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Miscellaneous - 141 SUTTON STREET 4/30/2018 (2)
TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ................................. 4 elta� ...................................................................... has permissiowtoperfonn...'��-k-k ................................................................ . .............. plu . mbing in the buildings oJ— . .. ...... North Andover, Mass. at ........ ......... Z %�71.h,.V) ....... . .... ............. Fee Lic. No. 2 ...... . ......... ............ PLUMBING INSPECTOR Check 5'770 :�k DRINKING FOUNTAIN FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTEF KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIP4NG OTHER ' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _ CITY MA DATE PERMIT#� JOBSITE ADDRESS �j�//�= �> II OWNER'S NAME yvy►, 7 d��_ POWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAtU EDUCATIONAL Q RESIDENTIAL Q! PRINT SIGNATURE bF OV Efts GENT CLEARLY NEW: Q RENOVATION: Q REPLACEMENT: U PLANS SUBMITTED: YES Q NOQ FIXTURES I FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB COMPANY NAME Ung ADDRESS CROSS CONNECTION DEVICE CITY J-�,�y����ISTATE ZIP ��� TEL o� I DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM 4 __- _ I A ._—J DEDICATED GREASE SYSTEM � _ I _� _-._fWE DEDICATED GRAY WATER SYSTEMDEDICATED WATER RECYCLE SYSTEM 1 j _I _^_j � ( f 1 ( I DISHWASHER __ __..___ ___J ___ _.._J .__._j -__� ..___ ___.__ _.1 ___I _ __.1 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTEF KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIP4NG OTHER ' _ INSURANCE COVERAGE: _ 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES , :.! NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 1, V LIABILITY INSURANCE POLI TI OTHER TYPE OF INDEMNITY Q BOND Q OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the i Massachuse is General Laws, and that my signature on this permit application waives this requirement. ` CHECK ONE ONLY: OWNER QI AGENT IQ SIGNATURE bF OV Efts GENT I 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'S NAME 3- ( LICENSE # % SIGNATURE MP 01 JPu CORPORATION Q#PARTNERSHIP Q#E-----1 LLC �f COMPANY NAME Ung ADDRESS CITY J-�,�y����ISTATE ZIP ��� TEL o� I FAX CELL] EMAIL - -- - - --,q - -lin -1 - 0 ❑ W CL ui LU U- 1 The Commonwealth of Massachusetts Department of IndustrialAccldints . Office of Investigations 600 Washington Street Boston, MA 02111 UV www.massgov/ilia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate bog: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2"© lam a sole proprietor or partner- listed on the attached sheet. ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions ilE. Plumbing repairs or additions 12.❑ Roofrepairs 13.❑ Other *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 anew 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. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder 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. Official use only. Do not write in this area, to be completed by city or town official. City or Town: PermitUcense # -- . R ) -,1 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 ofpublic 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. AIso 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 Mossachusetts Department of Industrial .Accidents Office of Investigations- 600 nvestigations600 Washington Street Boston, MA 02111 Tel, # 617-727-4900 eyt 406 or 1-877-MASSAFB Revised 5-26-05 Fax# 617-727-7749 Www.Mass,gov1dia t 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 ofpublic 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. AIso 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 Mossachusetts Department of Industrial .Accidents Office of Investigations- 600 nvestigations600 Washington Street Boston, MA 02111 Tel, # 617-727-4900 eyt 406 or 1-877-MASSAFB Revised 5-26-05 Fax# 617-727-7749 Www.Mass,gov1dia NS ON ('H 0381 1 22.1$ IB -JUN -2009 09:55 From:KESSLER KLEINF�' ole R (C1 )w , ._, MEMORANDUM TO: Town of NOrth Andover --� FROM: Mark Erickson, Project Manager RE: Removal of Remedial Trailer fro 14i Sutton Andover Street, N nATE: June 17, 2008 Remedial system at the facility boated st Kleinfelder has been operating a Dual Phase Andover. This system was installed In 141 Sutton Street (Fom,er FaoconMoba), andsorth in the soil and groundwater at this site. order to reduce Petroleum reiabed compo The remedial system 8000MPNShed its Purp080 and now needs to be removed from the site. Kieinfelder has prwidcd n0lifts"On to the Massachusetts i� of Environmental responsible a the trev�nnmental compliance for this $fate through the regulatory closure responsible for the en process. Thank you for your tlnla and understanding. Pape 1 3o Porter Road 4 LMICton, Mase t5 01400 b 978.4860060 + 9"4864= rex N 2 3 21- C; 7 Date................................... '40RT" TOWN OF NORTH ANDOVER PERMIT FOR WIRING 66 / - Check # 6 (- WHITE: ApOcant CANARY: Building Dept. PINK: Treasurer This certifies that ...................... .................................... has permission to perform wiring in the building of ...... I ................................................. .................. . North Andover, Mass. at.ZJ2 ... e 0--�j Fee/X.6 ....... Lic. P40 . ............. ....... i ..... . ................. ..... ..... ....... ... . ... INSP ECTOR LEcrRICAL / - Check # 6 (- WHITE: ApOcant CANARY: Building Dept. PINK: Treasurer Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. O Occupancy and Fee Checkedti� [Rev. 11/991 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (C), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPEL 0AL.) ATION) Date: City or Town of: e-5— To the Inspector of fres: By this application the undersigned gives notice of his or hey intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant q11Z1_n Owner's Address Telephone N( q)$) q::St Is this permit in conjunction with a building permit? Yes R No ❑ (Check Appropriate Box) Purpose of Building kc Utility Authorization No. i e)o 1614 Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service `cX: Amps �%o / ?d $ Volts Overhead Undgrd ❑ Number of Feeders and Ampacity No. of Meters No. of Meters , Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting. Fixtures Above In- Swimming Pool rnd. ❑ rnd. 11 No. o. o Emergency Lighting 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 Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number TonsKW ........... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW ecuritySystems: No. of Devices or Equivalent No. of Water KW Heaters o. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of MotorsTotal HPr79Telecommunications Wiring: No. of Devices or E uivalent OTHER: 0 > �Z t� . p. ;r Attach additional detail if desired or as required by the Inspector of Wires. 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 A BOND ❑ OTHER ❑ (Specify:) Z �� (Expiration Date) Estimated Value of Electrical Wort t<!)OM-0 (When required by municipal policy.) Work to Start: i �, Inspections to be requested in accordance with NEC Rule 10, and upon completion. I certify, under the pains ins and penalties o�('perj�M that the information on this application is true and complete. FIRM NAMLIC. NO.: A Licensee! S Signature LIC. NO.: (If applicable, en "exempt" in license b Ilie.) Bus. TeL No.� 15!El`!t Address: k CS6 2 Alt. Tel. No..A-X 2jZ `M:s OWNER'S INSURANCE WAIVER: I am aware that t%g- ensee does hot 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/Anent TTT1 liT TTT OI 19-56 Date... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING 7 This certifies that ...... pcu�J ...... �70.-e�/ ...... 9- o�. li-( . ............... has permission to pevi-orm ...... ......... � 'N '.W-irmg in the building of ....... t. (h,�o:dA �y ...... ........ . ......... at ... 111 ..... !�4 IV- A ..—North Ando7r, Mass/ )Tee-r�.K�. Lic. Noj�.W� ............ 1� ...... 10/ �.-do ELEcrRICAL INSPECMR C- (7 0, foc"O' WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office Use Only Tile Commonwealth of Massachusetts Permit No.1250 _ Occupancy & Fee Checked Department of Public Safety (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 APAB FOR PERMIT TO PERFORM ELECTRICAL WORK bFORW e performed in accordance with the Massachusetts Electrical Code. 527 CMR 12:00 ( PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date lawl Z99 The undersigned applies for a permit to per orm the electrical work_below. Location (Street & Number) % `7 'TL(�O Y1 Owner's Address Ve. C�_- Is this permit in conjunction with a building permit: Yes ❑ No ❑ Purpose of Building r Existing Service M New Service Amps / Volts Amps / Volts - Utility Authorization No. . Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ (Check Appropriate I No. of Meters No. of Meters Number of Feeders and Ampacity L r - Location and Nature of Proposed Electrical Work (_ A�,t ' sne c� 1 rn 'P nnrti - ti '..n n OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policyincludin Completed Operations Coverage or its substantial equivalent. YES ❑ NO 11I have submitted valid proof of same to this office. YES NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) National GranclP Mutua 1 03 /15 P0 r`, l (Expiration ate Estimated Value of Electrical Work $ dd n Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME Paul Foley Electric Company) Inc. LIC. NO. Al5686 Licensee Pan 1 Fol eV, Jr. SignatureLIC_ NO.5�$� us. Tel. No. - Address 2 Lane Street, Middleboro, MA 02346 v Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) r` Telephone No. PERMIT FEE $ I ! (Signature o caner or gen Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures g g Swimming Pool Above rnd. ❑ In- rnd. ❑ Generators KVA of Emergency Lighting Receptacle Outlets No. of Rece p No. of Oil Burners Batter Units Bat No. of Switch Outlets No. of Gas Burners FIRE ALARMS NO. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. Tons Initiating Devices No. of Sounding Devices Det of Self Contained Detection/Sounding Devices . ❑ Municipal Local El Other No. of Disposals Heat Total Total No. of Pum2s Tons KW No. of Dishwashers S ace/Area Heating Key p g Heating Devices KW No. of Dryers g Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts -wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policyincludin Completed Operations Coverage or its substantial equivalent. YES ❑ NO 11I have submitted valid proof of same to this office. YES NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) National GranclP Mutua 1 03 /15 P0 r`, l (Expiration ate Estimated Value of Electrical Work $ dd n Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME Paul Foley Electric Company) Inc. LIC. NO. Al5686 Licensee Pan 1 Fol eV, Jr. SignatureLIC_ NO.5�$� us. Tel. No. - Address 2 Lane Street, Middleboro, MA 02346 v Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) r` Telephone No. PERMIT FEE $ I ! (Signature o caner or gen N2 1973 Date. &.- ............ 0 TOWN OF NORTH ANDOVER 0 - PERMIT FOR WIRING This certifies that ...... 4L��t ...... ............. ........... .................... has permission to perform ........ wiring in the building of ................................... ...................... . North Andover, Mass. No6��-/'�� . ............ Fee.� .................... Lic ............. ... tr ................. ELEcTRicAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Offlef an only ••-•• monwealth .Qf machuseft 7 Perait No.__. ent Of P'Ub0c Spfety. _ $OARD.O occu"aey i left oaaelwe Y MMU.RiGiiLATiD l CMR:4200 3/90 PA Q (� (leave blank) LJ Off. PERMIT TO PELECTRICAL WORK Ail work to be VwWaed is mate M* IM Mamc2sussaa 0sel:ica2 Cede. 52? CMR 12M (iyLFAB� i'R I� . O& ME ALL Data Q City or Tows of .t .< AJg m... ?/�J —' .� -To the.Znspector o mires: --ir Ttic vudersignad applies ford Fesmit to Perform it-' a dlaetrieal work daecrbed below. Ae ioeat04 tStreet3,"",i.-i� Owner, or Tenant3--/0i J �.c.a.. Ownervs Addrass Is this pexmit in con ju=ti' ** with a building pexmit: Yes ❑ tposo,o! S+aiidin utility A4**rirat1eR NO. E4at3as Service mead 0' MW*rd❑ No. of Meters XUA .� Vol Ovet, F , Uadgrd0 No.of Meters N=ber of 'Feeders and Ampaci r.:. Location and _Nature of Yropodod 8isctriaal work � �►i.ti .• l i.� . _ % ' l Na. of Lighting Outlets Mo. of Lig0itirg lrixtureaAbdvein No. of Noe ,Tubs '_ Swimming Pool O ,a. No. of Receptacle Outlets No...of Oil Burner* No. of Smite* Outlets. SQ. Of 6as.Ba n�ra: No. of: Rangy No, of Air Cond. s NO. of Disposals16"1:. , PCs No., of DIshwsshers Spece/Ares Besting &W No.. of Dryers Ming Devices xW of Transformers KVA FIRE ALMS No. of Zonas No.' -of Detection and Sn tiatLftg Davie" No, of Souading Devices No. ofgel Contained 'DetectW'1Sziding Devices 14Ca1 r- !' micipa'1 INS COVSt Bc Furan t :to t2:$ si�u is to "of Mes'sa01M' Bette Goner41.Laws Z btlrs;.a curz+erit Liab3li:tgiraseo PolieV 3tlaludiiRg Completed Ogeratioas Coverage s®tsubstantial equivalent. US[] N0 [ I have o�nitt4d valid roof of sa�m to thin office. 0 if you Stave 411"kedY2:S, ila i LCste the type of coverage by ellecking the appropriate box. iNSMWCE [3 BOND 0 (Phase Specify) . Estimated Value of rElectrical V"k $ rat on ate Work: to Start1.'di`1)atd,.itegl�es.t-ad / Signed under theFIRM //�—�_Final}�j / .L •�L- p Wallies operj= G.. +�T...C&$lilt► ,Cit.tV� BR'S - Signature LIC. NO. Alt. Tel. No.�-.�I��C� Alta Tei.: No. that.�the Litensee does at h ve'the.insurance coverage or is su - �usetts Cenral-=, an that try signature on this permit :. Agent Oplease.chock:.:one)+ ----- Telephone. tis. 9�.� 3 : I ?,mix FEE $ T N2 2188 Date ... 14 7014 1� D 6 6 TOWN OF NORTH ANDOVER 6 0 0 PERMIT FOR WIRING This certifies that ...... 0.6 ................................................. has permission to perform ....... ......................................... wirmg in the building of ..... A TA�iMLW.v ....... ........................ at .... 5.�(. f/0!2 .... �t ........................ North.,"da Aivrt�,Mmass. Lic. No. ........... . .... ......... . Fee .7./)Ai.( LECMICAL INSPEC-MR C �( 11 5--7 3 >4��g WHITE: Applicant CANARY: Building Dept. PINK: Treasurer -�—� Office Use Only uhf TIIInI1lIIiiwralt Df _gassarh1I5Ptt5 Permit No. 3 rpmtmtW 1rf PubliL %- fPig Occupancy b Fee Checked BOARD OF FIRE PREVEIMN REGULATIONS 52i C 1 . 0 3/90 (leave Wank) APPLICATION FOR PERMIT TO PE FORD ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMA 120% G (PLEASE PRINT IN INK O,R TYPE ALL INFORMATION) Date J� City or Town of 4k, 7 A.A1dg4 ,, %�'i/>2 To the Inspector of Arest The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant _ Owner's Address Is this permit in conjunction with a building permit: Yes ❑,� No ❑ (Check Appropriate Box) Purpose of Building Utility bathorization No. Existing Service V Oy Amps /,gc' I _? 6Volts 31�9 /-, Overhead Undgrnd ❑ No. of Meters New Service Amps _1 Volts Overhead ❑ Undamd ❑ No. of Meters k Number of Feeders and Ampacity Location and Nature of Proposed Eiectrical Work-4A/.s �i� �� ��/��-� •S ���� .l !�-�i ll No. of Lic^ting Outlets i Total No. of Hot Tubs I No. of Transformers KVA No. Of Lighting Fixtures C� I Swimming Pool Above) � In- r Q crnd. crnd. Generators KVA No. c=mereency Lighting No. c` Recectacle Outlets f f I No. of C.: Burners Battery Units No. of Switch Outlets I No. c! Gas Burners I FIRE ALARNIS Nc. of —Zones No. of Ranges No. of Dicoosals No. of D!snwasners No. of Dryers No. of Air Cond. Total tens No.of Heat Tctal Total Pumps Tons KA, Soace/Area Heating KW Heating Devices KW No. of Nc. of No. of Water Heaters KW I Sions Ballasts No. Hydro Massage Tubs I No. of Motors Total HP No. of Detection and initiating Devices No. c` Soundinc Devices No. of Self Cont;:med Detection/Souneinc Devices. Local Municipal Other ❑ Connection n Low Voltage Wiring OTHER: �J1'C//1 �/ li D ��`�I% �nGl L�i�r� G b �1.4ic/�� ✓ �1 /cam INSURANCE COVERAGE: Pursuant to the recuire^ents of Massacnusens general Laws 1 have a current :lability Insurance Policy includin Comoieted Operations Coverage or its substantial equivalent. YES ❑ NO ❑ I have submitted valid proof of same to the Office. YE- u NO ❑ 11 you have checked YES. piease indicate the type of coverage by checking the apprcnriato box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specity) (Expiration Date) Estimated Value of Electrical Work 5 Work to Start Inspection ate � Requested: Rough Final Signed unser the Pen$Ities of _perjury: 1.2 % / v FIRM NAM= o s G- �� LIC. NO. License %% // Signatturre — - L LIC. NO. % 3 9Z 3 /%/ti4oyc / // /// Bus. Tel. No. /''7%'9 - 6 Address �� 46 Un! G %'d%� Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nct have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this perrttit application waives this requirement. Owner Agent Agent (Please chec): one pled GOP,1 ,� 3 / `ff `o R Telephone No. PERMIT FEE $ ✓✓_%,L��� CJ (Signature of Owner or Agent) ( x-8565 Location No. /c� Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 14 6 L-- 1 Building Inspector --V TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING s Section for Official Use 0nIyE,%%h'L1;-r BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Co ion��rff�or of Buildings Date 1.1' Property Address: /W Sc.,ffon S74, 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontagr (ft) 1.6 BUILDING SETBACKS (ft) 1, 1 Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided 1.7 Water Supply M.G.L.C.40. �iM) 1.5. Flood Zone Information: Public 0 Private 0 Zone - Outside Flood Zone 0 1.9 Sewerage Disposal System: Municipal On Site Disposal System 0 RKR' 2.1 Owner of Record Ka 1-7 U X/0/7 Name (Print) Address to; Service: ignature Telephone 2.2 Authorized Agent Name Print Address for Service: Signature Telephone 3.1 Licensed Construction Supervisor Not Applicable 0 Address License Number Licensed Construction Supervisor: Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name," Registration Number Address Expiration Date Signature Telephone � 6V tt L Workers Compensation Insurance affidavi must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building r Signed affidavit Attached Yea ....... No ....... 0 17 AV ESPO AM' im- '0 -- rT 3, Sstma T 7,7 5.1 Registered Architect: Signature Company Name: Responsible in Charge of. onstruction Telephone Expiration Date Not Applicable 0 Name: Address Signature Telephone 2-� kk:f +0 V Area of Responsibility C/o Registration Number I Expiration Date Name: IS— RO-OA:2--2-0 AVE 144Ld�,j 017,��Y IM4 Address 177b)54;6—eZyo Signa Total Not applicable 0 Name: Registration Number Address Signature Telephone Expiration Date Name Area of Responsibility Registration Number .Address Signature Telephone Expiration Date Name Area of Responsibility Registration Number Address Signature Company Name: Responsible in Charge of. onstruction Telephone Expiration Date Not Applicable 0 `^ ,;+��:, �8 .�!t!"�.11. �` ��RV ,..>rF��[�+lt�l►.ildl,a}�3E31'�WRV�i�':;'. New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other Specify &e Fa, 6 f f Brief Description of Proposed Work: >r, - % AL `�� r9 % /oma 7 e ter% 2,2 ❑ A-1 ❑ A4 ❑ A-2 A-5 BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels A J l Floor Area per Floors 2 `fU S Total Areas O .S' Total Height (ft) F& - Independent Structural Engineering Structural Peer Review Required Yes ❑ No L( SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Hereby authorize My behalf, m_aU- relative two work authorized Owner of the subject property permit application Signature of Owner / Date to act on USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 ❑ ❑ lA 1 B ❑ 0 B Business ❑ 2A 2B 2C ❑ 0 ❑ - C Educational ❑ F Factory ❑ F-1 ❑ F-2 ❑ H High Hazard ❑ 3A 3B 0 ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ 1-3 ❑ M Mercantile ❑ ' , — 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A 5B ❑ ❑ S Storage ❑ S-1 ❑ S-2 ❑ U Utility M Mixed Use S Special Use ❑ ❑ ❑ Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels A J l Floor Area per Floors 2 `fU S Total Areas O .S' Total Height (ft) F& - Independent Structural Engineering Structural Peer Review Required Yes ❑ No L( SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Hereby authorize My behalf, m_aU- relative two work authorized Owner of the subject property permit application Signature of Owner / Date to act on 1, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date Item Estimated Cost (Dollars) to be Completed by permit applicants 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number :iv / �i'hIn,z Y :,., n4 N A ra S'Cci `,'�.4?4 ,? 4i'..r ,7 +' 8�u,.: T.: �,.+ k s r'f'S kb �,'�;� .j{ f Rs 4a'� '' 1b4M F� t t fS '...f lf✓`5�titk 4'cY )- x%,r S� <��h1f 44��Sgq4,f�� 1 J ??'. i -:..--g �l �.,,� Iy, ��{�:..; IM t� Y P-.,Fy, tt "✓. 1 5•.:4 "c..ij 3t ky 3stw:iM?Sr'? Sr 5.4�y.t.t:P7fi4'�r iSY,�cr ,}n i,, w :; j9, a..Y f,ara riur^{' �",Tn, ^n : z ,.�_�, 4,C ; NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS lST 2ND 3 P SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBDvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE �7Y � r.ly. ' i`"t� '.E•X� f.,- �S' R £ r3.'k. 5� t6 ,t � 'irc 3 i+. ,? .✓ ^3.. tl^ atiis'�vi. ' X2 i'+,, i �`. � :,.. .. . 1 t / The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing. workers' compensation for my employees working on this job. Company name: -d 1.4 c S r (rrc P S c a rJo - Address Z{ 2- -7 o City: A/vZZ4' a 14 Phone #: Insurance Co. Policy # Company name: Address City: Phone # Insurance Co Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone #. ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION 4 1 ..y W O _Z �Z ZJ 0 Z 0 dLu W V) Ll O w U Q Z O Q W NW OO V Z z N m Q mZ -� Z LLLI L. F- m W Z w OLL.W O W W Q J C N V) NC W Z O w J Z W Q N Y LLJ W W 0= z O Q Q U d 0 w _Z z O V V) (n (N t Q m J O C9 O J J J O d � Q O O On Z -� QCL CL CL Z> 8 p ��`' W j it (Y- mon 0L)i� of m V) (f)z N 1+) H m O� W N m L W vj�W t�WU U _ Q WZN Q �OUOa 0 < t7C 7 W :D � 1: Licn 0ZNO WO—o 0 �-X �ZQ N 0W r:r of= LO C Ng O WZ . WE w w U z Li 0 V) w Jo ma U')CL ,� > a \ U N I O cQ m I W z� Q z 0 Q Q `. z 0 V) O m z 0 N V 0 0 W 7a c a� E 0 .15w c ca 0 co LO m rn 0 Q N • Q CO '• d J _ FORM - U - LOT RELEASE FORM ki INSTRUCTIONS: This form is used to verify that allnecessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the from ■..f...■ with any applicable requirements. _ ■-1-.-.-..-.7......%1..l.....■......l..l......■ PHONE MAP NUMBER LOT NUMBER SUBDIVISION /1%�A LOT NUMBER AIA STREET _©N___ STREET NUMBER .. t ..:......................................:.. ......... _ OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR COMMENTS TOWN PLANNER CORRVIENTS 10MM;MMO-101 DATE APPROVED DATE REJECTED DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED SEPTIC INSPECTOR - HEALTH CO&IMFNTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE O z co 0 ao O w Cf) L aAi Cf) 0 z A 00 p O c� U G w ca p u: G ii. x p w C/) w o A, p is G w ZW G as C/) . i O cn CD O CD Z O y y 9' L CD C CD m O M 0 CD CM o co M CD 'D CL. CD c4c ca C:j CD CD CL CO3 C U) W w w U) C ®� y:s v C: 0. CL, �� IS 8 ci t: y c �s c Iv :mom � H c H ? CDCA �= CA ca Co Eca CL o O• �.�� ® co co o m --:C3 o: C ® C ®iO/D ® =3: m C CD 0 � CL, � N m 6/D ui gCD .� 2=2z C �. 2-2 .0 Z CM C+* CLO R W '� 0. ® .O •� � = � CD O CD Z O y y 9' L CD C CD m O M 0 CD CM o co M CD 'D CL. CD c4c ca C:j CD CD CL CO3 C U) W w w U) 4psc GEOLOGIC SERVICES CORPORATION Hydrogeologists and Environmental Scientists MPmarnndnm Date: February 14, 2001 To: Todd Lunstrom — LaMountain Brothers, Inc. Matt Bovenzi — Geosearch, Inc. Ralph Meier — Petroleum Engineering Inc. Randy Kessler — Kessler Installation & Sales, Inc. From: David Macone — Geologic Services Corporation Re: Request for Bids Earthwork and Installation of Subsurface Piping Associgd with Re ed' ' System Former Exxon -Facility R/S #3-7817 i��, V ®Aj EI 4A1 Sutton Street X 0 �� w 4tfw RN orth-Andover; MV V � � 1� !� Geologic Services Corporation is seeking bids to perform eart work and the installation of subsurface piping associated with the remediation system at the referenced site. The scope of work shall generally include the following: • Saw cutting, excavation of trenches, and the installation of subsurface piping; • Furnish, install, and compact backfill for the excavations; • Installation of ten (10) 12 -inch road boxes (supplied by GSC) set within 2 -foot by 2 -foot concrete pad; • Saw cut and remove/dispose of asphalt for system enclosure concrete slab; • Furnish and install a 6 -inch gravel base and a 6 -inch reinforced concrete slab for system enclosure; • Furnish and install a 8 -foot high chain-link fence with privacy slats, with a set of 5 -foot gates, and a standard 3 -foot gate, along two sides of the system enclosure concrete slab; • Furnish and re -installing asphalt and/or concrete in presently paved areas and reseeding lawn/landscaped area to match existing conditions; • Stockpile soil as directed by GSC field personnel; and • Soil loadout and disposal. System design figures and drawings have been prepared to describe the required. work. Any deviation from the work scope and equipment specifications provided herein must be clearly indicated in writing and/or drawing in the final proposal. Bids must include all labor, equipment and material to perform the tasks detailed below and as shown in the attached engineering drawings: • Figure 1 — Site Plan • Figure 2 — Proposed DPE Piping Layout (With Well Locations) • Figure 3 — Proposed Discharge Piping Layout • Figure 4 — DPE Well Construction & Trenching Details A GSC construction supervisor will be on site throughout construction activities to verify compliance with the contract drawings and specifications. Any and all field modifications and changes must be approved by GSC in advance. Absolutely no change orders will be issued for activities not Page 1 of 6 15 Bonazzoli Ave. • Hudson, MA 01749 • (978) 568-8740 • (978) 568-9316 Recycled Paper previously approved by GSC. The GSC construction supervisor will have authority to approve minor scope changes. The Project Manager and Engineer must approve all major modifications. The Contractor shall be responsible for procuring all permits, approvals and police details as required by the Town of North Andover, Massachusetts. GSC is in the process of determining the permits required to tie-in to the sanitary sewer system and will work with the Contractor to obtain them. Also, the Contractor must exercise caution to ensure that existing facility operations will not be affected, and so that pedestrians traveling to/from the local buildings will not be endangered. Assume that all construction activities will require Level D health and safety protection. Contractor must assure that Level C health and safety equipment will be available at all times, should an upgrade be required. All onsite personnel must be OSHA 40 -hour health and safety trained and copies of current training certificates must be provided with the proposal. All onsite personnel must carry a valid OSHA 40 -hour training card at all times. No personnel will be allowed on the facility without confirmation of OSHA training. The Contractor is responsible for determining and providing the necessary safety devices (cones, barricades, etc.) to ensure the safety of all workers during trenching and piping activities. In paved areas, all existing paving must be saw -cut prior to trenching. The Contractor shall excavate soil to a maximum of 48 -inches below grade for the installation of the subsurface piping to connect lines from the system wells to the proposed remediation equipment compound. The Contractor will hand dig in all areas where underground structures are identified. The width of all trenching will be a minimum of 24 -inches. The Contractor should understand that certain soils and/or groundwater at the project site contain hydrocarbon constituents. All soils excavated from the trenches will be screened with a photoionization detector (PID) for total volatile organic compounds (VOCs). If PID readings are greater than 100 parts per million (ppm), the impacted soils will be stockpiled on 6 -mil poly plastic sheeting, pending off-site disposal. Otherwise suitable excavated soils can be used as trenching backfill. All soil piles must be covered with 6 -mil (minimum) poly plastic sheeting. Proper covering of the piles must be maintained the duration of the project. The Contractor is responsible for the disposal of asphalt and concrete. As noted above, the Contractor shall be responsible for providing labor and equipment to load any stockpiled soil for disposal. The soil will be sampled and analyzed (by others) and based on the results, the Contractor shall be responsible for loadout services only (if analyses show impact the soil will be transported to a recycling facility by others) or both loadout and disposal (if analyses show that soil is not impacted and therefore defined as construction debris). The Contractor shall assume a separate mobilization event for the equipment to load out the soil, as the stockpile must remain on site until analytical results are obtained. The Contractor will supply all of the materials (PVC piping, fittings, glue, primer, etc_) and labor for the installation of the subsurface PVC piping from the system wells to the system enclosure (refer to Figures 2 through 4). The system above grade piping and the connection to the system equipment will be supplied and handled by GSC .personnel. During the installation of the subsurface piping the Contractor will be responsible for maintaining a slope on each line toward the well (minimum 1% slope). The installation of the subsurface piping is summarized below: Install ten (10) 2 -inch, schedule 40, PVC pipes from the system enclosure to ten (10) dual phase extraction wells. Each 2 -inch PVC line will tie into a 2 -inch pit -less adapter, teeing into each 4 -inch diameter PVC dual phase extraction well, approximately 4 -feet below grade; and Install one (1) 4 -inch, -schedule 40, PVC discharge line from the system enclosure to the sanitary sewer manhole/line (location of the connection is pending on approval by North Andover's DPW). Page 2 of 6 Following installation of pipe bedding and piping, backfill above the system piping with additional pea gravel layer (minimum 4 -inch) and the placement of caution tape in the trench, followed by backfill. All backfill in paved areas must be compacted to 95% standard proctor density. The Contractor should assume that existing asphalt surfaced areas consists of 4- to 6 -inches of total asphalt. All resurfacing must match the existing surface (at a minimum provide 2 -inches of base coat and 2 -niches of wear coat). All mating seams between new and existing asphalt pavement shall be hot tar sealed. Any significant settling of the trenches caused by improper back filling or compaction activities will be the responsibility of the Contractor to repair at no additional cost to the project, for one-year after the completion of the project. The Contactor will be responsible for saw cutting and removal/disposal of asphalt of an area approximately 15 -feet by 15 -feet, next to an existing concrete slab, for the system enclosure concrete slab (refer to Figure 2 for location). The new reinforced concrete slab will be 6 -inches thick with a 6 -inch thick gravel bed and attach to the existing concrete slab. A portion of the existing concrete slab will be utilized as part of the system enclosure. An 8 -foot high chain-link fence with privacy slats will be install along two sides of the system enclosure. One side of the fence will be approximately 30 -feet long including the standard 3 -foot gate, which the other side (approximately 15 -feet) including the two 5 -foot gates. The other two side of the system enclosure will be located beside the existing building and a retaining wall. There is a pre-bid meeting on site on Wednesday, February 21 at 10 AM. The proposal and work shall be conducted in accordance with all applicable codes, regulations, standard industry practices and established guidelines. One original copy of your bid, signed by a principal of the firm, must be received by March 2, 2001 at GSC, 15 Bonazzoli Avenue, MA 01749. Please bid on the attached Four► for General Bid. It is expected that the successful bidder will execute GSC's standard contract and provide evidence of insurance in acceptable amounts naming GSC as an additional insured prior to commencement of the work. Payment will be made on a unit cost basis using the actual amounts of work completed and the unit costs provided by the Contractor on the bid form. GSC will retain 10 percent payment on all invoices until the work is completed in a manner acceptable to GSC and lien releases are provided to GSC by the Contractor. Please contact me at (978) 568-8740 if you have any questions regarding this request for bids of the enclosed form. Page 3 of 6 FORM FOR GENERAL BID PROPOSAL OF: A. The BIDDER proposes to furnish all labor and materials required for Earthwork and Piping Associated with System Installation in accordance with the accompanying drawings and specifications for the contract price specified below, subject to additions and deductions according the terms of the specifications. 1. Anticipated Number of Days to Complete the Project: B. BID ITEMS Items uanti Extended Total 1. Trench excavation (3'wide x 4' deep), including sawcutting, disposal of asphalt and/or concrete, backfilling, inspection and compacting fill, the sum of dollars ($ ) per linear foot of trenches 2. Furnish and install subsurface 2 -inch Sch. 40 PVC piping w/all associated fittings, the sum of dollars ($ ) per linear foot of pipe 4. Peastone as necessary, the sum of dollars ($ ) per ton 5. Install 10 12 -inch road boxes (supplied by GSC) set within a 2 -foot by 2 -foot concrete pad, the sum of dollars ($ ) per road box 200' 1000' 10 tons r 10 Page 4 of 6 i 6. Sawcutting and removal/disposal of Asphalt in an area 15' by 15', the sum of dollars ($ ) per square foot 7. Install a 6 -inch reinforced concrete slab next to an existing slab, with a 6 -inch gravel base, the sum of dollars ($ ) per square foot 8. Furnish and install a 8' chain-link fence With privacy slate (green), two 5' gates, And one standard 3' gate (total length of Fencing 45' including gates), the sum of dollars ($ ) per linear foot 9. Soil loadout for off-site disposal, the sum of dollars ($ ) per day 10. Disposal of non -impacted soil, the sum of dollars ($ ) per ton 11. Repaving (on-site) the sum of dollars ($ ) per square foot 225 SF 225 SF 45' 1 day 10 tons 600 SF Page 5 of 6 'd` TOTAL AMOUNT OF BID: (Amount in Words) (Amount in Figures) C. The BIDDER certifies that he has visited the site and received and reviewed the plans and bidding documents. D. The BIDDER hereby agrees to commence work under this contract and to fully complete the earth work and subsurface piping installation associated with the project within a specified time frame, mutually agreed on by the Contractor and GSC. Submitted: Date: By: (Signature and Title of Principal) (Name of General Bidder) (Business Street Address) (City and State) (Business Phone) Page 6 of 6 sic February 14, 2001 GEOLOGIC SERVICES CORPORATION Hydrogeologlsts and Environmental Scientists Ms. Collen Spero Monitoring Manager Greater Lawrence Sewer District 240 Charles Street North Andover, MA 01845 Re: Discharge Permit Former Exxon Facility R/S #3-7817 141 Sutton Street North Andover, Massachusetts Dear Mr. Willette: Geologic Services Corporation (GSC), on behalf of Exxon Mobil Refining & Supply (ExxonMobil), requests approval to discharge treated groundwater to the Greater Lawrence Sanitary District treatment facility. The following information and the attached figures are being provided regarding the proposed discharge: 1) Client Contact: Exxon Mobil Refining & Supply 52 Beacham Street, Everett, MA 02149 Attention: Eric Errico (617) 381-2952 2) Owner/Site Address: Trombly Brothers 141 Sutton Street North Andover, MA 01845 3) Purpose of discharge: Treated Effluent from Groundwater Treatment System 4) Anticipated discharge dates: April, 2001 through October, 2005 5) Potential Contaminants: Petroleum -related compounds, including benzene, toluene, ethylbenzene, xylenes, methyl tert-butyl ether, and total petroleum hydrocarbons. 6) Treatment Process: The proposed dual phase extraction system process is as follows: Groundwater will be recovered from an array of extraction wells via an oil -sealed liquid ring pump, directed into an oil/water separator, from the oil/water separator via a multi -stage centrifugal pump through a set of particulates filters, followed by a series of two (2) granular activated carbon units (GACs). If any non -aqueous phase liquid (NAPL) is present in the oil/water separator it will gravity feed into a 30 -gallon drum which will be grounded and contained in a 55 -gallon. overpack drum. NAPL will be disposed of off site at a permitted facility. Each GAC will be bedded with the appropriate amount of carbon to ensure discharge limits set by the Greater Lawrence Sanitary District are achieved. Once discharge limits are determined, the GACs will be sized appropriately. Refer to Figure 1 for the Proposed Process and Instrumentation Diagram. 15 Bonazzoli Ave. • Hudson, MA 01749 • (978) 568-8740 • (978) 568-9316 Recycled Paper 7) Operation & Maintenance (O&M): During the start up of the Proposed DPE system O&M visits will be conducted on day 1; 3, 5, 7, 14, 21, and 28 of operation. After the first month of operation O&M visits will occur twice per month. During each O&M visit system operation parameters will be collected to allow for system optimization along with discharge flow meter readings. Samples will be collected for laboratory analysis from the influent, mid- point, and after the GACs. The frequency of the sampling and analytical methods will depend on the discharge permit requirements set by the Greater Lawrence Sanitary District. 8) Proposed Flow Rate: Up to 7,200 gallon per day (5 gallons per minute) 9) Characteristics of Influent Groundwater: 10) Consultant Contact: Benzene: 5,000 µg/l_ Toluene: 30,000 µg/L Ethylbenzene: 3,000 µg/L Xylenes: 17,000 µg/L MTBE: 1,000 µg/l_ Geologic Services Corporation 15 Bonazzoli Avenue Hudson, MA 01749 (978)568-8740 phone (978) 568-9316 fax Project Manager: Brian Moore L.S.P.: Bruce C. Ross GSC is in the process of fulfilling all requirements set forth by the North Andover's DPE to tie-in to the sewer manhole or pipe located on the property for the continuous discharge of treated groundwater. GSC respectfully requests the approval to discharge treated groundwater to the Greater Lawrence Sanitary District. If you have any questions or require additional information please do not hesitate to contact us at (978) 568-8740. Sincerely, Geolo 'c Services Corporation Dave Macone Project Engineer . Brian D. oore Project Manager Cc: Mr. Eric Errico, ExxonMobil Refining & Supply, 52 Beacham Street, Everett, MA 02149 Mr. Tim Willette, DPW City of North Andover, 384 Osgood Street, North Andover, MA 01845 Ref#980502.GLSD Attachments ,O A LLL7,7aj S XIVIV 1 Li `to 3; -O ui Oj LLJ � LLJ I, , L cn ` I I • `� NCO \� O • I,. / N I J J�-- W I CCD JO(n m0 I 0� d \ ' o F- N , I �' l!� > < I Ln D zo QC.)� ` I� O b > O ® I ; S :2 Abd G/� WV� I \ > s g s 1 • cI OAI Z J O aINI 3 w me c� zo Q co V) m °' z OZ Z Z I V) ooh � OM � � LLIU J L'J m W Z �' N XW<U SC ... Z O ~Q Z c Q z N Z O Q Q a O Q Q J 0�w W CL M fy ¢ C�F-� L- ~> J U O\ F- � W w p (! 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N W�WU mw!—c W- c d-�x xN U00 ai In N J W � Q cc �zUp o :D0< _C lLXpzN0 O D N z Op of rn.. JW O..Mmm C.D J W Z La. W Wap W O W� ��0' � C% N O Em zQO U V) W O Cn F - z F- C) z W H Location No. Date 40RTN TOWN OF NORTH ANDOVER 0.1 -1 4 - i Certificate of Occupancy $ Building/Frame Permit Fee $ C14US Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector 12889 11/24198 10:39- 182. 00 PAID -, Div. Public Works Location fl Date 40 No. 14ORTh TOWN OF NORTH ANDOVER 0 a'n Certificate of Occup cy $ 41 Building/Frame Permit Fee $ T" Foundation Permit Fee $ u Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL 107: $ Building Inspector �/��24/98jlQ:39:—::� 12 21 S 9 f 71LI .--'"Mi.-Public works i i.i► Y 1; Ll Ltlf y O 1 .y. Tc W Y � :i� N N u') M K X I O� N Ln �r r - >Q C .4•. H a O M [� J Z z Z z Z- ..I 1� i i.i► Y 1; Ll Ltlf y O 1 .y. Tc W Y � :i� N N J - M K X I O� N - >Q C .4•. 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This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ---***•******�*''*'*APPLICANT FILLS OUT THIS SECTION* APPLICANT�R Pang ��� PHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) STREET ti� �u RJ ST. NUMBER:"'""— ..,�--..*"**"**.* ""*'**'OFFICIAL USE ONLY"""'"" RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED 'DATE REJECTED COMMENTS TOWN PLANNER DATE {APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR. HEALTH DATE APPROVEDDATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS • SEWERJWATER CONNECTIONS DRJVEWAY PERMIT - FIRE DEPARTMENT DATE /�/ RECEIVED BY BUILDING INSPECTOR T is to certify that ::Pent•; , v elapsed imm date of de�ciiss on 1W F:s�hout ti e���,. / / 7� Jclljco A. Sradst aw T;,,m Clerk Any appeal shall be flied within 1201 days after the date of filing of this Notice in the Office of the Town Clerk. NoRTN Of ,,,to ,. stip OL R EC F Ivr"' JOYCE pF A TOWN :s° ; *' NORTH A ND4 ER x OCT 13 2 OI TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS A 7l/k�ue Logy Towu clerk W Ski NOTICE OF DECISION O Property: 141-147 Sutton St. NAME. Trombly Realty Corp. DATE: 10/14/98 ADDRESS: 141-147 Sutton St PETITION: 039-98 North Andover, MA 01845 HEARINGS: 10/13/98 The Board of Appeals held a regular meeting on Tuesday evening, October 13, 1998, upon the application of Trombly Realty Corp. 141-147 Sutton St.., North Andover, MA , requesting a Variance from the requirementROU '3,+!9AiA11:41 of Section 7, paragraph 7.3, of Table 2, within the G-8 Zoning District, for relief of rear setback, to construct a proposed expansion for the use of an administrative portion of the business operation to an existing garage and existing service station. The following members were present: William J. Sullivan, Walter F. Soule, Raymond Vivenzio, Scott Karpinski, George Earley. The heanng was advertised in the Lawrence Tribune on 9/29/98 & 10/6/98 and all abutters were notified by regular mail. Upon a motion made by Raymond Vivenzio, and seconded by Walter F. Soule, the Board voted to modify prior decisions dated April 12, 1973, petition #11-23; and decision dated July 1, 1974, petition #8-74, (see plan by Charles C. Martin, dated March 1974), to allow a wall and roof over hang area and to allow the expansion for use of an administrative portion of the business operation to an existing garage and existing service station in accordance with the plan of land dated 9/16/98 as prepared by Scott L. Giles, Registered Land Surveyor. Voting in favor. William J. Sullivan, Walter F. Soule, Raymond Vivenzio, Scott Karpinski and George Earley. The petitioner has satisfied the provision of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a building permit as the applicant must abide by all applicable local, state and federal and building codes and regulations, prior to the issuance of a building permit as requested by the Building Commission. BOARD OF APPEALS Willliam J. Pullivan, Chairman Zoning Bo rd of Appeals decoct/1 V ♦�D 3? �' t ,•', OG 9 i TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS M -E -M -O -R -A -N -D -U -M TO: Trombly Realty Corp. FROM: William J. Sullivan, Chairman Zoning Board of Appeals DATE. October 19, 1998 SUBJECT. Addendum to petition # 039-98 Pursuant to the attached decision for Trombly Realty Corp., 141-147 Sutton Street, North Andover, MA 01845, and relative to the condition agreed to by Trombly Realty Corp., and the Zoning Board of Appeals on October 13, 1998 please read the following condition: The Zoning Board of Appeals requested that landscaping be added to the property by planting a shielding of approximately 10 shrubs, approximately 4 feet high, along the area of land relative to the administrative portion of the business operation. Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a building permit as the applicant must abide by all applicable local, state and federal and building codes and regulations, prior to the issuance of a building permit as requested by the Building Commission. cc: - ZBA file ml/addendum ' Board of Appeals, William J. Sullivan, Chairman Zoning Board of Appeals I NM rr i--� , •m � rel i '�i - i ' . Registry of Deeds Northern District of Essex County Lawrence, MA 01840 11/03/98 TROMBLY REALTY CORP DR # 92 Rec: Type PLAN 16. 00 Inst 37459 Copies 1.50 # 93 Rec: Type DECN 10.00 Inst 37460 Copies 1.50 Postage 0.32 Total 29.32 # 94 Payment Cash 40.0O # 95 Change 10.68 THANK YOU! Thomas J. Burke Register of Deeds f, .7- 08-1998 9 18PM FROM TROMBLY BROS INC 5086839118 SovoWy u+0 MITA OaiR w c P. 2 ilvv4gi vvs �.t'-+�"�sr�s (/J�F�B �-��A�'s�rs9��`�ooe►o cor��..�fssdd�MC�t�Yo� J*,q,1995 Sssilding Co�atter ?owa of Nath Aoaarar Comausity� rod swvioss 30 Moot Shea Noah Wiz, bb=KbwM OI84S ..51: 6 Ra R,esY "fwCoomesstl6sbsm==.ofa awftgftmg to dw Towa of NWO Ando W, MA Dile Noy ORMA- NWU Dar W. Nwonw I om wr frog wish roped lw for nay creat loo ft bwamm of a baaft ponak to volow8>r Paw Rea9 COrPmufto IN the proposrd consmmdn of a 482 ol—P fm acs ad&tim hoed an 141 -ISI $wma SMMc. NattD A Mssss I ! ; as kdowd m the Pka UOOcd: "Nobly &us. hw, Nm* AodstM MA. Sate I"=10' Opsin C. Draw 31Z M.r A bourims ma held at the FmpAivo OISct of T.,-1,,egmoae aatd Co�u1 va 1Vodsaadllq�, J*1.1995, s�sr publiaq$a is 1Le I,aw>~nce T an hme tz 19m A6 Phu$= CVW=W f awn, Chepoet 40 & mri Ia 54A ptdades tint a I*Y or tavern ow obIdD *0 mums of Vit SwcWY gfTn=Pftdm ad Coate peter to the iwmm of a pm=it for aw on bmsb y rased as a zwkew :~,Vsq or taods rPP tixstoa orad by asq► ssahord oomgp»ecy m floe Caa�toovoaai L lu papaw of Vee sae m is m peeaard6 for poem of oc �uee ,hogs. As she eneeuEivs o8ka rsapoa >bor aoenpe�eheoaive P is Vee sats oaF and .I bd1� 8sae o vaalOr �e a14�e s+o peotoct tach Air for tsmpoaslt0iotrrtdr0ed utas. 321ep1+" (6 17) 4:3.7000 TCO (617) 973-73(6 'T*WM (617) 973 -CM3 0 :. 7-08-1998 9:18PM FROM TROMBLY BROS INC 5086839118 P.3 —maw W www, wwv D. 1* 9,1993 . Afia ievkwbW ft b*camiom on Me d ow Qf5W it ba bm del! onioed 10 the ptoposod caomr ctioa does J' bapea �► poma l x W- Tbb bang *$ cw% I bumby oomew to the hmmma of *t ba*ft pewit to Trow* Wafto R=ly Cotpwmbm hr the ptvpvsed oomsbuodm u dom an The afa`ametdiooed pb>e. it cops► of which is gybed. 4 ks Argeo Paul Cellucci Governor Patrick J. Moynihan Secretary and MBTA Chairman Mr. D. Robert Nicetta Building Commissioner Town of North Andover Community Development and Services 30 School Street North Andover, Massachusetts 01845 (�� 90e� yele_� July 9, 1998 Re: Request for Consent to the Issuance of a Building Permit in the Town of North Andover, MA File No. 40/54A - 98A-23 Dear Mr. Nicetta: I am writing with respect to your request for my consent to the issuance of a building permit to Trombly Brothers Realty Corporation for the proposed construction of a 482 square foot office addition located on 141-151 Sutton Street, North Andover, Massachusetts, as indicated on the plan entitled: "Trombly Bros. Inc., North Andover, MA, Scale: 1"=10' Option C, Date: 3/20/97." A hearing was held at the Executive Office of Transportation and Construction on Wednesday, July 1, 1998, after publication in The Lawrence Eagle Tribune, on June 12, 1998. Massachusetts General Laws, Chapter 40, Section 54A provides that a city or town must obtain the consent of the Secretary of Transportation and Construction prior to the issuance of a building permit for any structures on lands formerly used as a railroad right-of-way or lands appurtenant thereto formerly used by any railroad company in the Commonwealth. The explicit purpose of the statute is to preserve former railroad property in the Commonwealth for present -or future transportation -related uses. As the executive officer responsible for comprehensive planning in the areas of transportation and construction, I have the obligation under the statute to protect such property for transportation -related uses. Telephone (617) 973-7000 TDD (617) 973-7306 Telefax (617) 973-8445 �orB D. Robert Nicetta July 9, 1998 Page (2) cont. After reviewing the information on file at our office, it has been determined that the proposed construction does not adversely impact any potential transportation use. This being the case, I hereby consent to the issuance of the building permit to Trombly Brothers Realty Corporation for the proposed construction as shown on the aforementioned plan, a copy of which is attached. Sincerely, Patri c J. Secretary 18aiJ TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS NOTICE OF DECISION Date .. July . 1 1 . 9.7.4............. Petition No.. 4-:'.74 ............... Date of Hearing ..June . W.,..1974... Petition of Naomi. L.: Trombly & .Trombly. Bros. ................................ . Premises affected .. 141-1,47. Sutton . Street .............................................. ................................. Referring to the above petition for a variation from the requirements of the ................. .... North Andover. Zoning. By—Law . Sec. ..6.1, . 6..3,..& .7. 2 .............................. . so as to permit .the erection, of .the, garage .and. rebuild. part , of. the garage as, ,shown. on .a.plan..on .the. two. lots. presently. owned. by. Naomi. E...T.r.ombly. After a public hearing given on the above date, the Board of Appeals voted to . -rant ..... the Vari...ance................. and hereby authorize the Building Inspector to issue a ..... permit to ....... ........................ ..................................... for the construction of the, above work, based upon the following conditions: Signed ... Frank. Serio,.. in, . Chairman...... . Dr. Eugene Beliveau, Clerk ..... ............... Louis DiFruscio ........................................ William N. Salemme ...................................... Alfred E. Frizelle, Esq., Aeeo. Member ................................. Board of Appeals s..-• John J. Lyons, Town Clerk Town Office Building North Andover, Mass. Dear Sir: (p APRILiM TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS April 12 , 1973 Trombly Bros., Inc. Sutton Street Petition A`71—t 73 A public hearing was held by the Board of Appeals on April 9, 1973 upon application of TROMBLY BROS.., INC. who requested a variation of Sections 6.3 and 7.2 of the Zoning By—Law so as to permit the erection of an automobile service center located at the south side of Sutton Street at the corner of Main Street. The following members were present and voting: Dr. Eugene A. Beliveau, Acting Chairman; Arthur. Drummond, Frank Serio, Jr., William N. Salemme and Associate Member Alfred E. Frizelle, Esq. who sat in place of. J. Philip Arsenault, Esq. Atty. Charles W. Trombly, Sr. represented the petitioners. He exmiained that several buildings had been razed to prepare for the erection of a new automobile service station; the presently existing station will also be razed if the petition is granted. It is necessary to apply for several variances because of the unique shape of the lot. The brick building will be approx. 20 feet away from the existing dwelling. A variance is necessary under Section 6.3 because the building does not have the required distances from the lot lines. Under Section 7.21 the following variances are necessary: A variance to allow the proposed building to be closer than the required 50 feet from a residential structure— 7.2, (k) The minimum average setback from all street lot lines is 30 feet, 40 feet is required. 7.2, (6) A variance is necessary to eliminate all but 20 feet of the curbing on the Sutton Street side. 7.2, (7) Screening shall be provided by (a) a four—foot strip of_ shrubbery. There was no opposition to the petition and no one else spoke. The petition was taken under advisement and during that period was reviewed by the Board. Mr. Drummond made a motion to GRANT the variances as requested with the condition that a sit foot stockade type fence and shrubbery shall provide screening as shown on the plan; Mr. Serio seconded the motion and the vote was unanimous. The Board found that the lot is of a unique shape and that the variances requested were necessary in order to properly locate the building; that by providing screen— ..r `7i Trombly Bros., Inc. _2 - April 12, 1973 ing near the dwellings, it would provide protection and enhance the appearance of the property. The petitioners had razed several old structures and by erecting a new service center, which is an allowed use in this General Business District, the appearance of the neighborhood would be greatly improved and would in no way be detrimental to the area. The proposed building will be further away from the lot line than the building that had been razed. The variances requested would not be in great deviation from the intent and purpose of the Zoning By --Law and there would be a hardship, financial or otherwise, to the petitioner if he were not allowed to locate the building as requested. Access in and out of the station would be regulated and controlled by the curbing and the design of the building. The Chief of Police reported that he had no objections. AD Very truly yours, _ BOARD OF. _APPEALS Dr. Eugene A. Be?iveau, Acting Chairman 01 plt"•N tO• �. AretLl!' TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS July 1, 1974 Naomi E. Trombly & Trombly Bros., Inc. 141-147 Sutton Street Petition No. 8-74 John J. Lyons, Town Clerk Town Office Building North Andover, Massachusetts DearSir: A public hearing was held by the Board of Appeals on June 10, 1974 upon application of Naomi E. Trombly & Trombly Bros., Inc. who requested a variation of Section 6.1, 6.3 and 7.2 of the Zoning By—Law so as to permit the erection of a garage and rebuild part of the existing garage as shown on a plan on the two lots presently owned by Naomi E. Trombly, located at 141-147 Sutton Street. .The following members were present and voting: Frank Serio, Jr., Chairman; Dr. Eugene A. Beliveau, Clerk; Louis DiFruscio; William N. Salemme and Alfred E. Frizelle, Esq., Asso. Member. The hearing was advertised in the Lawrence Eagle Tribune on May 25 and June 1, 1974 and all abutters were duly notified by regular mail. The petitioners seek a variation from the provisions of Sections 6.1, 6.3 and 7.2 of the Zonnng By—Law. Previously, the Board granted a variance from the same sections in a decision dated April 12, 1973. This application is essentially the same as theprevious application except that one lot is deleted and, therefore, the size of the lot is smaller. The petitioners con— t'end that developments subsequent to the granting of the original application make it unfeasible to construct as originally planned and accordingly bring in this petition. The Board, after reviewing this present application and its previous decision, grant this petition and, on the basis for its decision, incorporate herein its decision of April 12, 1973. Very truly. yours, B OF /AP Frank Serio, Jr., Cfiairman gb