU8oz4TJ 818401W d92:20 so of des 09/30/2005 PAI 13:11 PAX 978 657 5844 Wilmington Builders BC CALC® 2003 DESIGN REPORT - US ®001/002 Friday. September 30, 200511:23 Triple 1314" x 9112" VERSA -LAM® 3100 SP Fie Nanle: BC MC Projw: 1`1102 Job Name: KUSHNIERADDITION Desctipdon: Addraw. 176 VEST WAY Spetiw. City. Slate. Zip. NORTH ANDOVER. MA Designer: Customer. Company: Code "ads, ICSO 5512. NER 629 Mise 2ND FLOOR BEAM so 81 3900 Its LL 3900 Ibs LL 1970 Ibs OL 1970 lbs OL General Data Load Cane Version: US Imperial Member Type: Floor Beam Number of Spans. 1 Left Cantilever: No Right Cantilever: No Slope: 0112 Tributary. 12-0000 Live Load: 30 psi Dead Load: 10 psi PeAtion Load; 0 psi Duration: 100 Diwosure The completeness and accuracy of the input must he verified by anyone weo would refy on the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with the current installation Guide and the applicable building codes. To obtain an installation Guide or it you have any questions, please call (800)232-0788 before beginning product installation. eC CALC®, SC FRAMERS. BCIO. aC RIM BOARDTM. BC OSB RIM BOARD"`, BOISE GLULAMTM. VERSA -LAM@. VERSA -RIMS. VERSA -RIM PLUS®, VERSASTRANDTM VERSA -STUDS, ALWOIST®and AJSTM are tradea wks of Boise Cascade Corporation. Page 1 of 1 2-d Total Horizontal Length -10.00-00 Load Summary Load Cane - Moment 14675 ft4bs 70.1% 100% 2 1 - Internal ID Descriptlon Load Type Ref. Start End Type Value Trib. our. S Standard Load Unf. Area Left 00-00-00 10.00-00 Live 30 psf 1240.00 10VI, Max Deft. 0.352• 35.26 2 1 Dead 10 psf 12 -MM 9074 1 Unl Area Left 00-00-00 10.00-00 Snow 35 psi 1240-0 115% Design., arbitrary 01 Maximum load deflection criteria. Dead 15 psf 12.00.00 907- 0%2 2UK. Lin. Left 0000.00 10.00-00 live 0 plf n1a 90'/e Dead 80 Of nla WA Controls Summary Control Type Value '% Allowable Duration Load Cane Span I.ocatlon Moment 14675 ft4bs 70.1% 100% 2 1 - Internal Neg. Moment 0 ft -lbs n/a 100% End Shear 4941 lbs S1.2'% 100% 2 1 - Left Total Load Dell. U341 (0.3521 70.4'% 2 1 Live Load DOM. !1513 (0.234') 93.6% 2 1 Max Deft. 0.352• 35.26 2 1 Notes Design meets Code minimum (!1240) Total load de9eation criteria. Design meets User spedlied (1-1480) Live bad deflection criteria. Design., arbitrary 01 Maximum load deflection criteria. Minimum bearing length for 80 is 1-112". Minimum bearing length for 81 is 1-112'. ErteredlDisplayed Horizzortal Span Length(s) = Clear Span + 112 min. and !rearing + 112 into maleate bearing Connection Diagram Nailing schedule applies to both sides of the member. Member has no side bads. I Connectors are: l6d Sinker Nails a-2" b-3" t - 5-112' da12" e=3' 1 }b n F61AWzWG1ftCA\a cey\s+c uckior1 ES80-Eliz-I8G pjej8gz4TJ ajayaiW dLZ:ZO SO OE des CROSS INSURANCE - MANCHESTER ti 1 GORDON & POWERS INS. AGENCY, 490 South Main Street, Manchester, NH 03102 603-669-4947 * FAX (603) 626-5747 Sag1FAX Cover Sheet FAX TO: Insurance Department Town of North Andover Mass Building Department 19786889542 FAX FROM: Joyce Orcutt CROSS INSURANCE - MANCHESTER 603-669-4947 J FAX (603) 626-5747 FAX DATE: October 4, 2005 FAX TIME: 3 : 2 5pm NUMBER OF PAGES (INCLUDING COVER): 2 COMMENTS: Please see attached Certificate of Insurance. � Location No. tZl 9 Date ` TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ n TOTAL $ ` v ,/ Check # Z} lJper — / r1� U'_ Building Inspector v ' TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENO VAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BURRING PERAW NUMBER c;) DATE ISSUED: O SIGNATURE: BuiTnj Commissionerft r of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Q c Ola Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronto ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water Supply M.G.L.C.40. 34) Public ❑ Private ❑ Zone 1.3. Flood Zone Information: Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes _ No _ 2.1 Owner of Record M-160Le t A a_0. k UL N Name (Print) i < < �� �0 t2 .e. r Address for Service .� Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: /� 1 Licensed C6struction Supervisor. 1 Not Applicable ❑ ` 1 C) Ad License Number ta re " -7 5-D— 9b T Telephone Expiration Date_ I t7 - 3.�ARegistered Home Improvement Contractor 17-I'AZ115 n I 1 CC�,nS� r vc�-t '1 o n �raS , C- Not Applicable ❑ 3 Compan_0 y��Name �`. / _ D- Vi J C` \ f j U,( -( ,r �. n A 6 G Registration Number 111 (' i Add ss 11 Si atu a�),j Telephone Expiration Date v D M O Z m 90 O an ic r v M _r Z 0 r 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 .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition _14-" Accessory Bldg. ❑ Demolition ,e( Other ❑ Specify Brief Description of Proposed Work: )K W '� PJ J L.J a - r, I cut-rirnw c ri a rYM A TPi it lYINCTi?7T!'T7nN !Vn4ZTC l Item Estimated Cost (Dollar) to be Completed by permit applicant :,; OFFICIAL`USE 6A, Y , _. 1. Building O "f (a) Building Permit Fee Multiplier 2 Electrical 3 g, r (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (s) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I KA h y r� as Offer/Authorized Agent of subject property Hereby authorize , 1 Z� C-6 ��A ✓ J C } ✓1 J� i 1� E=S `i' ato act on ehalf, m all matters ra 've to work authorized by this building permit 12-3 oS' Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, Ka'LA rllb ^d\ " % -Ir l r2t!5- ew-ti t'--11 ,as Owner/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 'Of Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND 3 RD SPAN DEMENSIONS OF SILLS DIN ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE L CW4S I Cww ns / • s�8 ss� '8-388-1229 f C .dpkitchens.com i. om e"e rRt b d C*745 m IS U3 �11 Proposed kitchen Kushner residence Revised Aug. 22, 2005 Paula & Michael Kushnier 176 Vest Way No. Andover, MA 01845 978-685-0098 Untitled (10).max 8 N CWZ45�/hO• s sf EcSpays�.ftao `merest CW245 E t a` 1 o c � CMI* , l��` 978-388-1229 D N www.dpkitchens.com 2868 4068 va406 112436 1 3 Y m"y I) tia " t m bins f a� CO LL m o I Proposed kitchen I( Kushnier residence i( Revised Aug. 11. 2005 0� m FI CO �ufits.6 C � u MDR2t90 1 � �� I !1190 N W3636Q W3618X2t E_ �_`1 fl • 31068 r I " Paula & Michael Kushnier 176 Vest Way No. Andover, MA 01845 978-685-0098 Untitled (11).max I L4 4f I Sq I ty;IDI '00 'g, &4T47 yN I O<j,j' LUQ + ieA fi 11+17 �oLC��► r� ��ELE�a Wit. 16 oc- %L 4O/Lu9 Ft,/ �ec1G .co — , /2 rloofid, 9/m To# ST l6.OcI ,A� 1'2 zetc t. k Cctj1U To $��Us@ .s ►f�L 174 A NIVMX= "WROV 9• Remodeling Services Michael and Paula Kushnir 176 Vest Way N. Andover, MA 01845 September 17, 2005 2 Orchid Circle Burlington, MA 01803 Kitchen and Addition — Scope of work Building Permit — Obtain building permit Order cabinets — 4 week lead time Demolition — Remove all existing cabinets counter tops, back splash. Demo corner closet and cabinet where AC run pipe is inside. Remove sliding door frame and glass short left side. Remove siding inside corner of porch wall. Remove section of screened in porch and kitchen framing where new addition will be constructed. Remove hard wood floor in dining room and remove kitchen floor. Remove ceiling in hallway and kitchen. Dumpster — Will be placed in the driveway. Electrical - Remove old wiring in kitchen ceiling and all recessed lighting. Install 6 four inch recessed lights on dimmers. Install 4 dimmers and 6 switches. Install 10 recepticles to code on counter tops and island. Install wiring for 1 pendant lights above island on dimmer. Install dedicated lines for fridge, microwave above cooktop, disposal, dishwasher, instant -hot under sink. Install dedicated 50 -amp wiring for cooktop. Owner to supply all decorative lights. Plumbing - Re -pipe stub outs for kitchen sink water lines and drain as needed, allowing for dishwasher and disposal in new location. Pipe icemaker to fridge. Install a Quiet One toe kick heater or equal under sink base to provide heat for the kitchen area. Piping to be run above the drop ceiling in basement below. Remove baseboard heat on inside wall in kitchen and re -loop lines. All fixtures to be provided by owner unless other wise specified. All piping shall be installed to conform with MA state plumbing code and shall schedule 40 pvc and water lines shall be Type L copper Framin Frame 8 by 10 feet extending out of kitchen into rear deck. Construct platform through deck supported by lally columns on top of 10" concrete piers with plate lagged into main house sill with 16 on center Y2" lag bolts. Framing will consist of 2 X 12 floor joists with 3/4 " plywood decking and 2X4 outside walls with YZ" sheathing. Roof will be constructed with 2 X 8 rafters and 5/8" sheathing. New roofing will blend into existing roof. Addition roof line will match existing shed roof over screened in porch. Add support beam in place of second floor rim joist. The joist will hang off 3 LVL laminated beams. Beam design is subject to engineering approval. The beam jack stud will be supported on addition deck with 12" concrete piers underneath. Once addition deck is completed the old existing deck will be re attached to the new platform and deck boards re -installed. Existing screen door will be relocated to front of porch in front of new addition. 2 Orchid Circle Burlington, MA 01803 FitzGeralc CONSTRUCTION Siding and Trim Boards — Trim boards will match screened in porch. Siding will be textured masonite siding to match house. No painting included. Flooring — Add 2'h" red oak flooring in dining room, new kitchen floor and addition. All flooring will have two coats of poly except kitchen which will have 3 coats of poly. Sand and refinish stairs with two coats of polyurethane. Transition moldings will be provided between hardwood and tile. Tiles — Tile rear hallway, half bathroom and closet. Remove vinyl floor and add 1/4" wonder board to floor. Install tiles and grout. Allowance for tile $2,50 per sf. Insulation — R-30 fiberglass batt insulation underneath new addition floor, covered with 2" foil face poly Styrofoam insulation taped with clean polywrap. Walls will have R-13 fiberglass batts. Ceiling will have R-30 with baffle for insulation. Plaster — Blueboard and plaster kitchen and hallway ceiling and outside walls in addition, smooth finish. Windows - Provide and install two windows. One Anderson 3' X 3' gliding window on screened in porch and one Anderson 4'4 " X 3' 5" triple casement window over sink. Door — Provide and install Brosco fiber glass raised panel 36" X 6'8" door, where sliding door to porch used to be. Finish work - Install baseboard in kitchen and dining room. Install all door and window trim for 2 windows and a door. Install crown molding around new cabinets in both kitchen and new dining room. Cabinets. - Supply and install cabinets as per plans in both kitchen and addition with latest revision. General conditions — Project area will be left clean each day. Trash will be put into the dumpster. Project area will be left clean and ready to use at the end of the project. No painting included. Labor and materials $93,663 Received $1,50 - Can be deducted from initial $25,000 deposit O 61 Untitled (10). max Untitled (10).max 411 \ The Commonwealth of Massachusetts Department of Industrial Accidents 0. j„ ° ' Office of Investigations i.�t. � 600 Washington Street Boston, MA 02111 E'. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ( Please S Print LegiblName (Business/Organization/Individual): t L? ,f �, �, `C;:nS"� J �. L!A eV V , e 4'3 Address: - �- -13 \' , t -tom - c i rd City/State/Zip: l n V -G vx Phone #: ] i .-7 �_Q Are you an employer? Check the appropriate box: 1 !ffrI am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. $ ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7.-'1F'emodeling 8. ❑ Demolition 9. ❑ Building addition 10. El Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # I must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. _ Insurance Company Name: �t(G1 V F s n f>7 ��, Policy # or Self -ins. Lic. #: l7�k U 13 AVS -2 _8 3 " A Expiration Date: Job Site Address: ( lv _, "j City/State/Zip: N P AJ WIJ`e "j w 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 he(eby certify under the painjs,and penalties of perjury that the information provided above is true and correct. Qs� Phone #: '7 � 1 – 7!E0 .2.4 ( © j Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia �' 1ze -C�anvnzo�uuect� o���iaaaac�ivaeaa Board of Building Regulations and Standards HOME IMrOVEMENT CONTRACTOR Reg.0 94 32 rEp�ti�tr 1 6/2006 t_ 11_4 .t[. FITZGERALD CONSTRUCTI.M. -i" RAYMOND FITZGEL`1 2 Orchid Circle i BURLINGTON, MA 01803' Administrator BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR 1 Number: -CS 039692 Birthdate: '09/291;947 i Expires:09/29/2QQ5 Tr. no: 6805.0 Restricted ' ;00 a RAYMOND H FITZGERALD _ s 2 ORCHARD CIR BURLINGTON, MA 01803-`� t Administrator 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 at: I � (v e-� Vlek V is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: Fire Department Sign off. Dumpster Permit (Ile . (Locat on of Facility) Signature of Permit Applicant Date 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 J APPLICANT -LI -1 <` `t ��'-� <i `�v5 %n t PHONE qI -' j ' 007 LOCATION: Assessor's Map Number ('04 - 1 PARCEL C� (- 3 SUBDIVISION LOT (S) STREET � -7 Co V, e5'� W C- `-A ST. NUMBER I OFFICIAL USE ONL TION ADMINI TRATOR DATE APPROVED DATE REJECTED rnuu=NTQ I 1 VflfM > M 4AP i�- 6- hfj7AC-,(, bs�016�- i P` TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS DATE APPROVED PATE REJECTED DATE APPROVED PUBLIC WORKS - SEWERMATER GURNLU I IUNs DRIVEWAY PERMIT z0�5 FIRE DEPARTMENT RECEIVED BY BUILDING Revl"d 9197 JM E Sultollve EP7. CERTIFIED FOUNDATIONPLAN LOCATED IN t -1m wr- H lQ t SCALE. / "= DATE: a Zn a¢ l S.L.GILES R.L.S. 1,123 �,� L AWRENCE 8 NORTH ANDOVER UTA y U .,of_k /_0 Ilei cfxr y I CL'M IFY MAT THE OFFSETS SHOWN ARE F Ofe WE USE OF OFFSZ TS SHOWN THE BUIL D/NG ; NSPECTOR ONL Y, S SUCH CONFORM TO THE USE IS FOR DETERMINATION OFZON/NG ZONING B Y L A W OF CONFORMITY OR NON CONFORM/ T Y Q 012'1' H /� Sao 06v.. WHEN TAKEN. Lo-,- s s a z I C cm c o'0 •�CD m m �3 L ecv o a M: a cCc CD CAI c C Z C.3 to � C C •� C y W N Y/ oC W W 19 W N 'So x a0 x 0► O 7 O H C O Q: Ci •CL w$ a �' c o u, o rx U a x o w ir. W cw w" UW o a4 c u. w En 0 cn a z I C cm c o'0 •�CD m m �3 L ecv o a M: a cCc CD CAI c C Z C.3 to � C C •� C y W N Y/ oC W W 19 W N 'So 0► O 7 O H C O Q: Ci •CL c d O O '�• m C ;= O cc yam' V' C : oM CA EE 22= �L3: Co. C ,.. o -g cm ,mcT CHiN ` it ` 4. y 'Jo.. 3 Cm M ... con Eh m O L 'C CD y= y cc r: +_+ � C C 0QC .O p,C= 0 inOS -� Cy Z0 ca CO O C Q O O m C m=./p Q = O N LU CO •ca }. C A C H xE d= c�a�cay Z o C.3 a cm 5 mCA)��� IA 1�—_ CL Mo. �� a z I C cm c o'0 •�CD m m �3 L ecv o a M: a cCc CD CAI c C Z C.3 to � C C •� C y W N Y/ oC W W 19 W N 09/30/2005 FRI 13:11 FAX 978 657 5844 Wilmington Builders I L-- BC CALCO 2003 DESIGN REPORT - US ®002/002 Friday, September 30.2005 1 8.0s Double 13/411 X 117/8" VERSA-LAMO 3100 SP Floor Basin Job Name: KUSHNIER ADDITION File Name: SC CALC Project: FBQI Description: Address: 176 VEST WAY SpedBer. City, Stale, 2p: NORTH ANDOVER. MA Designer Customer. Comp Code MPOft ICBG 5512, NER 629 Mlsc. 2ND FLOOR BEAM 9V 81 3900 lbs LL 1958 lbs OL 3900 It It 1958 Ors OL General Data Version: LIS Imperial Member Type: Floor Basin Number of Spans: 1 Left Cantiever: No Right CanNever: No Scope: OM2 Tributory. 12-0D•00 Live Load: 30 psf Dead Load: 10 psf Partition Load: 0 psf Duration: 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability for a particular application. The output above i9 based upon budding code-acoepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with the current Installation Gide and the applicable building codes. To obtain an Installation Guide or if you have any Questions. please cal (800)232-0788 before beginning product installation. SC CALCS. BC FRAMERS. WA0, BC RIM BOARD'SC 0813 RIM BOARD^", BOISE GLULAM"", VERSA-LAMO. VERSA -RIMS. VERSA -RIM PLUM VERSA-STRANDTM. VERSASTUD®, ALUOM70 and AJS" are trademarks of Boise Cascade Corporation. Page 1 of 1 Total Horizontal Load Summitry ID Description Load Type Reif. S Standard Load Unf. Area Left -10-00-00 Start End 00-00-00 10-00-00 1 Unf. Area Left 004000 10-00.00 2 WE Lin. Left 0000.00 10-00-00 Controls Summary Type Value Will. Our. Live 30 psi 12.00-00 100'% Dead 10 psf 12.0000 OQ'% Roof Live 35 psi 12.00-00 115% Deed 1S psf 12.00-00 90°/9 Live 0 pif rJa 900/9 Dead 80 pif nfs 909E Control Type Value %A I*w*Ae Duration Load Case Span Location Moment 14846 ftabs 68.8'% 100% 2 1- Internal Neg. Moment 0 Rebs Ma 100% End Shear 4699 lbs 58.5% 100•% 2 1 -Left Total Load Deb, 0445 (0.27-) 54.0% 2 1 Live Load Deft. L1668 (0. IS-) 71,9% 2 1 Mar Defl. 027- 27,01Y• 2 1 Notes Design meets Code minimum (L/240) Total bad deflection arteria, Design meets User specified (0480) Live road delectlon criteria. Design meets arbi rary (1") Maromum load deflection criteria. Minimum bearing length for So is z". Minimum bearing length for B1 is 2'. EnteredMisplayed Horizontal Spen LergMz) = Clear Span + 1f2 mim end bearing • 112 intermediate bearing Connection Diagram Member has no We loads, Connecters are.1 Od Sinker Nails a=2' b=3• ib c = 7-7/8- d=1r a- • IC T::�i -�- 2-G era � � ConsArock;&% T -d E980—CLE—TSL riG Ves+ wo.1 pTejaOz4TJ 810401W d90:2o SO OE des i Location /f No. 6 (?/ t ( Date J7 - 61 TOWN OF NORTH ANDOVER Ii 9 Certificate of Occupancy $ SA -Is <� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ t Check # 7M C)I& 2�,t /� Building Inspect r 1.I Property Address: ' "'LUMJ 1.2 Assessors Map and Parcel Map Number Number: Parcel Number 4 U 1— - 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Fronta e ft 1.6 BUILDING SETBACKS R Telephone Front Yard Side Yard Rear Yard Required Provide R 'redProvided R red Provided SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private ❑ Zone 1.5. Flood Zone Information: Outside Flood Zone ❑ l.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT ' "'LUMJ 2.1 Owner of Record / 4 U 1— - Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ t �4Avt Licensed Construction Supervisor: License Number Address::2�� L, t�,?—/o ^� �j�/ Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ r C / UL 6 >-O Company Name Registration Number —� Q Q + r2`� `; !,�7�J — (� Ad dr_ _V� - Expiration Date ,Si nature Telephone MU M X z O M O z M 90 O ic M r z 0 SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 6 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 buildi/i permit. Signed affidavit Attached Yes ....... V No ....... 0 SECTION 5 Descri tion of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: � SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be OFJH'ICIAIrUSE,(INLy Completed by permit applicant .,. 1. Building (a) Building Permit Fee ,. U Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x @l 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT L Vilt l-2 as Owner/Authorized Agent of subject property Hereby authorize �� �1) ('�-✓(: G(?v�', to act on My behalf, in all matters relative to work authorized by this building permit application. -Signature of Owner Date -SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, t , �j% f't' IZV as Owner/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 P ' ame 1 -6� " 1 1 q Si a e o Owner /A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2ND 3 SPAN DTWNSIONS OF SILLS DIMENSIONS OF POSTS DIN ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Lil rA W LVF--; z � x w V) o U w o; U x o U G1�i G% a ° w w V) Lt. p U � a Lr. H w w as o 2 Cn v O cn • 0 i C N O C 'r O _v V p, C O ea ;,C O O Cc H Ea CF L s :r o CL y E C : 0 m c a o0 or mCD c V1 W mm o Z' c y m m3� .m N E O � m o c.c3 1 N m IND,, c0a o,cr mor i � HZ o c CL H C Q = 0 0a o � o CL. p F- r uyi r •N CZ O C *- �E v�vcm COD C O O.0 l00 i0., y�O z CL:a m J CD 5 vqll I CCM CO2co Q O ._ y O O '@ m m CL �" a CD O O Q O e_m o Q C- CM< ca c ev ev C.3 J •� .0 ' s V0 CL Z coy O C C cCL Q CO2 Q LLI 0 N U) ce W W W W N - i' BOARD OFBUILDING REOULATtONS License: CONSTRUCTION SUPERVISOR � Number: CS 050110 f' j Birthdate: 04/22/1956 Expires: 04/22/2005 Tr. no: 9641 RICHARD A FLUET 102 BRIDLE PATH LN ! i METHUEN, MA 01844 Administrator i 71. �orrmmzaruueaZ o�✓�aaoaclu�art Board of Building Regulations and Standards HOME IMl?ROVEMENT CONTRACTOR ! Registratiorv* . 106620 Expir*00n7124!2004 Corporation Administrator M The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: Cit ry Phone # 0 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity F1I am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address City: Phone #: Insurance. Co. Policy #_ Company name: Address City: Phone #: 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_well_as_civil..Renaltiesinthefnrm-of-_STOP WORK_ORDER..and.a fine_of.($100.00)_aidayagainstme. 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 ins and na perjury that the information provided above is true and correct. e 4 Signature n JDate Print name U l Ale ��—�% (7 P.hone # 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 #. ❑ Health Department R Other `ta- _Locationn � � p4z No. Date 93 NORTH TOWN OF NORTH ANDOVER O?o• t, .•,�Oo� Certificate of Occupancy $ s i Building/Frame Permit Fee $ �ss�cNuBEt Foundation Permitfee $ Other Permit Fee y $ �� v C ^ Sewer Connection Fee $ Water Connection Fee $ 9 ITffAL 6759, Building Inspector Div. 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O CO2 OO I CO CD E- CDCD z v y O �D o o CD 0 CCD C'f IZ 0 0 I� �C �d �O Cc 3'R O m 2 o -•vi0a H dO C m CA »CD In m C) H 0 O.0 m Z =r -p ycu -1 O ._.� � y T O ?d O y CD O W y p 0-,'0 > > 0 0 c tG �. p = ' oy.00 � CO) � CO) cO Col - OC Cl) CD H CD C-3-0 co o o. :w co NO. yt C 0. H a P. y 0 ECO) c = � 1 CD H b "tooA _�co a V ... 0 ire 'W0 .. :b O oo�: % CA V H CD o a.: oCO � EU CL,g •. 0 0 0; o c o o = o CD o CAm ma cn 0 O Cn rD o w " � C7 m w 7o G C7 y M w cn rD < 7� C tz y rA z n? w 7Z G r � co '?? w n 7� '� G rt � C r cn b � •n O x s• G7 O C Gn • in 0 .9 0 c CD 14. - - nrr�r ..�..�.rrlMiwr•wrr CFRT/F/E"D FdUNDAT/ON PLAN LOCATED /N SCALE. vit4o l SL.OIL ES R.L.S LAWRENCEa NORTH ANDOVER . -ss 1 ' ` EAyarnEu-r � OWN ARE FOR THE USE OF �►"` °� l CERT/FY THAT TH OFFSETS SHOWN OFFSE TS SHOWN,'- THE QU/LD/NG INSPEMR ONLY, 8. SUCH s r, coNFoRM To T.HE USE /S FOR DETERMINATION OFZON/NG #` 13572 .� IST C. j J~G:rr ZONING B Y L A W OF CONFORM/ T Y OR NON CONFORM/T Y'h,, ►.)o�z,-N A.�no�e� WHEN TAKEN. - ---------------------------------------------------------------------------------------------------- MANNING BUILDERS INC. NEW CONSTRUCTION REMODELING LICENSED & INSURED 158 Dale Street N. Andover, MA 01845 (508) 688-2005 nat'm t 1in q9% 5c /� L'c-,J1--f`. I, !Z( 000e1.L y,y'` cj. E- (=la NCA yg ►► FOnTw6s , cC�NC-1i? � r P� D UA-�Oifv 5THI 5. a,... u..- . ,��. ...�w.....e,., .VW4c wA" 404 W, LSZ- 95 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: PA)�1ooiv& P_1U1 LV)V_V0z-_J f II,�C Phone 5��3_O LOCATION: Assessor's Map Number Subdivision treet t;�ST w Ai Parcel Lots) 5 St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: V Date Approved Conservation Administrator Date Rejected Comments Town Planner Comments Food Inspector -Health 14 -�J,ZaA_lb ep is Inspector -Health Comments n6t4 Public Works - sewer/water connections - driveway permit Fire Department Date Approved Date Rejected Date Approved Date Rejected Date Approved a Date Rejected Received by Building Inspector Date uc-U-1%_ . v& . APPEALS ;1,• y; NORTH ANDOVER BUILDING t.+:a��r DIVISION OF CONSERVATION HEALTH PLANNINGPLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR Norin ^nuuvm- Massachusetts O 1845 16 1 71 6854777 5 .r • J In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number�j� is that the debris resulting from this work shall be disposed of in a prcperiv liccnscd solid waste disposal facility as dcfincd by MGL c 111, S 150A. The debris will be disposed of in: r (Location of Facility) Signature op Pc, -mit Appii f q �-Z' Dat i- NOT=•Demolition permit from the Town of North krtdover must be obtained for: this project through the Office of the 3uilding Inspector. 1W , l aaaRaoF��n�an►Raa�r�rs�arM�* Permit "°� f � � c APPLIONFOR P�T�O PERFORM ELECTRICAL WORK w. wo sB PERFORMED IN ACCORDANCE WTM THE MASSACHUSSTS FLIM CALCooe, 527 CMR 12:00 (PLEASE PRIM IN PK OR TYPE ALL ]MORMA7I014) D D a D Town of North Andover To the Inspector of Wires: The undersigned applies for a permit ta perform the electrical work described below, Location (Street A Number) I � Owner or Tenant V,�t v C f 4see&er Owner's Address S A� Is this permit in conjunction with a building permit YesM No O (Check Appmprime Box) Purpose of Building t °r C �t ✓t ctrl G(c ¢-,'� /1 Utility Authorization No. Existing Service Ampa..../ olts Overhead Underground E3 No. of Meters New Service Amps Volta Overlied Underground C3 No. of Meter Number of Feeders and Ampcity Location and Nature of Proposed Electrical Work of Na Of IDft0IIZYM WodWSM hpedlonD*Ra}r�d 3grdurrds;;=;pMW/� FRtMNME 04'i it eel LoQme / IC /'! t/1 Slpr�oaae FU M.AI M' No. of Zone• Na of Deleodoie end Wdedua Devi= Na of sm=fn Dedos Na ofswcb wnw • L ftW DrAm D� 0 do Yo ED M Y ouhnednaedB4� C7 ify ffaetrdarehtypedoaeavby _ �c1� ��oEs*WWVakzof>bkalAW d6 Lio MAMA LiomtieNo ; d2o F D, D x �% m "60 � Uhl ��Nice= At IaiN6 OWIWS IIVSURAiV(LWANFl1':IamiwaelhtlreLicveed=nd�tkirearoeanvagotit �la�ive�t$rec}iedby�neltlG'QaiILmM arlddrtrtws0uaaeondisFdapplcaivtwabsli (Please check one) Owner a Asara13 Telephone No, PER FEB I 09/30/2005 FRI 13111 FAX 978 657 5844 Wilmington suildere SC CALL® 2003 DESIGN REPORT - US ®002/002 Friday, September 30, 200513:05 Double 13/4" X 117/811 VERSA -L M@ 3100 SP I& Name BC CALL Project: FH01 Job Name: KUSHNIER ADDITION Description: Address: 176 VEST WAY Spedier City. State. Tip: NORTH ANDOVER, MA Designer: Customer. Company - Code reports: ICBG 5512. NER 829 Misc. 2ND FLOOR BEAM Pv 3900 lbs LL 61 1958 Ibs OL 3900 lbs LL 1958 tbs OL Gerwail Data 14646 ft4bs Version: US Imperial Member Type: Floor Beam Number of Spans: 1 Left Cant ww. No Right Cantilever: No Slope: OM2 Tributary: 12-00.00 Live Lead: 30 psf Dead Load: 10 P5f Partition Load 0 psi Duration 100 Disclosure The completeness and accuracy of the input must be verifred by anyone who wadd rely on ilia output as evidence of suitability for a Particular appliw5on. The output above is based upon budding Code-accepled design properties and anelysle methods. buhdlatim of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installetion Guide or if you have any Questions. piea9e can (800)232-0788 betre begin ningl Product irlstalle6on. SC CALM BC FRAMER6, SCO, BC RIM BOARO"' BC OSB RIM BOARD"' BOISE GLuLAM"' VERSA -LAM®. VERSA-RIMOD. VERSA -RIM PLuse. VERSA-STRANDTM. VERSA-0TUDO. ALWOISTS and AJSTM are trademarks of Boise Cascade Corporation. Total Noriaonlet Length-1o4lo-00 r.uau au "Mwy ID Deseripow Load Type Ref. 3 Standard Load Unf. Area Left 1 Unf. Area Left 2 Unf. Lin. Left Controls Summary Control Type Value Moment 14646 ft4bs Neg. Moment 0 ft4bs End Shear 46996a Total Load Dell. U445 (0.2r) Live Load Deft. 0688 (0.18•) Max Deg. 02r Start aw Type 00-00-00 1000-00 Live 10 psi 12-00-400 Dead 0400`00 10-00.00 Raaf live 15 psf 1240-00 Dead 004M 1040-00 Live 80 pit n/a Dead %AliowaMe Duration 68.8% 100% n/a 100% 58.576 100% 54.0% 71.9% 27.0% Value Tru Our. 30 IW 12.00-00 100% 10 psi 12-00-400 80% 35 psf 12.00-00 115% 15 psf 1240-00 90% 0 OF n/a 9076 80 pit n/a 90% Load Case Span Location 2 1 - Internal 2 1 -Left 2 1 2 1 2 1 Notes Design meas Code minimum (1240) Total bad denection Criteria, Design rrgef: User specified (LMW) Live load deflection'cnWia. Design meats arWary (11 Mwdmum load deflection criteriw Nknimurn bearing length for 60 is 2". Minimum bearing length for 81 is 2". EnteredlDisplayed Horixaltel Span Lengm(s) = C2ear Span + 1/2 min. end bearing + 1/2 intermediate bearing Connecthm Diagram Member has no We loads. ComwAws are: 1lid Sinker Nails a=2' b =.T lb d --.. c=7-718" d=12' �- - • I IC I Page i of 1 �r-�- Cons-V0ca\ Vest' via. f, I 09/30/2005 PRX 13:11 FAIL 978 657 5844 Nilmtngton Builders BC CALL® 2003 DESIGN REPORT - US IM001/002 Friday. September 30,2005 1123 Triple 1314" x 9112" VERSA -LAM® 3100 SP Fife Harm BC CALL Project: F802 Job Name: KUSHNIERADOITION Description: Address: 176 VEST WAY SpecW. City. State, Lp: NORTH ANDOVER. MA Designer: Customer Company: Code Motu: IC80 5512. NER 829 Mis¢ 2ND FLOOR BEAM so 3900Ibs u 3900 Its it 1970lbs OL 1970 IIs DL General Dada Value Version: US Imperial Member Type; Moor Beam Number of Spans: 1 Left Cantilever. No Right Cantilever. NO Slope: 0112 Tributary: 12-00-00 Live load: 30 pst Dead Load: 10 psf Partition Load: 0 pat Duration: 100 Dlsdosure The completeness and w4u acy of meinWtmust beverified by anyone who would rely on the output as evidence of suitability for a partiadar application. The output above is based upon building coda -accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in 9000r62nee with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or 9 you have any Questions. please call (800)232-0788 before beginning product installation. BC CALOV, BC FRAMEM, SCIA. BC RIM BOARD'. BC OSO RIM BOARDTM, BOISE GLULAMTM. VERSAA Alii®. VERSA -RIM& VERSA -RIM PLUS®. VERSASTRANOTm. VERSA-STU06. ALLJOISTO and AJSTM are trademarks of Boise Cascade Corporation. TOW Montalto larglh -10-00-00 Load Summary ID Description Load Type Ref. Start End S Standard Load Unt. Area Left 00-00-00 10.00-00 UrnL Area telt 00-00-00 10.00-00 unf. Lin. teff 00.00-00 10.00-00 Type Value Trio. Dur. Live 30 psf 12-00.00 100% Dead 10 psf 1240-00 90% Snow 35 psi 12.00.00 115% Dead 15 pe 1240.00 90% Live 0 plf Ne 90% Dead 80 pM Na 90% Controls Summary Control Type Value % Allowable Duration toad Case Span Wcatlon Moment 14675 ftabs 70.1% 100% 2 1 - internal Nee. Moment 0 ft4ba n/a 1=4 End Shear 4941 lbs 51.2% 100% 2 1- Left Total Load Dell. 0341 (0.352") 70.4% 2 1 Live Load Deli. 0513 (0234-) 93.6% 2 1 Max Det. 0.352' 35.2% 2 1 Notes Design Ile eb Code minimum (1./240) Total load deflection erderia. Design meets user sped6ed 41480) Live toad dBfledon criteria. Design meds arbitrary (1") Maximum load deflection criteria. Minimum bearing length for 80 is 1-112". Minimum basing length for 81 is 1-1W. • 112 irrkrmedrale bearing EnUmedulgI ayad horizontal Span Lmnglh(s) = Clear Span * 112 min. end bearing Connection Diagram Nailing Schedule applies b both sides of the member. Member has no side bads. COnnedors are. 16d Sinker Nads a-2' b-3" c 5-112- da12' e=3- F'1k*ZG6vWa% ceI\S+c uc6� rase�m+ - - - - - -' - -