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HomeMy WebLinkAboutMiscellaneous - 1525 Forest Street (2) �f�' I j _ � O p y e Y ��rSACi117g S� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number . Date adD THIS CERTIFIES T#AT THE BUILDING LOCATED ON Cs/o n-,e An ye w MAY BE OCCUPIED AS L 1 A-9 6 !�' /�i4 ll'I L 8 �o 1 ,3 3 A`r4s, 3 S-1Q /l 4 4,¢r G",Ct IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO S/1 e- dae l -L/L o CC h rep 1 10 Building Inspector o . f NORTH Town of Afi dove0 . . ...... � A �== LAK �` do►ver, Mass., r �A COCMICMEWICK - �ip ORATED S U BOARD OF HEALTH PERMIT T Food/Kitchen Septic Syste THIS CERTIFIES THAT............. �L� j.��.... � N • ire IQ BUILDING SPECTOR J ....... 11 ..... Foundation -Alk has permission to erect. ...... ..... buildings on � r... .Y+�.Y..,. /"!ST . •. W.Ar' w-I' to be occupied as......B....Q� t.3 .9 0 11.... #A C; t WWAt4 echimney .. )nY{ilk NYNt+f+IMt lifs•ii Y •. provided that the person accepting this permit shall in every respect.conform to the jp tt on`file in Final this office, and to the provisions of the Codes and By-Laws relating to the!R# e1luction of Buildings in the Town of North Andover. ` f .il x �0�� �� �iY s:� �.�i►.• PLUMBING IN R 1 , VIOLATION of the Zoning or Building Regulations Voids this Permit, 3 '10 PERMIT EXPIRES IN d. ELECTRICAL INSPE MR UNLESS -CONSTRUCTION S111, Tk R ll74 ........ISI!�"+ • TYYNYf•,iE! v !!YM ••••••r•• JJJ � �V 'INSPECTOR Final Occupancy Permit Required to Occupy &t GAS INSPECTOR w ; Rough Display in a Conspicuous Place on the Premises Do Notflemove F C: No Lathing or Dry Wall To Be Done FIRE DEPAR Until Inspected and Approved by the Building Inspector. Burner Street No: SEE REVERSE SIDE Smoke Det. Town of North Andover NORT/i Building Department O tt�e U ,6" ti- 400 Osgood Street 6 OL North Andover Ma 01845 O i (978) 688-9545 Fax (978) 688-9542 �sSgCHU`�tit APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION ' I TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. -WATER METER /v DATE b`i f O J D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. r-� SIGNATURE/DPW AUTHORIZATION Date f, TOWN OF NORTH ANDOVER f PERMIT FOR WIRING i i, / (� This certifies that .`�.�.".e o Q t-). . 4I�-�-,.S. . . . . . . . . . . . . . . . . has permission to perform . . . . p-' '?�.. . . . . . . . . . . . . . . . . . 4 wiring in the building of . . . . . . . . . . . . . . . . . . . . . . rth Andover, Mass. Fee *;�. . . Lie. No 11.6. . . . . .MO. . . . ELECTRICAL INSPECTOR Check# �7 11384 .1 ll U.- -t� Commonwealth of Massachusetts Offfificia(at only Permit No. 6' Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 peaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CMR 12.0 (PLEASE PRINT IN NK OR TYPE ALL INFORMATION) Date: I - .29 — ,20/3 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfo the electrical work described below. Location(Street&Number) • p Owner or Tenant F--An cz-5 eo k k Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. - Existing Service ;?,(V 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: 11- K W Completion of the following table may be waived by the Inspector of Wires. No.of Total ,n No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans Transformers KVA 1� No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o mergency ig ting •� No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units 1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas]burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Hear tap Number Tons KW•••••••••• No.of Self-Contained Detection/Alerting Devices �^ No.of Dishwashers Space/Area Heating KW Local❑ MunicConnectipal ion ElOther Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or E guivalent No.of Water No.of No.of Data Wiring: Heaters lbw Signs Ballasts No.of Devices or Equi valent Telecommunications Wiring: - No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (RPO' (When required by municipal policy.) Work to Start: 1 ;Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) /1j S� I certify,tinder the pains and penalties of perjury,that the information on tis application is true and complete. L FIRM NAME: 5 ,p v L-1-e- LIC.NO.: F3?"a5& Licensee: S�-y�.c_ 7' Signature LIC.NO.: (If applicable,enter "exempt"in the icense number line.) Bus.Tel.No.: '? �- ?`�(33� Address: qj,3 6 S74 P k 0/9(0 6 Alt,Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires DephIment 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 '�7� q 6Z S— I PERMIT FEE.$ .00,Signature elephone No. Town of North Andover Page 1 of 1. s ; r 1 I ❑ Base Map Zoning 2012 Aerials Watershed Zone Utilities ❑ Size 0[J� Selection Legend Location Markup Help Scale 1"= 304 ft Select Parcels L_!' .... i (show all) #� 9 Owner Prop ID F Address BEEKLEY FRANCES 1105.13-0002-0000.011525 FOREST STREET 44 S` jy t ah Y5 BoxfoiA d 4 1 selected To Mailing Labels To Spreadsheet {y, r - ❑ Property Building Permits Planning Septic Pu�{t t r b F Print •�� '4. Ownerl BEEKLEYFRANCES '� ! y V > � Address 1525 FOREST STREET EXT. PropertyID 105.13-0002-0000.0 Lot Size 2 A Fiscal Year 2013 Land Use 101 - c Code .tk" ` :... .�, _ ;:.. t_�.•_c�t..��i�nianna ''^^''ma�yy �°'�'1...! ._.... ._. - �� ,...F.....�...._......._.i Get Pictometry Imag Go v3.2.0 AppGeo Save Map as Image Ue n=k wl Ftansn Comninsion deer rm make s t ey ti any warranty,espresxd orlmpned,tror assure any Ispt NMlny Cr respmtgbYay fa'the accuracy.Co,ntletnn^ss, crusdutr d ee Geogryantvc wmmabon syst—PISS Data oranyomerdau proWded nefeln.The d2ta doers not taxa the pltce of a putessbr A savay and hm no teg9 beanna an the true strap–sem.bwom,oe olstmce d a geo"Oft twtim mpsty Ine,orpaNscal mvesamvmt.Mammack vat*y Flumen}ConngWon requests eat any use of tnt;ntfomatiot te acomvanlea by a mtwace b nssoun:e ami the M.eMmack tcrffiy F:rmtlrg Coronisstort'sraveat stat n makes np wtwraKJesa. rep�uvmts as to the am Scy d said Infwnatlan.Any U"of tws Wanwi n IS at ee fHC Imes Own ngk http://mimap.mvpc.org/NorthAndovermimapNiewer.aspx 1/29/2013 Town of North Andover Page 1 of 1 � - e — DOVER — Zoning 2012 Aerials Watershed ZoneIF Utilities ❑ Size OQ� Selection Legend Location ❑ Base Map Markup Help Scale 1"= 304 ft Select Parcels __. r „ LI c ._- kr.`-a. (show all) .... ..._ ..... ®'. �Pf Owner Prop_ID Address ,iG,. BEEKLEY FRANCES 105.8-0002-0000.0 1525 FOREST STREET Boxford El I selected To Mailing Labels To Spreadsheet a, Nnd ❑ Property Building Permits Planning Septic Pub Print v Owners BEEKLEY FRANCES `x Owner2 o: Address 1525 FOREST STREET EXT. "aU PropertyID 105.6-0002-0000. :r Lot Size 2 A Fiscal Year 2013 Land Use 101 vlu :- >,u;=' Code p Get Pictometry Imag Go v3.2.0 AppGeo Save Map as Image Ljj •.,� M&nn ck vFlley Planung Damn!-,,&n does not mate any warranty.CMM."rte m nprted.nW&Wun*any k4O MIfty or MSpOf>gibTdy W n*euurWX Cori lete"M. Cr t�-Uness of the raagMAC I WW Wn%iStCM{L'tS}Dals wary oVwdata pf&M-d herein.the da=ta d�"taW the place M a ptWeasianat suvey and nos no regcl an the tae ata? sts.IocatbR fxekl,-Ce"Ce of a geagra(>ni�ttrtue,prep-°'tY¢ie,mpolticai AkmmaeR tmt�5'r�lvmtrtq GomenlySldn reQuests `L afar amymy m use a!tns Itdartnetkn te agoongt."Yed oY a retxance to IG aouxe stq the M1ter:vnaek.Wipy p%'�M7 Cfxrani�nn'scaveat Stat n matins rq tt,arramies m eL*prz3£ntati�fs as to theaC acyof said Infomatim Any us^ct ttas mimnan fs at 4te ranoienrs CM asfL http://mimap.mvpc.org/NorthAndovermimapNiewer.aspx 1/29/2013 c - COMMONWEALTH OF MASSACHUSETTS; ! AS A.REG JOURI�tEYMAN ELECTRICIAN {SSUESrTHE�ABOVE` ICENSE 70 STEVEN; C ';PAPU`GH I5. mw' 9,3 C E NT'R A L ST 06Y .� a."MA�10 1960:=4315 '37256. 81043 E 0°7/31/13 General Information • Allow sufficient room on all sides of the generator for mainte- .-1:12:2. INSTALLATION GUIDELINES FOR STATIONARY nance and servicing.This unit must be installed in accordance STATIONARY AIR-COOLED 8-20KW with current applicable NFPA 37 and NFPA 70 standards; as GENERATORS well as any other federal, state and local codes for minimum ,. distances from other structures. DO NOT install under wooden The National Fire Protection Association has a standard for the decks or structures unless there is at least five(5)feet of clear- ��installation and use of stationary combustion engines. That " ance above the generator,three (3)feet of clearance on sides standard is NFPA 37 and its requirements limit the spacing of an and front, and 18 inches of clearance at back of unit. enclosed generator set from a structure or wall (Figure 1.10). • Install the unit where rain gutter down spouts, roof run-off, NFPA 37, Section 4.1.4, Engines Located Outdoors. Engines, and landscape irrigation, water sprinklers or sumpump discharge p g. does not flood the unit or spray the enclosure,including any air their weatherproof housings if provided,that are installed outdoors shall be located at least 5 ft.from openings in walls and at least 5 inlet or outlet openings. ,. • Install the unit where services will not be affected or obstructed, ft.from structures having combustible walls.A minimum separa- ; tion shall not be required where the followingconditions exist: including concealed, underground or covered services such as q electrical,fuel,phone, air conditioning or irrigation. 1. The adjacent wall of the structure has a fire resistance rating • Where strong prevailing winds blow from one direction,face the of at least 1 hour. - generator air inlet openings to the prevailing winds. /2. - The weatherproof enclosure is constructed of noncombus, • Install the generator as close as possible to the fuel supply,to tible materials and it has been demonstrated that a fire within•. reduce the length of piping. ;the enclosure will not ignite combustible materials outside theq' • Install the generator as close as possible to the transfer switch. jenclosure. REMEMBER THAT LAWS OR CODES MAY REGULATE THE Annex A—Explanatory Material DISTANCE AND LOCATION. A4.1.4(2)Means of demonstrating compliance are by means • The genset must be installed on a level surface.The base frame of full scale fire test or by calculation procedures. must be level within two(2) inches all around. Because of the limited spaces that are frequently available for • The generator is typically placed on pea gravel or crushed installation, it has become apparent that exception (2) would be stone. Check local codes if a concrete slab is required. If a beneficial for many residential and commercial installations. With ,� concrete base stab is required,all federal,state and local codes that in mind, the manufacturer contracted with an-independent testing laboratory to run full scale fire tests to assure that the should be followed. Special attention should be given to the enclosure will not ignite combustible materials outside the enclo- concrete base slab which should exceed the length and width sure. of the generator by a minimum of six 6 inches 0.152 meters on all sides. The criteria was to determine the worst case fire scenario within the generator and to determine the ignitability of items outside the Figure 1.9—Generator Clearancesengine enclosure at various distances.The enclosure-is-construct= - ed of.non-combustible materials and the results-and-conclusions + from the independent testing lab indicated that any fire within the* 'l generator enclosure would not pose any ignition risk to.nearby Xombustiblesw structures, with or.without•fire_-service personnel c l response. i Based-on this testing and the requirements of NFPA 37,Sec 4.1.41 ® the guidelines for installation of the generators listed above=are changed to 18 inches (457mm)from the.back side,of the genera- Jor to a stationary wall or building; For adequate maintenance and airflow clearance,the area above the generator should be at least 4 feet with a minimum of 3 feet at the front and ends of the enclo- sure. This would include trees, shrubs and vegetation that could obstruct airflow. See the diagram on the reverse of this page and the installation drawing within the owner's manual for details. Generator exhaust contains DEADLY carbon monoxide gas. This dangerous gas can cause unconsciousness or death.Do not place the unit near windows, doors,fresh air intakes (furnaces, etc.) or any openings in the building or structure,including windows and doors of an attached garage. 11 f Information Figure 1.10—Installation Guidelines No windows or openings in the wall permitted �•� f " within 5 feet from any point of the generator. Winches Existing Wall 18 inches Winches ' Minimum Distance ' r r r r r Clearance from windows, 36 inches Top of Generator Winches doors,any openings in the wall,shrubs or vegetation over 12"in height Clearance from the ends and front of the These guidelines are based upon fire generator should be 36 inches.This Winches would include shrubs,trees and any testing of the generator enclosure and kind of vegetation.Clearance at the top the manufacturer's requirement for air should be a minimum of 60 inches from flow for proper operation.Local Codes from the any structure,overhang or projections may be different and more restrictive be placed unlde a deck or other.The generator not than what is described here. structure that is closed in and would limit or contain air flow. 60"Minimum i 60"Recommended Minimum From Ends Generator 18inches Minimum This drawing supersedes installation instructions in all Carrier air-cooled installation and owner's manuals dated. previous to May 26 2007. � Y 12 i �� rOfficial U Only Commonwealthof Massachusetts Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (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: l — 21 — 2o 13 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfo the electrical work described below. Location(Street&Number) ii;;Z5 t ooJ Owner or Tenant F,-,art C.G5 B eCc kTelephone No. Owner's Address 5,k Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 9yV Amps / Volts Overhead❑ Undgrd rg No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: / K (5--eN,erA6r- Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No,of Zones tJ No.of Switches No.of Gas Burners No.of Detection and InitiatingDevices Ranges Tons No.of Ran No.of Air Cond. Total No.of Alerting Devices g No.of Waste Disposers Heat Pump Number Tons I.KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other p g Connection No.of Dryers Heating Appliances KW Security Systems:* Y No.of Devices or Equivalent No.of Water KW No.of No,of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of WYres. Estimated Value of Electrical Work: 64 - (When required by municipal policy.) Work to Start: I ,? Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Ods`"apv-pp�lica Gr4 6r t'r/--'7 � I certify,icnder the pains and penalties ofperjury,that the information on tion is true and cofnplete. L FIRM NAME: , w G.ie- CtP LIC.NO.: Licensee: S .y� '�k Signature LIC.NO.: (Ifapplicable,enter "exempt"in the icense number line.) Bus.Tel.No.- 9-7-I'-531'`(33$ Address: �j,3 S'f �P �� D/9�6 Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires DepaRment 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 �7� T a ko.Signature elepho I PERMIT FEE: $ 21f9 J ro �� ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c. 143,§3L,the ` 1 permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed 4 ! on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§ 32,an �a electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the ^ notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if lie or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass M Failed(] Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass(] Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass n Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: J Inspectors Signature: Date: ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: i Inspectors Signature: Date: FINAL INSPECTION: Pass n Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com A I I The Commonwealth of Massachusetts Department ofIndustrlgl Accidents Office of Invesfigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): L Address: 3 City/State/Zip: eedw Phone#: } —S 3.2— — ct 33 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have Hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.El Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: LL Expiration Date: Job Site Address: 16..26 54d ,c C f u✓e Fore 5 City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one=year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un ins andpenalties of perjury that the information provided above is true and correct. Signature: Date: 43 Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: f " � 4 j �. a� ✓ 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 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 640 Washington.Street Boston,MA 42111 Tel,#61.7-727-4900 ext 406 or 1-877,7MASSA.k'B Revised 5-26-05 Fax#617-727-7749 wwwxnass.govma, � ��jgr2009 13:37 19789773323 LINA PAPUCHIS PAGE 01/01 If 0 q91 m awl An& m 11 ENE PLS DATE: / l . .LOCATION: OWNERS NAME: i GENERATOR kw NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS* CONTRACTOR: � ��cN l'� �-�vel PHONE NUMBER: _ 62-'5 77Y ELECTRICAL GAS Na�v RESIDENTIAL. COMMERCIAL TEMPORARY LOCATION OF GENERATOR. . *ZONING DISTRICT: e� rt5 1tit ` I1 `CONSERVATION APPROVAL I� b .Official Use O,nlly— Permit No. J"�` s E ZdIZZUG`'1�.C� s 03 ,04 }} 'Dyfaat�xcat°��ar6lta Sa6dq g`p -' .r '' BOARD OF--FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy&Fee Cfieck 0 APPLICATION FOR PERMIT ' PERFORM ELECTRICAL WORK All work to be performed in accordance wit the Massachusetts Electrical Code 527 CMR 1 :OO (Please Print in ink or type all Information) fi�AA Date 1 in To tl:e Insp�tcr of'N:es: Town of North Andover i N��:>%``' r The undersigned applies for a permit to perform the electrical wolfs described below. Location(Street&Number _ rogz�`r .S:cq� Owner or Tenant f AALt, Y u vol A'+vl Owner's Address Is this permit in conjunction with a building permit Yes 0 No 0- (Check Appropriate Box) Purpose of Building LNE 1� Utility Authorization No. 1 G 1(eq- !V Existing Service Amps Voits Overhead o Undgmd a No.of Meters New Service 2LJLJ Amps Z 40 Volts Overhead 0 Undgmd 0 9C,, No.of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 9 In 0 11_�. Lighting Fixtures Swimmin Pool and B and 0 Generators KVA No.of Emergency Lighting Rece les Outlets J� No.of Oil Burners Ba Units Switch Outlets f✓ No of Gas Burners FIRE ALARMS Na of Zone otes Total � 5 No.of Detection and f Ranges No of Air Cond Tons Initiating Devices S> Heat Total Total Di 1 No. Pum Tons KW No.of Sounding Devices NoJ of Self Contained Dishwashers S ce/Area HeatingKW DetectionlSoumfing Devices B Municipal 0 Other Dryers Heating Devices. KW Local Connection No.of No.of Low Vokage Water Heaters KW Signs Bailases Wiring ro Massa Tuds No.of Motors Total HP ER: RANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YESNO submitted valid proof of same to the Office YES=NO - If you have checked YES p indicate the type of coverage by checking the appropriate box. RANCE k BOND - OTHER .Please Specify) (Expiration Date) ed Value of. i r►cal Works � � [�d to Start �4 Inspection Date Resquested Rough Finat under the Penalties of perjury: NAME LIC.NO. see'. < ' ► Signature ��Ajlaal, 1� Z t L- ( _ } Bus.Tel No. to Alt Tel.No. R1NSllRANCE WAIVER: 1 am aware that the Licenses does not have the insurance coverage or its substantia equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) /Uo Glc t' GARAfE' ��6?5 !yo MPf$TFX &0 , w..., 7' 4W7- 34'wV (Pr Act S�S, Location �. �S /ror�'� Ste' .t3. No. QQ Date NORTH TOWN OF NORTH ANDOVER f 1 49 � 9 Certificate of Occupancy $ +ss MUSE<� Building/Frame Permit Fee $ AC Foundation Permit Fee $ Other Permit Fee $ r TOTAL $ Check # 3 17378 x Building Inspector NO TE.- ASSESSORS: NORTH ANDOVER MAP 105B, A POR110N OF LOTS 1 & 2 THIS PLAN /S NOT TO BE CONSIDERED AN AL TAIA CSM BOXFORD MAP 31, BLOCK 2, A PORAON OF LOT 1.1 LAND TITLE SURI/EY. ZON/NG• NORTH ANDOVER RESIDENCE 1 j=L �6 a 6 y l a-3 f o lT BOXFORD RESIDENCE-AGR/CULTURAL DISTRICT -r AAlLo% °. (p` (5_ �� REFERENCES.• DEED BOOK 22808, PAGE 1 (ESSEX SOUTH) DOCUMENT#19261 (ESSEX NORTH) PLAN BOOK 359, PAGE 90 -SPGE �P� �OjJG EMENT) _ I.ROD Q (P Ep5 E� (SET) � E + ° 5 , 1 10 ; (pOsLRp)WI�TM)R .33 (SET) T (No RECO L FARES (SET) IK CLAIRE M. & J SCOTT ROTH DAVE C. DEACON, &. ROD PLAN BOOK 359, PLAN 90 ALti � (SET) LOT 2 A AL LOT 3 / TOTAL AREA: 88,500-t S.F. 2.03E ACRES AL 84,2001 S.F. /N N.ANDOWR 4,,3001 S.F. IN BOXFORD C.B.A.=65,7001SF. \ � /.ROD AL v (SET) J= COR. Q ONC O � F O FOo�cTilc Zt Q s AL h yy� AL CERTIFY THA T THE FOUNDA TION SHOWN HEREON IS L OCA TED ON THE S 0/ SHOWN. / JOSEPH / O O e �a M.a � ` ♦/ SAAALL ' No.o.4557171 7 AL IaO jl A9DFESS\��P�. V AL �AaD SUR A /.ROD/ aO AL (SET) .� \ AIL O AL / i� m IL PROFE#SJ& L D SUR V YOR f ALT PLAN CHK. BY �` C z � OF LAND /N w NORTH ANDOVER & BOXFORD, MA 0 X18 DA TE.• s� N o. 618104 PREPARED FOR.- MICHAEL F/NOCCH/O '9�E0 AN FROM P� 1 WNW POND S B ��ANCOCK SO SCALE. 1" - 50' Survey Associates, Inc. O 185 CENTRE STREET, DANVERS, MA. 01923 VOICE (978) 777-3050, FAX (978) 774-7816 10413 0 25 50 100 F.•VWd P%iscfa R2110413Idr9l 1041kpp.dwg Ain 14 2004- 9.*28 o,» Date. Q T NORrM •'tio TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING 41 'SS'q usE� This certifies that c . . ./.�`e r. . . . . . . . . . . . . . . . . . . . . has permission to perform . .JV�. . . . �'!? `� . . . . . . . . . . . . . plumbing in the buildings of . . I �.�`� . . �.!!�Oc '.a . . . . . . . . at . �a _ Pl7-� V. . .. . . . . . . . .. North Andover, Mass. A Fee. Lic. No..1. . .Y/. . �. )SPECTOR PLUMBING Check # 3 a 6171 MASSACHUSETTS UNIFORM PLICATION FOR PERMIT TO DO PLUMBI N( 1 (Type or print) NORTH ANDOVER,MASSACHUSETTS cy _ , ��-- Date / 9 Building Locatio /� � 6".Ow.e s Name jV414a&L /�/�JO ' '� Permit# Amount i Type of Occupancy ' New Renovation Replacement Plans Submitted Yes 0 No El El FIXTURES cr H w t a w w a � o SLDELSW PASE EW ]Sly 1tiI�0(�t 2 II F OMM 3t>N " 4M ISI" 5MHIM 6M 11fm 7MBDM 9M FLOOR (Print or type) Check one: Certificate Installing Company Name S-6-r r/84'`/ Corp. Address //3 &1 GV e AS-5 4 y ❑ Partner. r Business Telephone / Q 7Fj'ny r Firm/Co. f Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ❑ Other type of indemnityElBond ❑ Insurance W 'ver: I,the n rsigned ave been made " are that the licensee of this application does not have any one of the above t nce 're Owner Agent it 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 andjinslations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massats StAte PI ing Cod and Chapter 142'of the General Laws. By: Signature ol LicenseTrium5ev Type of Plumbing License Title 4' q� City/Town icense 74umver Master Journeyman ❑ APPROVED(OFFICE USE ONLY I f Date. ORT#q 01 0 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SA U -eu r,y This certifies that . . .5. . .C. . . . . . . . .4. . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation A%I in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. 'Fee. . . Lic. No.�.Tk . . GAS INSPECTO Check# 3 c�d 4834 MASSACwsEIIS UNu0RM APPUCATON FOR P TO DO GAS FfrTNG (Type or print) Date zzieL NORTH ANDOVER,MASSACHUSETTS Permit# Building �� �% %�V� � Buil g Locations ` Amount$ /(�•/�/��U __ � ` Owner's Na' e �✓� New ,/� Renovation ❑ Replacement ❑ Plans Submitted ❑ � a w w n W O OU F x x F z O W Q O ;:) O W H Ch W Q z � w w Z a a a w . w F w U �+ nz Ell z 00 a w o 3 a a U 94 a ° H o SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4 T H . F L O O R 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR. (Print or type) �? ��� Check one: Certificate.Installing Company Name C ❑ Corp. / hh nas vJ gv �fE'�lC✓ L� (� / Partner. Address 7 Business Telephone -?,F/ SQS ❑ Firm/Co. 6 Name of Licensed Plumber or Gas Fitter Coit /�1 INSURANCE COVERAGE Check one: d I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes,please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policy ❑ Other type of indemnity ❑ Bond Owner's Insu nce Waiver: I am aw hat the licen ee does not have the Insurance coverage required by Chapter 142 of the Ma al La s, th my atu`re on thi ermit application waives this requirement. Check one: Si lure of Owner or O e ' Agent Owner Agent 13 hereby certify that all --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 wte Gras Coe and Chapter 142 of the General Laws. Signature of Licensed Plumber Or Gas Fitter By' ";itle Plumber ?-?q l C.ity/Iown Gas Fitter =se um er r Master APPROVED(OFFICE USE ONLY) ❑ Journeyman I i Date......�-r; ..... NORTH 4, TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING I slow. 1* A US ...... ... This certifies that ... . .......IA.,.............................................................. has permission to perform ........ ............................................ wiring in the building of......... .. ............. ...................................... at� ...... .......................... ..................... .Noah Andover,Mass. FeeJW......... Lic.No.............. ...................... Check # �;�.&iNrCTX)R 317 Official UOnly Permit No. JW7 71;1.6 eoXWo7MEW71?1 7 W,4ss c, WS5775 Xhec2 q�°��` `Sammy/ Occupancy&Fee BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 1 :OD (Please Print in ink or type all information) Date to TO the uwpea.aan v1Wires: Town of North Andover t The undersigned applies for a permit to perform the electrical work described below. I Location(Street&Number ' Owner or Tenant -i- �1 Owner's Address Is this permit in conjunction with a building permit Yes 0 Y�, No 0 (Check Appropriate Box) Purpose of Building b",)EL�t i�C Utility Authorization No. 1 G ! Existing Serviceyyr��--��,, Amps Voits Overhead a Undgmd 0 No.of Meters New Service 2tyQ Ampsuazlio Voits Overhead 0 Undgmd 0 No.of Meters _ Number of Feeders and Ampacity, Location and Nature of Proposed Electrical Work Total -- No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above II In 0 No.:,of Lighting Futures Swimming Pool gmd 0 gmd 0 Generators KVA No.of Emergency Lighting N r.of Receptacles Outlets f No.of Oil Bumers Battery Units No.of Switch Outlets No of Gas Bumers FIRE ALARMS No_of Zone Total !!� No.of Detection and No.of Ranges No of Air Cond Tons 6. CJ Initiating Devices SMO1 L Heat Total TSI No.of Di I No. Pum Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices 0 Municipal 0 Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Si ns Bailases Wirin Nom.Hydra,Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES�NO have submitted valid proof of same to the Office YES= NO - If you have checked YES please indicate the type of coverage by checking tho appropriate box. INSURANCE F BOND - OTHER - (Please Specify) 74L71 �- (Expiration Date) Estimated Value of.FJrical Work$ 1 I 0 Work to Start 1:? Inspection Date Resquested Rough —Final Signed under the Penalties of perjury: FIRM NAME LIC. LIC.NO. License elC C:.r �l,'`Zc7Y 1 Signature y UC.NO. Z{� �� �fc'S t .C.EZ f.LV )./ Bus.Tel No. to � L Z ^� o_4 Address t1 1� Att Tel.No,-� ^ZD'S' OWNER'§-INSURANCE WAIVER: I am aware that the Licenses 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 requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) ��� � � G ', `���- � �� °� g I �� it :+ "t 1. a Date Z .�. f. . . . . t4'R"f.L.rwyQys , TOWN OF NORTH ANDOVER . PERMIT FOR GAS INSTALLATION This certifies that . AQJP&, , . . . . . . . . . . . . . has permission for gas installat*on . . . . . .PcJ e/: in the buildings of. . . .&el( I . . , ... . . . . . . . . . . . . t at . . .�.�-j Z.rj. P S'� ,�-�t: X- ",. . . . , . , No h An over, Mass. Fee .30`. . . Lic. No.1�:91 . . . My . . . . . . . . . GAS INSPECTOR Check#- 8584 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY _ 7�h �vc��i�.p.- � MA DATE PERMIT# JOBSITE ADDRESS C OWNER'S NAME [,,-J OWNER ADDRESS TE FAX J � TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL --- PRINT CLEARLY NEW:B-"-RENOVATION:0 REPLACEMENT:[ PLANS SUBMITTED: YESE-11 NOQ APPLIANCES-1 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE - DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE Jjs_ - 1 GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER VVATeR HEATER _ III III INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YESfQO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE 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. CHECK ONE ONLY: OWNER 01 AGENT 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-GASFITTER NAME L LICENSE#- ( SIGNATURE - -- MP '' MGF JP 0 JGF LPGI[ CORPORATION D# _j PARTNERSHIP( # LLC C f COMPANY NAME: �„ �� _ - ADDRESS CITY , �; th a STATE ZIP ZTELl _. FAX CELL33? EMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 214 r . o le r f 0 The Commonwealth of Massachusetts Department of IndustrialAccidints Office of Investigations k4ip 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zip: �� �cf Phone#: '1 7 e— -31-3 o V 3z Are you an employer?Check the appropriate box: Type of project(required): 1.[Tam a employer with / 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. E]Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13.0 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 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:. n e 4 r ° t"'`� Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 2._ u`'p y S f` ey E1 t City/State/Zip: u t 4 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 u to$1,500.00 and/or one= ear imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine P Y p 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 andpenalties ofperjury that the information provided above is true and correct. Sip-nature: _ 0 — Date: 'Z ''7 Q t :�t Phone#: c —.? ILI 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 ofhire,- express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,625C(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 fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense 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'saddress,telephone and fax number: The CommonwealthofMassachusetts 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#61.7-727-7749 www.mass,govfdJa IS PAGE 01/01GINA PAPUCH X2009 13:37 19789773323 , teir empi. itract loyees,� h'Te, "PLICATI " N -two or•tnoxe GENEK#kTw^R or the "'ever the _ 1 the hous DATE: e Mployer." e or LOCATION: F---f ly OWNERS NAME: 'shall trance GENERATOR kW---L]?- � _�-r­.erl.G NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS* Ind,if n the CONTRACTOR: d PHONE NUMBER: ELECTRICAL fGAS Na,k4Z RESIDENTIAL. COMMERCIAL TEMPORARY LOCATION OF GENERATOR. . �/r� �i✓ f C'� eR a��or'�e LJ ,e l/�i� S *ZONING DISTRICT: `CONSERVATION APPROUAI_ 1/ !� I i F&S.Than N1,=h Aio:o Ali PerforaLon: COMMONWEALTH OF MASSACHUSETTS BARD PLUM S�ERS AND GASfit1t IMPORTANT NOTICE SCD AS A-MASTEV PL0-ERPERMITS FOR PLUM13ING AND OAS 1S51lES THE A#30VE i10ENSE Tf�:: INSTALLATIONS ON STATE OWNED OR U.t a i FACILITIES MUST 13E FILED AT T14E TYPE t OFFICE OF T"E STATE BOARD. :H'ARi_ES H SABANTY I AA. MCDERMOTT FARM ROAD DANVERS MA 01923-3566 F I !.b8bb4 1.2291 05/01/14 168664 FE-P.I.Then Pe t,8ch I 0 a 6 9 Date.....Y...- .................... �0`°TM "° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING c - ; �,SSACMUSEt certifies that ,Y 1� .. L� ...... G.� .. .............. This certi has permission to perform ..... J 'z ..1..�4.. . .......................... wiring in the building of......... ��............................................. at./ 'rorth Andover,Mass: pts Fee y ---".... Lic.No.."l.. f' [1r .............. .. .... . ..........�.. ENCTRICAL INSPECTOR Check # !�1— 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: in ae-cordance-with the provisions of M.G.L.c.143,§,3L,the 1 f permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed- " on the prescribed form.After a permit application has been accepted by an inspector of Wires appointed pursuant to M.01 c. 166,§32,an electrical permit shall be issued to the person,fimm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall be limited as to time time of ongoing construction.activity,and maybe deemed by-thesnsp.ector-of_Wires abandoned-andda-valid-if he—.. or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the.permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job;growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically dxtends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008.and extendingthrough August 15,2012. Rule 8—Permit/Date Closed: /Z 46 —/6t, Note:Reapply for new per f ❑Permit Extension Act—Permit/Date Closed: -Commonwealth of Massachusetts Official Use Only " Permit No. / 00 /2 Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (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 WINK OR TYPE ALL INFORMATION) Date: 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) /S r=c�ecesT G7. 6;- w j j �� �« � � Owner or Tenant 6244-C 16 r-r K6£ y Telephone No. s-'r- i 0-M7 Owner's Address IJ-2-S- s10' FYrs©� Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building Rpm,i- Utility Authorization No. Existing Service o51 4-0 Amps /aV'U Volts Overhead ❑ Und rd I-L g t� No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 4peIgs' s .S,Ani R®aZ Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp:(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets . No..of Hot Tubs ' Generators 'VA No.of Luminaires Swimming Pool Above ❑ In- o, o mergency Ig ting rnd. rnd. " Batte 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 Initiatipg Devices No.of Ranges No.of Air Cond. . Tonsl No.of Alerting Devices No.of Heat Pum Number Was To Waste Disposers ns I' posers P ....................................................��'.6.'........... No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers S ace/Are Munic' Space/Area Heat' ► a1 p mg ' Local❑ Con ne tion 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of WaterNo.of Devices or E uivalent No.of No.of Heaters kw Signs Ballasts Data Wiring: ` No.of Devices or E uivalent No.Hydromassage BathtubsNo.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: qbudcL, Cifoawd P=e,e-L � P � Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 35y�-<:=b (When required by municipal policy.) Work to Start: y di Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAMES - o — i -� LIC.NO.: 9 78 7-is�L. Licensee: Signature�_� LIC.NO.: (Ifapplicable, enter "exempt"in the license number line.) Address: Bus.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt : L c.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 Nol:f-a3-;14y- FPEJ?M1TFEE. $ ELECTRICAL PERMIT NO. t' INSPECTIONREPORT: EIGECTRIGAL INSPECTOR-DOUG SMALL 1.ROUGE]NSPECTION: Passed—[ I Failed—[ ] Inspectors'comments: Re-inspection requirecT($50.00)-[ ] II (Inspectors'Signature-no initials) • Date 2•FINAL INSPECTION; Passed—[ ] Failed [ .] Re-inspection required($50.00)-[ ] Inspectors'comments: ------------------------ (Inspectors'Signature-no initials) Date 3.WJ DER_GREs PECTION: Passed— Failed—[ ] Re-inspection required($Sp,00)-1 I Inspectors'com /V��g'Signature-no initials) Y Date 4•INSPECTION—SERVICE: - DATE CALLED NATIONAL GRID: Passed—[ ] Failed—[ ] Re-inspection required($50.00) Inspectors' comments: (Inspectors'Signature-no initials) Date �i 5.INSPECTION-OTHER: Passed—[ ] Failed—[ ] Re-inspection required($50.00) Inspectors' comments: (Inspectors'Signature-no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE 714'T]B(E AREA TO BE INSPECTED IS NOT ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED. ' L The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual) �� �Q S i6Q G Gyt_-_4 Address: Q 7 i l j,a u. ,n c r.-r-- C?<i to City/State/Zip: -���,.Y,�-�,� -yx La c37s-�- _ Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with-7g, £i t 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.$ 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We ate a corporation and its required.] officers have exercised their 10.[:1 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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: /-TJdA,e" ��y3 C G• �G2`�S rn erc3� �( Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: IS24 relic c s'7' S z,.,I City/State/Zip: -)Io -7*4433 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. SienaturDate `1199-/e Phone#: 603 " 7Ls -'7aZ 2 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 fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia LTx �1 9'x' -`' SCALE: 118"= 1' to 313 SHATRICK WAY,NEWOVGTON,N.H.Q'iB01 voor.... 50J)W,.T800 •GPS ADDRESS' JOB INFORMATION POOL m 1525 smNELLEAVE RD 6119 Ifx35• OFe,w J' B• 80%PGRO.MA FRNIGE BEF]¢EY ]9310081 RELTANGIE 1525 FOREST6T EX1EN310N � 1],000 y,e' N0.ANOOVERPW STAitITE 1 9M561A001 BTBiT5t99A ,ea SfA-HiIE 6IY120 ��'/1�� �GBLRNN90WG®MSN.LOM PAGfAB JOHN FLANAGxN wixn�xast B�EtiS DIRECTIONS ID t\ mNx SR erB WOK ry P art:X ,On LOLORLOLJC W 95 SOUTH 32 ML TO TOPSFIELD RD EXIT Ra � RIGHT ON TOPSFIELD RD 2 MILES xsaYEs W LEFT ON MAIN BY Q MILES YE5 sKaxER p) LEFT ON TOWNE RD 112 MILE AcuA.w2E _ RIGHT ON HOLLOINTREE RD 1/0 MILE snle.s sALT I LEFT ON STONECLEAVE RD 112 MILE ixsoE sFxcN AUWm RBOX O OuaL twx oRAWs _ IJGKT O-A) ENTRrsTEPs R SPECIAL NOTES -°'°A"'s w,Rae aXauxE rEs �sPOOL&SPA Eeexcx ( AUTO•COVER(NON•WALK ON LID) wxrtE F Rx ryl Teo FN TURBO CLEAN xlwrn C� I�3Pr _I\ 9aE ruA ex." DECK •NOTE:PROPERTY LOCATED 1525 FOREST ST EXTENSION T WAvaer eq �6• 9 WA �\ •ONLY ACCESS TO PROPERTY IS 4-.S STONECLEAVE ROAD,BOXFORD,MA WA ter I GTONELLEAVE HOUSE TOWN RD NOLLMITREE .AN.T • roPSHELo Ro GUN a aumtOYFR sox rcERANx:n� 95s ��,.•• \ NE BP JI Le•eTFEL R- / CONCEPTUAL DRAWING ' :4"` 9 9 _ ACCEPTED BY: L� `�4 I I 131,N2010 1'd= REVISIONS _ x ouu NAW OWNS WHITE PLASTER Location No. G' D Date y a3 7 No�TM TOWN OF NORTH ANDOVER L # y Certificate of Occupancy $ CHU .1 Building/Frame Permit Fee $ Foundation Permit Fee $ D Other Permit Fee $ , TOTAL $ � Check # p w 17221 AA4 -� Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIJ RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: i SIGNATURE: /a ��G� Building Coffimissioner/IEWtor of Buildings Date Z SECTION 1-SITE INFORMATION 1.1 ^Property Address: 1.2 Assessors Map and Parcel Number: ®56 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red' Provide Required Provided Required Provided O ta0 — O 10 1 Z _t__ 1.7 Vater Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: / 1.8 Sewerage Disposal System: Public ❑ Private 1§1 Zone Outside Flood Zone (9/ Municipal ❑ On Site Disposal System SECTION 2-PROPERTY OWNERSHEN/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record Name(Print) Address for Service: igna. Telephone .2 Owner of Name Print Address for Service.-3. Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: h/000 e61 14� License Number aan ! Address Expiration Date ig Telephone t 3.2 Registered Home Improvement Contractor Not Applicable ❑ Ct�mpanyName Registration Number r Address r seri• Z Expiration Date ^ Si nature Tel hone Y, 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 au applicable) New Construction 19�," Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition ❑ Accessory Bldg. ❑ Demolition - ❑ Other 0 Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost � )to be � (Dollar) USE"Ift r, " Completed by permit a lice t , _ 1. Building n-4xw94fr v nd (a) Building Permit Fee /zyv"em a � Multiplier- 2 ulti lier-2 Electrical c (b) Estimated Total Cost of ' t ��"a �61)'"/ poO` Construction 3 Plumbing ° Building Permit fee(s)x (b) _ 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date -SECTION 7b 7b OWNER/AUTHORIZEEDD AGENT DECLARATION } 1, (,9as Owner/Authorized Agent of subject 1 property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Prin � . r t wner/A ent X Date O. OF STORIES SIZE 6 ,:- BASEMENT OR SLAB SIZEOF FLOOR TINIBERS Z Ktc 1 z (CC) 2 3 RD SPAN oL cv DM ENSIONS OF SILLS DMENSIONS OF POSTS L/1,l t DRAENSIONS OF GIRDERS HEIGHT OF FOUNDATION /— THICKNESS L LO SIZE OF FOOTING t o X Z o MATERIAL OF CHIMNEY ti IS BUILDING ON SOLID OR FILLED LAND oLi IS BUILDING CONNECTED TO NATURAL GAS LINE `' FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits frc Boards and Departments having jurisdiction have been obtained. This does not relies the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICA PHONE Cff 51IS��/5 LOCATIO : Assessor's Map Number PARCEL SUBDIVISION V - LOT(S) 3 STREETi�AP2ST. NUMBER 7 raR' 9,01./9 70 , trnaA z o m4 ************* ******** *** *OFFICIAL USE RE C M'ENDATION. WN AGENTS: CONSERVATION ADM_ INISTR OR DATE APPROVED DATE REJECTED COMMENTSMoO�TrPC0,0641 — st ro 0 ZTGiM4 DATE.APPROVED DATE REJECTED COMMENTS FOOD INS CTO -HEALTH DATE APPROVED DATE REJECTED T SP CTO-- EALTH DATE APPROVED DATE-REJECTED COMMENTS ' PUBLIC WORKS-SEWERfVVATER CONNECTIONS � DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE ---_ Revised 9197 jm All �-7 777a t 4_ y• \ti a North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: r- I/� o VPJ f Facility) (Locationo / Si nat of ermit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I I i GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption tinder section 3.7.6 of the Town of North Andover Growth IN/loa ement Bylaw. The applic t sha�,lovide all of the /V necessary information as requested below. Z16S11- - 5)1.e- �• o Permit Applicant Propertv address Map/Parcel Applicant's Phone Number Single Family Two FamiIv I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 ofthe Growth Management Bylaw.I also understand providingthis form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance ofthe building permit.Further I understand that my interpret,-tion ofthe exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 ofthe North Andover Growth Bylaw the above lot and the work as applied for on the above lot,in the building permit application and associated attachments,complies with one or more ofthe following sections as indicated by a check mark. This is an application for a building permit forthe enlargement-restoration or reconstruction of a dwelling in existence as ofthe effective date ofthis bylaw,provided that no additional residential unit is created. The lot(s)was/were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 ofthe Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals,where all ofthe conditions of 8.7.6 are met and or represents dwelling units for senior residents,where occupancy ofthe units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land.For purposes ofthis section"senior"shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40°o permanent reduction in density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions ofthe tract with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction.Conservation Restriction,dedication to the Town.or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date ofthis Section 8.7 and shall receive a onetime exemption from the Planned Growth Rate and Development Scheduling provisions for thepurpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit(all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits. Applicant must submit an approved FORM U with this EXE11APTIGN. PLEASE PROVIDE ANYAND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE'EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDFD A,ti?D THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUB TTAL OF vfiSLEADING OR INACCURATE CVFORMATION OR THF CHECKING OFF OF A ABOVE EXENIPTI c' ICH DOES NOT COMPLY,WHETHER DO\ TO VfY OWLEDGE OR NOT IS �c DS F FUSS BY ,BU'ILDING PAKT�fEVI TO ISSLL A BUILD .'G`PF.R` / / coY.�� SCANTS SIGNA - n TE I[IS FORM TO B 'HED TO THE BUILDING PERMIT APPLICATION -ACORD CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) TM 03/10/2004 PRODUCER (781)599-2200 FAX (781)581-3940 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Farquhar & Black ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 85 Exchange Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 101 Lynn, MA 01901-1475 INSURERS AFFORDING COVERAGE NAIC# INSURED Michael Finocchio INSURER A: Safety Insurance 39454 68 Hood Street INSURERB: Liberty Mutual Lynn, MA 01905 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'NTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE Y EXPIRATI LIMITS LTR NSR DATE MM/DD/YY DATE MM/DD/YY GENERAL LIABILITY BP00002927 08/29/2003 08/29/2004 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY $ PREMISES Ea occurence 100,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 10,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $_ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR El CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC531S344332013 06/02/2003 06/02/2004 TORY LIMITS ER EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 10O 000 If yes,describe under r SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Town of North Andover BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Building Dept. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. North Andover, MA AUTHORIZED REPRESENTATIVE `�u-k [Deborah Gilbert/D]G ACORD 26(2001/08) OACORD CORPORATION 1988 w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 c'�+M 5,•'' Workers'Compensation Insurance Affidavit Name Please Print Name: / /l�.°�/3� _ V' —/�1���.Gwo Location: ( � S City ��/!��/� � IY4� S Phone # ��l am dhomeowner performing all work myself. I am a sole proprietor and have no one working in any capacity, FJ 1 am an employer providing workers'compensation for my employees working on this job. Company name: Address CiEy Phone Insurance.Co. Poli, I � Company name: Address Insurance.-Co. Policv-# Paiture to secure coverage as required under Section 25A or MGL 152 candead t6the kr position of penalties of wi ine up to sl'. and/or one years'impasonment-as Wen-assheSamn-jota-STOP fine�€�,3I�0.0D��tta �9mn �e understand that a copy of this statement may t forwarded to the Office of Investigations cf the DIA for coverage verification. /do hereby ced&under the pains and penanies of perjury that the irdarnaatkrrprovided above k&w and correct Signature Date Print name Pie Olficlai use only do not write in this area to be completed by city or town dficiar ISI City of Town -.. ::Rerrrut/Licensing OCheck afimmediate response is requeed � Lkensfng Bb E] Selectman's i Contact person: phone# 0 Health Uepar Other i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 062643 Birthdate: 01/03/1962 Expires: 01/03/2006 Tr. no: 13165 Restricted: 00 MICHAEL P FINOCCHIO 68 HOOD ST ( , LYNN, MA 01905 Administrator i a�= ' = 1 ��ie �ajjzyna o- � -_ Board of Building Regulations -�% One Ashburton Place, (gym 1301 `= Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 01/03/1962 Number: CS 062643 Expires:01/03/2006 Restricted To: 00 MICHAEL P FINOCCHIO 68 HOOD ST LYNN, MA 01905 Tr.no: 13165 Keep top for receipt and change of address notification. I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit I MAScheck Software Version 2.01 I I I I 1 Checked by/Date I I i CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 3-17-2004 COMPLIANCE= PASSES Required UA = 567 Your Home = 551 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 2794 30.0 0.0 99 WALLS: Wood Frame, 16" O.C. 2220 19.0 0.0 134 GLAZING: Windows or Doors 628 0.330 207 DOORS 52 0.300 16 FLOORS: Over Unconditioned Space 1460 19.0 0.0 69 FLOORS: Over Unconditioned Space 816 30.0 0.0 27 HVAC EQUIPMENT= Furnace, 82.0 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 requirements of the Massachusetts Energy Code. 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 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 3-17-2004 Bldg. I Dept. I Use I I I CEILINGS: Q I 1 1. R-30 I Comments/Location I I WALLS: Q D 1 1. Wood Frame, 16" O.C. , R-19 I Comments/Location I I WINDOWS AND GLASS DOORS: Q ]I 1 1. U-value: 0.33 1 For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? Q I Yes Q ]I No I Comments/Location I 1 I DOORS: Q I 1 1. U-value: 0.3 1 Comments/Location I 1 FLOORS: Q I 1 1. Over Unconditioned Space, R-19 I Comments/Location Q 11 1 2. Over Unconditioned Space, R-30 I Comments/Location I I HVAC EQUIPMENT: Q ]I 1 1. Furnace, 82.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: Q ]I I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: 1 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 1 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: Q I I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: Q D I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. i I DUCT INSULATION: Q ]I I Ducts shall be insulated per Table J4.4.7.1. I 1 DUCT CONSTRUCTION: Q ]I I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be 1 omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. 1 I TEMPERATURE CONTROLS: Q I I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: Q ]I I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. Q ]I I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I Q I I HVAC PIPING INSULATION: 1 HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" 1 Low pressure/temp- 201-250 1.0 1.5 1.5 2.0 1 Low temperature 120-200 0.5 1.0 1.0 1.5 1 Steam condensate any 1.0 1.0 1.5 2.0 1 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I Q I I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I I PIPE SIZES (in. ) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" 1 170-180 0.5 1 1.0 1.5 2.0 1 140-160 0.5 1 0.5 1.0 1.5 1 100-130 0.5 1 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- 4 i ..ob Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 002 ROOF TRUSS 1 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 13 13:22:31 2003 Page 1 -1-0-0 4-7-0 7-6-0 10-5-0 15-0-0 16-0-0 1-0-0 4-7-0 2-11-0 2-11-0 4-7-0 1-0-0 Scale= 1:28. 4x4 = 4 7.00F12 1.5x4 = 1.5x4 = 3 5 8 5x8 = 2 6 ' 7 m �1 Io 3x4 % 3.50 F12 3x4 7-6-0 15-0-0 7-6-0 7-6-0 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.17 Vert(LL) -0.06 8 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.32 Vert(TL) -0.14 2-8 >999 180 BCLL 0.0 Rep Stress Incr YES WB 0.42 Horz(TL) 0.08 6 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Simplified) Weight:49 lb LUMBER BRACING TOP CHORD 2 X 4 SPF 1650F 1.5E TOP CHORD Sheathed or 6-0-0 oc purlins. BOT CHORD 2 X 4 SPF 1650F 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. WEBS 2 X 4 SPF-S Stud REACTIONS (Ib/size) 2=607/0-5-8,6=607/0-5-8 Max Horz 2=1 02(load case 5) Max Uplift2=-131(load case 6),6=-131(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/16,2-3=-1223/229,3-4=-949/128,4-5=-949/142,5-6=-1223/180,6-7=0/16 BOT CHORD 2-8=-213/1072,6-8=-129/1072 WEBS 3-8=-280/151,4-8=-84/767,5-8=-280/156 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf,BCDL=5.Opsf;Category 11;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)'This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 5)Bearing atjoint(s)2,6 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. 6)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 131 Ib uplift at joint 2 and 131 Ib uplift at joint 6. LOAD CASE(S)Standard I I Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 003 ROOF TRUSS 4 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries, Inc. Mon Oct 13 13:22:32 2003 Page 1 �1-0-Q 7-6-0 14-0-0 20-9-3 28-0-0 $9-0-p 1-0-0 7-6-0 6-6-0 6-9-3 7-2-13 1-0-0 Scale= 1:53. 5x6 = 7.00 12 5 3x4 3x4 1.5x4 11 4 6 3x6 3 7 cc co 1 2 12 8 9 coo 1 5x8 = Iq-o 0 0 3x8 % 11 10 4x4= o 3.50 F12 5x6 = 1.5x4 11 7-6-0 14-6-8 20-9-3 28-0-0 7-6-0 7-0-8 6-2-11 7-2-13 Plate Offsets X Y: 2:0-0-11 Ede [8:0-1-4,0-0-31 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) 1/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 1.00 Vert(LL) -0.21 12 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.53 Vert(TL) -0.37 11-12 >882 180 BCLL 0.0 * Rep Stress Incr YES WB 0.42 Horz(TL) 0.19 8 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Simplified) Weight: 110 lb LUMBER BRACING TOP CHORD 2 X 4 SYP No.2 *Except* TOP CHORD Sheathed. T1 2 X 4 SPF 1650F 1.5E,T4 2 X 4 SPF 1650F 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. BOT CHORD 2 X 4 SPF 1650F 1.5E WEBS 2 X 4 SPF 1650F 1.5E *Except* W1 2 X 4 SPF-S Stud,W5 2 X 4 SPF-S Stud REACTIONS (Ib/size) 2=1084/0-5-8,8=1084/0-5-8 Max Horz 2=-1 87(load case 4) Max Uplift2=-210(load case 6),8=-210(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/16,2-3=-2685/421,3-4=-2647/558,4-5=-2647/558,5-6=-1003/208,6-7=-1003/208, 7-8=-1447/209,8-9=0/18 BOT CHORD 2-12=-409/2380, 11-12=-72/897, 10-11=-117/1235,8-10=-117/1235 WEBS 3-12=-426/220,5-12=-446/1962,5-11=-69/197,7-11=-526/174,7-10=0/85 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category II;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)*This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 5)Bearing atjoint(s)2 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. 6)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 210 Ib uplift at joint 2 and 210 Ib uplift at joint 8. LOAD CASE(S)Standard Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 004 ROOF TRUSS 5 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries, Inc. Mon Oct 13 13:22:32 2003 Page 1 7-6-0 14-0-0 20-9-3 28-0-0 j9-0- 7-6-0 6-6-0 6-9-3 7-2-13 1-0-0 Scale= 1:52. 5x6 7.00 12 4 3x4 3x4 1.5x4 11 3 5 3x6 CZ � 2 6 i o 1 co 11 7 8 co O N 5x8 = I -o 0 o c 3x8 % 10 9 4x4 = 3.50 F12 5x6= 1.5x4 11 7-6-0 14-6-8 20-9-3 28-0-0 7-6-0 7-0-8 6-2-11 7-2-13 Plate Offsets X Y: 1:0-0-11 Ed a [7:0-1-4,0-0-31 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 1.00 Vert(LL) -0.21 11 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.53 Vert(TL) -0.3710-11 >882 180 BCLL 0.0 Rep Stress Incr YES WB 0.42 Horz(TL) 0.19 7 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Simplified) Weight: 109 lb LUMBER BRACING TOP CHORD 2 X 4 SYP No.2 *Except* TOP CHORD Sheathed. T1 2 X 4 SPF 1650F 1.5E,T4 2 X 4 SPF 165OF 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. BOT CHORD 2 X 4 SPF 165OF 1.5E WEBS 2 X 4 SPF 1650F 1.5E *Except* W1 2 X 4 SPF-S Stud,W5 2 X 4 SPF-S Stud REACTIONS (Ib/size) 1=1010/0-5-8,7=1084/0-5-8 Max Horz 1=-192(load case 4) Max Uplift1=-167(load case 6),7=-210(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=-2685/421,2-3=-2647/558,3-4=-2647/558,4-5=-1003/208,5-6=-1003/208,6-7=-1447/209, 7-8=0/18 BOT CHORD 1-11=-409/2380, 10-11=-72/897,9-10=-117/1235,7-9=-117/1235 WEBS 2-11=-426/220,4-11=-446/1962,4-10=-69/197,6-10=-526/174,6-9=0/85 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category ll;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)*This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 5)Bearing at joint(s)1 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. 6)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 167 Ib uplift at joint 1 and 210 Ib uplift at joint 7. LOAD CASE(S)Standard Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 005 ROOF TRUSS 13 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 13 13:22:33 2003 Page 1 -1-0-p 6-5-5 12-0-0 18-1-12 24-0-0 29-10-4 36-0-0 3,7-OTO 1-0-0 6-5-5 5-6-11 6-1-12 5-10-4 5-10-4 6-1-12 1-0-0 Scale= 1:66. 5x6 = 7.00 12 6 1.5x4 11 1.5x4 3x6 5 7 3x6 1.5x4 4 8 1.5x4 3 9 2 10 .po 1 1Iti 0 c 46 = 13 14 15 12 46 = 8x8 = 8x8 = 12-0-0 24-0-0 36-0-0 12-0-0 12-0-0 12-0-0 Plate Offsets MY): [2:0-2-12,0-2-01, 10:Ed a 0-0-8 [12:0-4-0,0-4-81,[13:0-4-0.0-4-81 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.36 Vert(LL) -0.29 12-13 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.44 Vert(TL) -0.38 12-13 >999 180 BCLL 0.0 Rep Stress Incr YES WB 0.56 Horz(TL) 0.06 10 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Matrix) Weight: 168 lb LUMBER BRACING TOP CHORD 2 X 4 SPF 1650F 1.5E TOP CHORD Sheathed or 4-4-14 oc purlins. BOT CHORD 2 X 6 SPF 1650F 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. WEBS 2 X 4 SPF-S Stud "Except` W3 2 X 4 SPF 165OF 1.5E,W4 2 X 4 SPF 165OF 1.5E REACTIONS (Ib/size) 2=1475/0-5-8, 10=1476/0-5-8 Max Horz2=243(load case 5) Max Uplift2=-260(load case 6), 10=-258(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/35,2-3=-2352/360,3-4=-2033/285,4-5=-1934/302,5-6=-2035/424,6-7=-1984/415, 7-8=-1893/294,8-9=-1993/284,9-10=-2291/352, 10-11=0/25 BOT CHORD 2-13=-373/1925, 13-14=-98/1220, 14-15=-98/1220, 12-15=-98/1220, 10-12=-216/1851 WEBS 3-13=-358/177,5-13=-436/202,6-13=-253/1070,6-12=-244/1029,7-12=-439/202,9-12=-318/175 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category 11;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)`This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 5)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 260 Ib uplift at joint 2 and 258 lb uplift at joint 10. LOAD CASE(S)Standard Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 006 ROOF TRUSS 7 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 13 13:22:33 2003 Page 1 6-3-12 11-3-6 17-8-4 1P-8T4 23-8-8 , 30-2-0 35-6-8 36-6T8 6-3-12 4-11-10 6-4-14 1-0-0 5-0-4 6-5-9 5-4-8 1-0-0 5x6 11 Scale= 1:71. 7.00 F12 5 4x8 5-4x6 3x4 3x6 6 4 2x4 3 7 1.5x4= 2 8 13 0 2x411 1 9 48 \ g � 11 � ti 12 4x4 0 0 6x6 = 17 18 16 15 5x6 5x10 = 2x4 11 48 1.5x4 11 11-3-6 18-8-4 26-4-15 35-6-8 11-3-6 7-4-14 7-8-11 9-1-10 Plate Offsets(X,Y): 9:0-2-14 0-9-15 9:0-1-1 0-1-15 14:0-3-0 0-2-4 17:0-3-4 0-3-0 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft L/d PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.81 Vert(LL) -0.28 11-13 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.58 Vert(TL) -0.44 11-13 >955 180 BCLL 0.0 * Rep Stress Incr YES WB 0.95 Horz(TL) 0.31 9 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Matrix) Weight: 180 lb LUMBER BRACING TOP CHORD 2 X 6 SPF 1650F 1.5E *Except* TOP CHORD Sheathed or 3-5-1 oc purlins. T3 2 X 4 SPF 1650F 1.5E,T4 2 X 4 SPF 1650F 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing, BOT CHORD 2 X 6 SPF 1650F 1.5E *Except* Except: B1 2 X 4 SPF 1650F 1.5E,B4 2 X 4 SYP No.2 6-0-0 oc bracing: 13-15. B2 2 X 4 SPF 1650F 1.5E WEBS 2 X 4 SPF-S Stud *Except* W5 2 X 4 SPF 1650F 1.5E,W4 2 X 4 SPF 1650F 1.5E WEDGE Left:2 X 4 SYP No.2,Right:2 X 4 SYP No.2 REACTIONS (Ib/size) 1=1315/Mechanical,9=1390/0-5-8 Max Horz 1=-244(load case 4) Max Uplift1=-213(load case 6),9=-257(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=-2109/349,2-3=-1830/293,3-4=-1690/309,4-5=-2502/348,5-6=-2615/389,6-7=-3286/415, 7-8=-3412/403,8-9=-3678/555,9-10=0/21 BOT CHORD 1-17=-361/1732, 17-18=-5/16, 16-18=-5/16, 15-16=-6/9, 13-15=-41/0, 13-14=-265/2844, 12-13=-268/2857, 11-12=-277/2846,9-11=-419/3136 WEBS 2-17=-344/158,4-17=-825/142,4-14=0/644, 14-16=0/123,5-14=-260/2110,6-14=-731/274, 6-11=-45/329,8-11=-252/217,14-17=-289/1873 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category 11;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)*This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 5)Refer to girder(s)for truss to truss connections. Continued on page 2 6 Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 006 ROOF TRUSS 7 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 13 13:22:33 2003 Page 2 NOTES 6)Bearing atjoint(s)9 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. 7)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 213 lb uplift at joint 1 and 257 Ib uplift at joint 9. LOAD CASE(S)Standard I c Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 007 ROOF TRUSS 5 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries, Inc. Mon Oct 13 13:22:34 2003 Page 1 0-5-8 -1-0,Q 6-9-4 12-4-3 18-1-12 11-1-,12 24-2-0 30-7-8 36-0-0 3T-0 0 1-0-0 6-3-12 5-6-15 5-9-9 5*B-95-0-4 6-5-9 5-4-8 1-0-0 Scale= 1:78. 0-5-8 7.00 12 6 3x6 3x6 3x4 3x6 7 1.5x4 5 4 8 ' 1.5x4= 3 9 v 14 13 ti 1 2 2x4 11 12 10 1 fP 4x8 I� c i,-24x4 o 4x6 = 18 19 17 16 5x6 5x10 = 2x4 11 4x8 1.5x4 11 0 5r8 11-8-14 19-1-12 26-10-6 36-0-0 0-5-8 11-3-6 7-4-14 7-8-10 9-1-10 Plate Offsets(X,Y): 2:0-0-1 0-0- 10:0-2-14 0-9-15 10:0-1-1 0-1-15 15:0-3-0 0-2-4 18:0-3-4 0-3-0 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.82 Vert(LL) -0.30 12-14 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.59 Vert(TL) -0.51 2-18 >831 180 BCLL 0.0 Rep Stress Incr YES WB 0.99 Horz(TL) 0.33 10 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Matrix) Weight: 166 lb LUMBER BRACING TOP CHORD 2 X 4 SPF 1650F 1.5E TOP CHORD Sheathed or 3-4-11 oc purlins. BOT CHORD 2 X 4 SPF 1650F 1.5E *Except* BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing, B4 2 X 4 SPF-S Stud,B3 2 X 6 SPF 1650F 1.5E Except: B5 2 X 6 SPF 1650F 1.5E 6-0-0 oc bracing: 14-16. WEBS 2 X 4 SPF-S Stud *Except* W5 2 X 4 SPF 165OF 1.5E,W4 2 X 4 SPF 1650F 1.5E WEDGE Right:2 X 4 SYP No.2 REACTIONS (Ib/size) 2=1401/0-5-8, 10=1399/0-5-8 Max Horz2=244(load case 5) Max Uplift2=-259(load case 6), 10=-257(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/30,2-3=-2137/351,3-4=-1852/296,4-5=-1713/311,5-6=-2511/353,6-7=-2640/394, 7-8=-3319/417,8-9=-3444/406,9-10=-3709/557, 10-11=0/21 BOT CHORD 2-18=-360/1755, 18-19=-4/14, 17-19=-4/14, 16-17=-5/8, 14-16=-27/0, 14-15=-267/2879, 13-14=-270/2885, 12-13=-279/2875, 10-12=-421/3164 WEBS 3-18=-353/162,5-18=-811/137,5-15=0/627, 15-17=0/104,6-15=-258/2124,7-15=-757/277, 7-12=-44/327,9-12=-246/216, 15-18=-287/1900 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf,BCDL=5.Opsf-,Category II;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)*This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 5)Bearing atjoint(s)10 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. Continued on page 2 Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 007 ROOF TRUSS 5 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 13 13:22:34 2003 Page 2 NOTES 6)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 259 Ib uplift at joint 2 and 257 Ib uplift at joint 10. LOAD CASE(S)Standard I Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 102 ROOF TRUSS 1 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 13 13:22:34 2003 Page 1 -1-0-0 4-7-0 7-6-0 10-5-0 15-0-0 16-0-0 1-0-0 4-7-0 2-11-0 2-11-0 4-7-0 1-0-0 Scale= 1:28. 4x4 = 4 7.00F12 1.5x4 = 1.5x4 = 3 5 8 5x8 = 2 6 ' oI1 7 Ia 3x4 % 3.50F12 3x4 r 7-6-0 15-0-0 7-6-0 7-6-0 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.17 Vert(LL) -0.06 8 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.32 Vert(TL) -0.14 2-8 >999 180 BCLL 0.0 Rep Stress Incr YES WB 0.42 Horz(TL) 0.08 6 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Simplified) Weight:49 lb LUMBER BRACING TOP CHORD 2 X 4 SPF 1650F 1.5E TOP CHORD Sheathed or 6-0-0 oc purlins. BOT CHORD 2 X 4 SPF 1650F 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. WEBS 2 X 4 SPF-S Stud REACTIONS (Ib/size) 2=607/0-5-8,6=607/0-5-8 Max Horz2=102(load case 5) Max Uplift2=-1 31(load case 6),6=-131(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/16,2-3=-1223/229,3-4=-949/128,4-5=949/142,5-6=-1223/180,6-7=0/16 BOT CHORD 2-8=-213/1072,6-8=-129/1072 WEBS 3-8=-280/151,4-8=-84/767,5-8=-280/156 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category 11;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)'This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 5)Bearing atjoint(s)2,6 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. 6)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 131 Ib uplift at joint 2 and 131 Ib uplift at joint 6. LOAD CASE(S)Standard 1 i I Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS I 330187A 103 STRAPPED GABLE 1 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 1313:22:35 2003 Page 1 7-6-0 14-0-0 20-9-3 28-0-0 49-0-0 1-0-0 7-6-0 6-6-0 6-9-3 7-2-13 1-0-0 Scale= 1:53. 5x6 = 7.00 F12 5 3x4 3x4 1.5x4 I I 4 6 3x6 3 7 cc co 1 2 12 8 9cc o lc� 0 5x8 = IT-o 0 3x8 % 11 10 4x4 = 3.50F12 5x6 = 1.5x4 11 7-6-0 14-6-8 20-9-3 28-0-0 7-6-0 7-0-8 6-2-11 7-2-13 Plate Offsets X Y: 2:0-0-11 Ede [8:0-1-4,0-0-31 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 1.00 Vert(LL) -0.21 12 >999 240 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.53 Vert(TL) -0.37 11-12 >882 180 BCLL 0.0 Rep Stress Incr YES WB 0.42 Horz(TL) 0.19 8 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Simplified) Weight: 110 lb LUMBER BRACING TOP CHORD 2 X 4 SYP No.2 *Except* TOP CHORD Sheathed. T1 2 X 4 SPF 165OF 1.5E,T4 2 X 4 SPF 1650F 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. BOT CHORD 2 X 4 SPF 1650F 1.5E WEBS 2 X 4 SPF 165OF 1.5E *Except* W1 2 X 4 SPF-S Stud,W5 2 X 4 SPF-S Stud REACTIONS (Ib/size) 2=1084/0-5-8,8=1084/0-5-8 Max Horz 2=-1 87(load case 4) Max Uplift2=-210(load case 6),8=-210(load case 7) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/16,2-3=-2685/421,3-4=-2647/558,4-5=-2647/558,5-6=-1003/208,6-7=-1003/208, 7-8=-1447/209,8-9=0/18 BOT CHORD 2-12=-409/2380, 11-12=-72/897, 10-11=-117/1235,8-10=-117/1235 WEBS 3-12=-426/220,5-12=-446/1962,5-11=-69/197,7-11=-526/174,7-10=0/85 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category 11;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2)Design load is based on 35.0 psf specified roof snow load. 3)Unbalanced snow loads have been considered for this design. 4)*This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. i 5)Bearing atjoint(s)2 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. 6)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 210 Ib uplift at joint 2 and 210 Ib uplift at joint 8. LOAD CASE(S)Standard Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 105 GABLE 2 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries, Inc. Mon Oct 13 13:22:35 2003 Page 1 -1-0-p 18-1-12 36-0-0 37-070 1-0-0 18-1-12 17-10-4 1-0-0 Scale= 1:66. 5x6 = 7.00 12 12 11 13 14 �� 3x6 9 10 15 3x6 16 00 78 17 6 18 5 19 4 20 3 21 0 1 2 22 2 0 0 3x6 =40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 3x8 II 5x6 = 5x6 = 36-0-0 36-0-0 Plate Offsets X Y: 22:0-3-8 Edge],[29:0-3-0,0-3-01,[35:0-3-0,0-3-01 j LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.08 Vert(LL) n/a - n/a 999 M1120 169/123 TCDL 10.0 Lumber Increase 1.15 BC 0.02 Vert(TL) -0.00 1 >999 180 BCLL 0.0 * Rep Stress Incr NO WB 0.18 Horz(TL) 0.01 22 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Matrix) Weight: 193 lb LUMBER BRACING TOP CHORD 2 X 4 SPF 1650F 1.5E TOP CHORD Sheathed or 6-0-0 oc purlins. BOT CHORD 2 X 4 SPF 165OF 1.5E BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. OTHERS 2 X 4 SPF-S Stud *Except* WEBS 1 Row at midpt 12-32, 11-33,10-34, 13-31, ST9 2 X 4 SPF 1650F 1.5E,ST8 2 X 4 SPF 1650F 1.5E 14-30 ST7 2 X 4 SPF 1650F 1.5E,ST10 2 X 4 SPF 165OF 1.5E STI 1 2 X 4 SPF 1650F 1.5E,ST12 2 X 4 SPF 1650F 1.5E WEDGE Right:2 X 4 SYP No.2 REACTIONS (Ib/size) 2=146/36-0-0,32=131/36-0-0,33=152/36-0-0,34=148/36-0-0,35=145/36-0-0,36=148/36-0-0, 37=147/36-0-0,38=146/36-0-0,39=148/36-0-0,40=141/36-0-0,31=139/36-0-0, 30=147/36-0-0,29=148/36-0-0,28=145/36-0-0,27=148/36-0-0,26=146/36-0-0, 25=148/36-0-0,24=140/36-0-0,22=148/36-0-0 Max Horz2=244(load case 5) Max Uplift2=-77(load case 4),33=-47(load case 6),34=-57(load case 6),35=-52(load case 6), 36=-54(load case 6),37=-53(load case 6),38=-53(load case 6),39=-56(load case 6), 40=-56(load case 6),31=-35(Ioad case 7),30=-59(load case 7),29=-53(load case 7), 28=-52(load case 7),27=-54(load case 7),26=-53(load case 7),25=-55(load case 7), 24=-67(load case 7),22=-27(load case 5) Max Grav2=168(load case 2),32=160(load case 7),33=181(load case 2),34=171(load case 2), 35=168(load case 2),36=171(load case 2),37=170(load case 2),38=170(load case 2), 39=172(load case 2),40=163(load case 2),31=169(load case 3),30=170(load case 3), 29=172(load case 3),28=168(load case 3),27=171(load case 3),26=169(load case 3), 25=172(load case 3),24=162(load case 3),22=169(load case 3) Continued on page 2 Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 105 GABLE 2 1 Job Reference(optional) � Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries, Inc. Mon Oct 13 13:22:36 2003 Page 2 FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/29,2-3=-220/155,3-4=-186/145,4-5=-159/142,5-6=-132/138,6-7=-105/132,7-8=-99/135,8-9=-78/138,9-10=-51/160, 10-11=-48/185, 11-12=-53/202, 12-13=-48/193, 13-14=-49/161, 14-15=-48/119, 15-16=-47/82, 16-17=-12/59, 17-18=-48/56, 18-19=-48/43, 19-20=-62/47,20-21=-89/50,21-22=-142/60,22-23=0/19 BOT CHORD 2-40=-43/145,39-40=-43/145,38-39=-43/145,37-38=-43/145,36-37=-43/145,35-36=-43/145,34-35=-43/145,33-34=-43/145, 32-33=-43/145,31-32=-42/147,30-31=-42/147,29-30=-42/147,28-29=-42/147,27-28=-42/147,26-27=-42/147,25-26=-42/147, 24-25=-42/147,22-24=-42/147 WEBS 12-32=-147/0, 11-33=-154/61, 10-34=-144/71,9-35=-141/65,8-36=-144/67,6-37=-143/67,5-38=-143/66,4-39=-144/68,3-40=-139/73, 13-31=-142/48, 14-30=-144/72, 15-29=-145/66, 16-28=-141/66, 18-27=-144/67, 19-26=-143/66,20-25=-144/67,21-24=-138/82 NOTES 1)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category II;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 2) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind(normal to the face),see MiTek"Standard Gable End Detail" 3)Design load is based on 35.0 psf specified roof snow load. 4)Unbalanced snow loads have been considered for this design. 5)All plates are 1.5x4 M1120 unless otherwise indicated. 6)Gable requires continuous bottom chord bearing. 7)Gable studs spaced at 2-0-0 oc. 8)"This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 9)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 77 Ib uplift at joint 2,47 Ib uplift at joint 33,57 Ib uplift at joint 34,52 Ib uplift at joint 35,54 lb uplift at joint 36,53 Ib uplift at joint 37,53 Ib uplift at joint 38,56 Ib uplift at joint 39,56 Ib uplift at joint 40,35 Ib uplift at joint 31,59 Ib uplift at joint 30,53 lb uplift at joint 29,52 Ib uplift at joint 28,54 Ib uplift at joint 27,53 Ib uplift at joint 26,55 Ib uplift at joint 25,67 Ib uplift at joint 24 and 27 Ib uplift at joint 22. LOAD CASE(S)Standard I I i i i Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO SS 330187A 301 ROOF TRUSS 1 Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries,Inc. Mon Oct 13 13:22:36 2003 Page 1 5-0-0 10-0-0 5-0-0 5-0-0 44 = Scale= 1:23. 2 9.00 F12 3 1 0 4x4 = 4 44 = 3x10 11 5-0-0 10-0-0 5-0-0 5-0-0 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 35.0 Plates Increase 1.15 TC 0.25 Vert(LL) -0.05 1-4 >999 240 M1120 197/144 TCDL 10.0 Lumber Increase 1.15 BC 0.69 Vert(TL) -0.08 1-4 >999 180 BCLL 0.0 * Rep Stress Incr NO WB 0.37 Horz(TL) 0.01 3 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Simplified) Weight:87 lb LUMBER BRACING TOP CHORD 2 X 4 SPF 1650F 1.5E TOP CHORD Sheathed or 6-0-0 oc purlins. BOT CHORD 2 X 6 SYP M 23 BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. WEBS 2 X 4 SYP No.2 REACTIONS (Ib/size) 1=3499/0-5-8,3=3499/0-5-8 Max Horz 1=-89(load case 4) Max Uplift1=-760(load case 6),3=-760(load case 7) Max Grav 1=3986(load case 2),3=3986(load case 3) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=-3066/608,2-3=-3066/608 BOT CHORD 1-4=-434/2360,3-4=-434/2360 WEBS 2-4=-676/3713 NOTES 1)2-ply truss to be connected together with 1 Od Common(.1 48"x3")Nails as follows: Top chords connected as follows:2 X 4-1 row at 0-9-0 oc. Bottom chords connected as follows:2 X 6-2 rows at 0-7-0 oc. Webs connected as follows:2 X 4-1 row at 0-9-0 oc. 2)All loads are considered equally applied to all plies,except if noted as front(F)or back(B)face in the LOAD CASE(S)section.Ply to ply connections have been provided to distribute only loads noted as(F)or(B),unless otherwise indicated. 3)Wind:ASCE 7-98;90mph;h=35ft;TCDL=5.Opsf;BCDL=5.Opsf;Category 11;Exp C;enclosed;MWFRS gable end zone;cantilever left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60. 4)Design load is based on 35.0 psf specified roof snow load. 5)*This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 1-0-0 wide will fit between the bottom chord and any other members. 6)Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 760 Ib uplift at joint 1 and 760 Ib uplift at joint 3. i LOAD CASE(S)Standard Continued on page 2 Job Truss Truss Type Qty Ply MOYNIHAN FINOCCHIO BS 330187A 301 ROOF TRUSS 1 n L Job Reference(optional) Wood Structures,Biddeford,ME 04005,MiTek Industries,Inc. 5.200 s Aug 19 2003 MiTek Industries, Inc. Mon Oct 13 13:22:36 2003 Page 2 LOAD CASE(S)Standard 1)Snow:Lumber Increase=1.15,Plate Increase=1.15 Uniform Loads(plf) Vert:1-2=-60,2-3=-60, 1-3=-673(F=-660) I NORT1y o" Of 2 And over - . No. zoo C, o �` doverMass. ,_4_O � LAK `' 7 1 COC HICHEWICK A. ADRATED PP .(5 S U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT /" � AO , CC Alp .....................�................................... . ............. Foundation l t : has permission to erect................ ..................... buildings on .1 0058................/ .. ...x.........T.... .... r Rough to be occupied as...... ...Q O.M!1 � 1�3 5 &* 61 A BOLI himney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Ins ction, Alteration and Construction of Buildings in the Town of North Andover. ADS`0 /C;L XA/a O A�_ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION N STARTS Rough 111r.......,/1� �� ..................... ......... .. semi BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. RTH Town o 4Andover ® No. 6 a a ~ -_~_ f dover, Mass., &/.a3•4P0051 T O . LAKE COCNICNEWICK !,p ADRATED F'? C, 7SSACHUSE FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ..... .......FJ* e..C.A.h..'o0................................................... has permission to excavate and our foundation at 1 U14. z$0 ^�s pp p . ......... . ......... ...... .... ...... ............. for the purpose of... :! A.OAP4.. . The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. J058 / 0z ,�� VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. BLDG, PERW F •f 74: LESS FDA FE +O - / SEE REVERSE SIDE BUILDING DUE FRAME PERMIT$ BUILDING INSPECTOR S (PURL/C eASSACE (P N N0.7180fMENrJ \s2 FOREST os SEET ; �fNO�RECORO c� D7NI\ `0 ET ` Ap Nlf DAVE C. IR. & CLAIRE M. �`sFT� / K f / ` O C� O DEACON X0137 LOT 3 // 01 5 / y LDS I ) TOTAL AREA: i 0� 00 PLAN ND 88,500± SF. IDIAN FRS q?e 2.03± ACRES MER 84,101#SF. IN N..ANOODER - RIS / 1 t •� O d h�- 4,3001 SF. IN BOXfORO SAO �O J z Q \ kF GB.A.=65,700tSF. ✓ �y PP SOP 4 2 ✓ I , / > x AD UJ 0 Lj Ld O�OT2 � � W � v Sj lip. �i+ �- �.-- //F SCOTT ROTH �-.. __....._._ _._._ � .,.. �-- .,." ,,��-�- _ ._. � U) w • !�5 l f>Q�o r� _ -^. '•4'ks /�/q�i "e�m-- - __� _�-' � '.'-.^"O I I O M � \ , I r '� t � _ H„q ! 7 •.r5�" . _ .�a' ° � � `� �.' k �S'��� '`r ✓ . �5..•• � { � � '�i � ) � L^rS/J1' ``\ c I } i 'moo ti / GE.�p9�*M ' 4 ? ✓ O t/ rj 0 � TOWN POND p- i b. � f t i t } oc, jrj j j ! 1 t ON LDP D p�{OP S O AREAlLf ! \ ° L f t J r Iqa�,.„/f_ra.. E Zyi t ,1 i ] •=T? WOOD fENCE / liy�giF t1, 7if_.--._ __- --- -_._ _.f METAL FENCf NO B0 0R LOT 2 O —'O O O05 Z ' SHEET JOB N F SCOTT ROTH 5 / NO. 7 OF 7 oc, 10413 i �� i - - i r