Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 54 CIDERPRESS WAY 4/30/2018
� - _ h '__----- \ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the \ permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of.ongoing construction activity,and may be_deemed by.the-Inspector-of Wires abandoned_and_invalid_ifhe—_. ._ 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. ule 8—Permit/Date Closed: _f ** Note:Reapply for new pe 0 Permit Extension Act—Permit/Date Closed: Date . . .?— TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . . . C.,... . .. e has permission to perform . . .e�t`�U�.�.%. S /t�y wiring in the building of . . . . . .//L/#Z C4/�cI) . . . . . . . . . . . . . . . at . '°r`�. C'! �7 � �. . , . . . . .N rth Andover, Mass. Z ELECTRICAL INSPECT (heck# 11005 . I � Official U�_OaI�,. i Oc€€�apancT and Fee Chea l ed BOARD OF IRE PREVENTION REGULATION i-e.. 1'� rr 0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ali.�ro.,I to ley peTf6nnea Ln xec"r:aue to itb.lie',,Machu ea_rL_ecn4kal Coda(!-!EQ..527 CNT,12.CIO DIY Y (FLEA 1�.��r, ' „ �'xF;���3a� �lA�.��,���.� 3� ���� �`,' Date: Thursday, July 12, 2012 ry NORTH ANDOVER City 144 .L 1' Tr of.. To i!F•" qf{FP"{'`u:.. By tarry applieviorr,the under isne t gives novice of his or her mte=,on to JR.M.r-rA the eleCUICZ),a.'rorlt d4e�cnibe€l lvlek 4a,; T oeati�rr l:`trert 'ttrulreri 54 CIDERPRESS WAY Owner oar Tenant ROBERT MARCHAND Telephone No, 9789845091 aOwner's Addraass SAME Is this permit in.conjunction with a building permit? Y'es NN,p � _p ❑ © (Check Appropriate Boy Fin,pose of Building Utility Authorization No. Existing se wire w _ W.. Amps i __Volts Overhead❑ T:nd nsd ❑ 'o.of Meters ..v,.. Nev S€rijef Amps i volts Overhead Fj Undai'd No.of Meter: . r :'umber of Feeder's and l inpiritv ' Lrtc:rtian aricl`atxrre a�f 1'rcpr�sed Electrical �'Qr^tie Ctvr,' Q. Lt,r»n 0 "sof TFirel. � No.of Recessed Lurninrrir•es No,of Fairs r o,of Iota] Transforme'r's meas K A, No, of Lurrrivairre Ouilets No.of Hot Tul s Generaltors V ore ❑ n_. ❑ : a o nzer Oerrc�. in rtrrr NoL. .of Lurainairtls Swimming Pool `.rud, grIn- } atterb U nits 0 X :fax.of Receptacle Outlets leo.of Oil:Bur'nez•.s. FIRE ALAR'115 -No. f Zones No,of Switches Noo of Gas Burnes o. a etinE rn air: Initaatins 1)(-vices — No.of Ranges No,of Air Conn, Tons N.0, of 4klertinl-Devices boa of Waste Disposers t rrrnla uxn er E.._ us o.u ,Hea - ontaruec P Totals Detectiow, ler•ting Dv ices `uzrrcr a ► o.of Dishwashers Space!At*a Heating Iii', Local❑ Connection ❑ Other No.of Driers Heati7rg ppliances R ecuart ;:"esterrrs.' o, Devicescar°E-uivalfnt 5.00 • ;�i _;o.o =artr ,,o.o n _ t co,of Dat r �` I3�1` HeaversSins Ballasts No.of Ilel-ices or E uri�alerrt 0.00 No.Hydr`omassaaeBathtubs IN70.ofMotorrs Total HP tete cornnrunrtatronsar3rin�: o..of.TDfvi,ce' s or ui;•a)erxt 0.00 l� OTHER:. Estimated Value racal' rorlc: $30000 (a-_� Y<xeu requrrel by asntnrcilal pr hcr.�a Work to Starz:—hi3peczlons no be Yequest�ed in accordance:whir MEQ,Rale 10,and upon conxp.enon. ENSURA CE tw OITRAGE: t dery xM' e.l by the ov.-ner,no permit for the perfo-rnance of ele.Trcal vvor1 ma, issue uralesss tlae lieensiee pyovides proof rf lin ihty mi sumnee nic],uding "compieted.operation''co erage or its substantial eq:ar:waler_ . The: undersigrxecl certifie•that:Mach coverage is M' force.And has exhibited proof of arn�e to the permi,isstia€rig office. C,_H1 .Cli 0_NTE: ENSUPUNCE ❑ BONsD. ❑ OTHER ❑ (Specify:) Icerk,ft"x aait.der thePC.in andpenvI ies )", tlrtrt fli0 iixf"rarnta on On Ails ofa Iisrrtiaara rs t aa� catr to vrrr�t'�t€:: FIRtI' _ ME.A rrrcrir,rrr. lir rrr t t�rrrrrarrrria:artisrrr5a l tit, 14 1 LIC.NO,: 1 z 1 2 C N1 A Licensee: p i e h a r J L;: S,i in p s o n. S r. Signature LIC,NO–5 0:} l) _ �Iff � cYit( . rhr ,t. Evrr ?7f;eBir ,Tel No_ 7N 1-441-20011 Address: 297 Brotjdwav_ Ar•liraatoji, MA 02=174 Alt,Tel.Nca.: Per aft.G.1 c.. 14"1117�. ? 1.ieciva�j worl require;i Departnent of Public Safety `,License: Lic.No. SS CO 0 lrlrr.�i t�i„`a Obi NER''S.LN,SUR_�XCE� AJYER. lam aware tbit the Licensee do-c's not}ave the h oilht7 iar-�tumce roc~erage r�ormall.,, required by law. By ory.ignature'oelow,l tlris re€ &ement. I am the(chec1 car ej❑r a7ie€ ❑oarn r=s-ar�esat:. Ot�ner::�.gent Signature IelephaneNo. 57� 7 FEE S 45.00 * NORrH q O 0 '' APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION eyti BUILDING PERMIT # 567 ACHUS ADDRESS/LOCATION OF PROPERTY:_ L S lCe� Map /p C Parcel__3/ Lot Number -- SUBDIVISION: DATE REQUESTED FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: �13D 2 FIVE 5 DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUSTYCO . ETED WITHIN THIS TIME FRAME. A REINSPECTION FEE OF TWENTY D20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPL ABLE APPLICANT SIGNATURE Permit Issued to: LMAU Address: $ �- ROUTING TOWN ENGINEER, SITE PLA -DRIVE-WAY REVIEW CONSERVATION per' F L� a L!2-t'1 y PLANNING N1 A- ❑ DPW-WATER METER oZ l SEWER CONNECTION v DPW MUST INDICA T THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL �JPANCY/INSPECTION REQUEST DPW SIGNA File:Applicat for OC form revised Jan 2007/2011 XAORTF/ Town of _ Andover No. 9(0N. �`yy �~ o d.over1 Mass. / fT LAKE GOC MIC ME WICK �S RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System o�l� �6 �0 � � e BUILDING INSPECTOR THISCERTIFIES THAT.....:.........�..f.........�.�.���................................................... ..................................................................... Foundation s r /�r has permission to erect...... . buildings on ....5 C E 0©•^�s� Va ............. .......... ............................ . .......... to be occupied as � 6 C�/V'� //� s �xi o �'L j �Y D�� VS-� Chimney provided that the person accepting this permit shall in every 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 PERMIT 1 L�RMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONr- TS Rough ....................... ........ .... ..... Service UIL�dIlQG INSPECTOR Final Occupancy Permit Required t® Occupy Building GAS INSPECTOR Rou Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE-DEPARTMENT.; Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. II Plans Submitted Plans Waived ❑ Certified Plot Plan Q Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning(Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS NlA ZtzA (A. !{O$ (rd p�u►. !, � CONSERVATION Reviewed on-4Si nature 1 — 1 COMMENTS A D6P It244Z -j 1)q ,A aGGet`rIXa rce W106 C u,J P4 aruix S HEALTH Reviewed on Signature COMMENTS /So k A,�v/444p/*) --N4,& , Zoning Board of Appeals:Variance, Petition No: Zoning Decisionfreceipt submitted yes m Planning Board Decision: Comments Conservation Decision: 2�/2/�1 Comments !Dater &Sewer Connection/Signature& D eL-;( Dnvewa Permit 11PW Town Engineer: Signature: - ace, Located 384 Osgood Street FIRE DEPARTMENT -Temp D er onsite yes no Located at 124 Main Street Fire Department signature/date /D 17,6/l COMMENTS I %ORTH Town of _ _ Andover .. . No. ''`` ✓fin I. �odxT ` = o dower Mass., /0LAKE COCHICEWICK 1 ,p A0RA7'ECl P`P ��CD �a U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System Ile. � BUILDING INSPECTOR THIS CERTIFIES THAT............ „e�< :' � ...nc..-f,&,fir ... ............�.................................................... Foundation has permission to erect........................................ buildings ....de"elr V� FA;......7......... Rough to be occupied as.............. . U.ce' ..... ''u.. ..��� ..................... 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, Afteration 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 UNLESS T ELECTRICAL INSPECTOR V 1 v LESS CONSTRT T CTIO�,T I V 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 Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i / / I 1) THE BOUNDARY INFORMATION SHOWN HEREON WAS TAKEN FROM A / / r MAP 1040 LOT 29 PLAN ENTITLED "PLAN OF LAND, MEETINGHOUSE COMMONS AT / GRN ESSEX COUNTY SMOLAK FARMS, SOUTH BRADFORD STREET, NORTH ANDOVER, GREENBELT ASSOC., INC. MASSACHUSETTS"; SCALE: 1" a 80'; DATE: JULY 20, 2001 BY THIS OFFICE. RECORDED AS PLAN X14828 IN THE ESSEX COUNTY / NORTH DISTRICT REGISTRY OF DEEDS. / 2) THE INTENT OF THIS PLAN IS TO SHOW THE AS—BUILT LOCATION OF THE FOUNDATION ONLY. MAP 104C 3) THE FOUNDATION SHOWN HEREON IS NOT WITHIN THE 100 YEAR 12.20' FLOOD ZONE AS TAKEN FROM THE FLOOD INSURANCE 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 -----" ' lstr3 _�t? ( 1'OB APPROVED BY THE TOWN OF NORTH ANDOVER PLANNING BOARD. f' ------ `.�\ � 7 , 0.34 I HEREBY CERTIFY THAT THE LOCATION OF THE TOWNHOUSE UNIT NUMBERS 20-23 FOUNDATION SHOWN HEREON IS THE RESULT OF A FIELD SURVEY BY THIS OFFICE MADE ON DECEMBER 30, 2011. i4� j`\ r ^ \ `v' / \ -••" � CHRISTOPHER�Tq FRANCHER LICENSED LAND SURVEYOR DATE CERTIFIED FOUNDATION PLAN / MEETINGHOUSE COMMONS TOWNHOUSE UNITS 20-23 AL\ AL AL GRAPHIC SCALE CIDERPRESS LANE ` 0 as Be lap NORTH ANDOVER. M fSOSSACHUSETTS MEETINGHOUSE COMMONS, LLC (IDT FUM 121 CARTER FIELD ROAD i imb - BO R NORTH ANDOVER, MASSACHUSETTS ■ um,SHIw Road,Sul.On. / \ / r SalaNw No paMn 03079 (603)993-0730 Aly, MW Damon Conau0; Ino. ENOIKW•PLANK"•SUMORS "IN / SCALE: 1' + 50' DATE: JANUARY 3, 2012 DRAWING -BlIA 1 \ NO. DESCRIPTION VBYDA7E DRAWN BY CH C ED B ' PROJECT N0. NAME REMSIONS CMF 250508 2505CFP.DWG AW Av REScheck Software Version 4.4.0 Compliance Certificate Project Title: Meeting House Commons Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Multifamily Building Orientation: Bldg.orientation unspecified 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 781-439-6166 ..,T'� "•, y .ter.... _ •;�_ ...�::,:�,.t�� 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. NONE a i•• a Floor 1:All-Wood JoisttTruss: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"D.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"o.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 buil P p p din design described here is consi t o 9 9 e t 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 theRES ck Ins tion Checklist. Ogg 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 _ I ' lIa�c;tehusctts-Department ofPuhtic Sarets Board Or Building Rcgutaticros and Standard's Constructkon Supervisor License License: cs 56417 Restricted,to:_00... _-- THOMAS D'2 k ORUIKO L f 115 CARTERFIELD` N ANDOVEW;-MA-Q 1845 ' Expiration: 45=2 C'+..mmiw4ioner" Z 21090 1 i the Commonwealth of Massuciiusetts Department of rAdust ial Accidents Office of.lravestigafions 400 Washinown Street Boston, M4 02111 wwN:rn¢s�bovI a Workers'Compensation Insurance AMdavit:Builders/C-ontractors/Eeetricians/Pinmb- AupIicant Information Please Print Lezbly Name ersr (Bnsmessrotganizatiou/lndividssal): Address: l t^ City/S_tE�p: Are you an employer?Check the appropriate be= 1-❑ I am a employer with 4. ❑ I am aType of project(required)- - employees(fid]and/orpart_time).* have hired the genmzic�actor and I 6. f�j Neap constmeti� 2.® I am a sole proprietor or part=_ IisiEd on the a#tached shycet# 7. (��Renaodelitg ship andhaveno employees These sub_c=ftctms have 8. ❑I3emolifion working forme m aay capacity. work=s' [No workers'comp.insurance 5. El We area c.q. fion nd COMP. its 9- ❑Building addition 3.❑ requfiel-] - Of have crud their 10-❑BICOWcal repairs or additions I am a homeowner doing an work right of car a mp6M PCr MGL 11. myself[No workers'comp. c. 152,§1(4)�and we ❑ repairs or additions have lzo - msta>3mce j t employees_ [No workers' 12.[]Rifrepairs caamp. mqnhz&) 13.0 Other brae—ael-IM Eaaneavvnem who eft at�v$' °�fire , fiY=--dit all-,*,,d tam ianoaQ;id� ��t s nrAv ZContiCMM that do*tLg boot mmatmcaedan addi�o�l.sh�t�ow�g�-aameaf�e ---- --- - ---- --— _._ ..ram anand$rete*odors•�- p rg workers wmp=saSoa uc.formairm". � fO1 m3'MV10YeM Below is fOheFo6c7'and jab sne Insurance Company Name: Policy#or self-ins.Lir.#� Expiration Date: Job Site Address: Attach a copy of the workers'co Crfy/Statel - mpeasafion policy mon pap(shy the poky nnminer and Farbue to secure coverage as �r Section 25A ofMGL C. 152 can lead to&e' espiraiion latae}. fine up to S1,500.00 and/ar one-year as Well as c va- °f , P.��of a Of up to 5250-00 a day against the violator. I3e _ penalties in the farm of a STOP WORK ORDER and a frac that a co of this Investigations of Ste DIA mr iasmmnce . . TY . statemeew may be f MWzded to the Office of rd 0 he eJio een fy raider Pains and 00irlmy 8iar Ae iitfor.�may- is true and correct Phone*-. ofikid use only. Do not write in this area, to be cemplekd by city ar town o lrcW testy or Town_ Pe�it/Laeense tr AUMM- Y(circle one)- - LBoard 6. er of Beat& 2.Burp DePa�ent 3-C' /Town Clerk 4. Inspector a PIambmp' e Inspector Contact Permit: t Phone i - Date... .................. Z-..... r10RTM -6 TOWN OF NORTH ANDOVER PERMIT FOR WIRING . t : s SAcMuSE� Thiscertifies that ....................................... .........,,.oo..... ................................... has permission to perform ......... v.......4: ? ( 0.......................... wiring in the building of.......m.�� �1 �`-�0,. e............1',<. L`. ...... ............. at ....... ..AE�ri North Andover,Mass. Fee 4?.. $ Lic.No&f<.�t b.............. .. . ... ....... ICALINSPEC, Check 10790 vCommonwealth of Massachusetts Official Use Only Department of Fire Services Permit No.- A0 BOARD OF FIRE PREVENTION REGULATIONS 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 IN INK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspector o rkd By this application the undersigned gives notice of his or her intention to performelectrical woescribed below. Location(Street&Number) �,C � S Owner or Tenant E E-0AjCC>A4 ;�i Telephone No. — Owner's Address % W,� C-k�`Ti� �� k/�` '�-��t a�l6( Is this permit in conjunction with a building permit? Yes 9-- No ❑ (Check Appropriate Box) Purpose of Building (� b � .5 LeA;( � ,, , Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters • Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �.1' ty"(a Ly A! i Completion of theifollowinz table m be waived b the Ins ector of Wires. No.of Recessed Luminaires L No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 2 Swimming Pool Above ❑ in o.o mergency tg ting rnd. rnd. 13 Units No.of Receptacle Outlets 1,0No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners I No.of Detection and No.of es Ran i Total Initiatin Devices Ranges No.of Air Cond. ( Tons 3 No,of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.ofSelf-Contained Totals: Detection/AlertingDevices (O No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection Other No.of Dryers Heating Appliances KW Security Systems:* No.of WaterKNo.of No.of", --- ---iE uivalent ms, Heaters No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent ZD Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value f Ele ical Work: � a (When required by municipal policy.) Work to Start: t Y Z 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE cove ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the-LQ, information on this appiication is true and corrtplete. FIRM NAME: Licensee: LIC•NO.: -AA t t� A),4.r_Signatu Wapplicable ent r "exempt"in the license number line. LIC.NO.: Address: w5 g ,�5� Bus.Tel.No.: *Per M.G.L c. 147,s.57-61,sec ity work requires Department of Public Safety"S"License: Alt.Tel.No.:RARC�a_74_Z_ �, OWNER'S I Lic. INSURANCE No. 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)El owner El owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ A ELECTRICAL PERVRT NO. t ELECTRICAL 1N8PECTOR-DOUG SINSPECMALL PORT: I.ROUGH SPECTION: Passed— Failed—[ ] Re-inspection requireci($50.00)-[ j Inspectors'comments: 41 (Insp tors'Signatur -no* tials) Date 2.FINAL INSPECTION; Passed— Failed—j .] Re-inspection required($50.00) Inspectors'comments: (In pectors'Signa re-no initials) Date FEs' Failed—[ jn required($50.00)Signature-no initials) Date 4.INSPECTION—SERVICE: - DATE CALLED NATIONAL GRID: NANfE: Passed—[ ] Failed—[ j Re-inspection required($50.00) Inspectors'comments: P (Inspectors'Signature-no initials) Date S.INSPECTION-OTHER: Passed—[ ) Failed—[ ] Re-inspection required($50.00) Inspectors' comments: 'Signature-no initials) Date DOOR TAGS.ARE TO BE FILLED OUT AND LEFT ON SITE W TBE AREA TO BE INSPECTED IS NOT ACCESSIBLE AND.A,RE-INSPECTION OF$50.00 IS TO BE CHARGED. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly . Name(Business/Organization/Individual): Ar A&A C' C Address: tte.b v ti City/State/Zip:. ,v L,Giz�,`j �'v S<<l phone #: r2. re yo it an employer?Check the appropriate box: Type of project(required): I am a employer with (, 4. El am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6' ��'construction ❑ I am a sole proprietor or partner- listed on the attached sheet. f 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition M 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' comp.insurance required.] 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 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 insurance for my employees. Below is the policy and job site information. Insurance Company Name: \rkst,V OU Gam- t--.Js Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:S (,l lAr�S!j w City/State/Zip: - A Attach a copy of the workers'compensation policy declaraion page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year 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 hereby certify,under the pains and penalties of perjury that the information provided above is true and correct. Si nature: Phone#: 7 k �,-- S——O kb 7 Official use only. Do not write in this:areabeompleted by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Deparity/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is 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 t requirements of this chapter have been presented to the contracting authority." Applicants wr 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# 617-727-7749 www.mass.gov/dia Date.. . .- � ...... . . N°RTH o? TOWN OF NORTH ANDOVER fig Io• - PERMIT FOR GAS INSTALLATION SACH This certifies that . . % !� � Q�. . .!/.i�� �. . . . . , . . . . . { has permission for gas installation . . . . . . in the buildings of ,l �ef�'� �d�' . . A. . . . . . . . . . . . . . . . . at . . . . .. 5. . . . . . . . . . . North Andover, Mass. Fee./0: Lic. No.�s!S . . .r . . . // GAS INSPECTOR Check# t ' 7 ' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK WCITY MA DATE oZ1 PERMIT# JOBSITE ADDRESS /� _ OWNER'S NAME GOWNER ADDRESS [._,. , TEL FAX�zzi1 TPYPPENOT OCCUPANCY TYPE COMMERCIAL f EDUCATIONAL E] RESIDENTIAL CLEARLY NEW:Rr RENOVATION:C]_.,I REPLACEMENT:® PLANS SUBMITTED: YES E] NOF-1 APPLIANCES-1 --FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER 77-1 BOOSTER CONVERSION BURNER COOK STOVES ___(. DIRECT VENT HEATER DRYER _ I FIREPLACE _ ( _._ I-.� _I( L _ I I __--J ._. f��_-( �_ _I Il!_M - G_:-�� FRYOLATOR _ FURNACE GENERATOR GRILLES i V -..- - - INFRARED HEATER LABORATORY COCKS -----J-.= 1 MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER -- ROOF TOP UNIT 1 TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER �!_ I . IJ iI _I i �I ._. _ I �E� .,_ i� _._ OTHER 11L_ Ji_ _fl INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES JdNO n IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERA5PRYINECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY [__vi� OTHER TYPE INDEMNITY _1 BOND DLJ 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 0 AGENT [�_I SIGNATURE OF OWNER OR AGENT 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 y knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertine of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBE ASFITTER NAME,( T � � LICENSE# 5 l5 SIGNATURE _ MP _ _I MGF __i JP JGF LPGI Q CORPORATION Q#� PARTNERSHIP D#= ----.-�-----_�1 LLC L COMPANY NAME:(J� t� J.J _ IIADDRESS -- CITY �- — ^—_I STATE ZIP I �J � — ITEL � � �S 3 " �3g/ FAX --� CELL. . EMAIL _ _ _-- Aff Z1//z: 271,1 Z_ The Commonwealth of Massachusetts Department of IndustriqlAccidints Office of Investigations Uf 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly Name(Business/OrganizatiorAndividual): Address: c2 U /( )�Jw"A 4/_ City/State/Zip: ?-41 Kim l� 6 30-1 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. �• F1 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.F1 Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]r employees.[No workers' comp.insurance required.] 13.[i 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 lice 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. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. f' Policy#or Self-ins.Lic.#: O Co T 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 Investigations of the DIA for insurance coverage verification. I do hereby certto under the pains and penalties ofperjury that the information provided above is true and correct - Signature: Date: Phone#: 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#: V 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 ofhire, 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 permittlicense 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 of Industrial.Accidents Office of Investigations 600 Washington Street Boston.,MA,02111 Tel.#617-727-4900 oxt 406 on 1-877,7M.ASS.AFF Revised 5-26-05 Faze#617-727-7749 vvrvw.mass.gov/dia Date. . 9405 HpRTM TOWN OF NORTH ANDOVER p� ,,.o e .... '• pL r _ PERMIT FOR PLUMBING i ,SSACMUS� ' This certifies that . . -.e? / �. has permission to perform f .. plumbing in the buil . ! buildings of . . .`!. 7. . . . _ .? . . . at . . . . ?�r!�?�!� . .Zee. . . . . . . , North-A.nnd/oder, Mass. Fee .V!�.Lic. No.. SA-0 PLUMBING INSPECTOR Check # r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE ( PERMIT# JOBSITE ADDRESS OWNER'S NAME P OWNERADDRESSI _ TELI FAX TYPE OR OCCUPANC TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL 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 J _ DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM T J DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER E DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN _J a J �j _ j J _ _ — _t �j 1 INTERCEPTOR INTERIOR KITCHEN SINK _J _ -i _ �} a LAVATORY _ ROOF DRAIN SHOWER STALL I SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES E] NO Ej IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY© OTHER TYPE OF INDEMNITY dJ 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 0 AGENT F SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance ith a Pertin t ion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME �IILICENSE# / " i� SIGNATURE MP[Ir- JP0I CORPORATION# PARTNERSHIP# LLC0 COMPANY NAME ADDRESS _ CITY Q — ISTATEDUFni ZIP �3 p '� (o TEL ftG _ FAX CELL MAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES � Y� 0 NY./Jj THIS APPLICATION SERVES AS THE PERMIT , FEE: $ PERMIT# PLAN REVIEW NOTES '4 � w The Commonwealth of Massachusetts Department ofIndustrigl Accidents Office of Investigations UT 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: _0() klmnt4 , City/State/Zip: Phone M Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. �• F1 Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. E]Building addition [No workers' comp.insurance 5. EJWe are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 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' comp.insurance required.] 13.❑Other *Any applicant that checks box#I 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 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 insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#:: Q (� (� 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 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. Ido hereby certto under thepains andpenalties ofperjury that the information provided above is true and correct. - Simature: Date: Phone#: 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#• 6 wAl r� 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 employeiis 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 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 of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA,02111 Tel.#617-727-4900 ext 406 or 1-877 MASSAFB Revised 5-26-05 Fax#617-727-7749 v wwanas$.gov/dia 1 4 1 Date ���. •-. .�'z..'. . NpRTM TOWN OF NORTH ANDOVER 0 PERMIT FOR MECHANICAL INSTALLATION 9SSAC'HUSZIA ES This certifies that . :J. �. .T. . . . !.. . —. has permission for mechanical installation�„ j( 4G in the buil ings of�.3.�.G.�-•. . l.t'�f h. . . . .�C� . . . . . . . . . . at . . . . . .Kllt r-lv -. . . . . . . ., North Andover, Mass,. Fe ��-a. . . Lic. No.. �k. . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of'Massachusetts Sheet Metal Permit Date: Permit# Estimated Job Cost: Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO Business License# 196 Applicant License# 45� Business Information: Property Owner/Job Location Information: Name: J&J Heating & Air Conditioning Name:Tara Lei& Development LLC Street: 17 Arlington St. Street: 54 Ciderpress Way City/Town: Dracut, MA 01826 City/Town: North Andgver, MA 01845 978-454-8197 Telephone: 978-687-2635 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"fami17y " V "NZulti-family Condo/Townhouses- 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 .r inrtol/ 01�7a / du67'work -6-If /�U�c sysTen.Y, INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 12 YevrNo❑ 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 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. 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 ❑Joumeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted. License Number: Fee$ ❑ Check at www.mass.gov/dpl Inspector Signature of Permit Approval G "M, A N_WEALTH OF MASSAGHUSE.TTt§ DIVIS!CIN Or • -BOARD OF A A. BUSINESS iSSUES.THE yBWE LICENSE fi{} ED:WAR t- AYOT-TE; J J WEATING AIR :C:DNAI-TONIN9. 17 ARLING70N S `REET; L1R-CU MA 01826 .; 315 >. 196, 01/10/14 9527 TI:e Commonwealtls ofMassachusetts . Department of Industrial.Accidents. Office of Investigations I Congress.Street,Suite 100. Boston,MA 02114-2017 www.ntassgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name.(Business/organizatioMndividual): JM Heating.&Air Conditioning,Inc. Address:17 Arlington St. City/State/Zi :Dracut, MA 01826 Phone#:978-454-8197 Are you an employer?Check.the appropriate box: Type of project(required): 1.0 I am a employer•with 4. ❑ I am a general contractor and I 6 New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me.in any capacity. employees and have workers' comp.insurance.t 9. ❑Building addition [No workers' comp.insurance P� required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E Roof repairs insurance required.]t. c. 152, §1(4),and we have no 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 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 employe6s,they.must provide their workers'comp.policy number. I am an employer that Ls 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 MGL 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the,2IA for insurance coverage verification. I do hereby cIM d rna tie u that the information provided above is true and correct. i na a 7 Phone.#:978-454-8197 Official use only. Do not write in this area,to be completed by city or town o iciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE .acoRnT. CERTIFICATE OF LIABILITY INSURANCE 06/06/2011 PRODUCER 7$,$87.4900 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 4S7 NAIC# Topsfi el d, MA 01983 INSURERS AFFORDING COVERAGE INSURED 30 Heating & Air Conditioning, Inc. INSURERA: Great American 17 Arlington. Street INSURER B: Dracut, MA 01826 INSURER C: INSURER 0: 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. POLICY EFFECTIVE POLICY EXPIRATION LIMITS INSR DD' TYPE OF INSURANCE POLICY NUMBER D D TE M IDD LTR NSR PAC6419906-04 06/01/2011 06/01/2012 EACH OCCURRENCE $ 1,000,00 GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300 O CLAIMS MADE OCCUR MED EXP(Any one person) b 10100U PERSONAL 6 ADV INJURY $ 1 OOO,OO A X GENERAL AGGREGATE $ 2 000,OO PRODUCTS-COMP/OPAGG $ 21000100 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECOT- LOC AUTOMOBILE LIABILITY CAP64189S7-02 06/01/2011 06/01/2012 PPROPERTY ED SINGLE LIMIT b ent) 1,000,00i . ANY AUTO ALL OWNED AUTOS INJURY b on) X SCHEDULED AUTOS A X HIRED AUTOS INJURY b dent) X NON-OWNED AUTOS DAMAGE b ident) AUTO ONLY-EA ACCIDENT b GARAGE LIABILITY OTHER THAN EA ACC 1 E ANY AUTO AUTO ONLY: AGG b EACH OCCURRENCE $ EXCESS l UMBRELLA LIABILITY OCCUR 0 CLAIMS MADE AGGREGATE b b b DEDUCTIBLE a RETENTION b WORKERS COMPENSATION WC6418907-04 06/02/2011 06/02/2012 X TORY LIMITS ER AND EMPLOYERS'LIABILITY Y 1 N E.L.EACH ACCIDENT $ 1 000,00C A OFFICERIMEM BER XCLUDED?E"'"' _j "— E.L.DISEASE-EA EMPLOYE $ 1 000,00C (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1 OOO,OO SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLITS PIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MARITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUSHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE S OR REPRESENTATIVES. Evidence of,Insurance AUTHORIZED REPRESENTATIVE Peter Sennott LA - k-»�^�' ACORD 26(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD /z41.0 lultll W11 I 0503031�u�GREAT AMERICAN ALLIANCE INS CO vv X ; Adminlstrative Ofnces WC 00 00 01A ( Ed . 01 /97) 301 E 4th Street Cinclnnatl OH 45202.4201 jtICAN. 513 359 5000 ph Policy No . ' W I C I I 1 6 14 1 1 1 8 1 9 10 1 7 I I 0 14l INSURANCE GROUP ``..'. Prior Policy No . lV'11C1 I 161411 181910171 I I WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE ` . . 1 nsurance is afforded by the Company named below, a Capital Stock Corporation : GREAT AMERICAN ALLIANCE INSURANCE COMPANY 1 NCCI Company No . 14028 t ... ...., .; ..;. ; ....;,. .., r•:';...:y:.;}%ff?:••;•I.i;•:::}}}}}'•;n }:?•fi:;}Y::?n::::::•i¢i�{:{S::%i:•'�::'fi•::'J.;:.;w::::::?{LL:•i:•:':i :�:•i :•,'r,'r, f:: .k.! /.J S '�{• +•'li/ r::•r+J.:f..ik.. ! ;'.;.}:;••f.;S;f'Gfy?r:. :::J.•f:.::::}:::;,••;,.;;.,r}?;?r,.<:.�:::?•:,r.. \ ;• •'j•}:•:+.���.ii• ::::!:•.}:}} �: { :•?ilti::b.,i(: `• :. ..r .?.;6.�Y+{Si'l. $�"R• hfif!'� ` r'�.�iJ. .,F,.+,fn.;.rl.,{.. ...?:.i'`i,'/{.x.J. :rfr'..... }.,�;.1,.;,f.,.:::x: ::f.?:';f};$ii: 'he Insured : J&J HEATING & AIR CONDITIONING Legal Entity : INC. Corgoration 't lailing Address : 17 ARLINGTON STREET FEIN No . : 042488433 DRACUT, MA 0182,6 1th.er Identification Number : See Extension of Information Page . j ether workplaces not shown above : See Extension of Information Page . !` ;;;s:.;:,.:n,.,.r ,s }. .� Yf,y: rr//f�ri:/. .::f+.+lr..,:•i,}Jrr:r.,:r,:: }.:.:::.:..?;::ff?;?::?.., ii ./. �, ff<Sf �}r.:� r„'f... ...Effr?:}?;;:,f 'fSf';'tf.<:•'•:•.!:::.......r...,r........:.ef:::•>::• •}}>}:•. •';•:} .. .:. •::?.:••:;;: :: ;::.: :.'`y: <:;.b?•:}.:fJ,fd'tf;7fitr�`2• '•; ,;J/fS fr,',d+`J:i3/'Z:. r.1.,c fy,%.5..1//...., .:.;}`:,.:::.•'•..:?'.<!.?>:••::.::..•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 . :N.f:?;:}y+.}.^..?,,.w,{..t,. .; .rrfi•+ :.f }. ;f•q:'.•:•f"�'f..a.:.rr:•+ •f//.h../ifi:??},.r::.!.::•},}•;+:r?•'.:.G�i!?.}•.t:::J•.,:!•::!H:R•:,c•..f a: '1' \. Workers Compensation Insurance.: Part One of the policy applies to the Workers Compensation Law of the states listed here : MA, NH (' t , Employers Liability Insurance : i, 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 ,000. each accident Bodily Injury by Disease S 1 ,000 ,000 policy limit it 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. ='z 9� I. This policy includes these endorsements and schedules : See FORMS AND ' ENDORSEMENTS Schedule , WC 99 06 22A (01/97) . .............:...............:::......... .; .........}:.^::,�::::;::.�:•..:•:r:•.•0;�y�?.?�:{•:r ,• :.J r.}'. •}.r,N J.l.;..;• fvr�i39f f} .:•r.1fi::.+.•r•::?•:;:.r ::ff.•,•::rr,..:::{.,??;?.; :..•}.:.::.......... .7J:.r:r �?i'.•• .:.f. :$ ••r,R:<!<}'::..:.:.r. JJ.. :r.t.;;:.r?•::•:.gii`.,ia::}:}2.'?•}::•:�•::••..::...::r,::•.:::•:::. . " .:� .ti?•:'•:•.v.. } ::•? � '{}}:::.;.;::'•4:H•:•:•;;.%?•:;•$. •.•:.•{:1.::, .rF.yv'+.`•F•;�:• 'f.;'"ri?�k•C.{•.{ '%f•� /".h'Yf:•i'/ r..�W�: r} }:'ri•;}':• >>'I'' �fV1::>> ::Q. :�:>::><:<::;}:•(*::' :.:::::...... ....:.;...:.:z`•.;:rr . .J.`..' •r r J he premium for this policy will be determined by our Manuals of Rules , :I ass ificat ions , Rates - and Rating Plans . All information required below is K ubject to verification and change by audit . See Extension of Information Page ........:......•:::: .:...; ..... .. . : Will'I��:�:::.V.�i:{:i:�:R. 1�.�.:��y:}. : : }}•.::..:}:•r:..::C.,:r,...•c.r.:....�H�}�.}},G:.,.u >.?•: : .rJ.:f•.,.f?.!..Jr u r r,.Y/.!6 `/.:Gr.+.:•f..2..?.#.`i:'?..:./r'rNw,.`+ ::Y..4:+...,.f.:.:(2.?:;{•:.:::::•::.:?:.:r:..J:':C' F,ra+/;..:.:..+:..::,./;}.}}:•}.'•`?4;}.:r?..;..:.,..:...a.:>.:f'::: .`+.:i:::i::r.::.....r..: 1 f{'fi,:Ji•.J.r.p:::^. !.i.. :.. .. ::.y::.:...F..:.....y.f•y..v.?:n:..:::::::.y.:.v•:v.�..n.}::}}}{::}:•:?•} ... 'OTAL ESTIMATED ANNUAL COST: $ 46 ,014 Minimum Premium: $ 750 leposit Premium: $ 46 ,014 Date of Iss.ua 06/22 /2011 ... .................... ...... ........ .. ... .::: •. :v::,:.,•..:....::.,..r?./.. :.; r J+ll fi+:r/rr:jr:+J; .:rl..}r¢f.. J.x.4:::..:}::w;:•r:. �y } •r r.•:.,r.,.?:.::.. ?•r}` ,?v J .n}+..:•.• n,}I.:,:•v}f!`.••1 MIS ./r.:J;..???L• .. u!4:... • :::•:. •. � .:: ;:.}:., . ...a:}d::f J•..,•:::.+v...iYJJ f�r# : .. �`f+.•7a. :•.:+.I: .:r:�...:...:.r:..:......:...t:•:•:::••r•.... R. ..............:..:.:.:......:::.:::::.}::.::::.. :..:. lame of Producer : EDWARD F . SENNOTT INSURANCE A Servicing Office : PO BOX 457 SPECIALIZED MARKETS TOPSFIELD 01983 657 :ountersigned by : Copyright 198.7 National Council on Compensation Insurance 472R390,r100 01A IEd . 01 /97 ) PRO (Page 1 of 4 1 f • i' Load Short Form Job: 54 Ciderpress press Date: Apr 26,2012 Entire House By: JW Heating and Air Conditioning 17 Arlington st,Dracut,ma 1826 Project • • For: Tara Leigh Development 115 Carterfield rd, North Andover, MA Design Information 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 GMH950453BX Cond GSX130301 D* AHRI ref no.2002182 Coil CA*F3030*6D* AHRI ref no.4700037 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-Suite®Universal 8.0.24 RSU05790 2012-Apr-26 08:05:58 Page 1 /4CCP. ...ts and Settings\OwneADesktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: h � 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. wrightsoft' Right-Suite®Universal 8.0.24 RSU05790 2012-Apr-26 08:05 age 58 PF Page 2 2 ACCA ...ts and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: r � Buildin Analysis Job: 54 Ciderpress press AIR CONOMOMNO g Y Date: Apr 26,2012 Entire House By: GRACM MASS WPM, J&J Heating and Air Conditioning 17 Arlington st,Dracut,ma 1826 Project • • For: Tara Leigh Development 115 Carterfield rd, North Andover, MA Design Conditions 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: Daily range 'F) - 15 ( L ) Method Simplified Wet bulb(° ) - 72 Construction quality Average Wind speed (mph) 15.0 7.5 Fireplaces 0 Component Btuh/ft2 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 Glazin I Infiltration 2.6 5701 16.9 Ducts 5084 15.1 Piping 0 0 Doors Ducts Humidification 5312 15.8 Ceilings Ventilation 3385 10.0 Floors Adjustments 0 Infiltration Total 33697 100.0 Component Btuh/ft' Btuh %of load Walls 1.0 1966 9.2 walls Blover Glazing 43.6 8101 37.9 Doors 10.3 434 2.0r Internal Gains Ceilings 1.3 1572 7.4 , .,... Floors 0.3 297 1.4 ` Infiltration 0.3 646 3.0 I Ducts 3694 17.3 Ventilation 0 0 Glazing Internal gains 2260 10.6 1 Ducts Blower 2389 11.2 Adjustments 0 Infiltration Total 21359 100.0000rs Ceilings Other Latent Cooling Load = 2170 Btuh Overall U-value= 0.060 Btuh/ft2-°F Data entries checked. wri htsoftw 2012-Apr-26 08:05:58 ..� g Right-Suite•1 Universal 8.0.24 RSU05790 /CCA .As and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: Page 1 HEATING& Component Constructions Job: 54 Ciderpress press AIR CONDITIOW4 Date: Apr 26,2012 DRACUT, 01625 Entire House By: J&J Heating and Air Conditioning 17 Arlington st,Dracut,ma 1826 Project Information For: Tara Leigh Development 115 Carterfield rd, North Andover, MA Design Conditions 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: 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 _ Insult R Htg HTM Loss Clg HTM Gain ft' Btuhfft'-°F f l-°F/Btuh Btuh/ft' Bluh Btuh/ft' Bluh Walls 12F-Osw:Firm 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 DO:Door,wd sc type sw 42 0.390 0 21.7 911 10.3 434 Ceilings 16B-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 fir fnsh,r-38 cav 945 0.029 38.0 1.39 1310 0.31 297 ins,tight bsmt ovr 2012-Apr-26 08:05:58 )66,t wrightsoftr Right-Suite®Universal 8.0.24 RSU05790 Page 1 6 ...is and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=MJ8 Front Door faces: Project Summa Job: 54 Ciderpress press AIR CONUTIONANCJ Date: Apr 26,2012 Entire House By: J&J Heating and Air Conditioning 17 Arlington st,Dracut,ma 1826 Project • • For: Tara Leigh Development 115 Carterfield rd, North Andover, MA Notes: Design Information 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 (ft2) 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 GMH950453BX Cond GSX130301 D* AHRI ref no.2002182 Coil CA*F3030*6D* AHRI ref no.4700037 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. Wrl htSOft' 2012-Apr-2608:05:58 9 Right-Suite®Universal 8.0.24 RSU05790 ...ts and Settings\Owner\Desktop\Tara Leigh 52 Ciderpress way.rup Calc=M.18 Front Door faces: Page 1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: 2 Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION CMei wr,n'�evs r, PROPERTY OWNER ►" C�YN1�`f/tit,s LLC Unit# $ Print MAP NO: fd itPARCEL:_ZONING DISTRICT: Iq Historic District yes o Machine Shop Village yes 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential JKNew Building ❑ One family ❑Addition VTwo or more family ❑ Industrial ❑Alteration No. of units:Nox d ir` k( • ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg V ❑ Others: ❑ Demolition ❑ Other aS ® We71) a ® oodpla ®IWefla_ �}Wafershed is cf� tr. a DESCRIPTION OF WORK TO-BE PERFORMED: I Ide tification Please Type or Print Clearly) OWNER: Name: M ...tiryms LI...L Phone: q7$-6s --Z6-3S Address: Y- RYAD CONTRACTOR Name: r� LLC Phone: Address: j Fritl Supervisor's Construction License: Q SS Exp. Date: �!Sf)Z Home Improvement License: Exp. Date: - ARCHITECT/ENGINEER d SulflyaLn Phone: 78l "�13q -616b Address: R0. QzrblReg. No. FEE SCHEDULE.BULDING PERMIT.$92.0 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER$.F. 4 Total Project Cost: $ ZS7, (.Z.S C, v�O'e-s FEE: $ 30Q I•SO+�bO•(t�v)� s,nt •Sb Check No.: 2 yy Receipt No.: •;2 :to NOTE: Persons contracting with unregistere ntractors do not have access the guarantyfund netorc Location No. Z-6 7 -/2- Date s 7 / Z Of NOR71� TOWN OF NORTH ANDOVER O � L f w 9 Certificate of Occupancy $ �pU 'Ss^cMus t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 2 4 9 4 0 Wfidj�g Inspector Plans Submitted M Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ v0 FL LCs' wtrifF,6riv RRm17 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on PSignature COMMENTS 6 HEALTH Reviewed on A\WSignature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS I� Dimension Number of Stories: L- Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 30.7- A-C ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Ij(A Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use oCasI?I' T 7.5f { 2 s� = Z061A IZ.SS = losses bZ�- ff' FFE oa I•S'd s F) 4- 10 i ao rc-o � 31 q i ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products 110TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products COTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit a all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi r N0RTH Town - of 0 . No. �dover, Mass., 0� COCMICEWICK p �oRA T E D ➢P `C BOARD OF HEALTH i v i Food/Kitchen Septic System A ..PERMIT T D BUILDING ING IlySPETqR THIS CERTIFIES THAT.....:........................... . ` oundation �...... Rou gh (i'. 7 buildings ��� � A�'' g has permission to erect...:... g .................... ... .... �..................� � P� �r, �Cf®L✓� `Chimney tobe occupied as.................. ..................... .................................................... ........................ ........................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. Rough e,9 PL �ING INS ���� VIOLATION of the Zoning or Building Regulations Voids this Permit. �j�/ Final rl f/�/!- • i c71Z' PERF EXPIRES IN 6 MONTHS ELECTRICAL INSPEC UNLESS CONSTRUCTIONMTsservice .. ...... ..................... . UILG INSPECTOR Occupancy Permit required t® Ocaipy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final •',�,���07 No Lathing or Dry Wall To Be Done FIRE-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. �1_l2 ONO oT ,SSACNO`'t1 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 567-12 Building Permit Date 1/27/2012 Date : June 26, 2012 THIS CERTIFIES THAT THE BUILDING LOCATED ON 54 Ciderpress Way MAY BE OCCUPIED AS one unit of a 4 Unit Townhouse IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Meetinghouse Commons LLC 115 Carter Field Road North Andover,MA 01845 Building Inspector Fee: $100.00 prepaid Receipt: 24980 Check 2744 c•NO R'N'h U • . • �sS9CHO CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 567-12 Building Permit Date 1/27/2012 Date : June 26, 2012 THIS CERTIFIES THAT THE BUILDING LOCATED ON 54 Ciderpress Way_ MAY BE OCCUPIED AS one unit of a 4 Unit Townhouse IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Meetinghouse Commons LLC 115 Carter Field Road North Andover, MA 01845 Building Inspector Fee: $100.00 prepaid Receipt: 24980 Check 2744 Off`,AO TN 1y ,SSACHU, CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 567-12 Building Permit Date 1/27/2012 Date : June 26, 2012 THIS CERTIFIES THAT THE BUILDING LOCATED ON 54 Ciderpress Way MAY BE OCCUPIED AS one unit of a 4 Unit Townhouse IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Meetinghouse Commons LLC 115 Carter Field Road North Andover, MA 01845 Building Inspector Fee: $100.00 prepaid Receipt: 24980 Check 2744