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HomeMy WebLinkAboutBuilding Permit # 10/26/2016 of NORTH�M BUILDING PERMIT ,6. O TOWN OF NORTH ANDOVER a2 hE'`¢- F APPLICATION FOR PLAN EXAMINATION a a= Bate Received Permit Na#: _ 4$SACFiUS�S Ap Date Issued LlIPORT VT.Applicant must complete all items on this page LEGATION i Pnnt I PROPERTY OWNER Print - ]ODYearSfrucfure yes no 1 MAP PARCEL. ZONING DISTRICTHistoric District no no ' ! Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE I Residential Non-Residential 7 Nevv Building One family 0 Addition 0 Two or more family 0 Industrial 0 Alteration No.of units: -1 Commercial 0 Repair;replacement 0 Assessory Bldg - Others: 0 Demolition v Other Septic G Well Floodplain G Wetlands ; Ei Watershed District D Water/Sewer - DESCRIPTION OF WORK TO BE PERFORMED. -g >. Identification- Please Type or Print Clearly OWNER: Name. €hone: I—7 71 Address: �i Contractor Name: S Phone: a � Email: Address: -S-1 . 3 Supervisors Construction License: C,Z7 1 �-: Exp- Date: j Home Improvement License: Exp. Date: s ARCH ITECTIENGINEER -W A ' Phone: e ' Address: " ey>- FEE SCHEDULE.BULDING PERMIT,512.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S.F. Total Project Cost:$ FEE:$ Check No.: b Receipt No.: NOTE: persaizs contracting with unregis,te-7d contractors do not have access to theoualay and Signature_of AgentlOwne- `` Si nature of contractor r' r!Ti - Plans Submitted❑ Plans Waived❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanaing/Massage/Body Art ❑ Swimming Pools D 3 Well ❑ Tobacco Sales ❑ Food PackaginWSales G Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM /PLANNING&DEVELOPMENT Reviewed On /011(11P Signature_ tr5?fc+ur COMMENTS t ( wbar (tf"' M' z 9\�". G d� TV vert At 8'5(, PnvtPttG4nc� CONSERVATION Reviewed on ?'(1)(o Signaturelip COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer:Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes ne Located at 124 MainStreetis Fire Department ignatureldate COMMENTS 0 R T Town of aver No. .. ter+ m h ver, Mass, IAIP Z" BOARD OF HEALTH PERMIT T I L Food/Kitchen Septic System THIS CERTIFIES THAT... � BUILDING INSPECTOR C � Foundation has permission to erect...................... buildings on..... {� r,r � Rough to be occupied as. �v "'.... I�^'7'Y—� I�— ............................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IMONTHS ELECTRICAL INSPECTOR UNLESS CONST ST Rough ervice .... .. .. ... Final .... ....... ..... BUILDING INSPE OR GAS INSPECTOR l �.c awc Per ndt Rei uir ed tq ( cwu. , 1�uildir�x 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. Smoke Det. `T I TI DATE: LOCATION: /a ccts�/zccs OWNERS NAME: "clitfrr cc�a/c — GENERATOR kw fa-o NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS* CONTRACTOR: PHONE NUMBER:_ s=f--31Z2 ELECTRICAL GAS RESIDENTIAL COMMERCIAL TEMPORARY LOCATION OF GENERATOR: *ZONING DISTRICT: *PLANNING APPROVAL(IF IN WATERSHED) *CONSERVATION APPROVAL November 25,2016 Seth Roberts Real Property Management 752 Charles Street Providence,RI 02904 RE:10 Pequot Street,Apt: 1,Providence RI. Kyle Corkery's, November,2016 Rent To Real Property Management, Enclosed,please find Kyle Corkery's rent check in the amount of$475.00. Check#216,for November,2016's rent at 10 Pequot Street,Apt: 1,Providence RI. Best Regards, Michele Grant 978-490-6680 93-7159/2113 216 M.E.GRANT 62WILDCRESTAVE BILLERICA,MA 01621-6102G`�.. ,ysj�� 1 t rdec o d�3u�i��� ANMV, 97 rr EV t f,! F 1:21134i586i: 039854i8RII` �21& FNcrt;,.Andover MIMAP September 28,2016 072.0-00.14 - = 052.0-0065. - 27 CHARLES ST - --2.7+CHARLES ST - 072 0 OQiS�_ �- - 052.0-0069 27 CHARLES 8727 GHYARLES ST _ 27 CHARLES 5T- '� D7 CHARLES ST.- � -- 27 CHARDES�ST.�� _ �L 039 0 0020. ELLSS ST E!!IS'ST - 039.0-002.3 =-- 15 C^HARLES ST _- r�s� ` � 039.0-0001 - � �`P� -- 039=0-0018 250 SUTTON ST F 039.0-0024, 039.0=•0016 - _ 238 SUTTON ST' _ SSU7�TON ST `- � � 253-SUTsT,0 N5T -_ 249 SUTTON 6T. 040.0-0002 .039 O 0010.` m:'A 8�atepane Cx:ena�e System,Gatvm naU3l, e. Of uORTH AH ( 1 ? r 00 verss� 3 a_ E C RT RUC "Rya n_SG__'.i_��+. a�,SSACHU$ER .Nis,nrcun.A.ioN Sub-Base Fuel, Tanks Power Systems Inc. Blue Star Pourer Systems,Inc.sub-base fuel tanks are listed and manufactured under UL 142&ULC-S601 standards for steel above ground tanks,which guarantees that every fuel tank meets the structural and mechanical integrity requirements for mounting a generator set directly on top of the tank. This provides a convenient,efficient,and safe way to store fuel for your gen-set. Sub-Base Fuel Tank Standard Features .Double walled secondary containment UL 142&ULC-S601 Listed >Electrical stub-up openings are standard to provide generator set wiring provisions through the base tank >Heavy gauge steel construction >Durable two part catalyzed epoxy finish paint '.. .Standard fittings:fuel supply with check valve(sized per unit),fuel return(sized per unit),2"NPT for normal vent,2"-6"NPT for emergency vent(sized per unit),2"NPT for manual fill,1 1/2" NPT for fuel level gauge,and 3/8"NPT basin drain(plugged).Removable 1/2"supply dip tube standard(size may vary with gen-set model).1 1t2"NPT for leak detection >Interior tank baffle:Separates cold engine supply fuel from hot returning fuel >Direct reading fuel level gauge >Low fuel level and fuel leak alarms '.. Design Options '.. >High and critical low fuel level shutdowns or alarms .Full pumping control systems for a true day tank system with a full array of electrical options >Additional Tank Fittings .Custom Fuel Tank Designs(sizes and shapes) '.. >Fuel Heater .Fill t Spill Containment '.. Blue Star Power Systems,Inc.offers two distinctive types of double wall sub-base fuel tanks,those with an electrical stub up area(standard) and those without.Each type can be customized to any specification to meet your specific requirements. c.c:raicarsrue ua naEn I l an riE � I UL 142&ULC-S601 double wall secondary containment sub-base fuel tank with stub-up. I I IINK_1111—T 1 Blue Star Power Systems,Inc. 1 52146 Ember Road.Lake Crystal,Minnesota 56055 1 Phone+1 507 726 2508 1 bluestarps.cem Flick Skiffin ton From: John Van Deusen[John@scherbon.com] Sent: Tuesday,October 18,2016 11:23 AM To: Rick Skiffington Subject: more tank info Per UL142.Rupture Basin must have a minimum of 110%capacity of the primary tank. Sohn Van Deusen Scherbon Consolidated Inc. 40 Haverhill Road Amesbury,MA 01913 978-423-9021 cell 978-388-3132 office www.scherbon.com joi�41m; -9Z1 Seh€roan Cpn5111daf�d Int. Generator Power Systems-Pump Stations i DaawlNc 3 0413 2 00 X.50 NPI F L k RN \ 2,J0 X.50 NPI .,,E,.SU-'PLY ,s .....r= �•�,,. ,,,. 1,50'JR h-_L GP \ f oon n ,u �-2 G�NR NORMAL VENT ..So.Gln 4$HR TANK II m EN TG NP-E-V ) / .... 7 VD3SO,VD400(01) ru.��.m�w n ...... i LVO/LV1/LV2/LV3 1 .. \ 7rn o I I 1,765) iJz.T xa �I r—= CD NF1 E V',T % 17 0oj,''� �0 a6, so NRT v L-EAK sw so 6q �� �.. �I 1 ��� t h 5 i �35GOD ,.,.._._..l (14x 3Q-TOM) 5 'N 40 DE fAlI .113 G.00G -.____-- JES dfi fEv v"ou 3 .7 RN l 4,0000 8000— 1 PJI<— % _. =f V� V riGL'[:5 /-NGl DTA' TJO � NUF (6X)yy.M1, ( Pr_M 1 b0 I ROD 34 h C 3 1..✓ 1 17.C'10 _ .. I DFGO'J ...__. . , J--25 ODO DOD 9G.Goc, __ . .. 3 f ➢U ..1 oesREVISION$- tipTF.3,. r Al 10GA Power Systems Inc. R AR" 0''v AIVAENI ANK, (-- 3•AINT"L.Oss BLACA TANS{SB 142D GL DW llL W/STUB-UP�I c BRF K f IU D ....,....1 I� I .r / u RAr Ij 2-17-15 - , / /INS BRACKETS T J ATE TSD I142"LS.6K60H X 36 H NE',— 3200 3 J C it�f'-r7 esel Rrocduct rine BLUE ST*R 400 Me t 360 Me Power Systems Inc. DGC-2020 Control Panel Standard Features swWrastoexnwim r-aa,m Slle,'we a-mwtt«: Digital Metering eco sorxso-11 �,ra,am;aamr i . l eot..,aum�t,a;wto� ,t I�r-+pan Te��Pus�oauar� .Engine Parameters B//r I V IE ✓ SNT 7I R .Generator Protection Functions i .Engine Protection I .CAN Bus ECU Communications 1 .Windows-Based Software _a .Multilingual Capability !r .Remote Communications to RDP-110 Remote Annunciator ^ L—• air .16 Programmable Contact Inputs .Up to 15 Contact Outputs(7 standard) O O o D .UL Recognized,CSA Certified,CE Approved o' t .Event Recording po r System inc. . IF 54 Front Panel Rating with Integrated Gasket Edit Pu,N,Cttlbn Aats PushDutteo aM Maas�n�icatar .NFPA 110 Le—I1 Compatible A„°w a„�mmiw,: o"P":',omt°"'eo^'°oe;" Rxset P,rsh�uticn Pun Pusneulten antl M.otle Intl;catar Weights 1 Dimensions l Sound Data L x W x H Weight lbs i��, L, OPU 120 x 66 x 83 in 7,875 Level t 156 x 66 x 94 in 9,125 Level 2 156x 66 x 94 in 9,200 Level 3 204 x 66 x 94 in.. PIcase allow 6-12 inchas ter h ght of exhaust stack _zs,;z�� -�i5 m -w No Load Full Load l 88 dBA 91 dBA .� O ORE! la'I Level 1 84 dBA 86 dBA __t• 'ii ' l Level 2 79 dBA 81 dBA I Level 70 dBA 32iB.S am ss,� I Drawings based on standard open power 480 volt standby generator Lengths may vary with other voltages.Subject to change without notice. Sound data as measured at 23 feet Q meters)in accordance with ISO 8528-10 at standby rating. 3 of,4 VD400-01 ..ter rbl `JJL tJLaVj vv.-»-.... •�-•-• r ...y.. � 99 Y11: 9 58B63G5578 SWTHWORTH POWER SYS PAGE 11 ? ltif�n x1 c irrE G 6a ✓ zf� $$ GeneratorAr D. ta ENGINE SPECIFICATtOt{ 60 He 50 Ht COOLING SYSTEM 60 Hz 50 Ha L Manufacturer: Perkins Engine Co. Radlator Syatam Capeelty Model: T4.236 incl.[ngine vs ae+ru 51009.11) 5.0(19.1) Type: 4 Cycle water PUMP Type: Centdtugat Aspiration: 4 Tuftcharged Mal Coolant Static Head:c ,o 1-,19.7(3.0) 6.7(2.0) Cylinder configuration: 4 i Lina Min Temperature to D(splocarnent:w.m.:e) § 236(3.9) Engine:Ffci 171(77) 171(77) SorsiStroka:m 1Mm: 1 3.87(g8.4)J 5-00(127.0) Temperature Rise Ac1994 C-P-Ioa Retia: ' 16.0:1 Ea91ne:v r'C) 9.0(5'0) 910(6.0) Q.-nor:Type Mechanicar Heat Rejected to Coolant Class Clads At at Rated Power:a�w+ t+ w) Air Cleanor Type: z Dry.Replaceable Paper Dement, Standby 2845(46.5) 2247(39.5) 3 Type with Restriction Indicator Prime:2400(42.2) 1991(3610) Engine Spesd:.pm 1 1800 1500 Total Host Radiated to Room Max Power at Rated rpm:vw) at Rated POwer:mw:a nue Stand y:98.4(73.4) 81.4(60.7) Standby:1428(25.1) 1246(21.9) Pri .69.8(67.0) 74.3(55.4) Prime:1308(23-0) 1115(1g.6) SMEP:e:•ar.• I Radiator Fan Load: Stanly: 184(1266) 182(1256) Prime: 168(1157) 1660146) Piston Speed:tor« 25.0(7.62) 20.8(6.35) Regenerative Potran w 11.7 10.9 doter Sell Capability!'i, 43S 38.4 x LUBRICATING SYSTEM 60 Hz So His AIR REQUIREMENTS 6o Hz 60 Hz Type ) Fut)Pressure Combustion Aft Flow:r,-;-) Total Oil Capacity:us o"(u 2.1(8.1) Standby-17'0(4.8) 142(4-0) O))Pan:u°6d 21 11.9(7.1) Prima: 165(4.7) 137(3.9) Oil Filter: Sp(n•On.Full Flow Mas.Alt Cleaner Off Cooter: Water Cooled Raat6irtim!-K0 HPgl 32(8.01 32(8.0) Oil Type Required: AN C415wa0 Radiator Cooling Alt:-W-1 6956(787) 5832(168) _ Alternator Cooling AD:u+n tm-1 572(16.2) 477(13.5) i FUEL SYSTEM 1 -OMI s0 Ha EXHAUST SYSTEM 60 Hit, 60 We ;Fuel Filter Type: $, Replaceable Element Max,Allowabta Seek Recommended Fera: -2 01esel Pr.xsur•:.+xe nor, 3.0 7102} 3.000-2) 333333 Exhaust Flow at Rated m Oanetor Set fuel Coneu.419n:us""I"(L" kW:ren v+ c+) Standby.450(13.0) 396(11.2) 100%Lead 1065,Lead T5,14 Land 5051 Load Prime:427112.1) 384110.3} Standby P IMe Stsodby Standby Exhaust Tamp at Rated kw t 60 He 5.54(20.96) 5.05 1 9.11) 4.23(16.031 3.06(111.66) OrY Exhaush� VG: $0 Ht 4.59(18.50) 4.42(A 6,711 3.61(13.66) 2.53(9.57) Standby:1040(560) 1686(688) _) Prime:977 OW 1013(545) r ENGINE 61,ECTR/CA L 5Y#TEM eo Hz so Ht GENERATOR SET NO)SQ RATING(WITHOUT iNLETOR - OUTLET MUFFLER)AT 0 PEETa(IHMETER) Yoita9atGreund: ; 121 NegoWe c'------^- - am"Charging Alternator Standby: AMWO Rating- 55 Prime: 49 dam+ 92 tlBA t e6A levee aro(or9uWan<e mq { 060P1 1 GENERATOR APPLICATION DATE: LOCATION: OWNERS NAME: - GENERATOR kw i;w NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS* CONTRACTOR: PHONE NUMBER: 78'- &e- -3«-Z ELECTRICAL GAS RESIDENTIAL COMMERCIAL TEMPORARY LOCATION OF GENERATOR: *ZONING DISTRICT: *PLANNING APPROVAL(IF IN WATERSHED) *CONSERVATION APPROVAL 2'he Commonwealth of Massachusetts Department ofTndustrtalAccidents 1 Congress,Street,smite 100 3 Boston,SIA 02_114-2017 www.massgov/dia atioubasurance Affidavit:BuilderalContractorstElectricians/Plumbers. Workera'CompensTO BE FILED WCfHTHE YER1427TfT\G AUTEIORITY. .,please Print Le g A 'lieantlnformatian Name(Sus Hess Otgau za on Ind vidu�l): " Address' _ - r s Phone#- !Y/ s X77 - r2.0 State/Zip: Jt�ORS" Typc of project(xequrred) au"" n employer?Check iha appropriate hox: 7 �N�,:'coristriiction empIoyeas(fill andlo[part-time} am a employer with � $,�Remodeling sen asole propriaoror parmersbipandhvenoemployeesti'arking forma in 9 DemolitlOIAny capacity.[No rwrkerscomp. required.] addittOn oworkers'comp.insumnceregnired.l t 10❑Buildingama homeower doing all woricmysel£[N Iwill airs or additions contractrstoeonductall wok-ary property. 11❑Electrical Sop,am ahaneown,r andwill be hiring airs ar additions ensurethat aIl contractors dth.th 4avvorkers'compansatian insurance or are sole ]�_Ll ptuMbing rep p/ioprietors with no empioYees. 13.E]Ro6f repairs $I�Yr�a general contrzctorand 1hsY-hiredtha suGconhactors]isEemdo[iha attt'°ched sheet. ld j�Ofher - L:J-ZYtuse sub-confrac[ors have a?uPloyees sndhawworkers'camp. O ion erMGL0. Ly,F� GG 6.Q vie are�co oa o do�poyets.[No wukers camp�mtsuo"' reginred} . 152,§1(4), eusatlonpoJicyinfo't tiou. `Any applicant tlratchec&sbox#1 igustalso Sitoutthssectionbelowsbovringtheirworku-ts imp 1'homeowners whosh,mi,tins'ffgp:vitindic6ngthoyaredoing P11vmrkmdthmhiI outside contractors must submitanew affidavit indicating such #{iantractors that check.lu,§boxmnst utwbedh.,addtionn tvide theirtw rkers'comgspolicy number. dststpwhether o}'potflrese eutifies,have employees,Ifthe sub-contractors have employees, Y pro _ Tam an en:pZayer flxat is pravidingworkers'compensafion insurance for ray employees. §elow is the pahcy arad jab site information. Insurance Company Name: Expiration Aate: Policy#or Self-ing.Lie.#: City/Statc/Zip: Job Site Address: decIaratiou page(showing the policy number.and-Wration date). Attach a copyoftkeworlcers'co rapensationpolicy Failure to secure coverage as requ r'ed under MGL 0-152,§25A is a criminal violet on punishable by a fine up to$1,500.00 well as civil be forwarded to the Office of luvestigadem;of the DIA for insurance and/or one-year imprisonment' of this statement may penalties m the form of a STOP WORK ORDER and a fate of up to$250.00 a day against the violator.A copy coverage ver]Hcaflon. T do hereby cert under the pains gnd aloes ofperyury that the information prarided above is fru and corl'ect• f% Date: "> signafore: Phone#: - �� feted by city or toxon afticxal. Official use only. Do not wl'ite in this area,to be comp permit/License City or Town: . Issuing Authority(circle one): ector 5.Plumbing Inspector1.Board of Health 2.Building Department 3.Cityfl own Clerk 4.Electrical Inspector 6.Other phone#: Contact Person: ��--1 ROADEXC-01 YFANARAS ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE 4/1512016 Y, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATtON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER I IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ONC PRODUCER CNAME:TAT Yvette Fanaras Davis&Towle Morrill&Everett,Inc. PHG NN E 1.(603)715-9741c No:(603}225-7935 115 Airport Road aa Concord,NH 03301 AE,DMDRESS:YfanaraS davistowle.com INSURER S)AFFORDING COVERAGE NAICN INSURER A:Liberty Mutual Insurance Company 23043 INSURED INSURER 9: Roadway Excavators,Me, INSURER C Property Maintenance and Construction PO Box 227 INSURER D: Derry,NH 03038 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCESURRf PODCYEFF POLICY EXP LIMITS LTR INSD Me POLICY NUMBER MM10U/YYYY MM/DO/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,U00 T X❑ CBP8846000 03/07/2016 0310712017 E ED 100,000 CLAIMS BE OCCUR PREMISES M—Er ence $ MED EXP HA yore Person) $ 5,000 PERSONAL&ACV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY O jECT N LOU PRODUCTS-COMPfOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY EO01aB�INNEDISINGLE LIMIT g 1,000,000 IA ANY AUTO BABB48900 03107/2016 03107/2017 BODILY INJURY{Per Porson) $ ALL OWNED X SCHEDULED I BODILY INJURY(Peraccident) $ X AUTOS X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS $ ){ UMBRELLA UAB X I OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS UAB CLAIMS-MADE CU8840301 0310712016,0310712017 AGGREGATE $ 3,000,000 j DED JXJ RETENTIONS. 101000 $ WORKERS COMPENSATION STATUTE �RH j AND EMPLOYERS'LIABILITY ANY PROPRIETORPARTNERIEXECUTiVE YIN E L EACH ACCIDENT $ OFFICER(MEMBER EXCLUDED'/ �N/A (Mandatory in NH) E.l.DISEASE-EA EMPLOYE S If yes,desrsibe under DESCRIPTION OF OPERATIONS E-1 E.L.DISEASE-POLICY L4MIT $ DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Various Work CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Charm Services THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 Riverside Drive Andover,MA 01810 AUTHORIZED REPRESENTATIVE 901988.2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD DATE CERTIFICATE OF LIABILITY INSURANCE 09/28/@D/YY. �® ACQRL3 o9la8/eels THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS :. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poiicy(tes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 1-627-723-7775 CONTACT Seamus zing PRODUGER �--EN�El : Hays Companies of New England FAX 133 Federal Street IESS: sking(Ohay.ccmpaniea.com 2nd Floor INSURERS AFFORDING COVERAGE NAIC ftBoston, NA 02110 36684 INSURER A:RIVERPORT INS CO INSURED INSURER e Roadway Excavators Inc. INSURER C: C/o Surge Resources, Inc. INSURERD: -_ 920 Candia Road INSURER E: Manchester, NH 03109 INSURER F: COVERAGES CERTIFICATE NUMBER: 48101809 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MSR ADDL.U RR POLICY EFF POLICY EXP LIMITS LTR' TYPE OF INSURANCE D POLICY NUMBER WEDUNYWI IMMIDDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ WkWUET—ORENTED en COMMERCIAL GENERAL UABILITV j PREMISES Ea oct ce .$ CLAIMS-kW DE❑OCCUR i s ( R1ED E%P A,3Y one persona $ PERSONAL&ADV INJURY $ i I GENERAL AGGREGATE I$ GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS-COMP/OP AGG $ POLICY PRO- LOG ' I$ MY DINED SINGLE LIMIT AUTOMOBILE LIABILITY Ilia aci denP ANY AUTO BODILY INJURY tP P—) $ ALL OWNEDSGHEO:ILED BODILY INJURY(P did I) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED +Pa-acddent $ HIRED AUTOS ^{AUTOS ($ UMBRELLA UAB OCCUR I ( I EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MAGE I I AGGREGATE ,$ CEC RETENTION$ 10/01/17; X`WC STAN- OTI+- $ A WORKERS GOMPEN$ATIDN I C-28-63-003934-05 (Nfi) � 10(01(1 O ITS E AND EMPLOYERS'LIABILITY YIN I 1,000,000 ANY IYr PRIETORIPARTNERlEXECUTIVE E L£ADH ACCIDENT $ OFFICERIMEMHEREXCLUOE D? �NIAI ( ! :£.L.DISEASE-EA EMPLOYE $1.000,000 (M}andatory in NH) 1,000,000 DESCRIPTION OF OPERATIONS be- ' E.L.DISEASE-POLICY LIMIT $ i DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES(Attach AGORD 101,Additional Remarks achedela,If mora space Is Ileired) This policy covers those employees leased by Roadway Excavators int, through Surge Resources, Inc. Manchester, NH 03109 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Charm Sciences THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANGE WITH THE POLICY PROVISIONS. 1 Riverside Drive AUTHORIZED REPRESENTATIVE riL� Andover , MA 01810 J' — USA ©1988.2616 ACORD CORPORATION.All rights rase:ved. ACORD 25(2610165) The ACORD name and logo are registered marks of ACORD .1—hv ��'�� DATE thSMNDtYYYY1 0,/122016 CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR '.. PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the policy(es)must he endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such entlorsement s. Pa.DUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY NAME; CI LENT CQNTACT C€NTER_� HOME OFFICE:P.Q.BOX 328 LA1GNNo,E.P,888-333-4949-__ _�,in c NRL 507-446-4664_.__ OWATONNA,MN 55060 nooeesS:CL,ENTCOt TACTCENTER-FEDINS-COM _ INSURER_I51 AFFORDING COVERAGE NAIC N INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 366-447-5 INSURERS: DRUID ELECTRICAL CONTRACTING LLC INSURER c: 87 BELMONT ST tnsuRER D: NORTH ANDOVER,MA 01845-1520 INSURER E. INSURER F: COVERAGES CERTIFICATE NUMBER:38 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ITR TYPE OF INSURANCE iNSRRL SCAR POLICY NUMBER MMtaCO'vvYY MMIoOO,YYYI LIMIT$ GENERAL LIABILITY EACH OCCURRENCE $1,000'000 .IMAGE TO RENTED $"'0'COMMERCIAL GENERAL LIABILITY P EMISES(fa_acpL.�La}__ CLAIMS-MADE [—X]OCCUR ED E P Iz'on p nI A X BUSINESS OWNER-S UABluTY N N 9353692 0310112016 0310112017 PER-RAL S ADV II—I Y $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPtOP AGG $2,000,000 X POLICY ,ECT ! (LOC AUTOMOBILE 11-11TY i COMBINED SINGLE LIMIT $1,008,400 X iaNY AUTO f_twaa' GA —'YINJURY IPer person! ALL OWNED ISCNEDULED �---'— A `AUTOS AUTOS N N 9353691 03/01/2016 03(01/2017 BODILY INJURY(1-16-0 DAUTOS NON-OWNED� -'—' "— AUTOS RO E TY DAMAGE X i UMBRELLA LIA9 I X i OCCUR EACH OCCURREtiCE $2,000,OQ0 A jExue71'OUXIM.-AGE 9353693 037012016 03101!2011 AOOREGAT $2,000,000 €DED! RETENTION WORKERS COMPENSATION X I WO STATU-I i OTH- ANDEMPLOYERS`LIABILITY _ TORY LYMITS j ER T YIN ANY PROPRIETOR(PRRTNERtEXECVTiVE EL.EACN ACCIDENT $500,000 El A OFnCENIMEMBER EXCLUGEP NtA N 9353694 03141/2016 0310112017 (lrtantlninry in Nm E .DISEASE-EA EMPLOYEE $5001608 DESCRIPTION OF OPERATIONS below IL DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES IF——RD 101,Aftfi.al R—OO 5—11,it more space Is regW—) CERTIFICATE HOLDER CANCELLATION 366-407-5 380 CHARM SCIENCES INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 659 ANDOVER ST THE EXPIRATIONDATE THEREOF, NOTICE WILL BE DELIVERED IN LAWRENCE,MA 01843-1032 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHGRIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License:CS-077145 Construction Supervisor RICHARD SKIFFINGTON 35 PLEASANT STREET ' NORTH READING MA 8180 , CA_ Expiration: Commissioner 05188/2818 8 7 I b I 5 4 3 2 1 ' REVISIONS REV. DESCRIPTION CHC DATE CH APPRO. 2 PDA7 -ADDED ERR.-FTHE AREA IO/21,2016;HD RS ------------------ ! ' ti S 4r !•- - - - - - _—_—___—_ _ _ _ Relocate electrical box 36 inches FrainD I 3 10124(2016D RS end of sound enclosureMAIN SERVICE 4 Conrebarre e po a 1xs X 16 Ic Ot2a12O1bo RS o 1600 AMP ( LPROPOSEDI ( EXISTING FENCE AND AIS 1600 EXISTING HVAC SAFETY BOLLARD POSTS I ( • 15 CHARLES ST. EQUIPMENT BUILDING -- - -�-- ---- I INSTALL:SHORT 314 GROUND�� _ 4 �i ROD -_ f r t, c 3 3/4"PIPES I (4)4"PIPES 1 20in -- PROPOSED AREA 56iti PROPOSED 400 KW GENERATOR 14 INSIDE BUILDING 3101 - - WITH DOUBLE WALL FOR ELEC.PIPE FUEL TANK 1400 GAL. ��"� ��` (KEEP 4"PIPES AGAINST THE BUILDING WALL IF ! 1 POSSIBLE) = `% 30in - - - 8 8 I � I I CONCRETE PAD 24FT X 9FT "' X 16IN THICK W/REBAR Q,CP,lj JAI-i:(Y O _'st_/L ARD 11 Dtil I( 4-1 y — 60;,t'T O s yt{'T m -,ai UNLESS OTHERWISE SPECIFIED THIRD ANGLE / ATJ /� -I TOLERANCES S ARE IN iNCNES j-�+j-} 1` I�f■ O TOLERANI;ES ARE: PROJECTION \j/ l i al♦.L 619 AND0YER STREET LAWRENCE,92 Ot FAX:FRACTIONS TEMS78487-9200 FAX:978.685-7929 O .XXX =±,005 NGL DRAFTINGSTANDARD:ANSI-YIE-SM SCIENCES, INC. .XX =±.010 ANGLES .X =1.015 t 0.5• ThEu�E"ris TITLE A �n�Nr�,TtTsN�Trfl99as��a��a s MATERIAL �Av �'rua9' �N9'ora: NLh�N N.ANDOVER GENERATOR BASE PROPOSED APPROVALS DATE - - FINISH SIZE CHARM DOCUMENT NO. CHARM PART NO. REV. I - DRAWN HD 10(12/15 B NA GENERATOR BASE PRO OSED - 4 I SHEET DO:`�OT SCALE DRAWING ENGINEER RS SCALE: 4:48 t OF 1 8 7 6 5 4 3 2 1