HomeMy WebLinkAboutMiscellaneous - 30 KEYES WAY 4/30/201814�14N
i 0 1 99
Date..:?.—Oy — //
.........................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... V e, 'l -ti, 'e, " , a* -?,..5 ., ....................
has permission to perform ...
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
wiring in the building of .... ....... 6-6.q.!� ......................
-vorth Andover, M s.
. .......... ......... ................. A
Fee.lor ....... Lic. ............
E CrRICA
L 17 LINSPECTO
Check #CRC�5-
Common -wealth of Mas,,achusetts Official Use Only
Department of Fire Services PermitNo. 91r,
mt No
BOARD OF FIRE PREVENTION REGULATIONS FOccuPancy and Fee Checked
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLE,4 SE PMTW AW OR YYPE AU WORW TIOA9 Date:
City or Town of- NORM ANDOVER TO -the Inspeqtor of Wires:
By this application the undersigned gives notice of his or her intention tn perform the electrical work described below.
Location (Street &Nun!ber) 3o
Owner or Tenant L L) 117Y
Owner's Address TelephoneNo. 7y- 9-79.*;
Is this Permit in conjunction with a buildingpermit? Yes
Purpose of Building A ey, h(.>,1,T-'Z No (Check Appropriate Box)
Existing Service 4?M Amps ------------------ Utility Authorization No.
�jew Service /JA!2_4LvoltS Overhead 0 U.dgrd No. of Meters
Amps -i—volts Overhead 0 Undgrd
Number of Feeders and.Ainpscity No. of Meters
Location and Natu
re of Proposed Electrical Work:
Of
Vr
M&IT -7—titf/T
NO. Of Recessed Lulnin2ifre-.
io. of LUnlinaire Outlets
-------------
10. of Luminaires
ro- of Receptacle Outlets
0. of Svdtches
0. of Ranges
I.No. of Waste Disposers
�No. of Dishwashers
!_ —0f �1
No. of Dryers
N W
o. of Aater
e
Heaters IKW
Hy
No.. rom s
HYdromassage Ba6htubsW
IOTHER:
No. of Ceil.-Susp- (Padd9e) Fans
/V / > 14 el
table may be waived by the
INoTW'
JNo. of Hot Tubs
Generators W�A
Switurning Pool Above Ej Jn-
d.
-1 grucy "guUng
'E3 Ing
nd.
No. of Oil Burners
BaySrV
_Units
'IMEALARMS NO-*ofZ-_nes
No. of Gas Burzters
-01 Detection and
No. Of Air Cond. Total
In] S
Tons
Heat Pump N Umber --tons
No. of Alerting Devices
Totals:
11 mle-d-
Space/Area Heating KW
DeteCtion/Alerting_Devices
i -Municir, F -,
oc wel"'
all]
Heating Applialaces KW
Connection EJ Other
See
No. of
.0 of Devices or'V . ......
Si Ballasts.
Data g:
No. Of Motors Total HP
T _Ie
!l !1
Attach all' 1,
Estimated Value of Electrical Work: 11li!1, or as req ired
Work to Start.. (When required by municipal policy.)
INNSURAN SPections to be requested in accordance with MEC Rule 10, and upon completion.
'M?AN COVER�-GE: 'Unless waived by the owner, no Permit for the performance of electrical work may issue unless
the licenseeprovides Proof of liability insurance including "completed operatioW, 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 N BONDE] OTHER E] .(Specify:)
I ce?10% under the pains andpenaldes ofpel tha
FMM NAAU: t the information on this aPPlication is true and complete.
Licensee: a, , 11C. NO.: 0
e- Sign Lure
ffapplicahle, enter "arempt " in the license number line.) LIC. NO.:
Address:
Bus. Tel.
*Per M.G.L c. 147, s. 57-61, security work requires Department of Public Alt. Tel. No.:
OWNER'S INSURANCE Safety "S" License: Lic. No.
WAIWR: 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 aria the (check one) El owner
Owner/Agent
Si ature owner's a ent
gn Telephone No
ELECTRICAL PEPWT NO. INSPECTION REPORT:
ELECTRICAL --
INSPECTOR- DOUG SMALL
2.3 CTION;
Passed — &/1 . Failed—[
fuspector's'&6mments: Re-insPectiOn required ($50.0o)
(Inspectors' Sloature
3. UNDER GROUND INSPECTION:
Passed — f I Failed
Inspectors' comments:
I,— GS-Wlai j3jrjj2jLure-)jojj
4. INSPECTION—
SERVICE:
- TECALLERDNATIONALGRlo-
Passed — f ] Failed —
InsPectors'coniments:
NAME:
��e-�spection required (S50.00)
Date
Date
(Inspectors, Signature - no initials) Date
5- INSPECTION - OTRER:
Passed — Failed -in ection required ($50.00)- r.
—Re sp
Inspectors, comments:
------------
(Inspectors' Signature no initials) Date
DO OP, TAGS ARE TO BE FILLED
9U --T— AND LEFT ON SITE IF TM AREA TO BE WSPECTED JS NOT
ACCESSIBLE AND A RE -INSPECTION O.F $50.00.TS To
BE CUARGED.
. A�
The Commonwealth ofAlassachuselts
Department Of r,"dustrial Accidents
Office of 1-nvestigations
00 Washington Street
Boston, M4 02111
www-mass.govldia
Workers' Compensation Insurance Affidavit: Buflders/Contrac�
Applicant "nformit-inn Lors/Electricians/Plumbers
NaMe (Business/Organization/Individual):
Address:_ _(2
City/Sfate/Zi�:_ AMbover- n I I o pholle --------------
A F�, #: F6 -
re you an employer'9 Check the appropriate box.,
a m Type of project (required):
m a employer with 4- El I am a general contractor and 1
e 03
employees (fiffl and/or part-time).* have hired th 6. New construction
2.X , e sub -contractors
1 am a sOle Proprietor or partner- listed on the attached sheet 1 7. Remodeling
ship and have no employees These sub -contractors have Wemeei r
working for me in any capacity. workers' comp. insurance. 8. Demolition
[NO workers' cOMP. insurance 5. El We are a c01POratiOn and its 9- Building addition
3. M required.] officers have exercised their 10. El Electrical repairs or additions
I am a homeowner doing all work right of exemption per MGL 11. E] Plumbing repair
'Myself [NO workers' comp. c- 152, § 1 (4), a_nd we have no s or additions
ills'O.rance requii (.,dJ t t1aPlOYf-es - [No -,iiorkers, 12.F_11�oof repirs
*A- cOmP. insurance required.] MEJ Other
on
who sub -it this affidavit indicating they are doing all work and then hire outside contractors
x�u`V a,-Pilcallt that ch—L- box �l t also fill, out the section -s
t Homeowners
Ittached an additional sheet showing the name ofthe s must submit a new affidavit indicating such.
contractors and their workers, comp. polic inf4
am an. employer that isproviding workers, com Y ormatton.
pensadon
informadom ln�urancefor MY employees. Below is thepolicy andjob site
Insurance Compa�ny Name:
Policy # or Sel�fins. Lic. #:
Job Site Address: ExPiration.Date: -------------
City/State/Zip:
Attach a copy of the workers' compensation Policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to
fine up to $1,500.00 and/or the imposition Of criminal penalties of a
one-year imprisonment, as well as civil Penalties in the form
Of UP to $250.00 a day against the violator. Be advised that a c py of of a STOP WORK ORDER and a fine
or insurance coverage velifleation. tatement maybe fo '
Investigations of the DIA f 0 this s rwarded to the Oftce of
I d ereby e I ' under hepains d es e
'Y I he infor a Yi�d ab;7 hue �and coi�-rect
0
Y "'I Jn lion pro
ur
Si re.
atu
Date:
Phone#: q-) V_ 99Z
QVI-cial use only. Do not wi-ite in
this area, to be completed by city or town ofj,-ca,
City or Town:
Issuing Authority (circle one): Permit/License #
I. Board of Health 2. Building
6. Other Department 3. City/ToWn Clerk 4. Electrical Insp
ector 5- Plumbing Inspector
Contact Person:
Phone #:
0
Departi-nent of, public . et"-
B-Offl'd (if Building Re-iflations -,jjj(I sj�
7, ri U,
License: Cs 73991
Restricted to: 00
GERALD WHITE
23 GLENDALE DR
DANVERS, MA 01923
DPS -CAI Ci 5010-04104-G1012%
0
-e01".'zowweaA16 olAlad-Jaclim4eM
office of Consumer Affairs & Business Regulation
HOME IMPROVEMENT CONTRACTOR
Registration:_ 129177
Tr# 287930
Expiration. 7/1912011
Type: Individ - ual::.
Gerald White
Gerald White
54 Emerald Drive
Lynn, MA 01904 Undersecretary
txplration: 417/2012
Tr--: 22470
Address D Renewal n Employment
License or registration valid for individul use only
before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, MA 02116
Notvali without signature
I
HP Officejet Pro L7700 All -in -One series Fax Log for
Nexus 11 Services
978 975 1263
Jul 09 2011 9:20AM
Last Transaction
Date Time Type Station ID Duration Pages Result
Jul 9 9:18AM Fax Sent 9783040581 0:53 3 OK
"PC " DATE JMMIDWYWY)
la..� CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTE F3/9/2011
R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATWELY 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 PRODUCEP, AND THE CERTIFICATE HOLDER.
IMPORTANT: It the certificate holder [a an ADDITIONAL INSURED, the policy(ies) 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 endorsoment(s).
PRODUCER
CONTACT Lauren Gold—
NAME:
Cross Insurance -Peabody
(978)532-5445 (97 6) 33 2.22.17
TIp-Vic
139 Lynnfield Street -
_t4 J' __
866; Isoldmauftrossagency - cam
ODUC -00060172
Yeiabqdy NA 01960
INSURER(S) AFFORDING COVERAGE
INSURED
NAIC I!
.1NSUREftA-.W06teZn W0=1d Tne. Co.
Nexua 11 Services LLC
iNSURER8:Saf8tV .1ndemnity
F.O. Box 2823
INSURER G:
AGGREGATE
INSURER D:
,Woburn MA 01888
INSURER E
COVERAGFR &MMMICIJ-A� .. - I
INSURER F:
Kr-VINILIN NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAJN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS.
NSR IIIK =9 -_
LTR TYPE OF INSURANCE POUCY W_ _POCFff_EXP
'GENERALUABIUTY INSR MWNYD POUCY NUMBER (MMIftb1YV_" (MMMDNYYYI LIMITS
EACH OCCURRENCE $ 11000,000
J COMMERCIAL GENERAL LIABIUTY -DAIME TO REN 6 :�
A -1 PREMISEliffeJoccuffen.) S
. i I CLAIMS -MADE F OCCUR RPF2286653 9/12/2010 8/12/2011 _MM rX�. 1 5,000
L (Arty one Damon) s
PERSONAL & AOV INJURY 3 3., 006, 00a
GENERAL AGGREGATE 111 2,000,000
_C!WL AGGREGATE LIMIT APPLIES PER:
" PRO LOC PRODUCTS - COMPIOP AGG S 11000,000
X 1 POLICY.'
AuromoaiLe LIAI1IuTy COMBINED SINGLE LIMIT
ANY AUTO (Ea Sc-ddent) S
ALL OWNED AUTOS 3116632 BODILY INJURY (Pcr Person) s
ix! 11/10/2010 11/10/2011 250,000
SCHEDULED AUros BODILY INJURY (Per seddent) 3
500,000
X HIRED AUTOS PROPERTY DAMAGE
Per aiddent) S 100,000
X NON-OWNE13ALrros Medical paymeniss S '6
'1 5, 00
UMBRELLA UAB � i
walve colftion Deductwe
OCCUR
EXCESS UAB I
I
_F�.qH OCCURRENCE
. CLAIMS -MADE
AGGREGATE
DEDUCTIBLE
RETENTION S
WORKMS COWENSATION
AND EMPLOYERTUABILITY
_WC STATU-
ANv PROPRGTORIPARTNERIMCUTive YIN
I TC Ry LIMas-
OFFICERIMFmaek EXCLUDED? I
F
NIA
I-- FA.'H ACCIDENT
(MandatoryInNN)
L!
If yes, dagedbe undcr
E.L. DISEASE - EA EMPLOYEd S
OESCRIPTION OF OPERATIONS befaw
E.J_ DISEASE . Pn'I Ir1V I Mir Ft
OESCRIPTION OF OpEMTIONS I LOCATIONS IVEI*CLES (Awch ACORD 101. AddItIOR1111 Remarks Schodufa, if mom apace le -qubco) L
Refer t* FOlicY fOr *=IuBionary emdoraaMenta ana Special proviSions.
CERTIFICATE HOLDER
CANCELLATION
(978) 975-1263
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL 86 DELIVERED IN
ACCORDANCE VATHTHE POLICY PROVISIONS.
AUTHORIZED RNPRF.SENTATIVE
ITimothy Tr—onte/Ml
ACORD 25 (2009iog)
1 88-2009 ACORD CORpORAT-_10N. All rights reserved.
IN8025(2oo9o9) The ACORI) name and logo -are regis�Wred ma GfACORD
TOOZ aoxvansmi SSOHO LTZZ US 8L6 XVJ SC:ST ITOZ/60/90
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, AM 02111
www.mass.gov1dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Ple'ase Print Legibly
Name (Business/Organization/Individual):---t�le4us Services
Address: Soy
City/State/Zip:. o\oxr U 01T -K- Phone#: —791 "760 2031
Are you an employer? Check the appropriate box:
LEI I am a employer with
4. El I am a general contractor and I
(full and/or part-time).*
have hired the sub -contractors
2.
Wehmployees
1 am a sole proprietor or partner-
listed on the attached sh%et. I
s ip and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. 0 We ate a corporation and its
required.]
3. El I am a homeowner doing all work
officers have exercised their
right of exemption per MGL
myself. [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.] t
employees. [No workers'
comp. insurance required.] _J
Type of project (required):
6. El New construction
7. El Remodeling
8. El Demolition
9. E] Building addition
10 -El Electrical repairs or additions
H-ElPlumbingrepairs or additions
12. D Roof repairs
13.n Other
' -J utaL UIUV," UUXffl MUSI also Iiii outtne section below showing their workers' compensation policy information
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new'affidavit indicating such.
�Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
Iam an employer that isproviding workers'compensation insurancefor my employees. Below is thepolicy andjoh, site
information.
Insurance Company
Policy # or Self -ins. Lic. #:
Expiration Date:
Job Site Address: City/State/Zip: I
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisoninent, 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 advis e*d that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certio under the VAIns andpenaldes ofperjury th at the information provided above is true and correct.
Official use only. Do not write in this area, to be completed by city or town official
City or Town:
Permit/License #
h I "
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 defmed 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 ajomit enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employ-Mig employees. However the
owner of a dwelling ho i use having not more than three apartments and 3�ho 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 com pliance 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 boxe's that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy; please call the Department at the number listed below. Self-insured companies should enter their
,self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in ' (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:'
The Cornmonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-26-05 Fax # 617-727-7749
www.mass.gov/dia
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Page I of 6
Nexus 11 Carpentry and
Construction Design
315 Candlestick Road
North Andover MA 0 1845
7817602031
Fax 978 975 1263
neXuscarpen,ryg_aoIco
WWW. nexuscarip—eentLYS-0—T
CS license #73991
MC license #129177
Contract
e Garcia of 30 Keyes Way, North Andover MA
This is a contract between Christin r c4ownee,) and Nexus 11 Services
01845 (Hereafter referred to as the 11owners" o
(hereafter referred to as 4,Nexus") dated July loth � 2011-
F W -0 -R -K -D
D CONTRACT FOR: work as stated
WE HEREBY SUBMIT SPECIFICATIONS AN
below
a5i�if �work;
General detal ordance with local building code regulations and will be
All work will be in acc g with the next phase — Nexus will be
inspected by local officials prior to continuin ctions
arranging and being available for all inspe
responsible for d directly between "Owners" and Nexus
All work will be coordinate licensed, insured as required and ensures any sub -
Nexus confirms that it is fully have the appropriate insurance coverage
contractors utilized on this site will rty an an
Nexus will be responsible for the safe storage of all its PrOPe d y materia s to
be used on the site of all items of the house in the areas that
owner is responsible for removal and return
will be affected and their safe storage prior to our work c0mmencingof the home after
owner will then be responsible for returning all items to these areas
completion of the scope of work ve and trash into Nexus supplied dumpster all trash
Nexus will be responsible to remo
. this project
associated " RPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND
SPECIALIZING IN QUALITY FINISH CA PROJECT MANAGEMENT
Page 2 of 6
General work
Encl se area aro and iecha Akeal rooW
+ Furnish and install framing for 2 walls to create a mechanical room
+ Cut framing under existing stair to create door access to new storage area
+ Furnish and install insulation to 2 new walls
+ Furnish and install sheetrock with smooth plaster finish to 2 walls only
+ Furnish and install an angled entry door for access to new storage area NOTE: door to
be made from 2 x stock and 1/4" luan on both sides
+ Furnish and install 2 1/2" primed colonial trim to face side of door
+ Furnish and install TO" entry door (door to have a louvered panel for fresh air access)
+ Furnish and install 2 1/2" primed colonial trim to door only NOTE: both sides
Sheetrack walls to balance of basemen ve rimeter walls and walls of staircase only;
+ Furnish and install 2" x 4" framing to perimeter walls
+ Furnish and install insulation to perimeter walls perimeter walls and walls
+ Furnish and install sheetrock with smooth plaster finish to
. of staircase
Sheetrock �eilin - (ha -d ceilin9l
NOTE: hard ceiling to be utilized in area iver existin. g kids pl y and _area in
immediate ent . from garag eiling joists
+ Furnish and install strapping to existing c
+ Frame out around the HVAC ducts etc.
+ Furnish and install sheetrock with smooth plaster finish
Suspended ceilin z- (so T �ceilin to new
NOTE: so.1 ceilin to be utilized in area over existing work out equipment qp
hard ceiling around the -mechanicals
+ Furnish and install suspended ceiling grid for 2' x 4' Sahara tile
+ Furnish and install the 2" x 4" Sahara tile to new ceiling grid
New closet door
+ Furnish and install door and frame to new closet on garage side of staircase
+ Furnish and install 2 1/2" primed colonial trim to face side of door
Work not inctucieu in tinsugnu -a-, L
- permit costs and unseen conditions
HVAC, t�mish tri
— -P.jin-trics- nlumbing, p4�1 g, f
SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND
PROJECT MANAGEMENT
Page 3 of 6
PERMITS
"Nexus" has accepted the responsibility to obtain the necessary building permits.
"Nexus" will act as a GC and work in accordance with fair and reasonable practices, and
cooperate fully and under the guidance of the "Owners" and authorized parties.
Standard Exclusions:
Unless specifically included in the "General Scope of Worw' section above, this
agreement does not include labor or materials for the following work (any Exclusions in
this paragraph which have been lined out and initialed by the parties do not apply to this
Agreement): Removal and disposal of any materials containing asbestos or any other
hazardous material as defined by the EPA. Custom milling of any wood for use in
project. Moving "Owners" property around the site. Labor or materials required
repairing or replacing any "Owners" - supplied materials. Repair of concealed
underground utilities not located on prints or physically staked out by "Owners", which
are damaged during construction. Surveying that may be required to establish accurate
property boundaries for setback purposes (fences and old stakes may not be located on
actual property lines).
Final construction cleaning ("Nexus" will leave site in "broom swept" condition).
Landscaping and irrigation work of any kind. Temporary sanitation, power, or fencing.
Removal of soils under house in order to obtain 18 inches (or code -required height) of
clear space between bottom ofjoists and soil. Removal of filled ground or rock or any
other materials not removable by ordinary hand tools (unless heavy equipment is
specified in scope of work section above), correction of existing out -of -plumb or out -of -
level conditions in existing structure. Correction of concealed substandard framing.
Removal and replacement of existing rot or insect infestation. Construction of a
continuously level foundation around structure (if lot is sloped more than 6 inches from
front to back or side to side, "Nexus" step the foundation in accordance with the slope of
the lot). Exact matching of existing finishes. Repair of damage to roadways, sidewalks,
or driveways that could occur when construction equipment and vehicles are being used
in the normal course of construction.
The "Owner" is to enter into contracts for all of the above-mentioned services and
provide direct payment to "Nexus" for all of the services we are to provide. "Nexus" will
be responsible for removing all components and all construction materials relevant to the
"scope of work" in this contract.
I
Dumpsters, trailers and signs
"Nexus" will provide as included in the cost of this project, a dumpster for the sole
purpose of the removal of trash associated with this project. This dumpster should not be
used by any persons for any other waste items or for any purpose outside of the specific
use under the scope of work, unless authorization is received from "Nexus". Nexus may
have on site for part, or the whole of the project, a trailer containing materials and tools
belonging to "Nexus". This trailer will be parked in a position agreed to in coordination
SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND
PROjECT MANAGEMENT
Page 4 of 6
with the "Owners" and will be covered under the insurances of "Nexus" at all times.
"Nexus" will have on site, a sign, with our contact details, in the event that anyone,
including your neighbors, has a need to contact us directly.
Photographs
"Nexus" reserves the right to, from time to time, take photographs of the contracted work
for use in its general marketing or for production on its web site. At no time will "Nexus"
share any personal contact details of the "ownee' for any photographs that it may use
without seeking authorization from the "ownee'.
Warranties,
All the components supplied by "Nexus" as part of the original order are covered under
the warranty exercised by "Nexus" and supported by the vendors or sub -contractors. All
labor and materials purchased from other suppliers to achieve completion of contract are
warranted (1) one year from completion of the construction.
Owner appointed sub contractors
From time to time an "owner" may request that we incorporate a sub -contractor of the
"owners" choosing on a project. "Nexus" will facilitate this request provided the assigned
sub -contractor is connected directly with "Nexus" for all scheduling requirements and
46nexus" will manage this sub -contractor in a fashion comparable with any other sub-
contractor. All sub -contractors must be licensed and insured in accordance with State
law. "Nexus" will meet with these sub -contractors and will ask them to submit a written
proposal of all the work that will be included which "Nexus" will then confirm with the
"owner". "Nexus" will oversee this scope of work and ensure that it is completed in a
professional manner but the sub -contractor will be responsible for any future warranty
issues directly with the "owners". All sub -contractors are responsible for the safe and
clean upkeep of the working environment and will be responsible to remove their
associated trash on a daily basis.
Deliveries
"Nexus" will be responsible for the safe arrival to site of all materials required for
construction purposes for items contained within the scope of work. The "owners" shall
be responsible for the safe arrival to site of other items outside of construction materials,
however, should "owners" require "Nexus" to collect and bring to site, any of these
items, "Nexus" will accommodate as able and add a minimal cost to cover time and fuel
to a change order.
Allowances with the contract cost
Within the cost structure of this contract, certain cost allowances may have been given
for the "owners" to purchase items chosen by them — these allowances will be noted
above with the amount allowed clearly noted. If the "owners" do not spend the full
allowance in an area, this amount will be credited back to the customer and not included
in the final contracted amount. If the "owners" spend beyond the allowance noted, then
the "owners" shall be responsible for this balance and a payment made to cover this
amount either to the vendor, the sub -contractor or to "Nexus"
SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND
PROJECT MANAGEMENT
Page 6 of 6
Contract Cost and Payment Schedule:
Total cost of work description and materials included in the Proposal (excent
materials/work stated), - $16, 800.00 (Sixteen thousand eight hundred dollars and
zero cents)
PAYMENT SCHEDULE
1st Payment due- upon signing this contract
2nd Payment when rough framing is complete
3rd Payment due when sheetrock installed
Final Payment due upon completion of scope of work
Amount due upon signing this contract is $5, 600.00
TOT $5, 660�0.
TOTAL $4, 000.00
TOTAL $4, 000.00
TOTAL $3,200.00
I have read and understand, and I agree to, all the terms and conditions contained
in the proposal above.
Date ... j ................. .. Nexus" Authorization .................. ....... P
Date ... ............ .. Owner/Owners" Authorization .............. .. ... ... ......................
Date ............................... ,owner/Owners" Authorization
SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND
PROJECT MANAGEMENT
Page 5 of 6
Expiration of this Amement:
This Agreement will expire 30 days after the date at the top of page one of this agreement
if not accepted in writing by "Owners" and returned to "Nexus" along with the necessary
deposits within that time frame.
People Authorized to SiLyn Chane Orders:
The following people are authorized to sign Change Orders:
"Nexus": Yark Gotobed
� ni T"Jo
"Ownerld�f': Christine Garcia
Concealed Conditions:
This Agreement is based solely on the observations "Nexus" was able to make with the
area in its current condition at the time this Agreement was bid. If additional Concealed
Conditions are discovered once work has commenced which were not visible at the time
this proposal was bid, "Nexus" will stop work and point out these unforeseen Concealed
Conditions to "Owners" so that "Owners" and "Nexus" can execute a Change Order for
any Additional Work.
Chanues in the Work:
During the course of the project, "Owners" may order changes in the work (both
additions and deletions). "Nexus" will determine the cost of these changes and the cost
of this additional work will be added to "Nexus" profit and overhead.
Schedule of work
It is agreed by both parties that this work will be coordinated with the "Owners" and
"Nexus" to be undertaken in various stages to avoid complete disruption of the
home environment. "Nexus" will give "Owners" no less than 2 days notice prior to
arriving on site for commencement of any of the agreed stages of work to allow
"Owners" to prepare. "Owners" commits to have sites identified for construction
work available for start at the beginning of the scheduled day so as to avoid any
unnecessary delays.
SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND
PROJECT MANAGEMENT
Location
No. Oa 41— 2— Date
Check # //00
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
24 66 1 /Z
/_ 'Building inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APP&CATION TO CONSTRUCT REPAIR, RENovxrE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
V.,
BUELDING PERNUT NUMBER: ATEISSUED:
1.
SIGNATURE:
Building Commissioner/Ins7tor of Buildi Date
SECTION I- SITE INFORMATION
1.1 Property Address:
L o -t S k/3 �
1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information:
J:� - -3 R C
Zoning DiArict Proposed Use
1.4 Property Dimensions:
& 5 -r -
Lot Area (sf) Frontage (ft)
1.6 BUILDING SETBACKS (ft)
Front Yard Side Yard
Rear Yard
Required Provide Required Provided
—+
9!�red Provided
30 -3 -1:70 �2 a
3 0 3
1.7 water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public .S./ Prrvate 0 Zone Outside Flood Zone
1.8 Sewerage Disposal System:
Municipal )< OnSiteDisposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Alorr# AlvrjovEe J?,-,qL-fY C09? loo IORIVAW^452 Ne, fi-walov<,-S, N? -,C5.
Name (Print) Address for Service
CA;7r 4 -SA , eariro Pr e"ride"
Telephone 6,?l -24er
Signature( --77
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed fonstritiction Supervisor:
V, CIlq 0 L
Address
f,) PIPr-R'S GLOV, A('41>19VFR11YA-55 6'ld)9
Signature Telephone',
C-6� V Lli:z:& y Y(,/
Not Applicable 0
License Number
�3Sd-3
Expiration Date
7-
3.2 Re � v4ered Home Improvement Contractor
ot A . pp , li . cable 0
Company Name
Registration, Number
Address
Expiration Date
Signature Telephone
I SECTION 4 - WORKERS COMPENSATION (MLG.L C 152 § 25c(6) I
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the buil�ing permit.
Simned affidavit Attached Yes ....... V No ....... 0
SECTION5 Descriptiono Proposed Work (check applicable)
New Construction 0
Existing Buildi ng 11
Repair(s) 0
Alterations(s) 0
Addition El
Accessory Bldg. 0
Demolition 11
Other 11 Specify
Brief Description of Proposed Work:
&UC7 7.wo 5-ra,�v \A1 o o r,> F8 /4 P rr: q Y j e
C 0 rj�T
NA/ I TH T11RC-6 C/V? 666 R G
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to
Completed by permit an licant
FFIC
jJ1
X,
819" ft
0
1. Building
/7 5/6049,
(a) Building Permit Fee
Multiplier
2 Electrical
0,0 d'
(b) Estimated Total Cost of
Construction
3 Plumbing
ddd" -
Building Permit fee (a) x (b)
4 Mechanical (HVAC)
—
a C'^
5 Fire Protection
6 Total (1+2+3+4+5)
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUTLDING PERMIT
L as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owmer Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
C k,,4 r- 5 A - 09 r re #1 Pre s / Ynt 71' —,as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Mo. �-wdover 1�eql�y Corp. Charles A. Cqrra�l,presdeni ?I
Print Na
Signature of Owner/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB Sd 5f M er-�
SIZE OF FLOOR TBMERS 2ND A -,CIO 3 P -D ;Z
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POST S
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS /0
S17 -E OF FOOTING .5 V X
MATERIAL OF CHNINEY 49,ric k
IS BUILDING ON SOLID OR FILLED LAND
-IS BUILDING COJ\NECTED TO NATURAL 7AS LINE 3,e5
FORM U - LOT RELEASE FORM
I I —
INSTRUCTIONS: This form is used t� verify - that all -necessary approval / permits from
Boards.and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
man
AppLICANT ]V -d r+ n Waver R f a (o r p. pHONE -7 7.? -V
ASSESSORS MAP NUMBER LOT NUMBER -/ 9'
SUBDMSION Y4MC T-Vq LOT NUMBER n3
STREET KEY e -sl W4 y STREET NUMBER .3 0
OFFICLAL USE ONLY
RECON04ENDATION� MOMFO UTOWN AGENTS
DATE APPROVED
go 38088 go 00,06020 M boo go
&O--NSER VATION ADNf U41S TOR
CONflVENT'S DATE - REJECTED
DATE APPROVED
`4TOWN PLAN.NER DATE REJECTED
CONBAENTS
DATE APPROVED
FOOD INSPECTOR - HEALTH DATE REJECTED
DATE APPROVED
SEPTIC INSPECTOR - HEALTH
DATE REJECTED
CONffVffiNT'S,
CONRvIENTS
RECEIVED BY BUILDING INSPECTOR DATE
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Building Value Calculation - for Property
at....
J
Room
Length Width
Sq.Ft.
Cost per Sq.Ft.
Total Cost
Kitchen
27
14
378.00
65
$
24,570.00
Living Room
20
14
280.00
65
$
18,200.00
Dining Room
14
14
196.00
65
$
12,740.00
Family Room
16
26
416.00
65
$
27,040.00
Study
12
14
168.00
65
$
10,920.00
Laundry
7
8
56.00
65
$
3,640.00
Garage
23
38
874.00
35
$
30,590.00
Entry
14
17
238.00
65
$
15,470.00
Basement Finished
-
65
$
-
Deck
5
16
80.00
10
$
800.00
Screened Porch
16
12
192.00
35
$
6,720.00
Breakfast Nook
4
9
36.00
65
$
2,340.00
Bedroom 1
16
23
368.00
65
$
23,920.00
Bedroom 2
14
14
196.00
65
$
12,740.00
Bedroom 3
14
14
196.00
65
$
12,740.00
Bedroom 4
14
15
210.00
65
$
13,650.00
Bedroom 5
-
65
$
-
Bathroom 1
6
10
60.00
65
$
3,900.00
Bathroom 2
14
10
140.00
65
$
9,100.00
Bathroom 3
8
10
80.00
65
$
5,200.00
Bathroom 4
-
65
$
-
Bathroom 5
65
$
29311 -, 76,'� RM NP,
/00om's B 12
0
GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT
TOWN OF NORTH ANDOVERBUILDING DEPARTMENT
This form shall be used to assist the Building Department in their determination of exemption under section
8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the
necessary information as requested below.
MO. A -n R,� I Z 3 �re
Permit Applicant Property address Map / Parcel
�9�- 77 -� I/ �* V/
Applicant's Phone Number Single Family Two Family
I the undersigned applicant for the above property attest that the attached building permit for which this form is completed
does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw. I also understand providing this form does not
absolve me or any party to this permit fi-oni the requirements of obtaining other permits required prior to the issuance of the building
permit. Further I understand that my interpretation of the exemption status is subject to review by the Building Department and is only
officially accepted when the building permit is issued.
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building
permit application and associated attachments . , comp lies with one or more ofthe following sections as indicated by a check mark.
'Ibis is an application for a building permit for the enlargement, restoration or reconstruction of a dwelling in existence as
ofthe effective date of this bylaw, provided that no additional residential unit is created.
The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw.
Ibis application is for dwelling units for low and or moderate income families or individuals, where all of the conditions
of 8.7.6 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens
through a properly executed and recorded deed restriction numing with the land. For purposes ofthis section "senior" shall mean
persons over the age of 5 5.
This application is part ofa development project which voluntarily agreed to a minimurn 40 % permanent reduction in
density (buildable lots) below the density permitted under zoning and feasible given the environmental conditions ofthe tract, with the
surplus land equal to at least ten buildable acres and permanently designated as open space or farmland. The land to be preserved shall
be protected from development by an Agricultural Preservation Restriction, Conservation Restriction. dedication to the Town, or other
similar mechanism approved by the planning board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent
parcel on the effective date ofthis Section 8.7 and shall receive a onetime exemption from the Planned Growth Rate and
Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel.
This application represents a lot which is ready for a building permit ( all other permits from all other boards and
commissions have been received and the project is in compliance with those permits), and the Development Schedule does not
accommodate issuing a building permit in that year. One building permit will be issued per year per Development until such time as
the development schedule accommodates issuing building permits. Applicant must submit an approved FORM U with this
ENEMPTION.
PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A
DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS.
BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED
BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE.
FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE
CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR
NOT IS -G 0 8 FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT.
12 vha
APPLICANTS SIGNATURE DATE
THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION
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,Name -No AN VO
Ng,—,e:
L,: C Z t, i c n:
The Commonwealt/7 Of Massac,�Usel-s
Department of lndustriaUcCidents
Office of Investigations
Boston, Mass. 02111
Workers' Compensation InsuranceAti-davit
Re2se Pnni
Phone #
I arn a hcmecwrer perfurning all work myseff.
am a sole pricphetor and have no oneviorkling in any C_'=P2Cb/
I am an empicyeripmviding workers' compensation for my employees WCr�ing on this job.
Ccrrcary n2me: A NpovER 'RaA LTY ( orl
-cress
cir/. / v W, r7 IV WO Vt.K I
!nsurarice Co. INSonna(E /VOW C 110314
Ccrrcanv name:
Phonp --,
!nsurance Cc. Pclic./
=aiiure to sect;reccverage 3srecuirec uncerSe-c*icn 25A criVIGL 152 can lead to the inn=idon cfc.imir.31 perialties ci a Fine up to S1,5COM
ans1cr one years' irronscnment as wed as c:vii pen afties in tl-,e (crm Of a STCPI/I/CRK r-IRCER and a Fine cf(SIGO.CO) aday Zgainsrrne. I
unce-stana that a ctpy ci; t;iis --mementmay "ce fcrvarced to the Office Of Investig3ticns cf 'he CIA fcr ccverage,/enficZt1cn.
,1 cc nerecy c2rry uncar rAcains and lenalties Of -e7L,ry 07at !he infcrrraticn)crcvided accve is frue anc ccrrIc'.
Q, 11-2 se -c-qcte
icn2ture_
72 V
,_�inr name F-hcne
C--fic:aj ;Secrily co not write in this area to te ccm.cletea ^�y c:,,y cr :cwn C7-;;C:al
c, Tc.vn ansirc
P-rml�/Uc�
Buddirg De pt
—C.'&& -f "'Mme Lcaqsing Board
res:crse is requlrea
Se!ecnman's 0).fflc�
Phcre ;�k- C:i �-,'eajth Deparrmc-flr
F-1 Other
BUIELDING DEPARTMENT
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number
Is that the debris resulting fornithis work shall be disposed of in a properly licensed solid waste disposal facility as
defined by MGL c 11, S 150A
Tle debris will be disp�osed of in:
Location of Facility
Signature of Pernut Applicant
Date
7.J.
NOTE: Demolition permit i�om. the Town of North Andover must be obtained for this project through the Office of
the Building Inspector
,Of- , 4eyl
MAScheck-C-OMPLIANCE REPORT
Massachusetts Energy Code
MAScheck �Softwa-re. 'Version 2.-01 -Relearm 3
TITLE: PLAN NO. 6421
CITY: Andover
STATE: Massachusetts
HDD: 632�
CONSTRUCTION 'TYPE: 1 or 2 Family, Detached
HEATING S-YSTEM Z-YPF- athex...�,Non--Ele-ctxic.
DATE: 12-8-1999
DATE OF PLI&S--. 2-8�92
PROJECT INFORMATION:
COLONIAL. HOTTS
COMPANY INFORMATION:
NORTH ANPOVZR RMA1TY
COMPLIANCE: Passes
Maximum UA = U4
Your Home = 536
Permit #
Checked by/Date
Area or Cavity Cont. Glazing/Door
-Pexime-t-e-r 'R-V&-lue R -Value -U-Va-lue . UA
------------------------------------------- -----------------------------------
CEILINGS 1945 3-0-0 0.0 68
WALLS: Wood Frame, 16".Q -C- 3,168. 13-.0 0.0 260
BSMT: Conc. 8.0' ht/7.01 bg/8-0' in -gill 1945 0.0 19.0 76
GLAZING: Windows or Doors 284 0.350 99
DOORS 93 0.350 33
HVAC EQUT-PME-NT-.--+u-rna-ee-, 47�-G-AFUE
--------------------------------------------------- ----------------------------
COMPLIANCE STATY1ffM- The px.oposed- building design described- here is
consistent with. the tuilxLnq -pi -ns, -speci-f:Lcatlons, and other calculations
submitted with the permit application. The proposed building has been
designed- to-- meet t -he -Eequlzement-s- -of. -ihe -Mas-&a-chu&e-tt-s Energy Code.
The heat -1-oad--for th1 bui-ldim-g ai th --m-olmn-g. -load -j7f I
app UP.Li-ate,
has beenttermined using the applicable Standard Design Conditions found
in the C?de. -T-he--HVAC-equ-i-pment--jelect-ed.--to he t -eT-cool the -bui-ldi-ng
shall be'no greater than 125% of the design load as specified in
Sections /7UDCMR -131-0 anU :J-4.4.
Builder/Designer Date
ooq'�r 4C
and cooling equipment and service water heating equipment must be
provided. -R-va-1-a-e-s, gi-a-z-±n�g -U`--values, and---h-eati-ng
equipment efficiency must be clearly marked on the building plans
or speci-ftcatiorys..
DUCT I-NS=TTM:
Ducts shall be insulated per Table J4.4.7.1.
DUCT CONSTRUCTION:
All accessible joints, seams, and connections of supply and return
ductwo,r-k—l-ozated out-sid concUtioned _space, --including stild bays or
joist'cavities/spaces used to transport air, shall be sealed
using pi&st�Lc --a-nd fibrous -ba-cki-ng -tape i -ns -t -all -ed -accor-di-ng to t -he
manufa`cturer's installation instructions. Mash -tape may be
omitte,d wh r -e -ga:ps .--,a-r-e I-ess -than I/B in�ch. -Duct tape i -s n-ot
permit'ted. The HVAC system must provide a means for balancing
air and water -sy-stems.
TEMPER&T.U.RE__CONZROLS_
Thermostats are required for each separate HVAC system. A manual
or automatic me-ans to -parti-a-lly restrict or —,hut off t -he h -eating
and/or cooling input to each zone or floor shall be provided.
HVAC EQUIPMENT SIZING:
Ra -t -ed -e�u-t-put -eaipac-ity -of -t-h-e -4�eat-i-ngkao�-iiig --sys-t-em i -s
not greater than 125% of the design load as specified
in Sections
SWIMMIVG--P00L6:
All heated swimming pools must have an on/off heater switch and
requ.ir(e--a.zcver-iinle--,s--,ove.r--2-0%. �o.f -the...heating energy is from
non-depletable sources. Pool pumps require a time clock.
HVAC PIPING INSULATION:
HVAC _7piping conve_yi� -f-lijids- -ab-ove _120 F -or -chi-ll.ed LlAii�ds
below 55 F must be insulated to the following levels (in.):
�IRCUIATZNG -HOT -WATER -SYSTEMS.:
Insulate circulating hot water pipes to the following levels (in.):
PIPE
PIPE
SIZES
(in.)
HEAT ING._S_YST_EMS_.-
TEMP 4 F)
-2 " -RUN-OU-T-S
_0�111
_1_2_5�2"
-2-5-4"
Low' pressure/temp.
201-250
1.0
1.5
1.5
2.0
Low ;te�er-a-ture
-12-G-2-00
�0. 5
1.-0
1._0
1.5
Steam condensate
any
1.0
1.0
1.5
2.0
COOLING -SYST-EMS4
Chilled water or
40-55
0.5
0.5
0.75
1.0
ref-ri1-era-nt
-bel-ew -4-0
1.0
1. ()
1.5
1.5
�IRCUIATZNG -HOT -WATER -SYSTEMS.:
Insulate circulating hot water pipes to the following levels (in.):
NOTES TO FIELD (Building Department Use Only) -------------------------
PIPE
SIZES (in.)
.No -C RCUIATIN-G A
CIRCULATING -MAINS _&
RuNA0U_TS
HEATED WATER TEMP
M: RUNOUTS 0-1"
0-1.25"
1.5-2.0"
2.0+"
170-1-H
--0.5
1.5
2.-0'
140-160
0.5
0.5
1.0
1.5
100-ILU
D__5
-0-5
-a--5
1-0
NOTES TO FIELD (Building Department Use Only) -------------------------
TITLE: PLAN NO.
MAScheck INSPECTION CHECKLIST
Massachu,9-ett-s.---Ynierg-y Cbde
MAScheck Software Version 2.01 Release 3
DATE: 12-8-1-9-9-9
Bldg. I
Dept. I
Use I
CEILINGS:
1., R-310
Comments/Location
I WALLS:
1. Wood Frame, 16" O.C., R-13
Com)nenta/Location
BASENENT 49ALLS:
1. Conc. 8.01 ht/7.0-' bg/8.0" insul, R-19 continuous
Comment -s-/ Loca-ti-on
I WINDOWS -AND �GLASS -DOORS:
1. U -value: 0.35
For windows without labeled U -values, describe features:
# Pa:ne s -Frame Type Thermal -Break? J� Yes No
Comments/Location
DOORS:
1. -U--va-1-ue: -0.35
Comments/Location
HVAC EQUIPMENT:
1. Furnace, 87.0 AFUE or higher
Ma" a-nd Model Nthrrdb r
I AIR LEAX4GE,
Joints, penetrations, and all other such*openings in the building
envelope -that -a-re _sou-rc�es -of -a-i-r I-ea-ka-ge 4aust -be s4eal-ed. -When
I installed in the building envelope, recessed lighting fixtures
I shall pe -et. -one -o-f th . fal1owd-ug requi remen t-
1. Type IC rated, manufactured with no penetrations between the
ir�s_ide -of the -r-ecs_-s-sed -ft-xt-u-r�e -a-nd -Gei-1-�Ln-g-c-av-ity -a4id sea-l—ed -or
gasketed to prevent air leakage into the unconditioned space.
2. Type ZC r-a:ted, -tn._a.ccorr1anr_e -w-i-th _St_andar4 ASTM Z 2S3, -wi-th no
more than 2.'0 cfm (0.944 L/s) air movement from the the
copditi-G�� spa -Ge to -t4ie -cei-l-i-ng -cav-ity. T -he li-g-htd-n-g -f�i-xtur-e
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure
di�_Ezrence -and .-sha-U _be Zabeled-
VAPOR ..RETARDER -
Required on the warm -in -winter side of all non -vented framed
ceilings, -walLs-, -and Ll_oor-s.
MATER_LUS 1DENT-I-F-I-C-AITI-ON:
Materials and equipment must be identified so that compliance can
be detexmi-ned- -Manulac-tux-ex-manual-s -far-al.1 _ixi-stalled -heating
Location'-�
No. /,, Date /02c;�ele)
TOWN OF NORTH ANDOVER
Certificate of Occupancy s 45 0 r
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
$ r 7.j
TOTAL
Check # //,-/ -(it/
11,432
Building Inspectol(,.