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Home My WebLink AboutMiscellaneous - 1940 Great Pond Road �1 4 i i i i' Date... ./7:.!�l......... NORTH °f 6 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING • i # 1 lo SS�cHuS� This certifies that has permission to perform ✓f.:.>...... �- ................ wiring in the building of...:f 'a.:./` . !. � . . .. ....1/' ... z . - . at.. � p......... 1................ .................................. ,North Andover,Mass. Feeds.'....... Lic.No.4V��- ..�.. ... ! fir: �'............ ELECTRICAL INSPECTOR Check # 112,r 5477 09/10/2004 10:10 9786821646 PAGE 02 �= COIpnt00weeflh of AInSwhusettS omcial Use only Department of F/m Sorvkos henroui No, -L4 `l BOARD OF FIRE PREVENTION REGULATIOJNRFORM . S Occupancy and Foe Chocked 01-1 j ff(ev. 11/991 (leave blsnt APPLICATION FOR PERMIT TELECTRICAL. WORK All*Wk to be petfonwd is wmdaw with fts ElmttiW Code(MSCI 527 CMR 12.00 (PLEASE PRINT ININK OR TME ALL IN,F1 PRMATI0N, Dote: 09/09/04 City or ToWa of: N".lndover I .To the Inspector of Wires: By this application theYea native of his to perform the electrical work desetibod below. Location(Street&Number) 1940 Grw pond Road Owner or Tesast North And der Water Tire arneat TdtpbW No 9n-M-9574 Owner's Address 420 great Pond RoA North Andover MA 01845 Ia this pan#in cosjoaactian with a building permit? Yes ❑ No ❑ (Cho&Appropriate Hos) 'rpm of SfAtioa Utility Ast6orLsntios No. 136328 Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Serol' g 100 Amps x20/240 Volts Overhead X Usdgrd❑ No.of Meierl Number of Feeders and Amepacky Location,and Nature of Proposed Electrical Work: Install 100 Amp,120/240 Volt Sen= complaw 0fdW oilai.' table be waived by the Ins wires. No.of Recessed Fbtdtres Na of Cell-SOW.TWd lc)thorn Traudormers Told KVA Na of Outlets No.of Hot Tubs y Gmesuon KVA No.of Lighting Flstnres Swimmiog Pod d e Q d. ❑ Haft=unlre y No.of Rs+oeptaele Outlets Na of Oil Dersers PMALAIM No.of Zo&m No.of Switches No.of Gas But im No. TOM b!Llaft Devices Na of Rases No.of Air Conti. Tom a of Alerd%Devices No.of Waste Disposers Totem: -ods..,,.. ,.,...,......._..... De°tatiad Devices 1 No.of Dishwashers SpftWAms Beadog ICT 1WA ❑ ❑ Other Na of Dryers Heatisg Appliasoes KW SMY S No. Devices or . alert o. o. e. Haben Klh► g• Ballasts D N&of xkwices or Egivalest No.Hydromassage Batbtnbs Na of Motors Total HPcom u Devices a,iL iri OTHER: Lm Aftch additional ddtail Vdarirwd oras required by the i►wpeetor of iPirr 1. INSURANCE COVitR,RG1P: Unless waived by the owner,no permit for theperfbmmmce of electneal work may issue unless the licensee provides proof of liability insarmtee inditg"completed operation"coverage or us sobstmW e"valem The wtdersigttod co ifies that such coverage is in force,and has emb ted proof of same to the permit na mg orate. CHECK ONE; INSURANCE x BOND ❑ OTHER [] (Specify;) xpusao�a see Estimated Value of Electrical Work; (Thea required by municipet policy) Wo&to Start; laspections to be requested in accordance with NJEC Ryle 10,Asad upon completion, I ewdfi,solder the parrs autdpertalUS of PedWY,that the Ir!joraratlon on thin q p&wdon is&ue and eawtpL ta: FIRM NAME: Lmdcn Electrical Co.,Inc. LIC.NO.: A3912 ya I.icewiee: Virtoem B.LsadeM Pres. LIC.NO.: A5912 llfappueawA enter"an"Pt"in the It MM rnneber line.) c/t Has.Td Ns:: 978-616.3= Address: '.1000 Osgood St.,No. Andover,MA 01845 Ale Tel,No.,• OWNERS INSURANCE WAMIi. I am aware that the Liceosoo does nor have tie iTabthty jagotanoe cmetage normally --"—A A..14— Aa.......:.....ti..r Min.. i 1,5_-,h—our rerw.:rn.wawl I ww.f1.�/,.1�w.b--'4 r,....,.,.r 09/14/2004 TUE 14:21 FAX 894 6383 CRONIN & GERVINO INS 001 AGD-R, Q CERTIFICATE OF LIABILITY INSURANCE 09/14/2 0 PRDDucER (Ci03)898-6500 FAX (603)870-9444 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cronin & Gervino Insurance ONL"AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 288 North Broadway ALTI!A THE COVERAGE AFFORDED By THE POLICIES BELOW. Salem, NH 03079 George Hahn INSURERS AFFORDING COVERAGE NAIL# tNSUREO Fortin Electric•• •• - NSUREPIA Peerless Insurance Company 8 Rebel Road wsum,e,Guard Insurance Coopany Unit 2 'Nsur+EFlc Hudson, NH 03051-3041 NSUREII o _• iNSUREp E: COV RAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMIED 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 DY THE POLICIES DESCRIBED HEREIN IS SUIIJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ II/SR P MqRrl TYPE OF N18URANGE POLM Y III1MBfA PRICY EFi-'_UTNE POLICY DPiRATI UWTS GtENERAL LIABILITY CCP9603598 07/12/2004 07/12/2005 EACHOCCURRENCE S - 1 000,00 01 X COMMERCIALGENERALUAHWTY TO RENTED I- - • S 5O 00 CLAIM5 MADE OCCUR MED EXP(AIN ane Deleon) S_AOOO, A - KRSONAL a AoV INJURY SGENERAL AGGREGATE SGEtfIAGGREGATEIWRMPLIESI'F PRODUCTS-COMPYOOAGG S POLICY .IST El LOC AU MMOBILE LIABILITY BA9629717 07/12/2004 67/12/200$ CONtBpyED:WGLE CDA'f S - ANYAUTD Meacodent) _ 1 000,00 ALL OWNED AUTOS BOMY INJURY S X SCHEOULEDAUTOS (Po�t✓d ) A X HIREDAUTOS BODILY NJURY (Pa�dert) $ X NON-OWNED AUTOS _. PROPERTY DAMAGE s< — (Per AWMI) GAR110ELWBI►TTY AUTO ONLY-EA ACCIDENT E ANYAUTO OUERTHAN IAACC S AUM ONLY: AGO S EXCESSNMBRELLALIABILITY EACH OCCURRENCE S OCCUR F-1 CLQMS MADE AGGREGATE S � S DEDUCTIBLE 3 � RETENTION S . $ WORKERSCDMPENSATIONAND FOWC5297S7 07/12;'2004 07/12/2005 wCS]r,, TM- EMPLOYERS'LIABILIYY E.L.EACH ACCIDENT S 500 B ANY tVE OFFICERIMEMSER EXCLUDEDI EL DISEASE-EA EMPLOY $ S00 r 0 Ry�"'W"i�o EL DISEASE-POLICY UMR S 500,0 SP6C4tL f�ROVIS10NS below OTHER r7 I DESCRIPTION OF owAATIONS 1 LOCATwNs I VEHICLES I EXCLUSIONS ADDED BY ENDORSEM ENT1 SPEC AL PROMWKS EIRTIFICATIF HOLDER CAN TIS %%ULD ANY OF THE ABOVE DESCRIBED POLIC"BE CANCELLED BEFORE THE EX.PIRATIONDATE THEREOF,THE ISSundr INSURER WILL ENDEAVOR TO MAIL j.O DAT:WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAM T:D TO THE LEFT, Town Of North Andover BUT FAIWRETOMAIL SUCH NOTICE SHAL4MMPOSENOOBLWArONORLIABILITY 27 Charles Street Of,ANY KIND UPON TMINSURER, NYS AEP T2:81 North Andover, MA 01845 AVYWRIZEOREPRESENTATIVE 7- ACORn25(200110g) FAX: (978)688-9542 @&ORD CORPORATION 1938