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Miscellaneous - 2130 TURNPIKE STREET 4/30/2018
lv 04 O Dateab..I.d..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... j j ........... &— ... ... i.*. .. .... 0 ... W ................................................... has permission to perform ...r --e.. ........... a*"* ................................. ................. wiring in the building of ....... ... it .. ........................................................ at 20�`. I ...,,.,,,A,Andover,,Mvias Fee... ..................... Lic. No. ........ ......... .. .......... . .. ..... .. . ... ... ELECTRICALINSPECTOR Check,, -f-2 1250 Official Use Only Commonwealth of Massachusetts Permit No. I a Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 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 PRINT ININK OR TYPE ALL )NFORMATIOA9 Date: 7-7—/q 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 the electrical work described below. Location (Street & Number) Owner or Tenant 6 ( 0� ,.�� IAJ I V 5� IL Telephone No. -0 - WO- f/fy Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. - Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location Nature of Proposed Electrical Work: j'% a ,,� (nC 44 1. CP Comnletion ofthe following table may he waived by the Insnector 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 Generators KVA No. of Luminaires Swimming Pool Above El ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number "' I TonsKW .......... "'" No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs - Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of 97res. (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 covera ism force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I'certify, under the�wins andpenalties gfperjury, that the information on this application is true and complete. FIRM NAME: 0 9�L uA I,.1 o vt S' L a 4-�) LIC. NO.: 915off -�= Licensee: (If applica) Address: enter "exempt" in the license number line.) Bus. Alt. !R-* NO.: Tel. No.:2&x^42 W"7 Tel. No.: `Per M.G.L c. 147, s. 57-61, security work requires Department ofPublic Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with the provisions of M.G.L. c. 143, § 3L, the Za permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed ,� l on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall.be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. ❑ Rule 8 — Permit/Date Closed: *** Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: Trench Inspection Pass [M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: t l Date: w,{ SERVICE INSPECTION: Pass IM Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: z Inspectors Signature: C Date: PARTIAL ROUGH INSPECTION: Pass n? Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass 0 Failed IM Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Y Pass [M Failed ❑' <, Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ... TOWN OF MERRIMAC, MA........dweinhold@townofinerrimac.com The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 0211.1 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly • c� Name (Business/Organization/Individual): 0(;z _ 1A 1 (n �1 L-) . Address: . AOR - Az K1 h3 s _111 City/State/Zip: ,. �,� �, l Phone #: 3 9 l 7 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I e oyees (full and/or part-time).* have Hired the sub -contractors 2. I am a sole proprietor or partner- listed on the attached sheet. t 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 3.01 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.] i employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. 1Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #:. Expiration Date: Job Site Address: 21 J V "ruv V -t ret � CA 3 P, Pity/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby c t,y under the pains and,penaldes ofperjury that the information provided above is true and correct. .Qiamafiir ata• / -7-14 3,- 9yv 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 #: Informati®n 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 d'eeined to'be an employer." MGL'chapter 152,.§25C(6) also "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 ofpublic 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 maybe 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 ofMassachbsetts � Department of Industrial Accidents Office of Investigations 6.00 Washington Street Boston, MA 02111 TO, # 61.7-72..7-4900 ext 406 or 1-877:MASSAFE Revised 5-26-05 Fax # 617727-7749 www mass,gov1dia P !i UCENSEiNUMBER IMI,EXPIRATION DATE: -1- aSERIAL'NUMBER Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that. has permission to perform..?. , a ..�.Lt . . . . . . . . . ..... . plumbing in the buildings of. . -WL , ; , , at ..�.?�cJ �.��Gy�� �� ......... North Andover, Mass. Fee. Lic. No.. '1(�'�. ........................ ... PLUMBING INSPECTOR Check # f 15p —1 &5 17> VV(— 1 j )1 < � t3 ;� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY +?'" 46 vl�e- MA DATE LGL -&—ice PERMIT# JOBSITE ADDRESS i TU OWNER'S NAME S ✓e. G_y� L,� /;� POWNER ADDRESS _ I TEL A -J,6.6 6 ar FAX { TYPE OR OCCUPANCY TYPE COMMERCIAL 01 EDUCATIONAL ® RESIDENTIAL' PRINTn CLEARLY NEW: RENOVATION: ©( REPLACEMENT: Ell PLANS SUBMITTED: YES 0 N00 FIXTURES'l FLOOR- BSM 1 2 3 4 5 6 1 7 S 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM ! _( DEDICATED GREASE SYSTEM --=- DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM _ __.._I .___.__I ____._I ____! DISHWASHER DRINKING FOUNTAIN i_ -.J _. [ .____f J ! ) { I ._. _f J _.__..... FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK —I ._1 _ -� ---- I - -_ ( .. _�l .� --I -- -� _-..--_ I - --I ----! - __} --.____P I -- - J •--fv LAVATORY ---------iJ . --i---_..J ROOF DRAIN f ( I f J .—J ---___! SHOWER STALLf SERVICE / MOP SINK .- _j _ _ f _-_....__J ._; TOILET i i. _f �-_� f URINAL WASHING MACHINE CONNECTION ( _ ; __J WATER HEATER ALL TYPES G f - E _� ( - I I f ! WATER PIPING OTHER _ ( i _I .... I ! _.._ ._ E f _ fi 1 _ f _ i T _ _- _ .__._ _ 00 IF ..-_J __I I INSURANCE COVERAGE: 9 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES a NO OF YOU CHECKED YES, PLEASE INDICATE TH YPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITYI BOND _i OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the S Massachusetts General Laws, and that my signature on this permit application waives this requirement. j SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER 0 AGENT 6 hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the FMassachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME g-- LICENSE # i/� _ I SIGNATURE MP E JPQ.f CORPORATION Q.(#=PARTNERSHIP # T t LLC L COMPANY NAME - cyc.v e to/ !ADDRESS Jed, t CITY /L/e ;STATE L ZIP Q i TEL .51 i 3��a MAIL FAX r vl F , o a F U a OF] z z �El o � W w F � IL LLI nt z° S ® a LLJ w dLLI k N O z p" 6z1 Q J a a a � z � w w I-- LL z a M a O a CbNPf111dN4NALTH OAMASSACII U17 S M Pi..UMBERS AND,GASFtTTERS, `LICENSED AS A JOURNEY1ViAN ALUMS f. ISSUES THE ABOVE LICENSE TO j. ! 'lORMANI?, FF ✓BERUBE A, INCOLN -ROAD t} NEWTON MH'. -03858 3103 p� t�L34Q . 05/.01/14 17,I•fi95 t�..� 1 i 1 I. V The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Naive (Business/Organization/Individual): pyo YzJR� Address: l'42k City/State/Zip: A) q:n who %0 A) I�, 6-37-'-q- Phone #: ,o 6 3 3 8a ';� 9�z .9 Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction ployees (full and/or part-time).* have hired the sub -contractors listed the attached sheet. 7• El Remodeling 2. I am a sole proprietor or partner- ship and'have no employees on These sub -contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance..9, ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL l l.&frlumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no. 12.0 Roofrepairs � insurance ] ired. re q u employees. [No workers' 13.❑Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. i Homeowners who submit this affidavit indicating they Sire doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. 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 of M'GL 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. X do hereby cert under the pains, andpen ofperjury that the in formation provided above is true and correct. (>63 SF,�P__wzaY Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License ,6-6—J.3 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 Date e. � �?t 1.3 . . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ertifies that ..... '�%�"��- P4 --I has permission for.gas installation .��.�^? "`u� in the buildings of .... <��✓�'�.? .! !�- .............. . . Q �...... North Andover, Mass. Fee. Lic. No. 1.t � � .................. . � � .... ....... .. N1 GAS INSPECTOR Check # 1 1 873011 r�P IG- « � jS �ti' > MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY �9 _ HJT/ t9 �/� Ji -�� MA DATE (�Lo �_ -_13 PERMIT # JOBSITE ADDRESS J i OWNER'S NAME✓e. �viaC GOWNER ADDRESS TE _ 7' 36d FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL 01 RESIDENTIAL PRINT CLEARLY NEW: ,[RENOVATION: 0 REPLACEMENT: PLANS SUBMITTED: YES F -7Q. NO[J1 APPLIANCES Z FLOORS- BSM 1 1 2 3 4 5 6 7 8 1 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE r f GENERATOR ^__ml 1—� —-. ( GRILLE [ - INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN J POOL HEATER - - - J _.__.. I - -! _ .,_,-1 ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER "' JN_VENTED ROOM HEATER - _.;,.HEATER I _ I a INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES JEJ NO E] IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BONDFL] OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER - AGENT SIGNATURE OF OWNER OR AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli a with all inentylovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME LO LICENSE # is- - SIGNATURE MPGF( JP n JGF LPGI CORPORATION -j # = PARTNERSHIP �#E LLC -I#_ COMPANY NAME: W-4jb L_- q� ��ADDRESS >a L✓-�-v CITY7__----__..__ STATEZIP 0 TEL FAX CE 163 Z6S'/a2 g4 EMAIL ... -- W H z° z U I W d ti O N r] W >- ~ W OF a Z u LU X v� Cl) w ® uj > W Q W V) O a a 0 E., a CL a � � w s w H LL H z z ®, U NWI C7 E Cx7 �' I. The Commonwealth of Massachusetts Department of IndustrialAccidints fu Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance .Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Name (Business/Organization/Individual): o(/d ✓�i'���'�'�— Address: �c7� L;bL City/State/Zip: /vim c ud o ;4_) A-) /, 637-(—q Phone #: 4�4P 6 Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction ,employees (full and/or part-time).* have hired the sub -contractors listed on the attached sheet. El Remodeling 2. (i_ I am a sole proprietor or partner= ship and'have no employees These sub -contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. El Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10. F1 Electrical repairs or additions required.] officers have exercised their 11. Plumbing repairs or additions 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. 12. ❑ Roof repairs insurance required.] employees. [No workers' 13.[i Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they tie doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Policy # or Self -ins. Lic. #: 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 requiredunder Section 25A of kGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as wellas 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 cern under the pa1Aand penyjties of perjury that the information provided above is true and correct. �v63 SF 1.-7,9a� Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # ,6-6— J.3 Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. PIumbing Inspector 6. Other - - - Contact Person: Phone M. ,-COMMONWEALTH OF MASSACHUSETTS PLUMBERS AND GASFITTERS� Wf d�ICENSED AS A --MASTER PLUMBEf S r s ISSUES THE ABOVE LICENSE TO NORMAND '-P B`ERUBE Z -Z L,I"NGOLN RD'. t 'NEWTON NH 03858 3103 l 11588 U5/Oi/14 1717rf COMMONWEALTH OF MASSACHUSETTS P"Luh/iBERS AND .GASFrTTERs S tr E ' LlCENSECb JOURNEYMgN RLIJMB - s * ; ISSUES THE"LIBOVE LICENSE TO:' ' t ? ORMAND. iF iBERUBE Y'p , �LI'NC.OLN ROAD l I`,IvEWTOM NH .'U 385 y 8 310 3 r _ r i ,-COMMONWEALTH OF MASSACHUSETTS PLUMBERS AND GASFITTERS� Wf d�ICENSED AS A --MASTER PLUMBEf S r s ISSUES THE ABOVE LICENSE TO NORMAND '-P B`ERUBE Z -Z L,I"NGOLN RD'. t 'NEWTON NH 03858 3103 l 11588 U5/Oi/14 1717rf COMMONWEALTH OF MASSACHUSETTS P"Luh/iBERS AND .GASFrTTERs S tr E ' LlCENSECb JOURNEYMgN RLIJMB - s * ; ISSUES THE"LIBOVE LICENSE TO:' ' t ? ORMAND. iF iBERUBE Y'p , �LI'NC.OLN ROAD l I`,IvEWTOM NH .'U 385 y 8 310 3 r _ r :<x i Date .....l ...-........ i....z-� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that �, ................... . .......................................................................................... has permission to perform ...... ��✓vS wiring in the building of...,,.,. «...................... .............................................................. at..�...:%.............,Tv.../�!..p!�"r:.. L- ............:..5.. ,North Andover, ass. Fee.. ........ Lic. No. 5..5...0%i............/%1y........: ELECTRICAL INSPECTOR'S Check #� Official Use Only Commonwealths of Massachusetts Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. l/07j (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC 527 C 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: s City or Town of: NORTH ANDOVER To the Inspector of fres: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) :21 sn r P1 '05 e -P S, Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes W-*-- No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. i Alb QQ Mn - Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:� ' Ma� FAI Comnletinn nfthe fnllnwina tnhl0 mm, ha wnlvorl iiv tbo Th cnartnv ni Wivov No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- El rnd. rnd. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: I.Num.ber I I Tons I KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Si ns Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Fires. Estimated Value of Electrical Work: (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 c�o�ve is . force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 'EBOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME:. eTbFL A W LIC. NO.:35 091�jc- Licensee: LTC. NO.: (If applicable enter "e em t" in the li ense number line.) ` Bus. Tel. No. • Address: 3�' Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Departmen of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent elm - Signature Telephone No. PERMITFEE. $ �. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall.be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. ❑ Rule 8 — Permit/Date Closed: * * Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: Trench Inspection Pass 0 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass ? Failed Re- Inspection Required ($.) ❑ Inspectors Comme Inspectors Signature: U Date: PARTIAL ROUGH INSPECTION: Pass 0 Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INCTION: Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: 01 ti Date: G /7 FINAL INSPECTION: Pass 0 Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ... TOWN OF MERRIMAC, MA. .......dweinhold@townofinerrimac.com The Commonwealth ofMassachusetts Department of IndustriglAccidents Office of Investigations 600 Washington Street .Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationffndividual): L4%_(r� YL ® LJ Address: 4 4 (3� tA/o-o City/State/Zip: L) 3 8 LA Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).` 2. ❑ I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. x �• E] Remodeling ship and'have no employees These sub -contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its ME] Electrical repairs or additions required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.Q Roof repairs insurance required.] i employees. [No workers' 13.❑ Other comp. insurance required.] I%ny applicant that checks box41 must also fill out the section below showingtheir workers' compensation policy information. i Homeowners who submit this affidavit indicating they ire doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. -Taman employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company N 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 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 maybe forwarded to the Office of Investigations of the DTA for insurance coverage verification. I do Hereby certify under the pains an dv enaldes ofperjury that the information pro vide/d�'abo/ve is true and correct. use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License P. Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. CitylTown 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 ofpublic 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 (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 maybe 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 homeowner 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 Massachuseats Department of fndusttial Accidents omoe of Investigations 600 Wasbiugtoa Street BostQn} MA 02111 TO, # 617-727-4900 at 406 or 1-877:MASSAFF, Revised 5-26-05 Fay,## 617-7277749 wV€w_maae anuhl.ln 1 2419 Date .. (.10. 1 t. -A ►. ...... TOWN OF NORTH ANDOVER PERMIT FOR MECHANICAL INSTALLATION A s This certifies that .. � �.. `:'� �-.+ Tk.'A. � °.. � • • • has permission for mech nical installation ` +'............. in the buildings of P-�� �'`? �?'... p� `v � rlt- .............. at��. •� •,4b North Andover, Mass. Fee ! t Lic. No... i � 3.. !' ................... . 477 GAS INSPECTOR ��7C WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Commonwealth of Massachusetts Sheet Metal Permit Date: Permit # Estimated Job Cost: % D,y -�JZ% Permit Fee: $ \� Plans Submitted: YES NO Business License # 1 & -S Plans Reviewed: YES NO Applicant License # - I Business Information: Property �Owner / Job Location Information: Name:qN Name: �I 6QA�i Street: 1(J� %�% �1e�1�%3P L� G Street: .3y 1�'j �z D City/Town: P31_6_4 -1D ' e9_3 W/City/Town: 'Pnft?Q119K Telephone: T) &` S 7 � �d Tel hone: 7)9— � ��� Photo I.D. required / Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family Multi -family _ Commercial: Office Retail Industrial Building _ Building Cubic Footage: under 35,000 cu. ft." Sheet metal work to be completed: New Work: V Condo / Townhouses Educational Institutional over 35,000 cu. ft. HVAC Metal Roofing Kitchen -Exhaust System Provide brief description of work to be done: Renovation: Chimney / Vents INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes No ❑ -�C p y q q If you have checked Yes, in 'cate the type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑, I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Date Date By Title City/Town Permit # Fee $ Inspector Signature of Permit Approval Progress Inspections Comments Final Inspection Type of License: ❑ Master ❑ Master -Restricted ❑Journeyperson ❑Journeyperson-Restricted X Comments Signature of Licensee License Number: Check at www.mass.gov/dpl Sheet Metal Commercial Guidelines / Life Safety / Critical Systems Inspection Checklist Yes No N/A, Set of stamped engineering documents and detailed description of mechanical system to be installed has been provided V All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper journeyperson-to-apprentice ratios Fire dampers with access door properly installed and checked foroperation Smoke and,combination fire / smoke dampers with access doors properly installed - actuator checked for proper operation (May also be verified by fire department during fire alarm testing) Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) Smoke / atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm testing) Stair pressurization systems installed (where required) and operation verified (May also be verified by fire department during fire alarm testing) Grease / kitchen hood exhaust system installed with all scams and connections welded airtight with properly located cleanouts. Proper clea`ances, fire rated enclosures and pressure testing required. Seisu:?ic res, �aints installi�L =rlibt6; required 'on egtiipment and d��=.� •. o,.,- Duct penetrations in fire'rd tmll:: and floors sealed Metal roofing systems installed watertight fusing proper materials and fasteners Flexible duct nuns installed 6'-0" maximum length Ductwork installed using proper hanger spacing, hanger stock, threaded rod and angle iron \\_1 Ductwork / plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining \ _ Volume dampers installed for each supply air branch duct V New/clean _ properly sized filters installed (final inspection) Testing and Balancing report complete (final sign-oft) Sheet Metal Residential Guidelines / Inspection Checklist Yes No N/A Detailed description and sketch of sheet metal system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper joumeyperson-to- apprentice ratios Equipment sized per heating / cooling load calculations Duct work sized per manual "D" calculations Bath / shower rooms contain mechanical exhaust fan vented outdoors Electric dryer exhaust properly installed maximum total run 35'-0", maximum flexible run 8'-0" Flexible duct runs installed 14'-0" maximum length Volume dampers installed for each supply air branch duct Ductwork installed using proper gauges and hangers Ductwork / plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining New/clean - properly sized filter installed (final inspection) Testing and Balancing report complete (final sign -off) .UMMONWEALTH OF MASSACHUSETTS i I'1 OF - SHEET METAL' -WORKERS ` AS AM'ASTER UNRESTRICTED y ISSUES THE ABOVE LICENSE TO r DONALD J QUINTAL JR 100MCINTDSH LANE I NH :03841 5319 H:AMPSTEAD�,�°^ 9253 01/28/15 310529 t x • s "' ! - " Fold Multiple Times Along Pertorations Before Detaching r .9i r .UMMONWEALTH OF MASSACHUSETTS i I'1 OF - SHEET METAL' -WORKERS ` AS AM'ASTER UNRESTRICTED y ISSUES THE ABOVE LICENSE TO r DONALD J QUINTAL JR 100MCINTDSH LANE I NH :03841 5319 H:AMPSTEAD�,�°^ 9253 01/28/15 310529 t x • s "' ! - " Fold Multiple Times Along Pertorations Before Detaching r .9i . i . 3 E Don Quintal Heating & Cooling 100 McIntosh Lane, Hampstead; NH 03841 MA 978-372-6503 NH 603-489-1623 41 Terms: Please detach and return with your remittance LJLJ-J!J L�G��� S 1 A Don Quintal Heating & Cooling ��Q�I� OU PrnyThis ColumnAmount --t136 ®on Quintal HVAC Load Calculations for Don Quintal Haverhill, MA Prepared By: Jack Richards The Portland Group 74 Salem Road Billerica, MA 978-262-1487 Wednesday, June 05, 2013 Rhvac is an ACCA approved Manual J and Manual D computer program. Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. pro iqqt Re Front door faces South Project Title: Don Quintal Designed By: Jack Richards Project Date: Wednesday June 5 2013 Client Name: Don Quintal Client City: Haverhill, MA Client Phone: 978-852-7207 Client E -Mail Address: dqhc@comcast.net Company Name: The Portland Group Company Representative: Jack Richards Company Address: 74 Salem Road Company City: Billerica, MA Company Phone-. 978-262-1487 Company E -Mail Address: jmr@theportlandgroup.com Company Website, www.theporflandgroup.com Reference City: Building Orientation: Daily Temperature Range: Latitude: Elevation: Altitude Factor. Wirder. Summer. Outdoor Dly Bulb 0 87 North Andover MA Front door faces South 0.875 Medium 42 Degrees 542 57 ft. 0-998 Outdoor Outdoor Indoor Indoor Grains Wet Bulb Rel.Hum Rel.Hum Dry Bulb Difference -0.65 80% n/a 70 n/a 72 49% 55% 72 30 -fo-61- Building -Supply CFM: 1,590 CFM Per Square ft.: 0.875 Square ft. of Room Area: 1,818 Square ft. Per Ton: 542 Volume (ft') of Cond. Space: 14,544 TotalHeating Required Including Ventilation Air. 65,624 Btuh 65.624 MBH Total Sensible Gain: 34,913 Btuh $7 % Total Latent Gain: 5,342 Btuh 13 % Total Cooling Required Including Ventilation Air: 40,255 Btuh 3.35 Tons (Based On Sensible + Latent) AC Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. All computed results are estimates as building use and weather may vary. Be sure to select a unit that meets both sensible and latent loads according to the manufacturer's performance data at your design conditions. CA ... \Don Quintal -North Andover MA.rh9 Wednesday, June 05, 2013,10:24 PM ti . •2 Building System 1 Dud Latent Zone 1 - Gig.: 54%, Htg.: 56% 1 -Dining Room 2 -Foyer 3-1-iving Room 4 -Half Bath And Laundry 5 -Kitchen And Breakfast I Zone 2 ... Gtg_: 46°j5, Htg.: 44% 6 -Bedroom 1 7 -2nd Floor Foyer 8 -Master Bedroom 9-Walkin 10 -Master Bath 11 -Full Bath 12 -Bedroom 1 of room aidkms may be greater than system airflow because xn has mufliole zones. Net, Toni fTon} I I Areal Sen Gam la t Gain Net ` Gain; Sen) Lossl Htg Sysj Hig, Gig ags Sys Acte CFMj CFM! GFM' 3.35 542 1,818 34,913 5,342 40,255 65,624 854 1,590 1,590 3.35 542 1,818 34,913 5,342 40,255 65,624 854 ,1,50 1,590 2,590 2,590 949 23,111 1,322 24,433 37.055 482 1,053 1,053 182 3,714 137 3,851 6,792 88 `, "1169 169 160 3,930 71 4,001 5,323 69 170, 179 247 4,986 162 5,148 8,916 116 :2' 227 60 889 81 970 3,315 43 ">'4 40 300 9,592 871 10,463 12,707 165 ='"'437 437 869 19,900 1,430 21,330 28,569 372 „% 905 156 5,009 327 5,336 5,855 76 6 228 160 4,077 71 4,148 4,146 54 .. `' 186 186 221 5,569 552 6,121 6,685 87 454 254 48 346 71 417 1,786 23 16 16 64 783 41 824 1,951 26 3i3. 36 64 783 41 824 1,961 26 36 36 156 3,332 327 3,659 6,175 80 162 152 C:\ ...\Don Quintal -North Andover MA.rh9 Wednesday, June 05,2013,10:24 PM L' Duc Size Preview ---- — ----- Room or ( Minimum Maximum Rough. ; Design SF f Duct' Duct Mg Clg ; Act i Duca DuciName _-.—_._...,........_____._....._ --_#Source !__ Velocityl^Velocity] Factori U100� toss; Velocity ^Length �, Floy+ x__Fluw.4 _�,ze_ System 1 Supply Runouts Zone 1 1 -Dining Room Built -In 450 750 0 0.1 430.8 881 169 2-6 2 -Foyer Built -In 450 750 0 0.1 455.9 69 179 2-6 3 -Living Roan Built -In 450 750 0 0.1 385.5 116 227 3-6 4-Hatf Bath And Laundry Built -In 450 750 0 0.1 206.2 43 40 1--6 5 -Kitchen And Breakfast Built -In 450 750 0 0.1 556.3 165 437 4-6 Zone 2 6 -Bedroom 1 Built -In 450 750 0 0.1 387.4 76 228 3-6 7 -2nd Floor Foyer Built -In 450 750 0 0.1 472.9 54 ; 166 2-6 8 -Master Bedroom Built-in 450 750 0 0.1 430.7 87 -:" 254 3--6 Malkin Built -In 450 750 0 0.1 80.3 23 16 1-6 10 -Master Bath Built -In 450 750 0 0.1 181.7 26 36 1-6 11 -Full Bath Built -In 450 750 0 0.1 181.7 26 36 1-6 12 -Bedroom 1 Built-in 450 750 0 0.1 386.5 80 y^ 152 2--6 Other Ducts in System 1 Supa Main Trunk Built -In 650 900 0 0.1 795.1 854 ?'1"59d 1,590 36x8 Summary System 1 Heating Flow: 854 Cooling Flow: 1590 QX ...1Don Quintal -North Andover MA.rh9 Wednesday, June 05, 2013,10:24 PM trvac Resitlesthat' &; LrghfCor?ifilal Hvl1C Loads r; EISbftwal re ieval�apmer 1, inc the #�ortlartri Group 19illenc Don Quirotali S tem ' Room Load Summaey -__ � ■ \� Y�I 1 ,J Y� '�, � - 4ie�S� / v'Y tf�d T"�� M' ��� �G7 iS a1F ' S Y3`�,�t �*.'?� 3 .�..�fi 3 j ,;,,�)y,}q]� i�,�" '�i..5��` ,��'t�it�� ' Le�a �: St�G.•x ri�.Vel� ;_��3tf1 ��ii.��=�` � �,�4`�� I -Zone 1- i 1 Dining Room 182 6,792 11.3 2-6 431 3,714 137 169 169 2 Foyer 160 5,323 8.9 2-6 456 3,930 71 179 179 1 3 Living Room 247 8,916 14.9 3-6 386 4,986 162 227 227 4 Half Bath And 60 3,315 5.5 1-6 206 889 81 40 40 Laundry 5 Kitchen And 300 12,707 21.2 4-6 556 9,592 871 437 437 Breakfast Zone 1 subtotal 949 37,055 40.9 23,111 1,322 1,053 -Zone 2- 6 Bedroom 1 156 5,855 9.8 3-6 387 5,009 327 228 228 7 2nd Floor Foyer 160 4,146 6.9 2-6 473 4,077 71 186 186 8 Master Bedroom 221 6,685 11.1 3-6 431 5,569 552 254 254 1 9 Walkin 48 1,786 3.0 1-6 80 346 71 16 16 10 Master Bath 64 1,961 3.3 1-6 182 783 41 36 36 11 Full Bath 64 1,961 3.3 1-6 182 783 41 36 36 i 12 Bedroom 1 156 6,175 10.3 2-6 386 3,332 327 152 152 Zone_ 2 subtotal 869 28,569 31.5 19,900 1,430 906 Dud Latent . 2,590 fSystem 1 total 1,8.18 65,624 72.4 34,913 5,342 1,590 1,590 System 1 Main Trunk Size: 36x8 in. Velocity: 795 ft./min Loss per 100 ft.: 0.101 in.wg Note: Since the system is multizone, the Peak Fenestration Gain Procedure was used to determine glass sensible gains at the morn and zone levels, so the sums of the zone sensible gains and airflows for cooling shown above are not intended to equal the totals at the system level. Room and zone sensible gains and cooling CFM values are for the hour in which the glass sensible gain for the zone is at its peak. Sensible gains at the system level are based on the Average Load Procedure + Excursion" method. „� .z.. �c*.s F=" FY :Ittt $rlu. s b a �j z a cd€ rr fi' t 1 s e ,�� • �� y i� r � Coolm��w � Scnst6l�� ,terif, ''� � . Sef►�sl�e �� .�;' i - Ot "�'�,.>, `� Y"��3ta�t Net Required: 3.35 87°h ! 13% 34,913 5,342 40,255 �����ld�z,."-..e.-"'.� - � r��M.'���� x��,.3 §..: ✓ y'�.u�.��;� #�:st�*_ �;��' ����� �'�' �R�Fa--.,r���.:n;..,:����:�;�;' � Heating Svstem Cooling S sy tem I Type: Natural Gas Furnace Standard Air Conditioner Model: Indoor Model: I Brand: I Efficiency: 0 AFUE 0 SEER Sound: 0 0 Capacity: 0 Btuh 0 Btuh Sensible Capacity: n/a 0 Btuh j Latent Capacity: n/a 0 Btuh I I i I i I C:\ ...\Don Quintal -North Andover MA.rh9 Wednesday, June 05, 2013, 10:24 PM JUN -13-203 11:05 From:N.PINGREE INSURANCE. 978 372 7182 To:19786889542 P.2/2 ACV® CERTIFICATE OF LIABILITY INDATE(MM/Dr)Nyyy) SURANCE6/13/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the POlicy(les) must bo endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollcies may require an endorsement. A statement on this cocl:lf(cate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER I cnN ArT -NAhLE---- Jill rarker -1 N. Pin$rce Insurance Agency, TnPHONE 2 c. E-LCN YD• 97$/372-7771 372AIL —718 .1.26 Merrimack Street; ADDR ,: — Havrrhill, MA 01830 PRODU ER tiL2fl1LB.ID INSURED INSURER(S) AFFORDING GOVERAOE NAk r1 INSURER A :_ T U Donald Quintal. Jr, or l nsuranr_.e Co. INSURER 8: _ 100 McIntosh Lane INEURGRC; Hampstead, NH 03841 INSURER D: INSURER E ;VYCKAUE8 CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWIIHSTANDING ANY REOUIRFMENT, TERM. OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE() HEREIN I& SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SR r NSURANCE ADDL I= 3ma N POLICY NUMBER PM/�DY E IPOLI' Y EX M LIMITS A NERAL LIABILITY NPP 8 () 9 8 4 7 2 9/ .l 7/ 1 EACH uccuRRENCE S 30 Q LO 0 0_ AfTAGE TO RFgTEt3— f-1 1 7 13 rREM1yE3 (g�OpcUrmnce] 3 5 0 0 0 0 E L J OCCUR MEO Fkr An GEN'L AftfREGATE LIMI 1 APPLIES PER. POLIt;Y PRC- IULT AUTOMOBILE LIABILITY ANY AI II'LI ALL OWNED AUTOS SCHEDULED AUTn.; HIRED ALTO$ NON -OWNED AUTOS UMBRELLAIJAB uCOUR EXCESS LIAR CLAIMS -MADE DFDuc rIBLE RETENTION E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY nFFICMMEMBER/EXCLUDE?ktf.UTIVE ❑ N / A (Mandatory In N11) M Yea, describe unda, 095CRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Anarh ACORD 101, Add111onnl Remarks;5cltedula, N mare apace le required) Heating and Air Condi r.i.on.ing ER Town of North Andovei- 1600 Osgood Street,'BI.d, 20, See. 2-36 North Andover, MA 01845 ACORD 25 (2009109) ( y one PULM!L JI W111-1 (_I _ PEHSONAL & ADV INJURY _$ 300.:—L-2: 0 Q Q GENERALAGGREGATE g 300 , 000 PRODI,ICTS•COMP/OPAGG 3 300.000 E.L. ;EA6E - FA EMI ;EA -'F - Pot IrA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 8F_ DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED C�) 1988-2009-ACORD The ACORD name and logo are registered marks of ACORD All rights reserved. a COMBINED SINGLE LIMIT (Ea aodaunl) $ BODILY INJURY (Par Perron) $ BODILYINJURY(Perarride 0 $ PROPER -i DAMAGE (Por IlWdonl) $ E.L. ;EA6E - FA EMI ;EA -'F - Pot IrA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 8F_ DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED C�) 1988-2009-ACORD The ACORD name and logo are registered marks of ACORD All rights reserved.