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Miscellaneous - 55 TURTLE LANE 4/30/2018 (2)
0 O U Ci [./1 C .'O 0 � N m z I o "' 0 The Commonwealth of Massachusetts � Department o ! P ,f Industrial Accidents •- Office of Investigations 600 Washington Street Boston MA 02111 www. nzass,b ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers nnllnanf Ynfnrmai-;_ . Name (Business/Organization/Individual): Address: City/State/Zip: Are you an employer? Check a appropriate box: Mal l . I am a employer with 4. employees (full and/or part-time).* 2. ❑ 1 am a sole proprietor or partner- ship and have no employees 3. ❑ working for me in any capacity. [No workers' comp. insurance required.] I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 5. Phone #: OX0-- ❑ 1 am a general contractor and I have hired the sub -contractors listed on the attached sheet These sub -contractors have workers' comp. insurance. ❑ We are a corporation and its officers have exercised. their right of exemption per MGL C. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] *Any applicant that checks box # I must also fill out the section below showing their workers' compensation policy information. + Homeowners who submit this affidavit indicatirw_ t;iey- arc doh:g e:1 ivor:: at'su then hire outside contraciors must submit a, new arndavir indicating such, lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. poi icy information. I am an employer that is providing workers' compensation insurance for m3' employees. Below is the poficy and job site information Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10:7 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 1.3.❑ Other Insurance Company Policy # or Self -.ins. Lic. #: _;/� �9v � / Expiration Date: Job Site Address:_ r� 1° / 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. I do herebJ certifyunder the palV�ti�penalties of perjurJ that the information provided above is true and correct 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 #: 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 permitto 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. Shouldyou have any questions regarding the lava or if you are required to obtain a workers' compensation policy, please call the Department at the nnrnber.iisted 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 permitAicense 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 G2111 Tel. # 617-727-4940 ext 406 or 1-877-MASSAFE Fax ,# 617-727-7749 Revised 5-26=05. vAv"%&,.raass gov/dia m m m m YI m mm COO) 10 CD �p O ar dd a� a� O C3ac CD p Q. Q cD o CO) d d O CO) n� C 0 CO) d CD O •rt CD -�v CD /A/�. \Y CO) O Q �. F a1 J C O c?mac a+ x 0 a 0 do y O'O m C7 ymac=j 06 m _i O O d C y y � �x o m o o a o. _ iv0 ZyC! O Cs 7 ; � y CL �m o � Mm O H 'a9 co lu 3 y CL cr C W d Vim: c C CD H m O = m �C n. f D oC.) Cr1 n r� rzro CD O m 0 1 n � ` poiO QGQ CD O = m C a r. c �• � tc O 0+ x 7' z7 .� N CD o CD nom• C O O O W AA �q O z O tv y 0 g , 0 Pod O C CD A Z hr) w O w n. f D Cr1 n r� rzro ^ O 1'� r m w n � ` poiO QGQ w 0 C a r. c �• � tc O 0+ x 7' z7 O 0 Pod O C CD Date. .`< . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING "J"his certifies that ........... has permission to perform.................. plumbing in the buildings of--�". . ............. North Andover, Mass. Fee .......... Lic. NoPPGG ........ ....... PLUMBING INSPECTOR Check # 8053 U MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT T0 DO PL (Type or print) UMBING NORTH ANDOVER, �MATTS SSACI USE Building Location 55 / r 1 �2.H�- /'q New El of Replacement '4 FWURES Date Permit # 3 Amount or, Plans Submitted YesElNo ❑ (Print or type) Installing Company Name 1- , Check one: Certificate g i r^C, '� Corp. ess elephone ❑ Partner. ae 1 Name of Licensed PlEl Firm/Co. umber. �J/' f:. ,t P(IlcafLAe type of insan Liace coverage by checking the appropriate boy; bility ' urance p cy Other type of finder + tY 0 Bond e unders ed have made aware that th ur e licensee of this application does not have any one of the above ce wee Ihereby certify that all of the details and information I best of my knowledge and that all plumbing work an cO compliance with all pertinent provisions of the Mas BY' Title T City/Town APPROVED comics usE oNL.Y L� erase Agent ❑ in above application are true and accurate to the tued for this application will be in an tte Prr 142 of the General Laws. Journeyman 0 I he commonwealth of Massachusets Department of Industrial Accidents Office of Investigations 600 Washington Street L'Oston, AIA 02111 ~W. n'+.ass.e, vldLlf Workers' Compensation Insurance.Affidavig. guilders/Contractors/Electridia.ns/Plnmbe Aca.nt Information rs Name (B„sin--ss/OrganizationMdividual): Address: . City/State/Zip: Phone #: Are you an employer? Check the appropriate box: ❑ I ana employer with 4. ❑ 1 am a Qeneral employees (full and/or part -time). - 2. ❑ 1 am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required_] 3. ❑ 1 am a homeowner doing all work myself. [No workers' comp, insurance required.] t contractor and I have hired the sub -contractors ltsted on the attached sheet I These st.tb-contractors have workers' comp. insurance. ❑ We are a corporation and its officers have exercised.their right of exemption per MGL . c. 152, § 1.. (4), and we have no employees. [No .workers' comp, ins,,— Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 1 I.❑ Plumbing repairs or additions 12:❑ Roof repairs Any appiicant.that checks box # i .must also fill out tine section below showi ce regalred ] I 13 ❑Other 1 iomcowners wire submh. c j ng tfeair workers' compensation oil i this daiadevit inuica[itz tiiej' art uiE.g =,.c=.. :}: �tvci tt:cn him outsid5 coniraetors mus aumni ant am . thata'S..Oh. •�..... �nwavncr'raa` [s rovWJ;zr••�� �- unoamarton, information p e� workers' comperrsatiori i�zsurance for JM' employees. Belo►n is the policy and job site Insurance Company Name: Policy # or Self -.ins. Lic. #: Expiration Date: Job Site Address: Attach a copy of the workers' compensation policy declaration Q CttyLState/Zip: Failure to secure coverage as required under Section 2�A of pabe (show'n,u the policy "umber and expiration date). fine up to 11,500.00 and/or one-year imprisonment as well as civil penaltic. 152 es in the tc) tthee impositionrril a STOP WORK ORDER Penalties of a of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Oc p and a fine Investigations of.the DIA for insurance coverage verification. pump ana penalties ofPerjurf' that the information provided above is true and correct Offecial use nnip. Do not write in this area, to be completed.63' city or town o ciaL City or Town: PermitlLicense # {ssuiag Authority (circle one): L Board of Healtb 2. Building Department 3. Cit erown C{erk 4. Electrical Inspector S. P{umbia� 6. Other a Inspector Contact Person: Phone # Date..`. `:?'o j ....... TOWN OF NORTH ANDOVER FO P o PERMIT FOR GAS INSTALLATION This certifies that ..' . ' ........ �`~............ . has permission for gas installation,! .. � ............. . in the buildings -of ....... .......................... at .'S �.`� .. C.. �... , North Andover, Mass. Feere:..v... Lic. No� pGAS INS_ PE.&OR Check 6767 ve MASSACHUSETTS UNIF+mm APPUCATON FOR PERM TO DO GAS G (Type or print) NORTH ANDOVER, MASSA HUSETTS Date Building Loqations S v 1,VNU Owner's Name New ❑ Renovation ❑ Replac ent M/ G SU B-BASEM ENT _BASEMENT 1ST. FLOOR 2ND. FLOOR 3R D. FL OO R 4TH. FLOOR STH. FLOOR 6TH. FLOOR 7TH. .FLOOR 8TH. FLOOR. (Print or Name Address IS—S Permit # Amount $ ,7 5W F& Plans Submitted + Name of.Licensed Plumber'or Gas Fitter Check one: Certificate installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE I have a current liability ranee policy or it's substantial equivalent Check one: If you have checked s p ase.i icate the a cove Yes ❑ No� Liability insurance fie �'p rage by checking the appropriate box. p Other type of indemnity ❑ ❑ Bond Owner's Insurance Waiver. lArn aware that the licensee does not_ have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: i hereby certify that all of the details and information I have si ed (or eOered wner m Agent best of my knowledge and that all plumbing work and instal ) application are true and accurst t 'h compliance with all I . pertinent provisions of the Massachus ° Perfo d and e ode P r►t apter I By: i � U w z Z cc v� C C a vi I C F Fa+ C m y W F Q a F C :7 z d Q x W W y C a w w N Q z W C C cc F W C7 O > W U + Name of.Licensed Plumber'or Gas Fitter Check one: Certificate installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE I have a current liability ranee policy or it's substantial equivalent Check one: If you have checked s p ase.i icate the a cove Yes ❑ No� Liability insurance fie �'p rage by checking the appropriate box. p Other type of indemnity ❑ ❑ Bond Owner's Insurance Waiver. lArn aware that the licensee does not_ have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: i hereby certify that all of the details and information I have si ed (or eOered wner m Agent best of my knowledge and that all plumbing work and instal ) application are true and accurst t 'h compliance with all I . pertinent provisions of the Massachus ° Perfo d and e ode P r►t apter I By: i ❑ gn re of Licensed P umbe Or Gas Fiyter Title , lu er T City/Town Gas Fitter icense um er _ 1APPROVED (OFFICE USE ONLY) aster Journeyman eote application will be in :ral Laws. K i bi, t c, The Commgrcwe.lth OfMassachusetfs Department of Industrial Accidents Office Of Investigations 600 Washington Street Bostorz, M,q 02111 Workers' CompensatiowwH?-�SS.gOvIdia n Insurance.Affidavit: guilders/Contractors/Eleetricians/Piamb �licant Information e rs Name(Business/Organization/individual): Address: -9 -) E/ i7 _ City/State/Zip: Are you an employer? Check x!1-1 I am a employer with employees (Hill and/or p .* 2. ❑ i am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] • ❑ I an a homeowner doing all work myself. [No. workers' comp. insurance required.] t 91 Ite. box: Phone 4. ❑ I am a general contractor and I have hired the sub -contractors listed oz.. the attached sheet x These su,b_contractors have workers' comp. insurance, 5• ❑ We are a corporation and its officers have exercised.their right of exemption per MGL c. 152, § I (4) and we have no employees. [No workers' comp. insurance required] I er + Tion eowueratwlao subn checks .0o e -Ii da t usdicat�io� t; eut e;art; ��,fbelow showing their work6n, compensation policy mTonnahon. xConttactors that check this box must ar=hed an additional sheet showing the na_*ne-of* cutsiae contractors rnuii submit a new atnuavit indicxtin .�e� I - c�=ton and their wnr P. a. Type of project (required): .6. ❑ New construction 7• ❑ Remodeling g• ❑ Demolition 9. ❑ Building addition 10:0 Electrical repairs or additions l l.❑ Plumbing repairs or additions 12•0 Roof repairs 13 ❑ Ot}� LllfolMatiplL a u�rai �S ProvLOlrte work=' c0mpel7SadotzLiLCllrQtLCe fl►t IIIJf employees. Insurance Company Name: Xlw; bt-dSZ�- ��i 7 Policy # or Self -.ins. Lic. #: r• r�••�y .u�urn�axror.. Below is the policy and job site _ Expiration Date: Job Site Address:. Attach a copy of the workers' compensation - Pofiry decia City/State/Zip: .Failure to secure coverage as required under Section 25A Of MGL page (showing the Poli Dumber and expiration date). fine up to $1,500.00 and/or one-year p MGL c. 152 can lead to the imposition of criminal penalties of a y. imprisonment as well as civil of up to penalties in the form of a STOP WORK ORDER and a fine .1250.00 a day against the violator. sed that a copy of this statement may be forwarded to the Office of Investigations of theBvi DD fo insurance cc�e verification- 1 do hereby 9,/, the information providedpbo a is Oficial use onlp. Do not write in this area, to be completed.hy city or town offccLaL City or Town: Issuing Authority (circle one): PermitlL,icense 4 1. Board of Healtb 2. Building Department 3. City/Town Clerk 4. �fectrGra� 6. Other . . Contact Person: Phone; ad Corre I Information r .nd Instructions 11 - 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 maint.-nance, 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 o r local licensing agency shall withhold the issuance or renewal of a license or permitto operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence mf 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 worllc 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 certiticate(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 affici-a.vit may submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to si-n and date the affidavit. Theaffidavitshould be returned to the city or town that the application for the pe or license is being requested, not the Department of Industrial Accidents. Should you have, any questions reg-4—Tding the law or if you ar: required to obtain a workers' compensation policy, please call the Deparmnent at the ntirnber.IisF.ed belovr. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that thiel -affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit foryou to fill out in the event the Office of Investigations has to contact you regarding the appii=L Please be sure to fill in the permitliicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/iiceme applications in arty 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 a (city or town)." A copy of the affidavit that has been officially starnped 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 Iicenses. A new affidavit must be filled out each year. Where, a home owner or citizen is obtaining a ticens� 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 fay, number: The CQmmon1vtE th of Massachusetts Department of lidustrial Accidents. Office of 1mvestigafioas 600 Wasl-dngtQn Street Briton; MA x}2111 Tela# 617-727-4900 e= 406 ear 1-8.77-MASSAFE Revised 5-2645 Fax f 617-7-7-7749 uJww.Mass.aov/dia LAWREN CF. H, OGDEN, P.E. 198 FAST MAIN STREET GFORGETONWN, MA 01833 978-352-8318 tax 978 —352.281 ctll: 978�'_q' 2-8921 ivri l .� 5 s .2009 Mr, Alan Smallntan Srnallman Construction P.0, Box 306 Boxford, Ma 41921 RZ: S%hveney Residence 5=T-- � Orth Andcver, P/`,.A, 01845 Dw Mv. Stzmallman As you reeluested .l visited Ybe p►cvject 4122/09 to-rrviviv the installation of the !.-'V]-,5 usW in the framing of'the above project. These are shown oo plus prepared by ?oppa Desi g, dated June 30, 2N)8 and revised September 22,2_0108, Sheet A.04 Foundation & Era rning Plants was ce*tifteii by tree December 9, 2008 for the fr;, ing. Based ori my site visit and engineering zeview I can cenjA that to the hest Of my km,,wiodge the. LVLs- are acceptable acid meets the loading conditions rrquired by the 7a, Edition of the Massachusetts State Building Cocle, Skuld ;ou have any questions please do not hesitate to call. Yours tri.1y, r Lawre�140gdcn, P.E. Structural 27765 LAWRiN"A Igh.r„ 111 C;rJ.n . m m m m CO) mm C2 COD ® CV 0 CD C7 Z y CED O '2 CL r c CO) ® CD CD CLQ %c CD CD O 0 e® w C CD CO) CD CL Cl O CO) CO CD CD CO) O 'CD CD Z ,0 cl) O G CD O w F,, C C S —• t/i o = H --4O 7 nCD °'- Q C O0 .0 C/! =.� 3 m mcmnC, m Cl) m CD Z y m N• n rCD �7 souls. o Cn �. � E3 Irl O n cl.,. . an d 0 y CD N H � > IE CD >"R O a 2.4 go b Cj c H tx CL U2 o n� to c n d m 3 H �C o N d N n Ccoo ' C H CCD tC CO) .rt H CS ilk H CD 3 FW m o es moo: mo' y •o o CD IL , o CD ,* CD H ® :� oo. o� nom_ q. O =CD Cn 0 d CC/ a7 7 nCD °'- )d aCv qty °'- C77n S. JC9 Cil X ?' 7U r t :p ?? n rCD �7 'r7 Cn �. � E3 Irl O n d ►�-1 b P tx Go M • • O y 0 9 0 c Alan Smallman & Co. Building and Renovating Contractor 190 Middleton. Road, Boxford Massachusetts 01921 (978) 887-6185 *ESTIMATE* "...to calculate roughly or to form an opinion as to amount, from imperfect data." Websters Dictionary 10/27/08 REVISED Mr. & Mrs. Sweeney 55 Turtle Lane North Andover, MA All quotes include stock and labor unless otherwise specified. Estimate for home renovations and/or new construction to include Revised scope of original plan as per new drawing provided. All final details to be discussed. �- Price includes removal of all demolition material. General specifications as per plan and described below. Excavation- finish grade, no rake, seed or landscaping Footings -10" x 20" keyed. Foundation -10" poured concrete 3000 psi. Crawl space w/ opening cut into existing basement. Damp proofing- foundation coating on walls. Concrete slab- 3000 psi concrete 4" thick for vapor barrier. Deck -none Steps -none Septic -no changes included, will check existing Title 5 inspection for compliance. Carpentry All stock #2 or better spruce construction and adhere to Mass. State Building Code. Framing- as per specs. Rough floor- 2" x 10" with 3/4" T&G AdvantecTM. Walls- 2" x 6" with 1/2" CDX plywood. Roof - 2" x 10" with 1/2 " CDX plywood. Roof shingles- New shingles to match new specs. Strip and reroof entire house. Building paper- Typar housewrap. Flashing- aluminum or galvanized where necessary. Trim- pre -primed pine to match existing. Prime all cuts. Exterior siding- to match existing. Pre -primed cedar clapboards. Gutters- one piece aluminum where necessary with downspouts to match existing house. Doors/Windows Andersen as per plan. Heating Check system for capacity. Add to existing system. Separate zone on first floor.. All specs to be discussed. Insulation Unfaced fiberglass with polyethylene vapor barrier. To capacity in all areas. walls- 6", ceiling 9" with proper venting. - continued on next page - d '14 Page 2. Estimate 10/27/08 Interior Finish Interior doors- to match existing. Casings/ Baseboard- to match existing. Stairs- none Finish floors- By owner Tile- By owner Carpet- By owner Finish hardware- "Schlage" or equivalent to match existing. Plaster All walls and ceilings of finished area (except where otherwise noted) to be 1/2" gypsum board with thin coat veneer plaster. Walls smooth and ceilings sand finish. Closet walls to be rough textured. Plumbing Included fixture allowance -$ $850.00 Fixtures -.Kitchen sink and faucet. Water Supplies -1/2' copper tubing. Waste and vent lines- PVC. Exterior faucets-. One at rear of new addition. Electric: final details to be discussed. Included allowance -$4,500.00 Add to existing service- plugs and switches as per code. Telephone outlets -1 Cable TV outlets -1 Recessed fixtures -As per plan provided. Closets- fluorescent fixtures controlled by switches. Finish fixtures- supplied by owner. Cabinetry- Included allowance for Kitchen cabinetry -$25,000.00 Counter tops- Included granite allowance for vanity top - $6,500.00 Masonry- none. -P, Painting/Staining -not included, a separate estimate can be provided. I never include painting or staining in a remodel like this. It is much to difficult for the painter to give a good estimate until they can see exactly what they are in for. Final plans to be submitted, all specifications to be discussed before construction. TOTAL ESTIMATE - Payment terms: 1. Start up- $44,921.00 3. Plaster completion- $44,921.00 2. Tight roof- $44,921.00 4. Completion- $44,921.00 $179,685.00 Customer Name: - continued on next page - Page 3. Estimate 10/27/08 Mr. & Mrs. Sweeney 55 Turtle Lane, North Andover job Location: Kitchen and interior renovations as per plan. existing bulked to be replaced as per plan. Playroom/ office Job Description: I/ We understand that this document is a description of estimated costs, and actual charges may varyldepending upon additions and or deletions to the work described. C4 oil), 4 4 10 /,-&) � d Homeo a /Custo er IDA Hi! Please give me a call so we can go over. Thanks Alan Even with the best efforts and planning there are unavoidable delays in home renovation and new construction. It is simply the nature of this business and we appreciate your understanding and patience. * Protect yourself and your home... by using licensed and insured contractors. * Work is scheduled by date of estimate acceptance. Contractor has full Liability and Workman Compensation coverage. .............. Date....l. .. ... .. I TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... -e . . . J............ JJ mss. has permission to perform wiring in the building of ................ ... . ...................... .......... / .... . . ....................... ... . North Andover, Mass. .. Fee � ... P .............. Lic. No .............. ...... 5 .... ...... ELECTRICALINSPECTOR Check # 8 7 1 5 Commonwealth of Massachusetts . Official Use Only Department of Fire Services Permit No. 6 7/-�' 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 ( EC), b27 CMR 12.00 (PLEASE PRINTININK OR TYPE ALL INFORMATION) Date: k City or Town of. NORTH ANDOVER To the Inspector of 'res: By this application the undersigned givqWtice of his or her intention to perform the electrical work described below. Location (Street & Number) '�� ivr+' k L A I Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a buil g permit? Yes No Purpose Building 11 ❑ (Check Appropriate Box) of Q M Utility Authorization No. + Existing Service o Amps Volts Overhead ❑ Undgrd No. y New Service Amps / Volts Overhead ❑ of Meters Undgrd ❑ No, of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: No. of Recessed Luminaires Com lehbn o the follou4 table may be waived by the Inspector of Wires. No. of Ceil: Susp. (Paddle) Fans No. of Total No, of Luminaire Outlets No. of Hot Tubs Transformers KVA Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ o. o mergenc V ag g — No. of Receptacle Outlets d. rnd. No. of Oil Burners Batte Units FIRE ALARMS lNo.ofzones No. of Switches No. of Gas Burners No. of Detection and No. of BaetCges e ' No. of Air Cond. Totsl Initisiin Devices Tr_ No. of Alerting Devices No. of Waste Disposers Heat Pump INumber Tons KW No. of Self -Contained Totals: No. of Dishwashers Space/Area Healing KW Detection/Alertin Devices Local ElMunicipal ❑Other No. of Dryers No. Water Heating Appliances KW Connection Security Systems: No. of Devices of Heaters Imo' No. of or Equivalent Data Wiring: Si s Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: OTHER: No. of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE �k BOND ❑ OTHER ❑ (Specify:) I certify, under tains andpenalties ofperju , that the information on this application is true and complete. FIRM NAME: t? e,m S C . LIC. NO.: Licensee: C o Signator q,�q.� (If applicable, er " e in e h e e n ber line.) LIC. NO.: �ol,,( _ Address: SL�((`o -� �1c ��� f Bus. Tel. No.: 7 8 V *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt. L lc. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 6- d�z-3 j; I r j www.mass gov/dia . Workers' Compensation Inskrance Affidavit: Builders/Contractors/Electricians/plumbers Applicant Information Please Print Legibly Name Address: � S j e (d City/State/Zip:"- /I0 , - 9- Phone #: - - Are you an employer? Check.the appropriate box: L ❑ i am a employer with 4. [] I am a general contractor and I The Commonwealth of Massachusetts employees (full and/or part-time).* 2. ❑ I am.a.sole proprietor or partner- Department of Industrial Accidents Office of Investigations t 600 Washington Street i Boston, MA 02111 working for mein any capacity, [No workers' comp. insurance workers' comp. insurance. 5. We are a corporation and its r j www.mass gov/dia . Workers' Compensation Inskrance Affidavit: Builders/Contractors/Electricians/plumbers Applicant Information Please Print Legibly Name Address: � S j e (d City/State/Zip:"- /I0 , - 9- Phone #: - - Are you an employer? Check.the appropriate box: L ❑ i am a employer with 4. [] I am a general contractor and I Type of project (required): employees (full and/or part-time).* 2. ❑ I am.a.sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. x 6. ❑ New construction 7• ❑ Remodeling ship and. have no employees These sub -contractors have 8. Q Demolition working for mein any capacity, [No workers' comp. insurance workers' comp. insurance. 5. We are a corporation and its 9. Building addition ❑ required.] 3. ❑ I am a homeowner doing officers have exercised their i08Ziectrical repairs or additions all work right of exemption per MGL I I.Q Plumbing repairs or additions myself [No -workers' comp. insurance c. 1.52, § 1(4), and we have no 12. Roof repairs required.] t employees. [No workers 13.❑ Omer comp. insurance required.] -v-rr••-••••• ..,.....��. ..X M, must also nu out the section below showing their workets' 'compensation policy information. 1 Homeowner¢ who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. SCorttractors that check this box must attached an additional sheat showing the name of the sub-comractors and their workers' imp•, ,!icJ information. I am an employer that is providing:workers' compensation insurance f or my employees Below is the policy and job site information. _ Insurance Company Name: Policy # or Self ins. Lie. #: U C Expiration Date: I /i 0 0 Job Site AddressA) City/State/Zip: JJWIO 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. I do hereby cern er re airs and penalties of perjury that the information providedabo a is a and correct Si ature: Date: J% / 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: IN Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. 'However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, notthe 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 nurnber. listed bellow. 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, pimse do not hesitate to give as 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 1-11.77-MASSAFE Fax # 617-727-7744 Revised 5-26-05 www.mass.gov/dia a, Date./-". A .=.3. 5743 TOWN OF NORTH ANDOVER °p PERMIT FOR PLUMBING SACMUS� This that -' certifies . . . . . . . . . . . . . . . / , [-' has permission to perform . f^�`- ..... • ... -K'�,, p'� plumbing in the buildings of ............ `-� ......... . at.. .. �.---t....... (Y !'r? ��-.¢ ..... , North Andover, Mass. Fee_.'...... Lic. No.......... . . �' ' _ _ -. _ f�«z .?fit / PLUMBING INSPECTOR Check #• 5743 I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) JI . _ v�� _ Mass`. Date ___.-PermitH__ Building Location _ �u" 1� /r''—.__..__ Owners Name ------------- — -- - ---- : =� - — -------- TYPe of Occupancy New - Renovation C, Replacement Plans Submitted Yes ❑ No FEATURES Installing Company Name �tj rC & %'QC- Check one: Certificate Address _% �% A- C PS i �`� � t—Corporation Partnership Business Telephone 9 7 K'� d 9 a Firm/Co. Name of Licensed Plumber—j9�4. �� rt 0 _ __-- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes I— No -- If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ✓ Other type of indemnity = Bond OWNERS INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Owner '-, Agent Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above 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 with all pertinent provisions of the assac setts State Plumbing Code and Chapter 142 of the General Laws. By -- --_-- - Signa uT re ns um or --- -- Title -_ _ ..... _ _. - - Type of icense: Master L-/ Journeyman CityfTown-_------___--- .-.- - License Number -_t9-� - z C/) Z W Z 0 Y Z Q > 4 W Y J U) Q= Z CQ Q Z� a L J U 0 W fr rn 0 = cc W M Q 2 W Q (n Y Z T o a, Q rn Z Q n Q 0-J� > X a = Z W O F W �� Q U) Q 0 W J to cc W F J Q Y 0 Cr W u_ W CC W W=~ QQ S z= Y D Q Q Y Cv FU-- Y Q Q J Co I co (_n U)Q D J>= >Q Q f— -j co -i u_ Q 0 rL rL O M Q> >Q Q Q m O > SUB-BSMT. BASEMENT t 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name �tj rC & %'QC- Check one: Certificate Address _% �% A- C PS i �`� � t—Corporation Partnership Business Telephone 9 7 K'� d 9 a Firm/Co. Name of Licensed Plumber—j9�4. �� rt 0 _ __-- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes I— No -- If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ✓ Other type of indemnity = Bond OWNERS INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Owner '-, Agent Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above 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 with all pertinent provisions of the assac setts State Plumbing Code and Chapter 142 of the General Laws. By -- --_-- - Signa uT re ns um or --- -- Title -_ _ ..... _ _. - - Type of icense: Master L-/ Journeyman CityfTown-_------___--- .-.- - License Number -_t9-� - z o l7r1 ro M M Id � R+ r H H �-C n ro a M H 0 H �Tl 0 z ro H O r z d ro H M z G7 t. H a l7r1 ro M Id `" r H n a H H 0 z ro O z ro M t. H H z O O 1 d _ O ro r cry -- z c� Date../ 6..-1U. .0..2�..... o TOWN OF NORTH ANDOVER 1.00 p PERMIT FOR WIRING This certifies that . G ` '� (' ............................................................................................. has permission to perform................................................................................ wiring in the building of ........!.�.. h �t,C�.�........................................ at c� 1 -C , North Andover, Mass. Fee ...........�........ Lic. No...!.0 3 ................ Ur `.°`� .i1 �l l� ......... ELECTRIC INSPECTOR b J C! Check # i, 775 TBECOl MOATWl+,ALTHOFMA,SSACHUSE77S Office Use only DEPARTARMOFPUBLICS4FETY Permit No. 4-7 7f BOA RD OF FIRE PR E M MON REG UL, 4 HONS 527 CMR I2. Occupancy & Fees Checked APPLICA77ONFOR PERMFFTO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /49 '—l© -0 Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) SS— 7 U Hl e L0. h Owner or Tenant E W Q rrJ L. i UA ,',,, e> / To the Inspector of Wire: Owner's Address 55— Is J5—Is this permit in conjunction with a building permit: Yes M No (Check Appropriate Box) Purpose of Building Existing Service Amps / Volts New Service Amps Volts Number of Feeders and Ampacity Utility Authorization No. _ Overhead M Underground M Overhead E= Underground M Location and Nature of Proposed Electrical Work Sep i-- Co .1, ,2 No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round round No. of Receptacle Outlets No. of Oil BurnersNo. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• I% -Jr& oeCovlW. Ptltarantli ftmgttiternelZofMassadx>seZG=rallaws Iha�ac�niartLiabllttyh>s IoePblicyinch>amg(ornplete CoveraWoritssubstanUegtlivalart YES © NO D Ihavostlbm mdvandptoofofsmrtodrOffim YESL�J rT F)mhavecheckDdYES, ple=mdtratethetypeofcovorageby drdingthe INSURANCEM ' BOND F OIHER M may) �" /0-13-03 Ester "ValueofF Wolk $ WolktoStatt _ a b, BRMNAME Lioenree �cg.�.t.�� Signe OWNER'S INSURANCE WAIVER; I am aware drat the Lion does not have i anddornysignattuemdmparrVplicabmwaivesthisreg cerrtatt. (Please check one) Owner ED Agent M Signature o . wner or Agent t q h Lxe=No. i o 3 Fs- 3 LicffwNoe/O 3 lgr- 3 BusatessTel. No. _ L G S 73 2 t-/ AltTel No. 3 7 V SG ( 7 Irmrce coverage orits substxtal ocpvalatt as t2cltrited by Massachusetts Genaal laws Telephone No. PERMIT FEE $ 1S The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: -- Address City Phone # insurance. Co. Policv # Company name: Address City Phone #: insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500.00 and/or one years' imprisonmentas yeah_as_civii.penaltiesJn2belcxrn-f-a�STOP-VV RM ORDFRand a.fineaf_($1.00.OD)ajlayagainst_me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone .# 4 Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing El Building Dept ❑Check if immediate response is required E] LicensingBoard Selectman's Office Contact person: Phone #: ❑ Health Departmen Other GENERAL NOTES: SWEENEY RESIDENCE, 55 TURTLE LANE, NORTH ANDOVER MA. 12/9/08 1. LVL BEAMS SHALL BE i LEVEL MICROLLAM by WEYERHAEUSER. E=1,900,000 PSI, Fb=2600 PSI. ALL INSTALLATION TO BE PER THE CURRENT MANUFACTURES RECOMMENDATIONS AND SPECIFICATIONS ALL COLUMS DESIGNATED ON DRAWINGS AS PARALLAM PSL TO BE 1.8E 2500 Fc, DO NOT KNOTCH OR CUT LVL BEAMS OR PENETRATE WITH ANY HOLES EXCEPT AS ALLOWED BY MANUFABTURER. 2. ALL LVL INDIVIDUAL MEMBERS IN BUILT UP BEAMS OF THREE MEMBERS OR LESS TO BE NAILED TOGETHER WITH 3 ROWS 16 d @ 12" oc. OR AS SHOWN ON DRAWINGS. 3. ALL LVL INDIVIDUAL MEMBERS IN BUILT UP BEAMS OF MORE THAN THREE MEMBERS TO BE BOLTED TOGETHER WITH 3 ROWS OF '/2" dia. BOLTS, ANSI/ASME STANDARD B18.21-1981 @ 12" oc. STAGGER OR OFF SET EACH ROW BOLTS SHALL BE PLACED IN SNUG HOLES, WITH A MINIMUM EDGE DISTANCE OF 2" AND WITH STANDARD WASHERS AT BOLT HEAD AND NUT, OR AS SHOWN ON DRAWING. 4. ALL LVL BEAMS TO BEAR ON BUILT UP POST OF A MINIMUM AS LISTED BELOW 2 TO 3 LVLS USE 3"X 3.5", 4 LVLS USE 4.5"X 3.5", 5 LVLS USE 6" X 3.5" OR AS DESIGNATED ON DRAWINGS OR ON STEEL. 5. BEARING ENDS OF ALL BEAMS TO BE BLOCKED 14.5 " SOLID EACH SIDE 6. ROOF AND WALL SHEATHING TO BE ATTACHED TO FRAMING WITH 8d NAILS @ 6 " OC. AT PANEL EDGES AND 12" OC. FOR ALL FRAMING MEMBERS NOT AT EDGES 7. GYPSUM BOARD TO BE ATTACHED TO FRAMING WITH TYPE W OR TYPE S SCREWS IN ACCORDANCE WITH ASTM C1002 2 12" OC. AND SHALL PENETRATE FRAMING A MINIMUM OF 5/8". 8. ALL OTHER FRAMING TO BE PER THE 7TH EDITION OF MASSACHUSETTS STATE BUILDING CODE. FRAMING LUMBER fb=875 psi, E= 1,200.000 psi 9 ALL JOIST AND BEAM HANGERS TO BE BY SIMPSON STRONG TIE, INSTALLATIONAND NAILING TO BE PER MANUFACTURERS RECOMMENDATIONS. 10. USE SIMPSON , HURRICANE TIE AT THE EAVE END OF EACH ROOF RAFTER OR TRUSS.ALL EXTERIOR HANGERS TO BE STAINLESS STEEL. SPECIFIED HARDWARE MAY REQUIRE SPECIAL ORDER ALLOW SUFFICIENT LEAD TIME FOR DELIVERY. 11. ALL PRE-ENGINEERED JOIST TO BE TRUS JOIST BY i LEVEL, AND INSTALLED PER THE CURRENT MANUFACTURERS INSTRUCTION AND SPECIFICATIONS, INCLUDING BUT NOT LIMITED TO ALL ACCESSORIES SUCH AS RIM BOARDS, WEB STHFINERS, BRIDGING, BRACING, NAILING AND CONNECTION REQUIREMENTS, ETC., DO NOT KNOTCH OR CUT JOIST OR PENETRATE WITH ANY HOLES EXCEPT AS ALLOWED BY MANUFABTURER 12. THE CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN AND FOLLOW THE MANUFASTURES LATEST INSTALLATION RECOMMENDATIONS AND SPECIFICATIONS FOR LVL BEAMS AND PRE-ENGINEERED JOIST. 13. ALL STEEL TO BE A36, STEEL COLUMNS, WITH BASE AND BEARING PLATES TO BE BEAM WIDTH* 8" * '/2" PLATES WITH 4- %" HOLES , BOLTED OR WELDED TO BEAM, ORAS SHOWN ON DRAWINGS. 14. ALL SUPPORTS UNDER BEAMS TO HAVE SUFFICIENT UNINTERUPTED SUPPORT ALL THE WAY DOWN TO THE FOUNDATION OR ONTO LVL BEAM. 15. BRING ALL DISCREPANCIES, PROPOSED DEVIATIONS AND ACTUAL FIELD CONDITIONS THAT ARE DIFFERENT THAN DEPICTED TO THE ATTENTION OF THE ENGINNER PRIOR TO PROCEEDING WITH CONSTRUCTION. 16. ALL BIGFOOT SYSTEMS TO BE INSTALLED PER BIG FOOT INSTALLATION MANUAL 17. COORDINATE ALL WORK WITH THIS DRAWING AND ALL OTHER PROJECT DRAWINGS INCLUDING SHOP DRAWINGS. 18.. LOADS FIRST FLOOR LL 40 PSF, SECOND FLOOR 30 PSF, DL 15 PSF ,ROOF GROUND SNOW LOAD 50 PSF, DECK LL 60 PSF WIND LOAD 100 MPH., EXPOSURE B 19 . FOUNDATION BE CARRIED DOWN TO UNDESTURBED SOIL HAVING A MINIMUM BEARING CAPACITY OF 2 TONS PER SQUARE FOOT. 20. AT THE COMPETION OF THE FRAMING WORK THE LICENSED CONSTRUCTION SUPERVISOR IS TO PROVIDE A CERTIFICATION THAT ALL WORK WAS PERFORMED ACCORDING TO THE DRAWINGS, DETAILS, NOTES, MANUFACTURES INSTALLATION REQUIREMENTS AND THE 7TH EDITION OF THE MASSACHUSETTS BUILDING CODE FOR 1& 2 FAMILY RESIDENCES. ENGINEER: LAWRENCE H. OGDEN P.E. 198 EAST MAIN STREET GEORGETOWN, MA. 01833 978-352-8318, cell 978-502-5921 vivinu3av1;51&nLA1v1.Lvu iiiiyiuis Town of North Andover aF tkaRrk Office of the Health Department a� �`°"E._ Community Development and Services Division * ? y 27 Charles Street .. �gATEO �y� North Andover, Massachusetts 01845 Heidi Griffin Acting Public Health Director TOWN OF NORTH ANDOVER BOARD OF HEALTH c ?► Telephone (978) 688-9E Fax (978) 688-9542 CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 12/01/03 This is to certify that the individual subsurface disposal.systein constructed ( ) or repaired (X) by Steve Marsh at 55 Turtle Lane .J has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. B riaIJ. LaGrasse Board of Health Inspector BOARD OF ,,VPEALS 685-9541 BUILDING 688-9545 CONSERVATION 685-9530 HEALTH 688-9540 PLANNING 688-9535 Boa o Bul dla� R�ulstloto� �d Staadardi _'.. HOME IMPROVEMENT CONTRl1a1OR Yid .. t • 4 y � N 14,E _ S � � : �'xh i �� 1 : .. - .1maQ w,i ii[thf�it � 180 MLQQTgN � - _� � � �;• t { � . �•�W / /y�/�� 4 � r t ` II { q� • f i 'Y. - 5. 1^ i r .� r � 1 �. '.* Y y,N .,i� Y 1 . ass c ase . #ate Buil a ' d`eJ ,,80W R App�endiz The Massachusetts State Building Code (780 CMR) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J 1.1.2.3.1). This FORM is. not intended to prevent a homeowner from selecting a "sunroom" of any size, configuration, orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations in in selecting and utilizing a "sunroom" addition. The connection of "sunroom" structures to residential" buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of "sunrooms", included below is a non -required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a "sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO "SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar beat gain • Frame materials • Glazing to frame sealing and gasketing materials/ seal durability and/or weather tightness of the sunroom • Adequate ventilation - Operable windows and fans • Applied Shading Systems • Insulation level in floors, walls, and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency, Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner (not the owner's agent or representative) acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information ill this document concerning sunroom comfort and energy conservation. Signature of Actual Bui g Owner Date �i�g lf� i�Siwe e.ye� Print Name �— Owner Address (if different than project location) ff ;�07ek )," Address of Permitted Project 0E--&ZZ-1iA3 Owner's telephone number ACORQrM CERTIFICATE OF LIABILITY INSURANCE 7 DATE (MM/DD/YYYY) 11/4/2008 PRODUCER Mathias Insurance Agency, Inc 5 y, 200 Sutton Street, Suite 160 North Andover, MA 01845 978-688-5531 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Alan Smallman PO Box 306 Boxford, MA 01921 INSURER A: AIG INSURER B: Safety 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. INSR LTR DD% INSRD Y OFINSURANCEPOLICY NUMBER POLICY EFFEE DATE MM DDCTIVDATE POLICY EXPIRATION MM DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGEIRENT PREMISES Ea occurence $ X COMMERCIAL GENERAL LIABILITY ICLAIMSMADE CI OCCUR M ED EXP (Anyone person) $ 10,000 PERSONAL -&ADV INJURY $ B BPOOOII040 10/011/08 10/01/09 GENERAL AGGREGATE $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OPAGG $ }( POLICY jE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Ea accident) BODILY INJURY $ ALL O W N ED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Peraccident) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ OTHERTHAN EAACC $ ANYAUTO AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 11000,000 }( I OCCUR CI CLAIMSMADE AGGREGATE $ 2,000,000 $ CU00000896 10/01/08 10/01/09 $ $ DEDUCTIBLE $ X RETENTION $ 10,000 WORKERS COMPENSATION AND TH WCSTATU- ER TORYLIMITS ER EMPLOYERS' LIABILITY wC 3729999 10/15/08 10/15/09 E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $ 500,000 A OFFICER/MEMBER EXCLUDED? Ityes, describeunder SPECIALPROVISIONSbelow E.L. DISEASE -POLICY LIMIT 1 $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30 DAYS WRITTEN NOTI TO TH CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL TOWri of North Andover IMPOS NO O LIGATION,OR LIABIJ ITY1eF ANY KIND UPON THE INSURER, ITS AGENTS OR REPR ACORD25(2001/08) I 1 111 \ / / SAGOFff CORPORATION 1988 XEScheck-Web: Project Information Page 1 of 1 REScheckows "" Code/Location Select the applicable code and the building location (view the current status of state energy codes): Code: 2000 IECC State: Massachusetts City: Essex i County: Essex If your city or county is not included here, choose a nearby location with similar weather conditions. Building Characteristics 1- and 2 -Family, Detached :_i Multifamily Project Details (optional This information will appear on the Notes: sweeney 55 Turtle lane http://energycode.pnl.gov/REScheckWeb/project.j sp?updateLocations=no&codeChange=F... 12/3/2008 REScheck-Web: Envelope Assemblies Page 1 of 1 Row: 'Edit 4" Duplicate Move Up Move Down X Delete Add: Ceiling Skylight Wall Window Door Basement Floor Crawl REscnelckoft&" No title assigned -- Code: 2000 IECC I Ceiling Flat or Scissor Truss 2 Skylight Wood Frame, 2 Pane w/ Low -E 3 W211 Wood Frame, 16in. o.c. 4 Window Vinyl Frame, 2 Pane w/ Low -E 5 door Glass 6 7 Basement Solid Concrete or Masonry Floor All -Wood joist/Truss Over Uncond. Space Gross Area Cavity I Continuous ' (ftz) Insulation R- Insulation R- f I Value I Value 350 ' 30.0 30.0 12 375 19.0 19.0 50 60 los 0.0 0.0 350 30.0 30.0 http://energycode.pnl.govIREScheckWeblenvelope.j sp?updateCompliance=yes&updateLo... 12/3/2008 REScheck-Web: Mechanical Equipment Row: 4 - Duplicate Move Up Move Down X Delete Add: Furnace Gas Steam Boiler Other Boiler Heat Pump Air Conditioner i ' 'O'-e srk Heating Cooling i�" Efficiency Efficiency No�title assigned -- Code: 2000 IECC Boiler Other (Except Gas -Fired Steam) 80.0 Minimum Efficiency 80.0 AFUE Page 1 of 1 http://energycode.pnl.govIREScheckWeblmechanical.j sp?prevTab=Project&updateLocatio... 12/3/2008 •RtScheck-Web: Compliance Results Fails -35.6% Your UA: 118.0 Max. UA: 87.0 Page 1 of 1 http://energycode.pnl.gov/REScheckWeb/results.jsp?runSilent=true 12/3/2008