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HomeMy WebLinkAboutMiscellaneous - 36 EMPIRE DRIVE 4/30/2018This certifies that ...,), .-�f�`�-a .................... has permission to perform ........................... plumbing in the buildings of. ....................... at . �l .. ��s.ri�......... . Fee / 1,, a.. Lic. Nq.1-�,� . . Check # ,� W�) ........,. , North Ando v r, Mass. 1 PLUMBING INSPECTOR MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY I North ANdover MA DATE 5/15/2013 7 PERMIT # JOBSITE ADDRESS 36 Empire drive OWNER'S NAMEJ Nelson P OWNER ADDRESS TELI IFAX TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL Q PRINT CLEARLY NEW: ] RENOVATION: ❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO❑ FIXTURES Z FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR / AREA DRAIN ,INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY 1 ROOF DRAIN SHOWER STALL 1 SERVICE / MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: 1 have a current liabllitv insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES NO 0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ 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 accto the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance vd all rti nt provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 41 PLUMBER'S NAME Mike Capeless LICENSE # 15851 f RE MPD JP❑ CORPORATION❑#PARTNERSHIP❑ LLC COMPANY NAMEI Boiler Guy/Mike Capeless ADDRESS F160A Pleasant st CITY I North Andover STATE ma ZIP 101845 TEL 19783821017 FAXI I CELL I EMAIL VVIYIjYIV IY YYv III v1 If�vv�. v...vv�♦ .� ` TEI LICENSEDUlu 4"19 -1806 AS A'MARPLUMBER ISSUES THE ABOVE LICENSE TO: MICHAEL 14 CAPELESS 105 TYLER s,r N METHUE14 MA 01844-1905 15851 [15/01/14 176378 A6C>R b® CERTIFICATE OF LIABILITY INSURANCE °A04i18/20'3"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Matthews Insurance Agency Inc 182 Parker St CONACT NAME: PHONE , (978) 681-1112JAIC. No FAx AIC No (978) 685-3855 MAIL ADDRESS: Lawrence, MA 01843 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Atlantic Casualty I MED EXP (Any one person) $ 1,000 INSURED Michael Capeless 105 Tyler St Methuen, MA 01844 INSURER B: Arbella INSURER C: INSURER O: is INSURER E: AUTOMOBILE 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. 1�TR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MOILDDY EFF MMID Y EXP LIMITS ,i GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1�1 OCCUR L143000684 i 08/07/2012 10810712013 I EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence)$ 100,000 I MED EXP (Any one person) $ 1,000 PERSONAL& ADVINJURY i$ 1,000,000 GENERAL AGGREGATE Is 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER : POLICY PRO- LOC PRODUCTS - COMP/OPAGG $ 1,000,000 is AUTOMOBILE LIABILITY ANY AUTO AUTOSCHEDULED OWNEDALL AUTOS NON -OWNED HIRED AUTOS AUTOS IHC357357 1 08/30/2012 08/30/2013 I COMaccident)BINED SINGLE LIMIT Ea BODILY INJURY (Per person) $ 300,000 BODILY INJURY (Per accidenq $ 300,000 PROPERTY DAMAGE $ 300,000 Per accident $ UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR X1111463 - 02/23/2013 02/23/2014 EACH OCCURRENCE $ 1,000,000 AGGREGATE S 1,000,000 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN`IR ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, tleseribe under DESCRIPTION OF OPERATIONS below N I A 890911-0937696 I 111/17/2012 11/17/2013 WC STATU• 70TH - E.L. EACH ACCIDENT S 100,000 E.L. DISEASE - EA EMPLOYEE S 100,000 E.L. DISEASE -POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Heating or combined heating and air conditioning systems or equipment, installation, servicing or repair, plumbing CERTIFICATE HOLDER RAtdf'=1 I ATIn K1 Town Of North Andover -------------- North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATN --4� ©1968-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Date ...0A 0A .............. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......................................... has permission to perform ,EJ ........ r.................................................................................. wiring in the building of ................................................................................ at &i� & ..................................... North Andover, Mass. e--,-.) .. ................ ............. ( ..... . .. .. ....... ........ CAL INSP OR Check# A21D ELELqq5 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 11 1 1 Z -- Occupancy and Fee Checked [Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL )NFORMATION) Date: S = F' I.3 City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 3 6 Owner or Tenant A1741-11- Telephone No. WORK Owner's Address FM Is this permit in conjunction with a building permit? Yes YJ No ❑ (Check Appropriate Box) Purpose of Building _) 60 � L L-) h 6-- 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: Completion of thefollowing table may be waived by the Inspector of Wires. IN, No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans s Total of Trsformers KVA Tran No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- Elo. rnd. rnd. o meLighting Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ran es g No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers P Heat Pump Totals: Number .... Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Systems:* SecuritNo. o or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications No. of Devices or E u valent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. -Estimated Value of Electrical Work: (When required by municipal policy.) 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 Nl undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) 00 I certify, tinder the pains and penalties of erjury, that the information on this application is true and complete. r" FIRM NAME: - �U i9 n !> >9 c� — IL LIC. NO.: 6 y b 7 ) Licensee: 5171YWe Signature LIC. NO.:/7d/ 8Yt--' (If applicable, enter "exem t" 'n the license mer lin .) •p Bus. Tel. No.: Address: /V31 , C � rm Yel yo, Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security w6rr< requires Dopartiront 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. $ j 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 shallbelimited 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 n Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass [N Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH IN PECTION: Pass Failed Re- Inspection Required ($.) ❑ Inspec ors Co m nts: .i Inspectors gnature: Date: FINAL INSPECT N: Pass Faile Re- Inspection Required ($.) ❑ Inspectors Comments: o, Inspectors Signature: �'cc-c.cpQ /i�lCu Date: "z_. ��— 'd The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 7 ►� Please Print Legibly Name (Business/Organization/Individual):_) (,IJ 4,0-J �JJ-Q 6 P, Address: City/State/Zip; Phone #: Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2.I am a sole proprietor or partner- listed on the attached sheet 10 ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. Y tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company 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 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 L4vestigations of the DIA for insurance coverage verification. I do hereby certlfv under thepains andpenalties o -"perjury that the information provided above is true and correct. -QionnfirrA. J d We,� e7 -Y "-ii nate. S-�-- 13 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - Contact Phone K Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to..carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The 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 Commonwealth of Massachusetts Department of Industrial Accidents, Office of Investigations 600 Washington Street Boston, MA. 02111 Tel, # 617-727-4900 ext 406 or 1-877,7MASSAFB Revised 5-26-05 Fax # 617-727-7749 wwwanass,gov/dia 211 Date ..LP .1 � ........ n,40RTiq TOWN OF NORTH ANDOVER PERMIT FOR MECHANICAL INSTALLATION wwo This certifies that . I.: ! lop'. ri C - e. has permission for mechanical installation .... . in the buildings of . r '1��:� .................... at .. :�(. x! :'. ....... North Andover, Mass. Fee. Lic. NoJ.P)?.).... M.0 ...................... GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer r Commonwealth of Massachusetts Sheet Metal Permit Date: Estimated Job Cost: $ Plans Submitted: YES NO Business License # Business Information: NameM[Y-C Street: � o A ;) (..-t5A<A nT <T City/Town: iso ( A�AWL&2 Telephone: 7 39j -1() C _? Permit # (f' 1' Permit Fee: $6 6/ Plans Reviewed: YES NO Applicant License # e(6 q'5 Property Owner / Job Location Information: Name: , �J b _C Street: City/Town: Telephone: Photo I.D. required / Copy of Photo I.D. attached: YES NO Staff Initial J-1 / M -1 -unrestricted license J-2 / M -2 -restricted to dwellings 3 -stories or less and commercial up to 10,000 sq. ft. / 2 -stories or less Residential: 1-2 family � Multi -family Condo / Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. I-- over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney / Vents Air Balancing Provide detailed description of work to be done: wi ` INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes,0o ❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policyAL Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box[], I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be In compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Date Date By Title Cityrrown Permit # Fee $ Duct Inspection required prior to insulation installation: YES NO Inspector Signature of Permit Approval Progress Inspections Comments Final Inspection Comments 06uster ❑ Master -Restricted C_�^ ❑Joumeyperson Signature of Licensee ❑Joumeyperson-Restricted License Number: 6 k ❑ Check at www.mass.gov/dpl Page 1 of 2 Mike@boiler-guycom From: "William Souza" <souzahvac�ja gmail.com> Date: Thursday, May 23, 2013 3:16 PM To: <mike@boiler-guy.com> Attach: North Andover.txt Subject: Heating and Cooling Loads for Project: North Andover Sent from my iPad HVAC COOLING AND HEATING LOAD BREAKDOWNS 1) Room Name A Room Project: North Andover Location: North Andover Ma, Massachusetts L, H & W in decimal feet and gross SgFt areas Length Height or Width Gross Area Length Height or Width Gross Area 6/4/2013 Indoor db Heating 70.0 Latitude 42N DR Medium 2) Exposed Wall Indoor db Cooling 72.0 99% db 0.0 HTD 70.0 3) Partition Indoor RH Cooling 67.0% 1% db 87.0 CTD 15.0 4) Floor Elevation 148.0 Grains 94.4 ACF 1.0 5) Ceiling Slope > Construction Number Direction & Details Net Area Heating Load Cooling Load Net Area Heating Load Cooling Load 6A Window & Glass Doors A IA -c (Window) 42.0 7,276.5 2,268.0 B IA -c (Window)15.0 1,086.8 465.8 C IA -c (Window)15.0 1,086.8 465.8 6B Skylights A Skylight (North) 10.0 917.0 1,730.0 7 Wood & Metal Doors A 8 Above Grade Walls P 12E -0s w (Large Room Wall #4)145.0 690.2 88.7 M 12E -Os w (Small Room Wall #1) 48.0 228.5 29.4 O 12E -0s w (Small Room Wall #2) 106.0 504.6 64.9 P 12E -Os w (Small Room Wall #3) 137.0 652.1 83.8 8 Partition Walls G None (Bathroom Wall #4) 64.0 0.0 0.0 Q None (Small Room Wail #4)148.0 0.0 0.0 9 Below Grade Walls D 15A19-Oocw-x (Bathroom Wall #1) 64.0 308.0 22.7 E 15A19-Oocw-x (Bathroom Wall #2) 52.0 250.3 18.4 F 15A19-Oocw-x (Bathroom Wall #3) 52.0 250.3 18.4 H 15A19-0ocw-x (Large Room Wall #1) 168.0 808.5 59.5 J 15A19-oocw-x (Large Room Wall #2) 72.0 346.5 25.5 K 15A19-0ocw-x (Large Room Wall #3) 726.0 1,931.2 0.0 10 Ceilings A 16B-19 (Bathroom Ceiling) 52.0 178.4 127.4 B 16B-19 (Large Room Ceiling) 660.0 2,263.8 1,617.0 C 1613-19 (Small Room ceiling) 342.0 1,173.1 837.9 10 Partition Ceilings A I IA Floors A 12 Infiltration A Envelope Leakage Tight Infil Airflow for Heating 21.3 1,635.4 175.2 WAR 64.4 6.9 Gross exposed wall area for WAR: 508.0 B No of Fireplaces 0 Infil Airflow for Cooling 10.7 0.04 13 Internal Gains A Number of bedrooms 0 # Occupants > 1200.0 # Occ > 1200.0 One occupant = 200.0 sensible load B Appliance Gains 1,200.0 Appliance Load > 1,000.0 14 Sub Totals 21,587.6 9,498.3 64.4 1,206.9 15 Duct Loss / Gain Factors > 10.0 2,434.7 1,179.7 16 Ventilation Airflow for this job > 36.0 2,759.7 591.4 19 Blower Heat Gain Manufacturefs performance data has blower heat 1,707.0 20 Total Sensible Loss or Gain (sum lines 14 through 20) 26,782.0 12,976.4 64.4 1,206.9 21 A) Latent Infiltration Gain 111.4 4.4 B) Latent for Occupants (One occupant = 250.0) 250.0 250.0 C) Latent Ventilation Gain 375.9 , D) Total Latent Gain (Btuh) 737.3 254.4 Phone: , Fax: , Email: E) Total Cooling and Heating Loads (Btuh) 26,782.0 13,713.7 64.4 1,461.3 Sent from my 1Pad Page 2 of 2 6/4/2013 __9w9 M t 1.1v R9' I I I wo tv"j" 1 9 •;a SHEET METAL WORKERS AS A MASTER -UNRESTRICTED 1HE ikm()V;.Jt:i' ! r 10: MICHAEL N CAPELESS 105 TYLER ST METHUEN MA 01844-1905 645 09/28/13 69476 AC�6R b® CERTIFICATE OF LIABILITY INSURANCE °A041 8/201' 3Y' 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 Matthews Insurance Agency Inc 182 Parker St ACT NAME: PHONE (978) 681-1112 FAX (978) 685-3855 ac ND E -Mal ADDRESS: Lawrence, MA 01843 INSURERS AFFORDING COVERAGE NAIC p INSURER A: Atlantic Casualty INSURED Michael Capeless 105 Tyler St Methuen, MA01844 INSURER B: Arbella INSURER C: COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR INSURER D: INSURER E: 08/07/2012 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 INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR L143000684 08/07/2012 DAMAGE TO RENTED 100,000 08/07/2013 PREME Ea occurr nee $ MED EXP (Any one person) 1 $ 1,000 PERSONALBADV INJURY 1 $ 1,000,000 GENERAL AGGREGATE 1$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:1 I _ ,PRODUCTS • COMP/OP AGG $ ,000,000 POLICY PRO- JFCT r7 LOC I $ AUTOMOBILE LIABILITY I Ea aBcINEDISINGLE LIMIT BODILY INJURY (Per person) $ 300,000 ANY AUTO HC357357 08/30/2012 108/30/2013 ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ 300,000 NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ 300,000 (Per accident) $ UMBRELLA UAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS UAB x1111463 02/23/2013 02/23/2014 DED RETENTION $ $ WORKERS COMPENSATION I WC STATU- O R AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N 1 A 890911-0937696 111/17/2012 11/17/2013 E.L. EACH ACCIDENT S 100,000 E.L. DISEASE - EA EMPLOYEE S 100,000 E.L. DISEASE . POLICY LIMIT I 5 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Heating or combined heating and air conditioning systems or equipment, installation, servicing or repair, plumbing CERTIFICATE HOLDER cehlral 1 ATlnm Town Of North Andover -------------•- North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIV j� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 90.:) TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING Iv\cam- t lvH This certifies that 6.q ..� . �................... has permission to perform ..H.-� Lt- ................... plumbing in the buildings of .. Q>R,0.u!kti4..V1.L1 1.<,,�7......... at .............. North Andover, Mass. eeF�. ...... PLUMBING INSPECTO Check # 7 t{ 6�0 t PLUMBING: PIPING — FIXTURES - FIXED APPLIANCES — APPURTENANCES 1 ENTER TOTAL AMOUNT FOR EACH SELECTION (LIMITED TO FIVE (5) NUMERALS ALTERNATIVE TECHNOLOGYDISPOSER MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO PLUMBING SINK: MOP SERVICE CITY/TOWN: - -- - - APPLICATION DATE:' .7 DRINKING FOUNTAIN JOB ADDRESS: PLANS SUBMITTED: YES[] NO[:] POCCUPANCY TYPE: COMMERCIAL❑ RESIDENTIAL STORAGETANK NEW VT ALTERATION[] REPLACEMENT REMOVAUDEMOLITION® t PLUMBING: PIPING — FIXTURES - FIXED APPLIANCES — APPURTENANCES 1 ENTER TOTAL AMOUNT FOR EACH SELECTION (LIMITED TO FIVE (5) NUMERALS ALTERNATIVE TECHNOLOGYDISPOSER SINK: MOP SERVICE ASPIRATOR DRINKING FOUNTAIN STERILIZER DRAIN: AREAD FLOOR EJECTOR [j STORAGETANK BACKWATER VALVE EMBALMING AUTOPSY URINAL BAPTISM: FONT SACRARIUM FOOD CHEST MISTING SYSTEM VACUUM DRAINAGE SYSTEM BAR SINK GLASS WASHER WATER CLOSET BATHTUBW WHIRLPOOL ICE MAKER WATER HEATER: ALL TYPES BIDET INTERCEPTOR: ALL INTERIOR WATER PIPING: CROSS CONNECTION DEVICE KITCHEN SINK T OTHER NOT LISTED Z DEDICATED: ACID WASTE SYSTEM LAUNDRY CONNECTION DEDICATED: GASIOIUSAND SYSTEM LAVATORY DEDICATED: GREASE SYSTEM PIPE RELINING WORK ONLY o DEDICATED: RECLAIMED WATER ROOF DRAIN 0 DENTAL FIXTURE I EQUIPMENT SINK: 1-2-3 BAYFI PREP. DISHWASHER SINK: CLINIC FLUSH RIM PLUMBING INSTALLER - FIRM -COMPANY INFORMATION j Galinsky Plumbing & Heating Inc P O Box 1701 NAME. --- - ADDRESS: Haverhill_ e i MA CITY: -- - ---.�� ��-�n__+STATE: S ZIP: N01831`�p_,._,- ! -521.41 mrplumber@aol.com = _M7 -521 EMAIL! NAME OF LICENSED PLUMBER: CHECK ONE ONLY aCorporation Business # alas ❑ Partnership Business #E�-� #0 ❑LLC Business978-374-1743 ❑DBA /Unincorporated 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. A liability insurance policy PI 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY OWNER® AGENT Signature of Owner or Owner's Agent OWNER'S NAME: ir_ `TEL• FAX:' I hereby certify that all of the details and information I have submitted (or entered) regarding this permit application is true and accurate to the best of my knowledge. I certify that all plumbing work and installations performed under the permit issued, will be in compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code, and Chapter 142 of the General Laws. (OFFICE USE ONLY) TYPE OF LICENSE: Permit # ❑ Plumber Inspector ❑ Master Fee: ❑ Journeyman $sBZ. s6 re of Licen%tITPlumber License Number:'10348 O z z 0 F U w 44 vi z a z w orl z z O o w � w W o w a ,� z 3 w I -- co u > o w a ui 30 zo aa.� a � w a � U J d a- < Q N I11 = W H LL w F 0 z z 0 F U w a z u z a a a x a 0 x 7 7 53 Date .. ....... TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION This certifies that ..6 :�1J; GOCCUPANCY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO GAS FITTING CITY/TOWN. _..�_l"�l_L V _. _ . I D� Q r.. _ .._. STATE: MA APPLICATION DATE JOB ADDRESS: L,,, ... 2 TYPE: COMMERCIAL F� RESIDENTIAL PLANS SUBMITTED: YES ❑ NO NEW® ALTERATION REPLACEMENT[] REMOVAUDEMOLITION[] r NATURAL & LIQUEFIED PETROLEUM GAS: PIPING - EQUIPMENT - APPLIANCES - SYSTEMS Z ENTER TOTAL AMOUNT FOR EACH SELECTION (LIMITED TO FIVE (5) NUMERALS AIR ROTATION UNIT FURNACE: ALL TYPES TEMP HEATING EQUIPMENT BOILER: ALL TYPES GAS PIPING THERMAL OXIDIZER BOOSTER gig GENERATOR STATIONARY ENGINE TURBINE BROILER ILLUMINATING APPLIANCE UNIT HEATER BURNER: ALL TYPES INCINERATOR WATER HEATER: ALL TYPES JL CO -GENERATION UNIT INDUSTRIAL AIR HANDLER EQUIPMENT OVER 12 500MBH COFFEE ROASTER INFRARED HEATER rOTHER NOT LISTED? COOK APPLIANCE HOUSEHOLD KILN !GLORY HOLE /CRUCIBLE COOK APPLIANCE COMMERCIAL LABORATORY COCKS DECORATIVE APPLIANCE MAKEUP AIR UNIT DIRECT VENT APPLIANCE MECHANICAL EXHAUST EQUIPMENT DRYER: ALL TYPES OVEN: ALL TYPES FIREPLACE: VENTED/ UNVENTED POOL NEATER FRYOLATOR ROOF TOP UNIT FUEL CELL ROOM HEATER-VENTEDNENTLESS PLUMBING / GAS FITTING FIRM -INFORMATION CHECK ONE ONLY NAME: Galinsky Plumbing & Heating Inc ADDRESS: P O Box 1701 ❑✓ Corporation Business# stns _..ox�.- -= -- — — — ®Partnership Business#0 CITY: HaverhillT _- -Y__--- _. _ STATE: t++tA iZIP. ; 1)183831 �' �` — ❑LLC Business # 978-374-1743 i FAX. Mrpl2mber@aol.com TEL: ! — - 978 521-41 s EMAIL: pllumber@aol.com I nDBA1Unincorporated NAME OF LICENSED PLUMBER / GAS FITTER: INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES n NO If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ®✓ Other type of indemnity F Bond El 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 ® AGENT Signature of Owner or Owner's Agent --------- ---- - --- __— ----- — — ------ _--- ---x OWNER'S NAME: TEL FAX I hereby certify that all of the details and information I have submitted (or entered) regarding this permit application is true and accurate to the best of my knowledge. I certify that all plumbing work and installations performed under the permit issued, will be in compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code, and Chapter 142 of the General Laws. (OFFICE USE ONLY) Type of License: Permit # Q✓ Plumber r -j Gasfitter Q✓ Master Journeyman Signature of Licensed Plumber/ Gas Fitter Inspector _.._—-------_—__— �10348 i Fee: ❑Undiluted LP Installer License Number: t Limited LP Installer 4/oo,00 H O z z 0 H U w a. z z w z El CD z }❑ o w a w O w a 4 z u = 3 o a W a a W o L d 0 a o a � w a � U J d �A Q 2 W F LL W 0 z z 0 F U W Fr z c� x a 0 a t I 10 2 1 8 Date ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... An ....... " T"f 4�� . .............. has permission to perform ........ ............................. wiring in the building of ................... ...... ............ .................................. at ....... �..G ....... Alt .............. 'Northdove 'Am r, Mass. iNECTOe Check # ZI ME SP Fee ..................... c. No. 3o . ............ �\ C.ornmonwealth o�cc7�a�ac�e� aLJeparimen�` o�.}ire �ervice� 60 BOARD OF FIRE PREVENTION REGULATIONS Official Use Only al� Permit No. l.�-' 2 03 Occupancy and Fee Checked .[Rev- 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT RV INK OR TYPE ALL INFORMATION) Date: City or Town of: —=y , , " -t . To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Ai f' Z .-, , Owner or TenantTelephone No. Owner's Address 2 ry Is this permit in conjunction with a building pe it? Yes No ❑ (Check Appropriate Box) Purpose of Building `� ✓ <� Utility Authorization No. -�3l Z r1 Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Ot/ Amps 1�i /Z yG Volts Overhead ❑ Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans o. of 7otal Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool nd, Above 11 in -d. El 0. Units o. o cy ng No. of Receptacle Outlets No. of OR Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detec"on an Initiating Devices No. of Ranges No. of Air Cond. Ton l No. of Alerting Devices No. of Waste Disposers eat Pump Totals: Tons ........... .................................. _.. o. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal❑Other Connection No. of Dryers Heating Appliances Iii' Security ystems: No. of Devices or Equivalent No. of Water KW Heaters o. of o. o Signs Ballasts Data Wiring: No. of Devices or Fauivallent No. Hydromassage Bathtubs No. of Motors Total HP a ecommunicationsinng: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:= 3& Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [E BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of per tory, that the information on this application is true and complete - FIRM NAME: a � ,Sri f T�c�i c LIC. NO.: /4%933 Licensee: Y41 6,4,e / si V// Signature LIC. NO.: (If applicable, enter "exempt" i the licens number line ,,// 11 Bus. Tel. No.; 9%Y'G�7 �10/ Address: 9 /Ab�� s�iao� /i%r� /�'nddR�l %%� O%�ys Alt Tel. No. *Per M.G.L. c. 147, 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 Signature Telephone No. PERMIT FEE. $ ELECTRICAL PERMIT NO. INSPECTION REPORT: ELECTRICAL INSPECTOR - DOUG SMALL 1. ROUGH INSPECTION: Passed 7.0 Failed — [ ) Re -inspection required ($50.00) - [ ] Inspecto s mments: (Inspectors 4ignaturi - no initials) Date 2. FINAL INVECTION: Passed —&' Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: (Inspectors' Signature - no initials) Date 3. UNDER GROUND INSPECTION: Passed — [ ] Failed — [ ] Re -inspection required ($50.00) - [ ) Inspectors' comments: (Inspectors' Signature - no initials) Date 4. INSPECTION — SERVICE:_ -:Z DATE CALLED NATIONAL GRID: NAME: Passed— [ Failed — ( ] Re -inspection required ($50.00) - [ ] Inspectors' comments: (Inspectors' ' natur - no initials) Date 5. INSPECTION - OTHER: Passed — [ ] Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: (Inspectors' Signature - no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT ACCESSIBLE AND A RE -INSPECTION OF $50.00 IS TO BE CHARGED. LAWRENCE H. OGDEN, P.E. 198 EAST MAIN STREET 978-352-8318 fax 978 —352-2858 cell: 978-502-5921 July 28, 2011 Mr. Robert Messina Orchard Village LLC. Empire Drive North Andover, Ma 01845 RE: THE FOXBROOK GB# F-676 Lot 7 Empire Drive, North Andover, Ma. 01845 Dear Mr. Messina As you requested I visited the site 7/8/11 and 7/28/11 to review the installation of the Engineered Materials consisting of LVLs and pre-engineered floor joist utilized in the framing of the above project. These are shown on plans prepared by G.J. Bruno and Associates A-1 to A-5 Dated 6/9/10 and 7/26/10 with the framing sheets certified by me 8/25/10 with sheet A-3 A-4 revised 2-18-11. The following items require additional work as discussed at the site. 1. Add additional 16-d nails at all exterior wall plates between studs @ 16" oc. as shown on the exterior braced wall connection detail. 2. Blocking should be added between floor joist at bearing walls, see Roseburg detail 1 g pg 18 copy of Roseburg details pg 16 to 19 attached. Based on the above site visit and based on what I could visibly see provided the above additional work is completed I can certify that to the best of my knowledge the LVLs members and Engineered Joist utilized in the framing as shown on the,drawings are installed properly and meet the loading conditions of the7th Edition of the Massachusetts -State-Building Code -for U-2 Family Residences. All other framing requirements of the drawings and code, including but not limited to materials, nailing schedules, blocking, connections and other details are the responsibility of the licensed construction supervisor responsible for the project. Should you have any questions please do not hesitate to call. Yours truly, L ence H. Ogden P.E. Structural 27765 Cc: Mr. Gerry Bruno Mr. Jeff Horne Copy mailed to Mr. Robert Messina �pEt'A OF W �`�� 712-9111 AN E HA LD C.) O DEN ti .00 27765 �p SOF' GE¢ k4' FSS��/STNAL Elk