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HomeMy WebLinkAboutMiscellaneous - 86 STAGE COACH ROAD 4/30/2018FR r u PRM Engineerin , LLC March 24, 2008 Mr. Steve McKay 86 Stage Coach Road North Andover, MA 01845-3140 • Foundation Design • Structural Engineering • Tensile'Structures • Building Investigations • Value. Engineering • Applied Technology REFERENCE: Site Visit to observe installed framing for house addition <r—at`WStageCoach Road, North Andover, MA 01845 Dear Mr. McKay: PRM Job#: J08-23 As per request of Mr. Bill Ferris. Contractor for the house addition construction referenced above, a site visit was scheduled for today March 24"', 2008 at 1:30 p.m. to observe the installed framing for the house addition under construction. A review of the site conditions reveals that in general the framing recently built have been installed in conformance with the construction documents, plans, details, notes, and specifications. In particular is noted that the (4) — 1-3/4"x16" LVL and the (3) - 1-3/4"x9-1/2" LVL beams at the 2" a floor level appeared to be properly installed. This letter have been prepared by Pedro R. Munoz, Ph.D., P.E. of PRM Engineering, LLC, licensed in the State of Massachusetts as a Structural Engineer and is intended to be used by Mr. Steve McKay for the purposes of presenting it to the Building Official of North Andover as part of the inspections and app royals=` of the new framing for the addition referenced above only. Reproduction of this letter and use of'parts 'of this letter for purposes other than those specifically described in this t i hout the expressed written, consent of PRM Engineering, LLC is strictly forbidden. �H OF MAS v O ., P.E. Mak'P6 UreoSe#42854 expires: 0/30/2002 PRM Engineering, LLC • 6 Woodman Way, Suite #116, Newburyport, MA 01950 • Tel: (978) 465-7105 Fax: (978) 465-7002 0 E-mail: prmeng(a,att.net Date ...... ........ .... ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... .......... ..... .................................................. has permission to perform ......................................................... wiring in the building of .-ai4 ....... A, ... at .... ....... .......... ...... n: .................... I North Andover, Mass. Fee. ...... ...... Lic. No Z. Check # 802.7. J' LU -t\- Commonwealth of Massachusetts Official se Only Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked W,/[Rev. -1/07] (]eaveblank 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 W INK OR TYPE ALL INFORMATION) Date: 0 3 /0 S /d City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 86 .91-66-6 Gp R Glf ►2 D FE o Owner or Tenant S --6L) C l4 51 �r� V Telephone No. Owner's Address 8.6 (Z_p 1. D Is this permit in conjunction with a building permit? Yes 9 No ❑ Purpose of Building 12W i; t,{,1 hf % Existing Service 2,0'o Amps ",2 / 2 jo Volts New Service Amps / Volts Number of Feeders and Ampacity (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd No. of Meters_ Overhead ❑ Undgrd ❑ No. of Meters Location and Nature of Proposed Electrical Work: k At PVZ ,e— Cmmnloti— nffhp fn llm.d..,,— 1,1-.... . LL_..r_ _ c__ No. of Recessed Luminaires 3 6 - No. of Ceff. Susp. (Paddle) Fans t.r.�y uc wuweu o Inc in ecror oI wires. No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ o. o Emergency ig g rnd. rnd. Battery Units No. of Receptacle Outletsf.� No. of Oil Burners FIRE ALARMS No. ofZones No. of Switches / 8 No. of Gas Burners No. of Detection and Initiatin Devices No. of Ranges 1 ��' '`� "�' Aw-.16Tons No. of Air Cd. Total on No. of Alerting Devices 4c, No. of Waste Disposers j HST tap Number .Tons KW No. of Self -Contained Detection/Alertina Devices No. of Dishwashers ( Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW SecNotyo ystemDevices No. of Water No. of No. of or Equivalent Heaters KW Si ns Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP TelecommunicationsWiring: No. of Devices or Equivalent OTHER: 0Aitacn aaditionat detail iJ desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: qo-,�?v . � (When required by municipal policy.) Work to Start: 03 lo 7 o, ' Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CO RAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 2`] BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the inforoation on this application is true and complete. FIRM NAME: H 14 C - & YO N LIC. NO.: 3413 2 j�5 Licensee: _ -STS i4p C . AVA-W Signature C.. LIC. NO.: 30.13 Z �. (If applicable, enter "exempt " in the license number line.) Bus. Tel. No. Sa8 ,[2 —6S�© Address: It ,i/o2-rlt LO ,E` s� .- bL(�TNGIE,tf ,14A t?i8tiy Alt. Tel.No.:4)B *Per M.G.L c. 147, s. 57-61, security work requires Tsepartrnent of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑owner's agent. Owner/Agent � Signature Telephone No. PERMIT FEE. $ /G?, Ott /6 - o( -499 r The Commonwealth of Massachusetts k� ! Department of Industrial Accidents Office of Investigations ti '' 600 Washington Street �Y1 «t t l Boston, MA 02111 c i www.nzass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Apniicant Information Please Print Ledbly Name (Business/Organizafion/lndividual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: 1. ❑ 1 am a employer with 4. ❑ 1 am a general contractor and 1 employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a.sole proprietor or partner- listed on the attached sheet t ship and have no employees These sub -contractors have working for mein any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per Mat, myself. [No workers' comp, c. 152, § 1(4),' and we have no insurance required.] t employees. [No workers' comp. insurance required_] Type of project (requireti): 6. ❑ New construction 7. ❑ Remodeling S. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other "Any applicant that checks bo>lrlt 1 must also fill out the section below showing their workers' compensation policy information, f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is.provrding workers' compensation insurance for my employees: Below is the policy and job site information. Insurance Company Name: ' Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $4500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORT{ 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 andpenatties of perjury that tine information provided above is true and correct. Signature: Date: Phone #: Official use only. Do not write in this area, to be completed by city or town official City or Town: PermitlLicense # 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 bustee 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 I52, §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 th.e he requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, 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 number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of lnvestiptions 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 1-8.77-MASSAFE Revised 5-26-05 Fax # 617-727-7744 www.mass.gov/dia 11 Date',.,5. i� f ppR7M 1 rp,<� TOWN OF NORTH ANDOVER p '° PERMIT FOR PLUMBING � • i i ,SSACHUSE� This certifies that ......- . has permission to perform -.. .. ......`.. . plumbing in the buildings of ..`�!�R ............... . 4-North'Andover, Mass. Fee`C...... Lic.,�- ...... ./.r ............ . P1sG INSPECTOR Check H 7675 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date 3�' Building Location �� �� I {� tJugGl� Owners Name ����P ! � tc4v Permit # Amount /GL - !S -Type of Occupancy NewrlRenovation Replacement "mv Plans Submitted Yes ❑ No ❑ FIXTURES (Print or type) 11) � � Check one: Certificate Installing Company Name_ �/� ) L �1b7 E-� ❑ Corp. Address f �� ❑ Partner. Business Telephone / yz - loJ'(r G� Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ Insurance Waiwn I. the undersigned, have been made aware that the licensee of this application does not have any one of the above three' uranc Signature " Owner ❑ 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 1 e ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts StKPIIUWAytng Code and Chapter 142 of the General Laws. ail ii1��2 IBy' s enseu T itle Type of Plumbing License ity/Townicense um er Master Journeyman Title (OFFICE USE ONLY Date .. .... ... 0 �0 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies thatG.....'..................... ............ has permission for gas ......................... in the buildings of ....... .. ; .......... at ....... ....... North Andover, Mass. ........... Fee'�-P,. -Lic.' No:,7.*. GAS I WNS��PW�T 0 FR Check # 0 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS F rn NG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations ?& — le �,�() ! -ev C P c C k Owner's Name New Renovation Replacement El Date , ':� /7— Permit 7Permit # Amount $ Plans Submitted n (Print or type) fes/' Name_ ✓� iG���f 1 l`� Check one: Certificate Installing Company 0 Corp. Partner. 1-3 Finn/Co. Name of Licensed Plumber'or Gas Fitter ,4 - --- --- .5,... owner V Agent us I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installation rmed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse tate Code and Chapter 142 of the General Laws. By: Title City/Town, APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber -1) Gas Fitter License Number 0 Master ILS Journeyman � w � w IX o w e a� a o o z w v a a > fx u w �, w e F z Q x W a d� u a d x w o Q a .I. z E, > a rn e m e z o O o z w o w x SUB -BASEM ENT u a > BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOGR 8TH. FLOOR p' (Print or type) fes/' Name_ ✓� iG���f 1 l`� Check one: Certificate Installing Company 0 Corp. Partner. 1-3 Finn/Co. Name of Licensed Plumber'or Gas Fitter ,4 - --- --- .5,... owner V Agent us I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installation rmed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse tate Code and Chapter 142 of the General Laws. By: Title City/Town, APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber -1) Gas Fitter License Number 0 Master ILS Journeyman � w Date... ...... ... .. . } 'a ,�oRT1 o? TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that..,i�i ,�Q �Y � '� d has permission for gas installation . !� ? ... C��A--A e `-c .... . in the buildings of ... rn.c. eA . Y ...................... at .................. .. `........... , North Andover, Mass. Fee .. `%. .-II Lic. No..�513 , �'�� •t GAS INSPECT R ,.'Check # ,4 4775 r MASSACHUSEI'I'S UNIFORM APPUCATON (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations ame New Renovation ❑ Replacement YORPFRMITTODO GASFIITWG Date p Permit # 17 Amount $,� Plans Submitted ❑ (Print or type) '10iJ..4—il / Name of Licensed Plumber or Gas Fitter f4 L,,-, i Check one: Certificate Installing Company ❑ Corp. ❑ Partner. Firm/Co. INSURANCE COVERAGE Check one: 7 have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked Les, please indicate the type coverage by checking the appropriate box. 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 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: ❑ Signature of Owner or Owner's Agent Owner ❑ 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts>taYGas Code an Chapter 142 of the General Laws. n I�YPROVED (OFFICE USE ONLY) Signature of Lic6nsed Phi as Fitter ® Plumber Gas Fitter License Number Master Journeyman Owl U1 a O W F a'' z O F z O 6. p z w z z W w z O z a ¢� O W O SUB-BASEM ENT BASEM ENT 1ST. FLOOR 2ND . FLOOR 3RD. FLOOR T H. FLOOR FLOOR �TH. [4 T H. FLOOR 7TH. FLOOR TH. FLOOR (Print or type) '10iJ..4—il / Name of Licensed Plumber or Gas Fitter f4 L,,-, i Check one: Certificate Installing Company ❑ Corp. ❑ Partner. Firm/Co. INSURANCE COVERAGE Check one: 7 have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked Les, please indicate the type coverage by checking the appropriate box. 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 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: ❑ Signature of Owner or Owner's Agent Owner ❑ 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts>taYGas Code an Chapter 142 of the General Laws. n I�YPROVED (OFFICE USE ONLY) Signature of Lic6nsed Phi as Fitter ® Plumber Gas Fitter License Number Master Journeyman