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Home My WebLink AboutMiscellaneous - 33 PILGRIM STREET 4/30/2018'IV V. Likt,X,Lf ,��tAtL 9 Cr t,J 00 r C: s A� W J ft O �'q O ft 00 Cr t,J 00 r C: s A� J ft ft J � r r w � C/v (7, 00 D4 ON � � o 00 t -A 74N Z rr, fTl Go ;u rm* .'.'.y.z CD r r 0 Co w e � I;_ I o; tewr Aw 3 1 1 3a PAcyn m % 3 Dan L. Gelinas PE [ph978.465.6436] Page) Gelinas Structural Engineering LLC 1Vq/ 579A North End Blvd or Salisbury MA 01952[danlgelinas@comcastnet StruCalc Version 9.0.2.5 J_O� ransfer of loads to Criteria: 0240 beanng Length 0.81 in 0.81 in BEAM DATA Center Span Length 10.75 ft Unbraced Length -Top 0 ft Floor Duration Factor 1.00 Notch Depth 0.00 MATERIAL PROPERTIES Versa -Lam 3100 Fb - Boise Cascade Base Values Adjusted Bending Stress: Fb = 3100 psi Fb' = 3279 psi Cd=1.00 CF=1.06 Shear Stress: Fv = 285 psi Fv' = 285 psi Cd=1.00 Modulus of Elasticity: E = 2000 ksi E'= 2000 ksi Comp. -L to Grain: Fc - I = 750 psi Fc - -L= 750 psi Controlling Moment: 14279 ft -Ib 5.375 ft from left support Created by combining all dead and live loads. Controlling Shear: 4782 Ib At a distance d from support. Created by combining all dead and live loads. Comparisons with required sections: Read Provided Section Modulus: 52.26 in3 76.65 in3 Area (Shear): 25.17 in2 63.44 in2 Moment of Inertia (deflection): 276.68 in4 277.87 in4 Moment: 14279 ft -Ib 20943 ft -Ib Shear. 4782 lb 12053 lb l t� 2 `i 1 /U' GI - all members CEI- MAS No Job 17816 May 4, 2017 FLOOR LOADING Beam Total Live Load: wL = Side 1 Side 2 Floor Live Load FLL = 660 psf 0 psf Floor Dead Load FDL = 310 psf 0 psf Floor Tributary Width FTW = 1 ft 0 ft Wall Load WALL = 0 plf BEAM LOADING Beam Total Live Load: wL = 660 plf Beam Total Dead Load: wD = 310 plf Beam Self Weight: BSW = 19 plf Total Maximum Load: wT = 989 plf t p X O_r /1 O ws''ri�'b ,rY LO �j 21 ZN� �d0�2 �'�VV 4x1�w1. a Pac-crim%- Aw Project: calc Hope Pilgrim St N Andover Job 17815 page) l ( Dan L. Gelinas PE [ph978.465.6436] )� Location: b21 five 7_25 deep LVLS Gelinas Structural Engineering LLC / Uniformly Loaded Floor Beam / 579A North End Blvd or [2009 International Building Code(2012 NDS)] Salisbury MA 0 1 952[danigetinas@comcast net ( 5) 1.75 IN x 7.25 IN x 10.75 FT Versa -Lam 3100 Fb - Boise Cascade StruCalc Version 9.0.2.5; ` 1 29 PM Section Adequate By: 0.4% Controlling Factor. Deflection D,kiv EL L' CLaminati ns are to be fully connected to provide uniform transfer of loads to all members 0 GELINAs �P DEFLECTIONS Center LOADING DIAGRAM "' v No 33:14 Live Load 0.36 IN U362 Dead Load 0.18 in Total Load 0.53 IN U241 ' .. Live Load Deflection Criteria: 0360 Total Load Deflection Criteria: 0240 t IAL REACTIONS 9 B Live Load 3548 Ib 3548 Ib Dead Load 1766 Ib 1766 Ib Job 17816 Total Load 5314 Ib 5314 Ib Bearing Length 0.81 in 0.81 in May 4 2017 BEAM DATA Center Span Length 10.75 ft Unbraced Length -Top 0 ft A= 10.75 ft Floor Duration Factor 1.00 Notch Depth 0.00 :::] I MATERIAL PROPERTIES Versa -Lam 3100 Fb - Boise Cascade Read Base Values Adjusted Bending Stress: Fb = 3100 psi Fb' = 3279 psi Cd=1.00 CF= 1.06 Side 2 Shear Stress: Fv = 285 psi Fv' = 285 psi Cd=1.00 0 psf Modulus of Elasticit : E = 2000 ksi E'= 2000 ksi FLOOR LOADING Read Provided Section Modulus: 52.26 in3 76.65 in3 Side 1 Side 2 Floor Live Load FLL = 666 psf 0 psf Floor Dead Load FDL = 310 psf 0 psf Floor Tributary Width FTW = 1 ft 0 ft Wall Load WALL = 0 plf Y• Comp. -L to Grain: Fc - -L = 750 psi Fc --L = 750 psi BEAM LOADING Controlling Moment: 14279 ft -Ib 5.375 ft from left support Created by combining all dead and live loads. Controlling Shear: 4782 Ib At a distance d from support. Created by combining all dead and live loads. Comparisons with required sections: Read Provided Section Modulus: 52.26 in3 76.65 in3 Area (Shear): 25.17 in2 63.44 in2 Moment of Inertia (deflection): 276.68 in4 277.87 in4 Moment: 14279 ft -Ib 20943 ft -Ib Shear. 4782 lb 12053 lb ��11�2.51k T Gl Beam Total Live Load: wL = 660 plf Beam Total Dead Load: wD = 310 plf Beam Self Weight: BSW = 19 pif Total Maximum Load: wT = 989 pif It 0 I J; 2? 2i Project: calc Hope Pilgrim St N Andover Job 17815 ` \4 -'Location: b21 four 925 deep LVLS �G Uniformly Loaded Floor Beam [2009 International Building Code(2012 NDS)] (4) 1.75 IN x 9.25 IN x 10.75 FT Versa -Lam 3100 Fb - Boise Cascade Section Adequate By: 66.9% Controlling Factor. Deflection ^ �ge Dan L. Gelinas PE [ph978.465.6436] Gelinas Structural Engineering LLC 579A North End Blvd or Salisbury MA 01952[danigelinas@comcast.net StruCalc Version 9.0.2.5 5/4/2017 8:12:09 PM ICAUTIONS I Laminations are to be fully connected to provide uniform transfer of loads to all members DEFLECTIONS Center Live Load 0.21 IN 1_/601 Dead Load 0.11 in Total Load 0.32 IN U401 Live Load Deflection Criteria: U360 Total Load Deflection Criteria: U240 REACTIONS A B Live Load 3548 Ib 3548 Ib Dead Load 1768 Ib 1768 ib Total Load 5316 Ib 5316 Ib Bearing Length 1.01 in 1.01 in BEAM DATA Cen er Span Length 10.75 ft Unbraced Length -Top 0 ft Floor Duration Factor 1.00 Notch Depth 0.00 MATERIAL PROPERTIES Versa -Lam 3100 Fb - Boise Cascade Base Values Adjusted Bending Stress: Fb = 3100 psi Fb' = 3191 psi Cd=1.00 CF= 1.03 Shear Stress: Fv = 285 psi Fv' = 285 psi Cd=1.00 Modulus of Elasticity: E = 2000 ksi E'= 2000 ksi Comp. J- to Grain: Fc -1= 750 psi Fc - -L'= 750 psi Controlling Moment: 14285 ft -Ib 5.375 ft from left support Created by combining all dead and live loads. Controlling Shear: 4571 Ib At a distance d from support. Created by combining all dead and live loads. Comparisons with required sections: Reo'd Provide Section Modulus: 53.72 in3 99.82 in3 Area (Shear): 24.06 in2 64.75 in2 Moment of Inertia (deflection): 276.68 in4 461.68 in4 Moment: 14285 ft -Ib 26544 ft -Ib Shear: 4571 Ib 12303 lb NOTES BEAM LOADING Side 1 Side 2 Floor Live Load FLL = 660 psf 0 psf Floor Dead Load FDL = 310 psf 0 psf Floor Tributary Width FTW = 1 ft 0 ft Wall Load WALL = 0 plf BEAM LOADING Beam Total Live Load: wL = 660 plf Beam Total Dead Load: wD = 310 plf Beam Self Weight: BSW = 19 pif Total Maximum Load: wT = 989 plf DANIEL L GELINAS STRUCTURAL No. 33994 Job 17816 May 4, 2017 Project: cafe Hope Pilgrim St N Andover Job 17815 '7 Page Dan L. Gelinas PE [ph978.465.6436] Location: header B22 2-2x12s Gelinas Structural Engineering LLC Uniformly Loaded Floor Beam 579A North End Blvd a� [2009 International Building Code(2012 NDS)] Salisbury MA 01952[danigelinas@comcast.net (2 ) 1.5 IN x 11.25 IN x 3.0 FT StruCalc Version 9.0.2.5 5/4/2017 8:40:03 PM #2 - Spruce -Pine -Fir - Dry Use Section Adequate By: 11.6% Controlling Factor. Shear * Laminations are to be fully connected to provide uniform transfer of loads to all members DEFLECTIONS Center LOADING DIAGRAM Live Load 0.01 IN U5274 Dead Load 0.00 in Total Load 0.01 IN U3334 Live Load Deflection Criteria: U360 Total Load Deflection Criteria: U240 REACTIONS A B Live Load 1750 Ib 1750 Ib Dead Load 1089 Ib 1089 Ib Total Load 2839 Ib 2839 Ib Bearing Length 2.23 in 2.23 in BEAM DATA Center Span Length 3 ft Unbraced Length -Top 0 ft aft — Floor Duration Factor 1.00 Notch Depth 0.00 MATERIAL PROPERTIES #2 - Spruce -Pine -Fir FLOOR LOADING Base Values Adjusted Side 1 Side 2 Bending Stress: Fb = 875 psi Fb' = 875 psi Floor Live Load FLL = 0 psf 0 psf Floor Dead Load FDL = 10 psf 0 psf Cd=1.00 CF= 1.00 Floor Tributary Width FTW = 12 ft 0 ft Shear Stress: Fv = 135 psi Fv' = 135 psi Cd=1.00 Point Live Load LL = 3500 Ib Modulus of Elasticity: E = 1400 ksi E'= 1400 ksi Point Dead Load DL= 1800 Ib Comp. -L to Grain: Fc - L = 425 psi Fc - 425 psi Point Load Location @ 1.5 ft Controlling Moment: 4117 ft -Ib Wall Load WALL = 0 plf 1.5 ft from left support Created by combining all dead and live loads. BEAM LOADING Controlling Shear: -2722 Ib Beam Total Live Load: wL = 0 plf At a distance d from support. Beam Total Dead Load: wD = 120 plf Created by combining all dead and live loads. Beam Self Weight: BSW = 6 plf Total Maximum Load: wT = 126 plf Comparisons with required sections: Read Provided Section Modulus: 56.46 in3 63.28 in3 Area (Shear): 30.24 in2 33.75 in2 Moment of Inertia (deflection): 25.62 in4 355.96 in4 Moment: 4117 ft -Ib 4614 ft -Ib Shear: -2722 lb 3038 lb ��'(1-4 C7FAA� DANIEL L GELINAS O STRUCTURAL No 33994 Job 17816 May 4, 2017 1 I�j�n1 122 ez'44 ,5fr'- 9 �& AVL- puo x I- . . - Project: calc Hope Pilgrim St N Andover Job 17815 s Dan L. Gelinas PE [ph978.465.64361 Location: header B22 LVLs Gelinas Structural Engineering LLC ! / Uniformly Loaded Floor Beam 579A North End Blvd (2009 International Building Code(2012 NDS)] Salisbury MA 01952[danigelinas@comcast.net ( 2 ) 1.75 IN x 7.25 IN x 3.0 FT StruCalc Version 9.0.2.5 5/4/2017 8:40:31 PM Versa -Lam 3100 Fb - Boise Cascade Section Adequate By: 74.4% Controlling Factor. Shear CAUTIONS Laminations are to be fully connected to provide uniform transfer of loads to all members DEFLECTIONS Cente Live Load 0.02 IN U2353 Dead Load 0.01 in Total Load 0.02 IN U1487 Live Load Deflection Criteria: U360 Total Load Deflection Criteria: U240 REACTIONS 6 B Live Load 1750 Ib 1750 Ib Dead Load 1091 Ib 1091 Ib Total Load 2841 Ib 2841 Ib Bearing Length 1.08 in 1.08 in BEAM DATA 4118 ft -Ib Center Span Length 3 ft Unbraced Length -Top 0 ft Floor Duration Factor 1.00 Notch Depth At a distance d from support. 0.00 MATERIAL PROPERTIES Versa -Lam 3100 Fb - Boise Cascade Beam Total Live Load: wL = Base Values Ad'usted Bending Stress: Fb = 3100 psi Fb' = 3279 psi plf Cd=1.00 CF= 1.06 BSW = Shear Stress: Fv = 285 psi Fv' = 285 psi wT = Cd=1.00 plf Modulus of Elasticity: E = 2000 ksi E'= 2000 ksi Comp. -L to Grain: Fc - = 750 psi Fc -1' = 750 psi Controlling Moment: 4118 ft -Ib 1.5 ft from left support Created by combining all dead and live loads. Controlling Shear: 2765 Ib At a distance d from support. Created by combining all dead and live loads. Comparisons with required sections: Read Provided Section Modulus: 15.07 in3 30.66 in3 Area (Shear): 14.55 int 25.38 in2 Moment of Inertia (deflection): 17.94 in4 111.15 in4 Moment: 4118 ft -lb 8377 ft -Ib Shear: 2765 lb 4821 Ib Floor Live Load FLL = Floor Dead Load FDL = Floor Tributary Width FTW = Point Live Load LL = Point Dead Load DL= Point Load Location @ Side 1 Side 2 0 psf 0 psf 10 psf 0 psf 12 ft 0 ft 3500 Ib 1800 Ib 1.5 ft Wall Load WALL = 0 plf BEAM LOADING Beam Total Live Load: wL = 0 plf Beam Total Dead Load: wD = 120 plf Beam Self Weight: BSW = 7 plf Total Maximum Load: wT = 127 plf rr! Job 17816 May 4, 2017 74b7 Date ///� ?// R ........ ,ORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... � .' .. Y- �'If � . ./ ............ has permission for gas installation ... P.< Z' 14 I -e- /1'" 14 . ..................... in the buildings of . ......................... at c: - ........... North Andover, Mass. Fee.W.) ...... Lic. 6AS INSPECTOR "'�� Check# 301 2,1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO (Print or Type) �fvj G 4 DO GASFITTING W9_18 AMID ER / Mass. Date � � � 26 yP�ermit # Building Location 56 P�L(Tki Ii � Owner's Name y15LJJA WAGE NA tit mm kmDeya' 10 HA Type of Occupancy_RES10!✓A}'f1AL StAIGLE New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ Installing Company Name BAY STATE GAS COMPANY D/6/A Check one: Certificate # Addr6ss 55 MARSTON STREET CDWHINA GA5 0f HASS4c,9U1MjfSU Corporation 1862 LAWRENCE, MA 01841-2312 ❑ Partnership Business Telephone q 7 IB— 6 8,7 '1105 Exr *306 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery �.. INSURANCE COVERAGE: I have a current liability Insoura❑nce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes If you have checked res, please indicate the type coverage by checking the appropriate box. A liability Insurance policy 1K Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent , Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in ab pplication are true and accu�te to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene s. (/ rAPPROVEDY(CO—F�FICCEE—USFE T e of License: Plumber Signature of Licensed Plumber or Gas WGasfitter Master License Number 374-5 wn Journeyman ONLY) s ONE No IMMEN unn Installing Company Name BAY STATE GAS COMPANY D/6/A Check one: Certificate # Addr6ss 55 MARSTON STREET CDWHINA GA5 0f HASS4c,9U1MjfSU Corporation 1862 LAWRENCE, MA 01841-2312 ❑ Partnership Business Telephone q 7 IB— 6 8,7 '1105 Exr *306 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery �.. INSURANCE COVERAGE: I have a current liability Insoura❑nce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes If you have checked res, please indicate the type coverage by checking the appropriate box. A liability Insurance policy 1K Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent , Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in ab pplication are true and accu�te to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene s. (/ rAPPROVEDY(CO—F�FICCEE—USFE T e of License: Plumber Signature of Licensed Plumber or Gas WGasfitter Master License Number 374-5 wn Journeyman ONLY) 2 - n U � W � N _Z r N N W tt n N O tt a ii MORELITi � r�o n z• r LL N J n z 0 o , 0 � r 41 r U � LL O W 2 0 Z D. a a o a IL 3 z to 0 a. 0 r w W m a a J f•' a .a CL a W � w a Z LL NI W S U F- W I X N ii MORELITi � r�o 7466 Date. ....... "ORT" ,ti0 Of ., •" o� ` °° TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION • � a SACMUSEtS� This certifies that ....%aj.s..`.....��5......... . has permission for gas installation ..%l/� .. A � X g �.,o /-. . . . in the buildings of ......................... at ...3...1��. 13.!'z ... .........., North Andover, Mass, Fee�J-.'.... Lic. No. �y..... ... y} s �........ G74S YCTOR Check # 7 U �) G MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Mass. Date A20 10 Permit # Building Location 3 P I L Grb M C'f Owner's Name.5W O ST�PN E NS UV...iZT�}A Type of Occupancy�(�EIIiY) A L - Si' tSCyLt G New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 018 4 1 - 23 12 Check one: X7 Corporation ❑ Partnership Business Telephone 9 7 IB — 6 8 ,7 -110 5 Exr *306 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery Certificate # 1862 INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked res, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy X Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent . Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in aboup pplication are true and accuWe to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will , n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (/ By T e of License. Plumber Signature of Licensed Plumber or Gas Title Gasfitter RMaster License Number Z74-5 City/Town Journeyman APPROVED OFFICE USE ONLY) son Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 018 4 1 - 23 12 Check one: X7 Corporation ❑ Partnership Business Telephone 9 7 IB — 6 8 ,7 -110 5 Exr *306 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery Certificate # 1862 INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked res, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy X Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent . Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in aboup pplication are true and accuWe to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will , n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (/ By T e of License. Plumber Signature of Licensed Plumber or Gas Title Gasfitter RMaster License Number Z74-5 City/Town Journeyman APPROVED OFFICE USE ONLY) Z O_ v� w CL N Z cn N w cc O O oC IL r, r uj a 't ,} Z n z_• 1- r /L N J n z o O C N r W r U � Z LL Wd O a .¢ a O SL I 3 Z � O O u Q yJj r W y r A. .a CL a W � W Q ' yWy Z N� W S v rI w x N r, r uj a 't ,} Z G (Print r Type) ••• -- ' •"•• wn rt`iiMIT TO DO ' ASFITTING Aile- Mass. Date % / g P ;:P,93 Building Location /L�,ei,,,, Owner's Name.�JT�t�,e Type of Occupancy New p r Renovation A---, Replacement Replacement p Plans Submitted: Yesp No 1� ❑ SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR N ' W cc N C mN~d = nV>hS'ttO Oa p W O ' 0 In IU YOH <�' U, p OW fX W aW Oy . W ~WZ W � o} U. Wyf aZ Ox W cc v+ xW W Cr , < O O W W U. c d r o Installing Company Name. BAY STATE GAS . COMPANY Addr&s 55 MARSTOW CTuWOm LAWRENCE; MA 01840 Business Telephone 508-687-:1105 Name of Licensed Plumber or Gas Fitter Francis X. Corke Check one: X_] Corporation ❑ Partnership ❑ Flan/Co. Certificate # 1862 INSURANCE COVERAGE: have a cumentliability insurance policy or its substantial . Yes No p equivalent which meets the requirements of MGL Ch. 142 U you have checked yes. please Indicate the type coverage by checking the appropriate box. A flabli ty insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S. INSURANCE WAIVER: i am aware that the licenseedoes not have the insurance coverage required b Chapter 142 of the Mass. General Laws, and that my signature on this permit Y application waives this requirement. Check one: lure o Owner or Owner s Agent Owner❑ Agent ❑ I hereby certify that all oppf�� the details and information I have submitted (or entered) in PwUnmt provisions of 9 Mass mbing work and installations Performed under the perms nation are true and soca to to the best of my t3y Massachusetts State Gas tide and Chapter IS of the this appiicatbn wllU n pica an T ��: Title �na are o um r or ibFF`t Jo�urne�an Ucense Number 8697 cF'II�ZiNL4i-- JI z 0 z N n x- a w N 0 � D I w O a ac 0 0 IL a. 3 z O 0 w Q CA ca IL CL i w 9L N w Q z cj d w x N JI z 0 z N � I a 0 I w CL N Q d au w r t7 c r a w a w I. O. O InIL n a 0 a co A Ivy 1, 3.7 7 Date...I�... ... TOWN OF NORTH ANDOVER = PERMIT FOR WIRING a 8 io This certifies that ...... �..� �!.a.`!....... .w...e............................ has permission to perform ...... wiring in the building of 7v .... C .(Z. .t..�' f .......................CCR ................ .... . 7 %� o �.......d.:.l....,�! G� .................. . North Andover, Masi; Fee..,,J.S -oa) Lic. No .1.. , l ............................................................... ELECTRICAL INSPECTOR C � R 39J-3 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer u4t l!ommnnweulth at 6ar4use s, "gs tree trrfry 137e7 permit �,-- Ecpttritncctt of Public $nfcrg pankef� occucy ♦ Fee 0oc� BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 Peaw bi np APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Q* or Town of NORTH ANDOVER To the Inspector of Wires-., The udersigned applies for a permit t Oct m trw electrical wo descrO d below, Location (Street 3 Number) Owner or Tenant -k-7 Owner's Address 13 this permit. in conj with a buil ing mit: Yes _ �NI (Check Appropriate Razi Purpose of Builds g Utility Authorization No 0' 11"( Existing Service too Amp S1 �_)'(D_jo��VoiIs Overhead "' Undgrnd F1No. of Melers �.�; • New Service AmPs�o�o ' IVolts Overhead Und rna 9 C No. of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical WorK No. of Lignting Outlets I No. of Hot '.cs I No. of Transformers Total KVA No. of Lignttng Pictures i Swimming Pco, Aocve.— :n- 7 grra _ grno. _ I Generators KVA No. of Receotacte Outlets I No. of Oil corners I No. of Emergency Lighting Battery Units No. of Switch Outlets I No. or Gas _ :rrers FIRE ALARMS No. of Zonee No. of Ranges I No. CI Air C.:r.c. O1di No. of Detection and Cns Initiating Devices No: of Disoosats I No.of Heal Tota' --otat aur'=s -ons KW No. of Sounding Devices No. Of Oishwasners SoaCeiArea rileatiro K\•/ No. of Seif Contained OeleCttOM$Ounding Devices No. of Oryers I Heating Cev.ces KW Local — Municipal ^Other Connection ' Sig of NU 1: NO. of Water Heaters KW Signs 9a las:s Low Voltage i Wiring No. Hybro Massage Tuos ' I No. of Moicrs alai HP OTHER: INSURANCE COVERAGE. Pursuant :o the reouiremenis --i '.tassacni-secs ;enerat Laws I have a current Liability Insurance Policy inciuoing C„mc:efec Cceraiions Coverage or have submittab valid proof of same to Office. its substantial equivalent, Yt:g — NO I the YES = VO = If you nave checked cnecking the approonate box. YES. pteaae inoicate the type of coverage sly INSURANCE = aONO = OTHER = tPlease Scec:..0 Estimated Value of Voctncal Work S (Exotration Oatei Work to Start Insoec:ion Date �aci.es:ec: Rough Final Signed under the.Penait.s of Penury. FIRM NAME ll LicenseeHca 144UC. NO. LIC. NO..�� Address l Sus. Tel. No. All. Tel. NO, i OWNER'S INSURANCE WAIVER: I am aware That the L:censee toes not nave ine insurance coverage or Its substantial equivalent as rw 4111611100 by Massachusetts General Laws: ano that my sig aturs Jn :^,is cermit application waives this requiremM6 Owner Agent )Piesis Cnetk one) sieonone No. '0 � PERMIT FEE •- lS�q stir of Owner or Agent) S sMYt 2859 Date.-'.�!...�.� •••• 0 NORTH TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION S This certifies that . �'.. •- g has permission for gas i stallation-- D— in the buildings"of......... • • • • • • • e at .. —a. (L'2Z�o... North Andover, Mass. Lic. No... .F,%... .......................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer C m O N Z D O m O Z m A 0 A D Z N r3 m c O N i m m m m \o D z "U \ O D m A lmm v m m c r 0 z O A D >'o m O O m m m m N Oi fir. r N O 0 m N O o N N N w m N N m a T -1 i -1 Z O n V O O O A GI GI L1 � 3 i N m 0 Z i i i O � Mm 0 co 3 � z N c n 0 Z N w ro M z N O* A O p m D m D -nl 0 ? r m C r O O ? 0 3 o N c r �_ Z O r Oi m 0 z N C r O_ Z O O 0 0 z y C r O_ Z O m D D O 'n r Oi o D I Z m A 3 r N I o D Z m A 3 A m i o D Z m 0 z3 m m N i � o m p m A N Z m D = i n i N z D m O m A N D O A m N 0 m A N Z D m r O -�.{ Z rS W N Z m 3 Z 0 u)r c 0 D z m o c N m\ O AGI Z 0 m m z N , Z 0. 0 n 0 m � AO Z D G) A m D A \ m p V W N m C r 0 L1 0 Z Z D i m v N m C r 0 O 0 Z N m -ni m o N m C r o O 0 Z -ni m v N m c r O O z= N O O 0 A 3 D i m A n P 0 z j N N m Om m 0 1 Z O x m G1 = p m m p c z0 O Z 0 A m N T N O m Z N o N 0 N r N m z N ND m 0 m O O A i 3 A N m m 3 Z i 0 A N D m m Z p 0 N i A0 N A C A 0 -i m c r c O N m n ;u 0 CTI < Z 0 D i M r O n N r z m 0 0 iE z m * m A 0 0 * z y i m A T r Om r Z O 1 t x - N z v N m _ v _ O D m n x � z N 0 O SII m ro M z N 0 G1 N N N r N m MM nN DO rnZZ v°c M m N ;ax -i D 0i0 Nv mim • mx —IzD ILn0 NO° ;uz_ mN3 0 D', N _ m C_ W0 (AC-r p rr!20 O6)r Z vN0 r D*D m Z:iZ A I� O MD v 0z In mm cn m M D0 Location / U4 J No. %� r Date N�RTN TOWN OF NORTH ANDOVER Certificate of Occupancy $ ;743 CHU tt� Building/Frame Permit Fee $ � s�cHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $� Check # 15841 /Building Inspector .it The Commonwealth of Massachusetts Lot Area (sq) j + r�(� rromagetn/ �l U State Board of Building Regulations and TOWN OF NORTH ANDOVER Standards BUILDING DEPARTMENT Massachusetts State Building code Provided 780 CMR Provides APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OF OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Building Permit Number: l a- q I Date Issued: L Signature: Building Commissioner/Inspector of Buildings Date SECTION i- SITE INFORMATION 1.1 Property A�.ress: , 1.2 Assessors Map and Parcel Number. A t n I 4pi Map Number Parcel Number e ZoningDistrict Proposed Use Lot Area (sq) j + r�(� rromagetn/ �l U 1.6 Building Setback ft. Front Yard Side Yard Rear Yazd Required Provided Required Provides Required Provided Address Expiration Date Signature Telephone 107 Water Supply 9M.G.L.C.40.4 § 54) PuPrivate a b c L5. Flood Zone Information: Zone n Outside Flood Zone a 1.8 Sewerage Disposal System: Municipals C On Site Disposal System 2.1 Owner of Record Name (Print) Address: �c�s ►3c�� ,�e-; I s. 'Y, Signature Telephone , ` 9S 2.2 Authorized Agent: Name (Print Address Signature Telephone QPrTInNA CnNQTV1T1-T1nN 1,FRV1rPQ M12 P12n1VrT r FCC THAN 2C firm r 1TnT ` VVVT nv rNry nQVn QPAPV 3.1 Licensed Construction Supervisor: Not Applicable Q Licensed Construction Supervisor: License Number Addfiess Expiration Date Sign;J\ture Telephone 3.2 Registered Home Improvement Contractor: Not Applicable Q Company Name Registration Number Address Expiration Date Signature Telephone tcevlsea tyyi jtnt, SECTION 6 - DESCRIPTION OF PROPOSED WORK check all applicable) F-1 F-2 New Construction 0 Existing Building [3 1 Repairs— Alterations E3 Addition 13 Accessory Bldg. 0 1 Demolition 0 1 Other 13 Specify Brief Descri tion of Proposed : t� .cMe✓� w_ [G°l bel G,7 n S : in < 4 vAe., -) R Residential [ R-1 R-2 R-3 S Storage Q S-1 S-2 U Utility [3 Specify: SECTION 7 - USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable) A Assembly A-1 A-2 A-3 A-4 A-5 B Business 13 E Educational El F Factory 0 F-1 F-2 H High Hazard 0 IB I Institutional 0 I-1 I-2 I-3 M Mercantile 2B R Residential [ R-1 R-2 R-3 S Storage Q S-1 S-2 U Utility [3 Specify: M Mixed Use Q Specify: S Special 13 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS. ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index (780 CMR 34) SECTION 8 - Building Height and Area BUILDING AREA Number of Floors or stories include basement levels Floor Area per Floor (sf) Total Area (sf) Total Height (ft) CONSTRUCTION TYPE IA 0 IB 0 2A Q 2B Q 2C 0 3A E3 3B El 4 Q 5A 0 5B Q Proposed Hazard Index (780 CMR 34) Existing (if applicable) Proposed SECTION 9 - STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 10a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , As Owner of subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date revised bldg form/state JMC SECTION 10b - OWNER/AUTHORIZED AGENT DECLARATION as Owner/Authorized Agent hereby declare that the statements an information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. 'ro C. fti Print Name of Owner/. SECTION 11 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be completed b permit applicant 1. Building 2. Electrical 3. Plumbing 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1+2+3+4+5' Official Use Only (a) Building Permit Fee Multiplier (b) Estimated Total Cost of Construction from (6) Building Permit Fee (a)x(b)• Check Number m m m m 0 m CO) CD 5Z Z CD O CL nco O v CL C CD O c CCD C:' O CO CD CA CD a O 7 CA O O n C O C CO) d CD O rM CD CD y� CD CO) O Z CCD 0 CD FA n O cn 2 O C cameo l CO cr CR n ® oc m CA O::t® CO's ® C) H C) n C) 177 Z ® . O y O� .d► ® HCL 0 T s o n � lv y O -I O O CO) O --, O 3E m m mCA CD n cc O OZ CA �CC2 CD o. a oCL �o CD C0 CD :1o� cCL toCD � m O fA H a d Cr H �l C s an C, N O fA m -, m d N > (jo co o m =rCD O�O CD ?: f m =m =,caCD dam' :♦: O m o, 03 -O n � n� * COO Al cm 9 * * I O 13 All W r M o w o m 70 0 zD gi o ::r ir1 n 0 ro o OC G Z M ?� p w - vn o CDr' d cn ., p W r M o w o � H -p p W gi o ::r ir1 n 0 ro o OC G Z M ?� p w - n � o OCN o .G7 r z �? M cn ^• CD: CD i3 o 0. x � O d O x The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Location: City r ' (A Nk-4e C' Phone 0 %c� 9 � �' 9 -SO 7 � am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: City: Phone #: Insurance Co. Policv # Company name: Address City: Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and'correct. Signatu r, /C,dG Print name Cx'k�s toy�'G� C,� C ` Phone # 7�S 9 Ve- 9S (J7 Official use only do not write in this area to be completed by city or town official' Building Dept ❑Check if immediate response is required Building Dept p Licensing Board p Selectman's Office Contact person: Phone #: Health Department ❑ Other FORM WORKMAN'S COMPENSATION North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: (Location of Facil Ln-� Si6n.aure of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector m m m m V/ V/ 0 C � CO2 C) cm CD a Z CA CD O CL c) CO � O CL = CO) o C.) 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