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Miscellaneous - 498 CHICKERING ROAD 4/30/2018 (6)
J� 1 1 1 i I 1 I, I '�t E f Date �7 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . .�E►v, ' ��-c 7,1-4,-. has permission to perform . wiring in the building of at N rth Andover, Mass. Fee , 577,,, ic. No. .� S!. g. . . . . . � S 3 -- ELECTRICAL'INSPECTbR7 Check# W a G 7, oa i 'r 028 I +fy�taSQ''J5) tiJ n/� n q�q Official Use Only l..ommonwea&o f t'v/assacAuaelh 2c�r� c7 Permit No. t 16 evarlmenl o1}ire Serviced Occupancy and Fee Checked /5?7, 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),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ?-y—/Z 26 19 City or Town of: N#&& ,gyp/ g/Z 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) z/?f ell/LI& e-/L/AI t; /� d Owner or Tenant (, we cG FyU� e-e4..97— S"IA14.t �AVKTelephone No. Owner's Address e/V E ALZZINAM/<� I-AZ!, C OW e /17.4 Is this permit in conjunction with a building permit? Yes [ No ❑ (Check Appropriate Box) Purpose of Building t 0/111 M e/L L°l 4-L Utility Authorization No. 13 3©6 �1 9 S Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service —q-00 Amps ?. k Volts Overhead❑ Undgrd No.of Meters Number of Feeders and Ampacity /—,f L'T 0 v (V �p DO /uClyt e(/ s 45�l/ �j vv,. 40 Location and Nature of Proposed Electrical Work: EG G 7-1,'1 c: /IV If Completion of the following table 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 LuminairesSwimming Pool Above ❑ n- ❑ o.o Emergency Lighting rnd. md. Batte 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 No.of Alerting Devices Tons g No.of Waste Disposers Heat ump Number Tons KW No.of Self-Contained Totals: " " Detection/AlertinE Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Omer Connection No.of Dryers Heating Appliances KW Security ystems: No.of Devices or Equivalent r No.of aterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Iydromassage Bathtubs No.of Motors Total HP Telecommunications Wurim No.of Devices or Equivalent OTHER: Attach additional detail i desired,or as required b the Inspector o Wires. ph .f 4 Y P f . Estimated Value of Electrical Work: 7` 8 7� (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 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 perjaty,that the information on this application is true and complete: FIRMNAME: RENAUD ELECTRIC & COMMUNICATIO S INC. LIC.NO 17459 Licensee: T h oma G R Pn a„d Signature LIC. --124 0 23 (If applicable,enter "exempt"in the license number line.) e. o. —RAS-1 00 Address: 18 Prnvid n Rd PQ Box 36 Sutton,MA 01590 Alt.Tel.No.:.5A �5T513 *Per M.G.L.c. 147,s.57-61,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 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.$ /3 9 -'r tpl 5 c/77;? RENAUD ELECTRIC & COMMUNICATIONS, INC. 14153 Ali VENDOR#-82101 NAME—Town of North Andover DATE-08/08/12 014153 YOUR INVOICE NO INV DATE AMOUNT DIS/RTNG REFERENCE NET APOUNT' 16269 LOWELL 5 08/08/12 139. 32 .00 139. 32 TOTALS 139 . 32 .00 139. 32 RENAUD ELECTRIC & COMMUNICATIONS, INC. 141'87 VENDOR#-82101 NAME—Town of North Andover DATE-08/15/12 014187 YOUR INVOICE NO INV DATE AMOUNT DIS/RTNG REFERENCE NET AMOUNT 16269ADD' L FEE 08/15/12 1223 . 36 .00 1223 . 36 �GG�jGC� TOTALS 1223 . 36 .00 1, 223 . 36 RENAUD ELECTRIC & COMMUNICATIONS, INC. 14186 VENDOR#-82101 NAME—Town of North Andover DATE-08/14/12 014186 YOUR INVOICE NO INV DATE AMOUNT DIS/RTNG REFERENCE NET AMOUNT' 16269 TEMP LOW 08/14/12 85 .00 .00 85 .00 i TOTALS 85 .00 .00 85 .00 RENAUD ELECTRIC & COMMUNICATIONS, INC. 14185 VENDOR#-82101 NAME—Town of North Andover DATE-08/14/12 014185 YOUR INVOICE NO INV DATE AMOUNT DIS/RTNG REFERENCE NET AMOUNT 16269LOWEL 5 08/14/12 139. 32 .00 139. 32 TOTALS 139 . 32 .00 139. 32 i RENAUD ELECTRIC&COMMUNICATIONS,INC. COMMERCIAL• INDUSTRIAL• INSTITUTIONAL Town of North Andover—Electrical Permits/Fees for the Lowell Five Cent Savings Bank @ 498 Chickering Road Originally mailed checks # 14125 on 8/6/12 for Temp Service= $ 85.00 i #14153 on 8/8/12 for Project= $139.32 (mailed to wrong#on Osgood Street)—But Mr. Murphy r-ec'd them on 8/15/12 Fedex'd out two (2) replacement checks: #14186 on 8/14/12 for Temp Service = $ 85.00 I #14185 on 8/14/12 for Project= $139.32 Per conversation with Mr. Murphy on 8/15/12—Project Permit fee is$1587.00 v Mr. Murphy will apply check#'s 14153 (139.32) and#14186(85.00) and#14185 (139.32) towards the $1587.00 permit fee for project leaving a balance of$1223.36 being fedex'd on 8/15/12 for early am delivery on 8/16/12. Mr. Murphy, Our apologies for all this mess. I hope you will be allset when in receipt of this final check to complete the Electric-al permit fee for this project. If there is anything else you will need—please call Frank Piscitelli or Cindy Hubley @ Renaud Electric @ 508-865-1300. Sincerely, Lindy Hubley ISM Assistant P.O. BOX 36• 18 PROVIDENCE ROAD • SUTTON, MASSACHUSETTS 01590 • TELEPHONE 508-865-1300• FAX 508-865-5441 •WWW.TRENAUDELECTRIC.COM INDUSTRIAL•COMMERCIAL•INSTITUTIONAL• HEALTH CARE•FACILITIES MAINTENANCE• DATA INSTALLATIONS• DESIGN BUILD • ENGINEERING •FIRE&SECURITY J 1 0 . Ofi "i 0 A UO T 11223 , 36 z" Date . !.4I: • w�a�Rp 7 TOWN OF NORTH ANDOVER Q PERMIT FOR WIRING This certifies that . . . . (a-1., �. . . . . . . . . . . . . . . has permission to perform . . . . SEC{. !2 . l'1y!, ,5,�!� r�. , , , , wiring in the building of . . . Q,W? .4-- . . . .`. .c��.. . . . . . . . . . . at . . . .`��� �. /�.�. . . . . . . . ,North Andover, Mass. e t"" ELECTRICAL INSPECTOR/ Check# O $ 11102 ` C'ommonw ah4 o f VadaaaLette Official Use Only Apartwd.1 im S md,em Permit No. l l t-92, 2, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank 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 ALLNFORMATION) Date: City or Town of: p L ZC_ (/ To theIn pector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 1/R 4myel�12, ' tt� Owner or Tenant 44w2- Telephone No. Owner's,Address a�g—,-;&124 S�' /�G�l /04- Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Nutility 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 Location and Nature of Proposed Electrical Work: Completion of the.followingatable 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 AboveIn- o.o mergency Lighting No.of Luminaires Swimming Pool rnd. Elrnd. ❑ Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of 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.of Self-Contained Totals: Detection/Alerting Devices •�� No.of Dishwashers Space/Area Heating KW Local[:] Municipal El Other �o Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent 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 Wiring: /� /No.of Devices or Equivalent OTHER: �I LGCk�II') 1Il� )4-a d V-e SS < -t r'I 5 Attach additional&tail if desired,-or as required by the Inspector of Wires. Estimated Value of Electrical Work: 9 9/Q (When required by municipal policy.) Work to Start: Id-3C�I�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 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,that the information on this app I' ion is true and complete. FIRM NAME:American Alarm&Communications,Inc. den LIC.NO.: 1 2 1 2 C M A Licensee: Richard L. Sampson, S r. Signature LIC.NO.: 5 0 2 D (Ifapplicable,'enter "exempt"in the license number line.) Bus.Tel.No.:781-641-2000 Address: 297 Broadway, Arlington, MA 02474 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.SS CO 000090 MA 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 a ent. Owner/Agent PERMIT FEE: S 5�-� ` Signature Telephone No. !� Y Date • TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that 6c1�' . . /� .! �-. . . . . . . . . . . . . . . . . . . . 1� `has permission to perform 1- h .. . r?.p . . . . . . . . . . . . . . wiring in the building of . /...07u e.11 . . Fye, ... . . . . . . . SI . . . , . , , , . ,North Andover, Mass. ELECTRICAL INSPECTOR Check# '113,57 11s30 �+ ammonweakh of Vamacc"Ifi Official Use Only I c� Permit No. 4133o Apartment o j}ire Sen ce.4 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 9 Vey. 1/07] 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: /,) -07 y - / a City or Town of: A). oq w 1,10 y p,/ 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) G�C1 C`i.c L )Geri"1.4 2c)— Owner or Tenant L 0 avL / Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Boz) Purpose of Building t 13W n K t w� 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 Location and Nature of Proposed Electrical Work: C 0 it/-'i J Av t lyo/- , Com letion of the following table may be waived by the Insector of Wires. No.of Recessed Luminaires No.of Ceil:Sus . addle Fans o.o Total p )FTransformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool ove ❑ ❑ o.o mergency mg d. d. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.o an etection d Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump NumbeTns ""W of el - ontame Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KEl Local Municipal . E] Other Connection No.of Dryers Heating Appliances KW ecurity ystems:* No.of Devices or Equivalent No.oWater. KW o.of No.o Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W�rmgg: No.of Devices or E uivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: / DO• UO (When required by municipal policy.) Work to Start: L 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 coverage is in force,and has exhibited roof of same to the permit issuing office. p p g CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this appheadon is true and complete FIRM NAME: t �l e C�frt Cd LIC.NO.:Iq -l !.5 0$ Licensee: JO�O �_i ti) Signature Q. /J 4 ---" LIC.NO.:E -a(-f Y3 3 (If applicable,enter "exempt"in the license number line) 11 Bus.Tel.No.: Address: 130 1--l"4 Z 'yo ! i /-7 [I-P— I Iff"IJ A'14 ©r 7y9Alt.Tel.No.•97 37 '7 -Ts-oo *Per MG.L.c. 147,s. 57-61,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 liability insurance coverage normally . required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑ ' agent. Owner/Agent owners Signature Telephone No. PERMIT FEE: $ Old X0213 "COMMONWEALTH OF MASSACHUSETTS.:;; OF ELECTRICIANS REG JOURNEYMAN`ELECTRICIAN ISSUES THE ABOVE LICENSE TO JOHN R-CAIN- 9 BO.NAZZOLIAVENUE UNIT 4 HUDSON ...:MA 01749..`-.2056-- n2w445..t3 E 07/31/13 814383 ' COMMONWEALTH OF MASSACHUSETTS OF ELECTRICIANS REGISTERED MASTER ELECTRICIAN ISSUES THE ABOVE LICENSE TO 4 CAIN EyLECT.RIC, CO INC JOHN R CAIN 9 ,BONAZZOLI: AVENUE HUDSON MA 01749 .2856 ; ; . Date../. I !/ Z047. .. ,�pRTh 3� TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION • o i SSACHUSE� This certifies that . . . r�. . � . . . . . . . , � s has permission for gas installation 4. . . i rS. ,. in the buildin s of . . ,f� a. . !1�i4l:17 . . . . 1. . . . . . . . . . . . . at . . . . . . . . ,we..... . . . .`. . . . . . . . North Andover, Mass. Fee. !.Wr. . . . . Lic. No.. ./.e3 � � � . . . . . . GAS INSPECT�R Check# ,,CJ 8300 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASF TTING (Print or Type) 165 T J� l oer ,Mass. Date - 20J,2. Permit# 1 Building Location yqj Owner's Name Gl�l� UG �J Owner Tel# Hype of OccupancyT New ❑ Renovation ❑ Replacement ❑ Plan Submitted: Yes ❑ No ❑ FIXTURES x x W V) W H U W U) w Ln w o U H x x z x H Q � z z o H w Q O W d a a o o z H W o w w ED W dW E. in o. d O U u] x rn z p Q > w z W W F W UJ (1) W Z d x C4 9 w [, x y Z Q w � Q a L w Z O Z 0 (n x w w > Of w a Z d (x d d O O W O w 0� = O 0 = w �5 3 Q 0 a U x > as a, o w SUB-BSMT i BASEMENT 1sT FLOOR 2"o FLOOR 3RD FLOOR 4T"FLOOR $T"FLOOR 6T"FLOOR 7T"FLOOR 8T"FLOOR Installing Company Name Amari Company, Inc . Check one: Certificate 11 Caldwell Drive Unit #1 Address [Corporation 2 0 0 6C Amherst, NH 03031 ❑ Partnership Business'Telephone# 603-882-4118 ❑ Firm/Co. Stephen M. Amari Name of Licensed Plumber or Gas Fitter p INSURANCE COVERAGE: I have&cu'rrent liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes taX No ❑ If you have'checked yes,please indicate the type coverage by checking the appropriate box. 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 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of,Owner or Owner's Agent 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 the permit issued for this application will be in compliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General La By Type of License: 9 Plumber S' re o icense Plumber or Gas Fitter Title 9 Gas fitter 9 Master License Number 11341 City/Town 9 Journeyman APPROVED(OFFICE USE ONLY) Date.19/?d�. . . 9547 NORT1y TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ajr � ,sSACHUs� This certifies that . �xh . .,� s . . has permission to perform . to . . . . . . . .. plumbing in the b tidings of . . . 1.44"v ! .. . . . . . . . . . . . . . . at. . . .0-(' N rth Andover, Mass. Fee./�Q?�Pylic. No.11A7f . . �v�. . PLUMBING INOECTOR Check F MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING �~ (Print or Type) k , i '/ —� Mass. Date " +/ 20 Permit# 9 a Building Location y� G,U1,L lerho Pt Owner's Name �/� &e Type of Occupancy New ❑ Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ FEATURES z z z Y W J Cl)Cf) CO CO O Q CO z W W U) Y Q rr Q z C7 tt S _ t!J W Cn � W U) c) CA Q Cl) O Z Z Z W H = CL Q W Cl) Y W a Q d X 0 Er w O m W co 2 U) c Q w CZ 0 < W z p o p O W 2 ¢ 2 0 M IL _ Y d C) F-cr Q Y Q W u_ LL Er Y W Y Q m O a E ¢ZD � Q O � Q tZ tr M Q o a H H C-/J) W C3 O Q rr m O SUB-BSMT. ., BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR ITTTI .Installing Company Name AJ"QLI �� Check one: Certificate Address / ca/d I"e1/ r Corporation C� `• //tt�� d �/�G oso / O Partnership Business Telephone VJ"' $O —17//n ❑ Firm/Co. Name of Licensed Plurriber /iiZ r o INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes No ❑ If you have checked 'yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNERS INSURANCE WAIVER: I 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 Acient Owner ❑ Agent ❑ 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 the permit issued for this application will be in compliance with all pertinent provisions of theyatpachusetts State Plumbing Cade and Chapter 142 of the General Laws. By igna ure o icens �PlUmDer Title Type of License: Master, otyneygian ❑ City/Town License Number 55// �7 APPROVED OFFICE USE ONLY) Date'. . .? . •.bx��r�.�n'r�a • TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that has permission for gas installation . ��... .:}— .l;•u-, , , , , , , , , , , , in the buildings of. ff r�, .�`. �.. . . . . . . . . . . . . . . . . at . . . . N rth And ver Mass. Fee . h� . GASINSPECTOR Check# Csc�� Lin . CITY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I "civ e C" MA DATE[.:=PERMIT# JOBSITE ADDRESS y98 C�xY�Qs,n� 1'2�,___ OWNER'S NAME OWNER ADDRESS Lsx�c TEL pPEO OCCUPANCYTYPE COMMERCIAL" EDUCATIONAL[ RESIDENTIAL® CLEARLY NEW'- RENOVATIONU REPLACEMENT:® PLANS SUBMITTED: YES " NO[] APPLIANCES Z _ FLOORS- J sSM 1 2 3 4 5 6 7 J8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER --- COOK STOVE DIRECT VENT HEATER -_-___7 DRYER FIREPLACE FRYOLATOR FURNACE -- GENERATOR GRILLE _ INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT - OVEN - — - POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT - TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER --- J _J C. I _ ._. _1 f[ - ! _J — _ j OTHER -^ -— - - - -J= -- --- INSURANCE COVERAGE I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO [ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY E-A 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 0- SIGNATURE OF OWNER OR AGENT 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 plumbing work and Installations performed under the permit Issued for this application will be In compliance 'th all rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBEGASFITTi R NAME LICENSE# SG ATURE MP MMMGF _Q JP � JGF LPG! ® CORPORATION # .;�.8� PARTNERSHIP[3#1 LLC COMPANY NAME: I:W EU(�L - •;�- �'__,,,,�,tI � -�tNQ_�(�U(;1�JV ►tw�viIADDRESS -_.. (' CITY _ ..!n_ 12!:9.. -- ---- -- --...._ STATE ZIP _._ - TEL FAX L-. A CELL ?%3 3'703 EMAIL r TOWN OF NORTH ANDOVER 1600 OSGOOD STREET Building 20 Suite 2-36 NORTH ANDOVER MA 01845 FURNACES, BOILERS, ROOF TOP UNITS, AIR CONDITIONERS EMERGENCY GENEREATORS Date: 12- The 2The undersigned applies for a permit to install the following at: Location LAS Cin --AOwner of premises Address':3A\a Si l oy-3.41 M A Name of mechanic thew Rln ia1ac, CmVuQ_14e�� Address La 46e� �, V1,1y t I `T�n95�cp Building occupied for _Material of building V-5009. Kind of fuel C caC" Chimney G No. Of flues 2 Sized Chimney Thickness jam\/(._ �gc'Y E&Ae LAO Lining If steel stack location Diameter Height DESCRIPTION OF HEATING APPARATUS I Kind of heater F'u c t1C At e how many Z make CA BTU Input_ Location in building Ar `! CA�r`� Protected against fire as required How protected See the State Code(Pertaining to Chimneys, Smokestacks and Heating Apparatus) I ROOF TOP UNITS OR EMERGENCY GENERATORS Make Weight Dimension Length Width Height Location of building how supported Size of'roof timbers Material of roof timbers Span of roof timbers Distance on center Protected against fire as required How protected AIR CONDITIONS Kind of apparatus make HVAC FORM REVISED 11.04 tvvi k\ i I f Divisicr,otRo userts 80 epstra;'Gr,. and of��umoin Cor V.= '7:^-•n:3� '. BENJAfV1 DAM 25 . 25 SherbppkEeef- =� ' TYngsbOro,;,, Master Pt =_ = ' PL 15798-M Umber :c se)Vo. 05/01/2012 Expiration Date. ' '-'004273,, '004273 . Serial No. I II i e 1- Fold,Then Detach Alone All Perforations : .. •.��pn�p� App�� p ^gyp �t^^��r l� �ro �op��p pia °g^Q� — ——.-1 �a�.00V000SONV EAG.U H �L F 1AAS,SAY,�+U I USE A U S BOARD PL REGISTERED AS A PLUMBING CORP' ISSUES THE ABOVE LICENSE TO: TYPE BENJAMIN A ADAMS NEW ENGLAND COOPING TOWERS, INC -C 33 SHERBOOK ST TYNGSBORO MA 01879-0000. . . ' 95460 3388 05/01/12 95460 ..,_...l��,lcail.?i, I'�r0.:..•..,--. j�a�=11i��ltu�rciu} .�d� _`� .iV '' o a f— Fold.Then Detach Along All Perforations t i •.., :::y::.v::::;:.:::::::.:::::::::::•-:::i.;c�;t;v}:t.:r...:.t:v:::;:::•:::,:...;:.::r::,:....�,..:::•:::.:.::•::r.:.?...r ...............r.........r...r.........:....::•::::•::::.;.................,............. of tF. :�.,.. .. .r:........... ;nr..,,,; ..v.. ,F...::: .....r;.i.r •.. ;:.y:...::..:.:.:�::;_F:: •}ii:{iii:,iii:::?:::•ii::i:•`ii}:!t:-? •}?: »: ni < rr: DATE(MMroDmI A " CORD ,r .r f:: . r ::Q•:?:!!!??PS:i: :':.}:{:;:•::::::::::..�.::::�:•::::::::.::::�::::^.-/,:...:..x... .,:.{,.v,•::.GY:.'.•;+:::.�.}.::.:.:.:-:.....n..........:::::::.v::::h:•i:•}:}:•:i::•}i}iif:?i}iii�•::}:i}}::•i}i:�Sii::• --K* 08/07/12 ,.4.................r....,...:.:.v.::.::::.:�.::.:�.�.�::::.::.:.::..�:::::::::n:v::::.�.v:}::'.;}:.;';;::.;: 080712 .. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FEDERATED MUTUAL INSURANCE COMPANY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Home Office: P.O.BOX 328 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Owatonna, MN 55060 _ _ COMPANIES AFFORDING COVERAGE Phone: 1-888-333-4949 COMPANY FEDERATED MUTUAL INSURANCE COMPANY OR _ A FEDERATED SERVICE INSURANCE COMPANY INSURED 298-238-1 COMPANY NEW ENGLAND COOLING TOWERS INC B 69 WESTECH DR —. TYNGSBORO MA 01879 COMPANY C COMPANY D :.A,n., ka .._.... ..,.>:•>::!a:::i:;y;::..:::::::.::::..:::..�:::::.::::.::;-<.>zto};::>;.,;,�•,:-:::,v:::•::::.•::.v::r:.v.::.•r.•:::::.........-........................ :�. VER. •.............:..:.:err.:....:..:....r:.::.vr:::r:.r..:.:�._::::,..............rr:::.,.-:r......... ................ : .. .. ....:-...v;;.::.v...... ....._... ......................................./r,...evY::::...::r.e.1.c:.:::.::n,.4,::y'•iii•:.:.:i':vn:}}}::ijC.ifi:::_:4:•i:'.'::::'}:t;::}:i:'::•''%L:.}{:..r.::.fi%::v.: 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. TLCTOR TYPEOFINSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MMIDDIYY) DATE(MMIDDIYY) GENERAL LIABILITY GENERAL AGGREGATE _ ._12;0 00 1gO0 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMtTP AG_G 6 2 OOQI000 A CLAIM$MADE IL`J OCCUR 9261404 02/23/12 02/23/,3 PERSONAL&ADV INJURY S 1a000,000 OWNER'S&,CONTRACTOR'S PROT EACH OCCURRENCE 5 1 OOO 000 X BLIStNESSOWNER'S POLICY FIRE DAMAGE(Any one fire) $ 50,000 MED EXP(Any one Person) S AUTOMOBILEUABIU Y X ANY AUTO COMBINED SINGLE LIMIT $ 1,000,000 ALL OWNED'AUTOS Y INJURY INJ � A SCHEDULED AUTOS 9261405 02/23/12 02/23/13 (Per IBODILYINJ X HIRED AUTOS BODILY INJURY X NON-OWNED,AUTOS (Per accident) _ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY EACH OCCURRENCP 8 5.000,600 A X UMBRELLA FORM 9261407 .02!23/12 02/23/13 AGGREGATE _ 5 5000,000 OTHER THAN UMBRELLA FORM 9 WORKERS COMPENSATION AND X I ORWCS M TATU• I 0TH EMPLOYERS'LIABILITY ER EL EACH ACCIDENT S 1,000,000 A PARTNERSIEXECUTIVE X INCL 9261406 02/23/12 02/23/13 EL DISEASE-POLICY LIMIT a 1,000,000 OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE S 1 000 000 OTHER P DESCRIPTION OF OPEIATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS PROJECT LOWELL FIVE BANK NORTH ANDOVER MA ......vv:::;....,.n...,•.{...n.., y.,..:.r.........,.:......:..,.... .,y.;.: .�.� r :•:v};}S}::.;{?!•::4'Y:•;i}};y;}:•}::-:+:ii:+f.::c::::5 /4�p �f( ..: \:•.v:,:::::�.v:::::::::..::. :}:n:},: •, - •::}::n_::.::::::::.-�::.:..n.:....:n:::..::r.•.::.v:Fw.v.e w::, [ .L�.J\T�FIY� �� ..::::.......::•.v.n••.v::..:{•}:•Y,...n4...u................. ......,nv .r ... .................5...-t...,.......n......:........ .....\C.F}:{rri:l'?.S::Yiii:tL::i^. ........... ... .. �n..-.....-......n........ .... ...nr.,..n.5.......::-.v:::i'-Y'wY}y:•$YY:•::},..,..... ......c_ ..r....r... .i•. :. n........r....._...r-..-...v }� ....::: �ht���lF::;:.;..::::.:':.:.v;.•.,•;r::::::•-::_-::.::v:.:vr.. ..:F?bi?$$}:�:::, ..r::p.:::::::.i:4ir.4......h r.,,v,,;.;:rrr•!}}::il:4i}Y.:is ..:..:.......rr.-.,rv..:,rr.rrr,...:u:::.:rr...r...:..+r:r:::.:..r...-....rrvr.Y.,.r,..l�..r.,........-.e...t-<.........-J.,:x:+..:::n,•n:?,•}:$,:,•:u:Ir},r:x:rrrc:::n:rrn.-r:::::::ri:isii4:8i::-iS::>-v.:Si::•ic3:'7.4i:?riS::ii'-:i}CY is v::'L�'b:::::,r,;•}. , .J l•�r4` 2982387 JEWETt CONSTRUCTION 61 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE COMPANY INC EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL PO BOX 405 -3v DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, RAYMOND NH 03077-0405 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ........,:::r.�;::{: }Y�'{: :Yw :::,.. ,..,II: r.:::,•:,,,.:::.�.v:::,;::,.::,.:•,::,.•:,,.::: UTHOAIZEDREPRESENTATIVE 1,..,,..........,...,:::::•:•::. ..:::::::.::: . ::..,....-. ..PBESIDExIi.... :� : x Y::.............,. ....:.:}•::•::}••.:•.: .' f•/>r%b:a,£'4i`;L'r:J?:r............................._..._............�:..��:::o:+:-:;>»;:-Y>:z;:::::::..u.-': --...............r... ....r.... ACO. ,x.�,:, . .,...,...,. , ....r:.e:• .. ..r...... : l,•:<;�?:::z$};s;}::>:.:;�:�v:::::;s;•ii::<.:<is�::>:;•:4fi::_»-�>::>;<i;«::=>:=>:$::;:;;:-::;Y:.;Y:-;;:.::.i;:-.;:1Y;:;:-;:-:: � - � - - '' •:•.. ; Zo->, e (?VtLocation �7e Ai' w No.015--Z olz Date /o�01Z ' TOWN OF NORTH ANDOVER • �fi .t,M) • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee���•J $3y,l� TOTAL Check# 3& 26050 Building Inspector SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER SiteOwner Applicant Tel ��� �'✓`�/—v���z/ Site Address iAl ;;v c Size of Proposed Sign P.%5,P6 A/ r"� Map Parcel P/t> f 6 Illumination: a)Not illuminated How attached: a) Against the wall b) Internally illuminated b) Roof c)Externally illuminated c) Ground d) Other Materials: E_&t6 ilvrn Proposed Colors: Background 611AX %Sr/, V_)GZvsS 717'.-5'/Z6 Lettering at la4ujud y r- Border Cost of Sign Required Attachments: v Note: No permanent/temporary sign ti e Photographs of building application on the appropriate form fi e kMaterial sample with the Sign Officer containing suc g e • Color sample and scale drawings, as he may requir ' -" P �, �, ;p • Site or Plot Plan (Required for all free-standing signs) or enlargement has been issued b hi ' : o o� , c9 gg � g Y ) _ Drawings of proposed sign Sign Officer determines that the sign) ,�� o .-� « � • Other, specify applicable provisions of the By-Law > ao E t a; ao` o Will sign overhang any public road or walkway Yes O No (•� W o If Yes,Name of Agency who will provide liability insurance: - AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: 1;7— Receipt# Check# Z Revised 10.31.2006Form Sign Permit Application SIGNATURE OF APPLICANT APPROVED BY, ii 487411 CNIf Lr _ 1 1 — C-S OC1 i Banic Lr rl- J i Lj" 1.5"deep fabricated alum.,custom Move set to the left and add "Bank". painted two colors. i _ , ALUM. DII�E�SIO�AL LETTERS QTY. 1 SET ■Match PMS#356 _ inri inetf-osig-n.ael Fax-- 978..851.2022 -Phone: 978.851.2424 170 terum Street Urilisdgry, MA 01876 • - 1cuslamer Dale/Revisions ited in .'FHe K=e: Lowell 5_No.Andoeef 498 Chickerng fld DLS 2-00000.s w —bprdcmp:Z-Nopd ahLowell Five 12.13.12-Ori final Sw ' Sa1eSRa0.: Designer: PrOLMDC: I Invoice: Drawing#: Lhtocanon North Andover,MA 12.18.12- Rev. 1 Amro �RppewdASNr<EDRa6aaM Ma T.D. J.P. I A.M. 00000 12-00000-1r1 I 148-6811 J 48 74 ii C-, OC � � � Iiani i, � 1.511 deep fabricated m.,custom Move set to the left and add "Bank". painted two colors. ?� ..�.� fit...... ..... .......... ..........*ALUM. DIMENSIONAL LETTERS , , 1 QTY. 1 SET E Match PMS#356 i wti�,rt,�,�.metrosign..net Faa: 978.851..2022 Phone: 978.851.2424 170 lorum Street Tewttsbury, MA 01815 (cnstemer �Date/Revisions mbde:UNarwU wwdUfileE:.nu ra.a.W aw u.o.^�'FNe Nenle: L-115_No.And—498 Chickering Rd US 12-00000A Lowell Five 12.13.12-Original ne hi-1"'- °"��"`Aib11��tt8Ty I.rfiien wiUwul written consem fiom Metm SiUn 6 AwninU.Inc. W.fre o~,_____x..____.._..___' Selesae0.: Uesioner: Prol.Mgr.: invoice: UraINIUM loblocanan North Andover,MA 12.18.12- Rev. 1 MAom oro.e��neo��..d m. T.D. ! J.P. A.M. 000nn 12-00000-1r1 i ne (_ommonwealth of Massachusetts ' Department of Industrial Accidents a ! Office of Investigations 600 Washington Street . Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information '' Please Print Leaibl)t Name (Business/Organization/Individual): mLsTADy / Gn! Address:_ /go City/State/Zip: /Etul<S a/Q• 0/$ pbOne Are you an employer? Check the Ippropriate box: I am a general contractor and I Type of project (required): ]. � ] am a employer with d 4. ❑ i employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 20 listed on the attached sheet. %. Remodeling 1 am a sole proprietor or partner- ❑ g 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. b _ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions J. U I am a homeowner doingall work officers have exercised their i 1.❑ ;?lambing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs instuance required.] t c. 152; §1(4), and we have no employees. [No workers' er S197A .S comp. insurance required.] 'Any applicant that checks box 9 must also fill out the section below showing their workers compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new af'ndavit indicatine such. 4Conractors 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 musrprovide their workers'comp.policy number. I am an employer that is providing workers'compensation in for my employees. Below is the polis} and foil site information. Insurancd Company Name: J,ujij%t Sys 66�J -� fv�l� N L J,+ Policy 4 Or Self-ins. Lic. �';9-^7'/7a Expiration Date: �—p?Q�3 Job Site Address: 7� C°��,4' r�p` 6 Azd City/State/Zip: i . ems, At�ach a copy of the workers' compensation policy declaration page (showing the policy number and expiry n a "e) � Failure to'secure coverage as required under Section 25A of MGL c. l 52 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 STOP WORK ORDER and a fine. Of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of 1.nvestigations of the DIA for insurance coverage verification. 1 do hereby certifjt under the pa' s and Wallies oJperjury that the information provided above is true and correct Signature Date: _ Phone#: Official use only. Do not write in this area, to be.completed by cit),or town official City or Town: Permit/License 4 Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other 1 Contact.Person: Phone : ii A D DATE IMMIDDN-M) CERTIFICATE OF LIABILITY INSURANCEF6/12/12612 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 anis 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 Maureen McDonnell J. Williams Insurance PHONE (781)848-9192 FAX (787)848-9]16 AIC No 14 Wood Rd ADDRESS:Maureen@ j Wil li amsinsurance.com Suite 4 INSURER(S)AFFORDING COVERAGE NAIC p Braintree MA 02184 INSURER A:HartfOrd Casualty Insurance 29424 INSURED INSURER 8 XS Brokers Insurance Agency C b D SIGNS, INC. DBA METRO SIGN & AWNING INSURER C: _ 170 LORUM STREET INSURER D: INSURER E TEWKSBURY MA 01876 INSURER COVERAGES j CERTIFICATE NUMBER:CL1261201431 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 SUBRI POLICY EFF POLICY EXP LTR INSR WvD POLICY NUMBER MM/DD/YYYY) (MMIDD/YYYYI LIMITS GENERAL LIABILITY x x EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES O REN occurrence) s 300_,0 0 0 A. CLAIMS-MADE aOCCUR 08SBAIJ4502 12/28/201112/28/2012 MED EXP(Any one person) S 10,000 PERSONAL 8 ADV INJURY s 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG s 2,000,000 POLICY' X JECT PRO LOC s AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I Ea accident S ANY AUTO BODILY INJURY(Per person) s ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) s NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident s 5 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5 10,000,000 A EXCESS .LIAB i 1.CLAIMS-MADE - AGGREGATE $ 10,000,000 DED X RETENTIONS 10,000 OBSBAIJ4502 12/28/2011 12/28/2012 $ B WORKERS COMPENSATION .XWC STATU- OTH- AND EMPLOYERS'.LIABILITY - Y/N X TORY LIMIT ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � NIA E.LEACH ACCIDENT $ 1,000,000 (Mandatory in NH) BD 7/7/2012 7/7/2013 If yes,describe under E L.DISEASE-EA EMPLOYE S 1 000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT s 1 000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR INFORMATION PURPOSES ACCORDANCE WITH THE POLICY PROVISIONS. I AUTHORIZED REPRESENTATIVE Jonathan Williams/MEM ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9ninn o ni Tho A rr1RrT nnmo and Innn nro ronictarnrl m2riec of arrwn i R Brian A. Chiprnan 151 Mosby Road Gardner, MA 01440 70 Whom It May Concern-. I hereby grant Kevin P. Duggan permission and authority to use my Massachusetts Consiruction Supervisors license to obtain permits for Metro Sign & Awning, This Ormission is.restricted to activity solely related to Metro Sign Awning. Feel ;vee io call me at the phone numbers below should you have any questions. Regards, I t Sfian Chipmzn I Office- 978.951.2424 Ext. 12 Cell 976.666.8036 Brian A. Chipman Office: 978651-2424 i Mobile: 978-866-8036 CStr 89645 Exp 11/8/2013 %U Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen kor License: CS-089645 , BRIAN A CBIPMAN i 151 HOSLEYAi0A1? GARDNER MA 01441D f I .�,•r:.-. ����``' ��: ," Commissioner Expiration 11/08/2013 v. 090757 NI5! .l 1630471 O ;', •t ' '��,, � !��� -11.0114 0117-19 b 11�j �2p. 11 .1o"�{fa t ' Dl1CM �.� 9FS7 If67 1 )9E7C � f" p ,! � S KEVWP AN 25 AGNES RD :�� t �.• (OWl LL,MA a v` a y tJ t: i 01862-3203 BR"A et-fl-tsL7 ti!.c }•.r 9C✓ 161 HDSL E�!fill _ tl144Qtrs� .�`' o "'= '� . TOWN OF NORTH ANDOVER "A:"-. R SIGN P E R IVI I T �SSAc.HtlS . ;r I DATE: September 5, 2012 PERMIT: S015-2013 THIS CERTIFIES THAT Lowell Five Bank has permission to erect 1 sign on side of building 25.26 inches H x 148.68 inches L = 26.08 sq. ft., the sign to read Lowell Five Bank of alum. Letters colored burgundy and green located on 498 Chickering Road provide that the person accepting this Permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the i Sign Regulations in the Town of North Andover. _ Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED F Inspector of Buildings AmoixntPaid:$Zb4.00 _ - - - Geck 1390. - r 6 V Date.//.f. .4! ./. .�r -. .... NpRTM TOWN OF NORTH ANDOVER pF ��ao ,a 1'40 0 � op PERMIT FOR MECHANICAL INSTALLATION �94SACHUSEt This certifies that !! .. G . . . . . . . . has permission for mechanical installation . .�� in the buildings of . 57. . . . .B�o �. at `���' . .<, 1,��./. �' .,el. . . . . , North Andover, Mass. Lic. No.. ���,i ,.��'� ?•. . . . . . . . w �, GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Sheet Metal Commercial Guidelines/Life Safety/Critical Systems Inspection Checklist Yes No N/A, ✓� Set of stamped engineering documents and detailed description of ' mechanical system to be installed has been provided f All workers performing sheet metal work onsite has valid Massachusetts sheet metal license i All sheet metal work being performed with proper joumeyperson-to-apprentice ratios f Fire dampers with access door properly installed and checked for operation ✓- Smoke and combination fire/smoke dampers with access doors properly installed- actuator checked for proper operation(May also be verified by fire department during fire alarm testing) 4 Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) r f Smoke/atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm testing) f Stair pressurization systems installed(where required) and operation verified(May also be verified by fire department during fire alarm testing) ./ Grease/kitchen hood exhaust system installed with all seams and connections welded airtight with properly located cleanouts. Proper cle�1. `ances, fire rated enclosures and pressure testing required.. - �1 - S�. .3�. re .ialnt 'f' . b Inst. a .. al�,�= het , rre.ui ecl' q r . on equipment and Duct penetrations in fire'ratc�-wali:,and floors sealed f Metal roofing systems installed watertight using proper materials and fasteners Flexible duct pins installed 6'-0"maximum length i Ductwork installed using proper hanger spacing,hanger stock,threaded rod and angle / iron ✓ Ductwork/plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining ✓ Volume dampers installed for each supply air branch duct New/clean-properly sized filters installed(final inspection) Testing and Balancing report complete(final sign-off) 4 x 4. SIGN PERMIT APPLICATION 1600 Osgood Street Building 20,Suite 2-36 TOWN OF NORTH ANDOVER Site Owner P!a R K J/1 a!anllr4w ori[(fir KEvi,v DyG GAi✓ Boll APPlicant/yfT/�GTG}ytAUV,-;aTel v", Site Address _C_H G/K JeA 1 06 /Q c/ ,Size of Proposed Sign Temp-&10 t,y Map Parcel %2/0�/•O —00674—aoa a, Q Illumination:A/—a)Not illuminated How attached: a)Against the wall / t b)Internally illuminated b)Roof c)Ground L1 d)Other Materials:_,S�E S&C S 27 ACNA01( Proposed Colors: Background IV HiTC Lettering 6 u R 6 u u d x • &s I-fre ) Border Cost of Si '4� 7 Required Attachments: Note: No permanent/temporary sign shall be erected,or enlarged until an Photographs sample building application on the appropriate form furnished by the Sign Office has been filed Material sample with the Sign Officer containing such information including photographs,plans Color sample and scale drawings,as he may require,and a permit for such erection,alteration Site or Plot Plan(Required for all free-standing signs) or enlargement has been issued b him. Such permit shall be is Y p sued only of the Drawings of proposed sign Sign Officer determines that the sign complies or will comply with all Other,specify applicable provisions of the By-Law. Will sign overhang any public road or walkway Yes O No(� If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED I DATE FILED: Receipt# Check# Revised 10.31.2006Fonn,Sign Permit Application SIGNATURE OF APP L A T APPROVED BY �NSTAtC 2 -QS X/ fl X u' lei MER/Siow/IL LeETj?rR 4IRZt cS'iG�f/• L�D �%GftT:wG' CES y�— i LLuMi�.d7`<� /�dNvAfr N7 cS�G 'y NS7,9C4 Cfi �fAez 3 X 6 OV-11l;*S,7t�8 tf x 7 NcS'TAGG 3 /Oo5r ,9N��IgXIaEL� �04�<<` fflc'Ea/ NO/tJ„�LLv�:.d,0`t ra>.S, _ r � NaiarH qw. 0 TOWN OF NORTH ANDOVER �•Q cncLAK q�gRTRD P. SIGN PERMIT �sS'A1CHU��� DATE: September 5, 2012 PERMIT: S004-2013 THIS CERTIFIES THAT Lowell Five Bank has permission to erect 5 signs, 1 25114" H x 8' W wall sign, 1 double faced 8' H x 7' Wide, 3 Post and Panel 56 "H x 32" W per ZoningL Board Approval located on, 498 .Chi' kering Road provi��-+"�+ +"^ con#orm to fhe.terms,of the application on file in this office, Sign Regulations in the Town of North Andover. Location/ f /l1 ViiQ�afiion "of the Zoning of Sign Regulations,Section #6, V No. Date 2-- INTERNALLY ILLUF. TOWN OF NORTH ANDOVER e • r . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Amount Paid:$204.00 Other Permit Fee Si�fv� $ Check -1390 Receipt "'25681 TOTAL $ Check#_1_ v 25681 Pui! ing Inspector 4 A Commonwealth of Massachusetts Sheet Metal Permit Date: ///0/ a, Permit# —§�l-- 0 � Estimated Job Cost: $ Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO1 ���'" • Business License# Applicant License# Business Information: Property Owner/Job Location Information: Name: Name: Street: k P Street: tV City/Town:g on City/Town: ., /d ��liv►��� Tel / 63 � � � �l3 Telephone: APhoto I.D.required/Copy of Photo I.D.attached: YES NO Staff Initial J-1 I 11A,1-unrestricted licen J-2 I M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq.ft./2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft.4 over 10,000 sq.ft. Number of Stories: Sheet metal work to be completed: New Work: !/ Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: i INSURANCE COVERAGE: I have a current liability insurance policy or its equivalentwhich 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 By checking this box❑,I hereby certify that all of the details and information 1 have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet 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. Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: i By ❑Master Title ❑Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ Check at www.mass.gov/dPI Inspector Signature of Permit Approval LF fN Lr 1.5" Deep Fabricated Aluminum C.1 Custom painted two colors. LED Cove Lighting �J4`LLF�1t'♦7 y'4'�1�t I3.L. F1 7:7 Proposed Front Elevation FABRICATED ALUM. DIM. LETTERS 0 Burgundy # 16.84 sq. ft www.metrosi0n.net Fax, 978,851.2022 Phone: 978.851.2424 170 forum Street Tewltshurv, MA 01876 • Customer Dale/iiaVl4ionf rm,dais d—fti,rd *.d omuwws�a4wda ra. MeNn": Lowell Five No wrtad dit-6e-.dac4--d---'='nary lowe115_No.And—r498Chickering Rd_New Signage Fkg_32-8362.fs 2.8.12-Original g - tea„ , tdesRiW: DeslDnw: Inaelce: Draian9�: 'Job Location North Andover,MA ow,,d o.�,.-d.,;d o. .�„�m., To: J.P. 0000. 12-8362-3rl J A A71-311 g FYPON CLADDING 6'-211 MLD523-16 r - Fypon top cladding: V �211. MLD523-16 4i1 18115211 4 i Sign/top cladding wz' 12.5" 6.5" 1.5" 30" 1.5" �—+ Framed aluminum angle post cladding with.063"thick — brakeform aluminum panels (painted white and gray). x.75' L Internal support pole: (1) @ 6"square steel tube,direct burial Sign _ --------- —1— i 6.75" _ J� a,- Sign cabinet to be custom framed aluminum. f, --Background face panel to be .125" thick C? aluminum painted white. - LowellFive --Graphics to be: ` C? 24 flour AT tuft __—� 50 7.�� \ j LovuWn"we routed from face panels with 13/4" thick clear acrylic push-thru letters. _ — 61011 ay ova za wa:,r ArM and grl_borde- r stripe routed' ofrom face panels and backed with translucent) 0 0 0 0 0 .0 0 '9 white acrylic. Gray translucent vinyl overlays. I �l1® `MOS - - - - - 1811 w — 3M transl-#48 "burgundy'= []Warm-Gray Akzo Sikkens#492-B2 -- - DOUBLE FACE-FREESTANDING 0NUMENT SIGN M3 #26 "Green" ❑White SCALE: 1/2" = 1'-0" 0 Oracal #748 "Laterite Grey" www.metrosign.net Fax: 978.851.2022 Poe: 978.851..2424 170 Lorum Street Tewksbu.r.y, MA 01876 � cuilemet "DSO Uktrar nz may 6e egoauamPeaa NaepN n.y Wwe115_No.Andover 498 Chickering Rd New Signage Pkg 12-8362. Lowell Five 2.8.12-Originalfs fahbn viNour rnuen cement fmm Metro S"yr6 dwina'Mc... .. _ ` mo►oeatlen North Andover,MA 2.10.12-Rev. 1 o•o�.a o b ..o >a T.D. J.P. 0000 12-8362-1r1 ° J F on to 3211 Framed aluminum angle post cladding with 811 063"thick brakeform aluminum panels Sign cladding: 11 611 2811 2011 , (painted white and gray). MLD610-8 Internal support pole: (1) @ steel tube I 7511 (size tbd),direct burial n 7n— : Sign , Sign cabinet to be custom framed aluminum. �. --Background face panel to be .125" thick �r - v aluminum painted white. --Graphics to be routed from face panels _. with 3/4" thick clear acrylic push-thru \_ ~--� letters and gray border stripe. F• - i 2711 Translucent gray vinyl overlays. LO 1 � E 1 , �! _,: , Reverse Side Layouts �•:'._ 6" ❑Warm Gray # , --- -- — ❑White #— DOUBLE FACE DIRECTIONAL SIGNStJOracai#748 Laterite Grey 2 @ (14 x 27 ) — 5.3 sq.ft. SCALE: 3/4" = 1'-0' Quantity: 3 Signs total www,metrosign.net Fax: 978.851.2022 Phone: 978.851.2424 170 Aerum Street Tewa0-urY. ISA 01876 f Cnstamer 981a/9aY15f01K mFan vJa..:a 6_0~Omura oAp a4.d.r Map: lrnmll5 N A dov 498 Ch ke' Rd N 5' Pkg 128362 fS Lowell Five rbPmanv a...•mare.rcw.am .v a1>aaN e�>� _o k _New ,gage _ 1 2.8.12-Orig.•2.10.12-Rev.1 - - ^� &4 -- - __.. SNO W: O Orc IaYs(a: Deawf99#: Job Location North Andover,MA 2.13.12 Rev.2•2.17.12-Rev.3 o,.�a�e g„,,,�„ T.D. 1.P.. 0000 12-8362-26 _28.0' -y 20' �1 f I \ i ra PROP. 11 S1r0q2Y o CONI. saf OD & STEFi��=FRAME BANK mW C.yasa 3,1 S. LD F. I wjLP69.55' — — — GFE=132.71 I \ 4 84' t�I _ _ _ I� _2. ' 98. ^ROOF o_ N A x`16.0 i'-� 20' C.1 • 116 ANOPY ,BOVE�� 00 ' 18' 59.50' 4 3 I p 9 27' 12 M2 SP @7 5.6' c 1Sc -9, 18' 25' LP 1 _j s 1 ICLu LP N z N mW N r I y � Sc o Sc l I BILE" I _ S ® 9' 6 ff•�r Lo Q N LP �B.1ILI .1 B.1 GR_ Exit251.12' GRASS XE— EnW S27" - -- —GRAS - — — - - - --- - - — - -- - --- - -- i - - - --— - —- -- uw a www.metrosign.net Fax: 978.851.2022 Phone: 978.851.2424 170 lorum Street 7ewnsburv, MA 01876 f Customer DateBevlsior�s ,N�.wd,>. �mP o:of�w,bw......,uH Fue1�o: n� Lowell Five lmvell 9_No.A ver 49SCh ng Rd—New Signage Pkg 12-8362.h rro wn.f ws mawwa m.rx«w.e.r.Y mP�or.drronea:.mr . � 2.8.12-Orig.•2.10.12-Rev.1 reN.nvi�haulwiteenawneoxhanMmaS�.BM�trc =��: ��: ���#: . JobLocatten North Andover,MA 2.13.12-Rev.2•2.17.12-Rev.3 _. . ... o��.� o��f� To. 1.F. 0000 _ 12-8362-4r3 t A Lr cc Lr 1.5" Deep Fabricated Aluminum C.1 Custom painted two colors. d LED Cove Lighting 4 m e m -_ r o=o } . 77 F1 LY (j �, tih�1.�}y�l � t T'l Proposed Front Elevation - FABRIEATED ALUM. DIM. LETTERS �0 Bu gundy# ■Green# 16.84 sq. ft www.metrosign.net Fax: 978.851.2O22 Phone: 978.861.2424 170 i.orum Street Tewkshury, MA 01876 • customer IMN2M: Lowell Five no wno d4 d,w Zmayh reprodu ed,copedo.Nbi ed nanr lowelt 5_No.andooer 498 Chickering 0.d New Signage Pkg 12-8362.fr 2.8.12-Ori final 'ya "'.."""""�en","m".""51°'a""nk% Original p... WesUpL: DeSKIM: Wiwi: Dtawta9#: Job tocation North Andover,MA Da ..d o.we+a.�.e o.;.>o„nm, T.D. J.P. 0000 12-8362-3r1 A 9 7'-3" FYPON CLADDING 61-211 MLD523-16 r Ir 21" Fypon top cladding: 5% MLD523-16 4° 18" 52" �,, �,�� I Sign/top claddingx,92` 12.5" 6.5" 30" 1.5" ;-L5. — Framed aluminum angle post cladding with.063"thick brakeform aluminum panels(painted white and gray). ^L75 Sign " _� Internal support pole: (1) @ 6"square steel tube,direct bursal ------�--- 6.75" , - A — Sign cabinet to be custom framed aluminum. v � --Background face panel to be .125" thick C? aluminum painted white. M LoweliFive , i� --Graphics to be: _ 00 7„ "� 24 '-tour �" F��routed from face panels with I ` 3/4" thick clear acrylic push-thru letters. 2d motrr&TM and gray oval border stripe routed' - from face panels and backed with translucent' © $00 0 6 ° 8 - white acrylic. y Y YGra translucent vinyl overlays. + - -- - - - - - DOUBLE-FACE FREESTANDING MONUMENT-SIGN - :3M#zs` #48 'Burgundy" _Warm-Gray Ai« Sil<I<ens#492-g2 - - - - — - - - White SCALE: 1/2" = 1'-0" 00racal #748 "Laterite Grey" www.meIros>lgn.neI >F;aX. 978.851.2022 Phone: 978.851.2424 170 serum Street Tewlisbur11, MA 01876 • Customer - - - _ note/Revision - l - axa"lp�Ja�n�.y"s�my�nNrcc 0oex"ex4 aupoevSyan athw.n.aiMeN"symo Raw: Lowell l5_No.A dover 498Chisk Chickering Rd New Pkg 12-8362.fsLowell Five 2.8.12-Original fatwn.nN.ur rr'wen wenmtforn Maro SOr&rrnuy,Mc .. _- _ .tea„ SalesMes: oeawner: loretce: orarA�u: Job Location North Andover,MA 2.10.12-Rev. 1 T.D. J.P. 0000 _ 12-8362-1r1` s g Fypon to 32N Framed aluminum angle post cladding with ice, p .063"thick brakeform aluminum panels Sign cladding: 2811 2011 (painted white and gray). ' MLD610-8 211 sllInternal support pole: (1) @ steel tube .751' (size tbd),direct burial N n j Sign — { Sign cabinet to be custom framed aluminum. --Background face panel to be .125" thick - -- .. aluminum painted white. --Graphics to be routed from face panels ` with 3/4" thick clear acrylic push-thru letters and gray border stripe. t . 27" Translucent gray vinyl overlays. I - 1 1 Reverse Side Layouts 6" E]Warm Gray # - - - - - - - - - - - - - t❑White # - -- - - -- - - - - - - - -DOUBLE FACE D(�EC110NR1 SIGNS f . . .,_� _ __ _ @W-, o o �o n Oracal #748 "laterite Grey" ( 2 @ (14" X 27") = 5.3 Sq.ft. - SCALE: 3/4" = 1'-0" Quantity: 3 Signs total www.metresion.net Fax: 978.851.2022 Phone: 978.851.2424 170 torum 'Street Tewhshurv, ISA 01876 � Costemet FftftM: i Lowell Five trnveU 5 No.Andorer 498 Clinkering Rd_New Signage Pkg_12-8362.h NOP.r.rd��+Ms=w�..w�.�.�o:e.r�:+•, '. 2.8.12-Orig.•2.10.12-Rev.1 ..• - r� .�„�s,a.-.:.K. orgo"#: loutoeatl•n North Andover,MA 2.13.12 Rev.2•2.17.12-Rev.3 o „,;� o.e,b.�r.. T.D. J.P. 0000 12-8362-2r3 a / 28.0 -�6 1 -- ( i 20 ;dS PROP. ?-,ISTI-MY o o `\ CONc. B OD & STE ��;'FOAME BANK MW I x(498r5. . 9Y L LP g9.55 GFE=732.71 \ tt N I 2 ' 98.84' — OF ROOOF O AN W16.0 20' C.1 O a - - - - \ ANOP" 9OVE� O o ' 18' 59.50' 4 3 1 © 9 27' 12 2 SP ® 5.6' 9'=1 25' 8' LP \ a � 1 ' LP p 6 1 1 i L h1 f 1 N z (n Mw N N � Sc Sc 1 a r `1 1 mo''`o ;eco 00 0 A nN lP B.1 B.1 - B.1 Gft" 25� _ `5a —� I°lo _ Ly!JI�So Q Exit251.12' GRASS \ X"X-1 — Enter S27*:: GRAS - - - - - - -- - - - - - - - - - rV www.me"_trosign.net Fon; 978.851.2022 Phone: 978.851.2424 170 lorum Street Tewizshury, MA 01876 � Customer Date/Revisions ploRane: rnKa..�m/a,+»wamor.rah�a:our:wws�.n a�.�nln..l.�. Lowell Five .P+ BVI d..^n6 6s«a.d .Q mp Ome bYe nvM L-91 5_No.Andover 448 Chickering Rd_New Signage Pkg .fs 128362 2.8.12-Orig.•2.10.12-Rev.1 bshnn.nWNntnmmerthpnMevoS�na�n aNc �: D""*: Wil North Andover,MA 2.13.12-Rev.2•2.17.12-Rev.3 d.�.�.,., o ,�„�, T.D. 1.P. 0000 12-8362-4r3 « Quote » Page 1 of 2 - __. — - - Quote Date 2/14/2012 Order Id S SalesRep TD Terms Code Due on Receipt 008362 Cust Id LOWELL5001 Phone 978 265-1413 Metro Sign&Awning 170 Lorum Street Fax 978 441-6533 Tewksbury,MA,01876-USA E-mail Phone:(978)-851-2424 Fax:(978)-851-2022 wone bocaruso@ towel Ifive.com ww.metrosign.net Ph Fax S Lowell 5 Savings Bank S Lowell Five 0 34 John Street H 498 Chickering Road D Lowell,MA 01852-USA p North Andover, MA USA T T 0 0 Item/D ©I Unit of M—e—a—su—re-1 Unit Price Extiended Price Post and Panel 0 EA $7,8 7 850.00 Type A.1 Drawing 12-8382-1 (Main ID) Design and manufacture a double faced NON-ILLUMINATED entrance sign. Overall dimensions:8' H x TT'W x 21"D. Sign size:3' H x 6'W x 21"D (oval shape) Faces: .125"aluminum. Graphics: 3/4"thick push-thru acrylic letters. Post:6"square steel tube,with 18"x18" .063"aluminum panel cladding,and fypon cladding at top. Post and panel 0 1 EA 2.1 $4,300.00 Type B.1 Drawing 12-8382-2 (Entrance& Exit) Design and manufacture a double faced non-illuminated directional sign. Size: 56"H x 32V overall. Frame:custom fabricated "oval"shaped aluminum cabinet with fabricated aluminum "cross arm"style support structure. Faces: 1/8" aluminum sheet with vinyl graphics Finish: (2) color custom painted. Support: (1) 6"square aluminum post set for direct burial. Dimensional Letters 0 EA2 250.002 250.00 Design and manufacture a dimensional letter set. Copy: "LowellFive". Overall size:25.25" H x 8'W. Material: 1/5"deep fabricated aluminum. Finish: Custom painted burgundy(Lowell) &green (Five, "swish" logo). Mounting: blind stud mounted. Option to install LED cove lighting strip above dimensional lette set:$300 Install 0 1EA $1,300.00 1300.00 Installation to include; - Main Sign'(direct burial into concrete footing) - Entrance& Exit signs (direct burial into concrete footing) - Dimensional Set (stud-mounted to side of building) A) Assumes normal business hours. Up-charge will apply for work required outside normal hours. B) Permits by others (unless otherwise noted). C) Final electrical hook-up by others. D) Assumes prevailing wage (Davis Bacon) is not required. "Terms: COD (cash on delivery). Payment in full is required at time of completion." Taxable NonTaxable SalesTax Frei ht Misc OrderTotal $14,400.00 $1,300.00 900.00 $0.00d I sn--.00 $16,600.00 i « Quote >> Page 2 of 2 -- ffTermsCode 2/14/2012 Order Id s TD Due on Receipt 008362 LOWELL5001 Phone I i9-78J265-1413 Metro Sign&Awning 170 Lorum Street Fax 978 441-6533 Tewksbury,MA,01876-USA E-mail Phone:(978)-851-2424 Fax:(978)-851-2022 www.metrosign.net towel Ifive.com ww.metrosign.net Phone Fax S Lowell 5 Savings Bank s Lowell Five .0 34 John Street H 498 Chickering Road D Lowell, MA 01852-USA P North Andover,MA USA T o o liem/D © unit of Measum Unit MiceExtended Edce LEASE OPTION AVAILABLE:Ask Sales Mgr if interested.Typical factor(T Rate)36 months .0435,42 months.0396,48 months.0369 GOLD STANDARD WARRANTY:Metro warrants its products to be free from defects in material and workmanship,under normal and proper use in accordance with instructions of Seller,for a period of three years from the date of delivery to Buyer. Conditions apply. TERMS and CONDITIONS:This Quotation is subject to the accompanying Terms and Conditions. With this signature, I acknowledge that I have read, understand,and agree to the included Terms and Conditions: Date: Signature: Print Name: Thank you for allowing us to quote on this project. We sincerely look forward to workino with vou. OrderTot $16,600.00 I, Taxable NonTaxable SalesTax Freight Misc OrderTotal 14 400.00 $1,300.00 900.00 0.00 0.00 $16,600. 1 tie Lommonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street _ Boston MA 02111 .ma www V SS 0 / g dia -e" Work rs Com ensation Insurance Affidavit: Build rs/Contract ors/Electricians/I'Iumbers A Iicant Information i� •r�z lel Please Print Leaibh, Name (Business/Organization/Individual): m eE7y90 'S <'n1_1,&Z _ N f 4)& Address: City/State/ZiplvkS,&R• O/ Phone : Are you an employer? Check the 4propriate box: I am a general contractor and 1 Type of project (required): 1. I am 4.a employer with D ❑ employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2. ❑ 1 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' insurance.{ 9. []Building addition comp.i [No workers' comp. insurance P. required.] 5. [] We are a corporation and its 10.❑ Electrical repairs or additions 3. ❑ I am a homeowner dolingall work officers have exercised their 11.❑Plumbin2repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[] Roof repairs insurance required.] t c. 152, §1(4), and we have no 12. / employees. [No workers' 1J R Other comp. insurance required.] `A-ny applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hint_outside contractors must submit a new affidavit indicating such, tContractors that checli 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 musr provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. // Insurance Company Name: J,W,*111%tN S _741v 6? ,CAJ7' Policy# or Self-ins.Lic.#: 4Q (b QL� 7--7o?�Q I Expiration Date:_ 0?0 Job Site Address: '0Y 9 City/State/Zip:_Aiq, Attach a copy of the workers' compensation policy declaration page(showing the policy number and expirati'r/dXe?T 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 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 Lnvestigations of the DIA for insurance coverage verification. J do hereby certify under the Ins a d penalties of perjury that the information provided above is true and correct Sienature: Date: Phone#: of 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 i r.% A`IO® DATE(MMIDDIYYYY) L.� CERTIFICATE OF LIABILITY INSURANCE 6�12/20i2° 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: Maureen McDonnell J. Williams Insurance PHONE . (781)848-9192 FAX (781)848-9116 AIC No 19 Wood Rd E-MADDRESS,Maureen@j williamsinsurance.com Suite 4. INSURER(S)AFFORDING COVERAGE NAIC If Braintree MA 02184 INSURER A:Hartford Casual t Insurance 9424 INSURED INSURER B:XS Brokers Insurance Agency C & D SIGNS, INC. DSA METRO SIGN & AWNING INSURERC: 170 LORI STREET INSURERD: INSURER E TEWKSBURY MA 01876 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1261201431 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 I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. S SUBJECT TO ALL THE TERMS, ILTR TYPE OF INSURANCE 'N wyn ASR SU R POLICY NUMBER MMIDDmYY MMI DmYY LIMITS GENERAI LIABILITY x X EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence S 300,000 A CLAIMS-MADE FxOOCCUR OBSBAIJ4502 12/28/201112/28/2012 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 }{ POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY!AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY-DAMAGE AUTOS Per accident $ S X UMBRELLA LIAR IN OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I X RETENTION$ 10,00C 08SBAI14502 12/28/201112/28/2012 $ B WORKERS COMPENSATION X WC STATU- 0TH- AND EMPLOYERS'LIABILITY Y/N X E R ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ 1 000 000 (Mandatory in NH) TED 7/7/2012 7/7/2013 If yes,describe under E.L.DISEASE-EA EMPLOYEE S 1,0001000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION IF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) I i I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR INFORMATION PURPOSES ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jonathan Williams/MEM " i ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r2mnnsim Tho Ar:f)Pr)-ma nnri Inn^nro ronicfcrnrt mnrirc^f Ar.r)Prt 7 Brian A. Chipman 151 Mosley Road Gardner, MA 01440 To Whom 11 May Concern: I hereby grant Yevin P, Duggan permission and authority to use my Massachusells Construction I Supervisors license to obtain permits for Metro Sign & Awning. This permission is restricted to activity solely related to Metro Sign Awning. Feel free to call me at the phone numbers below should you have any questions. Regards, I I ®rias Chniprncn 1 Office 978.851.2424 ext. 12 r II iIr Cell9 9.>166.9o36 Brian A. Chipman Office: 978.851-2424 Mobile: 978-866-8036 [`' CSA 69645 Exp 13/8/2033 Massachusetts-Department of Public Safety Board of Building Regulations and Standards C onoruction Supcn i+or License: CS-089645 I, °° 'r• I BRIAN A CHIlE►1VIAN 151 HOSLEY�`12OAI? d GARDNER 10A 01446 ' :ice .e Commissioner Expiration s 11/08/2013 757 ►+':, NW : . ..� 571639471 fl1=1714 01=17-19� ,, '� �- t �- ;:��•R � -� `�• �,I pe �g p3'K 'ef {f ,' txa: i e ppg F v` L OUG+GI�N ! � 1 ,2p1211 a° •.kms' UBS NEST fiGT� �9E1(. r KEVIN P r? fl fj lrit NN 1 j', ) ' t '. 25AGNESRD ¢=y r:�'� �`i ^�,�� ` ,x COWEI.L,'MA 'a �- - � • 101862-3203 a, , brs - 161 H A r; r h•»Tsm �/,� � �:.: 161 HOSLEY f#S'' � U ;'�--• i"`� GARDNER MA Sd it i i �sy op �2 TOP OF 41.10 rn 1A FOUNDATION io 22.30 EL-131.01 3 00' N a o $. 0)0 CEM. CONC. OEM. CONC. A �� p COLUMNS FOUNDATION CS! $ (4) 4o a '3.10' O� g8.61 "0to p � c0 99.80' L } j w C4v w,, o W 00 00 w I W w v' rn N Q 251.12' S27°3045"W CHICKERING ROAD ROUTE 125 II (PUSUC-80' WIDE) If o O NOTES: PLAN OF LAND 1. SITE IS SHOWN ON TOWN ,OF NORTH ANDOVER ASSESSORS IN #71 LOT #26 SEE E.N.D.R.D. DEED BOOK #7478 PACE #159 FOR SITE. NORTH ANDOVER, MASSACHUSETTS ,a- 2. SITE ZONE DISTRICT GB. DRAWN FOR In "I HEREBY CERTIFY THAT THE BUILDING IS LOCATED JEWETT CONSTRUCTION COMPANY a, ON THE LOT AS SHOWN 00 P.O. BOX 405 j RAYMOND, NH 03077 a i ���N�FM�s�9`d SCALE: 1"=40' DATE: AUGUST 30, 2012 rn � STEPHEN os #489 CHICKERING ROAD 00 1- ) sTAPI svj 0 20 40 80 120 (n MERRIMACK ENGINEERING ,SERVIC.E',S A s 86 PARK 9220ME'T 8130112 AKDOVAt alASSACSUSMTS 01810 i STEPHEN E. KI, R.L.S. DATE PRON& (878) 475-3565 FAX: (878) 475-1448 EM 10RUWAOL CO.V 1 " Of Massachusetts 'The Construction Testing People` Page 1 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Soil Inspection Report Report Date 08/08/2012 Report No. 2 Distribution Copy Job Number 15475 Project Lowell Five, North Andover, MA 498 Chickering Road Contractor Jewett Construction WEATHER: Clear .TIME: N/A CONTACT: Steve Dionne of Jewett Construction PURPOSE: Observe earthwork construction EQUIPMENT: N/A' TEST METHOD: ❑ Sand Cone ❑ Nuclear Densometer TITLE: ❑ Inspector ® Staff Engineer ❑ Engineer OBSERVATIONS: PURPOSE: Review the subgrade conditions and preparations for foundation support. DESIGN DATA: Conventional spread footings and concrete floor slab-on-grade. GEOTECHNICAL DATA: HTE Geotechnical Report. AREA INSPECTED: Perimeter footing SUMMARY: The perimeter footing was excavated to reveal the glacial parent subgrade considered suitable for foundation support. The subgrade was over-excavated one foot in depth to accommodate a 12" thick base of dense graded fill to maintain the competency of the glacial subgrade. The subgrade and fill exhibit stable, compact and firm conditions. There is no evidence of organics, groundwater or other •objectionable conditions or disturbance. I REMARKS: The subgrade is considered suitable to progress upon with foundation construction. Inspector Premium Travel Name Time Hours Time J. McCarthy No 4.00 .5 Hr(s) REVIEWED BY: Chuck Fraser ^A_� Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: NES Group Craig Fishman Jewett Construction Steve Dionne NES Group Paul Cavolowsky DRL Architects Jerry Blake Jewett Construction Steve Harris I TUTS of Massachusetts, Inc. Page 2 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Report Date 08/08/2012 Report No. 2 Job Number 15475 Project Lowell Five, North Andover, MA Attachment 498 Chickering Road Particle Size Distribution Report c = m o 0 0 00 0 o v o N M to IN iL 4k it ik lk it it "100! ——— MHD M1.03.0 GRAVEL BORROW TYPE B I S I I I I I I I I I 80 I \ I I I I I I I I I 701 I I I I I I I I I 60 1 I I \ I I I LL I I I I I I I I I \I I I \ I I I I I I Z 50 LU I I I I I I I I I I W ao I_ I I I I I a I I I I I I 1 1 I I I ,30 '20' 101 I I I TE 0 10 1 0.1 0.01 0.001 GRAIN SIZE-mm. %Gravel %Sand .%Fines Coarse Fine Coarse Medium Fine Silt Cla Y 0.0 22.6 11.6 4.8 25.6 30.6 4.8 SIEVE PERCENT SPEC' PASS? Material Description SIZE FINER PERCENT (X=NO) F-M SAND,SOME GRAVEL,TRACE SILT 3" 100.0 100.0 2" 91.1 881.2 Atterberg Limits 3/4" 77.4 PL= NP LL= NV P1= NP 318" 70.6 Coefficients #4 65.8 40.0-75.0 D90=47.5343 D85=33.2021 D60= 1.7832 410 61.0 D50=0.8430 D30=0.3461 D15=0.1765 #20 50.1 D10=0.1250 Cu= 14.26 Cc= 0.54 #40 35.4 Classification #50 26.3 8.0-28.0 #100 12.4 USCS= SP AASHTO= A-1-b #200 4.8 0.0-10.0 Remarks MHD M1.03.0 GRAVEL BORROW TYPE B Source of Sample:THE MATERIALS GROUP,3"MINUS Depth:0 Sample Number:626 Date: 8/07/2012 UTS OF MASSACHUSETTS, INC. Client: JEWETTCONSTRUCTION 5 Richardson Lane Project: LOWELL FIVE,NORTH ANDOVER,MA Stoneham, MA 02180 Pro'ect No: 15475 Figure I Date :. .!`—:.�.2 'f`TLP.O 7y�6� TOWN OF NORTH ANDOVER i PERMIT FOR WIRING This certifies has permission to perform . . . . wiring in the building of .�.•-:�.GC.. •�.rc. nn at . . .�T ! 1 � K /�p North Andover. Mass. o Fee . . . Lic. 41.7��. . . . . -. . . . . . . . ELECTRICAL INSPECTOR :heck# k ' 1 1 0 2 / Commonwealth of Massachusetts Official Use Only Permit No. / / 02- 7 ! Department of Fire Services 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),527 CMR 12.00 A (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Ci,y 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) Ll 9? �ilcncy aOGI� Owner or Tenant a L Well !"J r/P �f � ��/i/I4 gal?lf Telephone No. Owner's Address anc Me-O!YA;(la &26 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building (_&q6)eCc/ td Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters A New Service .1-00 Amps / Volts Overhead X- Undgrd ❑ No.of ii eters Number of Feeders and Ampacity {, Location and Nature of Proposed Electrical Work: SMV-1 Le — o head oZ wA- Y Com letion of the followingtable maybe 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 mergency Lighting ing rnd. rnd. Batter 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 g Tons No.of Alerting Devices No.of Waste Heat Pump Number Tons KW No.of Self-Contained to Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ElOther � Connection No.of Dryers Heating Appliances KW Security Systems:* y No.of Devices or Equivalent 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 Wiring: No.of Devices or Equivalent OTHER: ! Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of EI tri 1 Work: (J (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO R 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:) certify,under the pains and penalties of perjury,that;;the information on this application is true and complete. FIRM NAME: f vOM LIC.NO.: R—J7V5'9 Licensee: "QS 1 enaJ_t ' Signature LIC.NO YO Z3 (Ifapplicable, enter "exempt".in the licen e n n hn . e, (D Address: (�(J�dU!�g U e.fid g�3 *Per M.G.L c. 147,s. 57-61,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 liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. 1 am the(check one)❑owner ❑owner's a ent. Owner/Agent PERMIT FEE. $ Q U Signature Telephone No. I