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Miscellaneous - 50 CIDERPRESS WAY 4/30/2018
5D t 1 maimm --NNW 1 NOTES; 1) THE BOUNDARY INFORMATION SHOWN HEREON WAS TAKEN FROM A / MAP 104C LOT 29 PLAN ENTITLED "PLAN OF LAND, MEETINGHOUSE COMMONS AT N/F ESSEX COUNTY SMOLAK FARMS, SOUTH BRADFORD STREET, NORTH ANDOVER, GREENBELT ASSOC., INC. MASSACOFFICE.HRE(p SRDED AS PLAN /14828 IN THE ESSEX COUTE: JULY 20, NTY THIS / NORTH DISTRICT REGISTRY OF DEEDS. 11`�A�nn 2) H THE FOUNDATION ON Y.IS TO SHOW THE AS-BUILT LOCATION Aa.E� 104C 12 20' 3) FLOOD ZONE AS TAKEN FRON SHOWN OM THE FLOOD ON IS NOT WITHIN THE E RATE MAP LOT 28 FOR THE TOWN OF NORTH ANDOVER MASSACHUSETTS COMMUNITY PANEL NUMBER 250098 0007 C, MAP REVISED: 8/2/83. / 4) THE CONCRETE FOUNDATION SHOWN HEREON HAVE BEEN INSTALLED SUBSTANTIALLY IN ACCORDANCE WITH THE 408 SITE PLAN AS APPROVED BY THE TOWN OF NORTH ANDOVER PLANNING BOARD. moi' ;---_� ` ♦`♦`.♦ /1q"3�7 _i `N 0.34 �+�>�` `• ♦�`� �tSt ♦ / lq�3J \ I HEREBY CERTIFY THAT THE LOCATION OF THE TOWNHOUSE UNIT \ NUMBERS 20-23 FOUNDATION SHOWN HEREON IS THE RESULT OF A /!���/ ♦\ /\�' SCQ�,'' / -� � / FIELD SURVEY BY THIS OFFICE MADE ON DECEMBER 30, 2011. 4 r / AO j��1\/Yr♦��iv,r.�```` \ / �rC"�\`�,'_J ///_ \�\ _n IN, CHRISTOPHEMNCHERR N4 36118 as LICENSED LAND SURVEYOR DATE Ails '�` �` ��—� CERTIFIED FOUNDATION PLAN AL GRAPHIC SCALE MEETINGHOUSE CCIDERRhPISESLANETOWNHOUSE UNITS 20-23 IgD NORTH ANDOVER, M MASSACHUSETTS PREPARED AL � MEETINGHOUSE COMMONS, LLC / (IIT ma) 121 CARTER FIELD ROAD q / \•�\ 1 imb - 80 & NORTH ANDOVER, MASSACHUoegapSETTS ■ 44 SM a Read,Uft One SoMM Now Nanqmftm 03M m / ii�� ,/ `.+ ``—�, \\ mw pcwmftn% me. via�[[R0 AILer, PL SURvcmRS SCALE: 1' - !SO' DAZE: JANUARY 3, 2012 DNAAWMEO AL 0.�//� f I 1 N0. D�POTION BY DATE D 6 CMF P250508 D 2505CFP.DWO I AORTH TO" Of _ Andover .. 0 No. / =� o , over, Mass., COC MICMEWICK ADRATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES T ............��% �/a� Ile- HATBUILDING INSPECTOR �. s,�. �.�::�. Foundation has permission to erect........................................ buildings on ..tea,,. -?.,�. y,..�`�; ..... '-r'lt `s ...... . '........ Rough t0 be occupied as .v �� d-' (/� / Chimney ^.. "... ............................ ............ .... ....... .. .. .. . ... .... .. . .... .... .... .. . ... provided that the person accepting this permit shall in e ry respect conform to the terms of the application on file in Final 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 T.ARTS Rough .. Service ....... . ......................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT A Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE S 1 D E Smoke Det. - The ��►�e¢lth of.�assachus�s P ut Of Indusital Accidents Office OfZnvestieaions 600w4whirtton - - o Street i Boson, M4021111-7 Work=' Co wwe 1.nUzSsgov/dia Compensation Insurance A,fndavft BoilderslC`ontracfors/Etectriicia�/p��� . An licant Inforntafion � - - Please Print �biv . Name(Bns�ss/ onM�iiridua�: Address: " Ciiyis P: ,.} ear .4440) Phone� Are you an employer?Check the aPPmP�te bus: 1.01 .❑ I am a employer with 4. ❑ I am a general Type of Project(required): 2.® VCMVI%9=(fill!and/or part time).* have hired the and 6. XNew'a M ship and have no a sole Proprietor 1or p�= �d on�attached sheet t 7. []Remodeling �P oy These sub--contractors have for me any cepac,•hy, a, 8- ❑ worming in Demolition [No w°rkers'Camp- 5. �mP msurantx 9. Builds ❑We are a cion and its ❑ ° addition officers have exercised fitc�tr 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work rift of eztelMptiun Per MGL 11.❑ m3'Mif[No .�• c. 1�2,§I(4), Phmmbirtg repairs or additions and we have no msrasnce ircluu'ed]t er P* CM_ [No workers' 12.[7 Roofrepazrs COmP•insurance reqs) 13.C]Oth.�°r _ ra1' �t �ct�lmur3so6Iloat6 belowdwwimz , 'Ha�ovvaas wIm sebum tfiis at5davit �rs= - �-",r-.•- . '�u8�ocs that eb�k 8ta ba:must atbu*ed an addWaaal dM9 mid€em"hire onside camractum mm t submit a neav afiidarit -- I am an employer A&& worlrers'aompensa►Son infer my�loyees Below is:7--Y a►rd jnb site Insurance Company Name: Policy#or Senn&Inc.P ExPira on Date: Job Site Addr= _ Attach a copy of the workers eo Cze/ZrP: ' mPensatton poficy den Failure to secure ane age as under p�°f a(�ownag the po�ic9 nIImber and ezpiraiion date Setaioa 25A ofM � GL c. fine Up W S1,S00.00 and/or ons . 132 can lead tD the�osWon of �. y�unprisonmetrt,as well as ciiv$ - ��Penalties of a to WO- _ Peres m the nP a dap against the viohrtar. Be finm of a STOP WORK ORDER and a fine Investigatiom of flee DIA for insuranceCOVCEIQ a P-Py of iris SMtMCW may he forwardedto the Office of Ido hereby cefy pofirs and ofPa7mF d+ztthe iqfwwunion SiIS trZW ani!correct Phone 4*-- -757•',4-g7s'"F ol* Do not write in tlrrs area,to be completed by�,orn: hMdft- hority(circle one* pcentseHealthZBm'f�Depar6nent3_CrtyJTown Qerk 4.Elee4rit�I ecrur�► PIumbiug Inspector soB• Phone ft: '='' iassachusetta-Department of Public Safety- Board of Buildin=� Rcgtlations and Standards Consfruc#ion Supervisor License License: Cs 95417 Restricted-;p 00-... rr THOMAS`D ZAFiORUiKO fl 115 CARTERIElD ftD d N ANDOVER;_MA,01845 ' c— J-�—���` Expiration: 45=2 `nimnissi°ner Trft: 21WO REScheck Software Version 4.4.0 Compliance Certificate i i Project Title: Meeting House Commons Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Multifamily Building Orientation: Bldg.orientation unspecified j Glazing Area Percentage: 12% Heating Degree Days: 6322 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: Building 6 Tara Leigh Development,LLC O'Sullivan Architects,Inc. North Andover,MA 115 Carter Field Road 580 Main Street North Andover,MA Suite 204 978-6876-2635 Reading,MA 01867 781439-6166 1e' a. � m a«r.NE Compliance:1.1%Better Than Code Maximum UA:875 Your UA:865 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. • • s e Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 4396 30.0 0.0 145 Ceiling 1:Flat Ceiling or Scissor Truss 4396 30.0 0.0 154 Front Walls:Wood Frame, 16"o.c. 1613 19.0 0.0 80 Orientation:Unspecified Window 3:Vinyl Frame:Double Pane with Low-E 155 0.330 51 SHGC:0.30 Orientation:Unspecified Window 4:Vinyl Frame:Double Pane with Low-E 42 0.280 12 SHGC:0.27 Orientation:Unspecified Door 1:Solid 80 0.160 13 Orientation:Unspecified Sides:Wood Frame,16"D.C. 2660 19.0 0.0 151 Orientation:Unspecified Window 5:Vinyl Frame:Double Pane with Low-E 140 0.330 46 SHGC:0.30 Orientation:Unspecified Rear Walls:Wood Frame,16"D.C. 1784 19.0 0.0 80 Orientation:Unspecified Window 1:Vinyl Frame:Double Pane with Low-E 345 0.330 114 SHGC:0.30 Orientation:Unspecified Window 2:Vinyl Frame:Double Pane with Low-E 21 0.280 6 SHGC:0.27 Orientation:Unspecified Door 3:Solid 80 0.160 13 Orientation:Unspecified Compliance Statement: The proposed building design described here is consi tent with the building plan ,specifications,and other calculations submitted With the permit application.The proposed building as be n designed to meet th 009 IECC requirements in REScheck Version 4.4.0 and to comply with the mandatory requirements listed i the RESc ck Ins ion Checklist. 114 A i Project Title: Meeting House Commons Report date: 12/07/11 Data filename:K:\Zahoruiko\Meetinghouse Commons-No Andover\Meeting House Townhouses\CD's\Building 6\Building_6.rck Page 1 of 6 Date....... f ,aOR7/{1 t ?;.��``°:•_�."�,� TOWN OF NORTH ANDOVER o PERMIT FOR WIRING r �......Ez 7— This certifies that ............ .......G.............. ......................... has permission to perform N !�� wiring in the building of..... F1:;VW,�r........./—,/ at 2 ID2E555.............t.C1.#X....... , rth Andover,Mass. Fee...1�2.-T c.No.M— l.b........ A ELECT CAL INSPECTOR Check # "� 0728 Commonwealth of Massachusetts Official Use Only - Department of Fire Services Permit No._ I LI)7 2 f BOARD OF FIRE PREVENTION REGULATIONS Ov./o7cy and Fee Checked � . j (leave blank) ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code PVMC527 CMR 12.00 (PLEA SE PRINTWINKOR TYPEALL INFORMATION) Date: 3 117a I I 'V 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) S w Owner or Tenant >�l Gez1,� o Std r o m,,,j o. 5 1,z_,c Telephone No. 9)k 6 k7—ZA,3 S_ Owner's Address 17,1 C n._ Is this permit in conjunZoe—,-) n with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building E,�. t .r—L-- 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: lt>l.,l E )A7(L)D Comp letion o the ollowin table mE he.walvedby the Inspector of Wires. No.of Recessed Luminaires t( No.of Ceil:Susp.(Paddle)Fans 110.01 Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above nffl'annnad, o.o mergency Lighting rnd. Batter Units No.of Receptacle Outlets No.of Oil BurnersFIRE ALARMS No.of ZonesNo.of Switches 3 No.of Gas Burners ( No.of Detection and Initiatin Devices Tota No.of Ranges No.of Air Cond. ( Tonsl No.of Alerting Devices No.of Waste Disposers 1 He 'TPu p Number.,Tons KW No.ofSelf-Contained Detection/Alertin Devices No.of Dishwashers l Space/Area Heating KW Local❑ Municipal Devices No.of Dryers Heating Appliances Kms, Security Systems:-- No.of Water No.of Devices or E uivalent y No.of No.of Data Wiring: Heaters Si ns Ballasts No.of Devices or, Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin OTHER: g: No.of Devices ox E uivalent Jo Attach additional detail 1fdesired,or as required by the Inspector of Wires. Estimated Value IfEleltrical'Work: (, p p p, (When required by municipal policy.) Work to Start:.. f L-- Inspections to be requested in accordance with MEC Rule 10,and upon completion. P INSURANCE.COVE P RAGE. 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 cover3geis in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under thains and penalties ofpedu_ry,that the information on this application is true and cor p'eie. FIRM NAME: LIC.NO.: Licensee: /��U.[ /v1i4 �1 Signature LIC.NO.: �Z7�rpC' (Ifapplicab en "exempt"in the licens umber line.) Bus.Tel.No.: ��HS-6Z__9 Y Address: J 1,1.t-5 L�� > ,� N *Per M.G.L c. 147,s.57-61,sec ity work requires Department ofPublic Safety"S"License: Alt Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(che Owner/Agent ck one)El owner ❑owner's agent. Signature Telephone No. PERMIT FEE:$ FLECMCAL IWSk ON. rhspectorisl, Faled—( I Re-imCp�ec'®tzokn�x�esgnecY($50.00 ( jomme)ats: s r . I If 2 1 (Jffig ectore Signature-no hAtials) pate Passe$•-- Failed--( ) ate-inspectio)arequixed($50.00)-•( T Inspectors'co en . (.Lsispectors'lei ature- 40 inifials) Date VV�ONDIYIIR Re-inspectioarequired($50.00)-omments: (Inspectors' ignatuxe-noinifials) Date t.'.I SFF,CTIO Passed—( Pe-inspeedonregnixed($50.00)-•( ] Inspectors'comm.eufs: . r Cluspectors',Rignature-io inifials) Date r Passed-- p'ailed•-( ]• Re inspection required($50.00)•-( 7 luspectoxs'co)tm.ents: �L�specfors'l�ignature no imifials) Date JD OOP,TAGS AAPX TO BE FI>;LED OUT AO IF,FT OST SITE IF T.EE A=A.TO BE INSPECTED IS.WOT .A.CCFSSIBEEAND A.RE WSPECTZON OF L50.00IS TO 33E CHARGED. The Commonwealth of Massachusetts Department of IndustrialAccidints Office of Investigations kvi 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly Name(Business/Organization/lndividual): e,) A L M.}t C_ &L-6 C-(( C 4* _- Address: 3 euLt-5 60 itir�-G ti> City/State/Zip: ��� A-) 6 ( Phone#: 0�5 S-y Are ytn employer?Check the appropriate box: Type of project(required): 1. employer with_ 4. ❑ I am a general contractor and I 6, ew construction employees(full and/or part-tune).* have hired the sub-contractors 2.❑ 1 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 required.] officers have exercised their 10.❑Electrical repairs or additions 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.❑Roof repairs insurance required.]t employees. [No workers' 13.❑Other comp.insurance required.] • *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 aie doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Oj 0", Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip:__/,J-Q., Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration daite). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year 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. I do herebycert! under the pains and penalties of perjury that the information provided above is true and correct. Si nature: .� Date: 3 -Lo Phone#: 97 8- 3-2 S—c)2r,6 z_._ Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone M Information and Instructions r 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to 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:MASSAFE Revised 5-26-05 Fax#617727-7749 www.mass.9ov1dia J / � 1 9352 Date. "pRT►� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUS� This certifies that . . . ./. 7.�./�?. . K//���r. . . . . . . . . . . . . . . . . . ..'. has permission to perform . �K�.//✓P.� .//� /./. plumbing in the buildings of . . . . . . . . . /�Oul. . G4.,�. . . . . at . . . . . . . . orth Andover, Mass. Fee,.AK 01 Lic. No..14"I5 7 . . . r. .' . . . . . . . . . . . . PL WING INSPECTOR Check # �75�c Date..`fk!'.Z...... .. NpRTM 3� TOWN OF NORTH ANDOVER p .... A • PERMIT FOR GAS INSTALLATION h y,SSACHUSEt� This certifies that . . . .f � . ., �r�. . . . . . . . . . . . . . . . . . has permission for gas installation . P in the buildings of . . . . . `f. . .7"'h/` out SLC at . . . ��d. . . . . . .51.. .. , North dover ,Maass. Fee./ ? Lic. No..� 1 ,rl c h . . ioi GAS INSPECTOR Check# /7y� f 8 i 0 2 r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING CitylTown• L'? (�✓ , MA. Date: 3 l c Permit# Building Location: _�(� I /ess Owners Name: ftoL Type of Occu ancy: Commercial❑ Educational❑ Industrial ❑ Institutional ❑ Residential New: Alteration: ❑ Renovation: ❑ Replacement:❑ Plans Submitted: Yes❑ No❑ FIXTURES ww z Q U) 0 z W 0 z Is- o z W lz Z o W o z o Lu w o Q Lu in Lu 4 m 0 0 W > fn U z co ce U' Q w (n O Lu = LL Z tl' v W 2 0 —t lu Lu H h O z —1 (w7 u. N 2 Z w W W O � � W COJ 4 Q . m w O z o j z H 2 l=LL 0. � � Fw- SUB BSMT. BASEMENT 1 FLOOR 2 N u FLOOR f'-FLOOR EFLOOR ' Installing Company Name: Check One Only Certificate# Address: ElCorporation /CitylTown: State: Business Tel: G ' ,�` El Partnership 3 Fax: ❑Firm/Company Name of Licensed Plumber/Gas Fitter: Z INSURANCE COVERAGE: I have a current liabilityins � 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 Other type of indemnity ty ❑ 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 m signature y g on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent E] 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 plumbing work and installations performed under theermit issued for p this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. B Type of License: By ❑Plumber Title �as Fitter Sign ure of Licensed Plumber/Gas Fitter Master City/Town [-]Journeyman License N ber: APPROVED OFFICE USE ONLY ❑LP Installe The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ..600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Less><biy • ' Name(Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate boa: 1.❑ I am a employer with 4. ❑ I am a general contractor and Ir7. E] f project(required):" employees(full and/or part-time).' have hired the sub-contractors New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet Remodeling Ship and have no employees These sub:contractors have 8. E1 Demolition working for me in any capacity. workers' comp.insurance. [No workers'comp..insurance 5. 9. El Building addition ❑ We are a corporation and its required.] officers have exercised their 10-❑Electrical repairs or additions 3.❑.I am a homeowner doing all work right of exemption per MGL I L❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no insurance required.]t em to des. 1z❑Roofrepairs P Y� [No workers' • comp.insurance required.] 13.❑Other 'Any k;Thcant that checks box#1 mustk1S0 f11T tlLt the SS enni:rin. v coon below Yb i^eirwc kc a ccmPmsationpolicy info_W:tion. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation information. insurance for my employees Below is the policy andjob site Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of fine up to$1,500.00 and/or one-year imprisonmcriminal penalties of a ent,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. I do hereby certify under the pains and penalties ofperiury that the information provided above is true and correct. Sienature: Date.: Phone#: 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): L Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of-the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employe;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_maint--nance,_construction or.repair-work on-such dwelling-houseor 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 coinpliance 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-contractor(s)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,.are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. 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 tovm that the applira on for the _aPt o%license is beteg requested nut the ar ft *of i a p�-- � N. , D�f2•i-_ens Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' - compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.. Please be sure to fill in the permit/license number which will be-used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business.or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would'like to thank you in advance for your cooperation and should you have any questions, please do not-hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department ofFndiistrial Accidents Office ofInvestigations 600 Washington Street Boston,MA 02111 Tel. 617-727-4900 ext 406 or 1-8.77 MAS.SA.FE Fax 4 6.17-727-7749 Revised 5-26-05 r • b MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK lkw CITY tV,� MA DATE3j�a �p� PERMIT�# JOBSITEADDRESS S C'.dam►pro-5_5 OWNER'S NAMEJ jVO4 �ftC )v,).5e //C_ p OWNER ADDRESS I j ( S e4i L. TELJ JFAX J I TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ( I RESIDENTIAL)j 4� PRINT CLEARLY NEW;f RENOVATION:( REPLACEMENT:f ( PLANS SUBMITTED: YES ) N01 FIXTURES 1 FLOOR-' BSM 1 2 3 41 5 6 7 b 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 I DRINKING FOUNTAIN FOOD DISPOSER I " FLOOR!AREA DRAIN ; INTERCEPTOR INTERIOR i - —- KITCHEN SINK LAVATORY I `. ROOF DRAIN = i SHOWER STALL SERMCE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION / - WATER HEATER ALL TYPES. — WATER PIPING I OTHER INSURANCE COVERAGE: i -- have a current_liability iiisitratte policy.or its substantial equivalent which meets the requirements of MGL Ch.142. YES } NO IF YOU CHECKED YES,PLEASE INDICATE TH YPE OF COVERAGE.BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY( OTHER TYPE OF INDEMNITY( BOND( } OWNER'S INSURANCE:WAIVER:I ani aware that the licensee.dnes 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 1 hereby certify that all of the details and information I have submitted of enlered regardlog,this application ate true and accutate to the best of my knoerledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance t'ih Pertine�r b ro' n of the hlassachuse(ts State Plumbing Code and Cha�ptter 142 of the General Laws. PLUMBER'S NAME { 't'C.�1r 1 lu- � LICENSE# W57 ' SIGNA URE M MP( I JP) I CORPORATION) Ii'ft }PARTNERSHIP) !ifj ,LLC �{f COMPANY NAME VJ 1&-(bA di- { I ADDRESS I OL-) P"n.-A dv CITY{ PFJ". (STATE 1�� ZIP G S 0 7 1 !ELI 9 7 6-' �/�� I I , FAX II CELL I I EMAIL j f I r ROUGH PLUMBING NG INSPEC ION NOT] S BELOW FCP 0+ + CE USE ONLY FINAL INSPECTION NOTE,S Yes No ` y THIS APPLICATIO SERVES AS THE PERMIT ❑ FEE:*$ PERMFr 9 PLATT -M,VMW NOTEI S a r 4 'tYt Cptjtitioi��ueWit b, IGfr s f�crttrsells _ =� 11�fi�rx�fi�teitto,/`lucfrtsfrt�rl�s[cerrleirrs ; . �- (11,,�fc�'o,�`t�►>esfi�irlialrS � bapI1 rrshAt'gfoit A.4'et1 B#Ubn,,MA 02111 piVtii llwSS-.gi Wit �r�,�QK�(CFSZ°L''�llt]1Ct15fltiROEl��ii:�j��rnl�c�f(�tl.��rii.Bltif(fcislC'oftft�n�to s�[e�[l�tcin�tsl�'�utilpeli pt>IiEtt>it€Iitforitttifitiie . ....., - _L'Tetisi::C'�iitt.l `iCi: { I�itltie(13it;`utc�,�rai��Uiiiitiontlttifitidual}' ••• •• .• - 4it�1Si�ifei��lj��_.�. .. .. -• - .. ltltiotig ale kr� otrall efitiitotixr?CttecTr(fie iiplii•oprlate iiox; - •^y: - — � 1 7 y�1�;&f projecE(rciir�reii): I 1:0 inu�tzetnplo�crc�it(t rT.[ tamngeneralcoiltrRctoiald'I icttipto}ccs(fltfmutforti tttinic);� ha tielttreddtosith-Coritraclors �� bwwtells{1iiC(oil 2.�Xnulasoietiroprietorottiai�ner listetlotitiienttaciieristeet.t 7. �]Itetnottetiiig ship nttd tt(tXrotto ctnlifo}•ccr zlicsc sttb•coiilrttciors have, I7etitol.itioil ><orRitig 1'oriuefitnnycnpaciq+. �sof�er�comp.fnsi►rauce. []•iltitlding addition �a.tColtc[1`cQiiip'�nsuMIICO� �.L7�Ve rencouwalioliand Its of(rcersliavoexercfsed(ticir Id aRecirical(Cimimorndditi'oas �.❑LOliltrfionieoutieritoiilsallijel. tt�titofcmeauption,oe`i L ti l'Itnttltiugl jilir'sortttiditiott , ar31setf.(No workm comic. e.I_S2,slt�tj,fittcT�ecfiaeeho _ i2:�[Roofrepaft iiisuranccregaired j t etfiplo��ccs.[Noi;<orkcrs' j coiup,tnsuttntccrei)utrc(tj 1�,[j'Othcr �+1!•iitrl;'c�t�ilh�f<ti;.EsG.�('lrmtitriiofillraali;•:iecfinn[,feusltJningiGt�ruetE;.ri`Cmc+i:ctLstionpaliy�teCJinlilia:i 7 t,cm,auu:is�ri+a sutaiitttds e0i;rtrit lnrtic )gla t}eSn.011 mitt:rrd thtntdrednGtdtfeutr.�aais tain;tstr;atii nhtlepftTdt�it itdica7in�sutlr. ILl',lri:>.alia�hLtliCa3ilrtjl6\fl0ite:flifxd,nradilic�,tlsiatrsGattid�lk�tuntei�flbtStiG•rJ%tlrta�+nr�rdtlrtittii+iE:cr a?7:��i�iifri�lfiyruu[+riF • larttnrieui�rlylx>rlfcaClrlrvt�trlitrbrrt�vrtcrrs'evli�rc'ttscr(Ivitlrtstrr�ttcefrrr{trelt fvtec�s,Beloitrtrthepollctrnrttf/vGslfe�~ ti�arttrrrttvtt. ; lnst►ranccCor�grau}�1\ntirez..< j policy+/fotS2iFitts lic./i: 1� Sir t. ._; _ I •• �i .it i�ttUate:•. ; Job Site A4re3s- Attach n coft of(heti ogtrers'i pin�iensitiioit iibliey'c�ecTtu ntiou?loge(sJioii Tiig(tie�iolkS�iiia it)rgctt(ttl erjitinliost tittle?e i raiiltre torsaGur�•eo�'ciiigt as requited unc[erSectiolt 1514 oTMEii,c.152c6it Ind to(tic tilipash[oil QfcrpilitiattipIta dose.Or& Gilt:tinto:S(,SQO.aO andloi oiiGyear iniprtsonment;.ns.a cit as cit i t penalties.Lt lice forth ON STOPa@URtC 09©1;[t iintFn f ill Mill(OS250.00a&Y(Viiist(fieviolitrot. t3cntittisciithAtttcotty oFthisstalewetitivaybefoiivar<tetiloi[teUEfceot `` GtiestigationsoftGeDIA for itistimiicecoverage teeiCcation: r Itlalrerc�Gj�cerfj�urrrlc>rtlreltnAxcrtrtrfl��.a�ltleso; rertrnl�rrttlrtrlr(rvi'trod?ateprbtfcle>(lnlio►'�fslrts(ttrifccfi•��>t! src(tliuire:• Tioue � S{ LL�O sroare�r,foA!Colviefed4*p t(t?ot•la01,Offtctal•ii�t[tioftlealth 2.HalIdtngDeii,�tti toil1i{Otl: yy fi�'as$sfchuSEtts".GenerrdLttsys o1Fa�ter X52 retli►ies nlleiitpIhyerslo,J�eat�id'e:i�torfccr's'cQilt�i�tts�tio'tt foi`tttelr entpTo�'ees:. Pcii'suatttto:fnisstatutb-aneri Toy= i Tefiited9s.`:.,ei!etypersoit•fiZthesenliceo€ait.otltcriitider, tycontractoflii>e,, e�pi��s arittiplied,.prnlpt�sti�itteit G - ��l�Io3erist�cinetlas"Rg initivitliF��l,paiiiters�iipi,aSti�iafion,cpxpbtition pz oilier leIetltiCyr otrauy fsi a5}liiora oEtjte fot�goingeit;;agetinia�oinFettfeiprise,aiti iuZ litdin the Ieg'al zpraseufatic=es.ol`at7eoeased eivpfoj"e►;or the •tecen��cortrttsfeepfetfuttiii=id�ial,l►ttrGtersLi�„associatioti:orotherIegaTe)ttity;�tt),p�oa=ing;cmpIQ}rees A'os�cezerlae ownerafttdtt=elliitglioiise•Jtavingnot ibrztltaiithretraps,fittettts:and'ivlio tile occupant.oflite c[i}el(iitgitottseofntiollierts=hoentplo}rspetsotistedoaitaiiihnotice,cons[rtictibnorl:6p5iri0e Oil sttclicitt6lli g.,huise totpii:llt�grottndsoxbuildiiigAJtpurtenauftlterefo-5ltallhtahbecause•ofsticlt.einpio}=ntenrbecT eutecl'Cbbe�ugniplo�=et:'= It�GL;c'Gaplcr IS2;:�25[(6).also'states that'`•`aso1•}"'sfrifc=ai;�oea1 licensii"D ngettcy�sllitlr initiiTtolT the jsst fauce or• c"tetz 1t,i a 11ee?0 bJierntiffo oiler tfe a btiptessot fo:cottstriicf btiildin s in fhe conttribiurealtl"ioi Wiry tplicanf lv,L�l►as liotprotiueetl.accepfstbleei l"lettce of coutpliattcetvitfitltein`stii tinceeotet�geregnit etJ.' Additioitsit};h�Gl:clt�tpferlS��25C(7)sfafes`°�Ieithertnecotnntonsvt=altfutorati}=ofitspaliticalsubdivision$slzlt! Olt rintoanycontractfbrtlteparfom)aftcoofpubligieorkttttfilacceptabTeevidettceof";ampliati ti=titlitliFinsurance re iiIremenfsofttiscltsp[erltavalaecttprese�itetlfotlteeo)iiractingautltorit};" .�ilili.Iicttltls •. ... . ... .. ... j l?ieaseftl[oui itt�i4ot�:ers'-colllj��ilsatiorz-aT�id�iitt:bni'T:t410� .iitectitt 't�te�osesih�t•a Ip�4�yoiirsiinalrou�t�ii if � .. , necess�t3;snppi}�sitb cantrac or(s)itatue.01adtliess(est'atidpItonennthbei(s)alotuIV!1h llteu ceciificete(s}pP • insilranec-.Lfinitedljiabilit}f Cotnpaities(1LC)orL4mltedfiabiGlj!I.'atfiieisbips(LLP)}vitlt no empIo}=e?sotlter'tliatriite liientLers of puhters;:tre�totreouiredto eati}�workers"oanrpensation insurnnce. IfarrUC or LLP does Itave etplayeas,apolicyrisi�gaired..Bs:tdvisedtitaEthistiffTilaeitutay6esi�UmitfedtotheDep<�rtnientofIndustrial - Accidoittsforconfirniatinttofiitstnancecovet'age. Af obesllrefOsigitnttd(llitetltbfiffiidlyit: Thetif4daWtshould Ira refuritetT fa lira oily or fown that tltc application for ilte pe"utif or I icense is being reques Fed,trot the])eltartmett`s of Fndt�trial Aecidaitts. Shotitci youhttti ;aaty questions regardittg.tl►e lms or ify611 are required to•obtabt a workers' EbiriyteAltionpolicy,please call titeDeiiatiine izitthenuutberlistedbelm.y. pelf-insttre<t•cogtpa"iiessttottIcientertheir pelf ivsttrartce Iicense numberontliOgptopriate-line City or Tolsii Ofticials f Plettsc'bvsuretliaffhsof(iiiavitisco"itplet€atttiliriutetl,Iegibly- 7liebepa"ittientltasproxidetia.sparoatth�boittitit i o[tfig,aftLAW[fotyOUdfillot011theeveiiftheOftic6bfhivestigations]IRS tocautncEy=aar8ga)diii the applicant. Plembesurdtofillinthepentt'►fll4censetnnnberivTuchsviII.Be.ttsedasa:refereuceaipntFiet Inadtlilion,anapplic�tnf flint tntisf subtititntitifiplepenttitllicense ttpplicatiotis'in an}*g'Wit yen",nee(Ionty submit one affidavitiodicating current PoIicyinfonnation(ifnecessaty)eatdtuidetr"M SifaAddre&'theapplicatit'shouldwrileIWIlocaiioasor 14tv)"}2'A cppy oftlte aflidaVi€thathas been off"cialry slamped oi-n"arked by the city or fowil uta}•baprovided to the filiplicantasproof thatzt Valid aliidat=itis ori fite:forKitnre-perutits of license.s.1�tfett�.zikidavit it,,, be filled out each i ve=st lt7terealtouteott°�erorcitizeitisobfaiiiuig.alicenseoi�perniitnotrelatedfoan3 busi,tessorco"iunercialt=antuto f (i:e-a dog.lfcense orperntitto burn Eales etc)said petsoitisNOT rquued to coMplefef[ds affidavit. 'T1teOceoflri�ie�fiationslrot"fdlikeftithatiyo"ri"tailvauceforotiiCo¢trfiotaattls?t01ttcifot4ltai�r zrii�igtiestioits, Pig§e do.not ltesitafe ta.give W{t cplt- Ti"c bppaz-ittYeitt'sat[dress,telepltotteattt'f fay ittintTizr .. . - - -- The.trop.ultra>4YeOrt4q��\�zts��ltt�set�s - z D61iadmelif ofbtdtis[t[tti AaCiclsi)ts 4fCce o£ItiE=r?�li�aii�olt� 600AVasi1itigtbli Sheet i BOs€oaa,MA.02111 � Tex. 617-727-4PQD 09W.6 of 1-$77:MASSAV-g I?ei+iseil M V6I7-727 7749 , - % ,.peTM TOWN OF NORTH ANDOVER a<A PERMIT FOR MECHANICAL INSTALLATION meq•.,,.-.,r....`. • G� �9SSACHUSESt This certifies that . . . . . .T. . 1-44. . . . . . . . . . . . . . . . . . . . has permission for mechanical installation . . .. .rte. . . ... . . . . ... . . . . . in the buildings of . .`7��!!' :. . ./.P` �? . . . . . . . . . . at . . . . .�!r-� ��`C .'. . . , North Andover,-,Mass. ter r Fee�. ��-'.-. Li c. No..� . . . . . . . . . . . . . . . . .�.'. . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Sheet Metal Permit Date: Permit# Estimated Job Cost: $3000" Permit Fee: $ 'Plans Submitted: YES NO Plans Reviewed: YES NO Business License# 196 Applicant License# ��SD Business Information: Property Owner/Job Location Information: Name: J&J Heating. & Air Conditioning Name:Tara Leigh Development LLC Street: 17 Arlington St..; Street: 50 Ciderpress Way City/Town: Dracut, MA 01826 City/Town: North Andover, MA 01845 Telephone: 97854-8197 Telephone: 978-687-2635 -4 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:"T=2-fahuly ' -Mwti-family Condo/Tbwnhouses Other Commercial: ' Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. ✓ 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: Sueo /N i'nrtall A1ec7a / d4ct-lvarPC F INSURANCE COVERAGE: I have a current I iabiljhE insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 12 Yes [g No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this boxy,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. Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: By ❑ Master Title ❑ Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ ❑ Check at www.mass.aovldpl Inspector Signature of Permit Approval COMMONWEALTH OF MASSACHUSETTS ATA BUSINESS ISSUES-THE ABOVE LICENSE TO " EDWARD; T AYOTTE ',"J'.. HEATING AIR CONDITIONIN ro 17.. ARLINGTON STREET DRACUT MA 018261315 19G 01/14/14 95273 The Commonwealth of Massachusetts t r m o Department of Industrial.Accidents. ' Office of Investigations 1 Congress.Street,Suite 100. Boston,MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 18J Heating&Air Conditioning,Inc. Address:17 Arlington St City/State/Zip:Dracut, MA 01826 Phone#:978-454-8197 Are you an employer?Check.the appropriate box: • Type of project(required): 1.21 I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑✓ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. El Demolition working for mein any capacity. employees and have workers' o workers' com comp.insurance.: 9. ❑Building addition ' [N p.insurance P• required.] 5. E].We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doingall work officers have exercised their ]1.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E Roof repairs required.]t c. 152,§1(4),and we have no employees.[No workers' .13.❑ Other . comp.insurance required.] *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t liomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit.a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of•the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they.must provide their workers'comp.policy number. I a»r an employer that Is providing workers'compensation insurance for my employees. Below is the policy and Job site information. Insurance Company Name:Great American. Policy#or Self-ins.Lic.#WC 6418907 04 Expiration Date:06/02/2012 Job Site Address:All locations in City/State/Zip: . Attach a•copy of the workers'`compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 and/or one-yearimprisonment,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 IA for insurance coverage verification. I do hereby ce d r na tie 'u that the in ormadon provided above is true and correct. SinDate,=—� 771 Phone.#:978-454-8197 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: PermiMicense# 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#: DATE(MMIDDIYYYY) ,ACORD CERTIFICATE OF LIABILITY INSURANCE 06/06/2011 PRODUCER 7g,$$7.4900 FAX 978.887.2404 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 9 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Edward F. Sennott Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 16 South Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 457 NAIC# Topsfi el d, MA 01983 INSURERS AFFORDING COVERAGE INSURED JU Heating & Air Con itioning, Inc. INSURER A: Great American 17 Arlington Street INSURER B: Dracut, MA 01$26 INSURER C. INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INER DD' POL CY EFFE TIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER D M IDD PAC6418906-04 06/01/2011 06/01/2012 EACH OCCURRENCE E 1100010011 GENERAL LIABILITY E 300 COMMERCIAL GENERAL LIABILITY PREMISES Es occurrence 00 CLAIMS MADE a OCCUR MED EXP(Any one person) E 10,0001 PERSONAL&ADV INJURY $ 1 000,00C A X GENERAL AGGREGATE E 2 000,00 PRODUCTS-COM P/OP AGG E 21000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT M LOC AUTOMOBILE LIABILITY CAP6418957-02 06/01/2011 06/01/2012 COMBINED SINGLE LIMIT E (Ea acddent) 1 0()0,00 ANY AUTO ALL OWNED AUTOS BODILY INJURY E (Per person) A X SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY E (Per accident) X NON-OWNED AUTOS PROPERTY DAMAGE E (Per accident) AUTO ONLY-EA ACCIDENT E GARAGE LIABILITY OTHER THAN EA ACC E ANY AUTO AUTO ONLY: AGG E EACH 6CCURRENCE b EXCESS I UMBRELLA LIABILITY OCCUR 0 CLAIMS MADE AGGREGATE E b i DEDUCTIBLE E RETENTION b WORKERS COMPENSATION WC6418901-04 06/02/2011 06/02/2012 X TORY LIMITS ER AND EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT E 1,00 OO ANY PROPRIETORIPARTNERIEXECUTIVE❑ A OFFICERIMEM13ER EXCLUDED? E.L.DISEASE•EA EMPLOYE b 1,OOO,OO (Mandatory In NH) Ityes,describe under E.L.DISEASE•POLICY LIMIT E 1,000,00( SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN FNOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO 09UGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Evidence of:Insurance AUTHORIZED REPRESENTATIVE /J� L�`/ �—..�. Peter Sennott LA ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD � •- vi �� i � n�. 0VV/ 'V4 10UJ/L4/0 "U/ti UKIUINAL t ury x 0503031 GREAT AMERICAN •ALLIANCE INS CO Adminlstrati Offices WC 00 00 01A ( Ed . 01 /97) f 301 E 41h Street Cincinnati OH 45202.4201 tt�' RICAN. 513 369 5000 ph Policy No . IW I C I 1 1 6 1 4 1 1 18 1 9 10 17 I 001 141 INSURANCE•OROUP Prior Policy No . W161 I l61411 i8i9i0i7i I I 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE E nsurance is afforded by the Company named below, a Capital Stock Corporation : GREAT AMERICAN ALLIANCE INSURANCE COMPANY j NCCI Company No . 14028 a '•}7 is ?:{•:•'+:?•'f•'f.{.}v,:, ?•}Yf ?'•'f4'+•}}Y 4}':}}:•}Yv'::'}}"}rn}}::i}:{:4:?:•}:?:M:•i?}'}:.}'4{{:.}:•}:i+' .. .. ..... ;:{:....;•.:,i.}:{•:SY. }' rh: :'::4r' f...:.l::':.f:rr.. . ..... .... ...r.. .. .rrJ;..... ,/f Jv.. .� :.:::r::w;::•i::•r,.:•:}',.::?::r.:;•v:':.r•;:i::•.}}:•::4::4;:4}}}}:::}:$•}}:{{r;}:•}}?}fir}:::: 4 vr'.�:{..;f4.FFi:. fv. :..}.x r x, .r rl.:.r.:.:.:l.C• r ..f,....::l..;f.•.�..•..:::::v::;::}:+•?:4.v,v:4;::: :.,•: � :::. ....•:..+.. f.•.,;•4}:.,$':}ir}:;j{ nl...:J..} ..:iY:::.v:r:rv.v.:.iv;H.:A:x.... ��yy .:t.}:•}:••}. ... �+�+'?.' .:f..:x..fr.........+•:::•}:}:r.}::• .+ fv:iT.v;.•;:.r.::.....n... .... ..............r.....v•r...:i}:::.v.v::4:;•}::•}ii}::�}:•}:::::..:}:::{yii;;'r+;:i;4iiiii: ::�:'•E�+'�l»>:'.I�:W::{vt::«;:;i:;�-t-0.••..AIV:::::.: ••:. . �:• .. .. ... ......r..r: , . :.�•r}:• ..r r .rf: .rl.....r .r...r..J...... .. 'he Insured : J&J HEATING & AIR CONDITIONING Legal Entity : INC . Corporation lailing Address : 17 ARLINGTON STREET FEIN No . : 042488433 !+ DRACUT, MA 01826 ether Identification Number : See Extension of Information Page . j. ether workplaces not shown above : See Extension of Information Page . !` .. .Y.. .rY.?xi/f:iiY:i+'.{?tn/{+.•r:....Y:::rr..:;.}}'?{•F•:4}'?{ry•.}.rr.};:r.•'J.??•:•:i?4:4}}:iJ'};•}}'}:•}}}}:{•:•}Yl::{4}:{4}in}}•'!:}}}:4}}}:4}}}'•}i?:{{vi}?:^}}:4?}}?:tii{•i •r.{?v;{,•:;•v.,v}::.v., } {... .rY.. !Ffi. .fy.•:.;..•.;.• .r.!•.::x:w:::•::::•:.:::: tl.. •..: :w., ............ ...:.n.r .... ...:iC r..,.. ... w•$r.••:•%C.•r.:r� .. l..:r .rJ:.,.;y•f..lfi. ; .... ... r.. .,..r..v. :r, :••.. .:....:./...l.::•:viNFlf......r.:::::n. .nnv:;i:ii:� •:•: •::::•. .... ::::: :. •.:.:::•:.. i { ...{.::. ..n.r.r. r....r....}:f;.r .rr.+........r.4r.:...r.f.. r.Y.}:•::.�::::}.:;{t{:.}:•;;:.,r:%:::::::.::•.�.. 'he policy period is from 06 /02 /2011 to 06/02/2012 12 :01 A.M. Standard Time at he Insured ' s mailing address . . ...r.r:::::::......:::.rlf..::'::r. •Y+}•{{rr;v:;Y.: •: : . :. :-.:.. :}Y:•Y;!•}}}"::+•:.:.>}}}}'•>:i;::.;};}:<•::{::•:•::::::.}}:;?4r?•}}}}:•}}:.i:::{::.}Y?•>}:::::::::::::::::::::.:};:. Y: ../.. i}::: .. .. .. {rr}:•}'•::::: } .. :?{•?:r.•:.•::•.vr•.+r:::v.,v;.•.• ..r:• n• .. .. :i L}•• ::{rifY.??•}�Fi:+r i:•:•}:f{r::r.::::'{'r,::+lr,.:r•}Yr:•}???}:!:•.•. •:.4; ..t{.t,c,},.r:.:lrrk�}Y3.w/r..:•f.:{?.J/+f!•.};,t?.::.}'frf .'•./.•..r {•:!•:fr...r. v. •. .t::.Y/,Lr.•'.,..'•.... �{•:t;..r./......:.,�:•::•:::•::•:::::::f•:::•r.?•:::..;^::::::::::::.:.;?::•:::::•::}::::}:::::•::::::?::�:; i:�:��..i:;::�:F't35•�•$:.>:::::::::: .' 7F; •.•. ?iSi:�:?::{•}:y'•..;:.•:t;:t;:,};.:.:.;..rr.;.:.....:,,...:•r:::.;f�,C,...:.,•r. r:.:.... i, 1, Workers Compensation Insurance : Part One of the policy applies to the Workers Compensation Law of the states listed here : MA, NH i I . Employers Liability Insurance : Part Two of the policy applies to work in each state listed in Item 3 .A. The Limits of our Liability under Part Two are : Bodily .Injury by Accident $ 1 -,000 ,000each accident Bodily Injury by Disease $ 1 ,000 ,000 policy limit Bodily Injury by Disease $ 1 ,000 ,000 each employee Other States Insurance : Part Three of the policy applies to the states , if any , listed here : All states except ND , OH , WA, WY states designated in Item 3 .A. (A t: I. This policy includes these endorsements and schedules : See FORMS AND 'e ENDORSEMENTS Schedule , WC 99 06 22A (01 /97) . .............::.....:..:.:....::::.�::::::.........:..:.: . . .......r.......................................:..:::{.::::rr::r::.f..{+r.::{•:>r:.:r:::.::.,.r::.:}..tt..,::ti:.{:...;:...:::.:. .. .. . ........... . .. .............................. ...... .. . .... .....f. :..H s..r.r:..:..::.:•::r.+•:ri.:::..::::.::::.::::::?.;•.•.•..:.•.;:.}>;:r4;z•.iso:.:•:::.}••}}}•::}}}}}}}•:}::Y .{....,..r...:::{::.....:.r.r :.:..::••»tf:. ,r?...{! ...:. r..{.:r . .{.,::.+:?4::f4<•:rc:r::.:?•::•:::•...;.. :.::: ::.}:. ...:•.�:::::•:� •.: ........... .......:::::{;tr.:.�:•.. ..:{rx:,.,?.<a}•;•}:f:+r. ..�i......r.S.Fr::!{.}./.�.:.F......r.: :iii .. }......r......:...............r..r........ ....}: / ......•rr .:•:::v.,•rxv:• n.r.r....:r.4:::;,v:w::;:•.:v:::.v::::::{:4:4:?r{4}:'ry}v'v:::{}:y:'•:;�:v::;•• i :.T:��'J}:•}:•.r:Q. .R;.}}::r}}}}i��:' . :.{ .::::::::::::::::::.::.::.:...:.:...::v:.:.J.rr...:J.r..:::.r.<...r.rrr:}:r.:,;r.;:r..:•:Fir::{.:{;,:. .:.{.:...... t. •a' 'he premium for this policy will be determined by our Manuals of Rules , : Iassifications , Rates • and Rating Plans . All information required below is !3 ubject to verification and change by audit . See E.xtension of Information Page ..... ..... ..:.. .... .... ...r..r.....r............. . �...r.......rr.,. .r<rr .. ,.}?}:r>}'{:r:{::.Y.r:::..l.}}Y:::{{::.:.::::::::.r:::..::.:::::.:::::•.::::::::.::.�:......r. ...yit:ri...✓.•:::r:r }.r}::+.::. .fv//.Y,.:::it•.v,..:,tN.::..::::f......i.r. ::f:..r.,:.::.r..:r:.r::....::r. .... . .: ..:. r........... ...+........ .:...r..:rf.Y.f...f..r.r..rr. � ... r.:.... ff,: ,10�.:�.:1v'r�:::np.I�.l= •�•:� w:. •. . .:...........:................. r..r:..r.J:.r r.:......... r 4•, .v.:.:.+.r....::::;4•:•v:::.+i ii 'OTAL ESTIMATED ANNUAL COST: $ 46 ,014 Minimum Premium: S 750 leposit Premium: $ 46 ,014 Date of Issue : 06/22 /2011 :... .:.....:.......:...:......:::.: .:...:... .....:...:.... ::.: .;.... .. .:. ..r. ... .: •. .:? ......r.....,...i...:.:rfA. .:: .... .}..:.l.rx !.: .l: +• .f.. fii:i:>i.:iF r. i.l....:::, :.f......:{•}:i'}i:•:•:'::> .. .. .. .. ..r... .. ...... r....................... ....4... ...... !.....n fir .. fl../<.• ?ifvt........ ...f......:.r r. J.. ...r. ...!.•:...r.Y r.....v.r.:....:..r. ...:..::..•.:....rr.'i'� x�'{i.::•:::•i}:4:{v`:::v: .. .. .....:, •.:::. •. ... .. .r....... .r ..:.f.rr. f.....,... ...f.. ...i......f. ..f/f..........x ..F.•..............:. .. j ..s:. ... ..yy... yy!.:. ....... .:.:::::::•:rv:v;•::.rr,.. n...:..f..�.f......r..:: ..........r:•:R•r•r................:w:w::. .... ...:.................................:w:: �.�.::.i.►. •. :L.. •:A�:.,..� ,.•.......,.•..:..r......rn...1........r...}:... }.,.. .n... :....r..r..... .... .r....rrr....•v:::::::::•:::{..t•::::.v.v•::.:.:�.}:Y?4:•i}:??•i?}i:}:•}?i:{4?:4:C2::}::4::4:4:: game of Producer : EDWARD F . SENNOTT INSURANCE A Servicing Office : PO BOX 457 SPECIALIZED MARKETS TOPSFIELD 01983 657 countersigned by : —" Copyright 198.7 National Council on Compensation Insurance ;720390,1)00 01A ( Ed . 01 /97 ) PRO (Page 1 of 4 ) Load Short Form Job: 50 Ciderpress press Date: Apr 26,2012 Entire House By: JW Heating and Air Conditioning 17 Arlington st,Dracut,me 1826 For: Tara Leigh Development 115 Carterfield rd, North Andover, MA r © . o c • - Htg Clg Infiltration Outside db(°F) 12 88 Method Simplified Inside db(°F) 68 75 Construction quality Average Design TD(°F) 56 13 Fireplaces 0 Daily range - L Inside humidity(%) 50 50 Moisture difference(gr/Ib) 43 28 HEATING EQUIPMENT COOLING EQUIPMENT Make Goodman Mfg. Make Goodman Mfg. Trade GOODMAN Trade GOODMAN, JANITROL,AMANA DISTI... Model GMH950703BX Cond GSX130301D* AHRI ref no2002182 Coil CA*F3030*6D* AHRI ref noA700044 Efficiency 95 AFUE Efficiency 11.5 EER, 14 SEER Heating input 46000 Btuh Sensible cooling 19880 Btuh Heating output 44000 Btuh Latent cooling 8520 Btuh Temperature rise 42 OF Total cooling 28400 Btuh Actual air flow 947 cfm Actual air flow 947 cfm Air flow factor 0.038 cfm/Btuh Air flow factor 0.050 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.91 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) kitchen 180 2239 2172 85 108 hall 60 407 72 15 4 living room 195 3092 2135 117 107 dinning room 225 1556 1180 59 59 stairs 105 603 107 23 5 entry 180 3092 1879 117 94 m bath 108 1691 1053 64 53 laun 72 503 187 19 9 elev 60 420 156 16 8 Loft 264 3379 978 128 49 Bedroom 2 180 2628 3765 99 188 2nd stairs 105 629 253 24 13 1/2 bath 90 539 217 20 11 master bed 330 4223 4815 160 240 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. �� wrightsoft' Right-Suft2012-Apr-26 07:36:42 e®Universal 8.0.24 RSU057so Page 1 ...ts and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: Entire House d 2154 25001 18970 947 947 Other equip loads 8696 2389 Equip. @ 0.93 RSM 19779 Latent cooling 2170 TOTALS 2154 33697 21949 947 947 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. ftw ht wri so ...r � 9 Right-Suited Universal 8.0.24 RSU05790 2012-Apr-2607:36:42 Iip1Page 2 ...ts and Settings\Ovmer\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: Buildin Anal SIS Job: 50 Ciderpress press g y Date: Apr 26,2012 Entire House By: JW Heating and Air Conditioning 17 Arlington st,Dracut,me 1826 For: Tara Leigh Development 115 Carterfield rd,North Andover, MA Location: Indoor: Heating Cooling Boston Logan Int'I AP, MA, US Indoor temperature(°F) 68 75 Elevation: 30 ft Design TD (°F) 56 13 Latitude: 420N Relative humidity(%) 50 50 Outdoor: Heating Cooling Moisture difference(gr/Ib) 42.7 27.8 Dry bulb(°F) 12 88 Infiltration: Wetybu range (OF) _ 72 ( L ) Method Simplified Construction quality Average Wind speed (mph) 15.0 7.5 Fireplaces 0 o Component Btuh/ft' Btuh %of load Walls 3.6 7145 21.2 Walls Humidification Glazing 16.7 3102 9.2 _ Doors 21.7 911 2.7 Ceilings 1.4 1748 5.2 - ventilation Floors 1.4 1310 3.9 Infiltration 2.6 5701 16.9 Glazing Ducts 5084 15.1 Piping 0 0 Doors Ducts Humidification 5312 15.8 Ceilings :r Ventilation 3385 10.0 FlOorS Adjustments 0 Infiltration Total 33697 100.0 o0 0 Component Btuh/ft' Btuh %of load Walls 1.0 1966 9.2 Walls Blower Glazing 43.6 8101 37.9 Doors 10.3 434 2.0 Internal Gains Ceilings 1.3 1572 7.4 Floors 0.3 297 1.4 Infiltration 0.3 646 3.0 Ducts 3694 17.3 _. Glazing Ventilation 0 0 �• Ducts Internal gains 2260 10.6 Blower 2389 11.2 Adjustments 0 Infiltration Total 21359 100.0 Doors' Ceilingsther Latent Cooling Load =2170 Btuh Overall U-value=0.060 Btuh/ft'-'F Data entries checked. ^t wri htsoft" R 2012-Apr-26 07:36:42 9 Right-Suite®Universal 8.0.24 RSU05790 ACC�', ...ts and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: Page 1 HEATIM Component Constructions Job: 50 Ciderpress press AIR CONOTTIOtANG Date: Apr 26,2012 Entire House By: DRACUT.MASS 018a J&J Heating and Air Conditioning 17 Arlington st,Dracut,me 1826 Project • • For: Tara Leigh Development 115 Carterfield rd, North Andover, MA � De' sign'Cohditions Location: Indoor: Heating Cooling Boston Logan Int'I AP, MA, US Indoor temperature(°F) 68 75 Elevation: 30 ft Design TD(°F) 56 13 Latitude: 420N Relative humidity(%) 50 50 Outdoor: Heating Cooling Moisture difference(gr/lb) 42.7 27.8 Dry bulb(°F) 12 88 Infiltration: Daily range(°F) - 15 ( L ) Method Simplified Wet bulb( F) - 72 Construction quality Average Wind speed(mph) 15.0 7.5 Fireplaces 0 Construction descriptions Or Area U-value Insul R Htg HTM Loss Clg HTM Gain ft' Btuhf k'F ft?°FBtuh Btuhlft' Btuh Btuh/ft' Btuh Walls 12F-0sw:Frm wall,wd ext,1/2"wood shth,r-21 cav ins,1/2" ne 342 0.065 21.0 3.61 1236 0.99 340 gypsum board int fnsh,2"x6"wood frm se 737 0.065 21.0 3.61 2664 0.99 733 sw 252 0.065 21.0 3.61 911 0.99 251 nw 646 0.065 21.0 3.61 2335 0.99 642 all 1977 0.065 21.0 3.61 7145 0.99 1966 Partitions (none) Windows 2 glazing,clr outr,air gas,wd frm mat,clr innr,1/4"gap, 1/8"thk:2 ne 90 0.300 0 16.7 1501 38.0 3423 glazing,clr outr,air gas,wd frm mat,clr innr,1/4"gap,1/8"thk se 42 0.300 0 16.7 701 48.7 2047 sw 54 0.300 0 16.7 901 48.7 2632 all 186 0.300 0 16.7 3102 43.6 8101 Doors 11 D0:Door,wd sc type sw 42 0.390 0 21.7 911 10.3 434 Ceilings 1613-38ad:Attic ceiling,asphalt shingles roof mat,r-38 ceil ins,1/2" 1209 0.026 38.0 1.45 1748 1.30 1572 gypsum board int fnsh Floors 19A-38bswp:Fir floor,frm fir,10"thkns,hrd wd flr fnsh,r-38 cav ins 945 0.029 38.0 1.39 1310 0.31 297 tight bsmt ovr W rl htSOt- Right-SuiteUniversal 8.0.24 RSU05790 2012-Apr-26 07:36:43 is and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: Page 1 i Project Summa Job: 50 Ciderpress press AR CONUnOMNG Date: Apr 26,2012 17 MrQto,ft" Entire House By: MACUT'MASS 01826 978454.12T-V"744444 J&J Heating and Air Conditioning 17 Arlington st,Dracut,me 1826 ;Pr6jeCt Inform • For: Tara Leigh Development 115 Carterfield rd, North Andover, MA Notes: Desiigoon Weather: Boston Logan Int'i AP, MA, US Winter Design Conditions Summer Design Conditions Outside db 12 OF Outside db 88 OF Inside db 68 OF Inside db 75 OF Design TD 56 OF Design TD 13 OF Daily range L Relative humidity 50 % Moisture difference 28 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 19916 Btuh Structure 15276 Btuh Ducts 5084 Btuh Ducts 3694 Btuh Central vent(55 cfm) 3385 Btuh Central vent(0 cfm) 0 Btuh Humidification 5312 Btuh Blower 2389 Btuh Piping 0 Btuh Equipment load 33697 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 19779 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 1280 Btuh Ducts 891 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area(ft') 2154 2154 Equipment latent load 2170 Btuh Volume(ft') 17496 17496 Air changes/hour 0.32 0.16 Equipment total load 21949 Btuh Equiv.AVF (cfm) 93 47 Req. total capacity at 0.70 SHR 2.4 ton Heating Equipment Summary Cooling Equipment Summary Make Goodman Mfg. Make Goodman Mfg. Trade GOODMAN Trade GOODMAN, JANITROL,AMANA DISTI... Model GMH950703BX Cond GSX130301 D* AHRI ref no2002182 Coil CA*F3030*6D* AHRI ref noA700044 Efficiency 95 AFUE Efficiency 11.5 EER, 14 SEER Heating input 46000 Btuh Sensible cooling 19880 Btuh Heating output 44000 Btuh Latent cooling 8520 Btuh Temperature rise 42 OF Total cooling 28400 Btuh Actual air flow 947 cfm Actual air flow 947 cfm Air flow factor 0.038 cfm/Btuh Air flow factor 0.050 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.91 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. t { W rl htsoft® Right-SuiteUniversal 8.0.24 RSU05790 2012-Apr-26 07:36:43...ts and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: Page 1