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Home My WebLink AboutMiscellaneous - 315 ABBOTT STREET 4/30/2018 BUILDING FILE Date!q.��..'-�....�.��........ 10609 oF,"�pT"�ti TOWN OF NORTH ANDOVER ° 9 PERMIT FOR PLUMBING •• r ss,�c►�us� n� Thiscertifies that..................................................................... ....................................... has permission to perform..... N.Q ........................................................................... plumbing in the building-, .. 1--t--��—................................ �. ..........1.1.!-� .......... ...............North Andover, Mass. �L Feeu...�a. Lic. No:,�q.kbZ-_ .............................................................................. PLUMBING INSPECTOR Check# -3 T MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK l CITY i MA DATE 1'� ( PERMIT# JOBSITE ADDRESS 31S OWNER'S NAME POWNER ADDRESS I TEL=__7]FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL. ' PRINT CLEARLY NEW: 5�11 RENOVATION: I REPLACEMENT:Q PLANS SUBMITTED: YES-] NO© FIXTURES I FLOOR--> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB I [ _• _l [ ( I —_-..[ _I __ [ { CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM E —P i DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREADRAIN I __-.-.- _-. I � _.._ _. _J INTERCEPTOR(INTERIOR) KITCHEN SINK I L__1 LAVATORY ROOF DRAIN [ SHOWER STALL f .___► ____ ___. .f __—( ___[ _.__3 ____.I ___._I .-__.� ___[ _..-_.1 ___ I [ SERVICE/MOP SINK ( I J J 1 TOILET { ---L_l ASHINGMACHINECONNECTION kY, ATER HEATER ALL TYPES I I ___...� f { I E .i .___.._l � I JI I �I WATER PIPING OTHER INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES :.-..[ NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY DI BOND 0 OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER _I AGENT I0 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be innce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME I LICENSE# {G:2 ( J SIGNATURE MP 0 JP[M CORPORATIONJ#PARTNERSHIP®# LLC _ COMPANY NAME ADDRESS CITY� ��STATEl ZIP I Q�—� TEL `�� '• FAX __.E CELL EMAIL l ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES l Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 9 Date(o �Z3 . .................... �10RTly,�� TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION Huss i P�N G F This certifies that�...........�"i. -1.` .................. .......?.1..........'..!.. III has permission for gas installation��.Q..^?....... - - in the buildin s�o.(f,.,... ..1..... --L .................................................... 31 S ��Jr-�"rt.. '.._e e 1- at............................ ................................................................... North Andover, Mass. Fee W.-....... Lic. No 7j,,,k1.L..... ............................................................ GAS INSPECTOR _ Check# 63 9303 -` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY nJP� _ � MA DATE PERMIT# JOBSITE ADDRESS OWNER'S NAME G , OWNER ADDRESS TELT ` - FAX TY ,OR OCCUPANCYTYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION:El REPLACEMENT:® PLANS SUBMITTED: YES Q NO[�] APPLIANCES Z FLOORS--> BSM 1 2 3 4 5 6 7 8 1 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR ( I 1 FURNACE GENERATOR GRILLE INFRARED HEATER - --1 ---...- - - - ---- --- LABORATORY COCKS MAKEUP AIR UNIT - OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT _ TEST UNIT HEATER UNVENTED ROOM HEATER __ WATER HEATER �. ... 1 - 15- OTHER .�........ . . INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES QNO I IF YOU 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 N Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT �] SIGNATURE OF OWNER OR AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complia c with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME _ LICENSE# C SIGNATURE MP[3 MGF El JP 0 JGF 0 LPGI© CORPORATION©# PARTNERSHIPDI#F—_11 LLC E]#L !I COMPANY NAME:1_ g� _ , ADDRESS _ CITY _ n _ _ _ - _ ( STATE Cly !ZIP TEL FAX CELL _ __ EMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No / THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES I i The Commonwealth ofMassachusetts Department of Industrial Accidents Office O fInvestigations 600 Washington Street Boston,MA 02111 www.massgov/dip ' Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Orgaaization/Individual): H n� ealf\( i 1 Address: City/State/Zip: Ol S 64 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2 I am a sole proprietor or partner- listed on the attached sheet.� �• Remodeling ship and'have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers'comp.insurance. 9• []Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.ElI am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance a ired.re q uemployees.[No workers' � 13.❑Other comp.insurance required.) 'Any applicant that checks box#I must also irlI out the sectionbelow showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is fhepolicy an 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 requiredunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a flue up to$1,500.00 and/or one=year imprisonment,as wellas civil penalties in the form of a STOP-WORK ORDER and a flue 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. I do hereby certo under the pains and penalties ofperjury that the information provided above is true and correct. - Siafore:. Date: Phone# Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermiMcense# 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 Instruction 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.,, j 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-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 notrequired to carry workers'compensation insurance. If an LL C or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only.submit one affidavit indicating current Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit ii 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 Goxrmoawt-ajthofMa.,ssaohuset�s Department offadustrial Accidents Office ofInyestigaliew 6QQ Wasbbgtoa Streat DOAQn,MA 02111 Tel,#617-727-4900 est 406:or 1-877:MASSE Revised 5-26-05 Fax#617-727-7749 i j; COMMONWEALTH OF MASSACHUSETTS � e s - • e PLUMBERSVND GASfITTEAS � ISSUES THE FOLLOW fNG LICENSE. _ : LICENS;l13 AS AJOURNEYMAN�PL MU BE u —KENNETH R MARSHALL -71 15 GALEO RD ! Z {... ♦ W LYNN MA 01904-1247 \. 3012' 05/01/;1 22823 Date...�!.. t............................... r10RTly r. OF TOWN OF NORTH ANDOVER � PERMIT FOR GAS INSTALLATION 8$�cMus� This certifies that .........'...�........'.�..n.' U!.! C` has permission for gas installation ....G/ a..,..... �. ............................ 1 inthe buildings o�f�(.......:j... ................. ......................................................................... at....�1.. ....... !' .... ..........................................(North Andover, Mass. Fee... .t...`...... Lic. No. .�-. .......... .....M..+.�..........................:........................ GASINSPECTOR Check#—I to 7,44 034. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY North Andover MA DATE 6/2/2014 PERMIT# i JOBSITE ADDRESS 315 Abbott St OWNER'S NAME Bob Corcoran OWNER ADDRESS 9 Whitney Rd N Andover TEL I 617-512-3967 FAX 0 'I GOCCUPANCY TYPE COMMERCIAL F1 EDUCATIONAL RESIDENTIAL 3I £OR p -r NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YESE] N0= i EAIRL '` APPLIANCES Z FLOORS BSM 1 2 3 4 5 6 7 8 9 10 1 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK TOP DIRECT VENT HEATER DRYER FIRE PLACE FRYOLATER FURNACE GENERATOR GRILL INFRARED HEATER UfBORATORY COCK MAKEUP AIR UNIT OVEN �— POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT _ TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER GAS PIPING FOR 500 GAL UG LP TANK x jjz�/- Fl� INSURANCE COVERAGE �_— I have a current liabili 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 XQ 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: OWNER E] AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and a o e b of m knowl ge and that all plumbing work and installations performed under the permit issued for this application will be in ce with all Pertinent o e Massachusetts State Plumbing Code and Chatper 142 of the General Laws PLUMBER-GASFITTER NAME Timothy Surdam LICENS GF5 - AT.t1RE MP F] MGF❑ JPEJ JGF X❑ LPGI[:] CORPORATION XQ# 164 PARTNERSHIP [:]#OLLC []# COMPANY NAME: E Lorden Oil Cc Inc ADDRESS: 69 Fitchburg Rd,PO Box 669 CITY: Ayer STATE: ® ZIP 1432 TEL: 978-772-2000 FAX: 978-772-5956 CELL: EMAIL: 1 � �I i I �i l fall �l�lf BASF I '"� I • ,t�'��U�� `E'�i� EO�;�.dW�'�J� 1. 4`�1:NS:E A5 � i' L Ft1~ 15 � GASFf.- TEFt` T 1£t1Q�'H�f � �URppM z�. i 32 4E 1 Q Cali 03©fs3 X 1 3 f' fly./tat: l` + . 1.;2,17 I Date...! .. ' ............. � OF p►OR7�y,� . TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING cnus�tt9 This certifies that ....L1-PC� n.A�. ...1..IM1' ................. has permission to perform ..........►�aQ Y 1...U\, - ................ .......... ...... ........................... ................... ....... ...... wiring in the buildingof... .• ...c> ........ - ---.......................................... --� (� at .....:... 1?� .,,.` �.....0-� ' North Andover,Mass. t' ,,�i` Fee...t�'T�1�.......Lic.No. �.............. .N..A ............f.. l.v.! . ........................ ELECTRICAL INSPECTOR Check# t� Official Use O y ,1 � Commonwealth of Massachusetts Department of Fire ServicesPermit No. IZ '/ pOccupancy and Fee Checked a BOARD OF FIRE PREVENTION REGULATIONS [Rev.l/07] (leaveblank 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 IN JAW OR TYPE ALL)NFORMATION) Date: 6— Z y—ZU l q City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersign gi s notice of his or her intention to perform the electrical work described below. Location(Street&Number) S Owner or Tenant pp r Telephone No. Owner's Address `t b -h 4/ 4' ,1 Is this permit in conjunction with building permit? Yes F1 No ❑ (Check Appropriate Box) r Purpose of Building �/_�, Utility Authorization No. - Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: vM Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of Total 3 Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA AboveIn- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units (r No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons � Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers .................. p Totals: Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other p g Connection No.of Dryers Heating Appliances Kyr Securitio o Devi es or E uivalent No.of WaterIAV No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent rOTHER.Hydromassage Bathtubs No.of Motors Total HP Te1No.of Dvices or E uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) (1 Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The To— CHECKcertifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. J► CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofPerjury,that the in ormation on this application is true and complete. FIRM NAME: _ /� � eC tC•�1 4 S LTC.NO.: 7 y Licensee: n o <j Signature LIC.NO.: (Ifapplicable,ente "exempt elicense nzrm er line.) Bus.Tel.No.- l 2 Address: d/ Alt.Tel.No.: - *Per M.G. c. t47,—S.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE.$ Signature Telephone No. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c. 143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall.be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass 0 Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass Failed 0 Re-Inspection Required($.)❑ r 1X-7 Inspectors Comments: . r- 644 Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass F?1 Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSP TION: Pass EN X Failed Re-Inspection Required($.) ❑ Inspectors Comm ts. A Of �! Inspectors Signature: Date: FINAL INSPECTION: Pass F?1 Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: L q- ae - ly wf A PAA Inspectors Si nature: ��-- _ Date DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com 4 The Commonwealth ofMassachusetts Department of IndustriglAceirlents Office of Investigations 600 Washington Street Boston,MA.02111 www.massgov/dia Workers' Compensation Insurance.Affidavit:Builders/Contractors/Electricians/Plumbers Appficant Information Please Print Legibly Name(Business/Organi'zation/Xndividual): Ka fZ� Address: �e� �►�� CitylState/Zip: -Me-J "�W Phone#: Are you an employer?Check a appropriate box: Type of project(required): 1.I T1 am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. �• ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working forme in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roofrepairs insurance -required.) employees.[No workers' 13.n Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showingtheirworkers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. TContraetors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. X am an employer that is providing workerscompensation insurance for my employees: Below is the policy and job site information. Insurance Company Name:. 1 —c�' �►> Policy#or Self-ins.Lic.#: Expira'onDate: A/0UL I et! Job Site Address: — b b�� J7` Pity/State/Zip:�M,2w Attach a copy of the workers'compensation policy ileclaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a • fine up to$1,500.00 and/or one-year imprisonment,as well.as civil penalties in the form of a STOP.WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. X do laereby certto and, th pains and penalties ofperjury that the information provided above is true and correct. - 1pi Signature: Phone#: L Official use only. Do not write in this area,to be completed by city or town offrcial. 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 9: p Information and Instruction's ' 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 oa 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 PIease 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 numbers)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 notrequired to carry workers'compensation insurance. If anLLC 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,anapplicant 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 maybe 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 orpermit 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 CommonwealtI.ofMassaehusetts Department of laduMal,Acoldonts Office ofInvestigations 600 WuhiWoa Street Boston,MA.021 X Z Tel,#61.7-727-4900 QA 406-or 1-877,MASSAFF, Revised 5-26-05 Fax 4 617-727-7749 Division of Professional Licensure: License Search Page 1 of 1 The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Mass.Gov Home State Agencies A-Z Topics Home>Division of Professional Licensure> ONLINE SERVICES ........................................................................................................................................................................................................................................................... Check a License Check A Professional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change Contact the Agency LICENSEE More... Name:ANTHONY A. ROSA JR. REFERENCES& Business:TRE ELECTRICAL CONTRACTORS INC RELATED INFO METHUEN,MA Disclaimer Regarding MEEIM Website License Searches **This Licensee has additional Licenses,click here to view them.** Glossary of License Status Codes x Licensing Board: ELECTRICIANS More... License Type: MASTER ELECTRICIAN TYPE CLASS:A License Number: 17434 Status: CURRENT Expiration Date: 7/31/2016 Issue Date: 4/26/2004 Exam Date: 10/2/1999 School: This web site displays disciplinary actions dating back to 1993. This license has had no disciplinary actions taken during this time. ` The page above has been generated by the Division of Professional Licensure web server on Wednesday,June 25,2014 at 3:23:48 PM. ©2007-2011 Commonwealth of Massachusetts Site Policies Contact Us http://license.reg.state.ma.us/public/pubLicenseQ.asp?board code=EL&type class=_A&li... 6/25/2014 Location�_�l �f�.�� No. /e,- Date e - TOWN OF NORTH ANDOVER i • '{ Certificate of Occupancy $ Building/Frame Permit Fee _ J Foundation Permit Fee $�6O Other Permit Fee $ TOTAL $ yam i Check#�7 M32y7 j r-. G J 2u iding Inspector I L TOWN OF NORTH ANDOVER [, APPLICATION FOR PLAN EXAMINATION Permit NO: _`7 Date Received Date Issued: i9 IMPORTANT: A licant must complete all items on this page LOCATION 3 J 6e9t �" f Print PROPERTY OWNER Q 6 mac' � 1v L L G . P o�J C &.moo t-A JIA R Jv u e R- Print 100 Year Old Struc ure yes o MAP NO: S PARCEL: o20 . ZONING DISTRICT: 23 Historic District yes oo. Machine Shop Village yes no TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential I IN ew Building ',tone family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ; DS I eptic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: i CA Identification Please Type or Print Clearly) OWNER: Name: gob er�,,.� Lt,c Q,ay Ga t�oG��v ��r1yaye1 Phone: -�9�7 Address: f6 d CONTRACTOR Name: �a &0 9-,9,V Phone: lof 7 --.-/ L - _3!47- Address: LJ Q4k -6o Q d Z!�I,}S U_./ 9 r2 / Supervisor's Construction License: f,J"- D 6 S n1D S7 Exp. Date: 2 - /-- Jy Home Improvement License: Cz / l_ Exp. Date: .l 4( ` I ARCHITECT/ENGINEER CAP.,,f P 69G(VAs Phone: -W- 217 ' 117 I� Address: q5 A.. m-bw _f"-- A2 (rare /t4,44� 176 Reg. No. ro S�y FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: �27,2?2. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sigrenatuof Agent/Owner �ature of contractor Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ r Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ -TYPE OF::.SEWERAGEDiSP_OSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ ❑ Tobacco.Sales Food Packaging/Sales ❑ Private(septic tank,etc._ .. :Permanent Dumpster on Site ❑ THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY j INTERDEPARTMENTAL SIGN OFF - U FORM ]] I >. DATE REJECTED DATE.APPROVED PLANNING & DEVELOPMENT' ❑ i COMMENTS_ .CONSERVATION Reviewed on (0 /15 Si nature COMMENTS iPA�Z_4 3-14 r,,)- — �_Q a # HEALTH Reviewed on—P ` Signature U� CO MENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Commen ts*p4 0�1 10 0�3 Conservation Decision: -`(a) Comments Vv F� e0 Water & Seaver Connection/Signature& Date Drivewav Piernnit DPW'I owo.Engineer: Signature: Located 384 O ood ttreet J 'FIRE-DEPARTMENT' `- Temp Duinpst site es no Located-at 124,Mair Street `Fire Departiner`it-signature/date-' r ` COMMENTS Dimensi®n Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: oZS ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL-Chapter-166 Section 21A-F and G min.$10041000.fine NOTES and DATA— (For department use ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department 'The fol�swing is-a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire-Department prior to issuance of Bldg Permit Addition Or Decks Li Building Permit Application o Certified Surveyed Plot Plan Li Workers Comp Affidavit la o Photo CopY of H.I.C. And C.S.L. Licenses Li Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ,/ Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ,/ ❑ Copy of Contract ti liar o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products t-1 (�q NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apo,�al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subwted with the building application Doc: Doc.Bui!Jing Permit Revised 2012 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ^ Date Received Date Issued: IMPORTANT:Applicant must com Tete all items on this page LOCATION _ Print PROPERTY OWNER_ B Z 6 Q C , L 1,G__ A u b Co KGc_Kp,/ A.s u e R- Print 900 Year Old Struc ure yes o MAP NO: _- $ PARCEL: .2-0 ZONING DISTRICT: 23 _ Historic District yes o Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential -New Building '. One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other El Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: c Identification Please Type or Print Clearly) OWNER: Name: gob e r;,j L, c Q,oy Go l LOr—,py 1,4rr1yaye a Phone: f i 7 9�7 Address: CONTRACTOR Name: 0 6 C 5 flfL.Gvtifl!�/ Phone: l/ 7 -.1"� 2.-- -3267_- Address: (N�,I' ivz y �,�,i eak {aQ Supervisor's Construction License: G "- 0 6,Y.a' o F Exp. Date: Home Improvement License:==J= Exp. Date: 1Y ARCHITECT/ENGINEER Ck .,_r P QPcrVA_r Phone: ZY7- 917 - /17 3 Address: P A a,nr _r-f, 2 ( 6;- (-76 Reg. No. ro-"O 6 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ `/ 7s_0 FEE: $ Check No.: 5?6�9 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Adent/Owner -� Signature of contractor Plans Submitted Plans Waived ❑ Certified Plot Plan 0 Stamped Plans ❑ 01~0 eT"gel '1,Y 0 o r^"49 �,SS1CIWstt CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 546-14 on 1/14/2014 Date: October 10, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON 315 Abbott Street— Lot 2 MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Boberin LLC 9 Whitney Road Boxford,MA 01921 Building Inspector Fee: Prepaid $100.00 Receipt: 27232 Check : 3643 NORTH own of E : ndover �-w' f 0 64� - 1 �No. h , ver, Mass, )ZlAt SQA COC L^K6 I Z NIc"IMCK S U ARD OF H ALTH /Food/Kitchen PERMIT T D !Septic System ;��THIS CERTIFIES THAT .. „ Z1 �: r.:�!9..... kt<�............................................................................... BUILDINGINSPECTOR Found_.ation� has permission to erect buildings on .. .1,� 6 / ou to be occupied as ....................... p ............ !�.�...... t .�:..5� �1f...1... !tlf. . ................................... chi jtJ (2s provided that the person accepting this permit shall in every respec�E'conform to the terms of the application Fin on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and p Y g p � Construction of Buildings in the Town of yorth Andover. PWMBING INSPECT P Rough es,02 ,(f 11 VIOLATION of the Zoning or Building Regulations Voids this Permit. Finall��o� 1` PERMIT EXPIRES IN 6 MONTHS ELECTRICAL IW5PECTOR UNLESS CONSTRUCTION STARTS u h ......... .. Service BUILDING INSPECTOR �n 4�' �— 3©�-r GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final P� No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE f ' e ,O eIN.1 'til O4„°r''49 SSAC MISES CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 546-14 on 1/14/2014 Date: October 10, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON 315 Abbott Street— Lot 2 MAY BE OCCUPIED AS a single family.horne IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Boberin LLC 9 Whitney Road Boxford, MA 01921 Building Inspector Fee: Prepaid $100.00 Receipt: 27232 Check : 3643 I s tkpRTF# p��ttico ,6s9NG Fp-2 ayt, .. •.,s L� APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION �19p°`+Arco spa`�y BUILDING PERMIT # �SSACHus� ADDRESS/LOCATION OF PROPERTY:_ Map .3 F Parcel 0 Lot Number a� SUBDIVISION: DATE REQUESTED FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: /Uej (%7� Wn/ FIVE(5)DAYS NOTICE PRIOR.TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A REINSPECTION FEE OF TWENTY DOLLARS ($20.00)WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. APPLICANT SIGNATURE Permit Issued to: Address: 1 ROUTING G(O TOWN ENGINEER; SITE PLAN-DRIVE-WAY REVIEW CONSERVATION PLANNING DPW-WATER METER SEWER CONNECTION n I� DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OC CUPANCY/INSPECTION REQUEST DPW / SIGNA File:Application for OC form revised Jan 2007/2011 NORTH Town of E ILAndover No. �p 00 ver, Mass, —Z COCMICHIMCK A04ATED ' �y d/e S V ARD OF H ALTH /Food/Kitchen PERMIT T LD !Septic System / �t ��'� THIS CERTIFIES THAT ..,9e?-,/�3C-.-,cr-�v...........!�.. BUILDINGINSPECTOR/f has permission to erect .......................... buildings on ............................. cF°undatia 0 M to be occupied as ................... ........................ .... ... r? 1.l. . .......................................................... chi provided that the person accepting this permit shall in every respect conform-to the terms of the application i Fin .on file in this office and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and p Y 9 p � C_� Construction of Buildings in the Town of North Andover. MBINGINNS�^PECT Ra Rough �s�2'40 `f VIOLATION of the Zoning or Building Regulations Voids this Permit. Final �� `� PERMIT EXPIRES IN 6 MONTHS ELECTRICAL I PECTOR UNLESS CONSTRUCTION STARTS u h ........................ Service BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE ' NORTy 01 ,`,LED N, 0 02 APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION rapBITII.DING PERMIT it ��SSACHUS�� ADDRESS/LOCATION OF PROPERTY: J h � �t Map 3 Parcel___;-O Lot Number c� SUBDIVISION:. DATE REQUESTED FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: Ny yli7f" Wn/ FIVE(5)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A REINSPECTION FEE OF TWENTY DOLLARS ($20.00)WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. APPLICANT SIGNATURE Permit Issued to: / LLC Address: / W F� �ti 7 MA 9 f ROUTING TOWN ENGINEER, SITE PLAN—DRIVE-WAY REVIEW CONSERVATION PLANNING DPW-WATER METER � " I j Lf SEWER CONNECTION n DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUpANCY/INSPECTION REQUEST DPW SIGNA URE File:Application for OC form revised Jan 2007/2011 249 Date.. .�!/ HORTM TOWN OF NORTH ANDOVER 1h0 O PERMIT FOR MECHANICAL INSTALLATION � m F p • s • i� 'ti °�..e°•r•�Sh 9SSACNUSEt 1 This certifies that . �� . .�.�. .`�w� . . . . . . . has permission for mechanical installation . . . . . . . . . . . . . in the byildings of . . . � '"'' . . ..1 ? . .t. . . . . . . . . . . . . . at �.�/ `\b. � • --T- . . . .. North Andover, Mass. Fee. . .J • •I•T�Lic. No.. .r,-,2.17 f.7.. . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Jun. 11. 2014 3:32PM Town of North Andover No. 2416 P. 1 • to Commonwealth of Massachusetts Sheet Metal Permit �.. Date • Permit# Estimated Job Cos . 66,c 7 Permit Fee:$ Plans Submitted: YES NO Plans Reviewed: YES NO Business License# _� —I cl?2�4?M Applicant License# S l lg? Business Information: Property Owner/Job Location Information: Name:}-a SA�T �4�� C.L.C Name Street: � � ��- StHe : City/Town: �Nrmi D,66a 41M+ City/Town: Telephone: �� ^-SWO-70 a�.1 Telephone: Photo Z,D, required/Copy of Photo I.D. attached: YES J.&NO Building Type: Residential: 1-2 family Multi-family Condo/Townhouses s Commercial: Office Retail Industrial Educational Institutional Building Cubic Footage: under 35,000 cu. ft. over 35,000 cu.ft. Sheet metal work to be completed: New Work:� Renovation: HVAC Metal Roofing Kitchen..Umst System Chimney/Vents Provide brief description of work to be done.- (2 0M O one:(20MP. C k&I c mAw c U 44A - �. orn ], �j ��.I� 4 UCL VV PORAVAS DESIGN& CONSULTING 49 Appleton Street ra Mehm,MA 02176 ro - w-o• ira ra Telephone: - 339-927-1579 -- E-mail: va Pdcdesi$n)(�uail•oom Proposed �•_ n eau r T - -�j'�"'�'�L __ ___________ NewReaidenceet Lot2 303 Ahbw Strnet N Andover,MA UNFINISHED BASEMENT i --- •- - uR vAl19 MRA MNFINISHEO ATTIC +Ii Aeovu k ----------------------- Aa JLV �M—WW'k. .,RAC9 p) S.b-Heap: ha r-r R�1' PefsR w Ta naa, ewe: M'a Ce by: CAAMvro P91e None: AI 33ammtANaPlameeo g Date: B ».emem4 sa�3 Itevieione: BASEMENT FLOOR PLAN ATTIC FLOOR PLAN ae•a Dore _ SCALE:S/IL •I'-V SCALE:S/N'=r-O' Drawing N=ber A1 .3 �y Jun. 11. 2014 3: 32PM Town of North Andover No. 2416 P. 2 INSURANCE COVERAGE! I have a current fiablilty insurance Polley or its equivalent which meets the requirements of M.G.L.Ch.192 es Ne Q If you have checked Yes,Indicate the type of coverage by checking the appropriate box below: A liability insurance policy Other type of Indemnity ElBond ❑ OWNER'S INSURANCE WAIVER:I a aware that the licensee does not have the Insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application walves thls requirement. Check One Only Owner' Agent ❑ Signature of Owner or Owner's Agent By checking this boxO,I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installatlons performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Progress Inspections Date Comments Final Inspection Date Comments Type of license: By p Master Title El Master-Restricted City/Town Dourneyperson Signature of Licensee Permit fP ❑Journeyperson-Restricted License Number: Fee$ ' ❑• - Check at www.rnassmovidpi Inspector Signature of Permit Approval Company Info Name:East coast comfort Address:252 woburn street Location:Wilmington,MA 01887 Phone:978-580-7021 Client Info Building name/description: Contact name:Steve Corcom Address:303 Abbott rd Location:North Andover,Massachusetts,United States Phone: Load Summary Total building area: 1,335.0 Sq Ft Total cooling load: 45,207.3 BTUh Total cooling tonnage: 3.8 tons Total heating load: 57,258.9 BTUh Total airflow: 5,426.6 CFM Project Load Breakdown-Cooling C) Windows,glass doors,skylights: 33,1. 32.7 BTUh Envelope(walls,doors,roof,etc.):,'- 772.9 BTUh Infiltration: 1,722. BTUh Internal gain: 4,980. BTUh Duct and blower heat gain: 0.0 BTUh Ventilation: 2,274. BTUh Excursion adjustment load: 2,324.4 BTUh Total cooling: 45,207.3 BTUh Project Load Breakdown-Heating Windows,glass doors,skylights: 40,383.6 BTUh Envelope(walls,doors,roof,etc.):1 3,435.2 BTUh Infiltration: 8.314-1 BTUh Duct heat loss: 0.0 BTUh Ventilation/winter humidification: 5,125.3 BTUh Hot water piping load: 0. BTUh Total heating: 57,258.9 BTUh Project AED Curve ACCA-Approved Manual J8 Calculations 14:59:41 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual J8 residential HVAC load calculations. System Load Summary System description:System 1 ---- Total building area: 1,456.0 _ - Total cooling load: 45,207.3 BTUh - - ---- Total cooling tonnage: - - 3.8 tons — Total heating load: 57,258.9 BTUh Total airflow: v 5,426.6 CFM -System Block Load Breakdown-Cooling — — Windows,glass doors,skylights: 33,132.7]BTUh Envelope(walls,doors,roof,etc.):i 772.9 STUh Infiltration: 1.722. ,BTUh Internal gain: _ 4,980. BTUh — Duct and blower heat gain:�- -- -�— v 0,0 BTUh Ventilation: 2.274.1 BTUh Excursion adjustment load: 2,324.4 BTUh Total cooling: 45,207.3 BTUh System Block Load Breakdown-Heating _- _- Windows,glass doors,skylights: - 40,383.8,13TUh-_ Envelope(walls,doors,roof,etc.):; 3,435.2 BTUh --- Infiltration:L8,314.9 BTUh Duct heat loss: 0.3 BTUh Ventilation/winter humidification: 5,125.3 BTUh Hot water piping load: 0.0 BTUh -v--—— -- —--Total heating: --_--57,258.9 BTUh System AED Curve — — ACCA-Approved Manual J8 Calculations 14:59:41 06-11-2014 - This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual J8 residential HVAC load calculations. System Checksums - Cooling Total building area (SgFt): 1,335.0 Total building volume (CuFt): 13,350.0 Total cooling sensible load (BTUh): 41,599.3 Total cooling latent load (BTUh): 3,608.0 Total cooling load (BTUh): 45,207.3 Total tonnage (tons): 3.8 Total cooling infiltration airflow (CFM): 52.1 Total cooling ventilation airflow (CFM): 68.8 Total airflow (CFM): 5,426.6 Total infiltration fi Itration air changes/hr (AC!H): 0.23 Sensible heat coefficient (SHC): 1.10 Latent heat coefficient (LHC): 0.68 Cooling load density (BTUh/SgFt): 33.86 Cooling airflow density (CFM/SgFt):: 4.06 Cooling airflow/load (CFM/Ton): 1,440.5 Cooling area/load (SgFt/Ton): 354.4 System Checksums Heating Total building area (SgFt): 1,456.0 Total building volume (CuFt): 14,560.0 Total heating load (BTUh): 57,258.9 Total airflow (CFM): 5,426.6 Total building air changes/hr (ACTH): 22.36 Sensible heat coefficient (SHC): 1.10 Latent heat coefficient (LHC): 0.68 Heating load density (BTUh/SgFt): 39.3 Heating airflow density (CFM/S Ft). 3.73 ACOA-Approved Manual J8 Calculations 14:59:41 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual A residential HVAC load calculations. System Block Load Breakdown - Cooling •�s , Description Value % Windows and glass doors: 33,132.7 73.3% Skylights: 0.0 0.0% Wood and metal doors: 0.0 0.0% Above grade walls: 772.9 1.7% Partition walls: 0.0 0.0% Below grade walls: 0.0 0.0% Ceilings: 0.0 0.0% Floors: 0.0 0.0% Infiltration: 1,722.3 3.8% Internal gain: 4,980.0 11.0% Duct heat gain: 0.0 0.0% Ventilation: 2,274.9 5.0% Blower heat gain: 0.0 0.0% Excursion adjustment load: 2,324.4 5.1% Total cooling: 45,207.3 100.... System Block Load Breakdown - Heating Description Value % Windows and glass doors: 40,383.8 70.5% Skylights: 0.0 0.0% Wood and metal doors: 0.0 0.0% Above grade walls: 3,435.2 6.0% Partition walls: 0.0 0.0% Below grade walls: 0.0 0.0% Ceilings: 0.0 0.0% Floors: 0.0 0.0% Infiltration: 8,314.5 14.5% Duct heat loss: 0.0 0.0% Ventilation: 5,125.3 9.0% Hot water piping load: 0.0 0.0% Winter humidification load: 0.0 0.0% Total heating: 57,258.9 100.... ACCA-Approved Manual J8 Calculations 14:59:41 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual J8 residential HVAC load calculations. r Room Heating and Cooling Totals Room IName Gaoling Lead TWh) Heating Load (BTUh) Airflow (CFM) A Room 0.0 0.0 0.0 Totals 0.0 0.0 0.0 ACOA-Approved Manual J9 Calculations 14:59:41 06-11=2014 This software was developed by Carmel Software Corporation. It has been approved by RCCA for Manual J6 residential HVAC load calculations. System Block Load Breakdown-Cooling - I Windows,glass doors, skylights: 33,132.7]BTUh Envelope(walls,doors, roof,etc.): 772.9 BTUh Infiltration: 1,722.3 BTUh Internal gain: 4,980.0 BTUh Duct and blower heat gain:L0.8,BTUh Ventilation:L 2,274. BTUh Excursion adjustment load: 2,324.4 BTUh Total cooling: 45,207.3 BTUh System Block Load Breakdown-Heating Windows,glass doors, skylights: 40,383.8 BTUh Envelope(walls,doors, roof,etc. : 3,435.2 BTUh Infiltration: 8,314. a BTUh Duct heat loss: 0.0 BTUh Ventilation/winter humidification: 5,125.3 BTUh Hot water piping load: 0 BTUh Total heating: 57,258.9 BTUh System AED Curve ACCA-Approved Manual J8 Calculations 14:59:41 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual J8 residential HVAC load calculations. S Company Info Name:East coast comfort {/�_✓�1/ Address:252 woburn street Location:Wilmington,MA,01887 Phone:978-580-7021 Client Info Building name/description: Contact name:Steve Corcom Address:303 Abbott rd Location:North Andover,Massachusetts,United States Phone: Load Summary Total building area: 1,300.0 SgFt Total cooling load: 74,049.3 BTUh Total cooling tonnage: 6.2 tons Total heating load: 89,592.4 BTUh Total airflow: 9.201.0 CFM Project Load Breakdown-Cooling C) Windows,glass doors,skylights: 61,508.9 BTUh Envelope(walls,doors,roof,etc.):' 600.7 BTUh Infiltration: 11,198. BTUh Internal gain: 3,780.0 BTUh Duct and blower heat gain:C� J.O BTUh Ventilation: 2,848. BTUh Excursion adjustment load: 4,315.2 BTUh Total cooling: 74,049.3 BTUh Project Load Breakdown-Heating 0 Windows,glass doors,skylights: 74,970. BTUh Envelope(walls,doors,roof,etc.): 2,669.7 BTUh Infiltration: 5,985.4'BTUh Duct heat loss: O:g BTUh Ventilation/winter humidification: 5,967. BTUh Hot water piping load: 0. BTUh Total heating: 89,592.4 BTUh Project AED Curve ACCA-Approved Manual J8 Calculations 14:53:11 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual J8 residential HVAC load calculations. System Load Summary System description:System 1 Total building area: 1,352.0 Total cooling load: 74,049.3 BTUh Total cooling tonnage: 6.2 tons -— Total heating load: 89,592.4 BTUh Total airflow: 9,201.0 CFM System Block Load Breakdown-Cooling — Windows.glass doors,skylights: 61,508.7 BTUh Envelope(walls,doors,roof,etc.)::, 600.7 BTUh Infiltration: 1,196.1 BTUh Internal gain: 3,780.0,BTUh Duct and blower heat gain___ _ _0.0 BTUh - Ventilation 276-45e-. BTUh Excursion adjustment load: 4,315.2 BTUh Total cooling: 74,049.3 STUh - System Block Load Breakdown-Heating — Windows,glass doors,skylights: — 74,970.0 BTUh Envelope(walls,doors,roof,etc.):. 2,669.7 BTUh Infiltration: 5,985.4 BTUh Duct heat loss: 0.6 BTUh Ventilation/winter humidification: _ 5,967.d'BTUh Hot water piping load: 0. BTUh Total heating: 89,592.4 BTUh ---__ — --- _ System AEO Curve -_-- —�— - I — ACCA-Approved Manual J8 Calculations 14:53:11 06-11-2014 - — - This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual J8 residential HVAC load calculations. System Checksums - Coaling Total building area (SgFt): 1,300.0 Total building volume (CuFt): 10,400.0 Total cooling sensible load (BT1 Uh): 70,533.2 Total cooling latent load (8TUh): 3,516.1 Total cooling load (BTUh): 74,049.3 Total tonnage (tons) 6.2 . Total cowling infiltration airflow (CFM): 36.2 Total cooling ventilation airflow (CFM): 80.1 Total airflow (CFM) 9,201.0 III Total infiltration air changes/hr (ACH): 0.21 Sensible heat coefficient (SH'C): 1.10 Latent heat coefficient (LHC): 0.68 Cooling load density (BTUh/SgFt): 56.96 Cooling airflow density (CFM/SgFt): 7.08 Cooling airflow/load' (CFM/Ton): 1,491.1 Cooling area/load (SgFt/Ton): 210.7 System Checksums - Heating Total building area (SgFt): 1,352.0 Total building volume (CuFt): 10,816.0 Total heating load (BTUh): 89,592.4 Total airflow (CFM): 9,201.0 Total building air changes/hr (ACH): 51.04 Sensible heat coefficient (SH'C): 1.10 Latent heat coefficient (LHC): 0.68 Heating load density (BTUh/SgFt): 66.3 Heating airflow density (CFM/SgFt): 6.81 ACCA-Approved Manual J8 Calculations 14:53:11 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACOA for Manual J8 residential HVAC load calculations. System Block Load Breakdown - Cooling Description Value Windows and glass doors: 61,508.7 83.1% I'I Skylights: 0.0 0.0% Wood and metal doors: 0.0 0.0% Above grade walls: 600.7 0.8% Partition walls: 0.0 0.0% Below grade walls: 0.0 0.0% Ceilings: 0.0 0.0% Floors: 0.0 0.00/0 Infiltration: 1,196.1 1.6% Internal gain: 3,780.0 6.1% Duct heat gain: 0.0 0.0% I Ventilation: 2,648.7 3.6% Blower heat gain: 0.0 0.0% Excursion adjustment load: 4,315.2 5.8% Total cooling: 74,049.3 100.... System Block Load Breakdown - Heating Description Value % Windows and glass doors: 74,970.0 83.70/. Skylights: 0.0 0.00/0 Wood and metal doors: 0.0 0.0% Above grade walls: 2,669.7 3.0% Partition walls: 0.0 0.0% Below grade walls: 0.0 0.0% Ceilings: 0.0 0.0% Floors: 0.0 0.0% Infiltration: 5,985.4 6.7% Duct heat loss: 0.0 0.0% Ventilation: 5,967.4 6.7% Hot water piping load: 0.0 0.0% j Winter humidification load: 0.0 0.0% Total heating: 89,592.4 100.... ACCA-Approved Manual X18 Calculations 14:53:11 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACCA for(Manual J8 residential HVAC load calculations. r ' l w Roorn Healing and Cooling Totals Rt ori Name Cooling Load (BTUh) Heating Load (BTUh) Airflow (CFM) A Room 4.0 4.4 4.4 Totals 0.0 4.0 0.0 ACOA-Approved Manual A Calculations 14:53:11 46-11-2414 This software was developed by Carmel Software -Corporation. It has been approved by RCCA for Manual J6 residential HVAC load calculations. System Block Load Breakdown-Cooling Windows,glass doors, skylights: 61,508.7jBTUh Envelope(walls,doors,roof,etc.): 600.7;BTUh Infiltration: 1,196.1 BTUh Internal gain:[._ 3,780. ,BTUh Duct and blower heat gain 0 BTUh Ventilation: 2,648. BTUh Excursion adjustment load: 4,315.2 BTUh Total cooling: 74,049.3 BTUh System Block Load Breakdown-Heating Windows,glass doors,skylights: 74,970.0 BTUh Envelope(walls,doors,roof,etc.): _ 2,669.7 BTUh Infiltration: 5,985.4 BTUh Duct heat loss: 0.1 BTUh Ventilation/winter humidification: — 5,967.4 BTUh Hot water piping load: O.J E3TUh Total heating: 89,592.4 BTUh System AED Curve ACCA-Approved Manual JS Calculations 14:53:11 06-11-2014 This software was developed by Carmel Software Corporation. It has been approved by ACCA for Manual J8 residential HVAC load calculations. 6/17/2014 9:09 AM FROM: Fax M.J. Foster Insurance Services, Inc. TO: 978-664-1312 PAGE: 002 OF 002 EASTC-6 OP ID:JD2 CERTIFICATE OF LIABILITY INSURANCE 1 DATE(MM YY) 06!17/2012014 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(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 endorsement(s). PRODUCER CONTACT North Andover Insurance Agency PHONE MichaelLescord FAX M.J.Foster Insurance Services A1C No E :978-686-2266 AIC,Na3:978-686-6410 163 Main St. North Andover,MA 01845 ADDRESS: Michael Lescord INSURER(S)AFFORDING COVERAGE NAIC# INSLIRERA:GUARD INS COMPANY INSURED East Coast Comfort LLC INSURER 4 Porter Road North Reading,MA 01864 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER MIDDM'YY FF MMIDDIYYYY LIMITS GENERAL UABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITYAMA TO NT D PREMISES Ea occurrence) $ CLAIMS-MADE D OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATELIMIT APPLIESPER: PRODUCTS-COMP/OPAGG $ POLICY PRO- LOC $ ECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY WJURY Per acddent AUTOS AUTOS ( ) $ HIRED AUTOS NON-OWNED PROPAGE ERT DAM $ AUTOS PER ACCIDENT UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEO RETENTION$ $ WORKERS COMPENSATIONYJCSTATU- TH- AND CMt'LOVCRC LIAOILITV A AM.PROPRICTORlPARTNCPJCNLCIJflVCYIN SAWC534492 05/31/2014 05/3112015 E.L.EACH ACCIDENT S 600,00 OFFICER/MEMBER EXCLUDED? 0 NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,desaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(Attach ACORD 101,Add(ti anal Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/06) The ACORD name and logo are registered marks of ACORD ASSESSOR INFORMATION \ q n / ASSESSOR PARCEL/D 270/038.0-0020-0002.0 \\ �/9 2� \/ lti• 0.5744 ACRES(PER ASSESS/NG RECORDS) \ ►N St. U�y OWNER OF RECORD \ LOT 3 a 3 0 5 m �• B08ER/N, LLC \ THlsrc£RDu' Q 9 WHITNEY ROAD \ AREA=70,313 SFj- `a, • EY \ e BOXFORD. MA 01921 \ \ (1.6142 ACRES:&) $'•` µ US \ /JON LOT 7 46,118 SF-1- (CRA) NORTH ESSEX COUNTY REGISTRY OF DEFOs \ // AWE L SMG99 5� DEED REFERENCES• \ // I �5 BENfNTLARY e� DEED BOOK 13688, PAGE 61 (/JOJ ABBOTT STREET, LOT 2) / ^ SS•GQY'fp000 PLAN ST. PLAN 17014 (/30J ABBOTT STREET, LOTS 1, 2&3) \��, // Z 14• 1 Q� �` JQNNS°N ZONING THE PROPERTY IS LOCATED WITHIN THE RESIDENCE J ZONING DISTRICT ACCORDING TO THE'TOWN OF NORTH LOCUS MAP ANDOVER ZONING MAP'PRINTED APRIL 24,2013. ` / � / THE SUBJECT PROPERTY IS NOT SUBJECT TO ANY ZONING V/ / y�/ APPROXIMATE SCALE.• 1/NCH=1,000 FEET OVERLAY DISTRICTS INDICATED ON THE'TOWN OF NORTH 25.\ // 1 ANDOVER ZONING MAP'PRINTED ON APRIL 24,2013. THE SUBJECT PROPERTY IS NOT LOCATED WITHIN ANY � / �-BUFFER ZONE - � SPECIAL FLOOD HAZARD AREA ACCORDING TO NFIP FLOOD / --'-—---- \ N/F NOW OR FORMERLY INSURANCE RATE MAP NUMBER 25009CO236F, EFFECTIVE ` \ m SF SQUARE FEET \ TYR DATE OF JULY J, 2012- I /// DH 'E'\(FD)(HELD) FOJ FOUND L ///66.3' AVG AVERAGE EXISTING ' ® SMALL O 1. THE PURPOSE OF THIS PLAN IS TO PROVIDE THE NORTH CONCRETE Jo' �i R \• Ac SMALL GROUND LUMINAIRE \ ANDOVER BU/LO/NG COMMISSIONER AND PROPERTY OWNER FOUNDATIONLOT I c. STONE WALL WITH INFORMATION ABO UT THE LOCATION OF THE EXIS77NG �N j'' \ b o co o REMAINS OF STONE WALL BUILDING FOUNDATION WITH RESPECT TO LOT UNE LOCATIONS to $ AREA=25,022 SFt I EDGE OF PAVEMENT AS DESCRIBED IN THE RECORD PLAN. THE INTENT IS TO �• giilq •• WETLAND FLAG AND LABEL SATISFY THE CER77FYED FOUNDATION AS-BUILT REQUIREMENT 30' (0.5744 ACRESt) ` >Vy DENOTES WETLAND AREA FOR PROCEEDING WITH CONSTRUCTION OF THE PROPOSEDI 100 FT BUFFER ZONE \ / 1APPROXIMATE 100 FT BUFFER ZONE DWELLING AND SEPTIC SYSTEM. PROPOSED APPROX 80'OS APPROX/IMTE 80 FT OFFSET TO WETLAND EDGE 2. BOUNDARY AND TOPOGRAPHIC INFORMATION SHOWN SEEP•777CC 95.9' / 20• <c144.805> TOTAL LOT FRONTAGE HEREON IS BASED UPON AN ON-774E-GROUND FIELD SURVEY SEf CONDUCTED BY GREAT CIRCLE LAND SERVICES ON AUGUST 10 I ( NOTE 9) AND 11, 201 J, UTILIZING A LECA TCR 705 TOTAL STATION \, ^ 377• / INSTRUMENT. THIS PLAN IS NOT TO BE CONSIDERED AN m ALTA/AGSM LAND TITLE SURVEY. THE EXIST/NG FOUNDATION WAS FIELD LOCATED BY GREAT CIRCLE LAND SERVICES ON °L� APRIL 19, 2014. $ N / N 642 9i, J. MAPPING OF ONSITE UTILITIES IS LIMITED TO GATHERING 4 v \gfi• SURFACE-WS/BLE EVIDENCE OF READILY ACCESSIBLE UTILITIES AT TIME OF SURVEY ONLY THE LOCATION OF ANY UNDERGROUND STORAGE TANKS, IF ANY,ARE NOT SHOWN \ HEREON. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION, SIZE AND ELEYATON �� l \ /APPROX/MAT£ OF ALL UTILITIES PRIOR TO COMMENCING ANY SITE WORK. o� \ / LOCAT/ON OF 100' THE CONTRACTOR SHALL ALSO BE RESPONSIBLE FOR tjq __ \ \ / BUFFER ZONE I CONTACTING D/GSAFE AT 81 It AT LEAST 72 HOURS PRIOR TO cO ?' \ i // (5EE NOTE 7) I GRAPHIC SCALE ANY EXCAVATION, DEMOLITION OR CONSTRUCTION. 4. SOME SYMBOLS MAY BE ENLARGED FOR RFAOAB/UTY. 80 �� I \ /% 0 /0 20 40 N 5. ABUTTER INFORMATION IS SHOWN HEREON PER THE TOWN < 02 /' \; I I °f ( E7 OF NORTH ANDOVER ASSESSOR MMS FOR/LLUS77LITNE 1\' PURPOSES ONLY. N f LNCH/N=FE20 FEET _ / r� rn 6. WElL1ND RESOURCE AREAS DEPICTED HEREON ARE •� BASED ON FIELD LOCATIONS OF FLAGS AS DELINEATED BY BILL MANUELL OF WETLANDS AND LAND MANAGEMENT, INC. 4. ` q THE WETLANDS DELINEATION/S SUBJECT TO REVIEW AND/OR _; FOUNDATION AS—BUILT PLAN VERIFICATION BY THE TOWN OF NORTH ANDOVER 3/,383 ABBOTT ST., LOT 2, NORTH ANDOVER, MA 01845 CONSERVATION COMMISSION AND/OR THE MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION (S PREPARED FOR: 7. A PORTION OF THE BUFFER ZONE AT THE EASTERLY ZONING REQUIREMENTS I CERTIFY THAT THE FOUNDATION IS LOCATED BOBERIN, LLC PORTION OF THE PREMISES IS SHOWN APPROX/MATELY PER ON THE GROUND AS SHOWN, AND COMPLIES FOUR FLAGS SET BY BILL MANUELL OF WETLANDS AND LAND fB( REQUIREMENT [QQ,bQfQ WITH THE DIMENSIONAL ZONING REQUIREMENTS OWNED BY: MANAGEMENT TO SHOW AN APPROXIMATE OFFSET DISTANCE TO MINIMUM LOT AREA 2•$000 51 2.%022 5F OF THE TOWN OF NORTH ANDOVER. THIS/S OF7S/TE WETLAND RESOURCE AREAS. MINIMUM CBA 18,750 SF 25,022S' NOT A CERTIFICATION OF THE 77TLE OR BOBERIN, LLC MINIMUM LOT WDTH 100 FT 12077 FT OWNERSHIP OF EDN. 9 WHITNEY ROAD, BOXFORD, MA 01921 8. AREAS ARE ROUNDED TO THE NEAREST SQUARE FOOT OR MINIMUM LOT DEPTH 30 FT 19746 FT TEN THOUSANDTH OF AN ACRE. LINEAR DIMENSIONS ARE M/NNUM SIREET FRONTAGE 125 FT 12561 FT ROUNDED TO THE NEAREST HUNDREDTH OF A FOOT. MINIMUM FRONT YARD 30 FT 66J F7 FOUNDATION SETBACK DIMENSIONS ARE ROUNDED TO THE MIN/MUM SIDE YARD 20 FT 259 FT dd YYyy PLAN DATE.APR2 25,2014 SCALE. f'-20' NEAREST TENTH OF A FOOL MIN/MUM REAR YARD 30 FT 959 FT kNkryRl�Skiik ro DRAWN BY: JPM CHECK BY.' --- MAXIMUM BUILD/NC HE/G4T 35 FT N/A• 11`11k�M ®� DRAWING: 1713PP.OWC LAYOUT: FON—AB_LoL2 9. PROPOSED SEPTIC SYSTEM IS SHOWN PER PLAN F ` imi�® ® SHEET. 1 OF 1 PROJECT.: 2013-1713 ENTITLED "SEPTIC SYSTEM DESIGN— SITE PLAN'PREPARED 'NOT APPLICABLE. FOUNDA770N OM Y. NO BUILD/NG BY D.C.MocR/TCHIE, INC. DATED NOVEMBER 12, 2013 WITH COVS7RUCND AT 7H/S RAE I H�o�.As9 �{ - NO. BY DATE REV/S/ON LATEST REVISION DATE OF NOVEMBER 20, 2013. L A n H M®PVI 8 A o f JPM T126-12014 SHOW PROPOSED SEPTIC AREA JEFFREY P. MORRISSETTE DATE 34 ROAD, UNIT N22 ✓PM 4 30 2014 REVISE PLAN SCALE LY1Pr'RMJRO 1014. GREAT C/RaE UND smlc S ALL RACHIS RESERV£A P.L.S. yf148694 LOWEYL PEPP£RELL, ML 0146,77IT 12 2.1050 °e NORiM'1 'i o J'• �ss�cNus°t CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 546-14 on 1/14/2014 Date: October 10,2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON 315 Abbott Street—Lot 2 MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Boberin LLC 9 Whitney Road Boxford,MA 01921 Building Inspector Fee: Prepaid$100.00 Receipt: 27232 j Check : 3643 I NORTH own of E ndover No. 646 — iL4 h ver, Mass, ' 1 COCNICNt W.CK V �R'qTED P .�� S u ARD OF H ALTH /Septic PERMIT T LD d Septic System t >/ THIS CERTIFIES THAT ..... ................................... ..................................... 7t Fater BUILDING INSPECTOR'` . . Foun`..........has permission to erect.......................... buildings on ...-1: . .. .. .�........... ....... C to be occupied as ��'^� `'` "��1 ... �?01e.i. �J f�' ............................................. ......................................................... Chi w provided that the person accepting this permit shall in every respect conform to the terms of the application ;%Fin on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PWMBING `IINNSPECT 111 Rough 2 W VIOLATION of the Zoning or Building Regulations Voids this Permit. Final �� l`>L PERMIT EXPIRES IN 6 MONTHS ELECTRICAL 1 PECTOR UNLESS CONSTRUCTION STARTS u h � d6 `! ........................ Service ........... .�..... ..... ..,,,_.�........ in �_3 BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final (�, fly . 1 No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. REVERSE SIDE Smoke Det. SEE Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 428,750.00 m $ - $ 5,145.00 Plumbing Fee $ 643.13 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 643.13 Total fees collected $ 6,531.25 315 Abbott Street 546-14 on 1/14/14 Single Family Home PORAVAS DESIGN & CONSULTING June 23, 2014 Steve Corcoran 303 Abbott Street, Lot 42 North Andover, MA Regarding: Rough Framing Inspection/Affidavit for Lot 42, 303 Abbott Street, North Andover, Massachusetts Dear Steve, As Architect of Record for the above referenced project, Poravas Design & Consulting certifies that I have been present on the construction site on a regular and periodic basis, and to the best of my knowledge and belief, the rough framing installation (including engineered framing and beams) has been constructed in compliance with the requirements of the Massachusetts State Building Code, 8th Edition and the approved plans and specifications. Therefore, it is my opinion that the follow-on construction work to complete the construction of the work can continue without delay. If you have any questions or comments regarding this affidavit, please feel free to reach me at 339-927-1579 or pdcdesignl@gmail.com. SED AgCyi Best, V��Op4R 4,0 = Wo 5(1506 8oS.0v c Christopher A.Poravas, AIA Poravas Design&Consulting `c9CT8f OF MPSgR 49 Appleton Street,Melrose, MA 02176 - Phone: 339-927-1579 - lAcdeslgnIftin-,ul.con1 NORTH Town of O - R+ No. 64 — iL4 h , ver, Mass, COCMICKl WICK S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT.., ,?.a. BUILDING INSPECTOR 6 ............................. Foundation has permission to erect.......................... buildings on .... 1., ..��..r�.:d................. to be occupied as i (..�t7/✓J`'✓�r..c� �i �/�1/ / Rough ................................................�r�f"...��! .5�.� ........................................................ Chimney provided that the person accepting this permit shall in every respeonform.to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough �//�/�® Service ............�..... ....... """l"":.C..4+-..�.................... .. Final BUILDING INSPECTOR.. .. GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE t CREScheck Software Version 4.5.0 �(J Compliance Certificate Project Proposed New Residence - Lot 2, 303 Abbott Street Energy Code: 2009 IECC Location: North Andover, Massachusetts Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 2,905 ft2 Glazing Area 13% Climate Zone: 5 Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 303 Abbott Street, Lot 2 Chris Poravas North Andover, MA Poravas Design &Consulting 49 Appleton Street Melrose, MA 02176 339-927-1579 pdcdesignl@gmail.com Compliance: 2.6%Better Than Code Maximum UA: 387 Your UA: 377 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Glazing Door UA Perimeter IU-Factor Floor 1: All-Wood Joist/Truss:Over Unconditioned Space 1,573 30.0 0.0 0.033 52 Floor 2:All-Wood Joist/Truss:Over Outside Air 38 30.0 0.0 0.033 1 Ceiling 1.: Flat Ceiling or Scissor Truss 1,410 38.0 0.0 0.030 42 Ceiling 2: Cathedral Ceiling 200 30.0 0.0 0.034 7 Wall 1:Wood Frame, 16"D.C. 2,744 21.0 0.0 0.057 131 Window 1: Wood Frame:Double Pane with Low-E 329 0.290 95 Door 1: Solid 36 0.500 18 Door 2: Glass 40 0.320 13 Door 3: Solid 36 0.500 18 Compliance Statement The proposed building design described here is consistent wythaherbuilding plans,specifications, and other calculations submitted with the permit application..The proposed building has be sl ne beet the 2009 IECC requirements in REScheck Version 4.5.0 and to comply with the mandatory requirements listeda'f=h �l� �crinspection Checklist. Ct4215 RiZAVAS Q AF 1� /to /20 is Name-Title Signature = No.50506 I Date ® V BOSTON Co O MASS. iyhwh Project Title: Proposed New Residence - Lot 2, 303 Abbott Street � Report date: 11/10/1 Data filename: C:\01-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 1 of 9 Project Title: Proposed New Residence - Lot 2; 303 Abbott Street Report date: 11/10/1 Data filename: C:\O1-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 2 of 9 REScheck Software Version 4.5.0 Inspection Checklist Energy Code: 2009 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Req.ID 103.2 ;Construction drawings and ❑Complies [PR1]1 !documentation demonstrate ❑Does Not ;energy code compliance for the ❑Not Observable ' 'building envelope. ; ❑Not Applicable 103.2, (Construction drawings and ❑Complies 403.7 documentation demonstrate ❑Does Not [PR3]1 !energy code compliance for 'lighting and mechanical systems. ❑Not Observable ; Systems serving multiple ❑Not Applicable ;dwelling units must demonstrate ; !compliance with the commercial code. 403.6 Heating and cooling equipment is: Heating: Heating: ;❑Complies [PR2]2 sized per ACCA Manual S based Btu/hr ; Btu/hr :❑Does Not on loads per ACCA Manual J or ; Cooling: Cooling: UNot Observable other approved methods. Btu/hr Btu/hr ❑Not Applicable ; ; ; Additional Comments/Assumptions: I FI- High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Proposed New Residence- Lot 2, 303 Abbott Street Report date: 11/10/1 Data filename: C:\01-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 3 of 9 2009 IECC Foundation Inspection 7 Complies? Comments/Assumptions 303.2.1 'A protective covering is installed to ❑Complies [FO11]2 protect exposed exterior insulation ❑Does Not and extends a minimum of 6 in. below grade. ❑Not Observable ❑Not Applicable 403.8 Snow-and ice-melting system controls;❑Complies [FO12]2 installed. ;❑Does Not 'AJ ;❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Proposed New Residence- Lot 2, 303 Abbott Street Report date: 11/10/1 Data filename: C:\01-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 4 of 9 Section Plans Verified Field Verified # Framing /Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Door U-factor. ; U- U- ;❑Complies ;See the Envelope Assemblies 402.3.4 ❑Does Not table for values. [FRl]1 ; ,❑Not Observable , j ;❑Not Applicable 402.1.1, ;Glazing U-factor(area-weighted U- U- ;❑Complies ;See the Envelope Assemblies 402.3.1, average). ;❑Does Not table for values. 402.3.3, ; 402.5 ,❑Not Observable ; [FR2]1 ;❑Not Applicable i 303.1.3 IU-factors of fenestration products ❑Complies ; [FR4]1 are determined in accordance ❑Does Not !with the NFRC test procedure or ❑Not Observable (taken from the default table. ❑Not Applicable 402.3.5 ;Sunrooms enclosing conditioned ; U- U- I❑Complies [FR8]1 Ispace have a maximum :❑Does Not jfenestration U-factor of 0.50 in o ;Climate Zones 4-8. New glazing ;❑Not Observable separating the sunroom from ;❑Not Applicable ;conditioned space must meet 'code requirements. ; 402.3.5 (Sunrooms enclosing conditioned U U ;❑Complies ; [FR9]1 (space have a maximum skylight QDoes Not IU-factor of 0.75 in Climate Zones 14-8. ❑Not Observable ; I ❑Not Applicable 402.4.4 ;Fenestration that is not site built ❑Complies [FR20]1 lis listed and labeled as meeting ❑Does Not !AAMA/WDMA/CSA 101/I.S.2/A440 ❑Not Observable or has infiltration rates per NFRC :400 that do not exceed code []Not Applicable limits. 402.4.5 IC-rated recessed lighting fixtures ❑Complies ; [FR16]2 sealed at housing/interior finish ❑Does Not j and labeled to indicate s2.0 cfm ❑Not Observable ' leakage at 75 Pa. ❑Not Applicable 403.2.1 !Supply ducts in attics are R- R ❑Complies [FR12]1 (Insulated to >_R-8. All other ducts i R- R- ;❑Does Not im unconditioned spaces or ;outside the building envelope are; ;❑Not Observable !insulated to >_R-6. ;❑Not Applicable 403.2.2 ;All joints and seams of air ducts, ❑Complies [FR13]1 lair handlers,filter boxes, and ❑Does Not ;building cavities used as return ducts are sealed. ❑Not Observable ; ❑Not Applicable ; 403.2.3 Building cavities are not used for ❑Complies ; [FR15]3 supply ducts. []Does Not tpJ ❑Not Observable ; ❑Not Applicable 403.3 HVAC piping conveying fluids ; R- R- ;❑Complies ; [FR17]2 above 105 9F or chilled fluids I E❑Does Not below 55 9F are insulated to >_R- 3 ;❑Not Observable ; ❑Not Applicable 403.4 Circulating service hot water ; R- R- ;❑Complies [FR18]2 pipes are insulated to R-2. UDoes Not '9J ;❑Not Observable ❑Not Applicable 1 1 High Impact(Tier 1) 1 2'1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Proposed New Residence- Lot 2, 303 Abbott Street Report date: 11/10/1 Data filename: C:\01-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 5 of 9 Section Plans Verified Field Verified # Framing /Rough-In Inspection Value Value Complies? Comments/Assumptions & Req. ID 403.5 Automatic or gravity dampers are ❑Complies [FR19]2 installed on all outdoor air ❑Does Not intakes and exhausts. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Proposed New Residence- Lot 2, 303 Abbott Street Report date: 11/10/1 Data filename: C:\01-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 6 of 9 Section Plans Verified Field Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & Req.ID 303.1 All installed insulation is labeled ❑Complies [IN1311 or the installed R-values ❑Does Not provided. ❑Not Observable s❑Not Applicable 402.1.1, !Floor insulation R-value. R- R- ❑Complies ;See the Envelope Assemblies 402.2.51 ;❑ Wood ;❑ Wood ;❑Does Not table for values. 402.2.6 ❑ Steel ❑ Steel :❑Not Observable [IN111 ❑Not Applicable 303.2, iFloor insulation installed per ❑Complies ; 402.2.6 1manufacturer's instructions,and ❑Does Not [IN211 !in substantial contact with the ;underside of the subfloor. IE]Not Observable ; J❑Not Applicable 402.1.1, l Wall insulation R-value. If this is a; R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.4, (mass wall with at least 1/2 of the F-1Wood F-1Wood ❑Does Not table for values. 402.2.5 wall insulation on the wall ❑ Mass ❑ Mass i❑Not Observable [IN311 exterior,the exterior insulation �} requirement applies. E] Steel ;El Steel ❑Not Applicable i 303.2 'Wall insulation is installed per ❑Complies [IN411 manufacturer's instructions. ❑Does Not Q) ❑Not Observable ❑Not Applicable 402.2.11 ISunroom wall insulation has a R- R- ;❑Complies ; [IN811 (minimum R-value of R-13. New ;❑Does Not ` ;walls separating the sunroom ❑Not Observable from conditioned space must ; meet code requirements. ;❑Not Applicable 303.2 Sunroom wall insulation installed ❑Complies [IN911 iper manufacturer's Instructions. ❑Does Not ' ❑Not Observable ❑Not Applicable 402.2.11 i5unroom ceiling minimumR- R- ❑Complies ; [IN10]1 ;insulation R-value of R-19 in :❑Does Not U Climate Zones 1-4, and R-24 in Climate Zones 5-8. ❑Not Observable ❑Not Applicable 303.2 'Sunroom ceiling insulation is J❑Complies [IN1i]1 installed per manufacturer's ❑Does Not instructions. ❑Not Observable IE]Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Proposed New Residence- Lot 2, 303 Abbott Street Report date: 11/10/1 Data filename: C:\01-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 7 of 9 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Recl.ID 402.1.1, ;Ceiling insulation R-value.Where ; R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.1, ;> R-30 is required, R-30 can be ❑ Wood ❑ Wood ;❑Does Not ;table for values. 402.2.2 ;used if insulation is not ❑ Steel E] Steel ;❑Not Observable ' [FIM ;compressed at eaves. R-30 may y !be used for 500 ft2 or 20% i ;:F-]Not Applicable (whichever is less)where jsufficient space is not available. 303.1.1.1, ;Ceiling insulation installed per ❑Complies 303.2 i manufacturer's instructions. ❑Does Not [17I2]1 !Blown insulation marked every ';300 ft2. [-]Not ObservableCO) ; ❑Not Applicable 402.2.3 ;Attic access hatch and door R- ; R ❑Complies ; [F1311 insulation >_R-value of the UDoes Not QJ adjacent assembly. ' ,❑Not Observable I ; ; :❑Not Applicable 402.4.2, 1 Building envelope tightness ACH 50 = ; ACH 50 = ;❑Complies 402.4.2.1 !verified by blower door test result :❑Does Not [FI17]1 !of<7 ACH at 50 Pa.This ;requirement may instead be met :E-]Not Observable ; Ma visual inspection, in which ; ;❑Not Applicable ;case verification may need to occur during Insulation Inspection. ; 402.4.3 Wood-burning fireplaces have ❑Complies [FI8]2 gasketed doors and outdoor ❑Does Not combustion air. ❑Not Observable ' ❑Not Applicable 403.2.2 ;Post construction duct tightness ; cfm ; cfm ;❑Complies [F14]1 !test result of:58 cfm to outdoors, I UDoes Not for sy12 cfm across systems.Or, r ; ;❑Not Observable ;rough-in test result of<_6 cfm across systems or:54 cfm ;❑Not Applicable ;without air handler. Rough-in test j jverification may need to occur ; !during Framing Inspection. 403.1.1 Programmable thermostats ❑Complies [FI912 installed on forced air furnaces. ❑Does Not ❑Not Observable ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [FI10]2 on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable 403.4 Circulating service hot water ❑Complies ; [Flll]2 systems have automatic or ❑Does Not .49 accessible manual controls. ❑Not Observable ❑Not Applicable 403.9.1 Readily accessible switch on ❑Complies [FI12]3 heaters for swimming pools. ❑Does Not ❑Not Observable ❑Not Applicable 403.9.2 Timer switches on pool heaters ❑Complies [FI19]3 and pumps are present. ❑Does Not .�.' ❑Not Observable ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 13 1 Low Impact(Tier 3) Project Title: Proposed New Residence - Lot 2, 303 Abbott Street Report date: 11/10/1 Data filename: C:\01-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 8 of 9 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions j & Req.ID 403.9.3 Heated swimming pools have a ❑Complies [F120]3 cover.Covers on pools heated ❑Does Not over 90 OF are insulated to R-12. ❑Not Observable I ❑Not Applicable 404.1 50%of lamps in permanent ❑Complies [F116]1 !fixtures are high efficacy lamps. ❑Does Not ❑Not Observable j ❑Not Applicable 401.3 Compliance certificate posted. ❑Complies [FI7]2 ❑Does Not 0 ❑Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies [FI18]3 mechanical and water heating ❑Does Not f>! equipment have been provided. ❑Not Observable , ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Proposed New Residence- Lot 2, 303 Abbott Street Report date: 11/10/1 Data filename: C:\O1-Projects\Residential\Corcoran-North Andover\10-Energy Audits\Abbott- Lot 2.rck Page 9 of 9 2009 IECC Energy Efficiency Certificate Insulation . Wall 21.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): Glass& D.. Window 0.29 Door 0.32 Cooling Heating System: Cooling System: Water Heater: Name: Date: Comments low Massachusetts - Department of Public Safety Board of BuildingRegulations and Standards Construction Supers isur License: CS-065208 ROBERTS. C i CORAM 9 WHITNEYJRD. Boxford MA—,-01921 92, Commissioner Expiration C/9o��u,�e o�Cr2��a,�;luaeL�, Office of Consumer Affairs & Business Regulation ME IMPROVEMENT CONTRACTOR gistration: 171633 Type: xpiration: 4/3%20.14- _. LLC BOBERiN LLC. ROBERT CORCORAN 9 WHITNEY RD - BOXFORD, MA 01921 Undersecretary I I� BOBER-1 OP ID:BS ACORO' DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 11/04/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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 endomemen s. PRODUCER Phone:781-665-2775 NA McLaughlin Insurance Agency Fax 781-665-0295 PHONE : a/FAx 828 Lynn Fells Parkway A/c No F C No Melrose,MA 02176 E-MAIL William B.Markhard,CPCU ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC R INSURER A:Travelers Prop.Cas.Co.of Am INSURED Boberin LLC INSURER B:Western World Insurance Co. Attn:Bob Corcoran 9 Whitney Road INSURER C:Associated International Insur 27189 Boxford,MA 01921 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEVOL r POLICY POLICY EXP LIMBS LTR POLICY NUMBER MM MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. B X COMMERCIAL GENERAL LIABILITY NPP7349890 06/04/13 06/04!14 DAMAGE 10 RENT Ely PREMISES Ea occurrence $ 50,00 CLAIMS-MADE Fx-1 OCCUR MED EXP(Anyone person) $ 5,0 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,00 JECT POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea..'ki t $ ANYAUTO BODILY INJURY(Per person) S AALLOOWNED SSCCTHEEDULED OS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per acddent $ X UMBRELLA LIABOCCUR EACH OCCURRENCE $ 1,000,00 C EXCESS LIAB HCLAIMS-MADE CUBW4646413 06/04113 06704114 AGGREGATE $ DED I X I RETENTIONS 10,000 1 $ WORKERS COMPENSATION X WC STATU- I og AND EMPLOYERS'UABIUTY TORY UMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N O BE ISSUED BY CARRIER 08/06/13 0$105114 E.L.EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? F-1 N/A (Mandatory (Mandatory In NH) E.L DISEASE-EA EMPLOYE $ 100,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,B more space is required) Additional insured(s) are as follows if required by written contract with named insured: Town of North Andover, MA CERTIFICATE HOLDER CANCELLATION NANDO-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main St ACCORDANCE WITH THE POLICY PROVISIONS. North Andover„MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD n1gn-Liax riz-1 1110/LU13 11,171 YAur, G/UVG rax .7CZ-Vor, CERTIFICATE OF LIABILITY INSURANCE DATE11/051901 YYY) FlCATE 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 BYTHE POLICIES BELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER E CERTIFICATE IMPORTANT:U the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed If SUBROGATION IS WAIVED,subject to the arms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: MCLAUHGLIN INS AGENCY PHONE FAX 828 LYNN FELLS PARKWAY (A/c,No,Ext): (A1C,No): EdYIAI L MELROSE,MA 02176 ADDRESS: 28TGH INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS INDEMNITY COMPANY OF AMERICA BOBERIN LLC INSURER B: INSURER C: INSURER D: 9 WHITNEY RD INSURER E BOXFORD,MA 01921 INSURER R COVERAGES CERTIFICATE NUMBER: REVISION NUMBER-. RIODINDIrATM NOTIANIRSTANDING /WYREWREMENT TON ORCONDITION OFMIYCONTRACT OROTHER D000ME TVATHFESPECTTOW OC HIHSCERTFI ATE MAY BE ISSUED OR MAY PERTAIN.T}EINSURANCE Inf R BYTHEPMOESDESMBEDH9MNMMBJH,TTOALL7WTMrS,EXOJMMSMDCCPOmONSCFSUCH POLICIES, LIMITSSHOMMAYHAVEBEEN FS7ICEDBY PAIDCLAIMS ow ADD SUB POLICY EFF DATE POLICY DIP DATE LTR TYPEOPINSURANCE L R POLICYNUMBER (WAMYYYY) (MADIAYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE [3 OCCUR. REMISES(Ea c=rrence) ED EXP(Any one person) $ ERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER ENERAL AGGREGATE $ POLICY a PROJECT ]LOC RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINEDSINGLE $ ANY AUTO LIMIT(Ea acadera) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIREDAUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ ri (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION ANDX 'WC STATUTORY i OTHER EMPLOYERSUABILITY YM UB4787P930-13 08/05/2013 08V0512014 i UMTS ANYPROPERTOWARTNERTXECILITIVE OFRCEP VE MBER EXCLUDED? a WA E.L EACH ACCIDENT $ 500,000 (M_dataryinw E.L.DISEASE-EA EMPLOYEE $ 500,000 nyes ��desaider EL DISEASE-POLICY LIMIT $ 500,000 gE%RPncNOF OPE RArnw 6e. DESCRIPTION OF OPERATIONS!LOCATIONSIVEHCLES/RESTMCTIOWSPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFTTT.CTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCEl1 AT10N TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED IIA MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT YVE A NORTH ANDOVER,MA 01845 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reseryed.