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Miscellaneous - 67 RUSSELL STREET 4/30/2018
(L�.���X11 �1�✓e BUILDING FILE � � � , l� Date...lad.....................�.�............... OF r►ORTN TOWN OF NORTH ANDOVER 9 PERMIT FOR WIRING 88gC�gg C L Thiscertifies that ............................................................................................................................ has permission to perform tK—\ ��-- Ne ' j � 4`-- P wiring in the building of. .5 I }at .... 1. ...........,�..:? S t..�.......�-> .. orth Andover,Mass. Fee.�.L....1. b.�,to .. ......Lic.No. ............................ .. . .... .. . . .. �- EL CAL SPECTOR Check# 3� 119 0 2 c31 -- 14 Commonwealth of Massachusetts Offic ,l use Only Department of Fire Services Permit No. l li BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 0— [Rev. 11/991 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: to--7-13 City or Town of: 17� n tom, To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) G 7 fi,-6 fie,)( Q Owner or Tenant Telephone No. Owner's AddressPp /Iy��t Go! h// �reTS�.o- A4 Is this permit in conjunction with a building permit? Yes [f' No ❑ (Check Appropriate Box) Purpose of Building �_ Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service P10 Amps (Z4 /Z-V/0 Volts Overhead[]' Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: .r! Completion of thefollowing table may be waived by the Inspector of Wires. No.of Recessed FixturesNo.of Ceil:Susp.(Paddle)Fans 1' No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs ._ Generators KVA 1 No.of Lighting Fixtures 2L Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets 5- No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners Z No.of Detection and Initiatin Devices No.of Ranges r No.of Air Cond. Z- Tons TotNo.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons W No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers j Space/Area Heating KW Local Municipal ❑ Other Connection No.of Dryers Heating Appliances KW SecuritySystems: No.of Water o.o No.of Devices or Equivalent Heaters KW No.as Data Wiring: Signs Ballasts No.of Devices or Equivalent 14 No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsWiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. 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 a to the permit issuing office. CHECK ONE: INSURANCE 2- BOND [-] OTHER ❑ sa(Specify:) /2-/&--17 Estimated Value of Electrical Work: 8000.d (Expiration Date) � (When required by municipal policy.) Work to Start: 10- )-(3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains an/dJp_ena^_ltties ofperj//y�y,that the information on this application is true and complete. FIRM NAME: �� ,'C. .fit LIC.NO.: t 6 77 Licensee: C /(G j 6111-t-0— Signature Lk - LIC.NO.:PL 312 LB (/f applicable,ent r "exempt 'in the license num',er ine.)) Bus.Tel.No.- Address: �- f 0� 6t✓ A 1-cl.�,Jh.SS A10 �) Y 7 L Alt.Tel.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 a ent. Owner/Agent PERMIT FEE. $ Signature Telephone No. I 1 )PDA i YV DT Qp f -� 3 F The Commonwealth of Massachusetts Department oflndustrialAccidents ` Office of Investigations d I Congress Street, Suite 100 ` Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): CG Electric Address. 16 Boxcar Blvd City/State/Zip:Tewksbury Ma 01876 Phone #: 1-978-858-0665 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 20 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑■ New construction 2.❑ 1 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' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its WE 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 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 131-1 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 employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:The Hartford Policy#or Self-ins. Lic. #:08WECC12034 Expiration Date: 12/16/13 Job Site Address: 0 P,<,(SSt_f( City/State/Zip: lU- lgh�o✓.ems 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 certify under the sins andpenalties of perjury that the information provided above is true and correct. Si nature: C1 �"v Date: Phone#: I 1-tl- y S-P- U�65 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#: f Yf Vs-1V 11WYWf f:V ,�. ••• ^' BOARD iOf F. :. E.ECTR1 C I•ANS.: kgp "SUES TMEJOLLOWING L : 'E1+i5 AS Rf Rl 14ASTER,,ltlCTR ICI AN rye .. -• --. ' ;� C,..Gr r:E<, CTR I C I NC`�> 16 BOXCAR ` RY U sx :: 4A o1876-t400.V 15"677 A �r':ol%3a/t6: ;:.. 79926 COMMONWEALTH OF MASb`iKOi1iSETTS ` BOARD Of :E UTR'I Cl AN S, ; ISSUESTA' FOLLOW! "C`--tt'-EN'Sf "R OURNEYMAN<.,ELE.CTRI Cl ' .CffdS" E GENDRAi 36O1F wCAR"BLVD 01876-14WIllo 3126 E ,= . "0 /31/16>,,�'� 32917 L Date.... 022 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING .Ar ti This certifies that....... 0..L.T............................................................................... ...............r.. ...... .... .............. has permission to perform.....Q.��...... ............ ................... plumbing in the buildings ofd, :Qy\j.U3............... at.....//11. ........ .................. North Andover, Mass. Fee'.'Un—...Lic. No. ... .....M.1►..r........................................................... PLUMBING INSPECTOR Check# s) MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY. <. "�(Durr ! MA DATE //-,�G -1 ( PERMIT# JO8SITEADDRESS OWNER'S NAME sees Taw .✓d I P OWNER ADDRESS TEL����/� FAX' _— TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL Q RESIDENTIAL PRINT CLEARLY NEW: [a/ RENOVATION: REPLACEMENT: El PLANS SUBMITTED: YES Ell NO F-] FIXTURES"I FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE �( _ _ _ ) ) I _.•___,f -•_�.f I _i _ Cl) DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER AF-77-1 ..__-.J ___ _i _ f _._____( __.,.._.J � f J _._J -j .._...-_I I DRINKING FOUNTAIN _ i ..�__.) .____I ...____ f _ _.._{ I _____..► ---._..._J .___-) ___.._( _..__..iE __f ._...._lFOOD DISPOSER ( I ( f I I .____! .____) .__...-__) ..._._._I _.._-J � _--__I I __J FLOOR/AREA DRAIN .._( ..__--)INTERCEPTOR(INTERIOR) i ___f ___.j _ ,.-._x € ( _-__I .__ ) .� I J .I _.I ( I `7KITCHEN SINK J _ ._� _� LAVATORY _{ _ f -- _..-J -------1 ____J __-___1 __._._..I ( ( J _ _f .__._..._f _I I ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES ----- ---- - WATER PIPING I I _._.-.......J I _....__ __.1 __ .__l _ THER __ _ ______! f ..........1 ._____I _( f ______-( _..._._._f INSURANCE COVERAGE: tj 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW '+ LIABILITY INSURANCE POLICY LR OTHER TYPE OF INDEMNITY 0 BOND Q 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. rC. CHECK ONE ONLY: OWNER Q AGENT 1© S 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 with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME C P G' LUn i� T� j LICENSE# 8�� j SIGNATURE- 1 IVIP[0/ JP Q CORPORATION 0# PARTNERSHIP Q# LLC COMPANY NAME ADDRESS ZA), c CITY LASTATE ®ZIP d/g�� TEL 97 C 7 S� 7Pie 11 FAX 'CELL ry G�J3S7� EMAIL -- .�ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES WAAt, jO `'�1� 2`` 'rte Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ 4010 PC-aj(,t7, ( FEE: $ PERMIT# PLAN REVIEW NOTES O ll Date......!.. .�.... .............. NORTH I'AW 3�' " � TOWN OF NORTH ANDOVER g"� * PERMIT FOR GAS INSTALLATION 83�►CHU`3� Thiscertifies that ....................tP.................................................................................:......... has permission for gas installation\AA.Q -,j \()t-",x in the buildings of......-3.. !.. V.5....... .G �1Q ' at.......4.0.1......... ..��.....S4W—,eO+., NoA Andover, Mass. Fee...II O.-.... Lic. No. ..��, .. M A-77. ' GAS INSPECTOR Check# 9003 Uo, 1,3, MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY �� vim/ �� MA DATE PERMIT# JOBSITE ADDRESS _� __vS'_SG S% OWNER'S NAME CV, OWNER ADDRESS TE FAX PRINT OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL CLEARLY NEW: RENOVATION:El REPLACEMENT:® PLANS SUBMITTED: YES D- NO0 APPLIANCES'l FLOORS- BSM' 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER _ BOOSTER ... L�-_Zrj _ ..�1 _. ._._ . l - -- - - CONVERSION BURNER COOK STOVE DIRECT VENT HEATER - DRYER FIREPLACE LZ FRYOLATOR _ I FURNACE _ (❑�!L GENERATOR GRILLE INFRARED HEATER ❑--- ❑J = -- - _ -- _ -- - -_ c� LABORATORY COCKS MAKEUP AIR UNIT OVEN I POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST -- UNIT HEATER UNVENTED ROOM HEATER WATERHEATER Ei............................. . ................ ........................... 1 OTHER _ ----���_ - -►�-_ _ T — INSURANCE COVERAGE s have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES 12910 D IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERA BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ® BOND ❑_( OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER 0AGENT DDI � a 1 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 with all P rti- of the '1 Massachusetts State Plumbing Code and Chapter 142 of the General Laws. a PLUM BER-GASFITTER NAME LICENSE# f.�a� c SIGNATURE MP ❑ ® LPGI MGF JP JGF { ❑ � CORPORATION©# PARTNERSHIP D# LLC 0#= COMPANY NAME:Lx_ ADDRESS / CITY _ P�i� C/ff ( STATE dY,9 ZIP O/ G--2 ]TEL 7 .3�S FAX j�CELL jJEMAIL CC�� yin/ r¢DC Cdr ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ 3d v FEE: $ PERMIT# PLAN REVIEW NOTES The Commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations IN 600 Washington Street Boston,MA. 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly L� /1 Name(Business/Organization/Individual): Address: Z7 City/State/Zip: N' �� l°l/C'•�3 Phone#: 1`� s 7y 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 ployees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. E]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. El We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3111 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.[J Roof repairs insurance required.]t employees.[No workers' 13.[i Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance formy employees Below is the policy and job site information. Insurance Company Name:. / 1-7 Policy#or Self-ins.Lic.#: T Expiration Date �f Job Site Address: G 7 ��5 St'// S/ ' City/State/Zip: /,'U, 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 certtfy under the pains andpenalties of perjury that the information provided above is true and correct. Signature: `—//% i 3 � s� Date: Phone#: /y 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." i 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 cant'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 lice. 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 www.Mass,govldia COMMONWEALTH OF MASSACHUSETTS i r . . •. . :r .rr � PLUMBERS AND GASFITTERS LICENSED AS A MASTER PLUMBER j ISSUES THE ABOVE LICENSE TO: `f } RALPH C 'FLODIN JR 4 LAURIE ANN LN i N BILLERICA MA 01862- 1752 9822 05/01/14 176495 " 1 LICENSE NO. EXPIRATION DATE SERIALi LAWRENCE H. OGDEN,P.E. 198 EAST MAIN STREET GEORGETOWN,MA 01833 978-352-8318 fax 978 352-2858 cell: 978-502-5921 January 9,2014 Mr.James Mangano P.O. Box 602 Wilmington, Ma. 01877 \RE: 67 Russell,North Andover,Mr.-02420 Dear Mr.Mangano As you requested I visited the site 1/9/14 to review the installation of the Engineered Materials consisting of LVLs,Engineered Joist and details utilized in the framing of the above project. These are shown on plans prepared KDK Design dated 6/20/13 with the framing shown on sheets 3,6,7,9 and D-I to D-3 certified by me 7/19/13. At the time of this visit the exterior siding and interior insulation was in place. The following items must be completed. Connect all LVLs togeter with 2 rows of screws at 16"oc. as shown on sheet D-2. Add Simpson straps to the interior of the garage doors as shown on sheet 9. Based on the above site visit and based on what I could visibly see, and provided the above work is completed. I can certify that to the best of my knowledge the LVLs members utilized in the framing as shown on the drawings are installed properly and meet the loading conditions of the 8th Edition of the Massachusetts State Building Code for 1&2 Family Residences, All other framing requirements of the drawings and code, including but not limited to materials,nailing schedules,blocking, connections,manufacturers installation requirements and other details are the responsibility of the licensed construction supervisor responsible for the project. Should you have any questions please do not hesitate to call. Yours truly, OF en ce H. Ogden P.E. Structural 27765 0 0G 27765�Q�� LAWRENCE H. OGDEN,P.E. o 198 EAST MAIN STREET GEORGETOWN,MA 01833 978-352-8318 fax 978 352-2858 cell: 978-502-5921 January 9,2014 BOARD OF APPEALS Mr. James Mangano P.O. Box 602 Wilmington, Ma. 01877 RE: 67 Russell,North Andover,Ma. 02420 Dear Mr.Mangano As you requested I visited the site 1/9/14 to review the installation of the Engineered Materials consisting of LVLs, Engineered Joist and details utilized in the framing of the above project. These are shown on plans prepared KDK Design dated 6/20/13 with the framing shown on sheets 3,6,7,9 and D-I to D-3 certified by me 7/19/13. At the time of this visit the exterior siding and interior insulation was in place. The following items must be completed. Connect all LVLs togeter with 2 rows of screws at 16"oc. as shown on sheet D-2. Add Simpson straps to the interior of the garage doors as shown on sheet 9. Based on the above site visit and based on what I could visibly see, and provided the above work is completed. I can certify that to the best of my knowledge the LVLs members utilized in the framing as shown on the drawings are installed properly and meet the loading conditions of the 8th Edition of the Massachusetts State Building Code for 1&2 Family Residences, All other framing requirements of the drawings and code, including but not limited to materials,nailing schedules,blocking, connections,manufacturers installation requirements and other details are the responsibility of the licensed construction supervisor responsible for the project. Should you have any questions please do not hesitate to call. Yours truly, OF z� o CE ti en ce H. Ogden P.E. Structural 27765 0 oe 1/9 1' to .oP�F, 27765 3 2 2Date. . i� 6i. .. .... � �' I r NpRTn 1M TOWN OF NORTH ANDOVER i pf o , ti cp0 i ' PERMIT FOR MECHANICAL INSTALLATION OJ1�,�� p 0 9SSACHUSE� .� I This certifies that . ,. � %l!�. . . .?�. . . . . . . . . . . . . . . . . . . . . has permission for mechanical installation . .f h ?Q. . --. . . . . . . in the buildings of . .�1 f Y''! S. . fry1 '�`C; .!� 61. . . . . . . . . . . j at . . . . . . . . . .. North Andover, Mass. ` Fee. c. /. . Lic. No.6. . ��' . . F- !�1 ``� . . . . . . . . GAS INSPECTOR l WHITE:Applicant CANARY: Building Dept. PINK:Treasurer i Commonwealth of Massachusetts Sheet Metal Permit Date " Permit e 0 Estimated Job Cost: 900© Permit Fee: $ U Plans Submitted: YES NO 7` Plans Reviewed: YES NO Business License# /95 Applicant License# Business Information: ) Properly Owner/Job Location Information: Name: 5ejveeR &ATN ,A-o Sl►4 7'�5+4 I Name: -f/N1 A.Na Street: :5 AD Street: 6 7 -/?U City/Town: 13 lIeFi M ��1A �l City/Town: IVO /fAIOQV&Z Telephone: 9 —/ M—6-991 Telephone: Photo I.D.required/Copy of Photo I.D. attached: YES NO A Building Type: ' s Residential: 1-2 family Multi-family Condo/Townhouses • Commercial: Office Retail Industrial Educational Institutional Building Cubic Footage: under 35,000 cu.ft. ✓ over 35,000 cu. ft. Sheet metal work to be completed: New Work: ✓ Renovation: HVAC ✓ Metal Roofing Kitchen-Exhaust System Chimney/Vents Provide brief description of work to be done: .DEW i�'?�. A d ��� �`a�GLn•C �.i .�Gl�c,e���;1 INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes❑ No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this 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. Progress Inspections Date Comments Final Inspection i Date Comments Type of License: By 01Master Title ElMaster-Restricted Cityrrown ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ ❑ Check at www.mass.gov/dpl Inspector Signature of Permit Approval � ,sd Project Summary Date: Nov 01,2013 "►"` ' `°'°"'°"'"° Zone-2 Second FI By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtordce.com Proiect Information For: Seneca Company 67 Russell St, North Andover, MA 01845 Notes: 1) Distributor is not responsible for the accuracy of the load calculation if inaccurate/incomplete construction information is provided by the dealer. 2) It is the sole responsibility of the dealer to ensure that the duct system is adequately sized for the airflow capacity of the specified equipment. Design Information Weather: Lawrence Muni, MA, US Winter Design Conditions Summer Design Conditions Outside db -1 'F Outside db 88 °F Inside db 72 °F Inside db 75 °F Design TD 73 °F Design TD 13 °F Daily range M Relative humidity 50 % Moisture difference 31 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 17453 Btuh Structure 8043 Btuh Ducts 3191 Btuh Ducts 772 Btuh Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 20644 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 8180 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Semi-tight Fireplaces 0 Structure 452 Btuh Ducts 658 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area(ftp 1080 1080 Equipment latent load 1110 Btuh Volume(ft) 8834 8834 Air changes/hour 0.27 0.15 Equipment total load 9291 Btuh Equiv.AVF(cfm) 40 21 Req:total capacity at 0.70 SHR 1.0 ton Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref n/a Coil n/a AHRI ref n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 °F Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. ' r lihtSOft` 2013-Nov-13 12Page W fiC.C.A g Right-Suite®Universa1201313.0.04RSU17410 Page3 Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W Aw4j,,zos*gderd Component Constructions Job: Date: Nov 01,2013 Zone-1 First Fir By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtorrice.com Project Information For: Seneca Company 67 Russell St, North Andover, MA 01845 Design Conditions Location: Indoor: Heating Cooling Lawrence Muni, MA, US Indoor temperature(TF) 72 75 Elevation: 151 ft Design TD(TF) 73 13 Latitude: 43°N Relative humidity(%) 50 50 Outdoor: Heating Cooling Moisture difference(grAb) 54.6 31.2 Dry bulb(*F) -1 88 Infiltration: Daily range(TF) - 18 ( M ) Method Simplified 1Metbulb(°F) - 73 Construction quality Semi-tight Wind speed(mph) 15.0 7.5 Fireplaces 0 Construction descriptions Or Area U-value Insul R Htg HTM Loss Cig HTM Gain R' BluhiR'-°F tt=-°FBM Btuhff Btuh BMAt' Btuh Walls 12F-Osw:Frim wall,vnl ext,3/8"wood shth,r-21 cav ins,1/2"gypsum n 222 0.065 21.0 4.72 1048 0.91 201 board int fish,2"x6"wood frim a 244 0.065 21.0 4.72 1153 0.91 222 S 184 0.065 21.0 4.72 866 0.91 166 sw 17 0.065 21.0 4.72 81 0.91 16 w 222 0.065 21.0 4.72 1046 0.91 201 nw 17 0.065 21.0 4.72 81 0.91 16 all 906 0.065 21.0 4.72 4276 0.91 822 Q #tq.rtSm wall,stucco ext,r-13 cav ins,2'x4"wood frim 157 0.091 13.0 6.61 1037 0.93 146 Windows �aliaai�,tRk: a�ifi�alfriB a Qylr 11 6ifi�}4fYrR�R6Gc1if4" 6 3d low-e innr,1/4"gap,1/8"thk a 42 0.470 0 34.1 1433 48.2 2025 s 18 0.320 0 23.2 416 19.5 349 sw 5 0.320 0 23.2 126 32.3 w 41 0.320 0 23.2 962 36.9 1 AN nw 5 0.320 0 23.2 126 25.5 138 all. 160 0.320 0 26.1 4166 34.5 5500 Doors 11JO:Door,mtl fbrgl type s 39 0.600 6.3 43.6 1677 15.1 581 w 21 0.600 6.3 43.6 915 15.1 317 all 60 0.600 6.3 43.6 2592 15.1 898 11 AO:Door,wd he type n 35 0.470 0 34.1 1194 11.8 414 Ceilings 16B-30ad:Attic ceiling,asphalt shingles roof mat,r-31 roof ins,r-30 ceil 49 0.032 30.0 2.32 113 1.56 76 ins C part ceiling,:C part ceiling,hrd wd fir fnsh,frim fir,6"thkns,1/2" 12 0.257 1.0 18.6 224 12.5 150 gypsum board int fish Wr htS-Oft2013-Nov-1312:01:12 Right-SulteG Universal 2013 13.0.04 RSU17410 Pege3 "'• A94-'...Seneca C -67 Russell.St,North And �P•r1Y oWnrp GA)a¢tbM.Eierrt Door faoes:.W ... ..�,... �... _..,. - Floors 19,A-30bvhp:Fir floor,frm flr,6"thkns,hrd wd flr fish,r-30 cav ins, 1092 0.034 30.0 2.07 2263 0.37 399 leaky bsmt ovr C wri htSOR' 2013-Nov-1312:01:12 9 Right-Suite®Universal 201313.0.04 RSU17410 Page Seneca Company-67 Russell St,North Mdover.rup Calc=MJ8 Front Door faces: W „s, „d Component Constructions Job: Date: Nov 01,2013 Zone-2 Second FI By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtonice.com Project • • For: Seneca Company 67 Russell St, North Andover, MA 01845 Design Conditions Location: Indoor: Heating Cooling Lawrence Muni, MA, US Indoor temperature(TF) 72 75 Elevation: 151 ft Design TD(TF) 73 13 Latitude: 43°N Relative humidity(%) 50 50 Outdoor: Heating Cooling Moisture difference(gr/Ib) 54.6 31.2 Dry bulb(°F) -1 88 Infiltration: Dailyrange(°F) - 18 ( M ) Method Simplified VVet bulb(°F) - 73 Construction quality Semi-tight Wind speed(mph) 15.0 7.5 Fireplaces 0 Construction descriptions or Area U-value Insul R Htg HTM Loss Clg HTM Gain 112 Bluh/W-*F fP-°FBtuh Bluhff Btuh Btuh/W Btuh Walls 12F-Osw:Frm wall,vnl ext,3/8"wood shth,r-21 cav ins,1/2"gypsum n 220 0.065 21.0 4.72 1038 0.91 199 board int fnsh,2"x6"wood frm a 266 0.065 21.0 4.72 1258 0.91 242 S 231 0.065 21.0 4.72 1091 0.91 210 w 264 0.065 21.0 4.72 1243 0.91 239 all 981 0.065 21.0 4.72 4630 0.91 890 Partitions 12C-Osw:Frm wall,stucco ext,r-13 cav ins,2'x4"wood frm 329 0.091 13.0 6.61 2173 0.93 307 Windows 2 glazing,cir outr,air gas,insulated vinyl frm mat,dr low-e innr,1/4" a 30 0.320 0 23.2 686 36.9 1089 gap,1/8"thk:2 glazing,cir outr,air gas,insulated vinyl frm mat,cir s 9 0.320 0 23.2 203 19.5 171 low-e innr,1/4"gap, 1/8"thk w 53 0.320 0 23.2 1220 36.9 1938 all 91 0.320 0 23.2 2109 35.2 3198 Doors 11AO:Door,wd he type n 95 0.470 0 34.1 3244 11.8 1124 Ceilings 16B-38ad:Attic ceiling,asphalt shingles roof mat,r-38 ceil ins, 1/2" 1080 0.026 38.0 1.89 2039 1.26 1366 gypsum board int fish Floors 19A-30bvhp:Flr floor,frm flr,6"thkns,hrd wd flr fish,r-30 cav ins, 24 0.034 30.0 2.07 50 0.37 9 leaky bsmt ovr 19C-19cscp:Flr floor,frm fir,6"thkns,carpet fir fish,r-2 ext ins,r-19 25 0.049 30.0 1.23 31 0.22 5 cav ins,tight crwl ovr,r-11 wall insul 2013-Nov-13 12:01:12 1C + wrightsoft' Right-Suite®Universal 2013 13.0.04 RSU17410 Page ACCA ...Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W ;¢iw,%?aq s d Project Summary Date: Nov 01,2013 . ... 40tiD1t10YrM6 Entire HouseB y Christopher a Bergeron eron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtorrice.com Project • • For: Seneca Company 67 Russell St, North Andover, MA 01845 Notes: 1) Distributor is not responsible for the accuracy of the load calculation if inaccurate/incomplete construction information is provided by the dealer. 2) It is the sole responsibility of the dealer to ensure that the duct system is adequately sized for the airflow capacity of the specified equipment. Design Information Weather: Lawrence Muni, MA, US Winter Design Conditions Summer Design Conditions Outside db -1 °F Outside db 88 °F Inside db 72 °F Inside db 75 °F Design TD 73 °F Design TD 13 of Daily range M Relative humidity 50 % Moisture difference 31 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 36654 Btuh Structure 20868 Btuh Ducts 6701 Btuh Ducts 2003 Btuh Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 43354 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 21225 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Semi-tight Fireplaces 0 Structure 1927 Btuh Ducts 1323 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area(ft2) 2173 2173 Equipment latent load 3250 Btuh Volume(ft) 17572 17572 Air changes/hour 0.28 0.15 Equipment total load 24475 Btuh Equiv.AVF(cfm) 82 44 Rdq:total capacity at 0.70 SHR 2.5 ton Heating Equipment Summary Cooling Equipment Summary Make American Standard Make American Standard Trade SILVER ZI Trade GOLD SI Model AUH113060A9361A" Cond 4A7A3030G1 AHRI ref 2016796 Coil 4TXCB031 BC3 AHRI ref 5636141 Efficiency 95 AFUE Efficiency 11.5 EER, 13.5 SEER Heating input 60000 Btuh Sensible cooling 19600 Btuh Heating output 57000 Btuh Latent cooling 8400 Btuh Temperature rise 56 °F Total cooling 28000 Btuh Actual air flow 933 cfm Actual air flow 933 cfm Air flow factor 0.022 cfm/Btuh Air flow factor 0.040 cfm/Btuh Static pressure 0.10 in H2O Static pressure 0.10 in H2O Space thermostat Load sensible heat ratio 0.88 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Nov-13 12:01:12 C Wr� htSoft- Right-Suite®Universal 2013 13.0.04 RSU17410 Page 1 Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W A„��q shwda / Project Summary Date: Nov 01,2013 «4tira'c a •. co*u.uor�au Zone-7 First Fir By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtonice.com Project Information For: Seneca Company 67 Russell St, North Andover, MA 01845 Notes: 1) Distributor is not responsible for the accuracy of the load calculation if inaccurate/incomplete construction information is provided by the dealer. 2) It is the sole responsibility of the dealer to ensure that the duct system is adequately sized for the airflow capacity of the specified equipment. Design Information Weather: Lawrence Muni, MA, US Winter Design Conditions Summer Design Conditions Outside db -1 OF Outside db 88 OF Inside db 72 OF Inside db 75 OF Design TD 73 OF Design TD 13 OF Daily range M Relative humidity 50 % Moisture difference 31 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 19200 Btuh Structure 13927 Btuh Ducts 3510 Btuh Ducts 1337 Btuh Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 22710 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 14165 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Semi-tight Fireplaces 0 Structure 1475 Btuh Ducts 665 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area(ftJ 1092 1092 Equipment latent load 2140 Btuh Volume(ft) 8738 8738 Air changes/hour 0.29 0.15 Equipment total load 16305 Btuh Equiv.AVF(cfm) 42 22 Req:total capacity at 0.70 SHR 1.7 ton Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref n/a Coil n/a AHRI ref n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. Wri htSotit' 2013-Nov-1312:01:12 9 Right-Suite®Universal201313.0.04RSU17410 Page Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W Awuliwq Load Short Form Job: +.r»IUC . .•. CDNDIi1DVIF• Date: Nov 01,2013 • Zone-2 Second FI By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtorrice.com Project • • For: Seneca Company 67 Russell St, North Andover, MA 01845 Design Information Htg Clg Infiltration Outside db(°F) -1 88 Method Simplified Inside db(°F) 72 75 Construction quality Semi-tight Design TD(°F) 73 13 Fireplaces 0 Daily range - M Inside humidity(%) 50 50 Moisture difference(gr/lb) 55 31 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref n/a Coil n/a AHRI ref n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (fe) (Btuh) (Btuh) (cfm) (cfm) W.I.C. 62 1301 228 28 9 MASTER BATH 76 892 492 19 20 MASTER BEDROOM 268 3573 1921 77 77 LAUNDRY 24 210 49 5 2 BATHROOM 72 1299 537 28 22 BEDROOM 3 146 4212 1621 91 65 UPPER STAIRS 40 422 92 9 4 HALLWAY 81 805 175 17 7 BEDROOM 2 175 4900 2055 105 83 BEDROOM 4 137 3030 1646 65 66 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. wri htsoft' 2013-Nov-1312:01:12 9 Right-Suite®Universa1201313.0.04RSU17410 ...Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W Page 7_one-2 Second FI p 1080 20644 8815 444 354 Other equip loads 0 0 ' Equip. @ 0.93 RSM 8180 Latent cooling 1110 TOTALS I 1080 I 20644 I 9291 I 444 I 354 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Nov-13 12:01:12 wci htSOf ' Right-Suite®Universa1201313.0.04 RSU17410 Page J4CX>- ...Seneca Company-67 Russell St,North Mdover.rup Calc=MJ8 Front Door faces: W Component Constructions Job: Awtj�AoSla%Ard Date: Nov 01,2013 •wr+ren � •n. sawort+o«w• Entire House By: Christopher Bergeron . S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtonice.com Project Information For: Seneca Company 67 Russell St, North Andover, MA 01845 Design Conditions Location: Indoor: Heating Cooling Lawrence Muni, MA, US Indoor temperature(TF) 72 75 Elevation: 151 ft Design TD(TF) 73 13 Latitude: 43°N Relative humidity(%) 50 50 Outdoor: Heating Cooling Moisture difference(grAb) 54.6 31.2 Dry bulb(°F) -1 88 Infiltration: Daily range(TF) - 18 ( M ) Method Simplified VVetbulb(°F) - 73 Construction quality Semi-tight Wind speed(mph) 15.0 7.5 Fireplaces 0 Construction descriptions Or Area Ll-value Insul R Htg HTM Loss Clg HTM Gain ft' BtuhM'-*F W-"FIBtuh Btuhlftr Btuh BtuhAP Btuh Walls 12F-Osw:Firm wall,vnl ext,3/8"wood shth,r-21 cav ins,1/2"gypsum n 442 0.065 21.0 4.72 2086 0.91 401 board int fnsh,2'x6"wood frm a 511 0.065 21.0 4.72 2411 0.91 463 s 415 0.065 21.0 4.72 1958 0.91 376 sw 17 0.065 21.0 4.72 81 0.91 16 w 485 0.065 21.0 4.72 2289 0.91 440 nw 17 0.065 21.0 4.72 81 0.91 16 all 1887 0.065 21.0 4.72 8906 0.91 1711 Partitions 12C-Osw:Frm wall,stucco ext,r-13 cav ins,2'x4"wood frm 486 0.091 13.0 6.61 3210 0.93 453 Windows 2 glazing,clr outr,air gas,insulated vinyl frm mat,Gr low-e innr,1/4" n 18 0.320 0 23.2 416 10.8 193 gap,1/8"thk:2 glazing,clr outr,air gas,insulated vinyl frm mat,clr a 59 0.320 0 23.2 1373 36.9 2181 low-e innr,1/4"gap, 1/8"thk a 42 0.470 0 34.1 1433 48.2 2025 s 27 0.320 0 23.2 619 19.5 520 sw 5 0.320 0 23.2 126 32.3 175 w 94 0.320 0 23.2 2182 36.9 3466 nw 5 0.320 0 23.2 126 25.5 138 all 250 0.320 0 25.1 6274 34.7 8698 Doors 11X Door,mtl fbrgl type s 39 0.600 6.3 43.6 1677 15.1 581 w 21 0.600 6.3 43.6 915 15.1 317 all 60 0.600 6.3 43.6 2592 15.1 898 11 AO:Door,wd he type n 130 0.470 0 34.1 4439 11.8 1538 Ceilings 166-30ad:Attic ceiling,asphalt shingles roof mat,r-31 roof ins,r-30 ceil 49 0.032 30.0 2.32 113 1.56 76 ins 166-38ad:Attic ceiling,asphalt shingles roof mat,r-38 ceil ins,1/2" 1080 0.026 38.0 1.89 2039 1.26 1366 gypsum board int fish C part ceiling,:C part ceiling,hrd wd fir fnsh,frm flr,6"thkns,1/2" 12 0.257 1.0 18.6 224 12.5 150 gypsum board int fish 2013-Nov-13 12:01:12 wrightsOftr Right-Suite®Universal 2013 13.0.04 RSU17410 Page 1 -4CCA ...Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W Floors 19A-3Qbvhp:Fir floor,frm fir,6"thkns,hrd wd fir fish,r-30 cav ins, 1116 0.034 30.0 2.07 2312 0.37 408 leaky bsmt ovr 19C-19cscp:Fir floor,frm fir,6"thkns,carpet fir fish,r-2 ext ins,r-19 25 0.049 30.0 1.23 31 0.22 5 cav ins,tight crwl ovr,r-11 wall insul !�t wri htsafk' 2013-Nov-1312:01:12 9 Right-Suite®Universal 2013 13.0.04 RSU17410 Page 2 ...Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W n urn.�����r,,, s:�.Do1 _ Page 2 of 2 Date:8/132013 02:43 PM Page:2 of.2 .4CORU" OP ID: SS CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 08/13/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN.THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER y Phone: 978-688-7000 CON AC - Durso �Jankowski Ins AgcLLC NAME: 198 Massachusetts Avenue Fax:978-688-7001 PHONE Fax A1C No Ext): AIC No E-MAIL North Andover,.MA 01845 Durso &Jankowski Ins.Agcy. ADDRESS: CUSTOMER ID#:SENECA INSURERS)AFFORDING COVERAGE NAIC# INSURED Seneca Heating 8r Sheet INSURERA:Main Street America Assurance 14788 Metal Co. Inc. INSURER.B:Guard Insurance.Grou 574 Boston Rd. P Billerica, MA 01821 INSURER C:NGM Insurance 14788 INSURE10: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: . REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE.BEEN REDUCED BY PAID CLAIMS. SIR LTR TYPE OFINSURANCE- POLICY NUMBER MM DDIYYPOLIC YY MM ICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY MPT6642J 07/01/2013 07/01/2014 PDAMAGE REMISES Ea olccurrence $ 500,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENTAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- CT LOC _ $ AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT $ 1,000,000 ANY-AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) $ C X SCHEDULED AUTOS M1 T6642J 07/01/2013 07/0112014 BODILY INJURY(Per accident) $ ' HIRED AUTOS PROPERTY DAMAGE $ (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000;000 EXCESS LAB CLAIMS-MADE C DEDUCTIBLE CUT6642J 07/01/2013 07/01/2014 AGGREGATE $ 1,000,000 RETENTION $ $ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITYWC STATU- OTH- B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN. SEWC472707 07/01/2013 07/01/2014 X TORY LIMITS ER OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ 500,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Air Conditioning system CERTIFICATE HOLDER CANCELLATION NEWTONM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Newton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Load Short Form Job: .r � so�m t,o�4ac Date: Nov 01,2013 Entire House By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtorrice.com Project • • For: Seneca�Company 67 Russell St, North Andover, MA 01845 Design Information Htg Clg Infiltration Outside db(°F) -1 88 Method Simplified Inside db(°F) 72 75 Construction quality Semi-tight Design TD(°F) 73 13 Fireplaces 0 Daily range - M Inside humidity(%) 50 50 Moisture difference(gr/Ib) 55 31 HEATING EQUIPMENT COOLING EQUIPMENT Make American Standard Make American Standard Trade SILVER ZI Trade GOLD SI Model AUH16060A9361A" Cond 4A7A3030G1 AHRI ref 2016796 Coil 4TXCB031BC3 AHRI ref 5636141 Efficiency 95 AFUE Efficiency 11.5 EER, 13.5 SEER Heating input 60000 Btuh Sensible cooling 19600 Btuh Heating output '57000 Btuh Latent cooling 8400 Btuh Temperature rise 56 OF Total cooling 28000 Btuh Actual air flow 933 cfm Actual air flow 933 cfm Air flow factor 0.022 cfm/Btuh Air flow factor 0.040 cfm/Btuh Static pressure 0.10 in H2O Static pressure 0.10 in H2O Space thermostat Load sensible heat ratio 0.88 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF W) (Btuh) (Btuh) (cfm) (cfm) Zone-1 First Flr p 1092 22710 15264 489 613 Zone-2 Second FI p 1080 20644 8815 444 354 Entire House d 2173 43354 22872 933 933 Other equip loads 0 0 Equip.@ 0.93 RSM 21225 Latent cooling 3250 TOTALS I 2173 l 43354 I 24475 I 933 I 933 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Nov-13 12:01:12 - wrightsoft° Right-Suite®Universal 2013 13.0.04 RSU17410 Page 1 • �CA ...Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W F Awmjt ogSAwja rd Load Short Form Job: Date: Nov 01,2013 Zone-1 First Fir By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron(osgtorrice.com Project • • For: Seneca Company 67 Russell St, North Andover, MA 01845 Design Information Htg Cig Infiltration Outside db(°F) -1 88 Method Simplified Inside db(°F) 72 75 Construction quality Semi-tight Design TD(°F) 73 13 Fireplaces 0 Daily range - M Inside humidity(%) 50 50 Moisture difference(gr/Ib) 55 31 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref n/a Coil n/a AHRI ref n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 °F Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 ROOM NAME Area Htg load Clg load Htg AVF Cig AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) KITCHEN/EATING 350 6727 6172 145 248 DINING 203 3346 1659 72 67 LIVING 203 3211 2623 69 105 BATH 26 307 47 7 2 FOYER 109 5645 2029 121 82 FAMILY ROOM 201 3473 2735 75 110 Zone-1 First Fir p 1092 22710 15264 489 613 Other equip loads 0 0 Equip. @ 0.93 RSM 14165 Latent cooling 2140 TOTALS I 1092 I 22710 I 16305 I 489 I 613 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Nov-1312:0::12 wri htSaf ' Right-Suite®Universal 201313.0.04RSU17410 Page3 +CI� ...Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W r 4 v q.� Fold Multiple Times Along Perforations Before Detaching " h COMMONWEALTH OF MASSACHUSETTS BOARD SHEET METAL WORKERS;;,,. SN AS A BUSINESS F ISSUES THE ABOVE LICENSE TO: ! TYPE :ALAN R .ANDERSON SENECA .HEATING AND SHEET METAL ' -B 574 BOSTON RD UNIT 4 BILLERICA MA 01821-0000 304687 183 01/06/15 304687 Fold Multiple Times Along Perforations Before Detaching Fold Multiple Times Along Perforations Before Detaching :COMMONWEALTH OF MASSACHUSETTS - BOARD SHEET METAL WORKER'S`:' SM AS A:.MASTER-UNRESTRIQ,;TED t ISSUES.THE ABOVE LICENSE TO; TYPE ALAN .R ANDERSON . {� M1 7. ,1.UDY ST B'ILLER.I.CA MA 01821-5305 .. 327636 108 03/28/15 327636 LICENSE NO. EXPIRATION DATE SERIAL NO. Fold Multiple Times Along Perforations Before Detaching y AWflafff S&4 daid Load Short Form Job: Date: Nov 01,2013 Zone-1 First Fir By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtomce.c°m Project • • For: Seneca Company 67 Russell St, North Andover, MA 01845 4K— Design Information Htg Clg Infiltration Outside db(°F) -1 88 Method Simplified Inside db(°F) 72 75 Construction quality Semi-tight Design TD(°F) 73 13 Fireplaces 0 Daily range - M Inside humidity(%) 50 50 Moisture difference(gr/Ib) 55 31 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref n/a Coil n/a AHRI ref n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF W) (Btuh) (Btuh) (cfm) (cfm) KITCHEN/EATING 350 6727 6172 145 248 DINING 203 3346 1659 72 67 LIVING 203 3211 2623 69 105 BATH 26 307 47 7 2 FOYER 109 5645 2029 121 82 FAMILY ROOM 201 3473 2735 75 110 Zone-1 First Fir p 1092 22710 15264 489 613 Other equip loads 0 0 Equip. @ 0.93 RSM 14165 Latent cooling 2140 TOTALS I 1092 I 22710 I 16305 I 489 I 613 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. L e,t I� Q ` 2013-Nov-1312:01:12 W 9 Right-Suite®Universal 201313.0.04 RSU17410 Page 2 ...Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W c • t N First Flow 127 cfm 127 Cfm 75 cfm 7 " 7 " 6 " KITCHEN/EANG 75 cfm UI ING 1 7 ,. 2oxs 10x8 8x 2x 12 0.0-41 6 " Y L 8 „ BSMT. 240 cfm BAT 190 cfm 7 410cfm FAMIL ROOM 6 " HLIV NG CL. FOYER 108 cfm 113 c 9 cfm Job#: S.G. Torrice Co. Scale: 1 :67 Performed by Christopher Bergeron for: Seneca Company Page 1 67 Russell St 80 Industrial Way RightSuite®Unirersal 2013 North Andover,MA 01845 Wilmington,-MA 01887 13.0.04 RSU17410 Phone:(800)888-8359 Fax:(978)657-4255 2013-Nov-2013:56:25 cbergeron@sgtorrice.com ..:67 Russell St,North Andover.rup r N r~ Second Flooi 101 cfm 36 cfm 20 cfm EL CL. 10 " 4 „ 6 " I BED OM 3 BATH OOM A TER BATH 10 " " 6 - a s ' 137 cfm 6 „ CHALLWAY L SE y �01 cfm CL. l 7 if 113 cfm 61 6 " R STAIRS 9 BEDROOM 2 112 cfm ASTER BEDROOM BEbRO01 k 4 88 cfm 11 76 cfm Job#: Scale: 1 :67 Performed by Christopher Bergeron for: S.G. Torrice Co. Seneca Company Page 2 80 Industrial Way Right-Su items Universa 12013 67 Russell St Wilmington,MA 01887 13.0.04 RSU17410 North Andover,MA 01845 Phone:(800)888-8359 Fax:(978)657-4255 2013-Nov-20 13:56:26 6ergeron@sgtorrice.com ...67 Russell St,North Andover.rup 1 First Flooi KITCHEN/EATING DINING C) R � R � BSMT. � R BATH FAMILY ROOM TAIR LIVING CL. FOYER G� (� Job#: S.G. Torrice Co. Scale: 1 :66 Performed by Christopher Bergeron for: Page 1 Seneca Company 80 Industrial Way RightSuite®Universal 2013 67 Russell St Wilmington, MA 01887 13.0.04 RSU17410 North Andover,MA 01845 Phone: (800)888-8359 Fax:(978)65713255 2013-Nov-13 12:01:25 cbergeron@sgtorrice.com ...67 Russell St,North Andover.rup F� Second Floo . CL. BEDROOM 3 BATHROOM ASTER BATH W.I.C. CL LAUNDRY CLOSET HALLWAY R STAIRS BEDROOM 2 MASTER BEDROOM BEDROOM 4 Job#: S.G. Torrice Co. Scale: 1 : 66 Performed by Christopher Bergeron for: Page 2 Seneca Company 80 Industrial Way RightSuite®Universal 2013 67 Russell St Wilmington,MA 01887 13.0.04 RSU17410 North Andover,MA 01845 Phone:(800)888-8359 Fax:(978)657-4255 2013-Nov-13 12:01:25 cbergeron@sgtordoe.com 67 Russell St,North Andover.rup s �Srd Load Short Form Job: Date: Nov 01,2013 •Ii�yO • , 40 kOTiOvtk4 Zone-2 Second FI By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtorrice.com Project • • For: Seneca Company 67 Russell St, North Andover, MA 01845 Design Information Htg Clg Infiltration Outside db(°F) -1 88 Method Simplified Inside db(°F) 72 75 Construction quality Semi-tight Design TD(°F) 73 13 Fireplaces 0 Daily range - M Inside humidity(%) 50 50 Moisture difference(gr/Ib) 55 31 HEATING EQUIPMENT COOLING EQUIPMENT Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref n/a Coil n/a AHRI ref n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) W.I.C. 62 1310 229 29 9 MASTER BATH 76 898 494 20 20 MASTER BEDROOM 268 3949 2002 88 82 LAUNDRY 24 0 0 0 0 BATHROOM 72 1635 611 36 25 BEDROOM 3 146 4537 1690 101 70 UPPER STAIRS 40 0 0 0 0 HALLWAY 81 0 0 0 0 BEDROOM 2 175 5053 2086 113 86 BEDROOM 4 137 3397 1725 76 71 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Nov-20 13:56:10 wrightSoft° Right-Suite®Universal 2013 13.0.04 RSU17410 Page 3 Seneca Company-67 Russell St,North Andover.rup Calc=MJ8 Front Door faces: W c done-2 Second FI p 1080 20780 8836 463 364 Other equip loads 0 0 Equip. @ 0.93 RSM 8200 Latent cooling 1110 TOTALS l 1080 I 20780 I 9310 I 463 I 364 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. wri htlsoft^ 2013-Nov-2013:56:10 9 Right-Suite®Universal 201313.0.04 RSU17410 Page Seneca Company-67 Russell St,North Mdover.rup Calc=MJ8 Front Door faces: W -Aj&j�sq Slm� Load Short Form Job: Date: Nov 01,2013 hF.TIUG ♦f. CJM 012OMNO Entire House By: Christopher Bergeron S.G. Torrice Co. 80 Industrial Way,Wilmington,MA 01887 Phone:(800)888-8359 Fax:(978)657-4255 Email:cbergeron@sgtorrice.com Project • • For: Seneca Company 67 Russell St, North Andover, MA 01845 Design Information Htg Cig Infiltration Outside db(°F) -1 88 Method Simplified Inside db(°F) 72 75 Construction quality Semi-tight Design TD(°F) 73 13 Fireplaces 0 Daily range - M Inside humidity(%) 50 50 Moisture difference(gr/Ib) 55 31 HEATING EQUIPMENT COOLING EQUIPMENT Make American Standard Make American Standard Trade SILVER ZI Trade GOLD SI Model AU H 1 B060A9361 A* Cond 4A7A303OG1 AHRI ref 2016796 Coil 4TXCB031 BC3 AHRI ref 5636141 Efficiency 95 AFUE Efficiency 11.5 EER, 13.5 SEER Heating input 60000 Btuh Sensible cooling 19600 Btuh Heating output 57000 Btuh Latent cooling 8400 Btuh Temperature rise 56 °F Total cooling 28000 Btuh Actual air flow 933 cfm Actual air flow 933 cfm Air flow factor 0.022 cfm/Btuh Air flow factor 0.040 cfm/Btuh Static pressure 0.10 in H2O Static pressure 0.10 in H2O Space thermostat Load sensible heat ratio 0.88 ROOM NAME Area Htg load Cig load Htg AVF Clg AVF OF) (Btuh) . (Btuh) (cfm) (cfm) Zone-1 First Flr p 1092 22710 15264 489 613 Zone-2 Second FI p 1080 20644 8815 444 354 Entire House d 2173 43354 22872 933 933 Other equip loads 0 0 Equip. @ 0.93 RSM 21225 Latent cooling 3250 TOTALS I 2173 I 43354 I 24475 I 933 I 933 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Nov-13 12:01:12 i9_kL. wrightSOft' Right-Suite®Universal 2013 13-0.04 RSU1 7410 Page Seneca Company-67 Russell St,North Andover.rup Calc=MA Front Door faces: W 4 ' ^ T A",6h,W BRIGHT STAR lfcatiimg Su.ppty CO.,.[nc. 978-815-9452 Duct Leakage Test Form Customer Information: Test Conditions Name: ���„� C \�,,, Date: 1 ILl 113 Address: Lf jz,,AO., T Floor area: City: Location of State/Zip: supply duct work: w,-C'A t Phone: Location of return ductwork: Building Address System location: Total allowable StreV ,, e\ ST duct leakage: I L +�City o �� ��„� U 20091nternational ov nservation code Testing Option Used Maximum CFM per 100 square ft @25 Pascals At rough-in, air handler not installed 4 At rough-in,air handler installed 6 Post construction, leakage to outdoors 8 Post construction,total leakage 12 Total Leakage Test Test Pressure: 25 Pa Test no. Duct Pressure. (Pa) .Flow Ring Installed Duct Leakage (cfm) 1 S Results: Total Leakage: Total leakage as% of floor area: /o Tester Signature: ` Date... .. .3. 13........ NOR7�y TOWN OF NORTH ANDOVER p PERMIT FOR WIRING r BSgC�g6 `` �J1�/ � �Q�✓SIV This certifies that C..L?'".... s ................................................................................................ has permission to perform y 5e 2J!. wiring in the building of.......'S.....e (�p1 ...►�^55f V-".4z......... North Andover,Mass Fee..............................Lic.No. ................. ........::! ............... .................... ELECTRICAL INSPECTOR I Check# 1001, ItC1 2- Commonwealth Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. I l I BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1]/991 (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: 10 - 21-13 City or Town of: A)• ,4rd oytY- To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 6 1 P,(.(,S4-t.l ( t} Owner or Tenant A-Ss,--+ I1L c-t r c I k --1e /ZeG Telephone No.9 7$•Z 2,-., 2,L( -;j�- Owner's Address r D A e)-*< 402 (,J t I OA",t", (it1 6 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. I.S Ct,(,( I� j Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: !D D A b ilk Completion o the ollowin table may be waived by the Inspector of Wires. of No.of Recessed Fixtures No.of Ceil: TransSusp.(Paddle)Fans Total Trsformers KVA �.,. No.of Lighting Outlets No.of Hot Tubs Generators KVA AboveIn- o.o Emergency Lighting No.of Lighting Fixtures Swimming Pool rnd. ❑ rnd. El- Battery Units No.of Receptacle Outlets (, No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of RangesNo.of Air Cond. Total Tons g No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ....................... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kms, Security Systems: No.of Devices or Equivalent Heaters No.of Water Kms, No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: f Attach additional detail if desired,or as required by the Inspector of N"fres. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless S 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. , b CHECK ONE: INSURANCE [�BOND ❑ OTHER ❑ (Specify:) CRra, .� Ce—, t7--14-15 Estimated Value of Electrical Work: -209 -� (Expiration Date)o (When required by municipal policy.) ((� Work to Start: (y LL-1 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains nd penalties of perjury,that the information on this application is true and complete. FIRM NAME: CC (,�vf r LIC.NO.: t s6 77 Licensee: Cr(Q s t,c� ��o Signature LIC.NO.: E3 t Z6 gy (Ifapplicable,enter "exempt"in the license number line.) Bus.Tel.No.: - LG S Address:_(` a>,---r (3 t ve9 qet ks.�Ill. m 1B 1 6 Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE. $ j Signature Telephone No. __-- i 7-27-Vilte 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations hal d 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): CG Electric Inc Address: 16 Boxcar Blvd City/State/Zip:Tewksbury Ma 01876 Phone#: 1-978-858-0665 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 14 4. E] I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑■ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ 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 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ 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. t'I✓ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:The Hartford Policy#or Self-ins. Lic. #:08WECC12034 Expiration Date: 12-16-13 Job Site Address: 67 Russell St City/State/Zip: N.Andover Ma. 01845 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 10-23-13 Phone#: �- g It- toSB- G6 6 3- 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#• +vvrr s awroul BOARD OF. 5UES THE FOLLOWING 0..1v'94*' `r AS ``" Rf~G 1S'1" RA MASTEi>,;EIYECTR 1 C 1 AN .G> G%:1 ICTR I C I NC,`` 3+1I LL I AM;<":.P-MAiTl7QW- 16 BoxcAR"B`L1TD a x . e yJ .Y:•, .I If58&Y s><.: !!! 01876-1#00"'" 15677 LA, yo7%311;16 `79926 12 IM alan,meiiilli� lcOMMONWEALTH OF MAS AGHC SETTS. > BOAH!R Of GTR I C ANS ISSUES THE F0LLOW IAIG'::L`>f'CENS e . OURNEYM�4N ELECTR1C11 r, C## ! IS E GENDR ^ ONY f> 160)E CAR BLVD ^3ri Sci3URY r 4A 01876-14W"' , <; >zw 31268; E ,,:;' 07/31/16; :::;;;' 32917