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HomeMy WebLinkAboutMiscellaneous - 420 GREAT POND ROAD 4/30/2018 (5) 9 fz2o,+ fb�A i� r_'f J 4 Date..... ? A VkORT" TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING 'tSAcmU This certifies that ..... ........... .......... - has permission to perform .......P &A le .................................. 4. 7- wiring in the building of....... Po.�.. ...6W.. . at...... i �A ad 4, *).................... vorth Andover,Mass. /r . ..... Fee...A/// ..... Lic.Nofl;�© ............. CTRICALINSPECTO Check # 10641 .❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed " on the prescribed form.Ager a permit application has been accepted by an Inspector of Wires appointed pursuant to M.01c.166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of.ongoing construction activity,and may be.deemed.bythelnspector_of_Wires abandoned_and_invalid.ifhe—. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or-the installing entity stated on the permit application. The Permit Extension Act was created by 5eclion 173 df Chapter 240 of the Acts of 2010 and extended by Sections34 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. 14 Rule 8—Permit/Date Closed: 2 I� � ' *'s Note:Reapply for new pe 0 Permit Extension Act—Permit/Date Closed: Official Use Only ccconmoruoealth WSW aUe�artinen�o� ire�eruices Permit No. UV Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5J7 CT 12.00 (PLEASE PRINT IN INK OR TYPE L I1�FORMATION) Date: lzidaau City or Town of. t A� lout/V To the Insrecto ofWires: By this application the undersigned gives notice of his or her in ntEjerfolthe electrical work described below. Location(Street&Number) j Y k Owner or Tenant t A4, e wo I^ Telephone No.Q Owner's Address t- ,t,Ap C Is this permit in conjunction with a building permit? Yes ❑ No ❑ , (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overbead ❑ Undgrd❑ No.of Meters i New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters r Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: CV-R D G h Y tA,6 i, QV F 0e 1. ce Cr 0". Wh l Con1pletionlof the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. TotalTons No.of Alerting Devices No.of Waste Dis osers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems: i'Y No.of Devices or Equivalent No.of Water No.of No.of Data Wigg: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cot/'�is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [&BOND ❑ OTHER ❑ (Specify:) I certify,under theRains andpenafties of perjury,that the information on this application is true and complete: eiy- FIRM NAME: W O h i-t• 1 LIC.NO.: Licensee: �Q v, k Signature LIC.NO.: (If applicable,enter"ezem t"in the licezge nu be line.) /}� Bus.Tel.No.: � d' Address: �►1 n 'Q J 1" 'Q� Y� Alt.Tel.No.: �& � VJ I l �� *Per M.G.L.c. 147,s.57-61,security work requires Depar4iient of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's aent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 1 ' 0 n The Commonwealth of Massaeh usetts Department of Industrial Accidents Office of Invesdgations .600 Washington Street Boston,MA 02111 www.mass gov/dia. Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Letibly Name(Business/Organizatiowbdividnal): Weston and Sampson CMR, Inc. Address: 5 Centennial Drive City/State/Zip: Peabody, MA 01960 phone#: 978-532-1900 Are you an employer?Check the appropriate box: Type of project(required): ` 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers'comp.insurance comp.insurance:$ required] 5. F-1Weare a corporation and its 10.F1 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c.152, §1(4),and we have no 4 ] employees.[No workers' 13.El Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the sectien 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 a new affidavit indicating such. tContractors 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 provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for ny employees Below is the policy and job site information. Transportation Insurance Co. Insurance Company Name: Policy#or Self-ins.Lic.#:• 2099440613 n / Expiration Date: 01 /01 /2012 Job She Address: �� l r-V � r�hCi► ��t City/StatelZi� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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 c under the paints and pe allies !f, erjury that the injbrmadon provided aboveis true correct Si afore: Date: r r Phone#• — Official use anly. Do not write in this area,to be completed by city or town official -City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Date....I—\ ...... ........... OF r10RTly,� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION j � •Z { This certifies tha , h... . ..... ...r........ ............ ... has permission for gas installation . in the buildings of�v.�`�'......�..............:..... C11 ctu¢ !............................. at'y� ..��re-4 Vnrc North Andover,Mass. .......... ...... ........................... Fee......... Lic. No. 133 ............ ,•",•1............................................................... f GAS INSPECTOR Check# 929 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITYNo�rthAndover MA DATE! PERMIT# JOBSITE ADDRESS!,420 Great Pond Road OWNER'S NAME I Town Of N Andover G _ _ _ F OWNER ADDRESS 120 Main Street TEL=978 688-9500 FAX; TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL Ll PRINT CLEARLY NEW:D, RENOVATION: REPLACEMENT:Fj, PLANS SUBMITTED: YES:] NO[ - APPLIANCES-1 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER f i�J' l 1 1 BOOSTER CONVERSION BURNER _AJ^�.�i . .j (__ w(®-1 _J I �_S-i _.f�1 COOK STOVE 1�� '_.. ^1 —�. - �f�J—J �-I .1 -.._.._f—j —J DIRECT VENT HEATER DRYER _I__j __j I —I_1 I I_____j____f I__j ®.J __j _-__I FIREPLACE �J" �'_J FRYOLATOR FURNACE _T1 '_� f — GENERATOR f __. I._._.,j._ _j___1., j—..._(®_1.—i_-_.I.___-1 I.TJ.— J I GRILLE S J ( J _� 1 �J 1- -i INFRARED HEATER _^1.� i -�' 1 (',-j I LABORATORY COCKSI _j__j;___j _(----J—j —A®.J —1' I __f —I.__-J MAKEUP AIR UNIT P._l i ._�(.,�# _—} 1 OVENI POOL HEATER -. J .�1 �-1.�j ROOM/SPACE HEATER ROOF TOP UNIT TEST 1 ®! f I . e1 — f__j I 11----j UNIT HEATER UNVENTED ROOM HEATER __j___J I !__j _____j i —A--j I^j _J __j ^--i ATER HEATER !'__._ I j 1-1___j'_I —I !—I __j —J._—I J—� OTHER Flue Piping .—j —1 I __j ems____._! ___j _..1 ®.._i I —J,__._J I____j I . - INSURANCE COVERAGE _ I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES 1:3 NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true andaccurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compan Pertinent provis' n of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Christopher Orefice LICENSE#i 13325 1 1 SIGNATURE MP D MGF JP , JGF'j LPGI D- CORPORATION'%#,465_PARTNERSHIP;,,)# LLC J.- #, COMPANY NAME:'Marmy's Plumbing&Heating,Inc. ADDRESS'47 Tennis Road CITY �gawam STATE' MA ZIP 0 0O O TEL 413 786-2220 FAX'413 786-2021 CELL'i EMAIL'mannysplumbing@v dzon.net ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES 1 Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# �v�� K PLAN REVIEW NOTES Commonwealth of Massachusetts Sheet Metal Permit Date: 5/12/14 Permit# Estimated Job Cost: Permit Fee:$ Plans Submitted: YES NO X Plans Reviewed: YES NO Business License# Applicant License# 7976 Business Information: Property Owner/Job Location Information: Name: Menny's Pllabing & Heating, Inc. Name: TaLm OF North Andover Street:47 Tennis Road Street: 120 Main • Agawam rt3' Strc�i- MA 01001 C' /Town:N Andover MA City/Town Telephone: 413 78&-2220 Telephone: 978 688-9500 Photo I.D.required/Copy of Photo I.D.attached: YES__x__ NO Building Type: Residential: 1-2 family Multi-family Condo/Townhouses Commercial:Office Retail Industrial X Educational Institutional Building Cubic Footage: under 35,000 cu.I over 35,000 cu.I X Sheet metal work to be completed: New Work: Renovation:X___ HVAC X Metal Roofing Kitchen-Exhaust System Chimney/Vents Provide brief description of work to be done: Replace two (2) rooftop units, Air conditioning and make-up air , a INSURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes❑ No❑ If you have checked Yes,Indicate the type of coverage by checking the appropriate box below: A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the Insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent Gy checking this box❑,1 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 shoot metal work and installations performed under the permit Issued for this application will be In compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Progress Inspections Date Comments Final Insuection Date Comments Type of License: 3y ❑Master Flue ❑Master-Restricted :ity/i'own • ❑Joumeyperson permit# QJourneyperson-Restricted Si ature of Licensee 'ee$ License Number: _VM6 p n 'J 6 Check at www.mass.aovidpl ispector Signature of Permit Approval r { ON -OF MASSAhM, < � a o o • - o o . SHEfTETAL ;WORKERS I SSUS THE FOLLOWIid.GCENSE; AS A �1ASTER U R STR 1 CTE07 ¢. ; f`10NETTE =y 174 PARiffR STREET l lD:IAIJ' ORCHARD IMi4 O115i 222 0 2 } 20: 12 DRIVeR'S_ r. LICENSE OPq _.. M �4 -- 4.18S ,,aNONE 4d NUMBER J50933.6.12_ 4s:sEx M 1NGTY x .' Y ARiC ' i 8,174 PARKER ST_ INDIAN ORCHARD MA 01151-2225 1•!.,7- V S 0D 04-17.2013 Re r 67152009 ® DATE(MM/DDNYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 5/20/2014 ,THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: James J. Dowd & Sons Ins PHONE FAX 14 Bobala Road A/c No Ext):4 13-51 R- A/C No):413- - E-MAIL P.O. Box 10300 ADDRESS: Holyoke MA 01041 PRODUCER CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA:New Hampshire Employers Insurors Co Manny's Plumbing & Heating, Inc. 47 Tennis Road INSURER e:Peerless Insurance 24198 Agawam MA 01001 INSURER C:Travelers Indemnity Cormpany 25658 INSURERD:Torus National Insurance Company INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:30861440 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MMIDD/YYYY MM/DDIYYYY B GENERAL LIABILITY CBP6892262 6/29/2013 6/29/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED 100,000 PREMISES Ea occurrence $ CLAIMS-MADE F OCCUR MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2.000,000 POLICY X PRO-jECT LOC $ C AUTOMOBILE LIABILITY BA2D245484 6/29/2013 6/29/2014 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULEDAUTOS PROPERTY DAMAGE $ X HIREDAUTOS (Per accident) X NON-OWNED AUTOS $ $ D X UMBRELLA LIAB X OCCUR 81486G130ALI 6/29/2013 6/29/2014 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 rDEDUCTIBLE $ x RETENTION $10,000 $ A WORKERS COMPENSATION ECC4000403012013A 6/29/2013 6/29/2014 X WC6TATU- 12- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? FT] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) *10 Days on Liability & 20 Days on Automobile for Nonpayment of Premium. Job: 420 Great Pond Road CERTIFICATE HOLDER CANCELLATION 30* SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover 1600 Osgood Street, Bldg. 20, Suite 2035 North Andover MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD 12/05/2006 16:38 7813969076 _ PAGE 03 NOV 13 06 03t00p Ptortrh Ridge Contracting 603-B95-3997 P.2 a Asbestos Maid Remadistion Maid PreverlIkIn UST 8 5613 COA&Udlon Selective Demohtion North Ridge Environmental,LLC Construction Specialists MDMSAL ti Submitted To: Andy costa Phone: 781-9633526 Dace: November 13.2008 Company: ACRemodeling Fax: Maws Address: 113F.Wn Stfeat Job Nerne'-440 Grest sa a loCatiori'�NoRhAntiover-- City Maftrd Contftt: Andy Skates: MA ZIF-7-165 Contact Phone: Notch Ridge Em► nmetttat Is plOUNWiPubmilt a ob for Me o n sen►etas Mold romediation to garage area,sing!,-story Plat roof area and area from garage back towards the backyard(lake). Area will include Hoon above and anic speer. Some areas that have received new strapping for sheetrock will be extremely difficult to effectively treat. North Ridge will do its very best to apply biocide and encapsulant(mold inhibitor) to all surfaces.but there can be no guarantee in these locations. Owner will enckne work area to be heated and ail walls,doors and rafters need to be dry and free from water intrusion before and aftertreatment. Walls,floors.decking joists and strapmnS will be weated with a mold biocide that will eliminate ttn mold growth. After drying 12 to 24 bra,a mold Inhibitor will be applied to all surfaces, This will greatly reduce the opportunity for mold to regrow as long as the work area stays tree from water intrusion. Work space will be put under negative pressure by using NEPA filtration units and the v should not be any unauthorized entrance into contained spaces. Thle otopoal resped%ily submitted by- Erlo Cyganl Aeogunt Nbenatoer All work will be coarpltted In compllaace wkb local,state and federal regulations. Mea'PROPOSE hereby to AMIsh meterlel and labor•commels in ecoerdanee w4h"above apeoiRcarons.for the Burr,of Fourteen thowand swan hundred dollars $ $14,100.00 MR to R'm=as s: Pon cRvOwn Inte!+asl ChWM W 1.5%Oa month will be ehwged an eu outltandine baleno" All malars/b gvrnrntsed to to as apeffmd.Ad work toes eorrpler+ad in o wolmwftM monner sccoong to sundard pnWcas. Any Owot*n or devloWn Item ft above ap csicokbor invomog extra costa wltl be axwuted city upon wriaen ofde►s ww twi DEC"an axba rararpe twersnat above Pe quoted prte,All slwtarnalrrs*w*nprK Own woo#,socidrnts or dsNya beyond our control.Owner to carry No,Iomsdb end oftr fteons"tnsw ums.Ow w Wass to pay ort costa ossumlod with oYboAon.Our*01rers sic hruy cc nod by Warkara C Venwhon hratrww. I to above quare may be willrdmm by us Knot acoop w0 wIMIn 70 aaya. ACC MANCE. The above Prlcee,SWIliall and condlions are s Maxory ano gra nonsby acoapted. NOTE.If,aA4r yodr ao�\BPrerroe apvoposal ardpb is cemx/od k►rsnr roach,a lire o1 TMee iivrrdn►d DaJtars(sJt10.00j N fl be txrarM,to oovA costa incurred to Nbrstl Ridpe Envirmvnerrtat LLC. NcRh Is authofted to do the wax as spsdbed.Payment will to made as outlined above. NRE AvioALed CWtgrrlOrAyfhprieed nature anteI Dim Billing Address. Tel:603495.1 VT Fax:803.598. 97 Physical Address: 34 Langford Road 209 First NH.Tumpike Raymond,NH 03077 Northwood,NH 03261 12/05/2006 16:3B 7813969076 PAGE 02 Nov 13 06 031OOp North Ridge Contracting 803-885-3587 p. Z y e FAXNorth Ridge Environmental,LLC Dau: 11/13/2006 To: Andy Costa From: Eric Cygan Fax: 781-396-9076 Fax:603-895-3597 Total Pages-. 2 Memo: Work Area I{garage, I story flat roof,garage back to backyard all above floors and attic. Thank you, Eric 209 First NH Turnpike Northwood,NH 03261 12/05/2006 16:38 7813969076 _PAGE 01 w n Caft Andw&,to o+�w ftM'OM4MMM Few am F:amx —2--go V Cd�,_S A4 e'o da/L Al Gr�o�, Sys Aa./ C,6w Azz t ole /<'QS Serf/!a, 1c 7W vSe :;.7�AV I 164'01;�e G 7�d 4"ate 1cO a Call 6198 Date...i.�.` '.�5 ... f NORTH'1 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SACHUS This certifies that " ....... � /tf ...rF...t�l,�......... ..... . ...... .... has permission to perform/.Z).Aw.. ..-T� wiring in the building of..... p C ..! ��r .... .!.�' .. ...... at.. ..... .� . .. . . ............................. .North Andover,Mass. Fee. L,� ........ Lic.No1.q..�P �!'� . !.... ..... �-��.. ''• t ECTRICAL INSPECTOR Check # �W� 11/03/2005 15:04 FAX 978 475 1192 ANDOVER ELECT 0 002 i Commonwealth of Massachusetts omtialuseonly Permit No. Department of Fire Services Occupancy and Fee Checked . BOARDOE FIRE PREVENTION REGULATIONS ficavebium APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in aeemdanee with the Massacbuwetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Cityor Town of North Ant$o v e r To the Inspector of Wires: i By this application the undersignves notice his or her tentoD to�erform the electrical work described below. nter gtreet eta io Location(Street&Number) ! Owner or Tenant North n over water -1reatment Telephone No. i Owner's Address 420 Great Pond Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building water pump station Utility Authorization No. - Existing Service Amps I Volts Overhead L] Undgrd© No.of Meters New Service Amps / Volts Overhead C] Undgrd❑ No.of.Meters i i Number of Feeders and Ampacity Location and Nature of Propuskd Electrical Work: ti I completion of the fallowin table may be waived b the ins for o Wirer. rni o.oTotal No.of Recessed Fixtures No.of CeiL.Susp.(Paddle)Fans Transformers KV ! KVA No.of Lighting Outlets No.of Hot Tubs Generator's 1WNo.of Emergency Lighg' No.of Lighting Fixtures Swimming Pool LAv d e 11rnd, ❑ Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS N0.of Zones Wo.o etection an No.of Switches No.of Gas Burners Initiatin Devices No.of Ranges ,,; No.of Air Cond. TotaTonsl No,of Alerting Devices Beat Pump umber ons W No, t C o e on ained No.of Waste Disposers Totak: Detection/Alertin Devices . Muntcrpal No,of Dishwashers Space/Area Heating KW Local Other ❑ Connection ❑ Heating Appliances Key Security Systems: ea No.of Dryers No.of Devices or Equivalent IR-0.o a er o.o o,o Data Wiring: Heaters KW Sips Ballasts No.ofDevicts or F&ulvalent Telecommuaicattons Wi ng: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devitxs o )Ec uivalent OTHER: R.ew-Iring gf (2) 10HP Pumps L Attach odditlanal derail if desired,or as regnlred by the Intpedor offirv. 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 cedillas that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specnfy:) lmtton Date) Estimated Vslue of Electrical Work 2800.00 (When rtrquired municipal policy.) Work to Start: Inspections to be requested in aee a with MEC Rule 10,and upon completion. I ceidtfy,raider the pains and pan allies of perjury,that the ittfo►rtn o flus application it tree and complete. FMM NAME: r LIC,NO.:14 3. — Licensee: Robert J. Branca Signature LIC.NO.: _ 15-4995 9 5 (Jfappltcable,enter" "in the license number line.) Bus.Tel.No., Address: 206 Andover Street Atidove 1810 Alt.Tel.No OWNER'S INSURANCE WAIVER: 1 am aware that the nsee doer not have the liabilrry insurance coverage normally required by Isw, $y my signature below,I hereby waive thi equirement. I am the(check one ❑owner ❑owner's a eat. Owner/Agent Telephone No. PE&VIT FEI3:$ Signature r L Date..!�&/...... NORTp 3?oe tn•�`o�+e','eM�0L TOWN OF NORTH ANDOVER O 9 PERMIT FOR WIRING CHUS This certifies that has permission to perform ....... wiring in the building of... :L.... .......... ..... ....... ' ... - ....................,North Andover,Mass. Fee-�1� '::4:l... Lic. f J ELECTRICAi,,rI,7VSPECTOR Check # V 4n Commonwealth of Massachusetts Otlicial use only Department of Fire Services Permit No. (16-1410 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked L67/1/0 [Rev. 11/991 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordancewith the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO�AMTI N) Date: 4/15 City or Town of: North Andover k I To the Inspector of Wires: By this application the undersigned gives notice of hits o her intention to perform the electrical work described below. Location(Street&Number) 420 Great Pond RD. Owner or Tenant North Andover Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes x No ❑ (Check Appropriate Box) Purpose of Building Water Treatment Plant Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity N/A Location and Nature of Proposed Electrical Work: Installation of conduit and power for an access lift gate at driveway entrance. Completion of the ollowin 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 Swimming Pool Bove In- o.o Emergency Lighting rnd. Elrnd. E] Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No. of Gas Burners No. o Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No. of Waste Disposers Heat Pump Number Tons KW No.oSelf-Contained Totals: I... . I....................... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW SecuritySystems: No.of Devices or Equivalent No.of Water Kms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Lift Gate 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 ® BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: $8000.00 (When required by municipal policy.) Work to Start: 4/15/04 Inspections to be requested in accordance with NEC Rule 10,and upon completion. I certify,under the pains andpenalties of perjurv, that the information on this application is true and complete. FIRM NAME: East Corp. Electrical Services LIC. NO.: A17107 Licensee: David W.DeBeaucourt Signature / y _ :NO.: (If applicable, enter "exempt"in the license number line) Bus. Tel. No.: (978)250-1156 Address: PO Box 146 Chelmsford,MA 01824 Alt. Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hm e the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $