HomeMy WebLinkAboutMiscellaneous - 25 PEACH TREE LANE 4/30/201811272 Date..a.12n.(!..'57.... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ............... ...I V.n................�. -................................. has permission to perform ............. Q............� plumbing in the buildings of ....................................... ............................. ate.4 �-�` �North Andover, Mass. Fee.4.P. .... Lic. No..................................................................................... PLUMBING INSPECTOR Check # 1 r Cl—\ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK -��IIITY 4 MA DATE IT P OWNERIADD;?SIS 11 TEL=__ IFAX TYPE OR OCCUPANCYTYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: Ell PLANS SUBMITTED: YES NO 01 BATHTUB CROSS CONNECTION DEVIC DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM I DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER F ---j DRINKING FOUNTAIN FOOD DISPOSER I FLOOR / AREA DRAIN INTERCEPTOR QNTERIOR� KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET _71-0 ---I ___j __j --1 URINAL ED I WATPRHPATER ALL TYPES 7DA.- WATER PIPING L-! L -J' L- -111F -JIL-JI-i Hit u|nI:--x | m m m m m m m m m m m m m "I m o INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES19 NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY D BOND 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. CHECKONEONLY: OWNER D AGENT 01 SIGNATURE OF OWNER OR AGENT 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 plumbing work and installations performed under the permit issued for this application will be in com i nce wl h al ,en?nt provision of the Massachusetts State Plumbing Code and Chap 142 of the General Laws. PLUMBER'S NAME LICENSE # SIGNATURE eF J� - . .Q COMPANY NAME ADDRESS CITY --]STATE ZIP TEL tA FAx CELL EMAIL kr F O H U W W o El z O v, W � W w O W n- -it Z r ~ f- W O aa 5W �4 O w � w >co a O z w� C4 v .I LL n. B N Ll.l Z W H LL. H O O H W a a P6-1 O a u., ,i The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name (Business/Organization/Individual): Address: • Are you an employer? Check the appropriate box: 1� I am a employer with employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.Q I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance., 6. ❑ We are a corporation and its officers have exercised their right of 'exemption per MGL c. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] 0 Type of project (required): 7. ❑ New construction 8. E] Remodeling 9. ❑ Demolition 10 ❑ Building addition 11.0 Electrical repairs or additions 12. , lumbing repairs or additions 13.6 Roof repairs 14. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a neve affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. 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 MGL c. 152, §25A is a criminal violation punishable by 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. 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 pgjlne penalties ofperjury that the information provided above is true and correect. 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 #: V 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 foi 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 Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia Date ...�:. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION I 0 l This certifies that................yy) ....................................... Vlc/ . ................... has permission forgas i stallation .....: .."'......................................................... � A-�z inthe buildi s of................................................................................................................... at...Pc " ...........P.r�'.`.:h ..............................., North Andover, Mass. Fe0..... :.-... Lic. No.... o�.....�......... GASINSPECTOR Check # ETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK � In � fI _ --- �I MA DATE 97 ERMIT# _ - `ZE ADDRESS PCZW 'f __.,_ OWNER'S NAME —M InAl_ A.OWNER ADDRESS TE OCCUPANCY TYPE COMMERCIAL EJ] EDUCATIONAL E] Y NEW.V RENOVATION: El REPLACEMENT: El RESIDENTIAL NV PLANS SUBMITTED: YES D NO E3 APPLIANCES - CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES �10 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY N OTHER TYPE INDEMNITY L{ BOND R 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 0 AGENT O SIGNATURE OF OWNER OR AGENT 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 Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME_ LICENSE # MP MGF 0 JP ® JGF 0 LPGI6 CORPORATION ©# �( PARTNERSHIP®# __ (LLC [#�., COMPANY NAME: G ADDRESS A - FAX CELL ___ EMAIL N ❑ W The Commonwealth of Massachusetts VJ Department oflndustrialAccidents r - r 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PEMUTTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Are you an employer? Check the appropriate box: Phone #: 1. Q I am a employer with r employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.FJ I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insLrance.1 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. 0 Remodeling 9. ❑ Demolition 10 0 Building addition 11.0 Electrical repairs or additions 12.0 Plumbing repairs or additions 13.E] Roof repairs 14. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submif 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 state whether or not, those entities have employees. If the sub -contractors have employees,' they must provide their workers' comp. policy number. 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 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 MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone #: 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' compensatioii'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 Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia I I Date ..........`1..:....5 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........MA' -.1c ...... 5eil.e has permission to perform ..... .�. ... ....... .{..:1.Pov-a'............................................... wiring in the building of ....... i�61..tz,C-�ffrA........ Hr.: 1. j.z............................................... at ........ .. �<+G (.. i!P Q....... L�t..64 ..-...............: orth Andover, Mass. .............. Fee.4.as.:.............. Lic. No.................. .. .......r!r.....(. ........................................... Z ;?, 02/ _ A- ELECTRICAL INSPECTOR Check # 12.602-1 e Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ), 527. CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: 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) a-!5— P;,-e�±c&2e L �� Owner or Tenant 5 ("tom_ �n1 -^ 1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 0E51 d-Ao(, _C C -, Utility Authorization No. a/ G / % ,/ ? - Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Servic t260 Amps f / XY0 Volts Overhead ❑ Undgrd l e No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion ofthe following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Cell: Susp. (Paddle) Fans s Total Trsformers KVA Tran No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool rnd. grnd. El o. o mergency 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 g No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Dis posers p Heat Pump Totals: Number '" Tons KW '" "' ""' No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: — AA A Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: I O d C) (When required by municipal policy.) Work to Start:,fy, I 9 ( Inspections to be requested in accordance with MEC Rule 10, and upon completion. IlVSURANCE 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 cover e is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE WOND ❑ OTHER ❑ (Specify:) I certify, tinder the pains and penalties ofperjury, that the information on this application is true anti complete. FIRM NAME:. 4LIC. NO.: 2,af4- Licensee: Signature i LIC. No.�-� (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: `7—1 d `�Qo Address: (t6 —bn u— -A f 4 IA-,i(�, A4& ®t F:� _ Alt. Tel. No.: *Per M.G.L c. 141, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/AgentPERMIT FEE. $' d0 Signature Telephone No. {0 ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with the provisions of M.G.L. c. 143, § 3L, the w 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 conceming 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 Insp6ction Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE PECTION: Pass Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: �, Date: PARTIAL ROUGH INSPECTION: Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INFECTION: Pass 0 Failed ❑' Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: �- •� i i— FINAL INSPEC ON: Pass 0 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: �'~— Date: DEB WEINHOLD ... TOWN OF MERRIMAC, MA. .......dweinhold@townofinerrimac.com Name The Commonwealth of Massachusetts r Department of IndustrialAccidents I Congress Street, Suite 100 Boston, NIA 02114-2017 �t www mass.gov/dia Workers' Compensaiioniiisurance Affidavit: Builders/Contractors/Electricians/l'lnmbers. __ _., -vT ,xrrmrar muu- PE RMMTTING AUTAORITY. Address: City/State/Zip; Phone 4: Ase you n employer? Check the appropriate box: i.0 I amain a employer with �.. employees (fiill and/or part time). 2.0 I am a sole proprietor or partnership and have no employees Working forme in any capacity. [Noworkers' comp. insurance required.] 3.0 I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4.Q I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole w proprietors with no employees. 5. []I am a general contractor and I have hired the sub -contractors listed r the attached sheet These sub -contractors have employees and have workers' comp. insuance.t 6. Q We are a corporaiiori and its, officers have exercised their right of exemption per MGL c. 152, Rim and we have Ai employees: [No workers' comp. insurance required.] , *Any box #1 must also fill out the section below showing their workers' compensation policy information. applicant that checks homeowners who submit'bbk 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 state whether or not those entities• have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. workers' compensation insurance for my employees. Below is the policy and job site X am an employer that is providing Type of. jeet (required): 7, etxi'constriicilon 8. E] Remodelilig 9. ❑ Demolition 10 [] Building addition 11.❑ Electrical repairs or additions 12410-pti—mbing repairs or additions 13•. 0 Rb6f repairs 14.0 Other information. Insurance Company Policy # or Self -ins. Lic. Expiration Date, City/State/Zip: Job Site Address: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL e. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 enalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a and/or one-year imprisonment, as well as civil p ay be forwarded to the Office of Investigations of the DIA for insurance day against the violator. A copy of this statement m ocveraae verification. X do hereby certify under thepains that tlae information provided above is arae ariv, Gul I GI-- official use only. Do not write in this area, to he 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 Phone Contact 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'dr 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 ofthe 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 applicaixt•who:has not produced -acceptable evidence of compliance with the insurance coverage r`equired." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter inti) 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 Pleasb 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 certificates) 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 IndustrialAccidenis. Should you have any questions regarding the law or if you are required to obtain a workers' compensatioil 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 thai must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current Policy information (ifnecessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAYE Fax # 617-727-7749 Revised 02-23-15 wwwmass.gov/dia n ht C� v m a? m e Dyi�i�Tln�1�s"1�p_�I�I' � Zi v ��`.all�ll l ll�l l.W11 � n Date.. . P ... . ...... . TOWN OF NORTH ANDOVER PERMIT FOR MECHANICAL INSTALLATION D s This certifies that �... �t.�� �.1.�...P • .... • • • • • has permission for mechanical installation ^4 in the buildings of .:-.:{..!��-.............••••••••••••••• at North Andover, Mass. Lic. NoFee.. d .... ........ . GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Imo. lL— � U I; r s Commonwealth of Massachusetts Sheet Metal Permit Date Estimated Job Cost: V Plans Submitted: YES NO Business License # L/L -07 Business Information: Name: C&SW Ol /h4-CG1A4.6%6'W, ( Street: Qn� City/Town: )J LW IOU r!4 P D ` k Telephone: 01-N- WF-- Q 7 5 3 Photo I.D. required / Copy of Photo I.D. attached: Building Type: Permit # Permit Fee: $ I !� Plans Reviewed: YES NO Applicant License # (3,7 Property Owner / Job Location Information: Name: J Saodie4 /- At Y. 4-Z. Street: 26 at�llk h'46 /d City/Town: Elie.'+ An dpJ'0,1 Telephone: 9 7� ' /36 / - 6q03 YES NO ✓ Residential: 1-2 family / Multi -family Condo / Townhouses Commercial: Office Retail Industrial Educational Institutional Building Cubic Footage: under 35,000 cu. ft. ✓ over 35,000 cu. ft. Sheet metal work to be completed: New Work: Renovation: HVAC r/ Metal Roofing Kitchen -Exhaust System Chimney / Vents Provide brief description of work to be done: msAlt d. 00z) &U. N T1 S 4fL4ca- '7.J ye ! 2 <o AJ jk, 4 e t rFA, INSURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch.112 Yes [r�o ❑ If you have checked Yes, indicate the t pe of coverage by checking the appropriate box below: A liability insurance policy Other type Yp 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 boxn, 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 Progress Inspections Comments Final InSDection Date Comments Type of License: By Master Title r, ❑ Master -Restricted City/r'own �j ❑Journeyperson Signature of Licensee Permit # AA ❑Journeyperson-Restricted License Number: -1 Fee $ EJ Check at www.mass.gov/dpi Inspector Signature of Permit Approval i 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 / V", Equipment sized per heating / cooling load calculations .� Duct work sized per manual "D" calculations Bath / shower rooms contain mechanical exhaust fan vented outdoors J 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 -ofd : 4W 1 1 Sheet Metal Commercial Guidelines / Life Safety / Critical System_ s Inspection Checklist Yes No N/A, Set of stamped engineering documents and detailed description of mechanical 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 journeyperson-to-apprentice ratios Fire dampers with access door properly installed and checked for operation 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 seams and connections welded airtight with properly located cleanouts. Proper clea,`ances, fire rated enclosures and pressure testing required. SeikmId repl.caints installer li x r quirecl 'oilequipment and u,.ti.. • �,::- i- _ Duct penetrations in fire htea-i jall:: and flaors sealed Metal roofing systems installed watertight using 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 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 New/clean - properly sized filters installed (final inspection) Testing and Balancing report complete (final sign -off) M The Commonwealth of Massachusetts z Department of IndustrialAccidents t i_-• tl 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. ,Applicant Information Please Print Le2jbly NaMe (Business/Organization/Individual): c c( 5 Wf 1 / &I 2 C. Ila ✓1 -,cci i, Address: 3 G Ro° f 9\ D uk"� T & City/State/Zip: 1V e W B u K X Pav-F M A ('1" CPhone #: Are you an employer? Check the appropriate box: Type of project (required): 1,[Z amaemployerwith _employees (fi land/orpart-time).* 7. [�Kewconstruction 2. ❑ I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity. [No workers' comp. insurance required.] 9. ❑ Demolition 3. ❑ I am a homeowner doing all work myself: [No workers' comp. insurance required.] t 10 Building addition 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers' compensation insurance or are sole I L ❑ Electrical repairs or additions proprietors with no employees. 12. ❑ Plumbing repairs or additions 5. I am a general contractor and I have hired the sub -contractors listed on the attached sheet. ❑ 13.0 Roof repairs These sub -contractors have employees and have workers' comp. insurance.$ 6. ❑ We are a corporation and its officers have exercised their right of 'exemption per MGL c. 14. Other 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees.' Below is the policy and job site information. Insurance Company Name: h d,Tynovyg Ga T_ "5 u" q(4? Policy # or Self -ins. Lie. #: (A W C SS 7 ExpirationDate: Job Site Address: X5 P P—RG t1rty ee f V VMJ �� 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 MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify unller the pains and penalties of perjury that the information provided above is true and correct. q79 q �k�6 75i Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # � o cT 15 Issuing Authority (circle one): i 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 sex -vice 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 -contractors) name(s), address(es) andphone 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 foi• 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 Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia r r,,;t '!'u nn g,vv ur+�...,. EE .a s r4 r �„v�, r1 �>,r r 1�r11,r r.or a R�� y •. r . e ® • • "° ° • e .e, i ;q BUREAU,OF'BUILDING SAF..ETY &CONSTRUCTJON. .1..'. SHEET N�EAL 10 ORERSI PLUMBING SAFETY SECTION ISSUES„THE FOLLO iNG •-L'I'CENSE f As A Bus I ESS;. ; NAME: JEFFREY B CASVIIELL ,JEf TREY B CASWELL LIG #:4671 M W< '41J,.4,ELL MECtI:AN1.CAL INCH' J IZ 3 GRAF'HD `' I� EXPIRES: 03/31/2015 UNIT 8 r �I,W;URYPORT NIA 019 0 7-V IEH IRP /I 9/f) . � 33330 a (.0MMONWEALTH OF RlAt§ACHUSETrS .,<r State of New Hampshire GAS FITTERS LICENSE BOARD OF a SHEET 11ETAL `WORKERS NAME: JEFFREY CASWEL "z ISSUES THE FOLL Wwf i�L1 CENIAR , ;,� &A5A MASTER U R.�ESTR I CTED j'k ENDORSEMENTS: STN, $,TP 3`tr I� DATE ISSUED: 03/05/2013 KJEFFREY B CASWffL DATE EXPIRES: 03/31/2015 3:GRAF R3• z, W STE$ 8 s>: k LICENSE #:GFE0802900 ^ fN<E'WBURYPORT ,�.: •. BA 019.; —460'T ... b7>9 4 x3/28/1r 183b0'. �,.,.v �.r. 4i:' fiY r ti. cµ. MMONWEALTH OF M/1SSlCHUSETTS Y> t10 7 OMMONWEALTH OF MAS SETTS,'Lqi r e e s • • e • 1 ref BOARD OF PLUMBERS - N V'GASF ITTERS ,{ : PLUMBERS SAND, GASF �TiE1tS t : I SSUES THE FOLLOWI tdGL�CC•ENSE-s .% ISSUES THS, FOLLOWIN 'KLa1C,ENSE. ti =; LiCEISED ;AS A MASTER BER y a n _�a . REGI STtiRE AS A rPLUM ING CARP Q g e `> JEEFRbY -CASWELL -c JEFFREY B CASWELL�nr'; s ASWE.WLL tECHAN l CAL INC « y; 3 GRAf RD?_:x ,x c U 3 GRAFDkw UNIT UNIT 8 Y ENWBUt5�P0RTA 01950 4601 NEWBt1RYPORT MA o95Q 4. 01 f; ` 1549.» 5%01/16 z1997a5 u s 3144o/01/16 t 199786 r0GOMMONWEALTH.OF MAS.SICHUSETTS } e • - • e I' * STATE OF MAINE y` +; BOARD-'OF Nb' r I'LUMBERS�;AASF ITTER� DEPT OF PROFESSIONAL & FINANCIAL REGULATIONz PLUMBERS EXAMINING BOARD �� �t i SSUES THE FOLLOWING I CENSE } ". L 1 CENSE.D,aAS`' A JOURNEYMAN PLUMBER LICENSE # MSI 0014390 JEFFREY B. CASW LL JEf FRE'Y B CASWE& N... _ r LICENSED MASTER PL MBER 9 \ 3 GRAF UNI T $ .. �0M5A0ISSUED Apr 01, 2014 EXPIRES M r 31, 2016 ,956 0*-n4b0' 308x19}9 784 ,/0114 ... -- wrightsoft® Duct System Summary AIH 1ST FLOOR Project Information For: PEACHTREE FARM, CASWELL MECHANICAL LOT 1, NORTH ANDOVER, MA External static pressure Pressure losses Available static pressure Supply / return available pressure Lowest friction rate Actual air flow Total effective length (TEL) Heating 1.00 in H2O 0.31 in H2O 0.69 in H2O 0.299 / 0.391 in H2O 0.136 in/ 100ft 1172 cfm Job: Date: May 27, 2015 By: Cooling 1.00 in H2O 0.31 in H2O 0.69 in H2O 0.299 / 0.391 in H2O 0.136 in/ 100ft 1172 cfm 506 ft 213 Name Design (Btuh) Htg (cfm) Clg (cfm) Design FR Diam (in) H x W (in) Duct Matl Actual Ln (ft) Ftg.Egv Ln (ft) Trunk DEN -A c 4275 159 213 0.197 8.0 Ox 0 VIFx 46.5 105.0 st8 FOYER h 1683 68 62 0.188 5.0 Ox 0 ShMt 28.5 130.0 st8 GREATRM c 3322 128 166 0.396 8.0 Oxo VIFx 10.5 65.0 738 GREATRM•A c 3322 128 166 0.186 7.0 Ox 0 VIFx 20.5 140.0 st6 KMIDIN c 3097 125 155 0.345 7.0 Ox 0 VIFx 11.5 75.0 727 KIT/DIN-A c 3097 125 155 0.190 7.0 Ox 0 VIFx 42.0 115.0 st8 LAUND c 1081 53 54 0.146 5.0 Ox 0 VIFx 29.5 175.0 st11 LAV h 533 21 4 0.136 5.0 Ox 0 VIFx 34.0 185.0 st11 M.BATH h 2438 98 55 0.191 6.0 Ox 0 VIFx 51.0 105.0 st8 M.BED h 2028 82 55 0.177 6.0 Ox 0 VIFx 23.5 145.0 st3 M.BED-A h 2028 82 55 0.180 5.0 Ox 0 VIFx 36.0 130.0 st6 KWIC h 499 20 4 0.178 5.0 Ox 0 VIFx 42.5 125.0 st7 MUD h 2046 83 27 0.197 6.0 Ox 0 VIFx 36.5 115.0 st7 BoWltalic values have been manually overridden r 2015 -Oct -05 09:18:333 wrlhtSOft' g Right -Suite® Universal 201515.0.15 RSU02044 Page 1 ACCP....ments\WrightsottHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfams: N Trunk Htg Clg Design Veloc Diam H x W Duct Name Type (cfm) (cfm) FR (fpm) (in) (in) Material Trunk st11 Peak AVF 75 58 0.136 280 7.0 0 x 0 ShtMetl st3 st3 Peak AVF 919 851 0.136 919 14.0 8 x 18 ShtMetl st6 Peak AVF 762 738 0.178 0 13.0 8 x 0 ShtMetl st3 st7 Peak AVF 552 516 0.178 710 13.0 8 x 14 ShtMetl st6 st8 Peak AVF 450 485 0.188 727 10.0 8 x 12 ShtMetl st7 BoWltalic values have been manually overridden r 2015 -Oct -05 09:18:333 wrlhtSOft' g Right -Suite® Universal 201515.0.15 RSU02044 Page 1 ACCP....ments\WrightsottHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfams: N Name Grill Size (in) Htg (cfm) Clg (cfm) TEL (ft) Design FR Veloc (fpm) Diam (in) H x W (in) Stud/Joist Opening (in) Duct Matl Trunk rb5 Ox 0 150 117 287.0 0.136 429 8.0 Ox 0 Peak AVF VIFx rt5 rb4 Ox 0 118 59 223.0 0.175 339 8.0 Ox 0 370 VIFx rt5 rb3 Oxo 211 193 217.0 0.180 604 8.0 Ox 0 972 VIFx rt4 rb11 Ox 0 253 321 182.0 0.215 918 8.0 Ox 0 8 x 20 VIFx rt3 rb6 Ox 0 241 269 123.5 0.317 770 8.0 Ox 0 VIFx rt3 rb2 Ox 0 2001 213 92.0 0.425 610 8.0 Ox 0 VIFx rt1 BaIdritallc values have been manually overridden A-L� 2015 -Oct -0509:18:33 rF Wil FtSOCRight-Suite® Universal 201515.0.15 RSU02044 Page 2 AC+CK ...ments\WrightsoftHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaces: N Trunk Htg Clg Design Veloc Diam H x W Duct Name Type (cfm) (cfm) FR (fpm) (in) (in) Material Trunk rt5 Peak AVF 268 176 0.136 482 14.0 8 x 10 ShtMetl rt4 rt4 Peak AVF 479 370 0.136 718 14.0 8 x 12 ShtMetl rt3 rt3 Peak AVF 972 959 0.136 972 8.0 8 x 18 ShtMetl rt1 rt1 Peak AVF 1172 1172 0.136 1055 18.0 8 x 20 ShtMetl BaIdritallc values have been manually overridden A-L� 2015 -Oct -0509:18:33 rF Wil FtSOCRight-Suite® Universal 201515.0.15 RSU02044 Page 2 AC+CK ...ments\WrightsoftHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaces: N =- wrightsoft® Duct System Summary AIH 2ND FLOOR For: PEACHTREE FARM, CASWELL MECHANICAL LOT 1, NORTH ANDOVER, MA External static pressure Pressure losses Available static pressure Supply / return available pressure Lowest friction rate Actual air flow Total effective length (TEL) Heating 1.00 in H2O 0.36 in H2O 0.64 in H2O 0.299 / 0.341 in H2O 0.134 in/ 100ft 739 cfm Job: Date: May 27, 2015 By: Cooling 1.00 in H2O 0.36 in H2O 0.64 in H2O 0.299 / 0.341 in H2O 0.134 in/100ft 739 cfm 479 ft Name Design (Btuh) Htg (cfm) Clg (cfm) Design FR Diam (in) H x W (in) Duct Matl Actual Ln (ft) Ftg.Egv Ln (ft) Trunk BATH 1 h 857 25 23 0.134 5.0 Ox 0 ShMt 44.0 180.0 st13 BATH h 2298 67 34 0.134 6.0 Oxo VIFx 44.0 180.0 st15 BED RM 2 c 2240 88 95 0.134 7.0 Ox 0 VIFx 44.0 180.0 st5 BED RM 3 c 2796 85 118 0.134 7.0 Ox 0 VIFx 44.0 180.0 st4 BEDRM4 c 3131 103 132 0.134 7.0 Oxo VIFx 44.0 180.0 st4 BONUS h 4220 123 104 0.134 7.0 Ox 0 ShMt 44.0 180.0 st14 BONUS -A h 4220 123 104 0.134 7.0 Ox 0 ShMt 44.0 180.0 st13 LOFT -A c 1471 53 62 0.134 7.0 Ox 0 VIFx 44.0 180.0 st4 LOFT -C c 1471 53 62 0.134 7.0 Oxo VIFx 44.0 180.0 st5 WIC2 h 664 19 6 0.134 5.0 Ox 0 VIFx 44.0 180.0 st15 Boldrrtalic values have been manually overridden wrightsoft@ Right -Suite® Universal 2015 15.0.15 RSU02044 AC0, ...mentslWrightsoftWAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaces: N 2015-Od-05 09:18:33 Page 3 Trunk Htg Clg Design Veloc Diam H x W Duct Name Type (cfm) (cfm) FR (fpm) (in) (in) Material Trunk st4 Peak AVF 512 543 0.134 691 12.0 0 x 0 ShtMetl st5 Peak AVF 227 197 0.134 289 12.0 0 x 0 ShtMetl st15 Peak AVF 87 40 0.134 248 8.0 0 x 0 ShtMetl st5 st13 Peak AVF 272 230 0.134 499 10.0 0 x 0 ShtMetl st4 st14 Peak AVF 123 104 0.134 226 10.0 0 x 0 ShtMetl st13 Boldrrtalic values have been manually overridden wrightsoft@ Right -Suite® Universal 2015 15.0.15 RSU02044 AC0, ...mentslWrightsoftWAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaces: N 2015-Od-05 09:18:33 Page 3 Boldrrtalic values have been manually overridden ,► wrightsoft' Right -Suite® Universal 2015 15.0.15 RSU02044 ACCP.,,,ments\WrightsoftHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaces: N 2015-Od-05 09:18:33 Page 4 Grill Htg Clg TEL Design Veloc Diam H x W Stud/Joist Duct Type Name Size (in) (cfm) (cfm) (ft) FR (fpm) (in) (in) Opening (in) Matl Trunk rb9 0x0 149 126 254.9 0.134 425 8.0 Ox 0 126 VIFx rt7 rb1 0x0 155 128 254.9 0.134 444 8.0 Ox 0 692 VIFx rt2 rb8 0x0 226 236 254.9 0.134 676 8.0 Ox 0 VIFx rt6 rb7 Ox 0 72 68 254.9 0.134 132 10.0 Ox 0 VIFx rt2 rb10 Ox 0 138 180 254.9 0.134 517 8.0 Ox 0 VIFx rt6 Boldrrtalic values have been manually overridden ,► wrightsoft' Right -Suite® Universal 2015 15.0.15 RSU02044 ACCP.,,,ments\WrightsoftHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaces: N 2015-Od-05 09:18:33 Page 4 Trunk Htg Clg Design Veloc Diam H x W Duct Name Type (cfm) (cfm) FR (fpm) (in) (in) Material Trunk rt6 Peak AVF 512 543 0.134 691 12.0 0 x 0 ShtMetl rt2 rt7 Peak AVF 149 126 0.134 272 10.0 0 x 0 ShtMetl rt6 rt2 Peak AVF 739 739 0.134 692 14.0 0 x 0 ShtMetl Boldrrtalic values have been manually overridden ,► wrightsoft' Right -Suite® Universal 2015 15.0.15 RSU02044 ACCP.,,,ments\WrightsoftHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaces: N 2015-Od-05 09:18:33 Page 4 -- wrightsoft® Load Short Form Entire House Project Information For: PEACHTREE FARM, CASWELL MECHANICAL LOT 1, NORTH ANDOVER, MA Job: Date: May 27, 2015 By: Design Information Htg Clg Infiltration Outside db (°F) 2 88 Method Simplified 1 Inside db (°F) 70 74 Construction quality Tight Design TD (°F) 68 14 Fireplaces 1 (Average) Daily range - L Inside humidity (%) 30 50 Moisture difference (gr/Ib) 28 30 HEATING EQUIPMENT Make n/a Trade n/a Model n/a AH R I ref. n/a Efficiency n/a Htg load Heating input 0 Btuh Heating output 0 Btuh Temperature rise 0 OF Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Space thermostat n/a 913 COOLING EQUIPMENT Make n/a Trade n/a Cond n/a Coil n/a AHRI ref. n/a Efficiency n/a Htg load Sensible cooling 0 Btuh Latent cooling 0 Btuh Total cooling 0 Btuh Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Load sensible heat ratio 0 913 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) A/H 1ST FLOOR d 1734 28610 23237 1127 1127 A/H 2ND FLOOR d 1537 26379 18331 913 913 Entire House d 3271 54989 41099 2040 2040 Other equip loads 10646 2139 Equip. @ 1.00 RSM 43238 Latent cooling 4005 TnTAIC 4774 CCCoc A7nA0 n— V— 1 VVVVV 7/G7V LV`*V LVPFV Calculations approved byACCA to meet all requirements of Manual J 8th Ed. 2015 -Jun -0211:39:42 wrightsoft- Right -Suite® Universal 201515.0.15 RSU02044 Page 1 14CCX...ments\WrightsoftFNAC\CASWELL-LOTIPEACHTREE.rup Calc=1VJ8 FrontDoorfaces: N -I- wrightsoft® Load Short Form AIH 1ST FLOOR Project Information For: PEACHTREE FARM, CASWELL MECHANICAL LOT 1, NORTH ANDOVER, MA Job: Date: May 27, 2015 By: HEATING EQUIPMENT Make Trade Model AHRI ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 95AFUE 0 Btuh 0 Btuh 0 °F 1127 cfm 0.039 cfm/Btuh 0 in H2O COOLING EQUIPMENT Make Heil Design HEIL Htg Clg Infiltration Outside db (°F) 2 88 Method Simplified Inside db (°F) 70 74 Construction quality Tight Design TD (°F) 68 14 Fireplaces 1 (Average) Daily range - L Inside humidity (%) 30 50 Moisture difference (gr/Ib) 28 30 HEATING EQUIPMENT Make Trade Model AHRI ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 95AFUE 0 Btuh 0 Btuh 0 °F 1127 cfm 0.039 cfm/Btuh 0 in H2O COOLING EQUIPMENT Make Heil Trade HEIL Cond N4A336A(G)KB" Coil EN(A,D)4X36L21""++TDR AH R I ref 6416509 Efficiency 11.0 EER, 13 SEER Sensible cooling Latent cooling Total cooling Actual air flow Air flow factor Static pressure Load sensible heat ratio 28730 Btuh 5070 Btuh 33800 Btuh 1127 cfm 0.048 cfm/Btuh 0 in H2O 0.86 28 ROOM NAME Area (ft2) Htg load (Btuh) Clg load (Btuh) Htg AVF (cfm) CIgAVF (cfm) LA U N D 52 1300 1075 51 52 LAV 28 522 86 21 4 KIT/DIN 466. 6086 6160 240 299 MUD 56 2018 546 79 26 GREAT RM 320 6290 6616 248 321 M.BED 228 3963 2098 156 102 M'WIC 54 489 80 19 4 M.BATH 120 2397 1089 94 53 DEN 200 3881 4252 153 206 Fr)vF R 212 1663 1234 65 60 Calculations approved byACCA to meet all requirements of Manual J 8th Ed 2015 -Jun -02 11:39:42 .4CCAwrightsoft" Right Suite® Universa1201515.0.15 RSU02044 Page 2 ..mentslWrightsoftHVAC1CASWELL-LOTIPEACHTREE.rup Ca1c=MJ8 FrontDoorfaces: N A/H 1ST FLOOR d 1734 28888 23347 1166 1166 Other equip loads 4986 1002 Equip. @ 1.00 RSM 24349 Latent cooling 4086 TnT41 C 472A "070 now -3c 44l_V_I wwnn /JT JJV/Y GVYJJ 1100 I IOD Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. wrightsoft" Right -Suite® Universal 201515.0.15 RSU02044 2015 -May -28 0Page 4 Page 3 AC01....ments\WrightsoftHVAC\CASWELL-LOTIPEACHTREE.rup Calc =MJ8 Front Door faces: N - wrightsoft" Load Short Form AIH 2ND FLOOR Profect Infdrmation For. PEACHTREE FARM, CASWELL MECHANICAL LOT 1, NORTH ANDOVER, MA Job: Date: May 27, 2015 By: HEATING EQUIPMENT Make Trade Model AHRI ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 95AFUE 0 Btuh Design Infl6irmation Btuh Htg Clg Infiltration Outside db (°F) 2 88 Method Simplified Inside db (°F) 70 74 Construction quality Tight Design TD (°F) 68 14 Fireplaces 1 (Average) Daily range - L Inside humidity (%) 30 50 Moisture difference (gr/Ib) 28 30 HEATING EQUIPMENT Make Trade Model AHRI ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 95AFUE 0 Btuh 0 Btuh 0 OF 913 cfm 0.035 cfm/Btuh 0 in H2O COOLING EQUIPMENT Make Heil Trade HEIL Cond N4A330A(G)KC- Coil ENH4X36L17**++TDR AHRI ref 6415880 Efficiency 10.5 EER, 13 SEER Htg load (Btuh) Sensible cooling 23290 Btuh Latent cooling 4110 Btuh Total cooling 27400 Btuh Actual air flow 913 cfm Air flow factor 0.050 cfm/Btuh Static pressure 0 in H2O Load sensible heat ratio 0.87 127 ROOM NAME Area (ftp Htg load (Btuh) Clg load (Btuh) Htg AVF (cfm) CIgAVF (cfm) BONUS 333 8786 5128 304 255 BATH 1 53 891 563 31 28 BED RM 4 182 3654 3278 127 163 WIC2 27 688 154 24 8 BATH 2 88 2441 850 85 42 BED RM 2 170 3122 2345 108 117:' BED RM 3 210 3024 2927 105 146 LOFT/HALL .2-7 s-� 475 3773 3087 131 154. Calculations approved byACCA to meet all requirements of Manual J 8th Ed. ti Wrl htsOft° 2015 -May -2608:59:44 �_ 9 Right -Suite® Universal 2015 15.0.15 RSU02044 Page e 4 ACCK...ments\WrightsoftWAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FronlDoorfaces: N A/H 2ND FLOOR d 1537 26379 18331 913 913 Other equip loads 5661 1137 Equip. @ 1.00 RSM 19469 Latent cooling 2891 T260 93 OTALS 1537 32040 2 3 1 913 Calculations approved byACCA to meet all requirements of Manual J 8th Ed. FTF wri htSOftN 2015 -May -28 oPage 5 �j Right-SuRe® Universal RSU02044 Page 5 ACC%...ments\WrightsoftHVAC\CASWELL-LOTIPEACHTREE.rup Calc=MJ8 FrontDoorfaws: N z z 0 C o -i Y O Dp2 O O z vim O—m.�, �t �o a Z r m o — m G> o M m z 3 3 m 3 0 ® _ 0 n S D n c? � r-N;o®cc tW r000)� m N 000<'n3 oC,CD II j�T 1 O A N O D O O n Cn S ' 71 Z m O z C z .iOl rn � c� DOS 9 0 z � a O m -Q. D w 0 0o r m < w � - A GA O O r z W O O m m A 0 N S n N 2 N Dto no—� n > Ti rN Chg, = m m rN�Cc W ra,(n:1 m N r- o o m " 0 to II O O N O O _ n Z r—. CASWELL nac"knnticAi ,. Pt111IM-111IM-MR I 3 Graf Road Unit 8 Newburyport, MA 01950 I Name/Address I William McKay Construction Mgmt 4 Powdermill Sq. Unit 101 Andover ,MA 01810 Estimate Date Estimate # 6/3/2015 2874 Phone: Teras Project Void After 30 Days Peachtree Farm Lot#1 (978) 462-5858 Description U/M Cost Total The furnishing, fabrication and installation of two gas systems 22,769.00 22,769.00 with air conditioning units setup as one zone each. One serving the first floor and one serving the second floor using Heil equipment as follows: 1 st Floor * One Heil 95% efficient single stage furnace model# N9MSE0401712A. 'One Heil 13 SEER 3 ton R41 0 -A condenser model # N4A336AKB. * One Heil 3 ton evaporator coil model # END4X36L17A. 2nd Floor * One Heil 95% efficient single stage furnace model# N9MSE0401712A. * One Heil 13 SEER 2.5 ton R410 -A condenser model # N4A330AKB. * One Heil 3 ton evaporator coil model #END4X36L17A. This includes two drains to suitable sites, two programmable thermostats. The main supply and return distribution trunk will be galvanized steel, insulated with 2" FSK insulation and sealed per MA code. All branch runs will be insulated flexible duct connected to ceiling and floor mounted boots. Also a containment pan with float switch will be installed, which will shut the unit down in the event the pan becomes plugged. Complete less gas piping and wiring. Note: This home was sized as a HERS rated home with a cooling temperature differential of 14 degrees. Phone: Fax: E-mail Web Site (978) 462-8783 (978) 462-5858 jell@caswelimechanical.com ww<v.caswellmechanical.com Page 1 CASELL �4.,^,g F4 &. RYti1�77�U ` 11:M� i1�F `/ W i 3 Graf Road unit 8 Newburyport, MA 01960 I Name/ Address I William McKay Construction Mgmt 4 Powdermill Sq. Unit 101 Andover ,MA 01810 Estimate Date Estimate # 6/312015 2874 Phone: Terms Project Void After 30 Days Peachtree Farm Lot#1 (978) 462-5858 Description U/M cost Total Note: If the roof is not insulated with the attic space being outside the thermal envelope, the furnace in the attic must be enclosed within an insulated box to prevent condensate from freezing, Base price of plumbing; All waste pipe to be done with schedule 16,000.00 16,000.00 40 PVC pipe. All domestic water to be piped in Pex tube. Showers to be single function. Multiple functions not included in quote. Lavatories to be vanity style. Wali faucets not included in quote. (Please note price does not include fixtures). 4 Toilets. 6 Lavatories. 3 Tubs. 1 Shower. 1 Laundry hook-up. 1 Kitchen sink. 1 Dishwasher. 1 Ice maker. 2 Silcocks. Sparco thermostatic mixing valve if personal shower added to 400.00 400.00 soaking tub. Copper pan allowance for one pan. 550.00 550.00 75 Galion natural gas power vented water heater. 1,975.00 1,975.00 Gas piping range, water heater, 2 furnaces and fireplace. All 2,500.00 2,500.00 piping schedule 40 steel pipe. Phone: Fax: E-mail Web Site (978) 462-8783 (978) 462-5858 jeff@caswellmechanical.com www.caswellmechanical.com Page 2 CASWELL MCCH A MICA 1_40 p KWIi1Ytl -1111=111-N/1 k 3 Graf Road Unit 8 Newburyport, MA 01960 ( Name t Address William McKay Construction Mgmt 4 Powdermill Sq. Unit 101 Andover,MA 01810 Estimate Date Estimate # 6!3!2015 2874 Phone: Terms Project Void After 30 Days Peachtree Farm lot#1 (978) 462-5858 Description Ulm Cost Total Exclusions: Concrete cutting and patching. Cutting and patching of roof. Structural supports. Engineering. Affidavit forms. Meters. Backflow. Taxes. Permits. Electrical wiring. Balance testing and flow reports. Premium portion overtime hours. Prevailing wage. Trenching. Backfilling. Fire stopping. Customer ccept of ent Schedule Date ' (� $44,194.00 Phone: Tax: E-mail Web Site (978) 462-8783 (978) 462-5858 jeff@caswellmechanical.com www.caswellmechanical.com Page 3 n � C" o� *0- cu mit5,a- � 6 zt 05 a 00 Oc000:e m A N O D� o n � CD N 3 R3 r CD D � co cn *6.m mach®d T �6cn� m o0 OcOCOm N �� D -4a Q O n= T m