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HomeMy WebLinkAboutMiscellaneous - 885 FOREST STREET 4/30/2018 (3)/ Date . 41 ,�2111..<. . TOWN OP NORTH ANDOVER PERMIT FOR PLUMBING � �SACNUs�- This certifies that ... ................... has permission to perform ....er: C.,.a. M /I 4.�..:.............. . plumbing in the buildings of ................... at .... ......., , North Andover, Mass. Fee Lic. No.I (.. ..... � ..� ...:� �. ,�....... ? PLUMBING INSPECTOR Check # j 6 9 L;. 0 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date ''�' �' r%, Building Location, > �`r` �1J i��oiZJS' �C Permit #--� �'Yo Amount -2 �� Ownerr„�-e, �� .J hJ L �� �� � . �� � �t iQ -e—SNew Renovation 11"!M Replacement Plans Submitted Yes NoFIXTURES (Print or type) �- —� Installing Company Name d)"i lr� L _ v Address ' a `� `� k C, Check one: Certificate Corp. Partner. Firm/Co. Name of Licensed Plumber:�0. Insurance Coverage: Indicate e type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity D Bond D Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 11 Agent D 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 piffurned under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Sta u an hapter 142 of the General Laws. By: Signaturej5pLicensea riumneT Type of Plumbing License Title 6 2 9 City/Town cense um er Master D Journeyman APPROVED (OFFICE USE ONLY Date ..-$ *Z-..e'�, Gam....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... ........... has permission to perform ............................................ wiring in the building of ..................................................... at ....... ................... ,North Andover, Mass. Fee—�? z........... Lic. No.-�,7,?i6- ELEcrRicAL INSPE60R Check # 6 FOR OFFICE USE ONLY W P (,,The Commonwealth of Massachusetts �y,7 Public Safety 1v o. Department of e � ty Occupancy &Fee Checkedc;a3 ' S , BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (lea: c.an.:i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the MassachusJDa Code. 527 CNIR 12D) (PLEASE PRINT IN INK OR TYPE ALL INFORM ATION) City or Town of v2 - To the of Wires: The undersigned applies for a permit to perform the electrical work described Location (Street and Number) 8��� �5 Map: Lot: _ Owner or Tenant its one: Owner's Address T rte' Is this permit in conjunction with a building o permit. Yes No ❑ ,&v�Ld ® (Check Appropriate 60�' Purpose of Building �W�/�'�—=— Utility Authorization No.— '� 6`�`S $"� Existing Service POP Amps -o-0 / a2•2,0 Volts New Service -2040 Amps a Volts Overhead X Underground 0 No. of Meters Overhead 0 Underground No. of Meters Ir Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work `Sy y fJNC��f' C%rDd/fJ� �e'f�y/C �� �/1r'D.��C �'�►�rr� G�Go�. No. of Lighting Outlets No. of Lighting Fixtures No. of Receptacle Outlets 3 C) No. of Switch Outlets No. of Ranges No. of Disposals No. of Dishwashers No. of Dryers No. of Water Heaters KW No. of Hydro Massage Tubs OTHER: No of Hot Tubs ' No. of Transformers Total KVA Swimming Pool Above grnd. 0 In-grnd. ❑ I Generators KVA No. of Oil Burners I No. of Emerg. Lighting Battery Units No. of Gas Burners No. of Air Cond. Total Tons No. of Total Tota' Heat Pumps Tons K' Space/Area Heating KW Heating Devices KW No. of Signs No. of Motor No. of Ballasts Total HP FIRE ALARMS No. of Zones �— No. of Detection'and / U Initiating Devices No. of Sounding Devices No. of Self -Contained Detection/Sounding Devices Local 0 Muncipal Connection ❑ Other Low Voltage Wiring INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Ge eral Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YESN-NO 0 I have submitted valid proof of same to this office. YES (ANO 0 If you have checked YES, please indicate the type of coverage by checking the ap ropriate box.. r Please Specify) �.a" / � y /6 d� INSURANCE W BOND 0 OTHER 0((Expiration. D Estimated Value of Electri al Work $ � ���/���� - Work to Start Inspection Date Requested: Rouoh Final Signed under the pe alti s of perjury: 32J15_ FIRM NAME 5C �z LIC. NO. Licensee j�q-r��'i-'L w -->a Signature LIC NO. ������ Address �U L✓3SL'a' S"f i%ioc�� Bus. Tel. No. s©'4 JlE `532 Alt. Tel. No./ %%x',%77-�%.�1 OWNER'S INSURANCE WAIVER: I am aware that the Licensee DOES NOT HAVE the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requireme; tt- Owner 0 Agent 0 (Please check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Notes — Remarks I INSPECTION RECORD Inspector I 0 -A Location 5f'�&5—f No. UV-)pDate AOR,►, TOWN OF NORTH ANDOVER t Certificate of Occupancy $ �'�S'•^°',cn S cNUS Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ /;3 S -9t TOTAL $ zf Check # 1 ',�-3 18892 )Z4,6,1w ,rte Building Inspector iE� FOR OFFICE USE ONLY The Commonwealth of Massachusetts � Permit iv o. �`� y 7 + 1� Department of Public Safety Occupancy &Fee Checked, 7 Ilea':c G.an.o s / BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1 :00 --�,.,PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code. 527 C IR 12.09 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date U2/[�1/'� To the Inspector of Wires: City or Town of The undersigned applies for a permit to perform the electrical) work described below: �� c� �� Map: Lot: Location (Street and Number) `� - Zone: Owner or Tenant Owner's Address - 'unction with a building permit? Yes X_ I�'o El,�drLd �� (Check Appropriate Boy' I> this permit 1n con) Utility Authorization Nc Purpose of Building 1 ��� Am��v —! a� voltsOverhead 5 ,Underground ❑ No. of Meters Existing Service Amps / Amps d6 ! •'9a J Volts Overhead El Undergrounds No. of Meters New Service Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work yNolel- No. of Hot Tubs No. of Lighting Outlets No. of Lighting Fixtures of Receptacle Outlets i,4,0'. of Switch Outlets No. of Ranges No. of Disposals No. of Dishwashers No. of Dryers No. of Water Heaters No. of Hydro Massage Tubs OTHER: No. of Transformers Total KVA Swimming Pool Above grnd. ❑ In-grnd. I. Generators KVA (� I No. of Oil Burners No. of Gas Burners No. of Air Cond. Total Tons No. of Total Tota' Heat Pumps Tons Kw Space/Area Heating KW Heating Devices KW KW No. of Signs No. of Motors No. of Ballasts Total HP No. of Emerg. Lighting Battery Units ' FIRE ALARMS No. of Zones �-- No. of Detection'and fU Initiating Devices No. of Sounding Devices No. of Self -Contained Detection/Sounding Devices Local 0 Muncipal Connection ❑ Other Low Voltage Wiring INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Ge era) Laws I have a current Liability Insurance Policy including Co pleted Operations Coverage or its substantial equivalent. YES r -NO ❑ I have submitted valid proof of same to this office. YESNO If you have checked YES, please indicate the type of coverage by checking the appropriate bpox.: y /d• d� INSURANCE (BOND ❑ OTHER C7 (Please Specify) �'� (Expiration. Dc Estimated Value of Electrical Work S Inspection Date Requested: Rough W�/�����Final Work to Start p Signed under the pe alti s of perjury: �� LIC: NO. 32JI5 FIRM NAME ' S"C 7- ,. L g LIC NO. <973/St icensee dam' �- Y"� S� ?A Si nature ,- '0`1-%Z� - 3 9U G—SSt� �� �'/id��e � � Bus. Tel. No. idress Alt. Tel..1`'o.f 9�7W-777-3721 OWNER'S INSURANCE WAIVER: I am aware that the Licensee DOES NOT HAVE the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that m}' signature on this permit application waives this requme t Owner C1Agent ❑ (Please check one) `l — Telephone No. PERMIT FEE (Signature Iof Owner or Agent) ��v mm ®/f,-- _l/ - D sJrJ�1 f 4 T®WN OF NORTH ANDOVER + BUILDING DEPARTMENT APPLICATION TO CONSTRUCT OVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING a BUILDING PERMIT NUMBER 7D DATE ISSUED: SIGNATURE: Buildng Commissioner/Ir of BuilT 7gs Date Cirn�•7Aas 1 [7T7} nTTTAT1l 1 n.r�� Q1.1 Property Address: O� 'T—d Q is cS i 1.2 Assessors Mao and Parcel iov� Map Number Number: tO Parcel Number =--�A) Ain,tQLi � L' N5 1.3 Zoning Information: -2�&j 8 a6 ` Zoning District Proposed Use 1.4 Property Dimensions: *i 7 70 Lot Area Frotrta e ft 1.6 BUILDING SETBACKS ft O3 6 Front Yard Side Yard Rear Yard ReqWred Provide ReqWmd Provided R red Provided 73p 00 O t.7 Weer Supply ivLG.L.C.40. 34) Public X Private ❑ Zone t.3. Flood Zone lnfomntion: Outside Flood Zone A< 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System a.+a.aava. i -. — Kr '111 v77111G1n.7KILL"AUHistoric District: Yes No 2.1 Owner of Record ;j�ANE �_.�r1NNiN(o �jC12 p• �1�ItJ q%,S `ro��-S� /z Address for Service : Si atu Telephone 2.2 Owner of Record: Name Print Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: Address Signature Telephone License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ =--�A) Ain,tQLi � L' N5 i 2 UG � 0 t1 / Company Name O3 6 Registration Number AAddrc CtGC.�G%,P�j0/U/7/ p/�/ p( Tel bone G O f E xpiratioa Bate rAx 3 9,'y //9a 'ff A �a 1 SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) ' Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Descri tion of Proposed Work (check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) t❑ Addition Accessory Bldg.` ` ❑ ' Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: oar/ pkF,s / IP�6 I.e OAF 3;€a Rao,., r-/��:4 2•'� 7 ��2 ; o /si T�iL APL) 3 �N! (AbKrff $iDu 1 SECTION 6 - ESTIMATED CONSTRUCTION COSTS —1 Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building(a) -7 ,500 O Building Permit Fee Multiplier SIZE OF FLOOR TIMBERS 2 Electrical(b) "26 OUD Estimated Total Cost of Construction. /�S'go o 3 Plumbing 6 00 Building Permit fee (a) x tbl 4 Mechanical (HVAC) /w a 5 Fire Protection DIMENSIONS OF GIRDERS 6 Total 1+2+3+4+5 , ©pp Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as i? /�RNG �� in) -� as OnMWAuthorized Agent of subject property /Hereby authorize N to act on My be all ii a ers relative t rk authorized by this building pen -nit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ?E/Z /4 • ®i "i 5D ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge Print Name y of Owner/. _10 � Date NO. OF STORIES oz SIZE BASEMENT OR SLAB r /j8v yltsy` SIZE OF FLOOR TIMBERS 1 "2 x(a 2 ND0? v/b 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS /w a DIMENSIONS OF GIRDERS ,- /Z HEIGHT OF FOUNDATION THICKNESS /o ` SIZE OF FOOTING p X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Al e0 � \ aa-cz 94 U � w w a w O � w a a W - w2 u cin � w a � w w cn o cn c o ! c O o o ' C N . O C vV •CLC cc m C czm �+ v UZ d H c 40 :CAN.jom E �m o m 3� y �pr=f O J h C o i • . r m� j� Us o NJ m > C. = O CI r.+ a.. C e * m V4) C.o .cm�m� o c F- = m 0 H 0 m t W � �t''�Z � •fAA CL= CC Z W . 'E o .c o V3 a m O:5 g _a ` h = C2 H r Qm b Al y co .E L O C O a� v a y O V .CL (a O C.) !D C _ CA L O V y _C CM C 0 to m 0 CD H .0 Cc 3� � � O L o �- CL ca 4-0 � J ca p O O 4-0 z a CO) C LLI 0 vI LLI U) w W W I% W U) /��1/�//.' ����/~��/ ' ' Essex North County Registry of Deeds .Al Common Street Lawrence, Massachu-:.:.etts 01840 10/19/05 JANE RUNNING 0 # 8 Rev Type PL 5100 DOC, 40107 C. P. 20.00 R. D. 100 # 9 Rec: Type NOTC 50.00 DOC. 4O1OO C. P. 20.00 Total 150.00 # 10 Flywent Check THANK YOU! Thomas J. Burke Raymond Santilli, Interim Community Development Director Town of North Andover Town Clerk Time Stamp Community Development and Services Division Office of the Zoning Board of Appeals PF-CEIVED 4W Osgood Street TOWN CLERK'S OFFICE North Andover, Massachusetts 01815 Any appeal shall be filed within (20) days after the date of filing of this notice in the office of the Town Clerk, per Mass. Gen. L. ch. Telephone (978) 688-9541 Fax (978)688-9542 Notice of Decision Year 2005 NO W 27 PN 4-- 19 TOWN OF NORTI� ANDOVER MASS CHUSETTS T4ft is to certify that twenty (20) days have elapsed from date of decision, flied without filing t �p�?&i"Q� Da- doyGe A. Itidir" TOM 06fk 40A, §17 Pro at: 885 Forest Street NAME: Jane L. Running & Per Arne Oines HEARING(S): September 13, 2005 ADDRESS: 885 Forest Street PETITION: 2005-026 North Andover, MA 01845 TYPING DATE: September 21, 2005 The North Andover Board of Appeals held a public hearing at its regular meeting in the Town Hall top floor meeting room, 120 Main Street, North Andover, MA on Tuesday, September 13, 2005 at 7:30 PM upon the application of Jane L Running & Per Arne Oines, 885 Forest Street, North Andover requesting a dimensional Variance from Section 7, Paragraph 7.3 and Table 2 of the Zoning Bylaw for relief of the west side setback in order to build a proposed addition, and for a Special Permit from Section 9, Paragraph 9.2 of the Zoning Bylaw in order to extend an existing, conforming structure on a pre-existing, non -conforming lot. Said premises affected is property with frontage on the South side of Forest Street within the R-1 zoning district. Legal notices were sent to all abutters and published in the Eagle -Tribune on August 22 & 29, 2005. The following members were present: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R. Webster, and Thomas D. Ippolito. The following non-voting member was present: Daniel S. Braese. Upon a motion by Richard J. Byers and 2°a by David R.'Webster, the Board voted to GRANT a dimensional Variance from Section 7, Paragraph 7.3 and Table 2 of the Zoning Bylaw for relief of 10.8' from the west side setback in order to construct a proposed addition; and upon a motion by Richard J. Byers and 2nd by David R. Webster, the Board voted to GRANT a Special Permit from Section 9, Paragraph 9.2 of the Zoning Bylaw in order to allow the extension of an existing, conforming structure on a pre-existing, non -conforming lot per Certified Plot Plan, 885 Forest Street, North Andover MA, Assessors Map 105.1) Parcel 10, Prepared for Jane Running, 885 Forest Street, North Andover, Ma., August 10, 2005 [by] David Alves, Professional Land Surveyor, #45454, New England Engineering Services, Inc., 60 Beechwood Drive, North Andover, MA 01845 and Proposed Renovations, Oines Residence, 885 Forest Street, North Andover, MA, 8.2005. [9 sheets], with the following condition: 1. The proposed addition shall be less than the existing 331stracture. Voting in favor: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R. Webster, and Thomas D. Ippolito. The Board finds that owing to circumstances relating to the soil conditions, shape, or topography of 885 Forest Street, especially affecting this land and the residential structure and septic system placement on the lot but not affecting the zoning district in general. The Board finds that a literal enforcement of the provisions of Section 7, Paragraph 7.3 and Table 2 will involve substantial hardship, financial or otherwise, to the applicants by not allowing Jane Running's father to live on the first floor, and that desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the North Andover Zoning Bylaw because the use will remain as a single family dwelling and there will be a greater separation than 50' from the west side abutting structure. Page 1 of 2 vTEST: A True Copy Board of Appeals 978- 688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Pi-n%Y7535 d.•"''+ Town of North Andover Town Clerk Time Stamp R' .. Community Development and Services Division Office of the Zoning Board of Appeals RECEIVEQ 400 Osgood Street TOW' t t�E�K'S OFFICE Santilli, North Andover, Massachusetts 01&15 Interim CommunityTelephone 2005 SEP 27 ; 9 p (978) 688-95� 1 PM 4 Development Director Fax (978) 688-9542 ONORTH ANOOVICn HASSACHUSEYTS Also, the Board finds that the applicants have satisfied the provisions of Section 9, Paragraph 9.1 of the zoning bylaw and that this specific site is an appropriate location for this alteration and extension. The Board finds that the east and west side abutters both stated during the hearing that they have reviewed the plans and support the applicants, and that the use as developed will not adversely affect the neighborhood The Board finds that there will be no nuisance or serious hazard to vehicles or pedestrians. The Board finds that the Title 5 Official Inspection Form shows that the septic system passed inspection on 5-7-05 and that adequate and appropriate facilities will be provided for the proper operation of the proposed addition. The Board finds that this proposed addition to a single-family residence is in harmony with the general purpose and intent of the Bylaw and shall not be substantially more detrimental than the existing structure to the neighborhood. Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a building permit as the applicant must abide by all applicable local, state, and federal building codes and regulations, prior to the issuance of a building permit as required by the Building Commissioner. Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. Town of North Andover Board of Appeals, /v en P, McIntyre, Chair Decision 2005-026. M105.DPI0. Page 2 of 2 Board Of.-lppeals 978- 688-9541 Building 978-688-9545 Conservation 978-688-9530 licalth 978-688-9540 Ruining 978-688-9535 rUKm U - LU 1 KCLCFkQC r%imm INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT ✓�� 2 / f JVL�-S LOCATION: Assessor's Map Number JLS 1 STREET �U K €57` ,�� /lID • / itll�,9t��h OFFICIAL USE ON OF TOWN AGENTS: PHONE `26 96 /56 PARCEL_ LOT (S) ST. NUMBER-SLS' TOR DATE APPROVED6L�L "LT Z:) DATE REJECTED TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS F,.,.........._..�.,e uo`TMjf11k 11,111ROVE13— t C� DATE REJECTED S C INSPEGTO DATE APPROVED 'ye,5, �-IADATE REJECTED COMMENT:'4fJ (YY? /'/ ririIt', A (1,)L 4 jzt� �h=c PUBLIC WORKS - SEWERJWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT 'ECEIVED BY BUILDING INSPECTOR DATE f Rev 917 jm The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations �~ r. 600 Washington Street Boston, MA 02111 ^4 ,s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ��( .GAI An 0� r� a') Address: IL1,3 41- City/State/Zip: ,�j#I/ Q?JX Phone #: Are you an employer? Check the appropriate box: . ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2. ❑ I 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.] f have hired the sub -contractors listed on the attached sheet. These sub -contractors have workers' comp. insurance. 5. ❑ 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.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. Building addition 10.0 Electrical repairs or additions 1 LE] Plumbing repairs or additions 12. F1 Roof repairs 13.❑ Other •Any applicant that checks box # I must also till out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. `Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �� �r�_ Z__/VLo E4"eF Policy # or Self -ins. Lic. #: �%ZU8� �3�t X70 C' Expiration Date: 1S a Job Site Address: City/State/Zip:%o l./ebpzv2 , /W 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 tine 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 i n I the sins and penalties of perjury that the information provided above is true and correct. Si nature: /? Date: #Z (03 ?-Iy /i 9.3 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 #: 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-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to till out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia OCT -19-2005 13:51 A&IC FOWLER INSURANCE LLC 9^rAPPA22n9 P ni/m ACORD,M CERTIFICATE OF LIABILITY INSURANCEDATEIMM/DDNYYY) 10/19/05 PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION A 6 K Fowler Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THECERTIFICATE 200 Park Str®et HOLDER THIS CERTIFICATEDOES NOT AMEND, EXTEND OR North Reading, MA 01854 ALTIRTHE COVERAGE AFFORDED BYTHE POLICI6 SELOW. INSURERS AFFORDING COVERAGE j NAIC # INSU kPD INSUREAA. Central- Mutual Insurance Cc. i Jean Morin Construction - _.... ...__._ . INSURER BL In8uranae Solution 143 Hunt Rd. INSURER C: Zurich -American Insurance Co..' E. Hampstead, NH 03826 INSURER D: - - - - INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TME INSURED NAMED A0CvE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR 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 ANI) CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR POLICY NUMBER j POLICYEFFEr.1%C I POLICY EKPIRDAr Ipp=1 MMATDY.N LIMITS GENERAL LIABILITY EACH OCCURRENCE I S_ 1 r QQQ i QQQ I DAMAGETOWIE $ COMMERCIAL GENERAL LIABILITY 1BOP7993634 4/2/05 1 4/2/06 PREMISES (Ea coove!r, JL $ CLAMS MADE IAJ OGCURj I ,; MED EMP (Anyonepereon) _ j $ 51000 I PERSONAL& ADV INJURY I$ 1,000,000 j I i GENERAL AGGREGATE I$ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY �� PES F-1, LOC 1— PRODUGTS-GOMPIOPAGG is 3 1000,000 sUTOMOBILELIABILITY I ( COMBINEDSINGLELIMIT H -I ANY AUTO B"7993829 4/2/05 q/2/Og. (EaseddeN) j 500,000 i I ALL OVVNED AUTOS --- 1- ' X SCHEDULED AUTOS BODILY INJURY (Perperetn) $ ..-. _. II HIRED AUTOS r— F_ NON -OWNED AUTOS I BODILY INJURY IFS a«,a� i j I PRDPERTYDAMAGE $ (Per a=idw) j GARAGELIABILffY I AUTO ONLY -EAACC [DENT IS ANYAUTO � I EA ACC 19 OTHERTHAN ., AUTOONL'Y: AGG EXCESWMBRELLALIABILITY i I EACH OCCURRENCE $ !�OCCUR CLAIMSMApE jAGGREGATE $ j DEDUCTIBLE RETENTION 5 i WO RK ER 5 COM PEN &AT ION AND $ TI+i I I VVC 5TATU-6Z CEMPLOYERS' LU191LITY(6ZZUB3198BO6705 6/15/05 ANYPROPRIEfORIPARTNERIEXECUTIVa —SQBYJ.IM 6/15/06 E.LEACHACCIDENT S Odes IMEM4R EMC,LU DECK it les I %es descri Ga u,+de* I � j I E.L. DISEASE - EA EMPLOYEE $ 100,000 --- 6pEbIALPA0V190NSbolew r - E.L. DISEASE -POLICY LIMIT I $ -900,000 j OTHER i D ESCRIPTIO N OF OPERATIONS/ LOCATIONS / VEH CLE$ / EMCL USIONS ADDED BY END ORSEM ENT I SPECIAL PROVISIO NS Insurance Verification nGCTIO�+aTc unr nm -- __ - __ __ - ---- W%R% CLLA 1 WN Per A pines Fax # 978-685-3712 885 Forrest St_ N.Andover, MA 01845 ACORD 25 (2001108) SHOULD ANYOF THE ABOVE DESCRIBED POLICIESBECANGELLED BEFORE THE EXPIRATION DATETHEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL 10-,DAYSWRITTEN NOTIC ETO THE CERTIFK:ATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO D OBO SHALL I MPOSPNO OBLIGATION OR LIADILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AU CORPORATION 1988 TOTAL F.01 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: QUANTITY PUMPED /.'00 GALLONS CESSPOOL: NO _� YES SEPTIC TANK: NO YESy NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: C'ONINIENTS: CONTENTS TRANSFERRED 'T'0: LL 16- O N ME I I = c }Q V Q it tJ Q a w 0 m tN Q. L a. L 42 11 OL 11 OL EfG ZT to . c N O E c y 7 O m Q OGQ a� I :v F- c a c v 0 O c I I = MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.3 Release lc Data filename: Untitled CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 12/13/05 DATE OF PLANS: 12/13/05 PROJECT INFORMATION: 885 forest st. north andover,ma COMPLIANCE: Passes Maximum UA = 139 Your Home= 114 18.0% Better Than Code Permit Number Checked By/Date Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U -Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 385 30.0 0.0 13 Wall 1: Wood Frame, 16" o.c. 918 19.0 0.0 49 Window 1: Wood Frame, Double Pane with Low -E 104 0.340 35 Floor 1: All -Wood Joist/Truss, Over Unconditioned Space 364 19.0 0.0 17 Boiler 1: , 80 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lc and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.3 Release I DATE: 12/13/05 Bldg. Dept. Use Ceilings: 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation Comments: Above -Grade Walls: [ ] 1. Wall 1: Wood Frame, 16" o.c., R-19.0 cavity insulation I Comments: Windows: [ ] 1. Window 1: Wood Frame, Double Pane with Low -E, U -factor: 0.340 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments: Floors: [ ] 1. Floor 1: All -Wood Joist/Truss, Over Unconditioned Space, R-19.0 cavity insulation Comments: Heating and Cooling Equipment: 1. Boiler 1: , 80 AFUE or higher Make and Model Number Air Leakage: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. Materials Identification: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R -values and glazing U -factors must be clearly marked on the building plans or specifications. Duct Insulation: Ducts shall be insulated per Table J4.4.7.1. Duct Construction: All accessible joints, seams, and connections of supply and return ductwork located outside Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Table 2: Minimum Insulation Thickness for HVAC Pipes. - Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2" Runouts 1" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature 201-250 Insulation Thickness in Inches by Pine Sizes Heated Water Non -Circulating Runouts Circulating Mains and Runouts Temperature ( F) Up to 1„ Up to 1.25" 1.5" to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. - Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2" Runouts 1" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. ƒ ■ �a2 II\ t ��■■ \ 2 - � • 2 � ] \ /■ '. eD x.—t Bf22J ƒ � 0 k § ■ t } 0 .4 .0 ., � ■ } � ] z CO '. . Ut } } k } & �$��� / 0 LUa' LU E § 0 0 \ } ■ EE 7 / CC § k } i \� /2/< ' 1:y ) § - W 4 4 0 �- ,s . 'r -I a t9 to cr +� '<) v V � Vc �IZ) I �f i i iP I� I :1 Ij I to cr r D v C IN 0 to r Cfb A14 M pi 76 A14 M ' � � a y r I MR V 0 0 N x, n N I M I t z J�A 0 F e: 0 0 N M. zf�� u N I I z �� �: . . z s F O*b f ,� cry �; � �.. �' '� J a �d �a � a � o � � �� 4 /\ /'� v , t� ` V O ;:• J a �d X � � a � o � � �� 4 P ,..4T.-K8_,...nr. ,,�.,..�..-..........,..�..,a.�......� r v � �0 'C IE ;i 14 V c � o 4 , � V 4 r s i r i I i 14 V c r f 7 V R 1 a 1 t t` a p P f � J j { x I � � 1 { 7 V Zoning Bylaw Denial ' Town Of North Andover Building Department ver AAA. 01845 ,, •....., ,A' �y 400 Osgood .St. North Andovers Phone 978.688-9645 Fax 9784884642 Street Notes Ulla M 1 0 s i-5 lo Applicant: Request PQ P 1 ti f `' y` 3 2 ��I� /j,101` 5 ai< o i/ ti Date: S"- / _ d C-- -n S A--GpaNw•• iQ Please be advised that after review of your Application and rmns VW YOU, rwvv—mom•• •- DENIED for the following Zoning Bylaw reasons: item Notes Site Plan Review Special Permit C - L{ Item Notes A Lot Area Lot Area Variance F Frontage Congregate Housing Special Permit 1 Lot area Insufficient Special Permits Zoning Board 1 Frontage Insufficient Large Estate Condo Special Permit 2 Lot Area Preexisting y 2 Frontage Complies R-6 Density Special Permit Z:�, 3 Lot Area Complies 3 Preexisting ftntsge 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required y Y s 3 Preexists CBA ` S 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height c1 'c S 4 Ri ht Side Insufficient i( e f, 4 Insufficient Information 5 Rear Insufficient I Building Coverage 6 Preexists setbacks 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting y s 1 Not in Watershed y e S 4 Insufficient Information 2 In Watershed j Sign tJ R- 3 Lot prior to 10124/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking ,4.- 1 In District review required 1 More Parking Required 2 1 Not in district 11 -r 2 Pa ing Complies 3 Insufficient Information 3 Insufficient Infornation 4 Pre-existing Parking Remedy for the above is checked below. roam 0 Special Permits Planning Board Item 0 Variance Site Plan Review Special Permit C - L{ Setback Variance Access other than Frontage Special Permit Parldng Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Hes ht Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board IndeperWord Elderly Housing Special Permit Special Permit Non -Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned District S Permit V S ' Permit Use not Listed but Similar Planned ReskWdial Special Permit Special Permit for Sign R-6 Density Special Permit Z:�, Special Permit prewdsting nonconformin Watershed Special Permit The above review and attached O"netion of such is based on the pians and information subrniltd. No def five review and or advice shah be based an verbal u ptnstim by the applicant nor "such verbal er; tannsiiorre by the appicarrt serve to Provide dlflr va arrswsrs to the above reasons for DENIAL. Any insomscies, nwsisedirg Irrrormatlon, or other subsequent c was to the I domes ion subrrm0 by ft aI I - I shall be grounds for Oft review to be voided at the discretion of the Building DaPKtInunt. Tho titaclne ' document tribd'Plsn Rsviaw Nurstive ohd be attached lws &n and incowded herein by rNorena. The buil bq depubrmrt wa retain r pleas and documntsbon for the above fit. You must file a now building Puff aPPkdion form and begin the pu ft process. Buslding Department ficial Signature Application Received Application Denied r)—i-wl SPnt • If Phnna r�IrinnP�7s/im�f/w• Pian Review Nafmdve The following narrative Is provided to further explain the reasons for denial for the application/ permit for the property indicated on the reverse side: °'• Il�tilftO@001Wjam.,., x p,l I Al; %^ Av • G7 r tiNJ e+ pieA l S �'-/V VA RJA Nc v;reefer S id C iq 4 sr,� �Ac Au.., 4- 74 Referred To: Fire Health Police Zoning Board Con Deparfinwd of Public Works Planning Historical Commission Other BUILDING DEPT I TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT ELM& RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING �1' . ti%! . addl "06 BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number • / 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required _+ Provided ReqWred Provided 1 1.7 Water Supply M.G.L.C.40. 34) 1.3. Flood Zone Infomntion: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 , Sewetago Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP%AUTHORIZED AGENT ' �' �' i; i •` f (! Ct: �!? ; _mo 2.1 Owner of Record > Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to Provide this affidavit will result I hd.1fh' f n t o errs o t e issuance o the building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Workcheck ad appItcable New Construction ❑ Emsting Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: '�G� - _� i al► Sir ��► Item Estimated Cost (Dollar) to be OMCIAL USE ONLY Completed by permit applicant . 1. Building a () Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number QV VT1NnN ?o AWNVD ArT rUr%1Dr7 A 9r7Awr vau LTi 1 GL n IlL' 1\ I OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My b half in tters relatife to ork uthorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHOR17,F.D AGRNT nrtrr AU ATre%m property Hereby declare that the- at,- hea Tref Print Name__ _.. ,as Owner/Authorized Agent of subject its and information on the foregoing application are Lrue and accurate, to the best of my knowledge Signature of Owner/Agent NO. OF STORIES BASEMENT OR SLAB SIZE OF FLOOR TI10BERS SPAN DIMENSIONS OF STILLS DIN ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION SIZE OF FOOTING _ MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL �t'.> O vT Date SIZE 1' 2' 3 THICKNESS X N1UH I UAUL INSPL(; I]ON PLAN NORTHERN ASSOCIATES, INC. 630 TURNPIKE STREET N. ANDOVER MA TEL. (508) 975-7117 FAX. (508) 688--6060 0ORTiit OM PM A. OALES 6 JANE L. RIAWrN6 LOCATIWW Sed FOREST STREET 'TY STAM M04TH ANDOVER NA Q'itM ! / W / 94 Lor Joe N 0 Lbr saa DSD REP. 2970 / 49 PIAN fid . PLOI0132 SCALL* !- S0' * 941 WWI e $7 MY ��- Lor 1sA r aw k 48.137 :*9TIFZED Tib EASTEM BAW -- This mortgage inspection was prepared in accordancr with the Technical Standards Th HoTE: is mortgage inspection was prepared for Mortgage Loan Inspections as adopted by the Massachusetts specifically for mortgage purposes only and Board if Registration of Professional Engineers and is not to be relied upon as a land or property line OF Land Surveyors 250 CHR 605. survey. Building location and offsets /,iqs�� rther st in my professional shown are specifically for zoning determination `�PtiH yy �i� theustructuresesthat opinion that conform only and not to be used to establish property �� JAMES J. the local zoninhowng with g horizontal dimensional setback lines. The land shown hereon is based on F R ABELY requirements at the time of construction or referenced information noted and may be subject are exempt under provisions of H.C.L. CH. 40-� to further takings and easements. Northern NQ 2 520 Sec. 7. Associates, Inc, accepts no responsibility for`Z b XI•Property/House is not in a Flood Hazard. damages resulting from said reliance by anyone ❑ 2.Property/House is in a Flood Hazard Area. other than the said mortgagee and its assigns in ❑ 3.Information is irtsufficient to determine connection with its proposed mortgagefinancing y0 Flood Hazard. to said mortgagor. U Flood Hazard determined from late Feddeewraall,,Flood Insurance Rato Map Ona+.-a�h.l.S.a_._ Data=�(� Location-2Aj S S S No. ( : Date 1?f 12'56 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ /Building Inspector 06/31/98 14:13 162.50 PAID Div. Public Works A r "joM oilgnd -AQ 1 t y joloodsul buippq $ Idlol $ aad uoil3auuoo JaleM $ aad uoiloauuoo James $ aad liwJad Jaq}o $ aad iiwJad uoilepunod $ 89--JliwAad aweId/6uipling R $ Aouedn000 jo eleoippeo a3AOaNd HIHON 30 NMOL F11110 ales 'ON uoileOo-1 � z C n1 d cn N F- X z a G 12 4I 9 p � a Z � nl IL ICI 3 N 3 i�r e Q :C C C O Z N y ^Lu z — uV .;J L i © .". 7Q C Q L W W L z * Z__ * ? * z x z z ^'+ ` 5 W `n v W W '` v Z V) z N z a _z G L� o � ao s Q � � Q LU +: C Q W 10 CUA (� V) W v(o„ ►/� z J m X11 z w I �1 0Q Ly WW. U.LA n 00 17 _ LL;f zO Z z i (A w � 3 r ^_ W U L) Q `c ... LLI - z C z z z 4 • ^ ? VZJ '.Qn u w :n C W 5 W W U J tje Z C z C Z C n C L LU z J L:j 4I 9 p � a Z � nl ICI e �.ie T06f/NIIOfNlIEIOlG4 o�./�aaoaaivae!!a HOME IMPROVEMENT CONTRACTOR Registration 115194 Type - INDIVIDUAL Expiration 01/03/00 MORIN CONSTRUCTION CORP JEAN N. MORIN &yqgW FOREST ST , NORTH ANDOVER MA .01845 `} UEPARIMENT Of PU6':1 SAFETY =` CONSTRUCTION SUPERVISOR LICENSE Nuiber: Ezp�res: 8irtbdate x CS 021624 12/llil999 12/11/195e Restritle:d To: 00 JEAN N NORIN „ 895 FOREST ST Nv ANDOVER, MA 01845 N FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *APPLICANT FILLS OUT THIS SECTION* &,APPLICANT k1,(or? i✓/ r PHONE 0 / (79 / )A Jaq — L.1-OCATION: Assessors Map Number PARCEL 7a00 /71c2 0/ &)ES SUBDIVISION LOT (S) 1O� L/&REET 10( C1_ ST. NUMBERS *************OFFICIAL USE ONLY********* RECOMM�NDATIONS OF TOWN AGENTS: d6_NSERVATION ADMINISTRATOR` DATE APPROVED zjj a DATE REJECTED I COMMENTS f) b 0 A-,+ �-b TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH TH DATE APPROVED DATE REJECTED - DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED_ COMMENT!4 en,, - PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT. RECEIVED BY BUILDING INSPECTOR DATE NO . Ao Eq .D /�4EL-AlZL FAM Z/3 /v 42--0- C?7 71"x' E c 7`- �I US 'Lox a.�1` �,� �7• a ,Alo a� L�.vE ��•��r Z/3 /v 42--0- C?7 71"x' E c 7`- �I US OF -77 OF r t �t VNONo 2 7 5 Dat, ��..-..,/ � ........ as Q TOWN OF NORTH ANDOVER a PERMIT FOR WIRING S I� This certifies that %�- -� has permission to perform � ' ``..........................�-' .................................................... . wiring in the building of ............... ............. ......................................cru at ...!�....... ........................ . North Andover, Mass. Fee . '� �.. "........ Lic. No`s ��? .................... ........................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THECOADIONWE40HOFMASS4CHUSEM Office Use only _ DEPARTMUI TOFPUBUCSM= Permit No. BOARD 0FMEPREYEW0NRWNAT10ANJr MR 1200 Occupancy & Fees CheckedS APPLICATIONFOR PERMIT TO EIIILqM�LECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH TI1E ML CODE, 527 CMR 12:00 n,�y (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date I Z' %�` 7`lj „_• Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) ? Es ! ,#AJ 4,* Owner or Tenant Owner's Address .► AAA -1 Is this permit in conjunction with akuilding permit: Yes [B'No Purpose of Building Existing Service Z�_ Amp Q / olts Overhead New Service Amps / Volts Overhead M To the Inspector of Wires: (Check Appropriate Box) Utility Authorization No. Underground ri No. of Meters Underground M No. of Meters Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work d- No. of Lighting Outlets `„j No. of Rot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground around No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Bumers 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 t No. of Self Contained " Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW 0 Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER • arr . i • • •• FA, • i • ii r t1. • . • • :• :• - - A•�c u• r r.• • •:.•, .•• a s•- ro ►r ':• • • .9' ' :: •:•i Il/// _'a�a / ice. n A •r ,• •�, ( i .-.:.�. �::- • :n :,err y ' ,, Vakx fEkcftical Wads $ Rotgh w r'""1 Final LWISeNa P7 //f 1111 r: IN • (/ l/ Busine,sTeLNa OW MR'S INSURANCE WAMY, I am awm that 6 L" andfatmysignahaeonibisp appFtcariatwainthistet umni nt. (Please check one) Owner Agent M Ai Tel. Na �• I 0 / r %hstartdalerpvalet>tastt tiWbyMassdmemCmedLaws Telephone No. PERMIT FEE $ 06/01/2006 13:57 FAX. 6034312811 JSN ASSOCIATES. INC 0 002 ASSOeiates, Inc. One Autumn Street Portsmouth, NH 03801 (603)433.8639 Fax (603)431.2811 Web Site: JSNENG.COM June 1, 2006 Bruce Holmes Moynihan Lumber P.O. Box 1160 Plaistow, NH 03865-1160 Re: WSI Stamped calculations 885 Forest St., No, Andover, MA Dear Holmes, This is to verify that I did stamp the Versa -Lain beam calculations that were provided by Wood Structures, Inc. for this project. There were five members included. It is important to note that my stamp only verifies that each member is adequate based on the loads shown, however, I have no knowledge of the particular project and have not reviewed project drawings or load determination calculations that were done by WSI. Our disclaimer note states this. It is also important to note that two of the beams; a 3' 4" header and a 4' 8" header, did not have any load applied to their span as was noted and clouded on the Boise calculation sheet, and the resulting stress level was only at 0.2 and 0.3 %. If the 500 and 200 plf noted were actually intended to be along the spans, these headers would still be more than sufficient. Please contact me if you have any further questions. Sincerely, L� Jeffrey S. Nawrocki, P.E. President — JSN Assocfu[es, Inc. L��9 St�ucc S�rg�ccaia 06/01/2006 19:57 FAX 6034312811 JSN ASSOCIATES. INC `V-'""` MM samcmiatea, Inc. One Autumn Street Portsmouth, NH 03801 (603)433.8639 Fax (603)431.2811 Website: JSNENG.com To: Bruce Holmes Company: Moynihan Lumber Phone: Fax: 382-1935 From: Jeff Nawrocki Company: JSN Associates Phone: (603) 433-8639 Fax: (603) 431-2811 Date: 06/01/06 Pages inc. this cover page: 2 Re: WSi calculations Attached please find letter requested. Sincerely, / e, Jeffrey S. Nawrocki, P.E. President Copy — Sheila @, WSI —207-282-2423 e4-&S&w&we sii-em MAY -22-2006 11:29 WOODSTRUCTURES 2072822423 P.002 05/22/2006 10:10 PAX 1 978 664 9078 MOYNIHAN LUMBER X1002 BOME Double 1-3/4" x 5-112" VERSA -LAM® 2.0 3100 SP Floor SeamIF1301 SC CALL® 8.2 Design Report - us 1 span I No cantilevers 10112 slope Thursday, May 18. 2006 08:40 Build 141. Job Name: OMMIE RESIDENCE Address: 885 FOREST ST City, State, Zip: NO.ANDOVER, MA Customer. ESR -1040 File Name: SC CALC Project Description'I'801 Specifier. Designer. Company: Misc: T 4" HEADER 4 00, I -W Si, 7-314' LL 3000 Ws DL s ID6 DL 1209160 Total of Hadwrital Design Spans = 03-04.00 Load Summary Ltvo Dead Snow Wind RoofLlv4 ibD Description Load DM Ref. Start End 100% 0% 115% 133% 126% Trib. 1 ConC, Lin. Left 00-00-00 00-00-00 500 plf 200 plf 06-00-00 Controls SamrnEy varus %Alkwablo Duration Load Ceaa span Location Pos. Moment 6 ft -lbs 0.21% 900% 1 - Intemal End Shear 6 lbs 0.2% 90% 1 - Left Total Load Deft. U258106 (0") n/a 1 Live Load Defl. L10 (01 n/a Max Defl. 0" n/a 1 Span / Depth 7.3 n/a 1 Design meets Code minimum (1_/244) Total load deflection cd Design meets arbitrary (1") Maximum load deflection criteria. Minimum bearing length for BO is 1-0/8". Minimum bearing length for 81 is 1-117. Entered/Displayed Horizontal Span Leng h(s) = Clear Span + 1/2 intermediate gearing l -N / a minimum - 2'1 c = 1-1/2' b minimum = 3" d = 12' Connoaon design assumes point load le 'top -loaded'. F�Wnnse�flongn of sidetoaded' point loads, please cvnault a technical representative or professional of Record. Member has no side loads. Concentrated loads are not considered in side load analysis, ConneMra are, 16d Sinker Naffs Disclaimer: The supplier acknowledges that it has requested JSN Associates, Inc to review a pre-engineered building product identified as above for the span and loading conditions shown on this calculation sheet. The supplier further acknowledges that JSN Associates, Inc. will not engineer, design, manufacture or erect said item and is not responsible in any way for defects or deficiencies. Therefore, the supplier waves all claims against JSN Associates, Inc. arising in Page 1 of 1 any way from any defects, deficiencies, errors or omissions in the load determination, design, fabrication or erectiort of said item. Note: Adequate design of supporting structure must be provided by others Disclosure Completanesa and accuracy of Input must be verified by anyone Who woLdd rely on outpntas evidence of sultabitityfof particular appficatron. Output heft based on building code aoua0ftd design propertles 4nd analysls methods. Installation of BOISE engineered w0W Products must be in aomrdanoe with current Installation Guide and applicoblo building Codes. To obtain Installstlon Gulde or aak quesilons, please Call (800)232-0788 before installation. BC CALC®, 80 FRAMER0 , ALISTM. ALLJOISTO , 80 RIM BOARD-. SCIO , BOISE GLt LAMTM" SIMPLE FRAMING 6YSTEK0 , VERSA -1 -AMO, VERSA -RIM PLUS®, VERS"IMO, VERSA -STRAND'", VERSA-UTUDO are trademerks of Boise wood Products. L.L.C. 05/22/2006 MON 11:24 lTX/RX NO 90361 0 002 MAY -22-2006 11:29 WOODSTRUCTURES 2072822423 P.003 05/22/2006 10:10 FAX 1 978 064 9078 NOYNIHAN LUMBER 0003 11111 BOISEW Triple 314" x 9-1f2" VERSA -LAM 6 2.0 3900 SP Floor Seam1FB01 BC CALCO 8.2 Design Report - US 1 span I No cantilevers 10/12 slope Thursday, May 18, 2006 08:37 Build 141. Ba, 1.314- 511,11-3/4' LL 805 lbs LL 806 IDs DL 295 lbs DL 295153 Total or Hmtzontml Design Spans a 13.08-00 Load Sumrnary Liva Dead Snow 4YInd Roof Live Tag DoscrIoUan Load Type _ Ref. start _ End 100%i 90% 115% 1934/. 125% Trlh. 1 Standard Load Unf. Area Left 00-00-00 13-05-00 40 psf 10 psi 03-00-00 Controls Summary File Name: SC CALL Project Job Name: OMMIR RESIDENCE Description. F801 Address: 885 FOREST ST Specifier: City, Stat®, Zip: NO.ANDOVER, MA Deslgnor: Customer_ Company, Code reports: 1=SR-1040 Misc: CARRYING STICK Ba, 1.314- 511,11-3/4' LL 805 lbs LL 806 IDs DL 295 lbs DL 295153 Total or Hmtzontml Design Spans a 13.08-00 Load Sumrnary Liva Dead Snow 4YInd Roof Live Tag DoscrIoUan Load Type _ Ref. start _ End 100%i 90% 115% 1934/. 125% Trlh. 1 Standard Load Unf. Area Left 00-00-00 13-05-00 40 psf 10 psi 03-00-00 Controls Summary yaLwo %Allowable Duration Load Case Span Loatlan Pos. Moment 3591 ft lbs 17.6% 100% 1 1 - internal End Shear 959 lbs 10.1% 100% 1 1 - Left Total Load Det1. L/1010 (0.159") 23,8% 1 1 Live Load Defi. U1381 (0.117") 26.1% 1 1 Max Defl. 0.159" 15.9% 1 1 Span / Depth 16.9 n/a 1 Design meets Code minimum (IJ360) Live load deflection criteria. Design meets arbitrary (11 Maximum load deflection criteria. Minimum bearing length for BO is 1-112". Minimum bearing iength for 131 Is 1-112". Entered/Displayad Horizontal Span Langth(5) = Clear Span * 1/2 min, end bearing + 112 intermediate bearing Connection Dlaaram b tl m oT c C • 1 • e O O o a minimum = 2m c;-- 5-1/2' b minimum = 3' • d = 12" Disclosure CamplBteness and acatrecy of Input must be verified by any0% who would rely on output as evidence of suitability for Particular awlieatlon. Output here gated on b ulldtng aod"ccepted design propardes And analysis m6dwds. Installation of 8018E engineered wood products must bo in accordance with current Installation Guide and applicable bulking codes. To obtain Installation Gulde or ask questions, ptease all (800)232-0788 befam Installmon. BC CALCO. 90 PRAMER®, AJST"t. AU JOISTV , 5C RIM BOARD-. BCI®. BOISE GLULAMT'r. SIMPLE FRAMING SYSTEMS, VERS+4 .A VIV, VERSA -RIM PLUS®, V>=RSA-RPAA VERSA-STRAND7w, VE;Z8"TUDV ora trademarks of Boiaa wood Products, L.L.C. e minimum m:? Member hes no side loads. C01"necton2 Aro! 16d Slnlcar Nalla Disclaimer: The supplier acknowledges that it has requested JSN Associates, Inc °s to review a pre-engineered building product identified as above for :JEFFREY S. �",A the span and loading conditions shown on this calculation sheet. ci M ej NAWROCKI The supplier further acknowledges that JSN Associates, Inc. win not engineer, design, manufacture or erect said Rem and is not STRUCTURAL responsible in any way for defects or deficiencies. Therefore, the No. 34168 supplier waves all claims against JSN Associates, Inc. arising in A AEOIS1EaErQ1 any way from any defects, deficiencies, errors or omissions in the $slow Al E load determination, design, fabrication or erection of said item. Page 1 of 1 Note: Adequate design of supporting structure must be provided by others 05/22/2006 MON 11:24 [TX/RX NO 90361 [003 MAY -22-2006 11:29 WOODSTRUCTURES Ou/22/2006 10:11 FAX 1 978 e84 0078 MOYNIHAN LUMBER B0�'SE" Triple 1.314" x 5.112" VERSA LAM® 2.0 3100 SP SC CALOV 9.2 Design Report - US 2 spans I No cantilevers ( 0112 slope Build 14T. 2072822423 P.004 a 004 Roof Beam1R501 Thursday, May 18, 2006 08:47 F{ie Name: SC CALC Project Job Name: OMMIE Description: R801 Address: 685 FOREST RD SpecrRer. City, State, Zip: NO.ANDOVER, MA Designer: Customer. Company-- Code ompany:Code reports: ESR -1040 Misc FARMERS PORCH HME _ �o 12 Be, 1.314" 91, 3-12' 132, 1. W' DL 123 lbs DL 409 the DL 123 [be SL 324 lbs SL ®26 lbs SL 324 Iba Total of HortzontaI Design Spans s 12-D4-0 Load Summary Uwe Dead Snow Wind Root Lire ng cleacription Land Ro_ Stat End 100% 904E 11 aY. 183% 125% Trib_ 1 Standard Load Unf. Area Left 00 -OD -00 12-04-00 15 of 40 pe 0300-00 Controls Summary Value %Mlowable Duration Land Cass Span Location Disclosure Pos, Moment 576 ft -lbs 6.7% 115% 104 2 - Internal ComplatenwA and accuraw of IrN must Neg. Moment -823 ft -lbs 9.6% 115% 3 1 - Right be varlfled by anyone who would rely on End Shear 355 lbs 5.6% 115%, 193 1- Left oui ut as evidence of 9uttaDltlty for Cont Shear 563 lbs 8.9% 115% 3 1 - Right particular application. Output here basad Total Load Dell. L/3119 (0.024"' 518% 194 2 oropertlbuildin9 and a lysis d eesipn Live LAad Deli, L/3939 0.019" 6.1% 194 2 Installation and analysis methods. ( installation of BOISE engtn�r+ed wood Total Neg, Dee.-0.Ws.. 0.6% 193 2 products must be In accordance with Maus Defl. 0.024" 2.4% 194 2 current Instsilailon Guide and applicable Span / Depth 13.5 n/a 1 buileling codes. To obtain Inewliatlon Guide or oak questions, please call Notes (800)232-0788 before ln"lation. Design meets Code minimum (U180) Total load deflection criteria. SC CALC®. SC FRAMER®, AJSTm, Design meets Code minimum (L/240) Live load deflection miteria. ALLIOISTV , BC RIM BOARD'", BCI®. Design meats arbitrary (1') Maximum load deflection criteria.BU1SE GLULAMT", SIMPLE FRAMING SYSMMO, VERSA-LAMO, VERSA -RIM Mlnlmurn bearing length for 80 is 1-1/2". P1.1.136 , VERSA -RIM®. Minimum bearing length for 81 is 3'. VERSA -STRAND, VERSASTU06 are Minimum bearing length for 92 is i-112". trademarks of Boise W ucts, Enteredl.Qisplayed Horizontal Span Lengfth(s) = Cleat' Span + 1/2 min, endbearing + L.L.C. 1/2 intermediate bearing Member Slope = 0, consider drainage. Connection Dlagram o�4�P� �ss4cyG� b d �� JEFFREY S. �^.4 e NAWROCKI r' • T• • STRUCTURAL c No. 34168 •9 gE01S1EA�� ��! • • dRfSSIOkAI ENU�d� d aminimum =Y c- 1-1/2" ®� b minimum - 2-1/2'd = 24" Disclaimer: �� Member has no side loads. The supplier acknowledges that it has requested JSN Associates, In Oenneotma are: 112 in. Staggered Through Solt to review a pre-engineered building product identified as above for °ne span and loading conditions shown on this calculation sheet. i he supplier further acknowledges that JSN Associates, Inc. will :)t engineer, design, manufacture or erect said item and Is not A:sponsible in any way for defects or deficiencies. Therefore, the supplier waves all: claims against JSN Associates, Inc. arising in any way from any defects; deficiencies, errors or omissions in the Page 1 of 1 load determination, design, fabrication or erection of said item. Note: Adequate design of supporting structure must be provided by others 05/22/2006 MON 11:24 [TX/RX NO 90361 0 004 MAY -22-2006 11:29 WOODSTRUCTURES 2072822423 P.005 05/22/2006 10:12 fF&X 1 978 664 9078 MOYNIHAN LUMBER 045 B01S�r Double 1-3/4" x 5-112" VERSA-L.AMS 2.0 3100 SP Floor , 201FSQ1 90 CALCO 92 Design Report - US 1 span i No cantilevers 10!12 slope Thursday, Mayy 1 188, 2006 0$:41 Build 141, File Name: 9C CALC Project Job Name: OMM1E RESIDENCE Description: F601 Address: 88S FOREST ST Specifier: City, State, Zip: NO -ANDOVER. MA Designer- Customer. esignerCustomer. Company, Code reports: ESR -1040 Misc: 4' 8" HEADER 80, UVW LL 300D lbs OL1213lbs Total of Herizo(tat Design Spans = 04.0640 B1, 1.3/4" DL 13 Ibs Load Summary 13vo Dead snow Wind Roar Lire Tag DescrlQrton Load Type ROf. Start End 10094 90% 1150/4 _ 133% 1254/. Trlb. 9 Cone. Lin. Left 00-00-00 00-00-00 500 pff 200 plf 06-00.00 Controls Summary vaiuo %Allowable Duration Load Casa Span L.ocatlon _ Disclosure Pos. Moment 15 ft -lbs 0.3% 90% 1 - internal Completeness and accuracy of input must End Shear 10 -lbs •• 0.3% 80% 1 -Left baverified byrnyonewho-mid relyon• output as evidence of auitabilltytor Total Load Defl. 1-/84061 (0.001") 0.3% 1 paramolar application. Output here booed Live Load DEtt_ tJ0 (0") nla on building cod"coepted design Max Defl. O.o01" n/a 1 properties and analysis methods_ Span / Depth 10.2 n/a 1 InstBlsation of 1301E engineered wood product& must be In eccerdanos with Notes current Installation Guide and applicable building codes. To obtain Installation Guide Design masts Code minimum (11240) Total load deflection criteria. or ask questlons, please call Design meets arbitrary (1') Maximum load deflection criteria. (800)232-0788 before installation. Minimum bearing length for BO is 1-518". Minimum bearing length for B1 is 1-1/2". " BC CALCIS, BC FRAMER®, AJS"' Entered/Displayed Horizontal Span Length(s) = Clear Span + 1/2 min. and bearing + ALLJOIST®, SCRIM BOARD-, sCl® , SIMPLE MING 1/2 intermediate bearing ERSA-RIM SYSrEmS RSA-j,AMV, V PLUS®, VERSA -RIND. Connection Diagram VERSASTRANDTM, VERSA-STUDO are b d trademarks of Boise Wood Products. 17 �) v �p`ZN Q s4c a minimum - 2" e - 1-1/2' ?ao JEFFREY S. b minimum = 3" d = 12" u NAWROCKI r Connection design assumes polnt bad is 'top4oaded'. For connection design of'sideaoaded' point loads, STRUCTURAL please comutt a tachnlcal representative or profeasional of Record. Np, 34168 Member has no zlde loafs. Cad�o6are not Isdered in side road anaya. N Connectors r Disclaimer; o�FSS10NAl E 0�' The supplier acknowledges that it has requested JSN Associates, Inc to review a pre-engineered building product identified as above for loading shown on this calculation sheet. J/J the span and conditions The supplier further acknowledges that JSN Associates, Inc. witl not engineer, design, manufacture or erect said item and is not responsible in any way for defects or deficiencies. Therefore, the supplier waves all claims against JSN Associates, Inc. arising in any way from any defects, deficiencies, errors or omissions in the Page 1 of 1 load determination, design, fabrication or erection of said item. Note: Adequate design of supporting structure must be provided by others 05/22/2006 MON 11:24 [TX/RX NO 90361 Q005 MAY -22-2006 11:29 WOODSTRUCTURES 2072822423 P.006 05/22/2006 10:12 FAX 1 978 664 9078 _ __. 1OYNIEM LUMBER Q005 N, Single 1-314" x 9-112" VERSA -LAMS 2.0 3100 SP Floor Be=71302 BC CfSLC® 9.2 Design Report - US 2 spans I Right cantilever 10112 slope ThurSday, May 18, 2008 08;51 Build 141, Job Name: OMMIE D�F�2 escriptl n: ALC Project Address: 885 FOREST RD specifier. City, State, ZIP: NO.ANDOVER. MA Designer. Customer. Company: Code reports: ESR -1040 Miss: FLOOR JOISTS 90,1-314' 81, 3-1re LL 380 lbs LL 5631b DL98 lbs DL 168 Total of Horizontal Design Spans E 07-06-00 Odd Summary Live Dasd Snow wind Roof Live Tag Deeorlodan w Lcadbteg RAO. Stmt End 1001% 90% 115% 133% 126% 'crib. 1 Standard Load Unf. Area tett 00-00-00 07-06-00 40 psf 10 psf 03-00-00 Controls Summary yoluo Ne Altowabty DuParion Road Cass Swan Laeatlon Pos. Moment 677 ft -lbs 8.7% 100% 14 1 - Internal Neg. Moment -174 ft -lbs 2.5% 100% 15 2 - Left Eyed Shear 324 lbs 10.3% 100% 14 1- Left Cont. Shear 348 lbs 11.0% 100% 1 1- Right Total Load Defl. U4131 (0.01T') 5.8% 14 1 Live Load Doff. L15146 (0.01411) 7.0% 14 1 Total Neg. Defl, -0.013" 2.7% 14 2 - Cantilever Max Defl. 0.017" 1.7% 14 1 Span / Depth 7.6 n/a 1 Design meets Code minimum (0240) Total load deflection Criteria. Design meats Code minimum (L/360) Live load deflection criteria. Design meets arbitrary (1") Maximum load deflectlon criteria. Minimum bearing length for SO is 1-1/2". Minimum bearing length for 81 is 3". Entered/Displayed Horizontal Span Length(s) = Clear Span + 112 min, end bearing + 112 intermediate bearing Page 1 of 1 Disclaimer: The supplier acknowledges that it has requested JSN Associates, Inc to review a pre-engineered building product identified as above for the span and loading conditions shown on this calculation sheet. The supplier further acknowledges that JSN Associates, Inc. will not engineer, design, manufacture or erect said item and is not responsible in any way for defects or deficiencies. Therefore, the supplier waves all claims against JSN Associates, Inc. arising in any way from any defects, deficiencies, errors or omissions in the load determination, design, fabrication or erection of said itom. Note: Adequate design of supporting structure must be provided by others Disclosure Completsnems and axuracy of input must be verAad by anyone Who would rely an output as evidence of sultabitV for pabular application. Output hcm based on building oodaaccepted design properties and analysis methods. Installation of BOISE enyt omwd wood products must be In a000rdanoa with current Installation Guide and applimble bonding codes. To obtain Installetlon Guide or oak questions, please call (800)232.0788 bofore Installation. BC CALCO. BC FRAMER® . AJSn'. ALL101M . BC RIM SOARDTm, 60I0 . 'BOISE GLULAM-, SIMPLE FRAMING SYST'EMV , VERSA -LAM, VERSA -RIM PWS®, VERSA -RIME, VERSA -STRAND'', VERS"TUDOaro tradarnarks of Was wood Products, LLC. JEFFREY S. NAWROCKI STRUCTURAL No. 34168 \�stt:aE% 05/22/2006 MON 11:24 [TX/RX NO 90361 1@006