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Home My WebLink AboutMiscellaneous - 27 EAST PASTURE CIRCLE 4/30/2018 (3)PI) -lj I '.' I Date.4.2 .. k .. 1 '5 ................ ... . . . ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... (�,p ..................................................... ..................................... .. , has permission to perform c;2 I QLo(4-tv ......................................... .............................................................. wiring in the building of ............... P.! I -L k ,,, -:�- ........................................................................................ at ......... !��J ...... L .. . . ..... orth Andover, Mass. ....... ........ ... ........ ......... .... Fee ... . . ......... Lic. No. �13�1 ........ .................. ELECTR I P* C- T**O'RV Check # -T-lq Cl r Print Form Official Use Only Permit No, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS IRev-1/07] (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Mawachusetts Electrical Code (MUC). 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INPOROA TION) Date; -1 �, City or Town of: _4.IQC4-h HM(,)Q�P-r To the Inspector of Wires: By this application the undersign6d gives notice of his o Ictition to perform the electrical work described below. Location (Street & Number) 197) OwnerorTenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box) Purpose of Building w/ Solar - PV Utility Authorization No. n/a Existing Senice Amps Volts OverheadEl UndgrdE:l No. of Meters New Serxice Amps Volts Overhead El UndgrdE] No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install Solar Electric -Photovoltaic (PV) system [?--� panels]— rated'?,L')'7 kW -DC @ S.T.C. Grid Tied. In conjunction with a Building Permit. Comnlelion ofthe Milaivint, lahle maw he twived hu dre lacneelw tifivirike No. of Recessed Luminaires No. of Cell.-Susp. (Paddle) Fans No. oF Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above F] In- ernd. arnd. 0 No. ot Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS JNo. of Zones No. of Switches No. of Gas Burners N -5-.o? Detection and Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: I Number I Tons KW NK . of Self --Contained Detection/Alertiop Devices No. of Dishwashers SpacelArea Heating KW ips] lAcal El mun'c,ti,, El other Conne No. of Dryers Heating Appliances JKW urity Systems:* No. of Devices or Equivalent No. of Water Heaters KW No. of No. of --- Signs Ballasts Data Wiring: No. of Devices or faulvalent No. Hydromassage Bathtubs -rNo. of Motors Total HP Telecommunications Wiring: No. or Devices or Equivalent OTHER: Allach additional detail ff desired. a)- as required ft, lite Inspector nf'Wirex. Estimated Value of Electrical Work: 12-1 C)C)() (When required by municipal policy.) Work to start: A.S.A.P. , 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 uniess the licensee provides prootof 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 2) BOND [I OTHER [:1 (Specify:) I ceWfy, under thepainS 4ndpenaldes ofperjury. that the Information on this application is true and complete FIRM NAME: SOLARCITY CORPORATION LIC. NO.: 1136 MR Llcensseee: Matthew T. Markham Signature, LIC. NO.: 1136 MR (11'applicable. enter "emempi *'in the fiernse number finej Bus. Tel. No.., 774-258-8180 Address: 24 St. Martin Drive (Building 2 / Unit 11), Marlborough, M& 01762 Alt. Tel. No.: 774-25"505 *Per M.G.L. c. 147, s. 57-6 1. security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the li ifity insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) [] owner 0 owner's agent. Owner/Agent Signature Telephone No. PERurr FEE: s A , I - I I � a eA L-3 , - -i-, t .?J fyv 7-7 2, X0 T '*, 0 h,4 It -----Office of Consumer Affaim & BustinessRegulatian '. �A .- I , �16. -ffOME IMPROVEMENT CONTRACTOR e'. , Registration: 168572 Type Expiration: 31812017/ Supplement SOLARCITY CORPORATION MATTHEW MARKHAM 24 ST MARTIN STREET BLD2UNI WLBOROUGH, MA 01752 Undersecreftry COMMONWEALTH OF MAS"CHUSETTS ELECTRICIANS ISSUES THE FOLLOWING LICENSE AS A, REGISTERED MASTER ELECTRICIAN SOLARCITY CORPORATION MATTHEW T RARKHAM 24 'SA I N't MART I N OR BLDG 2 UNIT 11 MARLBOROUGH MA 01752-3o6o 4 The Commonwealth of Massachusetts Department of IndustrialAccidents Orice of In vesfigations I Congress Street, Suite 100 -2017 Boston, MA 02114 wwwmass.govldia Workere Compensation Insurance Affidavit: Builders/Contractors/ElectrAciang/Plumbers Anplicant Information Please Print Legibly Narric (BusineWOrganizationAndividual): SOLARCITY CORP Address: 3055 CLEARVIEW WAY UitylbtatetLip: —,- --- I --, imone n: %--vu Are you an employer? Check the appropriate box: Type of project (required): 1. N I am a employer with 5000 4. E] I am a general contractor and 1 6. C1 New construction mployces; (full and1WWTt--C6W).* 1 am a solc proprietor or partner- 2.0 c have hired the sub -contractors listed on the attached sheet. 7. E] Remodeling ship and have no employees These sub-contractots have 9. E] Demolition working for me in any capacity. employees and have workers' 9. [] Building addition [No workers' comp. insurance required.1 comp. insurance.1 5.0 We are a corporation and its I0.E1 Flectrical repairs or additions 3.E] I am a homeowner doing all work officers have exercised their I I.[] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E] Roof repairs insurance required.) t c. 152, § 1 (4), and we have no 13A Other SOLAR / PV employees. [No workers' comp. insurance required.) *Any applicant ihatchech box# I mitst also rill out she section below showing their work-ers'compemation policy inrufmation. t I lomeowners whosubmit this affidavit indicating they ate doing all work and then him outside contraMrs must submit anew affidavit indicating such. lContracim that check- this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees. they must ptovide their workcFe camp. policy number. I am an employer that Isproviding workerscompensaden Insurancefor my employees. Below Is the policy andjob.file Information. Insurance Company Name: LIBERTY MUTUAL INSURANCE COMPANY Policy # or Self -ins. Lic. N: WA7-66D-066265-024 Expiration Date: 09/01/2015 job Site Address: -Z-:2 F, 1'�f zx-e ccr- City/Statelzip: �Unr�h Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to swore coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 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 that floe iorformadon provided above Is true and correct. 'A Phone ft- Offlclat use ottly. Do not write In this area, to he completed by city or town offtchil. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: ACC>R& CERTIFICATE OF LIABILITY INSURANCE wy DATE (HMO YYY) 1 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL (197910114 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. It SUBROGATION 13 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 andorsement(Q. PRODUCER MARSH RISK & INSURANCE SERVICES CONTACT HAPPE: -- PHONE !FAX 345 CALIFORNIA STREET, SUITE 130D jar E.11� JAIC' Nei; CAUFORNK LICENSE NO. 0437153 SAN FRANCISCO. CA 94104 ADDRESS: 100,000 INA!!RER(SJ AFFORDING COVERAGE NAIC 4 998301-StNO-GAWUE-14-15 INSURER A: Liberty MoW Fits Insurartm Company 165H INSURED INSURER 0: L'Wrly 'nswarim Cowabon 42404 Ph (650) 963-5100 MED E XIP (Any.pria person) 'S SolarCity Corporabon INSURER C: NIA NFA 3055 Ckmv;ew Way INSURER 0; Son Maloo CA 94 402 INSUR RE: 2,000.000 INSLIR:R r CCIVFRAr.FS rr-QTIVl1f`ATF MHUR1120- 01N.UJIMInu UIIIU11w0. I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOIWITHSTANDING ANY RLQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH RESPECT 10 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. U XCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOM MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSU ADD SUOR 'O-OL#CY EFF POLICY EXP I INN i — - RANCE =WVD POLICY Human fumiow"m . imurourryTyl UMITS A 011.E"t UARILITY T92al-OG6265-014 M6112014 EACH OCCURRENCE 1.000.000 109/0112015 X COMMERCIAL GIENERAt 04811 I1Y DAMAGE TORE POED 100,000 X IOCCUR 10.000 CLAVAS -MADE MED E XIP (Any.pria person) 'S PERSONAL & ADV INJURY 6 1.000 ODD GENERAS AGGREGATE S 2,000.000 OEWL AGGREGATE I IMI I APPLIES PER PRObUCTS - COMPIOP AGG S IDeduclible 2,0DO.0001 X I POLICY: X . M 4 � LOC - Is 25.= A AUTOMOBILE UAINUTY AS? -661-06G265-044 ONI12DI4 100,10112015 I i C471MONE5 SINGLE LIMP I . (CO pocideni) I 1F 1.000,D00 X I ANY AUTO BOOK Y INJURY (Per oe(wril S ALL OVMFD SC14L DUL ED AUTOS AUTOS HODILY INJURY IP*r aecdont) 3 I PRIDAUIOS NON OVINED PROPERTY DAMAGE :AUTOS Phys Damar (Per awo") x COMPICOU Oro, $1.00011im LMOReLLA I" 4 �OGCUR EACH OCCURRLNCL EXCESS LIAO I CLAIMS MADE AGGREGATE 1*0 1 1 RETENT;QN$ WAI-6604K 'WORKERS COMPENSATION OMIM14 109MI7015 4M24 X AC STATLI- 10TIO., AND EMPLOYERS' UAOILJTY AW PROPMETORIPAR11 NFRII K(CUT IVE iWC1-66t4)66265-034 (WI) '09-00112014 0910112016 . I DRY LIMIT S ER 1,000,000 I DFrICERIVEMBER EXCLUDE J�NNIINIAI 1 B IM6ndblory—Hp 'WC DEDUCTIBLE: $350.000 E I I AClIACctDENT 4 S t t 01SE-ASE - FA EMPLOYEX S I.000.0w MAPTtam MOPC 1.000.000 RA1.ONS 0 t I DISFASE POLICY LIMIT!$ "SCIMPTION OF OPERATIONS I LOCATIONS I VEHICLES fAftech ACORD 110i. Additional Remark* Schedule, It more space Is required) I vaeim or Insuratim W&C11Y C01WdlOt 3055 Clearviewway San Matoo. 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U -0 -0 0 0 ow 03 z 2 r_ 0 LU -j = 4 0 LU LLJ I.- z (1) u - 0) C- Z) 'D *5 a) ..9 0 C 'A Lu u dw D U.F 0 C6 06 E 0 u E z 0 E u 0 >� �;, �;- c: z z LU U E 6 6 -0 o 0 c, CL 2 CL :) U-70 c = 0 V) c 0 c: 0 ui n 2 4) v > u U- LU -� z E 0 C) 0 m U 0 :E —0 3: =, :, -0 o a 0)0 ID C 2 -5 -�; 'ED -o- C3 i= -6 > 0 W > (D 09 0-9 LL. -0 E ul u 0 c 0 ui CL '0 .2 a C) = cL EL > of LU LO LU 0 0'a 04 10 LU U z 0 CL. (1) S; 0-0 0 -0 c =) (1) .0 @ 0 u 2t 2 fl- = n c ou cc � E 2 8 6 9 8 8 a 8 8 a 2 0- Z- 2 0 0 a) u I z 0 w u Z 0 0 5� U U 0 Z Q) Q) - CL 0. U -0 -0 0 0 ow 03 z 2 r_ 0 LU -j = 4 LU LLJ I.- z (1) u - 0) C- Z) 'D *5 a) ..9 0 C 'A Lu u dw D U.F 0 C6 06 E 0 u E z 0 E u 0 >� �;, �;- c: z z LU U E 6 6 -0 o 0 c, CL 2 CL :) U-70 c = 0 V) c 0 c: 0 ui n 2 4) v (j u U- LU -� z E 0 C) 0 m U 0 :E —0 3: =, :, -0 o a 0)0 ID C 2 -5 -�; 'ED -o- C3 i= -6 > 0 W V) (D 09 0-9 LL. -0 E ul + 0 0 c 0 ui CL '0 .2 a C) = cL EL of LU LO LU 0 0'a 04 10 LU U z 0 CL. (1) S; 0-0 0 -0 c =) (1) .0 @ 0 u 2t 2 fl- = n c ou cc � 0 u 0 u -0 0,6 r) .�- > z< < -6 '6 < 'o o . FE i.s � 0�: S a u � t 0. 0 F� 0 rl �g LU -j = LU * LU LLJ I.- z (1) u - 0) C- Z) 'D *5 a) ..9 0 LL. Lu u dw D U.F 0 C6 06 E 0 LU z z z LU 6 6 -0 o 0 c, z = 0 E' .0'-2 E -c. (01 O,Z: -c -0 E (3 -6 > UJ I.- o C4 U- LU c5 o U.0 :)'� . 0.- - -C 0) .0ca) �-X-o Muo)OcLt2�6 "o 0 0-4 0 -0 0 c: jo-- u c (D E c u - 2,5— ow E 0 C) 0 m U :E 3: =, :, -0 o a 0)0 ID C 2 -5 -�; 'ED -o- C3 i= -6 > 0 W V) 09 0 + 0 C: o � o o D -0 0 u a) ,� u 'Lao of LU LO LU C-6 ;a)Q)E C: , 6.21-6 2 _0 u z a.2 0 �6'Fj 0 T"4)UC QRn (D=-2*6�00) 0'a OEM t 0 CL. (1) S; 0-0 0 -0 c =) (1) .0 @ 0 u 2t 2 fl- = n c ou cc � E C4 10L. 0 9L c < 0 0. �- E 2 R �p _,a o no -b .5 t 3: co rl: Ln mm ui ml 0 M c; o ZZ M 0 .6 .6 w 1 6 N'LL , c6 i m K 6 �6 u ad LU -.6 a 0 6 >, -u u � o o E o n -a a 2 '5 E 0 0 o 0 z 0 mi z :3 E 0 > E 6 c� o6 Lo u ma uj ;5 0 E U. U. ui 0 0 -.r u O)o 0-- cc LT 'a 0 0,12 C 0 0.0 0 0 4-- (D:.0 u IC) c t- CwESQg5-d2-6-_o- 75)0-0"8�20E-c- b "0 u CL � a) c -�Oo>015-- 0)= 0 LU a) 0 0 u 0) � 6 >,t; a) 2 � a) 0) U.0 0 c 3� 0- 2D 3: c E� a) Q)lu-aaD -5 � 0) c E '6 u W) L3U: x 'A o u a 0 0 � �5'0 �:E 0 u c 0"- (D = 0 U D 15 C 0 0.0 0) Q) -o 0.. 0 � .-.s =) a) � s < C40 E 0 0 U U 0 7C) C3 0 0 3: a) > < E 0 "E 2 CL o a o 4 0 = [L cL E > _c i 0 E E: c) E z E u 2� > - () o u Y 0 L *5 =� U 3: 0 E , E 2 , 6 2 u E E E 2 u < E .9 . 2 E U sz 0 . a) 6 U 0- :E 0 0 .,u :E -6 :E :E 0 :E o 0 > E E z 0 z 180 150 990 i i i —1 <1 U59L co I C) 0 CL <1 pull N'LL u z 4 0 U59L co I C) 0 CL 0 u o E z a) U E o Z -Z o Fu 0 o 0 :E 3� 0 u i 0 0 u u C) < 2 2 z E :E o > :E o > Z .2 LD z u u -0 (D a) 0 0 0 0 U CL 02 2 2 2 R R 2 R a) a) d) E , E E E E z -1) -1' -1' ui :E pull u z 4 0 0 Lu u ad LU -.6 a 0 6 >, -u u � o o E o n -a a 2 '5 E 0 0 o 0 z 0 mi z :3 E 0 > E .2 E 0 i5 D- 3� 0)76 0 a) �2 E ic , � E.2 -6 C)-> 5 0.9 0) ma uj ;5 0 E U. U. ui 0 0 -.r u O)o 0-- cc LT 'a 0 0,12 C 0 0.0 0 0 4-- (D:.0 u IC) c t- CwESQg5-d2-6-_o- 75)0-0"8�20E-c- "0 u CL � a) c -�Oo>015-- 0)= 0 LU a) 0 0 u 0) � 6 >,t; a) 2 � a) 0) U.0 0 c 3� 0- 2D 3: c E� a) Q)lu-aaD -5 � 0) c E '6 u W) L3U: x 'A o u a 0 0 � �5'0 �:E 0 u c 0"- (D = 0 U D 15 C 0 0.0 0) Q) -o 0.. 0 � .-.s =) a) � s < C40 91- 0 0 —0 0 7C) C3 0 E o LL. E 0 C: 0 LU c: W.- Q C) CL o a o c? 0 = [L cL E > _c i 0 E E: C 0 C -,T ui 0 E z E u 2� =3 u Y E 0- - ;. 0 b -5 E 2 . 2) E < -u -6 0 E E < 0 > E E 7 E :E 0. < , �i C'� 3: - 'i . - E '- = 0 u o E z a) U E o Z -Z o Fu 0 o 0 :E 3� 0 u i 0 0 u u C) < 2 2 z E :E o > :E o > Z .2 LD z u u -0 (D a) 0 0 0 0 U CL 02 2 2 2 R R 2 R a) a) d) E , E E E E z -1) -1' -1' V 310Z 4—W N3 VqSl 2 3: 0- 4 -o :E 27 U 0 t E 3: 0 o C, z 0 0 EL -P 0 u U 0 0 3 7 u 0 0 :i :E 6� 8' z 0 2 r 0 ui :E pull u z 4 E 0 Lu u V 310Z 4—W N3 VqSl 2 3: 0- 4 -o :E 27 U 0 t E 3: 0 o C, z 0 0 EL -P 0 u U 0 0 3 7 u 0 0 :i :E 6� 8' z 0 2 r 0 ui :E u z 4 E 0 Lu u ad LU -.6 a 0 6 >, -u u � o o E o n -a a 2 '5 E 0 0 o 0 z 0 mi z :3 E 0 > E .2 c: 0 a u 0 i5 D- 3� 0)76 0 a) �2 E ic , � E.2 -6 C)-> 5 0.9 0) ma uj ;5 0 E U. U. ui 0 0 -.r u O)o 0-- cc LT 'a 0 0,12 C 0 0.0 0 0 4-- (D:.0 u IC) c t- CwESQg5-d2-6-_o- 75)0-0"8�20E-c- a CL � a) c -�Oo>015-- 0)= 0 LU 0 U a) 0 u 0) � 6 >,t; a) 2 � a) 0) U.0 0 c 3� 0- 2D 3: c E� a) Q)lu-aaD -5 � 0) c E '6 W) L3U: x 'A o u a 0 0 � �5'0 �:E 0 u c 0"- (D = 0 U D 15 C 0 0.0 0) Q) -o 0.. 0 � .-.s =) a) � s C40 91- 0 0 —0 7C) C3 0 4) o LL. E 0 C: 0 LU c: W.- Q C) CL o a o 'o = [L cL 0 0 > _c i 0 E E: C 0 C -,T ui 0 z =3 LU a o .2 2. LD -6 0 z w E o c -o lo 0.= u 0 'u OF F- 2 rc m w -E 4) 0 E Z. �g j c -8 li� 21 I'd LU I m ui :E u z 4 - a) c '6.Y - 0) - �5 u 0 Lu u ad LU -.6 a 0 6 >, -u u � o o E o n -a a uj U. I-. z LU --i 0 c o .2.2 Q 0 C: C: mi z :3 z LO < ag LU 0 i5 D- 3� 0)76 0 a) �2 E ic , � E.2 -6 C)-> 5 0.9 0) ma uj ;5 0 40 U. U. ui 0 0 -.r u O)o 0-- cc LT 'a 0 0,12 C 0 0.0 0 0 4-- (D:.0 u IC) c t- CwESQg5-d2-6-_o- 75)0-0"8�20E-c- CL � a) c -�Oo>015-- u(A >- cc u z 0 C4 LU > 0) � 6 >,t; a) 2 � a) 0) U.0 0 c 3� 0- 2D 3: c E� a) Q)lu-aaD -5 � 0) c E '6 W) L3U: x u a 0 0 � �5'0 �:E 0 u c 0"- (D = 0 U D 15 C 0 0.0 0) Q) -o 0.. 0 � .-.s =) a) � s C40 91- 0 CL (D -0 .9 - .0 c -0 u � 2 O.0 0 a) C: 0.6 < 0 OL Ou �- �L a _0 0: -� .6 0-2 -0.2 0 n 1---d PO9IUO=O E ,a 0 4, u 0 -a 9 3: 0 F F- F 16 -E 0" "R 70 IR pu� sm� ":4 'o va 0 23 po R-.2 m w RA -r, >0 INT 0 0,0 0 9 Z 0 0. 02 0 41 0 . 0 8b - 0 80' g -0! W- C-, v �R r -i Ei 2 51 - L- � -. -,� .8 -- bD 4, 0 0' 0 �>"'� w -Q E! o o in 0 0 010 m 0 040 4� 0 E '04 12 --rz o (U 0 0 40� 41 .2 4� 0 0-0-2 o L, r.. 0 0 or- o :Ei eq !:I Lg 0.2 C*A 0 P4 0-2 98bl 12- >-8- / 'q Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING A ....... 4 This certifies that ................. . ... z7 ,5'& e- & n / - perform ....... ../ ........... has permission to wiring in the building of ......... ........................... at 7 ........................................................................... ;,,\, North Andover, Mass. #!'#'P' C FeeLic. No.... 4/� ... ................... . .................. ........... Check # 3 -� ?, 2 EtycmicAL INSMCiOR / - <n\ , COMM40nttleall 4 / rdiia.-lutieffi fficial Use Only 6 F Permit No. '),--cup-,mry �ind Fee Checked BOARD OF FIRE PREVENTION REGULATIONS fRev. 1,07"' flea\t� blank) —J APPLICATION FOR PERMiT TO PERFORM ELECTRICAL WORK All work to be perforined in accordance vitli flie �\lassarlluseirs L1,�c1rical Code 00EC). �17, C%IR I lo() (PLE.-!S,'-�'PR1,VTI.,NT1jVK0R TYPFALL LVFOJ�,114T[0�,v) Date: / 1:P - -�) C) - 1.6 City or Town of: .. Zuoy- M 4 A)dJV4,& To the h7q)ector ofk'Vires: By this application the undersi2ned Oves notice o is o5�er intention to perfarm the electrical %%'-'ork described below. f h' Location (Street & Number) -3 7 111�-. a �u /1 6 - Z' -5 Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Purpose of Buildin Existing Ser,?ice Amps New Service Amps Number of Feeders and Ampacity Telephone No. 79-6 Yes 0 No (Check Appropriate Box) Utilit-vAuthorization No. Volts Overhead I- nd-,d Volts Overhead [::I Un'd-rd El Location and Nature of Proposed Electrical NVork: No. of Meters No. of Nleters No. of Recessed Luminaires I -- "' —I — ... "' -- No. of Ceil.-Susp. (Paddle) Fans 1-- 11 1-11VU U� MC lnsvecior oT wires. No. of Total ITransformers KVA No. of Luminaire Outlets No. of Hot Tubs iGenerators KVA No. of Luminaires Above In- r�, ISwimmin- Pool I, O.Ot mera-encyll-ignting 2rnd. 2rnd. 113attery Ur nits No. of Receptacle Outlets lNo. of Oil Burners FIRE ALARMS No. of Zones No. of Switches ..No. of Gas ]Burners No. of D—etection and I Initiating Devices No. of Ran -es L- No. of Air GQnd. Total Tons No. of Alerting Devices No. o."Waste Disposers H iqel*..[.1.9.p�_.I..K.N.�N."..�� —.No. of.Self-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW El Municipal Local Other No. of Dryers Heating Appliances KW 'ecu itvsyste.msl:* No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No..of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications �V'irina: N f)f [07T�ER-, imucn uaamanat aerou Y desired, or as required by the Inspector offires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: ct-�/) Inspections to be requested in accordance with MEC Rule 10, and . upon completion. INSURANCE COVERA(§E: U---nless waived by the owner, no permit for the perf6rmance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. Tile undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 2 BOND EJ OTHER (SpeciN:) Self insured I certify, u nder th e pains and penalties ofperjury, th at the orination on this application is true and complete. FIRM NAI'NIE: ADT Security Services LIC. NO.: Licensee: — Mark A. Brophy — Signature— LIC.NO.: C-45 (If enter "exenipt " in the license number fine.) Bus.Tel.No. 603-504-5928 Address: 18 Clinton Drive Hollis, NH Alt. Tel. NO.':*—_— - f *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lie. No. 00953 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) [I owner Downer's agent. Owner/Agent Signature Telephone No. FPERMIT FE, E: $ 411� ,Z) :7- '-1 7.. �l DEPART-MENT OF PUBLIC SAFETY D TEM co .0 R SYS S - Li--efise =RF -G ISTERED �.- :�-' - � Number SS CO 00-3c-53 'ISSUES T�iE ABOVE L iCENSET0.--,. J. Expires: 17-2-17"10.1 Tr. no: 117.0 'A D.T.- S E U n i Ty S E� R V I c I N -��i ME A R r�. ;7- A :BROPHY.-:-.SR -License: AD YICE S T SECURITY SER' U �-I /'tR§-LTY.-A V :4. �ROPHY S- -.W E S TW 0 0 b MA`� 0 -)-0 9.0 1 f.-IORS:= ST NORV)000. NIA 0204.52 :--.45 C 07/31/1 3 C 0 11 1-ts 5 ion e f 'Fold, Tbon oglacil AlangLAM PgeOmtic� ,Z) tzj r 0— Location S/ rilc Ile No. Date TOWN OF NORTH ANDOVER w gm �Inj k Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ CHU Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building ln�pector 03/16/9'1 Div. Public Works El fn I > iz LU cc < vi z Z z z ww U; z LZLJ 0 IY) < LU LLJ G3 Lu —2 7, < ce W 4 Lu Z < w I LLI —i z z tn 6" w LU < < Z Z LU 4 0: uj u LU z t IQ LU z u Z, z V) z W . Fj z z m z CT , ce U, LU w w m z E FORM U - LOT RELEASE FORM 0 INSTRUCTIONS: This form is used to -verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICA-N FILLS OUT THIS SECTION************ APPLICANT_ Oft 0 ru- PHONE (i LOCATION: Assessoes Map Numbe PARCEL Z097 SUBDIVISION LOT (S) STREET ST. WNBER-�Z ,TIONS OF TOWN AGENTS: CONSER ATION ADMINISTFL*TOR COMMENTS F TOWN PLANNER COMMENTS USE DATE APPROVED DATE REJECTED. DATE APPROVED DATE REJECTED FOOD INSPECTOi� HEALTH DATE APPROVED /2 — DATE REJECTED /00 iEPTiC R-HEALT DATE APPROVED DATE REJECTED COMMENTS i1---1C�QS4-* - 2,-D' lCe= PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING 4NSP-E-CTO --- DATE— Revised 9197 jM 0 I SEPTIC I SYS TEU DESIGN IN NORTH ANDO Rol VE MA 55. SCA�ES' AS N07Z-D HA YZ -5 EM, YM T -RING, CIVIZ ENGINEERS -q0l,v L41VD sU1?VEy01?5 N OWE-- MARCH J1, 19-95 INC. 90J SAZ Ev 57REZ-T A-, 0 IQ 4AIAEFIE�,o R�5 , MASS 01990 TEL 677-246-2,500 HG n �Y6S Ej s Inc. 12CS lb&&n r9tC1;7ea' to AVMI�Fb c Se ,Ystem 0`esl�rn pla,7 to C&C 07& RES. 2 ClIent b4lt 17CS not been r,9tG1;7&d to construct or s uP&rvl]5'(9 const)-UCM017 of the //7 vi&w Of some, no gucrc17t&& 0/- worcnt 'Dress 0', /�p mco(& to the cl'&nt npl i &G, 7' 0/- to &2& uffi;,ncte use,- relctive SYS16M h7StO11&o(,Ou1-suont to the Olcn. to cny 1-10,V19S dO65' r910,`&S&17t tho't Me 01G/7 meets tb& Stcte Coo'e, 71tle 5 t17e r&qu1?e1-n&17lS of &_yce ,ot wl7ere vcr, Icnces or& noteal ContrCCIOr to 170t/;�V Zngl�7Cer Of C/7 �)/ SI?6 COnditlbn IrOM MOS6 1�7&CCteol diff&1-1�7g All work ond mcten�71s s17011 conform to tl7& c S&CtIbnS of 7itle 5 of tl7e 'O'clicc,ble Stcte Env1?on,-n617tC1 Code. 72ES75- Z 0/7 4 OF S4Z 7H A CENT A YES EAIC INC 43 PETER J. 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M r -1 >01 .zm cb n OZ Ox c x -4 > U) O:r 0 0 mx -i z > ion ;a z 2 rf, 0 x 'U e-, M 0 MWO Wsz urm 00 d r >*> m F z es 10' 0 m r 0 q 0- F 2 c z -0 U r : ' z 0 0 r 0 > *Z. 2 nz %0 nz rfl m M 00 Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building PLeritt (below) Address of Prope f ermit (below) rX for P! Mawl3`ana Parcel Puff ose of Aplication (check below) Pho �fbqp ofApplicant: _JeSingle Family Two Family — 72 fio/cl I the u-ndersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in existence as of the effective date of this by-law, provided that no additional residential unit is created. _Le�f -The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. — This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section "senior" shall mean persons over the age of 55. — This application is a part of a development project which voluntarily agreed to a minimum 40% permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism. approved by the Planning Board that will ensure its protection. — This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. — This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. L".�2 Signatur6-of Owner or Authorized A&d1who—signed the Attached Building Permit Datb This form must be attached to thWBuilding Permit upon application for such permit. FOR14 U - LOT RELEASE FORK INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Phone ca LOCATION: Assessor's Map Number Parcel bN&Pkb1 V,--) Subdivision C-A.D± V,-nh,-,S Lot (s) Street A St. Number RECO TIONS A S: Conservit'ion Adminisl-IlYtor Comments use only************************ Date Approved Date Rejected Kptuwn�rg:�� Date Approved T6wn Planner Date Rejected Comments Date Approved Food Inspector -Health Date Rejected SelAtic Inspector -Health Date Date Approved Rejected .;7134DA� Comments Public Works - s4mpetf/water connections V 2_X1 - driveway Y,!-.rmlt Fire Department Received by Building Inspector Date a - -� gl - —7 0-3 %. %, 41!� cell JUL 3 0 1996 rw�r .A' 4 9! CERTIFICATE OF USE & OCCUPANCY Town of North Andover Date Building Permit Number -1 -1 - THIS CERTIMS THAT THE BUILDING LOCATED ON _�p - ANCE N ACCORD MAY BE OCcUPIED AS WITH THE PROVISIONS OF THE MASSACHUSETTS STATE B ING CODE AND SUCH OTHER REGULATIONS. AS MAY APPLY- Oq CERTEFICATE ISSUED T01"44 ADDRESS ACHUS C2 CO) Cl) 10 0 CD CO) CD CL V) Cl CO2 C -J CD CD CD CL Cr CD CD 0 CD CO) CD co CD ca "0 co z 7 CD CD F OR IN CD CD (0 0 E co CD co C2 C2 CD ca �-o � S- E - C3 =r w ca cr ca So Rco -0 C*') = :=-- 0 im — C) n CL -i co Cl) -1 m CO) C =r"o 1w a) (A -4 C42 =r CL CL 0 Fn co . =r w 0 CA CO) -.40 CD �-o : =r CD -4 co -4 co CA CD 2>4 -0 cw, c) CS co C" 0 to CL C, =r E: Cl) CO) co C-1 -0 C3 0 I= co co, 0) CA cr CL Im CL C=' :E cy r ca -J) co CD I= -0 co CO C'J ir :D co CO) .0 co 0 =r co > = co) C-1 co CO C-) c2i i c') co 4D U) (1) 0 D rD rD z Oil 1-4 r\ -11 C/) '-4 or- rD 0 to 0- n ::r- or T C: E3 C: eD 0 a 0 CL C/) 0 NJ Pj NO "IV I%\ 0 W 0 ME H 0 9 0 41� CD 01 p