HomeMy WebLinkAboutMiscellaneous - 45 DANA STREET 4/30/2018 (2) 46 Du,
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Li u I L D I N G F 1 ,11--
NORTH
Town of : _ ndover
p Y'
No.
6 �y
h ver, Mass /�•, ���
A_ cocNic«l WICK
U BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
I,C
THIS CERTIFIES THAT i r.��.C.. �........... , �j� Av.0...... BUILDING INSPECTOR
. . . . . .. . .. .... ..
. Foundation
has permission to erect ........................ buildings on �.
. .. .. .. .....
Rough
Cto be occupied as .... .... �� Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION S Rough
Service
.................... ..... ......... .................................. Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
i
W
1 Date.............�..�...............
�aORTM
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
sS4CHUS �
This certifies that ...... ....
has pelmission to perforr -!I. .:�::1 . ...... .............................................�
r •
wiring in the building of...... ��e
-t-'.................................
"":-`." ,North Andover,Mass.
F ............... Lic.No &20.............. ff '
ELECTRICAL INSPEC (/
Check #I �J G lO
7843
a.vissillLollm dun oT massdcnusetts Official Use Only
�`;�•�O. it No.
le
Department of Fire Services Perm -
Occupancy and Fee Checked C
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) eave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 C R 12.00
(PLEASE PRINT IN NK OR TYPE ALL INFORMATION) Date: /
City or Town of: NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of 's or her intention to erfozm the elec 'cal work described below.
Location(Street&Number) S
Owner or Tenant v
Owner's Address Telephone No.
Is this permit in conjunction with a building permit? Yes
❑ No LV (Check Appropriate Bog)
Purpose of Building �eS�a� �� Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Und d
�' ❑ No.of Meters
New Service Amps / Volts Overhead❑ Und rd
g ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: G14 S r'..7 %.r J -
v
Com letion o the ollowin table ma be waived b the Inspector o Wires.
w No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans o.of Total
o.
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of.Luminaires Swimming Pool Above In- o. o mergency ag g
nd. ❑ d. ❑ Natter. Units
No.of Receptacle Outlets No. of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners o.of Detection an
Initiating,Devices
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers
eat Pump umber Tons
p Totals: """"� -' —~ o.of Se -Contained
Detection/Alertin Devices
a No.of Dishwashers Space/Area Heating KW ��❑ unicipal
Connection 0 Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of water No.of No.of Devices or Equivalent
a Heaters KW Signs Ballasts , Data Wiring:
No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total gpTele communications Wiring:
No.of Devices or E uival mt
OTHER:
'
E-
�l Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of lectri al Work: o�-C� (When required by municipal policy.)
Work to Start: 9 �� Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE C VE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,th¢t the information on this application is true and completes
FIRM NAME: I
LIC.NO.: G 5" 00 3
Licensee: — Signature
(If applicable, ent /tem11 pt"in the licens number line.) LIC.NO.:
Address: 1 C a Vh�1. 5 /G n� 1�i , Bus.Tel.No.: 7 S`5 0 o
*Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.
L cl.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$Qb `�
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The Commonwealth of Massachusetts
r
�f ! Department of Industrial Accidents
', Office of Investigations .
`
Pit
� 600 Washington Street
\moi Boston, MA 02111
r www mass.gov/dia .
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
ApRlicant Information Please Print Leeibi
Name(Business/Organizadon/Individual);
Address:. Ldl,
City/State/Zip:_ (�r 6 Phone# �Di ( —S 61
Are you an employer?Cheek.the appropriate box: •
1.❑
I-am a employer with 4. F1 atn a general contractor and l Type 6• ❑Nof ow
(r-tion t1):
employees(full and/or part-time).* have hired the sub-contractors ew construction
2. I am.a.sole proprietor.or partner- listed on the attached sheet t. 7. ❑Remodeling
ship and have no employees These sub-contractors have ti. Demolition
working for me in any capacity, workers' comp,insurance.
[No workers'comp. insurance 5. ❑ We are a corporation and its 9. ❑Building addition
required.] officers have exercised their 10.Q Electrical repairs or additions
3.Q I am a homeowner doing all work right of exemption per MOL l I.Q Plumbing repairs or additions
myself.[No-workers'comp. C. 152, §I(4),'and we have no 12. Roof
insurance required.1.1 ❑ repairs
�I j .employees. [No workers'
comp. insurance required.] 13:Q.Other
•Any applicant that checks bo><#I must also fi[I out the section below showing their woikert''compensation policy information..
P Homeowners who submit this affidavit indicssting they an doing all work and then hila outside oonuactors must submit a new affidavit indicating such.
4contractors that check this box mustattsched an additional sheaf showing the name of the sub-conM==and their workers'com
p.policy information
I am an employer that rs pravuiutg workers' or naperrsatma tresurance
information. co .f RV employee Below is-the policy and job site
Insurance Company Name: '
Policy#or Self ins. Lie.#:
Expiration Date:
Job Site Address- City/statnizip:
Attach a copy of the workers 'cotnpeusation 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 itnpositign 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 the pa' and penalties of perjury that the information Provdded above is lace and correct
Signature:
Date: / �}
Phone#•
E=t=r
only. Do not write in this area,to be completed by city or town official
Town: Permit/License#
hority(circle one):
Health 2. Building.Depart::_ment 3. City/Town Clerk 4. Electrical inspector S. plumbing Inspector
son: Phone k
Date. . . �/2 � ........
NORTH
0Fao ,6,ti0
TOWN OF NORTH ANDOVER
• PERMIT FOR GAS INSTALLATION
L ► p9 .�
YiR � o��nu err",�h'Iss CHUSEt
This certifies that .
has permission for gas installation
in the buildings of °. . .k �� s !? . . . . . . . . . . . . .
at �� . . . j�?. v. . . . . . . . . . . . . . . North Alndover, Mass.
Fee. .Ste. . .: Lic. No.. /"A U. �.� - - /,.�!< �►
(�GAS INSPECTOR
Check# 13995
6 2 4-4
Date.. .............
OF NORT/y�
TOWN OF NORTH ANDOVER
O 9
PERMIT FOR WIRING
Be+cHuss
p/7 / ►v/ '�
Thiscertifies that/............................................................................ :........................................
has permission to perform .. '2
.........................................................................................
wiring in the bTL-,4
' ng of .4, S�u
�,( . .......................................................................................
at ............��.._............. plNorithn Andover,M s.
..............Fee,�0?51:.........Lic.No 2. ...`......1.................... ................................ .....
ELECTRICAL INSPECTOR I
Check# ��� V
. Commonwealth of Massachusetts OfficiaallJA Only
Permit NO. l� I I 0
Department of Fire Services
' Occupancy and Fee Checked
' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1/17/14
City or Town of. North Andover To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 45 Dana St
Owner or Tenant Peter KalafarSki Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? YesF,/] No❑ (Check Appropriate Box)
Purpose of Building Residence Utility Authorization No.
Existing Service Amps / Volts Overhead Undg No.of Meters
New Service Amps / Volts Overhead Undg No.of Meters
Number of Feeders and Ampacity _
Location and Nature of Proposed Electrical Work: installing a 6.4 KW Photovoltaic System �--
Completion of thefollowing table may be waived by the Inspector Qf Wires.
No.of Recessed Fixtures No.of CeilSusp.(Paddle)Fans No.of Total
:
Transformers KVA
No.of Lighting Outlets. No.of Hot Tubs Generators KVA.
ove In- o.
of Emergency Lighting �S5
No.of Lighting Fixtures Swimming Pool rnd. ❑ rnd. El Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones
No.of Switches No.of Gas Burners o.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total g
No.of Alerting Devices _
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained �—
Totals: I. I I Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances Kit Security Systems: �J
No.of Devices or Equivalent
No.of Water KW o.o o.o Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No,Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
3
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:)
Estimated Value of Electrical Work: 3,816.00 (When required by municipal policy.) (Expiration Date)
N
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify,under the pains and penalties of perjury,that the inform . n on this application is true and complet .
FIRM NAME: SunBug Solar
070-A
Licensee: Patrick McDonough 17 LIC.NO.:
SignatureIC.NO.:
31
(If
41 in�lerHlgx i1TSnc �ec§uitem lr i omerville Ma 02144 Bus.TeL No.- -617-505-1-
Alt.Tel.No.:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilit rance c ge normally
required by law. By my signature below,I hereby waive this requirement. I am the(check on owner wner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$ 1 /
Y
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
U. 600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant InformationC� Please Print Legibly
Name (Business/Organization/Individual):S u n B u g Solar
Address: 411 A Highland Avenue, Suite 312
City/state/Zip: Somerville, MA Phone#: 617-500-3936
Are on an employer?Check the appropri "I'am
Type of project(required):
1 I am a employer with 10 4 a general contractor and I 6. New construction
employees(full and/or part-time).* have hired the sub-contractors
2FJI am a sole proprietor or partner- listed on the attached sheet. $ emodeling
ship and have no employees These sub-contractors have 8. Demolition,
working for me in any capacity. workers' comp.insurance. 9. Building addition
[No workers' comp. insurance 5.F—]We are a corporation and its
10 Electrical
required.] officers have exercised their
repairs or additions
3❑I am a homeowner doing all work right of exemption per MGL 11 Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12 oof repairs
insurance required.]t employees. [No workers'
13 ✓ ther Solar Installation
comp. insurance required.]
*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 a new 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: Liberty Mutual Insurance Group
Policy#or Self-ins.Lic.#: WC31 S37506-019 Expiration Date: 4.30.14
Job Site Address: 45 Dana Street City/State/Zip: North Andover, MA 01845
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 certify under the pains nalties of perjury that the information provided above is true and correct
Signature: - Date: 1
Phone#: 617-590-3936
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
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#:
i
r
Conditions at STC: Solar World SW 265 Panels 2 strings of 12
Panels: 24 string At Inverter
Max current - IMAX 8.3 A 8.3 A 16.7 A cin o
Max voltage - VMAX 31.9 V 382.8 V 382.8 V a
Max system voltage - VOC 38.1 V 457.2 V 457.2 V
Short-circuit current - ISC 8.8 A 8.8 A 17.6 Alrn a)
_ E
�U)
v
Rated maximum power-point current (Imax) 17 A
Rated maximum power-point voltage (Vmax) 383 V
Maximum system voltage (VOC) 562 V
Short-circuit current (ISC) 22 A > U
m `^ o v
b r Go
Y 0 a O
Solectria PVI 6500 240 208 277
Continuous current 27.1 A 31.3 A 23.5 A
z
Strike Voltage 230 V 230 V 0 V
Over current protection 40 A 40 A 0 A M
Bus-bar needed 200 A 200 0 Al •`s co
y N
N
� f0
C
W N
Rated output current 27 A m
Nominal operating voltage 240 V
� o
Notes:
W
1)All equipment to be listed or
j labeled for its application Dec 6,2013
2)installation to be compliant with
National Electric Code
3)Equipment labels to comply Not to scale
with NEC 690
4)Point of connection to existing power �_
distribution system shall be coordinated
with local utility company
1
• 1
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COMMONWEALTH OF MASSACHUSETTS,- `
WARP PF 1
E CTR I C I A N
fSS
UES THE FOLLOWING
.:,l,C :o-J'EN`5E AS ;po x,
I REGISTERED MASTER ELECTRICIAN
r i
SUN B`UG SOLAR LSC `
i'ATRICK F MCDONOUGH f
�s r N
7 FLINT 1/E � Z
lj
AI
:<4A 02180
STONEHAM 35.
21070.A 07`/3:1./x: 52209
1
j AWG#10 USE-2/RHW-2 CT M
Moll 1111
in o
61 a �;
_=
DC Wires in EMT 0 E
inside building Solar array composed of 24 SolarWorld SW 265 watt panels _¢(nn
Wired in 2 series strings of 12 panels each.
Module frames grounded to main panel ground or ground rod.
a
Y �
b � O
Xst
Y C
I y 0 0 0
To utility grid a o
z
Solectria 6500
Output 6500 Watt, 240V, 27.1 Amps
UL#1741 Neg Grounded o co
T N
(1) (3)AWG#8 THWN-2 (1)AWG#8 GND in%EMT
L1 m e
19 Utility NET o m
DC Disconnect 77 Inverter 8 Meter it �
Neg Grounded
Inverter Integrated -White Lockable 3R 2-pole
Pos Disconnected C� 40A Fused
In Open position + Black AC Disconnect Supply Side TapP3
M
Point of
r Interconnection
NEC 705.12.(A)
Notes:
100A Service Panel _
1)All equipment to be listed or - Solar toon 240V AC -
labeled for its application Production 100A Main
2)installation to be compliant with Meter Dec Breaker 6,2013
National Electric Code -.
3)Equipment labels to comply Lockable 3R 2-pole (11 Not to scale
with NEC 690 AC Disconnect I
4)Point of connection to existing power External
distribution system shall be coordinated E-1
with local utility company
MASSACHUSETTS UNIFORM APPUCATON FOR PERNU TO DO GAS FITTING
(Type or print) Date 111L d-`d '7
NORTH ANDOVER,MASSACHUSETTS
Building Locations Permit#
Amount$
Owner's Name 414
New D Renovation D Replacement E Plans Submitted D
w v1
U
C7 W OU ;D F x
z O j O Z
W U W x z Fr �r O OG W
d x x oc w w H A F x
z Er z E, z w } p >G w w w x
z w > a W x o
SUB -BASE >
M ENT
BASEMENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR `
6TH . FLOOR
7TH . FLOOR
8TH . FLOOR
IF
(Print or type) �� r �Y Che k one: Certificate Installing Company
.
Namer �, /�/ �JlI.P
Corr)./ rp.
Address QX F,4 `2 d Partner.
Business I a ep one /a _Q. Lp D'Firm/Co.
Name of Licensed Plumber or Gas Fitter
1id17
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. YesD' No 13
If you have checked yes,please indicate the type coverage by checking the appropriate box.
Liability insurance policy 0- Other type of indemnity Bond 13
Owner's Insurance Waiver: 1 am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass.General Laws,and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner 13 Agent 13
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusett tate G Code and hapter 1 2 of the eneral Laws.
By: Signature of Licensed 41fumber Or Gas Fitter
Title [3—Plumber 'v
City/Town Gas Fitter =cense lNumber
Master
APPROVED(OFFICE USE ONLY) Journeyman