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Miscellaneous - 26 STANTON WAY 4/30/2018
_ 8'X UPI���;may rpintc 11 tr dr -ma xwPoeadadca�ts! i�- tsf P*rssa�mtszoia-rewa.. x� ®�. 0 ecwd 1014 Town of North Andover, MA 1 21014 i 'i *Gas Permit - In conjunction with a Building Permit (Commercial or Residential) I r TIMELINE ® Submission received — — Jul 28,2016 ac-11:47am ®Gas Permit Review IA ".8- Permit Eric. V Pay, - Permit Issuance 0 cume�c Your request is in progress We'll let you know of any updates via email. Feel free to check the status at anytime by coming back to this page. Cc F.ppllca.^.: James burns 1-1- 26 STANTON WAY, NORTH ANDOVER, MA 0—, WILLIAM J. BROSNIHAN Attachments :, uP,<...., F. -OT45JCIODIF Thujul 28 2016_15:47:.PDF V i ,... I Q Zi s' ® <9 ®1'e {f} � 1 2/289016ULI ?bd Thursday, Jul 28, 2016 11:47 AM The Commonwealth ofMassachusetts Department of industrial Accidents 1 Congress Street, Smite 100 Boston, MA. 02114-2017 www mass.govldla s�• Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FMED WITH THE PER1WT1M\ G AUTHORITY. Name (Business/organization/Iudividual): Address: City/State/Zip: ZZ1jYYJ° /a't Are you an employer? Check&e appropriate box: Phone in u�/7 1. am a employerwith • :.. employees (full and/or part-time).* .2,Efl I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] IF] 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 einployees. 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.E] 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 ILL] Electrical repairs or additions 12: Plumbing repairs or additions 13.0 Roof repairs 14.0 Other *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information. i Homeowners who submit Ibis 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•a#ached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contactors have employees, they must provide their workers' comp. policy number. I arae an employer that is piovidingworkers' compensation insurance for my employees ' Below is thepolicy acid job site information. Insurance Company Name: Policy# or Self -ins. Lic. Expiration Date:. Job Site Address: ��— City/State/Zip: (Q I0 `r Attach a copy of the workers' compepsation 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 bnprisonment, 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 r the ' s a penalties ofperjury that the information providd eed above is ferue and correct T)AtP.'/�O �O 411 Official use only. Do not write in this area, to be completed by city or toren 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 ofhire, 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 au 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 applicant vvho lias 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 ofthis 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 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. lie advised that this affidavit may be submitted to the Department of • Ihdustrial 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 ox if you'are required to obtain a workers' compensation policy, please call the Department• at the number listed below. Self -insure_ d 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 axeference 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 bum 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 1~evised 02-23-15 www.mass.gov/dia c.;r ' 7/29/2016 21014 This is an e -permit. To learn more, scan this barcode or visit northandoverma.viewpointcloud.com/#/records/21014 OF p10RTy qti S�= OOL m O p 5 ��SSACHUS�� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that James F Burns has permission for gas installation pool heater gas piping in the buildings of WILLIAM J. BROSNIHAN at 26 STANTON WAY, North Andover, Mass. Lic. No. 10761 Date: July 29, 2016 o Date... ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING -. This certifies that J�e .......... ....... M— ..................................... M--- ............................... has permission to perfori�P.... .......... � ................................. wiring in the building of............ 6� .................................................................................... ............. at �6, Ci r*,*** ................................. ***North Andover, Mass. Fee....... ... Lic. No.k-.6.70� . . .................................................................................... ELECTRICAL INSPECTOR 4t Check Commonwealth of Massachusetts Department of Fire Services aM BOARD OF FIRE PREVENTION REGULATIONS Official Use Only j Permit No. � 1 1 1 Occupancy and Fee Checked [Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: % City or Town of. NORTH ANDOVER To the Inspe for of Wires: By this application the undersigned gives notice oaf his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant 61 Owner's Address _ r� Q G-1 Is this permit in conjunction with a building permit? Yes ❑ Purpose of Building X"eS(r ezwe Telephone No. No ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps /�G OVolts Overhead ❑ New Service Amps / Volts Overhead ❑ UndgrdC No. of Meters j Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 4coo �►-, Comnrctinn nfthv fnllnwinn table may be waived by the Inspector of Wires. No. of Recessed Luminaires __..-�------ -� - --..-- -- o No. of Cell: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool rnd. ❑ rnd. ❑ o. o Emergency Lig ting Battery Units No. of Receptacle Outlets /0 No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No. of Gas Burners Initiating Devices No. of Ranges Tot No. of Air Cond. Tons No. of Alerting Devices Heat Pump Number Tons KW No. of Self -Contained . No. of Waste Dis osers P Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Mucal Local ❑ Connect on F1 other No. of Dryers Heating Appliances KW Security of Systems:"* s or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, oras required by the lnspeccur v� Estimated Value of Electrical Work: 8CD (When required by municipal policy.) Work to Start: 6 /6 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) Icertify, under thepains andpenaltcies ofperjury, that the i formation on this application is true anti complete. FIRM NAME: v. Qs e Z, cI C—V-- LIC. NO.: 3, 10 (C) A Licensee: Signature LTC. NO.: IQ U '7a 1 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.:�?�'1'�5? Address: \z CSS �.►,e Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lie. 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) F] owner ❑ owner's agent. Owner/AgentPERMXT 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 permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed ' 7 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 EN Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass 0 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSP ION: Pass MFailed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ]FINAL INSPE TION: Pass Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: i Date: - z Z — 4 DEB WEINHOLD ... TOWN OF MERRIMAC, MA. .......dweinhold@townofinerrimac.com The Commonwealth of Massachusetts Department of IndustrialAceidents 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: \�Zl L�ss City/State/Zip: V4�a ffirO) 1`'W Are you an employer? Check the appropriate box: Phone #: 7e) - 6S� 1. ❑ I am a employer with employees (full and/or part-time).* 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.FJ 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.1 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.] Type of project (required): 7. E]New construction 8. Remodeling 9. ❑ Demolition 10 Q Building addition 11.�lectrical repairs or additions 12. [] Plumbing repairs or additions 13. E] Roof repairs 14.0 Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who sixlirriit 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 -coria actors have employees, they must provide their workers' comp. policy number. ]: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 certify user the pains and penalties of perjury that the information provided above is true and correct —1_ 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 -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 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 0"'COMMONWizAl I" IF MASSACHti.qFTT-q t' 1 Date.. �.`P........1................. 1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .!......1.....:... ` \ � r has permission to perform?. (�^..........` --`............:.................................... wiring in. the building of....?.....(�- ..........................................! at �2jjYQQ...........................G:........................................ , orth Andover, Mass. Fee 11�.U...� .... Lic. No.�. Y. !.....1............, ..................... ` ELEcmcAL INSPECTOR Check # 12292 ( `- , (q 11 2A i1 Lul Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use /Only Permit No. 7 I Occupancy and Fee Checked [Rev. 11071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code W), 527 MR 12.00 (PLEA WINK OR TYPE ALL INFORMATION) Date: U / p t° wn of: NORTH ANDOVER To the Inspector o Wires: 41 By this the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) a (a $777¢1rr—A,n r .,,a,-4 Owner or Tenant Owner's Address Is this permit in conjunction G03 9/0� 7S'70 Purpose of Building ®/}Q� Utility Authorization No. Existing Service Amps / Volts New Servic 20 © Amps ,2 D / o?Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑. of Meters Overhead ElUndgrd No. of Meters f,___ln); _r17 - 4,_77-. - , -7 ___ -. I No. of Recessed Luminaires r=�==�•_ ✓ _«�✓�.�.��1�s No. of Ceil: Susp. (Paddle) Fans "�1r u�uy ue w'" oy ane tns ecror of n Cres. No. of Total f7� Transformers KVA No. of Luminaire Outlets -3 O No. of Hot Tubs Generators KVA No. of Luminaires '30 Swimming Pool Above ❑ In- ❑ o, o Emergency Lighting rnd. rnd. Batter Units No. of Receptacle Outlets 7 S' No. of Oil Burners FIRE ALARMS No, of Zones l� No. of Switches �10 No. of Gas Burners No. OlDetection and es �vZ No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number.. Tons KW..... No. of Self -Contained Totals: � Detection/Alertin Devices /a' No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑Other Connection o. of Dryers ! Heating Appliances KW Security Systems:* of Water No. of No. No. of Devices or E uivalent [No. KW of Si ns Ballasts Data WirinHeaters g: No. of Devices or E uivalent o. Hydromassage Bathtubs No. of Motors Total HP Telecommunications WiNo. of Devices or E uivalent THER: hrtacn aaamonat detail y desired, or as required by the Inspector of Wires. Estimated Value of Elec ical Wo . /D, O®b (When required by municipal policy.) Work to Start: 1001V Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C VE GE: 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 cove eis in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify) I'certify, under thepains andpenalties of'perjury, thatthe information on this application is true and complete. FIRM NAME: _ ,(� t LIC. NO.: Licensee:W_27����i 8 ,,I Signature LIC. NO.: /77/,T%L (Ifapplicable, enter "exempt" in the license number line.) u .Tel. No. - ./e 603 �'9S—oi low Address: A el. No.: D 3 -a 33� (c 3 ?% *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" Lice e: 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 agont, Owner/Agent Signature Telephone No. PERMIT FEE: $ 7 �� ❑ 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 r 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 Acct 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`�pproval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. Nk..; 71 �. ❑ Rule 8—Permit/Date Closed: *** Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: Trench Inspection Pass M Failed IN Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass 0 Failed Re- Inspection Required ($.) ❑ Inspectors Commen s: Inspectors Signature: Y Date: PARTIAL ROUGH INSPECTION: Pass Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: r. ROUGH INSPECTION: Pass Failed Re- Inspection Required ($.) ❑ J Inspectors Comme Inspectors Signature: Date: FINAL INSPECTION: Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: r � , Inspectors Signature: Date: &WEINHOLD ... TOWN OF MERRIMAC, MA.......Aweinhold@townofinerrimac.com r� The Commonwealth ofMassachusetts Department of IndustriglAccirlents Office of Investigations 600 Washington Street Boston, MA. 02111 www.mass govIdia Workers' Compensation Insurance Affidavit: Builders/Cointractors[Electricians/Plumbers Applicant Information Please Print Leizibly Name (Business/organization/fndividual): �� Is ` le C7\- C C - Address• I e, City/State/Zip: `� Phone #: C3 S%? C52 Are you an employer? Check the appropriate box: - Typo of project (required): L ❑ 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 liste n the attached sheet. : 7. El Remodeling ship and'have no employees working forme in any capacity. _f T sesub-contractors have comp. insurance. 8. E] Demolition -1 9. [] Building addition [No workers' comp. insurance 5. We are a corporation and its 10.❑ Electrical repairs or additions G1 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 ] ired. re q u employees. [No workers' 13.0 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 Aire 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 anal job site information. Insurance Company N Policy ## or Self -ins. Lic. M Expiration Date: Job §ite Address: City/State/Zip: Attach a copy of the workers' compensation -policy declaration page (showing the policy number and expiration date). Fai'ture 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 cerfify under the pains and penalties ofperjury that the information provided above is true an correct. Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License 0 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 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 (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. Anew 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 Gorr_ oRMazth of Massa husPtts Deparimeut of T.ndustriat ,Accidents Wave of Investiptious 600 WashiVoa Street Boston} , 02111 TeJ, # 617-727-4900 ext 40& oar 1.-877:MASSAFF, Revised 5-26-05 Pax # 617-727-7749 i7CF{xF{xF YY1A Q(RhSFfl�no 4 r i F j 10479 Date .... ... U.!!.:1.. TOWN OF NORTH ANDOVER This certifies that.. .............. .......Q�1r�e(�(�S 2 .. ti ...... I . ............... has permission to perform ............ —0..-.) ................. .................................... plumbing in the buildings of...(' ..................................................... at ........ -�DF L� C�k -- w............ A -Y .................. North Andover, Mass. F4........... —.. Lic. NoZ u . ..... ...... H.Q .............................................................. PLUMBING INSPECTOR Check # 5iZ- PERMIT FOR PLUMBING W. �-- 12A 1 19 4 .. A POWNER TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY NORTH ANDOVER MA. DATE4-10-14 PERMIT # JOBSITE ADDRESS 126 STANTON WAY OWNER'S NAMEGREEN AND COMPANY ADDRESS: POBOX1297 N HAMPTON NH 03862 TEL: 8004298615 FAX: OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL ❑■ NEW: 0 RENOVATION: ❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ FIXUTRES -1 FLOORS- Bsmt 1 2 3 4 5 F _6F 7 8 19 10 11 12 1 13 14 BATHTUB 2 CROSS CONN DEVICE DEDICATED SPECIAL WASTE SYS DEDICATED GAS/OIUSAND SYS DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYS DEDICATED WATER REUSE SYS DISHWASHER DRINKING FOUNTAIN FOOD WASTE GRINDER UNIT FLOOR / AREA DRAIN INTERCEPTOR INTERIOR KITCHEN SINK LAVATORY 3 ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET 1 2 URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING SPIGOTS 2 1 INSURANCE COVERAGE I, I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES 0 NO ❑ ',If you have checked YES, please indicate the type of coverage by checking the appropriate box below. LIABILITY INSURANCE POLICY 0 OTHER TYPE INDEMNITY ❑ 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. CHECK ONE ONLY: OWNE [__1 AGENT ElSIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted (or entered) regarding this application e e and rate the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this applica ' n II be i o Iia with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER NAME: MIKE BURKE LICENSE # 113127 1 IGNATURE COMPANY NAME: POWERHOUSE PLUMBING AND HEATING CORP ADDRESS: PO BOX 896 CITY: PLAISTOW STATE: NH ZIP: 03865 FAX: 6033780040 TEL: 116033780020 CELL: 19784909385 EMAIL: J.LAUR -- _ ENCIO@POWERHOUSEPLUMBING.COM MASTER 0 JOURNEYMAN ❑ CORPORATION 0 # 2482 PARTNERSHIP ❑ # LLC ❑ w F O z z U a a Q z w o❑ Z z }❑ o � w F W a wui ca a x W O W d 3 N ►� 0 0 a w a � U J IL CLQ N 111 S W F- LL W O z z 0 H U` W A, z z � x 0 x Date Yzqk.............. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION Tihis certifies that ............................. P ---i In cvvok-0 has permission for gas installation ............................................................................ in the buildings 0 .................... ............. ...................... ; ............ at ......-.............. North Andover, Mass. ... Fee/ Lic. No. 2—L+Z.L ......................... ..................................................................... GASINSPECTOR Check# 9230 (�� ��-l�} � Iz5�1�( Y -- GOWNER TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I NORTH ANDOVER MA. DATE 410-14 II PERMIT# 17- JOBSITE ADDRESS 126 STANTON WAY OWNER'S NAME rGREEN AND COMPANY ADDRESS: POBOX 1297 N HAMPTON NH 03862 TEL: 18004298615 FAX: OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL NEW: ❑■ RENOVATION: ❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ FIXUTRES 1 FLOOR— Bsmt 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST i UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE I have a current liabilily insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box below. LIABILITY INSURANCE POLICY ❑■ OTHER TYPE INDEMNITY ❑ 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. CHECK ONE ONLY: OWN E F1 AGENT El SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted (or entered) regarding this application ar ru and rate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this applicati wil e i co pliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER/GASFITTER NAME: MIKE BURKE LICENSE # 13127 GNA E COMPANY NAME: I POWERHOUSE PLUMBING AND HEATING CORP _ ADDRESPOBO, 96 03865CITY: I STATE: ZIP: FAX: 603; TEL: 6033780020 CELL: 9784909385 EMAIL: J.LAURENCIO@EOWERHOUSEPLUMBINGAND HE) MASTER W JOURNEYMAN ❑ LP INSTALLER ❑ CORPORATION 9 #12482 1 PARTNERSHIP ❑ # LLC Zk �a C-� .-' w F O z z 0 F U W a a w oEl Z z O o w o WCL w W f z w a W O a W U)LU w d 3 N a O 2c a a � w a � U J a a Q N 111 = W H LL F O z z 0 w a z 7 x x 0 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): POWERHOUSE PLUMBING CORP Address: PO BOX 896 PLAISTOW, NH 03865 Phone #: 6033780020 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 6 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 3. ❑ 1 am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no employees. [No workers' comp insurance required ] Type of project (required): 6. N New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0 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 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: HARTFORD UNDERWRITERS INSURANCE COMP Policy # or Self -ins. Lica#: 04WECIT2480 Job Site Address: 26 STANTON WAY Expiration Date: 7-28-14 City/State/Zip: NORTH ANDOVER MA Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-yeap imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day a nst t iolator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the for ' rance coverage verification. I do hereby certi7u der t ins and penalties of perjury that the information provided above is true and correct. .vio„ar„rP• — 4-10-14 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 #• ,tiMMt NWEALT'+H OF MASSACHUSETTS PLUti3ERS AND GASFITTERS L(CEN �:T AS A MASTER PLUMB MICHAEL if BUR+:E 61 CORLISS k10. RD HAVERHILL AA 01830-1613 13127 05/Ui/14" 160677 COMA40NWEALTH OF MASSACHUSETTS PLUMBERS AND GASFITTER REGISTERED AS A PLUMBING 7.0 MICHAEL W BURKE n POWERHOUSE PLB 8 HEATING Cl ` 61 CORLISS HILL RD HAVERHILL MA 01830-1611 2482 05/01/14 160675 a. €0 AS A JOl-!RMYtJiA'i ;TSUrS THE ABOVE UC f', A,STo. HICIIAEL W BURKE 61 CUPLISS HILL RD HAVEPHILL - MA alaxo-114 3 , � P ACCORDFCERTIFICATE OF LIABILITY INSURANCE 1 7/31/2013 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 be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER QONTA Kathleen Millar, CISR, CPIW INSURANCE SOLUTIONS CORPORATION PHON- (603) 382-4600 (603) 392-2034 kmer@isc-iaaurance.com 60 Westville Rd Plaistow NH 03865 INSURER A Merchants INSURED INSUREReXartford Underwriters Ins. Co. Powerhouse Plumbing & Heating Corp. INSURERC: PO Box 896 INSURER o: Plaistow NH 03865 IINSURERF! r ..�.,...,. �.- ....v __e T_1 Q'D991.31 Al RF -VISION NUMBER. COVERAGES GCKllrn.►aICnUM12F-r%.------------ _ ---- -- --- BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, PERTAIN, THE, INSURANCE AFFORDED BY THE POLICIES DESCR18ED HEREIN IS SUBJECT TO ALL THE TERMS. CERTIFICATE MAY BE ISSUED OR MAY EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSRPOUCY LTR TYPE OF INSURANCE N MBER MMID UPP LIMITS EACH OCCURRENCE S 1,000,000 GENERAL LIABILITY S 500,000 "'— X COMMERCIAL GENERALLIABILITY 1z BOP1065497 /1/2013 /1/2014 MEDEXP An one on S 15,900, PERSONAL 8 ADV INJURY S Include A CLAIMS41ADE OCCUR GENERAL AGGREGATE S 2,000, 000 PRODUCTS - COMP/OP,AGG S 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: S IN 11000,000 TX POLICY PRO LOC AUTOMOBILE LIABILITY BODILY INJURY (Per person) S A X ANY ALTO A�� ED SCHEDULED 1058154 /1/2013 /1/2014 BODILY INJURY (Per aoddetd) s PROPERTY DAMAGE S S NON -OWNED HIRED AUTOS AUTOS (per Imnij s 5.000 Medical payments UMBRELLA LfAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIM CLAIMSIaIADE f DE RuewmN - - ` YuC STATU I B WORKERS COMPENSATION E.L. EACH ACCIDENT 5.., 100 OOQ AND EMPLOYERS' LIABILITY ANY PROPRIETORMARTNERlEXMunvE Q OFyFas� �EM� EXCLUDED? NIA 4WECIT2480 /28/2013 /28/2014 El DISEASE - EA EMPLOYE S 100,000 (MoUpESCRI�Ot OrF8OPERATIONS beiaw E.L. DISEASE •POLICY Lou S 500 OQO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE'S (Attach ACORD 101. Additional Remarks Schedule, if more space Is required) r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIM REPRESENTATIVE eith Maglia/KRMT- ®1988-2010 ACORD CORPORATION. All rights reserved. ranictamei marlrc of Arman 243 ' I Date ."T.�k�( ,......... . TOWN OF NORTH ANDOVER PERMIT FOR MECHANICAL INSTALLATION This certifies that �' 4.0- Sv')............ has permission for mechanical installation`s 1f .. ! r p: , ' . V►� in the buildings of f�-�t P.Q .. !--?............... ...... ;.,-�North /Andover, Mass. Fee..\':�'�. Lic. No...... (. . C� �ij ) GAS INSPECTOR HA p nt CANARY: Building Dept. PINK: Treasurer IPcruA ICAL MECHANICAL Neot/ng 0 Air Cond1008211 service Steve Stephenson (Project Mgr.) smsbrookside@aol.com Q 603.494.1153 Shipping: 387 Pepsi Road • Manchester, NH Billing: P.O. Box 6656 Manchester, NH 03108 1r �� Commonwealth of Massachusetts Sheet Metal Permit Date Estimated Job Cost: Plans Submitted: YES ANO Business License # Permit # 24z-;� Permit Fee: $_ Plans Reviewed: YES 132-'_ NO Applicant License # Business Information: Property Owner / Job Location Information: Name: _ S%�i�,�uz/ �j ��%r�� Name: Street: Street: < s City/Town: ���i�e� ���' City/Town: �•l�` Telephone: ,Q 3 _ Gly cl_ �is-� Telephone: Photo I.D. required / Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family -Z,,��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: JZ Renovation: i HVAC Metal Roofing Kitchen -Exhaust System Chimney /Vents Provide brief description of work to be done: C INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes ❑ No ❑ If you have checked Yes, indicate 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 boxE], 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 3y ritle ;ity/Town permit # =ee $ ispector Signature of Permit Approval Progress Inspections Comments Final Inspection Type of License: Master ❑ Master -Restricted ❑Journeyperson ❑Journeyperson-Restricted ❑ - -- Comments Signature of Licensee License Number. Check at www.mass.gov/dpi Sheet Metal Commercial Guidelines / Life Safety / Critical Systems Inspection Checklist Yes No N/A, ti 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 dampets 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 616111ances, fire rated enclosures and pressure testing required. StiRi:3i� e taints installed =*rlrequired'oir equipment and du, tv.,a'ri b ... _ Duct penetrations in and floors sealed Metal roofing systems installed watertight using proper materials and fasteners Flexible duct rims 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) 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-ofo 0 COMMONWEALTH OF MASSACI{USETS SHEET METAL WORK IFZ ERS"' "AS A.MASTER-.,NR 15$UES THE ABOVE LICENSE TO:.. 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I - o �I(D .._.__ _�_v — — — I o 0o O O - 0 =Dr ,r not ! = '' � � 00'!&I � 3 -p D y o � DI — -t �. rn f y 0 i I I I A 00 -� y.4.0-ip I -4 I I Taco Load Program Project: Andover prime Project Information Project Title: Andover prime Address: Lot #16-8 Stanton Woods City: North Andover Comments: Project Input Data State: MA Zip: Engineer: The Granite Group (Jeff Lapointe) Address: 1035 Westford St City: Lowell State: MA Zip: 01851 Comments: Client: Brookside Mechanical Address: 387 Pepsi Drive City: Manchester State: NH Zip: Comments: Project Weather Information Nearest Climatological Location: State: Massachusetts City: Lawrence Latitude: 42.70 Clearness Factor: 1.00 Elevation: 57 Air Density Factor 0.99735 Outside Design Temp Cooling: Dry Bulb°F 92.0 Wet Bulb°F 73.0 Daily Range°F 22.0 Heating Dry Bulb°F -6.0 Outside Design Temp Heating: Dry Bulb°F -6.0 Weather Temperature Detail Dry Bulb Temperature °F 04/21/2014 Hour 1 2 3 4 5 6 7 8 9 10 11 12 January 22.0 22.0 21.0 20.0 20.0 20.0 21.0 23.0 26.0 30.0 33.0 37.0 Februay 26.0 26.0 26.0 25.0 24.0 24.0 25.0 28.0 31.0 34.0 38.0 41.0 March 33.0 33.0 32.0 31.0 31.0 31.0 32.0 34.0 37.0 41.0 45.0 48.0 April 45.0 45.0 44,0 43.0 43.0 43.0 44.0 46.0 49.0 53.0 56.0 60.0 May 56.0 56,0 55.0 64.0 53.0 54.0 55.0 57.0 60.0 64.0 67.0 71.0 June 67.0 67.0 66.0 65.0 64.0 65.0 66.0 68.0 71.0 74.0 78.0 81.0 July 72.0 72.0 71.0 70.0 70.0 70.0 71.0 73.0 76.0 80.0 83.0 87.0 August 68.0 68.0 68.0 67.0 66,0 66.0 67.0 70.0 73.0. 76.0 80.0 83.0 September 59.0 59.0 58.0 57.0 57.0 57.0 58.0 60.0 63.0 67.0 71.0 74.0 October 47.0 46.0 46.0 45.0 44.0 44.0 45.0 48.0 51.0 54.0 58.0 61.0 November 33.0 32.0 32.0 31.0 30.0 30.0 32.0 34.0 37.0 40.0 44.0 47.0 December 24.0 24.6 23.0 22.0 22,0 22.0 23.0 25.0 28.0 32.0 36.0 39.0 Weather Temperature Detail Dry Bulb Temperature OF Hour 13 14 15 16 17 18 19 20 21 22 23 24 January 40.0 41.0 42.0 41.0 40.0 37.0 34.0 32.0 29.0 27.0 26.0 23.0 Februay 44.0 46.0 46.0 46.0 44.0 42.0 39.0 36.0 34.0 32.0 30.0 27.0 March 51.0 52.0 53.0 53.0 51.0 48.0 46.0 43.0 40.0 38.0 37.0 34.0 April 63.0 64.0 65.0 64.0 63.0 60.0 57.0 55.0 52.0 50.0 49.0 46.0 May 73.0 75.0 76.0 75.0 74.0 71.0 68.0 65.0 63.0 61.0 59.0 57.0 June 84.0 86.0 87.0 86.0 84.0 82.0 79.0 76.0 74.0 72.0 70.0 68.0 July 90.0 91.0 92.0 91.0 90.0 87.0 84.0 82.0 79.0 77.0 76.0 73.0 August 86.0 88.0 88,0 88.0 86.0 84.0 81.0 78.0 76.0 74.0 72.0 69.0 September 77.0 79.0 79.0 79.0 77.0 74.0 72.0 69.0 66.0 64.0 63,0 60.0 October 64,0 66.0 66.0 66.0 64.0 62.0 59.0 56.0 54.0 52.0 50.0 47,0 November 50.0 52.0 52,0 52.0 50.0 48.0 45.0 42.0 40.0 38.0 36.0 33.0 December 42.0 44.0 44.0 44.0 42.0 40.0 37.0 34.0 31.0 29.0 28.0 25.0 Wet Bulb Temperature OF Hour 1 2 3 4 5 6 7 8 9 10 11 12 January 17.8 17.7 17.1 16.5 16.1 16.3 17.1 18.5 20.5 22.9 25.3 27.6 Februay 21.7 21.6 21.1 20.4 20.1 20.2 21.0 22.5 24.5 26.8 29.2 31.5 March 27.6 27.5 26.9 26.3 26.0 26.1 26.9 28.3 30.3 32.7 35.1 37.4 April 37.3 37.2 36.7 36.1 35.7 35.8 36.6 38.1 40.1 42.4 44.9 47.1 May 46.1 46.0 45.4 44.8 44.4 44.6 45.4 46.8 48.8 51.2 53.6 55.9 June 54.8 54.7 54.2 53.6 53.2 53.3 54.1 55.6 57.6 59.9 62.4 64.6 July 59.7 59.7 59.1 58.5 58.1 58.3 59.1 60.5 62.5 64.8 67,3 69.6 August .58.0 .57.9 57.3 56.7 56.3 56.5 57.3 58.7 60.7 63.1 65,5 67.8 September 51.3 51 ,2 50.6 50.0 49.6 49.8 50,6 52.0 54.0 56.4 58.8 61.1 October 40.5 40.4 39.9 39.3 38.9 39.1 39.9 41.3 43.3 45.6 48.1 50.3 November 27.7 27.6 27.0 26.4 26.1 26.2 27.0 28.5 30.4 32.8 35.2 37.5 December 19.7 19.6 19.1 18.5 18.1 18.2 19.0 20.5 22.5 24.8 27.3 29.5 Hour 13 14 15 16 17 18 19 20 21 22 23 24 January 29,4 30.6 31.0 30.6 29.5 27.9 26.0 24.1 22.4 21.2 20.0 18.4 Februay 33,3 34,5 35.0 34.6 33.5 31.8 29.9 28.0 26.4 25.1 24.0 22.3 March 39.2 40.4 40.8 40.5 39.3 37.7 35.8 33.9 32.3 31.0 29.9 28.2 April 49.0 50.2 50.6 50.2 49.1 47.4 45.5 43.6 42.0 40.7 39.6 37.9 May 57.7 58.9 59.3 58.9 57.8 56.2 54.3 52.4 50.7 49.5 48.3 46:7 June 66.5 67.7 68.1 67.7 66.6 64.9 63.0 61.1 59.5 58.2 57.1 55.4 July 71.4 72.6 73.0 72.6 71.5 69.9 67.9 66.0 64.4 63.1 62.0 60.4 August 69.6 70.8 71.2 70.8 69.7 68.1 66.2 64.3 62.6 61.4 60.2 58.6 September 62.9 64.1 64.5 64.1 63.0 61.4 59.5 57.6 55.9 54.7 53.5 51.9 October 52.2 53.4 53.8 53.4 52,3 50.6 48.7 46.8 45.2 43.9 42.8 41.2 November 39.3 40.5 40.9 40.6 39.4 37.8 35.9 34.0 32.4 31.1 30.0 28.3 December 31.4 32.6 33.0 32.6 31.5 29.8 27.9 26.0 24.4 23.1 22.0 20.3 Taco Load Program Building Input Data Project: Andover prime Design Conditions Cooling Design Conditions Heating 04/21/2014 Inside Cooling Dry Bulb (°F) Inside Cooling Rel. Hum(%) Cooling Air Temperature Difference (°F) Cooling Hydronic Temperature Difference (°F) Building Data 75.0 50 20 10 Inside Heating Dry Bulb (°F) Heating Air Temperature Difference ('F) Heating Hydronic Temperature Difference (°F) Design Loads 72.0 50 10 Wall Height (ft) 8.0 People Sensible (BtuH) 250 Hour Average (hr) 2 People Latent (BtuH) 200 Supply Air Min. (cfm/ft2) .00 People /Area (ft) 100 Supply Air Min. (AC/hr) .00 Max. People 1000 Equipment / Area (W/ft2) 1.20 Lighting / Area (W/ft2) 1.50 Infiltration Ventilation Cooling AC (AC/hr) .10 % Fan 0 Cooling Diversity 1.00 Flow/ Person 20.00 Heating AC (AC/hr) .10 AC 1.00 Heating Diversity 1.00 Flow / Area .20 Diversity Factor Lighting .00 Equipment .00 People .00 Taco Load Program Project: Andover prime Unassigned System Input Data Design Conditions Cooling Design Conditions Heating 04/21/2014 Inside Cooling Dry Bulb (°F) 75.00 Inside Heating Dry Bulb (°F) 72.00 Inside Cooling Rel. Hum(%) 50 Heating Air Temperature Difference (OF) 50.00 Cooling Air Temperature Difference (°F) 20.00 Heating Hydronic Temperature Difference (°F) 10.00 Cooling Hydronic Temperature Difference (°1710.00 Building Data Design Loads Wall Height (ft) Supply Air Min. (cfm/ft2) Supply Air Min. (cfm) Infiltration Cooling AC (cfm) Cooling Diversity Heating AC (cfm) Heating Diversity Diversity Factor Lighting Equipment People 8.00 People Sensible (BtuH) 250.00 People Latent (BtuH) 200.00 .00 People / Area (ft2) 100.00 .00 Max. People 1000 Equipment/ Area (BtuH/ft2) 1.20 Lighting / Area (BtuH/ft2) 1.50 Ventilation .10 % Fan 0 1.00 Flow / Person 20.00 .10 AC 1.00 1.00 Flow / Area .20 1.00 1.00 1.00 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Dining SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Fir —Partition — Hr.---AC/Hr— Length Width' Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 11.9 12.0 8.0 8.0 1 0 0 0 1 0 .0 2.0 People Lights Roof Transmission Equipment 0 Infil. CFM Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 Floor 0 1258 0 A A Exposure Exp Wall —Window— 0 0 People Lgth ID Area Ra ID Nr. RA 0 0 E(-90)/Vertical(90) 11.9 1 65.2 1 2 Safety Factor 0 0 S(0)/Vertical(90) 12.5 1 100.0 6326 193 2969 250 Ventilation 0 0 0 PEAK LOAD occurs at 7 AM, June Heating for -6 DB and 0 WB OSA Total 6326 193 2969 250 General Loads Area (ft) 143 COOLING LOAD Volume (ff) 1142 HEATING LOAD Sen Heat Ratio w/o Vent .97 Sensible Latent To RA Sen Heat Ratio with Vent .97 Int. Gain To RA Window Transmission -27 1006 50 Window Solar 6354 2.0 .4 Wall Transmission -14 541 3 Wail Solar 53 290 Roof Transmission 0 0 Roof Solar 0 2 2 Partition 0 0 Floor -286 1258 Infiltration -4 =7 163 Lights 0 0 People 250 200 250 Equipment 0 0 0 Sub Total 6326 193 2969 250 Safety Factor 0 0 0 Sub Total 6326 193 2969 250 Ventilation 0 0 0 Total 6326 193 2969 250 General Loads Area (ft) 143 Total Load (BtuH) Volume (ff) 1142 Total Load (BtuH/ft2) Sen Heat Ratio w/o Vent .97 Total Load (Ton) Sen Heat Ratio with Vent .97 Total Load (ft;'/Ton) Flows Cooling Heating Cooling Heating 6519 2969 Water (gpm) 1.3 .3 45.6 20.8 Air Room Peak (cfm) 290 50 .5 Air Room Peak (cfm/ft2) 2.0 .4 263 Air Room Peak (AC/hr) 15 3 Return Air (cfm) 290 Exhaust Airflow (cfm) 0 Infiltration (cfm) 2 2 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Family Room SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Flr ---Partition — Hr. —AC/Hr -- Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 16.0 25.0 8.0 8.0 2 600 0 0 1 0 .0 2.0 - — People Lights Equipment Infil. CFM Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 480 0 .1 .1 Exposure Exp Well —Window — Lgth I D Area Ra ID Nr. RA N(180)Nertical(90) 35.0 1 250.0 1 2 W(90)/Vertical(90) 16.0 1 98.0 1 2 PEAK LOAD occurs at 2 PM, June Heating for -6 DB and 0 WB OSA COOLING LOAD HEATING LOAD Sensible Latent To RA Int. Gain To RA Window Transmission 459 2012 Window Solar 7108 Wall Transmission 248 1140 Wall Solar -128 Roof Transmission 0 0 Roof Solar 0 Partition 0 0 Floor -800 3520 Infiltration 0 0 456 Lights 2046 2046 People 500 400 500 Equipment 1638 0 1638 Sub Total 11071 400 7129 4184 Safety Factor 0 0 0 Sub Total 11071 400 7129 4184 Ventilation 1492 1506 6846 Total 12563 1906 13975 4184 General Loads Flows Cooling Heating Cooling Heating Area (ft) 400 Total Load (BtuH) 14470 13975 Water (gpm) 2.9 1.4 Volume (fV) 3200 Total Load (BtuHlft2) 36.2 34.9 Air Room Peak (cfm) 500 130 Sen Heat Ratio w/o Vent 97 Total Load (Ton) 1.2 Air Room Peak (cfm/ft2) 1.3 .3 Sen Heat Ratio with Vent .87 Total Load (ft2/Ton) 332 Air Room Peak (AC/hr) 9 2 Return Air (cfm) 500 Exhaust Airflow (cfm) 0 Infiltration (cfm) 5 5 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Foyer SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Fir --Partition— Hr.—AC/Hr— Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 15.0 10.0 8.0 8.0 0 0 0 0 1 0 .0 2.0 People Lights Roof Transmission Equipment — —Infil. CFM — Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 Floor -300 0 0 A .1 Exposure Exp Wall --Window— 0 0 Lgth ID Area Ra ID Nr. RA Equipment 0 0 W(90)/Vertical(90) 10.0 1 50.0 1 2 0 Safety Factor PEAK LOAD occurs at 3 PM, .tune Heating for -6 DB and 0 WB OSA General Loads Area (ft) COOLING LOAD Total Load (BtuH) HEATING LOAD 1200 Sensible Latent To RA Sen Heat Ratio w/o Vent Int. Gain To RA Window Transmission 216 1006 Total Load (ft2/Ton) Window Solar 6207 Infiltration (cfm) Wall Transmission 34 164 Wall Solar -13 Roof Transmission 0 0 Roof Solar 0 Partition 0 0 Floor -300 1320 Infiltration 0 0 171 Lights 0 0 People 0 0 0 Equipment 0 0 0 Sub Total 6144 0 2661 0 Safety Factor 0 0 0 Sub Total 6144 0 2661 0 Ventilation 527 550 2567 Total 6671 550 5228 0 General Loads Area (ft) 150 Total Load (BtuH) Volume (ft') 1200 Total Load (BtuH/ftz) Sen Heat Ratio w/o Vent 1.00 Total Load (Ton) Sen Heat Ratio with Vent .92 Total Load (ft2/Ton) Flows Cooling Heating 7221 5228 Water (gpm) 48.1 34.9 Air Room Peak (cfm) .6 Air Room Peak (cfm/ft2) 249 Air Room Peak (AC/hr) 0 Return Air (cfm) 2 Exhaust Airflow (cfm) Infiltration (cfm) Cooling Heating 1.4 .5 280 50 1.9 .3 14 3 280 0 2 2 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Front bed left SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Flr —Partition — Hr. —AC/Hr — Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min, OSA 12.5 12.0 8.0 8.0 0 0 1 150 0 0 .0 2.0 People Lights Equipment Infil. CFM Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 557 0 0 .1 .1 Exposure Exp Wall —Window— Roof Transmission 82 Lgth ID Area Ra ID Nr. RA Roof Solar S(0)Nertical(90) 12.5 1 100.0 Partition W(90)Nertical(90) 12.5 1 70.0 1 2 Floor PEAK LOAD occurs at 3 PM, June Heating for -6 DB and 0 WB OSA COOLING LOAD HEATING LOAD Sensible Latent To RA Int. Gain To RA Window Transmission 216 1006 Window Solar 6207 Wall Transmission 114 557 Wall Solar -44 Roof Transmission 82 398 Roof Solar 3 Partition 0 0 Floor 0 0 Infiltration 0 0 171 Lights 0 0 People 0 0 0 Equipment 0 0 0 Sub Total 6579 0 2132 0 Safety Factor 0 0 0 Sub Total 6579 0 2132 0 Ventilation 527 550 2567 Total 7105 550 4699 0 General Loads Flows Cooling Heating Cooling Heating Area (ft') 150 Total Load (BtuH) 7656 4699 Water (gpm) 1.5 .5 Volume (ft3) 1200 Total Load (BtuH/ft2) 51.0 31.3 Air Room Peak (cfm) 310 40 Sen Heat Ratio w/o Vent 1.00 Total Load (Ton) .6 Air Room Peak (cfm/ft2) 2.1 .3 Sen Heat Ratio with Vent .93 Total Load (ft2fTon) 235 Air Room Peak (AC/hr) 16 2 Return Air (cfm) 310 Exhaust Airflow (cfm) 0 Infiltration (cfm) 2 2 Taco Load Program Room Results 04121/2014 Andover prime ROOM Kitchen SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Fir —Partition — Hr.—AC/Hr— Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min, OSA 22.0 12.0 8.0 8.0 1 0 0 0 1 0 .0 2.0 People Total Load (BtuH) Lights -10 Equipment 380 Infil. CFM — Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 317 0 0 .1 .1 --Exposure Exp Wall —Window— Lgth ID Area Ra ID Nr. RA E(-90)/Vertical(90) 22.0 1 116.0 1 4 PEAK LOAD occurs at 7 AM, June 13482 186 Heating for -6 DB and 0 WB OSA COOLING LOAD General HEATING LOAD Loads Sensible Latent To RA Int. Gain To RA Window Transmission -54 2012 Heating Window Solar 12709 Area (ftz) 264 Total Load (BtuH) Wall Transmission -10 2.7 380 Volume (fC) Wall Solar 41 51.8 19.0 Air Room Peak (cfm) 610 Roof Transmission 0 .99 0 1.1 Roof Solar 0 .3 Sen Heat Ratio with Vent .99 Partition 0 Air Room Peak (AC/hr) 0 3 Floor -528 2323 Return Air (cfm) Infiltration -8 -14 301 Lights 0 0 0 People 250 200 Infiltration (cfm) 250 Equipment 1082 0 1082 Sub Total 13482 186 5017 1332 Safety Factor 0 0 0 Sub Total 13482 186 5017 1332 Ventilation 0 0 0 Total 13482 186 5017 1332 General Loads Flows Cooling Heating Cooling Heating Area (ftz) 264 Total Load (BtuH) 13669 5017 Water (gpm) 2.7 .5 Volume (fC) 2112 Total Load (BtuH/ftz) 51.8 19.0 Air Room Peak (cfm) 610 90 . Sen Heat Ratio w/o Vent .99 Total Load (Ton) 1.1 Air Room Peak (cfm/ft2) 2.3 .3 Sen Heat Ratio with Vent .99 Total Load (ftzfTon) 232 Air Room Peak (AC/hr) 17 3 Return Air (cfm) 610 Exhaust Airflow (cfm) 0 Infiltration (cfm) 4 4 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Left bed front SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Fir Partition— Hr.—ACIHr— Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 11.0 12.0 8.0 8.0 0 0 1 132 0 0 .0 2.0 People 300 Lights - Roof Transmission Equipment 350 Infil. CFM Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 0 0 A .1 Exposure Exp Wal! —Window— Lgth ID Area Ra ID Nr. RA W(90)/Vertical(90) 11.0 1 58.0 1 2 PEAK LOAD occurs at 3 PM, June Heating for -6 DB and 0 WB OSA Total 7049 550 4264 0 General Loads Area (ft2) 132 COOLING LOAD Volume (ft') 1056 HEATING LOAD Sen Heat Ratio w/o Vent 1.00 Sensible Latent To RA Sen Heat Ratio with Vent .93 Int. Gain To RA Window Transmission 216 1006 30 Window Solar 6207 2.3 .2 Wall Transmission 39 190 2 Wall Solar -15 300 Roof Transmission 72 350 Roof Solar 3 2 2 Partition 0 0 Floor 0 0 Infiltration 0 0 151 Lights 0 0 People 0 0 0 Equipment 0 0 0 Sub Total 6522 0 1697 0 Safety Factor 0 0 0 Sub Total 6522 0 1697 0 Ventilation 527 550 2567 Total 7049 550 4264 0 General Loads Area (ft2) 132 Total Load (BtuH) Volume (ft') 1056 Total Load (BtuHIft2) Sen Heat Ratio w/o Vent 1.00 Total Load (Ton) Sen Heat Ratio with Vent .93 Total Load (ft2/Ton) Flows Cooling Heating Cooling Heating 7599 4264 Water (gpm) 1.5 .4 57.6 32.3 Air Room Peak (cfm) 300 30 .6 Air Room Peak (cfm/ft2) 2.3 .2 208 Air Room Peak (AC/hr) 17 2 Return Air (cfm) 300 Exhaust Airflow (cfm) 0 Infiltration (cfm) 2 2 Taco Load Program Room Results Andover prime ROOM Living SYSTEM TERMINAL 04/21/2014 Room Room Wall Clg Nr. Total Roof Fir Partition — Hr. —AC/Hr — Length Width Height Height People Watts ID Area RA . 1D ID Lgth Avg Min.. OSA 14.9 11.9 8.0 8.0 2 0 0 0 1 0 .0 2.0 People Lights Wall Solar Equipment 0 Infil. CFM — Sen. Lat, Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 0 0 .1 .1 Exposure Exp Wall —Window--- -354 1558 Lgth ID Area Ra 1D Nr. RA Lights S(0)Nertical(90) 14.5 1 116.0 0 People 500 400 W(90)Nertical(90) 11.9 1 65.2 1 2 0 PEAK LOAD occurs at 3 PM, June Heating for -6 DB and 0 WB OSA Total 7346 1134 6783 500 General Loads Area (ft2) 177 COOLING LOAD Volume (ft3) 1418 HEATING LOAD Sen Heat Ratio w/o Vent _94 Sensible Latent To RA Total Load (W/Ton) Int. Gain To RA Window Transmission 216 60 1006 Air Room Peak (cfm/ft2) Window Solar 6207 251 Air Room Peak (AC/hr) 13 Wall Transmission 122 Return Air (cfm) 594 Wall Solar -47 0 Roof Transmission 0 2 0 Roof Solar 0 Partition 0 0 Floor -354 1558 Infiltration 0 0 202 Lights 0 0 People 500 400 500 Equipment 0 0 0 Sub Total 6644 400 3360 500 Safety Factor 0 0 0 Sub Total 6644 400 3360 500 Ventilation 702 734 3423 Total 7346 1134 6783 500 General Loads Area (ft2) 177 Total Load (BtuH) Volume (ft3) 1418 Total Load (BtuH/ftz) Sen Heat Ratio w/o Vent _94 Total Load (Ton) Sen Heat Ratio with Vent .87 Total Load (W/Ton) Flows Cooling Heating Cooling Heating 8480 6783 Water (gpm) 1.7 .7 47.8 38.3 Air Room Peak (cfm) 310 60 .7 Air Room Peak (cfm/ft2) 1.7 .3 251 Air Room Peak (AC/hr) 13 3 Return Air (cfm) 310 Exhaust Airflow (cfm) 0 Infiltration (cfm) 2 2 Taco Load Program Room Results 04/21/2014 Andover prime ROOM main bath SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Fir —Partition — Hr.—AC/Hr— Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 8.0 7.0 8.0 8.0 0 0 1 56 0 0 .0 2.0 People 20 Lights Wall Transmission Equipment 150 - Infil. CFM — Sen. Lat. Pfl W/ft2 Pfi RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 0 Roof Solar 0 .1 .1 Exposure Exp Wall —Window— Lgth ID Area Ra ID Nr. RA E(-90)/Vertical(90) 8.0 1 49.0 1 1 PEAK LOAD occurs at 7 AM, June 56 Total Load (BtuH) Heating for -6 DB and 0 WB OSA 448 COOLING LOAD 1.00 HEATING LOAD Sen Heat Ratio with Vent Sensible Latent To RA 57.3 Int. Gain To RA Window Transmission -14 .3 503 2.7 Window Solar 3177 Air Room Peak (AC/hr) 20 3 Wall Transmission -4 150 161 Wall Solar 17 Infiltration (cfm) Roof Transmission -4 149 Roof Solar 40 Partition 0 0 Floor 0 0 Infiltration -2 -3 64 Lights 0 0 People 0 0 0 Equipment 0 0 0 Sub Total 3211 -3 876 0 Safety Factor 0 0 0 Sub Total 3211 -3 876 0 Ventilation 0 0 0 Total 3211 -3 876 0 General Loads Area (ft) 56 Total Load (BtuH) Volume (ft3) 448 Total Load (BtuH/ft2) Sen Heat Ratio w/o Vent 1.00 Total Load (Ton) Sen Heat Ratio with Vent 1.00 Total Load (ft'/Ton) Flows Cooling Heating Cooling Heating 3208 876 Water (gpm) .6 .1 57.3 15.6 Air Room Peak (cfm) 150 20 .3 Air Room Peak (cfm/ft2) 2.7 .4 209 Air Room Peak (AC/hr) 20 3 Return Air (cfm) 150 Exhaust Airflow (cfm) 0 Infiltration (cfm) 1 1 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Master bath SYSTEM TERMINAL Room Room Wall Clg Nr, Total Roof Fir --Partition — Hr.—AC/Hr— Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 12.0 8.0 8.0 8.0 0 0 1 96 0 0 .0 2,0 People Lights Roof Transmission -7 Equipment . Infil. CFM Sen. Lat. Pfl W/ft2 PfI RA Inc Sensible Rad. Latent PfI Summr Wintr 250 200 1.5 2 Partition 0 0 0 .1 .1 Exposure Exp Wall —Window— Infiltration Lgth ID Area Ra I D N r. RA Lights E(-90)/Vertical(90) 12.0 1 66.0 0 1 2 0 PEAK LOAD occurs at 7 AM, June 0 Equipment Heating for -6 DB and 0 WB OSA 0 COOLING LOAD 0 HEATING LOAD 6404 Sensible Latent 0 To RA Int, Gain To RA Window Transmission -27 Volume (ft3) 768 1006 Sen Heat Ratio w/o Vent 1.00 Window Solar 6354 Total Load (ft2/Ton) 66.7 16.5 Air Room Peak (cfm) Wall Transmission -6 .5 216 3.0 .Wall Solar 23 Air Room Peak (AC/hr) 23 2 Roof Transmission -7 290 255 Roof Solar 68 Infiltration (cfm) Partition 0 0 Floor 0 0 Infiltration -3 -5 110 Lights 0 0 People 0 0 0 Equipment 0 0 0 Sub Total 6404 -5 1587 0 Safety Factor 0 0 0 Sub Total 6404 -5 1587 0 Ventilation 0 0 0 Total 6404 -5 1587 0 General Loads Area (ft2) 96 Total Load (BtuH) Volume (ft3) 768 Total Load (BtuH/ft2) Sen Heat Ratio w/o Vent 1.00 Total Load (Ton) Sen Heat Ratio with Vent 1.00 Total Load (ft2/Ton) Flows Cooling Heating Cooling Heating 6399 1587 Water (gpm) 1.3 .2 66.7 16.5 Air Room Peak (cfm) 290 30 .5 Air Room Peak (cfm/ft2) 3.0 .3 180 Air Room Peak (AC/hr) 23 2 Return Air (cfm) 290 Exhaust Airflow (cfm) 0 Infiltration (cfm) 1 1 Taco Load Program Andover prime Room Results ROOM Master bed SYSTEM TERMINAL 04/21/2014 Room Room Wall CIg Nr. Total Roof Flr Partition — Hr. —AC/Hr — Length Width Height Height People Wafts ID Area RA ID ID Lgth Avg Min. OSA 17.0 15.5 8.0 8.0 1 0 1 264 0 0 .0 2.0 People Lights Roof Transmission Equipment 700 Infil. CFM -- Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 Floor 0 0 .1 .1 Exposure Exp Wall —Window— 0 0 Lgth ID Area Ra ID Nr. RA Equipment 0 0 W(90)/Vertical(90) 15.5 1 94.0 8035 200 1 2 250 Safety Factor N(180)/Vertical(90) 17.0 1 106.0 Sub Total 1 2 3668 250 PEAK LOAD occurs at 2 PM, June Heating for -6 DB and 0 WB OSA Total 8968 1141 7947 250 General Loads Area (ft2) 264 Total Load (BtuH) Volume (ft') 2108 Total Load (BtuH/ft2) Sen Heat Ratio w/o Vent .98 Total Load (Ton) Sen Heat Ratio with Vent .89 Total Load (ftz/Ton) Flows Cooling COOLING LOAD Cooling HEATING LOAD 10109 Sensible Latent To RA 2.0 Int. Gain To RA Window Transmission 459 2012 70 Window Solar 7108 1.4 .3 Wall Transmission 143 655 2 Wall Solar -75 370 Roof Transmission 153 700 Roof Solar -2 4 4 Partition 0 0 Floor 0 0 Infiltration 0 0 301 Lights 0 0 People 250 200 250 Equipment 0 0 0 Sub Total 8035 200 3668 250 Safety Factor 0 0 0 Sub Total 8035 200 3668 250 Ventilation 933 941 4279 Total 8968 1141 7947 250 General Loads Area (ft2) 264 Total Load (BtuH) Volume (ft') 2108 Total Load (BtuH/ft2) Sen Heat Ratio w/o Vent .98 Total Load (Ton) Sen Heat Ratio with Vent .89 Total Load (ftz/Ton) Flows Cooling Heating Cooling Heating 10109 7947 Wafter (gpm) 2.0 .8 38.4 30.2 Air Room Peak (cfm) 370 70 .8 Air Room Peak (cfm/ft2) 1.4 .3 313 Air Room Peak (AC/hr) 11 2 Return Air (cfm) 370 Exhaust Airflow (cfm) 0 Infiltration (cfm) 4 4 0 Taco Load Program -27 Volume (ft3) 1152 Room Results Window Solar 04/21/2014 Andover prime Total Load (ft2/Ton) Wall Transmission -14 290 531 ROOM Rear bed. 52 2.0 SYSTEM Roof Transmission TERMINAL 15 3$2 Roof Solar 103 290 Room Room Wall Clg Nr. Total Roof Flr --Partition Hr.—AC/Hr-- Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min, OSA 12.0 12.0 8.0 8.0 0 0 1 144 0 0 .0 2.0 —People 0 Lights Equipment 0 Infil. CFM — Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 0 0 .1 .1 Exposure Exp Wall ----Window----- Lgth ID Area Ra ID Nr. RA E(-90)/Vertical(90) 12.0 1 66.0 1 2 S(0)/Vertical(90) 12.0 1 96.0 PEAK LOAD occurs at 7 AM, June Heating for -6 DB and 0 WB OSA COOLING LOAD HEATING LOAD Sensible Latent To RA Int. Gain To RA Window Transmission -27 Volume (ft3) 1152 1006 Window Solar 6354 Sen Heat Ratio with Vent 1.00 Total Load (ft2/Ton) Wall Transmission -14 290 531 Wall Solar 52 2.0 _3 Roof Transmission -10 15 3$2 Roof Solar 103 290 Partition 0 0 0 Floor 0 2 0 Infiltration -4 -7 164 Lights 0 People 0 0 Equipment 0 0 Sub Total 6454 -7 2083 Safety Factor 0 0 0 Sub Total 6454 -7 2083 Ventilation 0 0 0 it Total 6454 -7 2083 0 General Loads Area (ft) 144 Total Load (BtuH) Volume (ft3) 1152 Total Load (BtuH/ft=) Sen Heat Ratio w/o Vent 1.00 Total Load (Ton) Sen Heat Ratio with Vent 1.00 Total Load (ft2/Ton) Flows Cooling Heating Cooling Heating 6447 2083 Water (gpm) 1.3 .2 44.8 14.5 Air Room Peak (cfm) 290 40 .5 Air Room Peak (cfm/ft2) 2.0 _3 268 Air Room Peak (AC/hr) 15 2 Return Air (cfm) 290 Exhaust Airflow (cfm) 0 Infiltration (cfm) 2 2 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Study SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof Flr Partition Hr.—AC/Hr— Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 11.9 8.0 8.0 8.0 1 0 0 0 1 0 .0 2.0 People -17 Lights Equipment — —Infil, CFM — Sen. Lat. Pfl W/ft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 0 0 0 .1 .1 Exposure 836 Exp Wall —Window— 0 109 Lights Lgth ID Area Ra ID Nr. RA People 250 W(90)Nertical(90) 11.9 1 65.2 1 2 0 Sub Total 6510 200 2164 250 Safety Factor 0 0 PEAK LOAD occurs at 3 PM, June Heating for -6 DB and 0 WB OSA Total General 6861 567 Loads Area (ft) 95 COOLING LOAD Volume (ft) 762 HEATING LOAD Sen Heat Ratio w/o Vent .97 Sensible Latent To RA Total Load (ftzlTon) Int. Gain To RA Window Transmission 216 40 1006 Air Room Peak (cfm/ft2) Window Solar 6207 154 Air Room Peak (AC/hr) 24 Wall Transmission 44 Return Air (cfm) 214 Wall Solar -17 0 Roof Transmission 0 1 0 Roof Solar 0 Partition 0 0 Floor -190 836 Infiltration 0 0 109 Lights 0 0 People 250 200 250 Equipment 0 0 0 Sub Total 6510 200 2164 250 Safety Factor 0 0 0 Sub Total 6510 200 2164 250 Ventilation 351 367 1711 Total General 6861 567 Loads Area (ft) 95 Total Load (BtuH) Volume (ft) 762 Total Load (BtuH/ft2) Sen Heat Ratio w/o Vent .97 Total Load (Ton) Sen Heat Ratio with Vent .92 Total Load (ftzlTon) 3876 250 Flows Cooling Heating Cooling Heating 7428 3876 Water (gpm) 1.5 .4 78.0 40.7 Air Room Peak (cfm) 300 40 .6 Air Room Peak (cfm/ft2) 3.2 .4 154 Air Room Peak (AC/hr) 24 3 Return Air (cfm) 300 Exhaust Airflow (cfm) 0 Infiltration (cfm) 1 1 Taco Load Program Room Results 04/21/2014 Andover prime ROOM Sun Room SYSTEM TERMINAL Room Room Wall Clg Nr. Total Roof--- Fir —Partition — Hr.—AC/Hr-- Length Width Height Height People Watts ID Area RA ID ID Lgth Avg Min. OSA 16.0 11.0 8.0 8.0 1 0 1 176 0 0 .0 2.0 People 1 Lights 1 2 Equipment — —Infil. CFM — Sen. Lat. Pfl WIft2 Pfl RA Inc Sensible Rad. Latent Pfl Summr Wintr 250 200 1.5 2 0 Partition 0 .1 .1 Exposure Exp 12534 Wall —Window— _.....__.. Sensible Lgth ID Area Ra ID Nr. RA E(-90)/Vertical(90) 16.0 1 83.0 1 3 N(180)Nertical(90) 11.0 1 43.0 1 3 S(0)Nertical(90) 11.0 1 58.0 1 2 PEAK LOAD occurs at 9 AM, July Heating for -6 DB and 0 WB OSA. General Loads Area (ft) 176 Total Load (BtuH) Volume (W) 1408 Total Load (BtuH/ftz) Sen Heat Ratio w/o Vent .98 Total Load (Ton) Sen Heat Ratio with Vent .98 Total Load (ft2/Ton) Flows Cooling COOLING LOAD 12534 HEATING LOAD 71.2 Sensible Latent To RA Air Room Peak (cfm/ft2) Int. Gain To RA Window Transmission 54 Return Air (cfm) 4025 Exhaust Airflow (cfm) Window Solar 11874 Wail Transmission 8 603 Wall Solar -2 Roof Transmission 6 467 Roof Solar 62 Partition 0 0 Floor 0 0 Infiltration 0 0 201 Lights 0 0 People 250 200 250 Equipment 0 0 0 Sub Total 12252 200 5295 250 Safety Factor 0 0 0 Sub Total 12252 200 5295 250 Ventilation 44 39 3423 Total 12296 239 8718 250 General Loads Area (ft) 176 Total Load (BtuH) Volume (W) 1408 Total Load (BtuH/ftz) Sen Heat Ratio w/o Vent .98 Total Load (Ton) Sen Heat Ratio with Vent .98 Total Load (ft2/Ton) Flows Cooling Heating 12534 8718 Water (gpm) 71.2 49.5 Air Room Peak (cfm) 1.0 Air Room Peak (cfm/ft2) 168 Air Room Peak (AC/hr) 0 Return Air (cfm) 2 Exhaust Airflow (cfm) Infiltration (cfm) Cooling Heating 2.5 .9 560 100 3.2 .6 24 4 560 0 2 2 Taco Load Program Building Results Flows 04/21/2014 Andover prime Cooling Heating Cooling Heating PEAK LOAD occurs at 2 PM, June Total Load (BtuH) 71336 68021 Water (gpm) Heating for -6 DB and 0 WB OSA 6.8 COOLING LOAD 17974 Total Load (BtuH/fF) HEATING LOAD 30.3 Air Sm Rm Peaks (cfm) 4560 Sensible Latent To RA 1.00 Int. Gain To RA Window Transmission 4246 Sen Heat Ratio with Vent 18615 Total Load (ft'/Ton) 378 Window Solar 55593 .3 Wall Transmission 1296 2 5945 Wali Solar -263 Roof Transmission 588 0 2700 0 Roof Solar -9 30 Partition 0 0 Floor -2458 10815 Infiltration 175 176 2564 Lights 0 0 People 0 0 0 Equipment 0 0 0 Sub Total 59168 176 0 40638 0 0 Safety Factor 0 0 0 0 0 Sub Total 59168 176 0 40638 0 0 Ventilation 5968 6024 27383 Total 65136 6201 0 68021 0 0 General Loads Flows Cooling Heating Cooling Heating Area (ftz) 2247 Total Load (BtuH) 71336 68021 Water (gpm) 14.3 6.8 Volume (ft') 17974 Total Load (BtuH/fF) 31.8 30.3 Air Sm Rm Peaks (cfm) 4560 740 Sen Heat Ratio w/o Vent 1.00 Total Load (Ton) 5.9 Air Room Peak (cfm) 2700 Sen Heat Ratio with Vent .91 Total Load (ft'/Ton) 378 Air Room Peak (cfm/ft2) 1.2 .3 Air Room Peak (AC/hr) 9 2 Return Air (cfm) 4560 Exhaust Airflow (cfm) 0 Infiltration (cfm) 30 30 Ventilation (cfm) 320