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HomeMy WebLinkAboutMiscellaneous - 14 ROYAL CREST DRIVE 4/30/2018 i � �� �. c� s ---r-�- 14 ROYAL CREST DRIVE#4 Complaint Detail RepoYt Printed On:Mon Jan 27,2014 Complaintt# CT-2013 000053 ;Status ' tCl : osed , ,i GIS#i Violator: .r - - _. � rcrar Address: 14 ROYAL CRESTDRIVE#4 Map Address: 'h 5 • r Date Recvd. Juri,18 2013 Time Recvd .7 _O1 50 PIv1 Block • Category5 Pest Controls s Lot Type: . GeoTMS Module Board of Health F District: Trade: ° a ,�^ Recorded By i L>sa Blackburn M o Z mng: Structure: � Com lalnt: Complaint received by email from Laura Stevens apf #4 complammgof indents m the`,walls of hevapartment:.She was told by a neighbor that the problem was p addressed liowevei she'is still having problems She was woken up lastmight/early this mo niug by hereat'chasing a squirrel around'herapartment.She called the on- caivr aintenancexstaff and'got�no answer-8he would`hke the;Healtli'Dept to,look;into`this pompl`aint CalledX' e closed Comments:. Michele Granth ^ InspectorAssigned to.Complaiht . .: r Contacts Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Tenant Jun-18-2013 1:50 PM Laura Stevens (978)328-3611 Q Lisa Blackburn Forwarded to Health Inspector Actions Taken GeoTMS Module Status Date Time Response Type Action Taken Comments Board of Health REFERRAL GeoTMS®2014 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 t Grant, Michele a .r" From: Nicholas, Bryan (042401-Royal Crest Estates (North Andover)) [Bryan.Nicholas@aimco.com] Sent: Sunday, January 26, 2014 5:07 PM To: Grant, Michele Subject: Royal Crest Estates- Building 14 Squirrel Complaint Good Afternoon Michele, wanted to send you an email regarding a complaint from a resident related to hearing a squirrel in the wall on the 1st floor of building 14 on Saturday. I received an email regarding the issue from Laura Stevens on Saturday afternoon at 2:51 pm; I did not see the email until today because I only worked yesterday until about 1:00 pm. The residents email indicated that she intended on contacting the Health Department tomorrow morning to complain about the issue therefore I wanted to notify you of what Royal Crest is doing to resolve the issue. Laura has reported this complaint to us before on December 1st. On Monday, December 2nd we had our pest control company Watch All inspect the building for activity; and they located no entry points for squirrels. On Tuesday; December 3rd Tony Russo and one of our Service Technicians met with Laura in her apartment. Maintenance snaked her dryer vent and found no sign of squirrels or rodents. We secured all exterior vent covers to the building. I reached out to the Service Manager Tony today about the issue resurfacing. Watch All will be on site in the morning tomorrow, we will be accessing the attic of the building to set squirrel cage traps incase the squirrels are entering the building through the 3rd floor. During the setting of the traps we will inspect the attic for any access points. You are welcome to contact me if you would like to come down on Monday to be present during our inspection of the attic. area as well as the exterior of building 14. Please let me know if you need any additional details. You are welcome Yours Respectfully, Bryan Nicholas Aimco City Manager T: 978.682.7200 www.RoyaiCrestNorthAndover.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 1 ' 14 ROYAL CREST DRIVE#4 Complaint Detail Repopt Printed On:Wed Sep 25,2013 Complaint#: CT-2013-000053 Status: Closed GIS#: Violator: , r Address: 14 ROYAL CREST DRIVE#4 Map: Address Date Recvd.: Jun-18-2013 Time Recvd.: . 01:50 M Block: Category: . " Pest Control Lot: Type: GeOTMS'Module: Board-of Health District: Trade: Recorded.By: Lisa.Bfackburn Zoning: Structure: Description, Complaint: Complaint received by email:from Laura Stevens,apt.#4;complaining of rodents in the walls of her apartment.She was told bya.neighbor that the problem was addressed:however she is still having problems.She was woken up last night/early this motning by her cat chasing a squirrel around her apartment.She called the on- call maintenance staff and got no answer.She would like the-Health Dept to look into this complaint.Called.Case closed. Comments:' InspectorAssigned10 Complaint: Michele Grant . ` Contacts Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Tenant Jun-18-2013 1:50 PM Laura Stevens (978)328-3611() Lisa Blackburn Forwarded to Health Inspector Actions Taken GeoTMS Module Status Date Time Response Type Action Taken Comments Board of Health REFERRAL GeoTMS®2013 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 606 FOSTER STREET 104.B-0052 Complaint Detail Report Printed On: Wer!Sep 25,2013 Complaint#:= CT2013-000041 Status:, Closed �' ,; GIS#: , 5868 Violator: vrcesn, Address: 606 FOSTER STREET Map: 104.B Address: • Date Recvd : Apr-22-2013 Time Recvd :x 02:17 PM Block: 0052 , Category: Odors Lot: Type: fi GeoTMS Module: Board of Health District: Trade: Recorded By: LisaBlackburn Zoning: Structure: Description Complaint: Homeowner of 606 FostenStreet,Joseph Pas,"508.561'.8974 thinks there is septic coming from 22.4 Hay Meadow(property,directly behind his to the right).Ile is seeing.liquidand paper:States that it stinks and he sees it daily"coming out of the ground".He states that it has been going on for years.Even before the beavers' (note that 554 is his aunt's house).He does not believe that it is the swamp. . Sue Sawyer and Michele Grant went out.The water,is not septic.Not health hazard.Case closed. Comments:' _ . _ Inspector Assigned to Complaint: Susan Sawyer Contacts Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Caller Apr-22-2013 2:17 PM Joseph Pas (508)561-8974() Lisa Blackburn Follow-Up by Health Director Actions Taken GeoTMS Module Status Date Time Response Type Action Taken Comments Board of Health REFERRAL Jun-06-2013 11:55 AM Follow-Up by Health 6/5/13(conservation took Director pictures of area)Michele Grant and Susan Sawyer went to site and met with Joe.Saw the same as conservation.Source of water is inconclusive.Saw flexible pipe with water trickling but no odors. Possible point source problem.Origin of pipe not know yet.Joe will call when it get's bad again.Case remains open. GeoTMS®2013 Des Lauriers Municipal Solutions, Inc. Page 1 of 2 1 606 FOSTER STREET 104.E-0052 Complaint Detail Report Printed On: Wed Sep 25,2013 Apr-22-201.3 2:30 PM Follow-Up by Health Susan Sawyer talked to Director caller.She told him that she would pull the septic files and then come to take a look.Caller would like to be home when inspection is taken place.Please call him (he is usually around).Susan Sawyer will request conservation to go out with the health department if possible. GeoTMS®2013 Des Lauriers Municipal Solutions, Inc. Page 2 of 2 s"r 14 ROYAL CREST DRIVE Complaint Detail Report Printed On:Mon Jan 27,2014 Complaint# CT4204--060.6;6 Stafus:;,r.h Closed., ; .`. . GIS#: .;; Violator: Royal Crest.Esfates. Aad er ss 14`ROYAL CREST4)RIVE Map Address 50 Royal_Crest Drive Date;Recvd w ` Jan=27 2014 Time.Recvd 4r. 08 08 AlVI Block NORTH"ANDOVER,MA 018 Category: w> Housing Issues'kats~' Lot Type: Commercial GeoTMS.Module Board of Healths Dt'strfctr Trade food Recorded By Lisa131ackbtirn ;: , ' {Zoning: Structure. to De"scr�ption ;. Complaint,r Email received'fr0 a6ia Stevens regarding rodents iri'the wall;fofover a yearEa id'still nothing has been done to fix the issue:'T Comments InspeetorsAssigned to�Complaifit. Michele Grant' " n � - Contacts Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Tenant Jan-27-2014 8:08 AM Laura Stevens Lisa Blackburn Follow-Up by Michele Grant Actions Taken GeoTMS Module- Status Date Time Response Type Action Taken.. Comments Board of Health REFERRAL Jan-27-2014 3:31 PM Follow-Up by Michele spoke with Laura . Michele Grant Stevens.Royal Crest informed Michele that they have an appointment set up with Watch All to take care.. of the rodent issue.Laura will call the Health Department back if the issue isn't resolved.Case closed for now. GeoTMS®2014 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 Grant, Michele From: Blackburn, Lisa on behalf of Department, Health Sent: Monday, January 27, 20148:08 AM To: Grant, Michele Subject: FW: Problem at Royal Crest Estates This was in the Health Dept. email. From: Laura Stevens [mailto:laurajs123@1mail.com] Sent: Saturday, January 25, 2014 2:35 PM To: Department, Health Subject: Problem at Royal Crest Estates Hello, I have been in contact with the health department once before, and I'm not sure what came of it, but I live at Royal Crest and there have been rodents in my walls for over a year. They said they fixed the problem,but we heard them again last night; so I think I need to involve the health department at this time. You can always email me back or call me at 9783283611. Thanks, Laura Stevens Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and o ials are public records.For more information please refer to:http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. p :; 1 Date... .............. TOWN OF NORTH ANDOVER 10k PERMIT FOR WIRING C*H4U This certifies thalt .�.�". :. Ujr.A6........... ........... has permission to per-. 0CA�tA PA-Lofs form oA,4�...6N-3,,_ .i;4 I/Sk............................... wiring in the building of..A..VY.)<._©.....co.......................................................... vL ............................... ,-,N,orth Andover,Mass. e No. J_Z_5...........Lic. _Te ....... ELECTRICAL"&S�PECTOR Check# 2> "S1 Commonwealth of Massachusetts Official Use Only z Department of Fire Services Permit No. y Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. l/07j (leaveblank 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 INMK OR TYPE ALL INFORMATIOA9 Date: Augw - ;(6 . I L4 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) '50 Q O U 0-1 Owner or Tenant 4 M t C O 146 rLj- A N DO-L tV- �'. Telephone No. Owner's Address bu i I&I r1 (q Is this permit in conjunction with a building permit? Yes ❑ No (CheckAppropriate Box) Purpose of Building Utility Authorization No. - Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: C, ec-K PJaS@bCe-,rCt enle-drt_i G ).lea:_+ t Line vol Irk� e- 4,1n{rr,4oSbJS c-n& Cir(-o LJ, bcce,-kerS Geeng h—z5 e— 'u n i+ ° 5 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 No.of Luminaires Swimming Pool Above ❑ In- Elo.o mergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones " No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: - .........�����.������.......... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent 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 Wires. Estimated Value of Electrical Work: 3®� I®� (When required by municipal policy.) Work to Start:8(a I 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:) I certify,under the pains�and enalue`s/of er'ury,that the information on this application is true and complete. FIRM NAME: ®�1-4 i e— P, Y t�)e— LIC.NO.: A 15"79 of Licensee.Dwi 21 PA Vt 1:7�1 e. Signature P t&cJ-e— LIC.NO.:3 165®E (If applicab a enter "exempt"in the license number line.) Bus.Tel.No.: Address: 1q0 ID R I E 54-- W t Kiel-M m 19- Cha Lk S Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE. $ SignatureturaTelephone No. The Commonwealth of Massachusetts - - ' Department of IndustrialAccldehts Office of Investigations 600 Washington Street Boston,MA.02111 www mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant A Information Please Print Le ibl �p :: v Name(Business/Organization/Individual): Address: ((1, 6 City/State/ZipA ,ajA('�1C,,_V'y) MA- ®atS) Phone#: �)09 -S 0 I—pqon Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 1+ 4. ❑ I am a general contractor and I 6. F1 Now 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.1 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. El We are a corporation and its j 10.F1 Electrical repairs or additions ' required.] officers have exercised their 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.❑Roofrepairs insurance required.] employees.[No workers' 13.❑Other comp.insurance required.] y *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ,"Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. ` 1Contractors 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:. A .�- 1 ra,v, C Policy#or Self-ins.Lic.#: W C`JG�(0.`i a te_ ExpirationDate: Job Site Address; 6 c?o �� CY-�� City/State/Zip: 14,h4J 0 Glti r VSA,4 016 4S 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 o. 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do h erebucertryy under the pains an1d penalties of perjury that the information provided above is true and correct. Signature `y` -�-- Date �(Q L g- Phone# Official use only. Do not write in this area,to he completed by city or town official. City or Town: Permit/License# Issuing Authority(circle ane): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: COMMONWEALTH.-OF MASSACHUSET{TS { o o MELEE xxl BOARa Of , LEC7"R I C I ANS ISSUE$ THE FOL3LOWI NG .L{CENSE AS ;A ;ry REGISTERED MASTER TLECTRICIAN � DANIEL P VITALE ( � Z 190 DALE ST z r WAt.THAM MA 02451-3773 15799 A 07/31/16 35001 k" COMMONWEALTH.OF MASSACHUSETTS `;j f BOA RD E `r ELEC:TRIC�ANS ISSUES THE FOLLOWING .LI'CENSE I AS A REG JOURNEYMAN :_ELECTRICIAN DAN.fli P VITALE �� a f z 190 DALE'ST Z 1� I WALTHAMMA 02451 3773' " 3185G...;E - 07/31/16 35002 t� /io e+o 6SC'e� ® CERTIFICATE OF LIABILITY INSURANCE DATE :4COR0 ' 8/26/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ACT NAME: LESLIE HANNON James O'Connell Insurance AgenPHONE FAX (978) 667-6150 A/ No: (978) 667-0587 572 Boston Rd ADDRESS: JIMINS@OCONNELLINS.COM Unit 7 INSURE S AFFORDING COVERAGE NAIC# Billerica, MA 01821 INSURER A:Merchants INSURED I NSURER B:A.I.M. Insurance DANIEL P VITALE ELECTRIC INSURERC: 190 DALE ST INSURER D: WALTHAM, MA 02451 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY BOP9098053 9/12/14 9/12/15 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMASEES(Eaocc a occurrence) $ 500,000 CLAIMS-MADE OCCUR MEDEXP(Anyone person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PRO LOC $ T F AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED .. DAMAGE $ HIREDAUTOS _ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERSCOMPENSATION WCC5006538012009 10/11/13 10/11/14 X WCSTATU- OFT EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTVE Y/N E.L.EACH ACCIDENT 100,000 OFFICER/MEMBER EXCLUDED? N1 A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yyes,describe under DESCRIPTIONOFOPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is regui red) ELECTRICAL WORK CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF NORTH ANDOVER MA ACCORDANCE WITH THE POLICY PROVISIONS. 120 MAIN ST NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE , LESLIE HANNON ©1988-2010 A ORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: x 994 Date.................................. j t VAORTN 3ro:;�``�-•°�ti°0 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACNUS� - This certifies that .......... .... �l ........ .... ..... ...............c. ...... has permission to perform s wiring in the buildin of.......... .yyC.... ' ......................................... atS6�q/4�74 57- )g4tdt No h Andover,Mass. v tFee.t....:� ........ Lie.No...i �� . . ....................... ....... .... ..... # 16 EL CTRICALINSPECTOR Check i (fommonwea&o f WaieacAwelb Official Use Onlv cc�� aLJePartmenE ol3ire�ervice.4 Permit No. Dv 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: March 4. 2011 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) 50 Royal CreSt Drive Building # I q Owner or Tenant Royal Crest Apartments Telephone No. 978-681-1822 Owner's Address 50 Royal Crest Drive North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X❑ (Check Appropriate Box) Purpose of Building Commercial -Apartment BuildincsUtility Authorization No. Existing Service Amps / Volts Overhead ❑ rd Und g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity t Location and Nature of Proposed Electrical Work: Install 6 Gell Packs! Completion o the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ccil.-Susp.(Paddle)Fans No.of Total Transformers KVA ' No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.of Emergency Lighting rnd. grnd. Battery Units 6 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: " ''""' Detection/AlertinE Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: N No.of Water No.of No.of o.of Devices or Equivalent Heaters KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunicationsirmg: 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: $ 600,00 (When required by municipal policy.) Work to Start: 03/04/2011 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 NAME: The Electricians & Co. Inc. LIC.NO.: A10737 Licensee: Michael J. Parziale Signature LIC.NO.: E20269 (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.: 781-322-9344 Address: 50 Branch Street Malden, MA 02148 Alt.Tel.No.: 781-322-3100 *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. SS CO 001021 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. Owner/Agent PERMIT FEE: $ 125.00 Signature Telephone No.