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Miscellaneous - 50 ROCKY BROOK ROAD 4/30/2018 (2)
/ 50 ROCKY BROOK JI _ MAP PARCEL I I►3 Date........................................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING IH4U This certifies that ............................................................................................................................ has permission to perform ! .......... .. .............................................. wiring in the building of L(X ............................................................................................................... at ............�.50..........f..10..........(LV...I................................................Nqrth Andover Mass. .......... .. ....... 12-(A CI -J Fee..12 5..........Lic.No. . . .....................P ................... ................. ........ f... .......................... ELECTRICAL INsPEOOR Check# 1490 Commonwealth of Massachusetts Offial qse Only OE - - Permit No. I I Department of Fire Services Occupancy and Fee Checked r 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 . (PL,EASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4/1/2013 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) 50 Rocky Brook Road Owner or Tenant John Caron Telephone No. 978-269-4757 Owner's Address same Is this permit in conjunction with a building permit? Yes ® No ❑ BLDG PERMIT# Purpose of Building Residence 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: Installation of a 4.655 kW rooftop solar array Completion of thefolloiving tablebe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.o ota Transformers KVA ` No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above1:1 n- ❑ o.o mergency Lighting or d. rnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o Detection an No.of Switches No.of Gas Burners No. Initiating Devices No.of Ranges No.of Air Cond. Tots TonNo.of Alerting Devices No.of Waste Disposers eat Pump Number ons o.oSelf-Contained ti Totals:I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local[3 Municipal E] Other � Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.o KW o.o o.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage BathtubsNo.of Motors Total HP a ecommunications rrmg No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $16,430 (When required by municipal policy.) Work to Start: 4/15/2013 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 t undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. i CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the informatiogffl this application is true and complete. FIRM NAME: The Boston Solar Company LIC.NO.: 12689 Z Licensee: William T.Foglietta Signature LIC.NO.:_ (Ifapplicable,enter `exempt"in the license number line.) Bus.Tel.No.: 7R1-462-R702 Address: 10 Churchill Place,Lynn MA 01902 Alt.Tel.No.: *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"Licen 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 PERMIT FEE: s 12 Signature Telephone No. 1' t 'C.�.�'1^I,� Q- ��'fr✓t`�•�.H' 1 ^ 'Cil INt1 1 T-e C., S p a,J v v 1 lit u-�. �c- L. � " C � 7��s—' A2o,v w L� � �� �� ,��.. d� �� �r � 3 I �t �, � �� ': � i i t Fold Muttlpls Times Al Perforations Belpre Detaching COMMONWEALTH OF MASSACHUSETTS " BOARD EELECTRICIANS EL REGISfiERED MASTER ELECTRICIAN ISSUES THE ABOVE LW ENS TO: t: TYPE THE BOSTON SOLAR COMPANY I WILLIAM T FOGLIETTA III -A 10 CHURCHILL PLACE LYNN MA 01902-2719 308377 12689 A 111 07/31/_13 308.3.77 UNNIM Fuld Multiple Times Along Perforations Before Detaching � Fold Multiple Times Along Perforations Before Detaching CONTROL# H 5 5 2 7 41 IMPORTANT If this license is lost or destroyed, notify your Board at the: Division of Professional Licensure, 1000 Washington St., Suite 710,Boston,MA 021186100. If your name or address shown is changed,notify your board of correct name or address to insure proper mailing of next Renewal Application. Always refer to your license number. This license is subject to the provisions of the General Laws as amended.It is a personal privilege,and must not be loaned or assigned to any other person. Keep this license on your person or posted as required by law. Fold Multiple Times Along Perforations Before Detaching a m JIM ... s � yyy� f 6 me V s\ The Commonwealth of Massachusetts Department of Industrial Accidents 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 Legibly Name (Business/organization/Individual): The Boston Solar Company Address: 10 Churchill Place City/State/Zip: Lynn MA 01902 Phone #: 617 858 1645 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 2 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. E]Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. E]Building addition [No workers' comp. insurance 5. El We are a corporation and its required.] officers have exercised their 10.❑ Electrical 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.❑ Roof repairs. insurance required.] t employees. [No workers' 13.® Other 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 Policy#or Self-ins.Lic.#: WC2-31 S-384393-013 Expiration Date: 1/14/14 Job Site Address: 50 Rocky Brook Road 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 and penalties of perjury that the information provided above is true and correct. Signature: Date: 4/1/2013 Phone#: 617 858 1645 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#: ELECTRICAL DESIGN PV MODULE RATINGS @ STC INVERTER RATINGS 690.53 PHOTOVOLTAIC POWER SOURCE SERVICE PANEL RATINGS ARRAY DETAILS SIGN ON INVERTER MEP BRAND:SIEMENS MODULE'MANUFACTURER: Sunpower INVERTER MODEL:PVI-3.6 BUS AMP RATING(A):200 MPPT1 MODULE MODEL#:SPR-245NE-WHT-D OUTD OPERATING CURRENT(A):12.10 SERVICE VOLTAGE(V):240 MODULES PER STRING:10 OPEN-CIRCUIT`,OLTAGE(Voc): 48.8V MAX DC VOLT RATING(V):600 OPERATING VOLTAGE(V):405 MAIN AMP RATING(A):200 NUMBER OF STRINGS:1 RATE6-VOLTAGE(Vmpp): 40.5V NOMINAL POWER @ 40-C(W): MAX SYSTEM VOLTAGE(V):554.61 BREAKER RATING(A):30 MPPT2 RATED CURRENT(Impp): 6.05A 3600 MAX CIRCUIT CURRENT(A):15.13 MODULES PER STRING:9 SHORT-CIRCUIT CURRENT(Isc):6.43A NOMINAL,AC VOLTAGE(V):240 NUMBER OF STRINGS:1 NOMINAL POWER(+5/-3%):245W MAX AC CURRENT(A):16 ELECTRIC SHOCK HAZARD TEMP COEFF(Voc)=-0.273%/°C MAX OCPD RATING(A):20 THE DC CONDUCTORS OF THIS RED IS POSITIVE PHOTOVOLTAIC SYSTEM ARE BLACK IS NEGATIVE UNGROUNDED AND MAY BE ENERGIZED , I UTILITY M METER I LGATE 200A 101 MEP u� I ICT NL]L1 #OF MODULES IN SERIES:10 #10 THWN-2 Wire #8 Through Brea Through Breaker J #6 THWN-2 Ground I 1"EMT INDOORS to L1 &L2 #OF MODULES IN SERIES:9 5 WIRES I — 0 ICT �1 B CK N DC+. LINE L1 o C L2 L7 LAC, GND L2 I [--CF- N DC DC. - LOAD G _ -_-_-___-___-_- SolaDeck-Pass INTEGRATED Ac Through ' DC INTERFACE DISCONNECT INVERTER OUTSIDE = PVI-3.6-OUTD DISCONNECT GROUNDING 30A 240V ELECTRODE #10 PV rated Cable (NOT FUSED) #6 Bare Copper 1"PVC OUTDOOR #6 T 5 WIRES Neutral anndd Ground Licensed Electrician Assumes All Next Step Living Inc. 04-01Draw113 HM-NSL-03/14/20131Revised � - Responsibility For Determining '� Onsite Conditions and Executing �f�` ® '?` One Line Diagram Customer Name: John Caron Installation In Accordance with � �� 1- g Address: 50 Rocky Brook Rd, North NEC 2011 Codes Solar Installation Andover, MA, 01845 Ll t Phone: 978-269-4757 ARRAY DESIGN / SITE DIAGRAM HEIGHT OF HOUSE PANEL ORIENTATION (TRUE) ROOF PITCH (DEGREES) 240" 1640 R1=8°, R2=38° d H 0 O 220" z M O O W N � i I Y O 4 V O _- O % T0 ti PLACE INVERTER INSIDE ti w °' o °r° BASEMENT TO THE LEFT z W o 04 za < Co OF THE MEP WITH x Ln r_ CUSTOMERS APPROVAL jc4' EN� E° 4o= = c mD000a � Q I - V 75" 0 12" Cl) W q YJ N M > CU O Co 30 c — OJJ ® CUva- � a) C **NOT A FINI. ED ATTIC** R2 ti 40 R1 X C: U) z J Solar mount portrait R1 Solar mount Landscape(R2) p ) F-31.42"� Final rail length: 61 Ft Final rail length:68 ft . #of L-Feet: 22 # of L-Feet:24 ` ***ARRAY LAYOUT IS NOT TOTOtaI'S Ci SCALE*** EcoFasten Solar Flashings will be Total#of Panels:19 used on every roof penetration i 0 'I Customer Signature: Date: 1 http://www.readyshare.com/Users/cbateman@rstcenterpri ses-conitUpl o... Now Available! New SolaDeck SolaDeck lllL STD1741 Combiner /Enclosure FLASHED.PV ROOF-MOUNT COMBINERIENCLOSURE Basic Features Stamped Seamless Construction 18 Gauge Galvanized Steel : Powder Coated Surfaces Flashes Into the Roof Deck . I i Low Profile- 2.625" Deep 3 Roof Deck Knockouts .5", .75", 1" SolaDeck Wdel 0783-41 5 Centering Dimples for entry/exit of fittings or conduit 2 Position Ground Lug Installed . Mounting Hardware Included Roofing Industry Approved all for Information 1 (866)-367-7782 or simply request more info at sales@commdeck.com 1� ® �rE ® COM SolaDeck UL50 Type 3R Enclosures y - All the basic features listed above, ideal for pass through e wiring. Transition to house wire is simple, clean and contained in the flashed enclosure. r, UL50 Type 3R Models: Com, Model 0783- (3" Fixed Din Rail) F F Ak Model 0786 - (6" Slotted Din Rail). f4 11/18/2009 1:39 PM http://www.readyshare.coni/Users/cbatermn@rstcenterpri ses-com[Upl o... SolaDeck UL STD 1741 Combiner/ Enclosure Systems Maximum Rating -600VDC, 120AMPS Frequency DC Models 0783-41 and 0786-41 are ETL listed and labeled to the UL STD 1741 for Photovoltaic Combiner Enclosures. Model 0783-41 Model 0786-41 3" Fixed Din Rail 6"Slotted Din Rail fastened using Norlock System fastened using Steel Studs typical Widnig Configurations "Fuse holders,terminal blocks and power blocks are sold separately.Fuse holders and terminal blocks added in the field must be UL listed or recognized and meet 600 VDC 30 AMP 110C for fuse holders, 600V 50 AMP 90C for rail mounted terminal blocks and 600 V 175 AMP 90C for power distribution blocks. Use copper wire conductors. SolaDeck Model 0786 ETL Listed UL50 Type 3R - - Rain tight enclosure for outdoor use , („ Shown: 1. `v ER 6 Terminal Blocks Transition outdoor wire to THWN wire ER 6 Terminal Blocks used for positive ER6and negative ' ER5 TnimQiil,'k'A T8 mnel8txk Om 165.,, f'drvr 5"v7 SolaDeck Model 0783-41 ETL listed UL STD 1741 Combiner/Enclosure Shown: with 4 strings with UL Recognized Fuse Holders for PV Positive Power Block for PV Negative Fuses combined with Positive Bus Bar 2 of4 11/18/2009 1:39 PM http://www.readyshare.com/Users/cbateman@rstcenterpri se s-c om/dJpl o... Ra�3roe8us ii� � PV negative combined with Power Block tTr@418 t� Pasrik. fuss H$Oms' r F&W 1452 SolaDeck Model 0786-41 ETL listed UL STD 1741 Combiner/Enclosure W.WEB � rrE�l368F paopi160 Shown: with 4 strings with UL Recognized Fuse Holders for PV Positive ER 10 Terminal Blocks for PV Negative $ ER 15 POW 5*0- _ Fuses combined with Positive Bus Bar FUloSz NEOx ER 10 Terminal Blocks combined using Negative Bus Bar F9>t~1�,4i olaek Accessory 90- its Now Available 4 String kit for SolaDeck Model 0783-41 (Part#07831) +" Includes: 4-Midget Fuse Holders Rail Mount(Part#1452) - � 1 - Power Block(Part#1440) 1 -Bus Bar for Fuse Holders(Part#0784BB) 4 String kit for SolaDeck Model 0786-41 (Part#0786K) �. Includes: • . j 4-Midget Fuse Holders Rail Mount(Part# 1452) :- 4-ER 10 Rail Mount Terminal Blocks(Part# 1451) 1 - Bus Bar for Fuse Holders( Part#0784BB 1 -Bus Bar for ER 10 Terminal Blocks(Part#0785BB) 1 - ER 10 End Plate Cover(Part#1453) f4 11/18/2009 1:39 PM http://www.readyshare.com/Users/cbateman@rstcenterpri ses-com/Upl o... Midget Fuse Holders Rail Mount (Part#1452) a. Rated to 600V 30 AMPS, Wire#8-18AWG *Use Part#0784BB Bus to combine PV Positive Fuses Power Block (Part# 1440) Non Fused Rated to 600V/175 Amps, Main(1)2/0- 14,Tap(4)4-14 Combines up to 4 Strings PV negative Rail Mount Terminal Blocks i ER 10 Rail Mount Terminal Block(Part# 1451) Rated to 600V 65 Amps,Wire#16-6 AWG, 10mm wide *Use Part#0785BB Bus to combine strings ER 6 Rail Mount Terminal Block(Part# 1450) , Rated to 600V 50 Amps,Wire#26-8 AWG, 8mm wide *Use for positive&negative pass through to transition to house wire Bus Bars-Include CA4-SP lug and install Screw Bus Bar(Part#0784BB) PV Positive Bus-Combine up to 4 midget fuse holders �> Bus Bar(Part#078566) PV Negative Bus- Combine up to 4 ER10 terminal blocks RSTC Enterprises, the® 2219 Heimstead Road®Eau Claire, WI 54703 Phone: 715-830-9997®Pair: 715-930-9976 4 of 11/18/2009 1:39 PM Mono Multi Solutions V1?nmi) mount 11 10 YEAR PRODUCT WARRANTY FOR MODULE byTrinasolar AND MOUNTING SYSTEM FOR PITCHED ROOF 5X FASTER TO INSTALL SIMPLIFIED GROUNDING GROUND BOND CONNECTION 10X BETTER THAN UL MINIMUM CRITERIA SUITABLE FOR COMBINING EV MODULE EXPERTISE WITH A HIGHLY INNOVATIVE MOUNTING SYSTEM SOLUTION. COMPOSITION SHINGLEINNOVATIVE Solar is introducing Trinamount—the fastest,easiest and least expensive way to mount PV modules onto residential and commercial rooftops.With a series of drop-in and quarter-turn connections on a TRAPEZOIDAL METAL specialized module frame,this mounting solution installs up to 5 times faster than conventional mounting systems.Trinamount connects directly to the module frame,eliminating the need for long rails. STANDING SEAM ROOF By drastically reducing the number of parts, cost of materials and installation time,Trinamount offers the optimal solution for residential and commercial installations. ® �OMFgt/ Tpobms®lar The power behind the panel Fa e OOMPP~\ i Trinamount Il FOR PITCHED ROOF TSM-PC05/PA05.10/18` Fast and simple to install through drop in mounting solution TRINA MODULE MOUNTING SYSTEM HARDWARE Low parts and SICU count in ® comparison to conventional mounting solutions Interlock Superior aesthetic solution for residential rooftops ._ Long rail elimination reduces Leveling Foot inventory and freight cost Theft resistant with auto grounding hardware TSM-PC05/PA05.10/18' Ground Lug � Compact packaging with module and mounting hardware delivered together TRINAMOUNT SYSTEM X ' ow NAM a aJ " IID o b 9101a affiw fid, • RM . 6% polo Mr! g as Y bbq fto Im also available with black frame Mono Multi Solutions BASIC HARDWARE Q Interlock The Interlock provides north-south and east-west structural and ground bond connections creating a structurally contiguous hyper-bonded array. ETL Listed to UL1703. 6 360i 4 .1.Ibtml Min �12Boa ml� 1 �I�,JZn 0 Leveling Foot \ I dh 4 The Leveling Foot provides a means of attachment between the PV array T' and the mounting surface or flashed attachment apparatus and allows for . easy array height adjustment(1.25'throw). k [31.8mm] [30.7mm] 1 1.25n 1.21m p [J9.amm] -- O [57.9mm] 1.$6In 2.25n 1 [83.20n] 44 I O 4.J_ [101.6mm] min ® Hybrid Interlock The Hybrid Interlock functions as both Interlock and Leveling Foot for areas - where the structural attachment falls at an Interlock location. s [39.Im1 f [2033mm 1 [30.7mm] B.OQn 1]lin Q O O [30.7mm] 1.21in Ground Lug 'pal Provides point of connection between PV array&the equipment 1 4 grounding conductor.ETL listed to UL467.One lug grounds up to 72 IIiYVJy' modules. ® wire clip ACCESSORIES Trinamount Tool,Flat Tool Clips into Groove for ultra-fastand easy management of PV wiring and micro-inverter cabables. Flaam l:nt Fori term dine re 1 tool. 8 Flat Tool:Forinfer-module removal. � • ® Arra 63.31n 11.60mm) Y Skirt ".lin[I,627mm) [1041 ] d5.aln 1,661mm 1 !m �•; 78.3in 11,989mm1 � r' T ..:�._ Enhancing both function and aesthetics,the Arrayskirt facilitates •� "' � - easy front-row installation while providing a clean look at the front of the PV array(available in both clear and black finish). For more information,go to Trinamount Online Design Tool—www.Mnasolar.com/frinamount TrinC'C1 oust H FOR PITCHED ROOF TSM-PC05/PA05.10/18" Mono Multi solutions ELECTRICAL DATA @ STC 225 230 235 240 245 DIMENSIONS OF PV MODULE TSM-PC05/PA05.10/18' Peak Power Watts-Pnux(Wp) ff 225 1 230 235 240 245 936 Power Output Tolerance-Ptmx(%) E 0/+3 0/+3 ;0/+3 1 0/+3 - ?0/+3 Maximum Power Voltage-VMP(V) 29.4 29.8 30.1 30.4 30.7 n" Maximum Power Current-IMar(A) 7.66 17.72 7.81 7.89 7.98 sxs� Open Circuit Voltage-Voc(V) 36.9 37.0 37.1 37.2 37.3 Short Circuit Current-Isc(A) j 8.20 '8.26 ;8.31 8.37 8.47 j Module Efficiency Om(%) 13.7 14.1 14.4 14.7 15.0 Values at Standard Test Conditions STC(Air Mass AM 1.5,Irradiance 1000W/mT Cell Temperature 25°C). AL JA ELECTRICAL DATA @ NOCT 225 230 :235 240 245 Maximum Power(W) 164 f 168 172 175 : 178 aas.,x Maximum Power Voltage(V) 126.9 i 27.1 ;27.4 27.7 27.8-TA-8 ® r Maximum Power Current(A) 6.12 `6.20 6.27 6.32 6.41 i onou"owo Open Circuit Voltage(V) .1 33.8 ;33.9 {34.0 i 34.1 34.2 0.DMM"°lf Short Circuit Current(A) 6.62 6.68 6.70 6.75 6.83 NOCT:Irradiance at 80OW/m',Ambient Temperature 20°C,Wind Speed 1 M/s. Back View MECHANICAL DATA Solar cells Multicrystalfine 156 x 156mm(6 inches) _ Cell orientation 60 cells(6 x 10) 11 Module dimension 1650 x 992 x 40mm(64.95 x 39.05 x 1.57 inches) Weight 20.3kg 144.8 Ib) Glass High tronsporancy solar glass 3.2mm(0.13 inches) i Frame `: Anod'¢ed aluminium alloy J-Box !IP 65 rated A-A Cables/Connector !Photovoltaic Technology cable 4.Omm'(0.006 inches'), 1100mm(43.3 inches),MC4/H4 5L I-V CURVES OF PV MODULE TSM-230PCOS/PAOS.10/18- 90d --- 1000w/m� 800 TEMPERATURE RATINGS 700 -800 rn Nominal Operating Cell i 46°C(2°C) 60p Temperature(NOCT) Q 600W/m" c 500 - Temperature Coefficient of Pwx .-0.437./°C 400aoow m/m/ Temperature Coefficient of Voc -0.32%/°C 3- zoow/m - - 200 _ Temperature Coefficient of Isc 10.047%/°C O00 -.. 000 1000 20°0 3000 40°0 ' MAXIMUM RATINGS Voltage(V) Operational Temperature -44-+85°C Maximum System Voltage 1000V DC(IEC)/600V DC(UL) o Max Series Fuse Rating 15A , CERTIFICATION u ai UG-1-01 PV CYCLE �� C U� Us rri N-117 "°':` , FISTED WARRANTY o n 10 year workmanship warranty a ( � zi ` c us 25 yearGnearperformancewarranly (Please refer to product warranty for details) E also available with black frame lAmsar CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. The power behind the panel 92011 Trina Solar Limited.All rights reserved.Specifications included in this datasheet are subject to change without notice. �y Datasheet: Zep System II ZepS,oLar Zep System 11 Zep System II from Zep Solar offers the fastest and least expen- Zap CompatlblC sive way to mount PV arrays for flush mount installations.With a series of drop-in and quarter-turn connections,Zep System II installs up Zep System II mounting hardware is i& to 5-times faster than conventional mounting systems.The structural designed for use with Zep 0 Compatible'PV modules. ! connections of Zep System II are auto grounding,eliminating the need �O""� ` for separate grounding hardware.And with its hyper-bonded grounding For a current list of Zep Compatible'" matrix,Zep System II offers the safest,most reliable way to ground PV PV modules,please visit:http,//www. arrays. zepsotar.com/modules.html Key System Benefits Key Technical Features Suitable For TOV tested to IEC 61215 for 5400Pa Dramatically reduces installation � ; Composition Shingle time load conditions Suitable for high wind applications Corrugated Metal Eliminates mounting rails and clip hardware Interlock ETL listed to UL 1703 as Standing Seam Metal ---- ground bond means Eliminates separate grounding ` hardware i Ground Zep UL and ETL listed to UL Trapezoidal Metal _. . _�. 467 as grounding and bonding device Ultra-reliable hyper-bonded Interlock,Hybrid Interlock Carports/Canopies grounding matrix 1 i (grounding),and Ground Zep listed to o UL 2703 as PV bonding device Rapid,top-accessible precision I array leveling Ultra-low parts count Enhanced aesthetics _ For product and purchase inquiries contact: �C�® 0 �� CLEAN ENERGY SOLUTIONS U� www.eoodirect.com 1888-899-3509 USTEDt L 9Y' Datasheet: Zep System II Ll'dTt.SLTd?'[fts fir,e,han-scal Information na Interlock 113r�,1 I.a4, The Interlock provides north-south and east-west structural and ground band connections creating a structurally contiguous hyper-bonded array.Interlock UL listed to UL 2703 and ETL listed to UL 1703. Hybrid Interlock [39Amm] 0--11 [30.7mm] 1.65in 121in [2032mm] ,;� [30.7mm) 8.00in 1.211n ,Lp The Hybrid Interlock functions as both Interlock and Leveling Foot for areas where the structural attachment falls at an Interlock location.Hybrid Interlock(grounding)ULlisted toUL27O3. Leveling Foot [31.8mm) �..�.•1307mm] --F _ 1,251n 1.211n (57.2mm) [39.4mm] 2.25in T.SSIn ]81.2mm) "` ----I �— 3.2Oin 4.001n lot* The Leveling Foot provides a means of attachment between the PV array and the mounting surface or flashed attachment apparatus and allows for easy array height adjustment(1.25"throw). Ground Zep The Ground Zep provides a point of connection between the PV array and the equipment grounding conductor.One Ground Zep is required for every 72 PV modules.UL and ETL listed to UL 46T UL listed to UL 2703. Accessories Universal Box Bracket Wire Clip Comp Mount The Universal Box Bracket allows rapid attachment of Clips Into Zep Groove for ultra-fast and easy Comp Mounts provide a means of flashed attachment electrical boxes to the module frame. management of PV wiring and micro-inverter cables. for composition shingle roofs. Array Skirt Array Skirt Cap Set Zep Tool,Flat Tool The Array skirt facilitates easy front-row installation The Array Skirt Cap Set provides an aesthetic cover for Zep Tool:4 functions,I tool;Flat Toot:For inter-module while providing a clean took atthe front of the PVarray the exposed end of the Array Skirt.Made of anodized removal. (available in both clear and black finish). aluminum,each set comes with two Skirt Caps. This document does not create any express warranty by Zep Solar or about its products orseiAces.ZepSolarssalewarrantyiswntainedinthewritenproductwarrantyforeach Visit www.zepsolor.com/resources.htmiformoreinformationaboutour — product,The end-u ser documentation shipped with ZepSolar'sproductsconstitutesthesolespecificationsreferredtointhepmductwarranty.The customer is solely responsible for prod uctsandcompany. verifying the suitability of ZepSolaPs products for each use.Specifications are subject to change without notice,Copyright®2010 Zep Solar,Inc US Patent 117,592,537,U.S.S Int'I - PatentsPending.Last Update March 1,2012139 PM Page 2 of 2 �o�er�o�e Renewable Energy Solutions AURORA a 4 PVI-3,04L E-4. —TL GENERAL SPECIFICATIONS n 4. OUTDOOR MODELS r I � The most common residential inverter is the ideal size foran average- sized family home. This,family of single-phase string, inverter complements the typical,number.of rooftop solar panels,allowingi i home-owners toget the,most efficient energy harvesting for the size of the property.This rugged outdoor inverter has been designed as a completely sealed unit to.withstand ithe.harshest environmental! Conditions, One.of the key benefits of the Uno family of single-phase inverters is the dual input section to process two strings with independent .f MPPT especially useful for rooftop installations with two different f! t� e i orientations(ie East and West).The high speed MPPT offers real=time power tracking,and improved energy harvesting. t The transformerless operation gives,the.highest efficiency of up•to, i ' ti :iing 97:0%. The wide input voltage range makes the inverter suitable too, low power installations with reduced string size: l . µ .6 Sai�eF&L13ring QrtK � I v F � t C Each inverterisseton specific grid codes which canbe selected in the field - • Single phase output e Dual input sections with independent MPPT;allo_.ws optimal energy harvesting from two sub:arrays oriented in differentdirections a e Wide input range C High speed and precise MPPT algorithm.for.real.time power tracking and im:proved energyharvesting e Flat efficiency curves ensure high efficiency at all output levels ensuring consistentand stable performance across. the entire input voltage and output power1range • Outdoor enclosure for unrestricted use under any environmental conditions o Integrated DC disconnect switch in compliance with international Standards(-S,Version) • RS-485 communication interface(forconnection to laptop or datalogger) o Compatible with PVI-RADIOMO.DUL•E for wireless communication with Aurora PVI_DESKTOP BLOCK DIAGRAM OF PVI-3.0-OUTD,PVI-3.6-0UTD AND PVI.4.2-OUTD FOR NORTH AMERICA •-----------• --------------------------------------------------------------------------------- ; 1 I I MPPT1 INVERTER IN1.1(+) I I + NC/DCI BULKCAPS (DVAQ i + i s I IN1 ) INl W1 I t _ UNE GRID PARALLEL FILTER RELAY Ll y 3% y 'f 51 L2 I �1 � IN211+)d--I i I I MPPT2 LL11T..FF Ill�y-� LyyJJ•• ` II (DUDQ IN21(l) + + IN2 IN2 BJl i I 1 .,. � flE51DCURRENT j DETEETl CTION IN2.11-) I 11,12.10 �•LLi.4�JII I I I I IN1S- I I I I I{J PE STANDARDVERSION -S VERSION 11 .. i 85485 +T/R -T/R I I I I I � •. RTP1 I I I _______________ REMOTECONTROL y, COPIIii. CTiNTII +R -R I GROUND - ____________________ FAULT I DETECIIDNIP ALARM - 1 N.0 A N.O 1 C CONTROLOflCUIT I •_________________________________________________________________________________ PVI-4.2-OUTD-US PVI-4:2-OUTD-US / 100.00% 97A 100 99 96,6 98 80,00% 75.0096 95b 97 _` 70,00% 95.3 `x 65A0% 96 • � 95 - _..,- 55,00% B 9aA 50,00% 94 I yfr n+ 45.00% �O 40,0096 93,6 93 }�! .� 35.00% 993 W 92 92b ``•^' ±-35.00% —340 Vdc �+..�'. '"-�`„ ...- -'�L 'x.95,1 20,00% 97b1 91 —480 Vdc -- 90 5A0% 93 10,00% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% _ 596 91A 215 150 300 345 400 480 %of Rated Ootpot Po39e7 MPPT Voltage M i t I Nominal Output Power W 3000 3600 4200 ----- ------ - -- Maximum Output Power W 3000 3300** I 3_300** 3600 4000** ; 4000** i 4200 1 4600** ? 4600"* Rated Grid AC Voltage V L 208 240 277 208240 _ , 277 i 208 240 ; 277 Number of Independent MPPT Channels 2 _ _ 2 _ __ 2 Maximum Usable Power for Each Channel W 2000 3000 3000 Absolute Maximum Voltage(Vmax) V 600 600 600 Start-Up Voltage(Vstart) V 200(adj.120-350) 200(ad j.120-350) 200(adj_120-350) Full Power MPPT Voltage Range V 160-530 120-5_30 140-530 Operating MPPT Voltage Range - - V 0.7xVstart-580 0.7xVstart 580 0.7xVstart 580 Maximum Current(ldcmax)for both MPPT in Parallel A 20 32 32 Maximum Usable Current per Channel I A 10 16 16 Maximum Short Circuit Current Limit per Channel! A 12.5 20 20 _Number of Wire Landing Terminals Per Channel _ 2 Pairs(1 on-S version) 2 Pairs(1 on-S version) _2 Pairs(1 on-S version) _ Array Wiring Termination Terminal block,Pressure Clamp,AWG10-AWG4 Output Side(AC) Split- Split- - Split Grid Connection Type 10/2W 10/2W 10/2W 10/2W I 10/2W 10/2W - -.. 0/3W ; 0/3W 0/3W Adjustable Voltage Range(Vmin-Vmax) V 183-228 1 211-264 j 244-304 1 183-228 211-264 244-304 183-228 211-264 1 244304 Grid Fre quency--------_......_._._._..._.....----------_ Hz 60 60 60 Adjustable Grid Frequency Range Hz 57-60.5 _ 57-60.5 57-60.5 _ Maximum Current(lacmax) Aams 14.5 14.5 12 17.2 16 16 20 T 20 20 Power Factor - >0.995 >0.995 >0.995 j Total Harmonic Distortion At Rated Power % <2 <2 <2 Grid Wiring Termination Type Terminal block,Pressure Clamp,AW610-AWG4 Protection Devices Input _ Reverse Polarity Protection Yes Yes Yes Over-Voltage Protection Type _ Varistor,2 for each channel Varistor,2 for each channel Varistor,2 for each channel PV Array Ground Fault Detection Pre start-up Riso and dynamic GFDI(Requires Floating Arrays) requirements requirements requirements LOWIR 9. ..-- ----- -- -_._. _ --- - - --- -- -. Anti-Islandm Protection Meets UL 1741/IEE1547 Meets UL 1741/IEE1547 Meets UL 1741/IEE1547 ---- - Over-Voltage Protection Type Varistor,2(L,-L2/Li-G) Varistor,2(L,-L,/L,-G) Varistor,2(L,-Lz/L, G) --- - - -. Maximum AC OCPD Rating A -wM 20 20 15 25 20 20 25 25 25 Efficiency ( Maximum Efficie� .- -__...._�_. -._m. _ �._._ -------ci �� -96_9 97 97 CEC E ciency % 96 96 96 Operating Performance Stand-by Consumption Wai,s <8 <8 <8 Night time consumption W,ws <0.6 <0.6 <0.6 �- _. Communication -�J User-Interface _ 16 characters x 2lines LCD displ y _ Remote Monitoring(1xR5485incl.) -J - AURORA-UNIVERSAL(o�)_ -- -- Wired Local Monitoring (1xR5465 incl) - PVI-USB-RS485 232(opt.),PVI-DESKTOP(opt.) --_ Wireless Local Monitoring PVI-DESKTOP(opt)with PVI-RADIOMODULE(opt.) Environmental e Ambient Air Operating Temperature Range °F(°C) 13 to+140(25 to+60)with 13 to+10+140(25 to+60j with -13 to+1+140(25 to+60)with derating above 131(55)_,- derating above 131_(55). „derating above 113(45) ... . _. u ---- Ambient Air Storage Temperature Range F(°C) -40 to 176(-40 to+80)- -40 to 176(-40 to+80) 40 to 176(40 to+80) -- -- -- Relative Humidity i /o RH 0-100 condensing 0-100 condensing 0 100 condensing Acoustic Noise Emission Level I db(A)@1 m i <50 <50 <50 Maximum Operating Altitude without Derating ft(m) 6560(2000) 6560(2000) 6560(2000) Mechanical Speiifications _ _ Enclosure rati-g NEMA 4X NEMA 4X NEMA 4X Cooling -- - Natural Convection Natural Convection Natural Convection Dimensions(H x W x D) in(mm) _ 33.8 x 12.8 x 8.7(859 x 325 x222)-S wrsion Weight <_4_7.3(21.3)-S version <47.3(21.3) S version <47.3(21.3) S version Mounting�fstem Wall bracket Wall bracket Wall bracket Trade size KOs:(tea x 1/2")and I Trade size KOs:(2ea x 1/2")and i Trade size KOs:(tea x 1/2")and Conduit Connections*** (2ea x 1-1/4,3 places side,front, (2ea x 1-1/4",3 places side,front, (2ea x 1-1/4;3 places side,front, _ _ ___ _ rear)....---- rear)---- rear) DC Switch Rating-(Per Contact) AN 25/600 25/600 '- 25/600 Isolation Level Transformerless(Floating Array) Transformerless(Floating Array) Transformerless(Floating Array) i ___.. Safe and EMC Standard UL 1741,CSA C22.2 N.107.1-01 UL 1741,CSA-C22.2 N.107.1 01 UL 1741,CSA-C22.2 N.107.1-01 Safety A royal ..... _ .. .-_ _... _ -- r Y PN _ CSACSA, CSA, Warranty - Standard Warranty years 10 10 _ 10 -- - - --- --- Extended Warranty years 15&20 15&20 15&20 Available Models , ..Standard-.-Without DC Switch and Wiring Box PVI-3.0-OUTD-US PVI 3.6-OUTD-US PVI 4.2-OUTD-US _. With DC Switch and WiringBox PV1�3.0-OUTD-S-US PVI-3.6-OUTD-S-US PVI-4.2-OUTD-S-US *All data Is subject to change without notice "Capability enabled at nominal AC voltage and with sufficient DC power available '**When equipped with optional DCSwitch and wiringBox 4 W V O C t5 O ' t C Ol E d O n. E 'c c V O1 O t'J d 1] 7 N d yNA � V 7 n rrti tri 0 rq ori Power-One Renewable Energy Worldwide Sales Offices Country Name/Rec3ion Telephone Email Australia Asia Pacific +612 9735 3111 sales.australia@power-one.com China(Shenzhen) Asia Pacific +86 755 2988 5888 sales.china@power-one.com China(Shanghai) Asia Pacific +86 21 5505 6907 sales.china@power-one.com India Asia Pacific +65 6896 3363 sales.india@power-one.com Singapore Asia Pacific +65 6896 3363 salessingapore@power-one.com Belgium/The Netherlands/Luxembourg Europe +32 2 206 0338 sales.belgium@power-one.com France Europe +33(0)141 796140 sales.france@power-one.com Germany Europe +49 7641 955 2020 sales.germany@power-one.com Italy Europe 00 800 00287672 Opt.n°5 sales.italy@power-one.com Spain Europe +34 91 879 88 54 sales.sppain@power-one.com United Kingdom Europe +44 1903 823 323 sales.UK@power-one.com Dubai Middle East +971 50 100 4142 sales.dubai@power-one.com Canada North America +1877 261-1374 sales.canada@power-one.com USA East North America +1877 261-1374 sales.usaeast@power-one.com USA Central North America +1877 261-1374 sales.usacentral@power-one.com USA West North America +1877 261-1374 sales.usawest@power-one.com •Jill s• a n ELECTRICAL DESIGN , PV MODULE RATINGS @ STC INVERTER RATINGS 690.53 PHOTOVOLTAIC POWER SOURCE SERVICE PANEL RATINGS ARRAY DETAILS SIGN ON INVERTER MEP BRAND:SIEMENS MODULE MANUFACTURER: Sunpower INVERTER MODEL:PVI-3.6 BUS AMP RATING(A):200 MPPT1 MODULE MODEL#:SPR-245NE-WHT-D OUTD OPERATING CURRENT(A):12.10 SERVICE VOLTAGE(\/):240 MODULES PER STRING: 10 OPEN-CIRCUIT VOLTAGE(Voc): 48.8V MAX DC VOLT RATING(\/):600 OPERATING VOLTAGE(V):405 MAIN AMP RATING(A):200 NUMBER OF STRINGS:1 RATED VOLTAGE(Vmpp): 40.5V NOMINAL POWER @ 40°C(W): MAX SYSTEM VOLTAGE(\/):554.61 BREAKER RATING(A):30 MPPT2 RATED CURRENT(Impp): 6.05A 3600 MAX CIRCUIT CURRENT(A):15.13 MODULES PER STRING:9 SHORT-CIRCUIT CURRENT(Isc):6.43A NOMINAL AC VOLTAGE(V):240 NUMBER OF STRINGS: 1 NOMINAL POWER(+5/-3%):245W MAX AC CURRENT(A):16 ELECTRIC SHOCK HAZARD TEMP COEFF(Voc)=-0.273%/°C MAX OCPD RATING(A):20 THE DC CONDUCTORS OF THIS RED IS POSITIVE PHOTOVOLTAIC SYSTEM ARE BLACK IS NEGATIVE UNGROUNDED AND MAY BE ENERGIZED I 1M UTILITY O I METER LGATE 200A I ICT 10NUL, MEP ql #OF MODULES IN SERIES: 10 #10 THWN-2 Wire Through Breaker ) ) #6 THWN-2 Ground to L7 &L2 I � I 1"EMT INDOORS �1 #OF MODULES IN SERIES:9 5 WIRE —IC^ 03 A ICT �1 I B K LINEAC`l.i L1 o o J.N ND L2 L7 . _ L2 - \ I DC- DC¢ N b DC- LOAD I -J SolaDeck-Pass INTEGRATED AC Through DC INTERFACE DISCONNECT INVERTER OUTSIDE AC — PVI-3.6-OUTD DISCONNECT GROUNDING (NOT FUSED) #10 PV rated Cable 30A 240\/ ELECTRODE #6 Bare Copper 1"PVC OUTDOOR #6 THWN-2 WS IRES Neutral and Ground Next Step Living In C. 04-01-13)HM-NSL-03/14/2013 Revised- Licensed Electrician Assumes All rf 9= Responsibility For Determining /'� Onsite Conditions and Executing V�; ® One Line Diagram Customer Name: John Caron Installation In Accordance with o �. Address: 50 Rocky Brook Rd, North NEC 2011 Codes Solar Installation Andover, MA, 01845 Ji Phone: 978-269-4757 ARRAY DESIGN / SITE DIAGRAM HEIGHT OF HOUSE PANEL ORIENTATION (TRUE) ROOF PITCH (DEGREES) 240" 164° R1=8°, R2=380 N d 0 O 220" Z M O O w N (0 4 00 O O i m _ 9 0 to- PLACE \BA E INVERTER INSIDE z 4; 0 001 r` E Wo 'Z8 MENT TO THE LEFT z o a N CO F THE MEP WITH = L �' OMERS APPROVAL = r c o Vn 'a -v o O o U Q Q a - Q 75" 0 12" M W E C M cu 0 4-4 2 30„ C CU ca 0 C **NOT A FINI ED ATTIC** R2~ 40 R1 x C /�� _ _ z O Solar mount portrait(R1) Solar mount Landscape(R2) X31.42°—> Final rail length: 61 Ft Final rail length:68 ft #of L-Feet: 22 # of L-Feet:24 ARRAY LAYOUT IS NOT TO ”` Total's `� 0 SCALE"' Total#of Panels:19 EcoFasten Solar Flashings will be D1 4 used on every roof penetration �no--� Customer Signature: Date: " i i/ f��c i Date.................................. t NpRTM q 3r,•`r���-+•_,e�ppc TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,SSACHU`�� 4 This certifies that ..... f.......: :- ................................... K has permission to perform r' ..........o...;;..... .................................. wiring in the building of.... at... '. } / :...: .. �✓t , �� ... ,North Andover,Mass. :. Fee-R5.............. Lic.No 2 .... .... "^-ELECTRICAL INSPECTOR Check # 4535 i Commonwealth of Massachusetts Orheial Use Only 14 fir` Permit No. 445 3 S k , l Department of Fire Services -.d OCCU Banc and Fee Checked l Y �5 BOARD OF FIRE PREVENTION N REGULATIONS [Rev. )1/99] (leave blank) APPLICATION FORPERMIT 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) Bate: Lj Z. e� City or Town of: To 117e Inspec or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street& Number) ;t6 Owner or Tenant ��7—i�1/�/ll� Telephone No. Owner's Address S Is this permit in conjunction with a building permit?,7/(o Yes No ❑ (Check Appropriate Box) Purpose of Building Aal�j;FL Utility Authorization No. Existing;Service 260 Amps Volts Overhead❑ Undgrd[k No. of Meters l New Service 4 Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Com plelion of the following.lable man'he tiraived hr the h7.e lector o/IVires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting;Outlets No.of Hot Tubs Generators KVA Above ❑ In ❑ o.o Lighting ig ing No. of Lighting Fixtures Swimming Pool rrnd. Vrnd. Battei:y Units No. of Receptacle Outlets No.of Oil: Burners IFIRE ALARMS No.of Zones No. of Switches z No.of Gas Burners No.of Detection and `F Initiatin Devices No.of Ranges No.of Air Cond. Total Tons No. of Alerting g Devices b No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertinr Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection E] Other No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: b No.of Devices or Equivalent OTHER: Atlach additional detail i/dcsired,or as required br the Inspector of Wirc.v. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless A the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The Undersipied certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE �T BOND ❑ OTHER ❑ (Specify:) Z,Opy (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start 2 Inspections to be requested in accordance with MEC Rule 10,and Upon completion. I cet7ijjr, under the pmns and penalties of'peijurv, that the hilbrinallon on this a1)phcallon is trite and complete. QQ FIRM NAME: JAC. NO.: �79�J Licensee:�i �.cs%/�J�-O.G�y Signature LIC. NO.: (If applicable, enler "etrmpt"in the license nuniber•line.) Bus.Tel. No.,2?—,f— Address: Alt.Tel. 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 anent. Owner/Agent Signature Telephone No. PERMIT FEE: S d s� 9� Date.............. ..�... ....... t pCRTH 1 ° "'°;• "o TOWN OF NORTH ANDOVER 00 p PERMIT FOR WIRING CMusE� This certifies that ............ ....:..�:.y ....................... ................................. has permission to perform SSf P`�l -11 wiring in the building of ` �1..................................�ja ` v ............./..''......,?... .......x(. 06 k ....��.��.. .NorthAndo,MYass� F �? V•G Lic.No.....:�/.!7�.. .................. ..i...�... ........ ELECTRICAL INSPECTOR i Check # 45 ; 7 Commonwealth of Massachusetts Official Use Only Permit No. "2' S 7- 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 WINK OR TYPEAL INFORMATION) Date: p City or Town of: To the Inspect r ofWires: By this application the undersigned gives ice o his or h intenti n t11, o orm the electrical work described below. Location(Street&Num r) Owner orTenant Telephone No. �7 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters ,v New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Above ❑ In- F-1 o.o Emergency Lighting No.of Lighting Fixtures Swimming Pool rnd. rnd. Battery 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. 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 ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equi alent No.of Water Kms, No.o No.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: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of El ctrical Work: �— (When required by municipal policy.) 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 information on this application is true and complete. FIRM NAME: LIC.NO.: 15 q 1(` Licensee: John S. Bassett Signature LIC.NO.: 1533C (Ifapplicable, enter"exempt"in the license number line) Bus.Tel.No.: 603 594 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lic see 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: $ 44�- I Safety Insurance Form of Notice of Casu'afty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building.Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: JOHN CARON Property Address: 50 ROCKY BROOK RD,NORTH ANDOVER, MA Policy Number: HMA 0378672 Claim Number: BOS00040080 Date of Loss: 11/12/2013 Company: Safety Property and Casualty Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable.: If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Allan Leavitt Claim Examiner 11/14/2013 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 Fax: (617) 53178891 . Email: AllanLeavitt@Safetylnsurance,.com. I Safety Insurance Form of Notice of Casualty Loss to Building Under MASS: GEN. LAWS, Ch. 13% Sec.-3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 --RE: fii iif d:' -_.JOHN CA-RON - Property Address: 50 ROCKY BROOK ROAD,NORTH ANDOVER, MA Policy Number: HMA 0381200 Claim Number: BOS00040166 Date of Loss: 11/12/2013 Company: Safety Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Allan Leavitt Claim Examiner 11/22/2013 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 Fax: (617) 531-8891 Email: AllanLeavitt@SafetyInsurance.com .0 Z, A 49 Date.... .........7................. NORTH TOWN OF NORTH ANDOVER 60 PERMIT FOR WIRING ,'MACMUSEt This certifies that .........1........!.... ............ ... .................................................. has permission to perform ..........tova ...................... 4W.60-1..... wiring in the building of....................e ....0 . ........................... .... ..7; 3 at........�R........A.C....A�c.,Y.......RA.94�............... .North Andover,Mass. _Z9 CIO Fee.IS............. Lic.NoJ./....... .......... .t ELLfCTRICAL INSPECTOR Check # 7443 Commonwealth of Massachusetts Official Use Only �A Department of Fire Services Permit No. 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /-07 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives tice of his or her intention to perform the electrical work described below. Location(Street&Number) 91-Mk 41 Owner or Tenant r Telephone No. WF f 77- Owner's Address C§10 P40 00�( Is this permit in conjunction with a tuilding permit? Yes No El (Check Appropriate Box) Purpose of Building St J;''r,,,�, h� 626'0 1 Utility Authorization No. Existing Service S,66 Amps ),)o/ .,Stp Volts Overhead ❑ Undgrd Lg" No.of Meters New Service -aD Amps J,�O /,)-q0 Volts Overhead ❑ Undgrd � No.of Meters Vie, Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 16pArn,2 a12l&SA t L�t3* CY0)GL&mD4 irwJ Completion of the followingtable may be waived by the Inspector of Wires. i No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tr o Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- o.o Emergency Lighting rnd. rnd. If Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.o Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Conneectiounictio n ElOther pp No.of Dryers HeatingAppliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.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: t rD Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work r �Q7®, (When required by municipal policy.) Work to Start: Cc-,R-0-1 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 2 BOND ❑ OTHER ❑ (Specify:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: aA- :aC_Cy ; 16-n LIC. NO.://5'/9'fj Licensee: ofinAA a,60AIO.►� Signature LIC. NO.-.1,167Y-6 (If applicable, nter "exempt"in the lice s�j l�umber line.) Bus.Tel. No.9'7�/ala?-/84� Address: t,a�r,'cc K6 �illQriGtl�,�10., Alt.Tel. No.�,,03-305-`2 911 *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S" License: Lic.No. //S --t5 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, 1 hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ r W The Commonwealth of Massachusetts b Department of Industrial Accidents r Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r Please Print Legibly Name (Business/Organization/Individual): _I C,V1GL's'�V, ���Ct.t t�I ;Gia 1'l Address: :ay) 11 Ce City/State/Zip: 9 f 16 r;(,,_, 0)X4-1 Phone #: 9?c 66 7 'J Fd,3 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6.XNew construction employees(full and/or part-time).* have hired the sub-contractors 2X1 atn a sole proprietor or partner- listed on the attached sheet. E] Remodeling 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. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑ Other *Any applicant that checks box#I 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 anal job site information. Insurance Company Name: IV�S �.n,5' Y�cc CDyr �n Policy#or Self-ins. Lic. #: ///C' Vg©31 Expiration Date: 9-17-0-7 Job Site Address: Sb Ldeleu &A( /d City/State/Zip:,f1,kkVer,/lea, , 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 a d penalties of perjury that the information provided above is true and correct. Sijznature: Date: - y`U 7 Phone#: 2 7F` 66,-71-) F,� 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#: Date. r�. !4�. two/ i .stip TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 41 SSACMUS� � - 1 � This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . - ! . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . ate: . . . 7. . . . . , J . . . . , North Andover, Mass. Ft. s�a. . .Lic. No.. . . . . . . . :' . . . . . . . . . . . . . . . . . . . �/ PL�rING INSPECTOR Check !t �/�Z i 6546 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS l Date t1- Building Location� wkAl Owners Name N� Pem2o Amount ko6gf ra, Type of Occupancy New 0 Renovation El Replacement 0 Plans Submitted Yes No FIXTURES 96A a SLBB9vR B�w>Hlvr u EUXR M RDM 3M RDM 4M RDM 5M ELCM 6M RDM 'IIII140CR _—�-H SIH KDOR (Print or type) Check one: Certificate Installing Company NameCorp. Address vk ��� Partner. Business Telephone d -&6ry- Np q 0 Firm/Co. Name of Licensed Plumber: 54W �k Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy a Other type of indemnity D Bond Q Insurance Waiver: 1,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent 0 41 I 1 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 Massachusetts S to Pbing ode and pter 142 of the General Laws. By: Signature of icensea riumner Type of Plumbing License Title lip, ity/TowniNim er Master Journeyman 1APPROVED(OFFICE USE ONLY i 5932 Date... ................ TOWN OF NORTH ANDOVER 0 I PERMIT FOR WIRING 44 S CHUS This certifies that .. ........ '40A.4A rdO . ............ lr Jj..................................................... has permission to perform ...... ..............(. ......................................... CA 4A IAAJ 0 wiringin the building of................................................................................... O ............ .NortbAndover,Mass. at..... .... ....................I................................ P, ? Fee....3 ... ............ ... Lic.No. ./�- 0'A. ELECTRICAL I P CTOR Check DEPAWiti WOFPUBUMFE7Y Permit No. 5 9 3 Z BaM0FnWPREVFN WRB UTAWM517a21bW Occupancy&Fees Checked APPUCATTONFOR PERMITTO PERFORM ELECTR/�12RK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 (PLEASE PRINT IN INK OR TYPE ALL R*`ORMATION)Town of North Andover Inspector of Wires: The undersigned applies for a pennit to perform the electrical work described below. Location(Street&Number) 0 Ck- r06\<, (� Owner or Tenant _ �e�1"� L� S7 C 777 7 Q N Owner's Address Is this permit in conjunction with a building permit: YesM No E3 (Check Appropriate Box) Purpose of Building _,-1C LL, J Utility Authorization No. Existing Service Amps / Volts . Overhead Underground No.of Meters New Service Ampsolts Overhead EM Underground M No.of Meters Number of Feeders and Ampw ity Location and Nature of Proposed Electrical Work i tel or\1 No.of Lighting Outlets No.of Hot Tuba No.of Transformers Tota KVA No.of Lighting Fixtures Swinuning Pool Above Below Clerteratos KVA zroun 171 rl No.of Receptacle Outlets No.of Oil Burner No.of Emergency Lighting Battery Units No.of Switch Outlet No.of des Boman No.of Ranges No.of Air Cond. Tota FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Tota TOW No.of Detection and. Pumps Toru KW Initiating Devices No.of Dishwasher Space Area Heating KW No.of Sounding Devices No.of Self Contsined Detecdon,Sounding Devices No.of Dryers Heating Devices KW Local Municipal O ConnectionsNo.of Water Heaters KW No.of No.of Siam Bailasis No.Hydra Massage Tubs No.of Motors Tota HP OTHER- hataartaeCo�pitsutrtbdeteguaana��GentsalLawa IhueactwMIA tyl=aartaeFbk7JndAJC arlasimirlw0valat ws ED NO IhmesuhniuBdvaidprodofs=lDt OffMYES rMV ff)tthatisoled®dYMplmindmtderAecfaAuWby . --- -- - - — !r LMMMJ k4SURANCE [A. BOW B#sdanDde Etm*dVab cfEhcWcdWads:S WodooSma -06- kgecdmDateRmpmWd Rough Find -qgrodutderRndd!sCfpetjtry. EMMNAME 1 )��J � LO N(�wo e L- C-�eN L INa Lioa>9eNo Buda= dNa 99 21L4 81 ate, 4ritM 1-Z-6 C1, l<N., 6A LL la (LL. k oD sow N41 uz�.r;) A LTdNa OWI�WS)NS<1RAN EWAM3kla nmmdudieLioml dpesmi heirnuaneooroa�eCrilss>t>6mrrialegtrivaiat�regmedbyMas�rfi��tsGenaalLawa oraddietmys1VAwcnftpmritaQ kWmwai"Mrrwinni t (Please check one) Owner ED Agent � Telephone,No. PERMIT FEES ibgnature or uwner or Agent COMMONWEALTH OF MASSACHUSETTS OF ELECTRICIANS AS A REG JOURNEYMAN ELECTRICIAN ISSUES THIS LICENSE TO DANTE E LONARDO {m 128A KIMBALL HILL RD HUDSON NH 03051-3922 '• I 50555 E 07/31/07 017795 { DEPAW 1g9 TOFPUBMSAFM Permit No. BQARDOFF=PREI�F11t1froNRFJGUTA?7�Oi 527C1m12� Occupancy a:Fees Checked APPUCA'HONFOR PERMITTO PERFORM ELECTRICAL WORK AL1.WORK TO BE PERFORMED IN ACCORDANCE WrrH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date I�� Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) C L C 6K Owner or Tenant ?V-e. I Li SCS C Abq A No Owner's Address Ls this permit in conjunction with a building permit: Ye4M No [:3 (Check Appropriate Box) purpose of Building �. N Utility,Authorization No. Existing Service Amps....�.V o is Overhead a UnderpoundG No.of Meters New Service Ampa..L. Volts Overhead Undergrou No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.R Lighting Outlets No.of Hat Tubs No.of Transformers Total KVA No.of Lighting Fixtom Swimming Pooh Above Below Oerwratats KVA Around 1:1 pound No.of Receptacle Outlet No.of OU Burners No.of Emergency Lighting Battery Units No.of switch Outlets No.of Oaf Burners No.of Ranges No.of Air Cad. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Ponys Tons KW Initiating Devices No.of Dishwashen Space Area Heating KW No.of Sounding Devices No.of Self Contained DetectimSounding Devices No.of Dryers Heating Devices KW Local a Municipal Other -•:-- Connections No.of Water Heaters KW NO.of No.of signs ail"is No.Hydro Massage Tubs No.of Motors Total HP OTHER- ]nettwtae A�u9ttbdletec}tsare�ctNl�IS�C,e�mlLawa ]tmeac ,cl�brBylrstaatxR�i�yirrlydrBt7c*nplet ar>lssu> rliaala};va1Qt Yf14 Np Ih=&tt niwdmddp aicfstt�aetolhe�YM )fioufatededmdYFiS,pi�rdczledZtJpcfaotieVby DZURA ECS BCND MM � �iraae�mljr) EM*dVa zdE1acWcdWok$ WadcbSlist _ - DaRagnsiod Rotes Final �Iv � �ArJrt� l_�,.� e L� C+(?-.\C- LiaalaeNa SoSs`sF &d=TdNa 52A 2iU S1 o(-1 Arkim_ I zg 1��.r,(3A U 1) nLL TZJ A-DS0,,J /\)41 G3 vg-) ALTdNa OWI,,WSMRANCEWAMIamawmdNiftLKzrw r their iaeao�eag~ar s It�giivala�astaQaLadbyM �eitsGaies�Lawa xdd tnVdVft=onaispmri iCmotwa�aefeq�ams (Please check one) Owner C3 AgentNignam or Owner of Figeng Telephone No. FEE S . 1 i o l The Commonwealth of Massachusetts State Board of Building Regulations and TOWN OF NORTH ANDOVER Standards I BUILDING DEPARTMENT Massachusetts State Building code 780 CMR APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OF OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Building Permit Number: Date Issued: /a—/p a_6 Signature: a "t /X C644A.A Building Commissioner/Inspector of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: p�_K-" L ^, 1.2 Assessors Map and Parcel Number: n O A ��li 1 i� 1J Map Nmnber vl Parcel Number 13 Zoning Information: IA Property Dimensions: ZZst Z O t Lot Area(sq) Zoning District Proposed Use 1.6 Building Setback ft. Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided 0201 -76t / 3k O 72 r 107 Water Supply 9M.G.L.C.40.454 I.S. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private Zone D Outside Flood Zone o Municipal a On Site Disposal System 2.1 Owner of Record 1..1 TER- LISA G-FYT&LPcti-3O 5U �c�t�. -$f200\4- 'CDAD , til, At4DOV M. Name(Print) Address: Si a Telephone 1 2.2 Au gent: . (_o �1 t_ �►� `QRt�o l� � E C Name(Print Address Signature Telephone SECTION 3 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE 3.1 Licensed Construction Supervisor. Not Applicable Q Licensed Construction Supervisor: License Number . &>RZE11_ V&4 'D'INA�A&tcS• CS D'�-t 5 $ Address Expiration Date b6o Essex 2�0 Signature TelephonelWgIS $� 3.2 agistered Home Improvement Contractor. Not Applicable Q Company Name Registration Number (G l 5 Address Expiration Date -r Ne EssEX, S ►0 0 Signature Telephone Revised 1997 JMC SECTION 4 WORKERS'COMPENSATION INSURANCE AFFIDAVIT[M.G.L.c.152§ 25C(6)] .Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No SECTION 5- PROFFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDING AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE 5.1 Registered Architect: No Applicable Name(Registrant): Address Registration Number Expiration Date -Signature Telephone 5.2 Registered Professional Engineer(s) Name Area of Responsibility Address Registration Number Expiration Date Signalure Telephone Name): Area of Responsibility Address Registration Number Expiration Date Signature Telephone Name Area of Responsibility Address Registration Number Expiration Date Signature Telephone Name Area of Responsibility Address Registration Number Expiration Date Signature Telephone 5.3 General Contractor Not Applicable Company Name: h..l 141nn l G Responsible in Charge of Construction 19VaP,1 ,-- Address `JPS (� DI� Q E lam"f. �55�x r Vrl�- OI�12� Signature DIS ( Telephone SECTION 10b-OWNER/AUTHORIZED AGENT DECLARATION I, ` � �"(oaQ - QRA' "'��b'Nkvtt(r—S ,as Owneruthorized Agent]w1odge by declare thai the statements and information on the foregoing application are true and accurate,to a and belief. Signed under the pains and penalties of perjury. (;(L— Print Nam td z5' oZ Signature of Owner gent Date SECTION 11 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to Official Use Only be completed b permit _ applicant 1. Building 4 33 r (a) Building Permit Fee Multiplier 2. Electrical ISoV•^ (b) Estimated Total Cost of Construction from(6) 3 5D 3. Plumbing Building Permit Fee(a)x(b) 4. Mechanical(HVAC) 5. Fire Protection r 6. Total= 1+2+3+4+5 3(4 "!��: Check Number SECTION 6-DESCRIPTION OF PROPOSED WORK check all applicable) New Construction Q Existing Building Q 1 Repairs Q Alterations Q Addition Accessory Bldg. Q Demolition Q 1 Other Q Specify Brief Description of Proposed: otJ 2 CRr2 L vv\ K > 13 X 2b SECTION 7-USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly A-1 A-2 A-3 lA Q A-4 A-5 1B Q B Business Q 2A Q E Educational Q 2B Q F Factory Q F-1 F-2 2C Q H High Hazard Q 3A Q I Institutional Q I-1 1-2 1-3 3B Q M Mercantile Q 4 Q R Residential 0 R-1 R-2 R-3 5A Q S Storage Q S-1 S-2 5B EJ U Utility Q Specify: M Mixed Use Q Specify: S Special Q Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS. ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index(780 CMR 34) Proposed Hazard Index(780 CMR 34) SECTION 8-Building Height and Area BUILDING AREA Existing(if applicable) Proposed Number of Floors or stories include basement levels Floor Area per Floor(st) 33$ Total Area(sf) (off Total Height(ft) t& SECTION 9-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes Q No 0 SECTION 10a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS SENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, N _� `��I`a _0 ,As Owner of subject property J hereby authorize &RR_ o(2-K P Cc-)%IaL D?A• Geo to act on my behalf,in all matters relative to work authorized by this building permit application. v� Signatur6,Qf Owner Date revised bldg form/state JMC FORM U - LOT RELEASE FORM wC 0 '-e—, Sccs� INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Poo wi Size_ Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. A)Qd�t��oti **"**""***"*"***********APPLICANT FILLS OUT THIS SECTION*********************** ",�Cb RS APPLICANT8�(OK 91( --�k���NOPIICS PHONE_�I�� $�S ��5I LOCATION: Assessor's Map Number v A PARCEL 39 _ SUBDIVISION LOT(S) a313 STREET ?OG_ Y-- AV ST. NUMBER—S� ************** *****OFFICIAL USE ONLY*** *********** RECOMM ATI NS OF N AGENTS: ^` C RV TION ADMINI TOR DATE APPROVED DATE REJECTED__ COMMENTS 1A4 o; _ C , At TIOW14 P NNER DATE APPROVED DATE REJECTED — COMMENTS_ FOOD INSPECTOR-HEALTH DATE APPROVED �X J DATE REJECTED_ SEPTIC INSPECTOR-HEALTH DATE APPROVED_' DATE REJECTED COMMENTSD ( ► � �J N�r1y nnS_- C v,� lti� PUBLIC WORKS-SEWER/WATER CONNECTIONS I DRIVEWAY PERMIT i FIRE DEPARTMENTRECEIVED BY BY BUILDING INSPECTOR DATE Revised 9197 jm i North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Fa igna ure of Permit Applicant 291A 2— Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Date. � . ��. t TOWN OF NORTH ANDOVER 3a .•_.r - �.°oma PERMIT FOR PLUMBING This certifies that at-1, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform -J-:0 . . . . . . . . . . . r plumbing in the buildings of . -- �� -nn '` . . . . . . . . . . . . . . . . . . . at�7'. . u"° ` ✓`?�'. . . .r North Andover, Mass. r Fee?—,, . .Lic. No.. . . . . . . . . �iA_ . . . . . . . . . . . . . . . PLWI 1NG INSPECTOR Check H 6546 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print 6=M Name: Location: City Phone ( -1 am a homeowner performing all work myself. uF-11 am a sole proprietor and have no one working in any capacity I am an employer providing workers!compensation for my employees working on this job. Company name: &FC> L y U f &,(C�S Address S A Lwe; City: e S S X Phone#: Insurance Co. L-e�BN ( Policv# MlG32t ��� Company name: Address City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this state t may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pa i s of perjury that the information provided above is true and correct. Signature Date L0 VS az. Print name &ac-to(Lk Phone Wlit 1e1 T+S I Official use only do not write in this area to be completed by city or town official' ❑ Building Dept E]Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone A ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSAnON 11/8412002 10:41 9789219182 LAURANZANO INSURANCE PAGE 03 .......... AMC It 2 PRO"CER Lauranzano Insurance Agency THO CERTIFICATE 118 ISSUED AS A MATTER OF INFORMATION' 107 Dodge Street ONLY AND CONFERS NO RIGMS UPON THE CERTIFICATE HOLDER. THIS CEIMFiCATE DOES NOT AMEND, EXTEND OR Beverly MA 01915 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. • (978) 927-8420 COMPANY COMPANIES AFFORDING COVERAGE A Providence Mutual Fire Insurance Co Gregory Corbeil a Safety Insurance Com an dba Geo Dynamics COMPANY SA Brook Pasture Lane 0 Legion Insurance Com an Essex MA 01929 COMPANY V D THIS 16 TO CERTIFY THAT THE POLICIES OF INSURAI� INSURED NAM CE LISTED BELOW HAVE BEEN ISSUED To ThIE IN-6'-*n"�"-"EO ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERMS. S(CLUSION$AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED 13V PAID CLAIMS. LTR : TV"OF INGURAMCK POLICY NUMBER POLICY EFFECTM POLICY 9MMTM -wt� CATE(mKMWM BATE(mom" LIMIT9 A GENERAL LIABILITY — GENERAL AGOREUATE .12,OC)0, 000 X COMMEFCIIAL GENERAL upimuTy SCP35305771 08/28/02 08/28/03 PRODucys-00mPiopAgG 62 000 000 D, CLAM MAW FX]OCCUR OWNEITS A CONTRACTORV PAOT PERRONAL A ADV INJURY $14 0 )-0--L 0 00 EACH OCCURRENCE $1 000 000 PRE DAMAOE(Adq we fire) $50. 000 B AUTOMOBILE UASIUTv — Mm EXP Wy-a peon) s5000 'IT ANY AUTO 3175637 10/04/02 10/04/03 COMBINED SINGLE LIMIT 4 1. 000 000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY X HIRED AUTOS NON-OWNED AUTOS SMXY INJURY PFIDKFrrY DAMAGE S _GARAGE LIABILITY AUTO ONLY-EA AOCIDENT 9 ANY AUTO OT.ER wANAUTOaNLY: ...... EACHACCIDENT S MR56 LIABILITY AGUREGATE 6 r -I EACH OCCURRENCE a HUMBRELLA FORM AGGREGATE I OTHER THAN UMBRELLA FORM WORKERS COMPENSATM AJ40 X I STATUTORY LMTS EMPLOYERS*LIABILITY WC321784 10/04/02 10/04/03 EACH ACCIDENT 16100,000 THE PROMETOR/ INCL DISEASE-POLICY LIMIT 1&300, 000 PARTNERSIEXeWTIVE OFFICERS ARE: RX EXCL DISEASE'EACH EMPLOYEE s 10 0, 0 0 0 OT#Nft F- DESCRIPTION Of OPGRATIONS/LOrANION ICLESAPWAAL ITEM Colvin's Inc. is listed as additional insured. t OHIO" SHOULD AKV OF THE ABOVE 09WRHUD POLICJES BE CANCELLED BEFORE THE EXPIRATION DATE THER&W, "If 1SWIND COMPANY WILL ENDEAVOR TO MNL Peter & Lisa Catalano 2 0 DAYS WRITTEN NOTICE TO THE CERTWICAn NOLKR NAMED TO THE LOT, 50 Rocky Brook Road BUT PAILURE TO MAIL S"#07110E SMALL IMPOSE NO OBLIGATION OR LIABILITY North Andover MA 01810 OF MY Ima {MON THE COMPANY, fla,A ..OR RUMMMTATIVIEL AUTHORIZM 1 ✓!e i�a�nrinzo�zusea`fl d����� Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR = Registration:, 1:26269 Expiration, 5110/04 ' Type: DBA GEO DYNAMICS - GREGORY COR8EIL` 746r LOWELL ST. zz . PEABODY,MA 01960 Administrator 5 ;; - �/ze ioorrurno�rzurea�/ ��.cxaoac�i,�.ceP,lta �' BOARD OF BUILDING REGULATIONS i License: CONSTRUCTION SUPERVISOR Number:-Cs 071598 . Bi rthdite:904/17%1958 ExprrEs: 04/17/2004 Tr.no: 21889 ' f Restricted 00 GREGORY P CORBEIL 746 R LOWELL ST ( ,� t PEABODY, MA 0196: i Administrator i . 1 GREGORY P. CORBEIL D.B.A. GEO DYNAMICS 5A BROOK PASTURE LANE ESSEX, MA 01929 978-768-7046 HOME IMPROVEMENT CONTRACTOR# 126269 MASS. CONSTRUCTION SUPERVISOR#071598 CONTRACT AGREEMENT CONTRACT SUBMITTED TO: DATE: 10-14-2002 NAME: Peter&Lisa.Catalano ADDRESS: 50 Rocky Brook Road CITY: North Andover, MA 01845 JOB SITE: Same CITY: PHONE: 978-794-1787 CONTACT: Pete &Lisa I hereby submit specifications and cost estimates for GEO DYNAMICS to supervise provide labor to construct and/or install the following structures and/or materials: (NOTE*TOTAL ESTIMATE PRICE IS APPROXIMATE AND SUBJECT TO CHANGE). ITEWDESCRIPTION MATERIAL LABOR TOTAL 1 Build addition to extend garage&family room 2 above approx. 13'x 26', to include all labor& 3 materials to complete project. $16,400.00 $16,722.00 $33,122.00 4 Plans submitted by owner will be.used as 5 reference to build project. 6 7 8 9 EQUIPMENT RENTAL included $0.00 $0.00 10 TAX ON MATERIAL $820.00 $0.00 $820.00 11 DEBRIS/CONTAINER/HAULING $625.00 $0.00 $625.00 12 PERMITS $340.00 $0.00 $340.00 13 TOTALS $18,185.00 $16,722.00 $34,907.00 14 DEPOSIT, Due upon contract signing. $11,635.66 15 2ND. BALANCE, Due with foundation placed. $17,453.50 16 FINAL BALANCE, Due upon completion. $5,817.84 Clean up of job site will be done by GEO DYNAMICS. (DOES NOT INCLUDE HAULING UNLESS NOTED AS PAID FOR ABOVE.) All above specifications are to be implemented as described; any sub-contracting needed will be done through and by GEO DYNAMICS, ANY DEVIATION WITHOUT WRITTEN AGREEMENT WILL BREECH CONTRACT AND CAUSE CONDITIONS OF CONTRACT TO TAKE EFFECT. t 2 Estimated amount of time to complete work is; 8-10 weeks,(approximately). Date work is scheduled to be started, (approximate and may change due to unforeseen conditions including weather affecting prior contracts); 11-28-2002. Date work is scheduled to be complete(approximate); 2-6-2003. CONDITIONS OF PAYMENT ACCORDING TO THE CMR CONTRACTOR REGISTRATION AND ENFORCEMENT OF HOME IMPROVEMENT CONTRACTOR PROGRAM, SECTION R6.5.2.3: WHERE THE CONTRACTOR DEEMS HIMSELF TO BE INSECURE HE MAY REQUIRE AS A PREREQUISITE TO CONTINUING SAID WORK THAT THE BALANCE OF FUNDS DUE UNDER THE CONTRACT, WHICH ARE IN THE POSSESSION OF THE OWNER, SHALL BE PLACED IN A JOINT ESCROW ACCOUNT REQUIRING THE SIGNATURES OF THE HOME IMPROVEMENT CONTRACTOR AND THE OWNER FOR WITHDRAWL,IN AN INSTITUTION UNBIASED TO EITHER PARTY,AS NECESSARY TO MAINTAIN A TIMELY SCHEDULE FOR THE DURATION OF THE PROJECT. A deposit equal to 33.33% of labor and of materials is to be paid in advance to GEO DYNAMICS; the estimated cost of material includes permit, sub- contractors fees, bond, insurance fees, tax and costs of rental equipment necessary to complete proposed work as specified in attached agenda,with the balance be paid according to attached schedule of payments. Any special order material will be paid for aside from initial deposit in a timely manner to allow continuance of work schedule. CONDITIONS OF CONTRACT 1. All materials are guaranteed to be as specified,all work will be completed in a timely,workmanlike manner according to standard practices. 2. Exterior work will be delayed by adverse weather conditions, and will extend completion time. (May also include additional cost). 3. Any alteration or deviation from the specification plan in this contract involving extra cost, labor, material or payment will be done only with written agreement, (change order requisition) by owner and contractor, at such time and will become an extra charge over and above the original contract, paid at time of signed change order. 4. Owner assumes risk and cost of unforeseen differing site conditions resulting in any delay, additional costs and consequential solution, including cost of extended completion time labor(requiring change order requisition to be signed and paid). 5. In the event of any type of official or unforeseen delay, including interference by owner or third parties,the owner hereby grants an extension of the completion period commensurate with the delay, including extended labor costs. 6. Owner may not accelerate the project without incurring additional costs, caused by interruption, addition of labor or material and/or change in plan, contractor reserves right to nullify contract and receive full payment for work Y 3 performed, material paid for and any anticipated profit for the entire job and also any outstanding fees due to sub-contractors and/or vendors. 7. If owner fails to pay contractor according to schedule set forth in contract or attached schedule,the contractor reserves the right to immediately withhold further performance on the project until owner pays as required by the contract schedule. 8. Any unforeseen complications or changes to scope of project discovered or arising apart from any complication in destruction, construction and/or reconstruction resulting in additional costs and labor will cause the owner to be responsible for the cost involved and will initiate a change order or may cause voiding or renegotiating of contract or addition to contract. 9. Upon notice the owner shall pay to the contractor any fees or payment due to any subcontractor used in the project for materials required or completed work done in the scope of the job,this condition is precedent to owner's final payment to contractor for all work completed on entire project. 10. In the event of war or some other extraordinary occurrence that would make continuance of work unreasonable, unsafe and/or impractical the contract will be either postponed or terminated by agreement between owner and contractor, the contractor will be excused from further performance, and the contractor will be entitled to full payment for the work performed to that date as well as any outstanding accounts receivable due to subcontractors or vendors. 11. Any designs or drawings including copies either created or acquired by GEO DYNAMICS will be the property of GEO DYNAMICS unless customer purchases them, separate from contract. 12 Owners or any agent of theirs shall not interfere or join in ant part of project without causing additional costs and/or delay, causing extra cost to the owner, and shall warrant a change order to be written and signed at that time, contractor assumes no responsibility of the safety of anyone doing so or for the work done by them. 13. Owner shall make available restroom facilities for contractor and workers involved with the job either in the home or a portable john on site at the owner's expense. 14. Constant observation and/or constant conversation of/with contractor and/or workers by owner or any agent of theirs will be deemed interference and harassment and will be fined a charge of$200.00 per day with incident; due on day of incident. Owner may have time to bring matters of attention to the contractor after work day is ended either in person or with phone conversation. 4 All home improvement contractors shall be registered by the director and that any inquiries about a contractor should be directed to: Director Home Improvement Contractor Registration One Ashburn Place,Room 1301 Boston,MA 02108 (617-727-8598) Owner has three days cancellation rights under M.G.L. c.93,—48; M.G.L. c.140D,—10, or M.G.L. c.255D— 14,as may be applicable. Project abandonment by owner, after three days, before construction or purchase of materials and the contractor has not incurred any actual expenses, entitles the contractor's anticipated profit (20%), proven to a fair degree of certainty as ascertained by fair market value to be paid in full. Termination of contract by owner during construction will entitle contractor to the contract price for the work completed plus contractor's anticipated profit for the work complete and not yet performed, including any materials already purchased. All warranties and owner's rights under the provisions of 780 CMR R6 and M.G.L. c. 142A; A mechanic's lien or security interest is on the residence as a consequence of the contract; however this agreement may not waive any rights conveyed to owner under the provisions of 780 CMR R6 and M.G.L. c. 142A; Required building permits shall be obtained as the obligation of the home improvement contractor as the owner's agent; Owners who secure their own construction-related permits or deal with unregistered contractors will be excluded from the guaranty fund provisions of M.G.L. c. 142A. DISPUTE RESOLUTION CLAUSE THE CONTRACTOR AND THE HOMEOWNER MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT THE CONTRACTOR HAS A DISPUTE CONCERNING THIS CONTRACT, THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c. 142A. THIS CLAUSE PERTAINS ONLY TO OWNER OCCUPIED PRIMARY RESIDENCES. CONTRACTOR SIGNATURE: OWNER SIGNATURE: 5 • NOTICE: THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO ALTERNATIVE DISPUTE SETTLETMENT INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE PARTIES DO NOT SEPARATELY SIGN THIS SECTION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES ACCEPTANCE OF CONTRACT: The above contract for specifications, costs and conditions are satisfactory and are hereby accepted. GEO DYNAMICS is authorized to start and complete the work as specified. Payment will be made as conditions specify. DATE: OWNERS SIGNATURE: CONTRACTORS SIGNATURE: Permit Number MECcheck Compliance Report Checked By/Date 1995 MEC MECcheckSoftware Version 3.4 Release la Data filename:Untitled.cck TITLE:Catalano Addition CITY:North Andover STATE:Massachusetts HDD:6322 CONSTRUCTION TYPE: Single Family DATE: 10/16/02 DATE OF PLANS:7-27-01 PROJECT INFORMATION: 2 car garage with family room above COMPANY INFORMATION: Gregory P.Corbeil d.b.a.GEO Dynamics 5A Brook Pasture Lane Essen,MA 01929 COMPLIANCE:Passes Maximum UA=86 Your Home=79 8.1%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 338 30.0 0.0 12 Wall 1:Wood Frame, 16"o.c. 416 19.0 0.0 20 Basement Wall 1: Solid Concrete or Masonry,5.0'ht/4.0'bg/5.0'insul 130 13.0 0.0 9 Window 1:Wood Frame:Double Pane with Low-E 60 0.340 20 Door 1: Solid 21 0.340 7 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 338 30.0 0.0 11 Furnace 1:Forced Hot Air,78 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the 1995 NEC requirements in MECcheckVersion 3.4 Release I and to comply with the mandatory requirements listed in the MECchecklnspection Checklist. d Builder/Designer Date ti Ducts outside the building must be insulated to R-6.5. Duct Construction: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120 OF or chilled fluids below 55 °F must be insulated to the levels in Table 2. i ti Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range(F) 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) 'r ,p Date... ...... HORTI� Of.«1O{e,M1�O 3: O� TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUSEt This certifies that ..... ..... . ; r .......fi.e ........... .... has permission to perform. ..:.. r '................................................... �. �� wiring in<the building of..,.:.1:...... ...I!-.,i✓........................................... fat.��.J.... �^ . .......•/'r ........... ,North Andover,Mass. s ' - .Fee ` 0 , � s............ Lic.No��.:!. . .. ..,,s�............. .� .a.% ?.......... ELECTRICAL INS"ECiOR 1 Check # 66611 Y Commonwealth of Massachusetts Official Use only P Permit No. 4'y Department of Fire Services Oc BOARD OF FIRE PREVENTION REGULATIONS [Revc9/05]y and Fee Checked Z/(5r ulug (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: 5 — 11 '-O G City or Town of: 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) wO v C J(- 3ack 2d Owner or Tenant ee,tey C1,w �' VY`n Telephone No. Owner's Address 50 1Z-1-k / 8fook fZ,d Is this permit in conjunction with a building permit? Yes ❑ No [A- (Check Appropriate Box) Purpose of Building 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: Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.o Tota Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- No.ot Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No. of Waste Disposers Heat Pum Number Tons KW No.of a -Contained Totals Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mun'cipal ❑ Other Connection No. of Dryers Heating Appliances Kms, Security Systems: No.of Devices or Equivalent No.of Water KW No.o No.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications ging: No.of Devicee�o s orr E uivalent OTHER: '✓ Attach additional detail if desired, or as required by the Inspector of lVires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 6 - 06 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 application is true and complete. FIRM NAME: Wt[ttAV\, 8l+C4N FAeC� tt LIC. NO.: /c)i74 -3 Licensee: (,,,Jk t A th mak" Signature '�,,(�, �l�,�i�i LIC. NO.: 101 '1 G (If applicable, enter "exempt"in the license number line) Bus.Tel. No.: Address: Alt.Tel. No.: *Security System Contractor License required for this work; if applicable,enter the license number here: 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 SignatureTelephone No. PERMIT FEE: $ L7NJ i �L � � - ,� •1 I s,. :.� y� 'Locationt.,(© No. v Date �oRT� TOWN OF NORTH ANDOVER 3? ' oc ►041 . v Certificate of Occupancy $ S'••� E� Building/Frame Permit Fee $ s�cHus Foundation Permit Fee $ '" Other Permit Fee $ TOTAL $ — � Check # f7 r -� 1 8 2 1 8 ! Building Inspectof� I t// E ` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1W M BUILDING PERMIT NUMBER: DATE ISSUED: --6_ - 49 , eq S t/ ' ic East SIGNATURE: Building Commissioner/I for of BuildingsDate SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number. 7 so 9� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: tl Zoning District Pr Use Lar Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 34) 1.5. Flood Zone Infmmatioa: 1.8 Sewerage Disposal System: �ir1 Toe Outside blood Zone ❑ Municipal ❑ On Site Disposal System ❑ s�sss�a Public ❑ Private ❑ il: 'i,L:l'i !•`.ifl!�,t; V_❑ �•�,7 1 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ' en, Po el A/&40aki. Name(Print) Address for Se ice t Telephone Signature Tel eP 2.2 Owner of Record: C Name Print Address for Service: 2 Sinature Telephone 9 SECTION 3-CONSTRUCTION SERVICES 3.1 ' nsed C traction Supervisor: Not Applicable ❑ 'awl Licensed Construction Supervisor: C O f ., R(j� License Number (�JY V VstExpiratlon Date Telephone 3.2 Registered Home ImprovemejContrac tor Not Applicable ❑ Company Name ( � f i41# �,��[ Registration Number IVB 1III` �i Addr (3- n �w �O � �� Exptratioo Sign ' re _ Tele hone r SECTION 4-WORKERS COMPENSATION(11LG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will fesult,. in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check se applIcable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. CI Demolition ❑ Other ❑ Specify Brief, ascription of Proposed Work: �s13U &-,- NO 124 1V1V0qZ- 9004 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL,USE ONLY Com leted by permit applicant 1. Building j (a) Building Permit Fee ✓ --- Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing or Building Permit fee(a)x(b) 4 Mechanical HVAC `=�V 5 Fire Protection 6 Total 1+2+3+4+5 / Check Number SECTION 7a OWNER AUTHORIZATION O BE COMPLETED WHEN OWNX9S' GENT.JQR CONTRACTOR APPLIES FOR BUILDING PERMIT I' as Owner/Authorized Agent of subject property HerAtithoto act on Myll el e t)Okork authorized by this building permit applieatign- Si ure of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION property ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are Lrue and accurate,to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES f SIZE U �� BASEMENT OR SLAB SIZE OF FLOOR TIMBERS X I"T 2� 3KU SPAN DIlVIENSIONS OF SILLS DUVIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING MATERIAL OF CHIMNEY X IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 1 _r FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTIO APPLICANT U/ L d) PHONE Z qS3 3aDLf LOCATION: Assessors Map Number 0 PARCEL_ 39 SUBDIVISION LOT(S) a 313 STREET__TR b C�U 6=k K� ST. NUMBER--> OFFICIAL USE ONL TI TOWN S: /,,,-CONSE ATIO MINISTRATOR DATE APPROVED DATE REJECTED COMMENTS 1 r TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS ;FOOD INSPECTOR-HEAL T DATE APPROVED _. DATE REJECTED Sjdy,/_4L_ EPTIC INSPEcToR-AEAfTH DATE APPROVED S DATE REJECTED COMMENTS_j&� G1� r I PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENTS/I �2✓,�,, 5 Pec ,a.v� � ,�" Q/f` 9�?cam RECEIVED BY BUILDING INSPECTOR DAT E Revised 9197 jm ¢ BOARD(IF BUILDING REP ' License: CONSTRUCTION SUPFR ISOR, i Numblt-XS 080918 ? . " 8uthdate: 0?jQ3/1.960 Expires 01Z/Q31+2906 _ Tr.no: 809181 •- - Restricted zQ9 j PAUL L CATALANO ' 46 BLACKOAK LANA DO L 'MA 01826. _ Administrator ✓fie L/JD'i77lIYL04LUJP.CGGIiL �`'/ acfivaelta Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR - Registration: 135795 Expiration: 5!8!2006 Type: DBA i CATALANO CONSTRUCTION. PAUL CATALANO. 46 BLACK OAK LN. i DRACUT,MA 01826Administrator DI MCI The Commonwealth of Massachusetts Department of Industrial Accidents Of11ce of Invesdgatlons Boston, Mass. 02111 Workers'CornperlsaUW Insurance Affidavit lop Name Please Print Name: %- -F/?//� A '7911 I am a hommwer pelf ng all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providng workers'compensation for my employees working on this job. �V t may: W Phone i Instuance Co. Poky# Commix name: Address- CIM Phone it Insurance Co. Palms Fdkays to setae coverapa n re*dred under Section 25A or MOL 1112 can lead to to knimMbn d crkrirrd Panama d,•This up to$I,SW.W and/or am ye@W imprYarrnant_m.nasi.r.cbA ponsti lalohm idA B o VVDMoRcIg AIdA f oo d.(SIWAMAAW MGohw.mOL 1 wx*stwW that a copy of this ststerrwit may be forwarded to the Office d Inveadge e d the DIA for coverepe verfts"on. I db hereby un errd d ped/ury that du kftn *m provided above is true and correct Signatue�1,glo Print name Phone IK r Official use only do not write in this area to be compkrted by city or town olddd' City or Tawn ParrritaJcarnino 13 BuNding Dept []Cheek 11 immediate response Is required Lternkig Board p Selectmen's Office Confect person: Phone t 0 Health Department O Other North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. will be dis The debris The of in: G;�' (Location Fac ' ) Sig ature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I a . f CATALANO CONSTRUCTION 46 Black Oak Lane Dracut,Ma 01826 Office(978)957-2252 Fax (978)455-8265 Cell (781)953-3204 www.catconstruction.net catalanoconstruction@yahoo.com 3/11/05 Mr.&Mrs.Peter Catalano 50 Rocky Brook Road North Andover,Ma 01845 Regarding:Proposed 10 x 28 one story addition. Dear Peter and Lisa,all of us at Catalano Construction share a deep commitment to produce only high quality results.Our passion is driven by our understanding that quality craftsmanship,and workmanship j are the main ingredients in producing quality results.In short we are committed to customer satisfaction, and the knowledge,Nobody does it better.This quote shall address the following items during construction Engineering:Provide structural documents to floor plans supplied,foundation ,Roof,and Floor framing plans.Obtain building permits.(Permit paid for by customer). Safety: Contact dig safe 36 hours prior to any excavation,OSHA approved aid station on site,Work mans compensation and general liability documentsavailable by contacting John Doherty @ Wilmington Ins. (978)658-3805. Safety plan implemented.(7 years no accidents). Demolition:Tactically remove portion on existing deck,provide structural stability,remove section of siding for the proper placement of proposed addition,remove sections of existing exterior walls in order to accommodate newly proposed floor plans.(This stage of demolition shall not take place until structure is weather right).Remove all construction debris for site in 30 yard containers to be delivered by truck Some lawn,or possible drive way damage may occur from either cement trucks,lumber trucks,or container trucks,delivering to the job site .Catalano Construction does not take responsibility for any damage,but shall take an active interest to limit,if possible to eliminate any such occurrence. Excavation:Excavate for the placement of one l Ox28 foundation.Once foundation is placed back fill and sub grade.Remove excess dirt,excavate to depth of 48 inches. I Concrete:Form,Place,and finish l x2 footing with key way, 10 inch frost wall,anchor bolts,install vent j -2 inch rodent slab,all concrete 3000 PSI.'/4 aggregate. Construction:Fabricate according to plans supplied by customer one 10x28 one story structure.Walls 2x4 Sills 0 ply P.T.2°d ply K.D.&ceiling joists 2x6,Floor joists 2x10,Rafters 2x10,ridge pole 2x12. Plywood: '/i CDX wall sheathing,5 ply CDX roof sheathing,'/4 Advantech T&G sub floor ring nailed with construction adhesive.Advantech comes with a 50 year guarantee from defects.Roofing:Metal drip edge perimeter of fascia,and rake.Metal flashing roofline connections to any vertical plane.Ice and water barrier(Grace brand)applied entire roof, 12 inches beyond any vertical plane at roof line connection. 15 #felt paper,matching asphalt shingle&cap. Siding:Install Tyvek house wrap,primed clap board siding red wood grounds at inside comers,primed pine comers,frieze boards optional.Continuously vented soffits.Deck:Fabricate connection between the remaining portion of the existing deck,and the new structure,matching existing deck material. CATALANO CONSTRUCTION 46 Black Oak Lane Dracut,Ma 01826 Office(978)957-2252 Fax (978)455-8265 Cell (781)953-3204 www.catcon struction,net www.catalanoconstrictio@yahoo.com 3/11/05 Electrical:Electrical to code GFI duplex receptacle outlets bath and exterior,reconfigure bath room exhaust fan,provide ceiling mounted fixtures(builders grade)Florescent light fixtures closets,exterior flood light.Plumbing:Provide trap,vent,hot and cold supply lines,3x3 builders grade shower,mixing valve,and faucets.Heat:Extend existing line to supply new construction .Insulation: Insulate to code R-13 Walls,R-19 Floors,R-30 ceilings proper vent if ceilings are clipped,fire caulking all plate,and wall penetrations,and install vapor barrier.Blue board&Plaster: '/a board installed,plaster ceilings to match existing .Interior trim:2-'/z colonial casing 3-`/2 colonial baseboard primed,Flooring:Match existing species of oak flooring in the study,match existing tile&grout in the bath room. Windows:New construction vinyl,tilt sash,low E Argon,double lock,night security feature,grilles between glass 6 over 6,screens.Doors:Exterior vinyl new construction 6/6-8 slider with dead bolt and lock set.Doors Interior:Hollow core raised panel primed white with brass p age set. COST$34,500.00 n `T-i u? TERMS IN THIRDS SIGNE f/05 SIGNED` --------- -_Jc�r!Jl_2 -- ---------------- r7.( /05 Dear Peter and Lisa,thank for the opportunity to quote this work,look forward to hearing from you soon. Sincerely Paul Catalano Catalano Construction. VA1\1A LAC it AORT#q T0VM of 6Andover No. s0 ` o. dover Mass. .� Otis HE WICK V ' AORATEOiP�\ t5 �S Gt."♦ 4` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System e7�lrr Ca04 A ( -4 40 , BUILDING INSPECTOR THISCERTIFIES THAT............... ............................................................................... ........ ....... Foundation has permission to erRect.....7. . . .............. ....... buildings on..�..... ... .D.,.. ...... ....... lTIV.V � ou to be occupied as.. 4. SOI*..... � AjW4W'&Vim n, provided that the person accepting this permit shall in every respect conform to the terms of the app cat an on file in Final this office, and to the provisions of the Codes and By-Laws relatipg to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. */0#4/3 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S Rough /....... ...... ........ Service . .. .. .. ..... .................................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INsPEcrm 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. SEE REVERSE SIDE Smoke Det. P l a n o f L a n d Schedule of In verts 1 q • Invert ® 1 Lot 24B $� 1 North Andover, Mass. <) = '3°62' i _ 1 D , S h o w i n 9 Septic Tonk /n = 130.07', Out = 729.75' "As—Built Sanitary Disposal Sys tem" D-Box /n = 129.57', Out = 129.39' 127.00' T " Lot 23B Rocky Brook Road Trench 1 /n = 129.26', End = 128.96' i�l N 16 Prepared For Trench 2 /n = 129.25', End = 129.00' !' 141ar TK.0. Developmen tSchedule of Tie Distances // u 4 Scale.- 1" = 20' Dote: Jul20 2000 ! Water Service p Q y AC = 43.6' AE = 67.6' AG - 59.0' !! !/ (Approximate r � Assessors Map 90A - Parcel 39 BC = 46.6' BE = 81.5' BG = 68.8' l Location) AD = 54:4' AF = 122.0' AH = 1179 r !/= 10 BD = 65.6' BF = 126.9' BH = 119.6 ! / �1�1 ti O l`n _—W---- X l� �f� q LA a �-- A 15 Wetland Replication Area /--�..�-_ A148 / / -��. /! I 1 ,. ILI Cb 00 Top of Foundation �--�I O / \ ow // Elev. = 136.78' , y 1 1 \-:,� ----------------------- l 9 '/ ' 1 B Alo X83-, At All \ \\ Aff 1/ l/' Utl ties -4,_ _ Location) O A 16-1 C11 i Bi �If? �$ 500 Go/%n �+44- Pipe ,j (/ / onk r d ��' serA' Septic T 9y- .Q �y J� v D-Box � fee P-z fG Approximate \Op G Driveway // E Location 18toe5 Lot 23 B I I ,/ TP-3 , { � � � es 91,9f34 S.F. 1 A• 2. 11 Acres 87 CBA = 65,34 1 S.F. Leach Trench System: t 2 Trenches 63' Long, N (759 Of zoned Area) 4' Wide f' veep oz-96 1A-_--� \ o vC 1 FVent �± J ss, v ' 0 66' Z� / hereby certify that l hove inspected the construction of this disposal system and that 9 1 N the construction and final grading has been in accordance with the designer's intent and that the materials used conform to the plan specifications and 310 CUR 15.0i �` / Lot 2A This plan has been prepared for the purpose of showing the "As—Built" conditions Ogunquit Homes, Inc. of the sanitary disposal system instal/ed on the premises. All n+ork was done in , 7 O substantial conformance with the design plans as prepared. All work was done I within the construction limitations expected for a lob of this typ oA Di 44 Q,, o MOHN hL RN - Ogunquit Homes, Ina Thomas E. Neve Associates, Inc. Engineers — Surveyors — Land Use Planners fu Design Engineer P.E. Dote: +fid �� 447 Old Boston Road — U.S. Route 1 Topsfie/d, Massachusetts 01983 887-8586 LEFT 51DE ELEVATION �EXI5TIN6 HOUSE BEYOND--,,,,, 4 I2 4 r 2 El a � 1 i REAR ELE\/ATION i�'(.GOPtSTRUGTIOH P,UBTIN6 STRUCTURE r thn l ?�i allo15 HSn2h Po vq-x �n ro t +,+ol j till s v(S.IN?poi � ., - a IZ 4 .• a. M ��fi :{Q -1A 1,�tia� y�wr anio 'a -'21 ' dvauuvoRmw y4/ r/d ruder, .�roc , �s ?�, rou ►pN,�.o �a�la : 0 r sJN!Qts O,li Q- wQ - ��Q£• 447 bl - - s Ilti M €1 -)J No114sjn%wr Ij 9NIX3a1 -35no,+4 9NUs rx3 •�'®,, � +109y W!� see Q B��ck 014kZ, Da�cv� �� blgZ6 4S3 -.S o- 26410 2"026410 25410 26/6'6 5' � 1� o 10' � NEW s xS .0i o sHor� o ewsnNs DECK 26/6'5 id L `j t� EXISTING STUDY X� W EXISTING HOUSE TO NOTES IkJOHANS�� 1. REMOVE ALL PARTITIONS IN7IGATI57 BY REMAIN DOTTED LINE. 2. ALL NEW WORK ABUTTING EXISTING SHALL MATCH IN TEXTURE AND APPEARANCE. 3. PATCH FLOORS,WALL5 t CEILINGS WHERE P,AV��TT7ITIONS WNE H!`Ei1 REMOVED SO THAT SU�AAGES ARE PLUSH MID CONTINUOUS. NOTE; 4. PROVIDE ALL SHORING AND TE.WORARY MODE.NJNBH¢S SHOWN FOR WINDOW! BRACING TO EXISTING STRUOTURE DURING ARE FOR THOSE AS MANIFACTMED BY DEMO OPE ATICAis TO ASSURE THAT IT 15 ANDERE AND ARE USED POR SUBSTANTIALLY SUPPORTED. PURPOSES OF SIZE AND U VALUE ONLY-ANY OPTIONS ARE THE s. PROVIDE TEMPORARY MOTPP40F PARTITIONS RE.+PONSIBLITY OP THE CONTRACTOR i IN AREAS OF WORK TO DISC4165 WITH OWNER b. CONERI TRACTOR SHALL VFY AND BE RESPONSIBLE FOR ALL Vit- 10N5 AND FIELD OON7ITION5. i 04/07/05 THU 15:51 FAX 16036359627 PELHAM BLDG.SUPPLY 0 001 13C CALCI 2003 DESIGN REPORT-US Thursday,April 07,200516:49 � Single 1 3/4!'x 9114"VERSA-LAM®3100 SP Re Name, BC CAL_C Project:SH01 Job Name: CATALANO Description:HIP RAFTER Address: Specifier: City State,Zip:NO_ANDOVER,MA Designer. Jim Customer Company. Pelham Building Supply .a Code reports: ICBO 5512,NER 629 MisC: �J2.8 12 . . :...:.... B1 B2 Q=10-cx7 Oi) 605 Ibs LL 1045 lbs LL o=uT-uU-oU 368 Ibs[)L 599 Ibs DL Total Horizontal Length-15-06-11 i General Data Load Summary Version: US Imperial ID Description Load Type Ret. Start End Type Value LUa Dur. S Standard Load Simple Hip Left 0040.00 155.06-11 five 30 psf nla 115% Member Type: Simple Hip Dead 15 psf n/a 90% Number of Spans: 2 Left Cantilever. Yes Controls Surrlmary Right Cantilever. No Cm*ol Type Value %Allowable Duration Load Case Span Location Rafter Slope: Moment 4654 ft-ft 61-0% 115% 5 2-Internal pe. 4112 Neg.Moment -15 ft4bs 0.2% 115% 2 1-Right_ End Shear 1400 Ibs 38.90/a 115% 5 2-Right Cont Shear 915 Ibs 25.4% 115% 2 2-Left Total Load Defi_ L231 (0.753') 77.8% 5 2 Live Load Defl. U366(0.477-) 65.6% 5 2 Live Load: 30 psf Total Meg.DefL -0228" 30.3% 5 1-Right Support Dead Load: 15 psf Partition Load: D psf Slope and Cut Lengifi Duration: 115 Fnd Condition Slope Facia Depth Horiz. Length Product Length Disclosure Plumb Cut with Hanger 6o dbl.top plate 4/12 0" 15-06-11 15-11-13 The completeness and accuracy of Notes who would rely on the ou the input must be vee led t as anyone Design meets Code minimum(W80)Total load d&cfion criteria. evidence of suitability for a Design meets Code minimum(La240)Live bad deflection criteria. particular application_ The output Minimum bearing length for B1 is 3". above is based upon building Minurrum bearing length for B2 is 1-112'- code-accepted design properties Entered/Displayed Horimo l Span Length(s) Clear Span+12 min_end bearing+1/2 ir> rmecWe bearing and analysis methods. Installation of BOISE engineered wood products must be in accordance with the cunent Installation Guide and the applicable buBding Codes. To obtain an Installation Guide or if YOU have any questions,please call (800)232-0788 before beginning product insfaffation: BC CALCO•BC FRAMER®,BCT®, BC RIM BOARDTm,BC OSB RIM BOARDTTM BOISE GLULAMTA. VERSA-LAM®,VERSA-RIM®, .-VERSA-RIM PLUS®, VERSASTRANDTM, VERSA-STUDO•ALLJOISTO and AJSTTM are trademarks of 'Soise Cascade Corporation_ Page 1 of 1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICA110N TO CONSTRUer REPAIR,RENOVATE. OR DEMOLISH A ONE OR TWO FAMILY DWELLING ". .�. BUILDING PERMIT NUMBER: , DATE ISSUED: 40 s X SIGNATURE: Building Commission-er/lasZqor of Building Date SECTION 1-SITE INFORMATION Q 1.1 Property Address: 1.2 Assessors Map and Parcel Number. Sat gmhsc bg- W Kat r Map Number ASSE um IP—-'�� 0PY. y en ap, 1.3 Zoning Information: 1.4 Prpat-Dimen�l oEpa®I,V� U �!E e� O Zonin District Proposed Use LA Area Fronts f1 _- 1.6 BUR DING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide Required. Provided Repired, Provided a 1.7 Water SupplyM.LC.40. 34) 1.3. Flood Zone Information: 1.8 Seworap Disposal System Public ❑ Private ❑ Zone outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSEMAUTHORIZED AGENT ''-�'•c'!tc; 'iStf!Ct: ,STs 2.1 Owner of Record D $ Name(Print) Address for Se ice II� Signature Telephone i 2.2 Owner of Record: Name Print Address for Service: M Signature Tele one SECTION 3-CONSTRUCTION SERVICES 3.1 'c nsed C truction Supervisor: Not Applicable ❑ it Licensed Construction Supervisor: MOW License ber O -01 "n Addr s Expiration Date�l1 Sig tore Telephone r 3.2 Registered Home ImprovemM Contractor Not Applicable ❑ Company Name V� Tliy (0 Registration Number r Addr N 6 r. % V Expirationto /� Si nature Telephone V' %ORTH ovm Of : 6 over No. Gtoo o. over, Mass. 3 �A COCMICMEWICK 7� 0 RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT Pefif' .... CA04 A 1 -40J o BUILDING INSPECTOR ............................. ............ ............. .. ..... .............. � ........................................ � Foundation ,, has permission to erect. buildings on Rough �o �a 8 �C to be occupied as Rear S for /� I l t 040 1rIPO" � ney provided that the person accepting this permit shall In every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relat' g to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. *10 3 t PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S Rough ...... .......... ............. ............................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises - Do Not Remove Fn No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. IF SEE REVERSE SIDE Smoke Det. NORT#i Town of VE Andover 0 No. 3/6 h o AP dower Mass.f A02 — � —d o0 Q' S COCNICM 1 V ADRATED P �� S � � BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... P.�... .ie.. '...i,,1..5.a......... a..!...��... �4N..a ...................... ................................. . .. Foundation ion has permission to erect.. x ... buildings on ... ��� . 23twD�........... ................... . ....... ..�. Rough A/L to be occupied as.... .a y.4-.... .r` ^'. .� !>....�d ... •4!�J.. !0►1..... 1 -�V S/d-�.....w! �i Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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. C� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough .......... r_1............... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. 3556 Date �. .J.: �� .. NORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION � F This certifies that . . . . • • . • • • has permission for gas installation . . . . . . . . . • • • • in the buildings of . . . . ... .. .. . . . • • • • • • • • • • • • • • • • • at �'. . (:: ''�7...� G � ., North Andover, Mass. Fee. p�"~. . Lic.�No.f�ra. . . . . k',� . h; �: . . . . . . .. . . . �. GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer r �, t SS1��'r�tJS� UNIFORM APPLICATIONt�� t E'er. i fi t e C5 DO �S E YItd> j . +} (Print or Typed t NORTH ANDOVER A»DOVEF iV4ass. Gateas-/ a �' i clitdlzig, Locatacr� \o7oc3 1u(nS3:>- ( p4 f err I i � K yrJaaner's Marne New _ Re' novat.aOn Replacement Plans -Submitted "` FIYT1ID_C { h �� C7 YJ 1�1 Cr � o w 3 } ip m N N w yi ow r ark `n c x ut d F u1 t= N } w "e N d "t wC W D7 J — = x w Y w Y G 5� O (.7 ��' d w G F >— u) ay O w O 4z 4 t t ? C W 4 G ¢ O Q w O cz r:. ca cs v c g a n ►- o f rr . r, SASEm>`xT *1 IST FLOOR ,�, bA 2x0 FLOOR v , .'3RQ FLOOR yy " �?F�l } ' ' E I I i f l l i l I 1���<*�Li,�a J, STH FtOOft I �� 1 I Fk° '•''f;y, `STH FLOOR n" fi 8TH FLOOR 7TH FLOOR 50 BTH FLOOR r� a (Print or Type) � r F Yp Ci,ec4c one: Certlftcat :il Installing Corn any Name c� L p1, y tlfl P / - v .Cy--` b .-.�__ (J� Corp. r.d ,PE Address `gid Partner. , �fiRJ �"55'�� � G�� FiI m/Co. Gusiness Telephone: game of Licensed Plumber or Cas Fitter { � 1E1II insurance CoverageIi : ndc:',e a _ L ty:.� o, insurance ce coverage by checking th�.��{ t ,��,� appropriate box: Liability insurance policy Otter type or indemnity Bor,d rpt Insurance Waiver_: 1 , the di undersigned , have been made aware that the licensee` iT WS }: this application does not have anv one or the above three insurance coverages:`. �qi,i t l IIS 1 l , trr$ t Signature of owner/agent of property Owner L'J Agent u�fJ r 1 hctaby ccrtify that all of the dctails and informatiah I hare tubmitted (or cn(c=cd)in xl:ove kpt,liution are Uric and aa-•u:ate tai tha'Nes�b�rtt�i , i W —.Qwted&c and tl,.at aLL IumLin war; 2nd mita"tions 4 ,1 F p � 7ator.•rc: u[u:er Perr^it izsocd [o: this apT+i;cst�o wits oe in cornpliaesau,vttTr t1�,j7K��IIt7.ti1G ; paovixioas of tha Matsithua:(tt Siate Cit Cade and Chbptax 14Z ni oin icr,cr:i Laws. #'hx+ ¢ 4 ` y _ TYPE LYCENS-' ri g' xi Tithe g ,- Si nature of �i' +I I„ ,y ) r city i :�.aste:r P1jb r o Gaisfit�ez``' r'E Journeyman 25 ;iy 1 ' + APPROVEE) (OhFTCE USE ONLY) L_1 License Number Date/, .(7�1 .,• G N2 4272 4, TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING s � •_;'a SACMUS� This certifies that y � '' �:-?' _ • • • . . . • . • • • • • F-` has permission to perform ._- �t . . ... . . . . . . . . . . . . . . . . . . . . . . . plumbing plumbing in the-buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . .s at . . . ..j Z' ...A. .. : .F.:,.North Andover, Mass. Fee. �- PLUMB N/ NSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 79 MASSACNUSETTS .UNIFOW APPLICATION FOR PERMIT TO DO PLUMBING ()Tint or Type) �p viii kph MaS S . �....1.tY �' cx .�'w+;.... I�r'1"11t Int .Sa k' `� g13ui1�liltcl `:, = m Owner Ar),_.. f;OC-41Lic)n `l\1� � N��1110. 1 _ o `)+Yhe Of (3r. palicy:. ..)�-S' iJew Renovation ❑ Reid. cetnel ' P1itIIs FIXTURES Subill 1t:I.-ed : Yes, ❑ No ❑ 1. fn to u) O Z W Y J N >~ U Q t/� j C7 W � N Z N Q K Q ~ Z O z O '.w I- W to [C x a la. z - z I- I: .� to It Q UI yl It4111 w h r a J rt LL ac j w x ' 4 x 3 X o z X Y q O 1- z x .4 w LL sc w ` I U > 1- o x q O (7 1' x O t 0 _x - w 1- O U x 0 Q •( O ( J Ct 6 cc cc 0: Q O Q I- !•' I- N Y. LC en O i BASEMENT 1St. FL o on IT- 2ND FLCOR 3RD FLOOR 4711 FLOOn 3 TNLO Fon a -M ts• +++ I 6111 FLO0R p 7711 FLOOR ' BT11 FLOQn + . (feint or'I ypC) > _ — Check One: Certificate i Installing Company Namc d•� ,.6� �� S. ._._� ❑ (701`11. ------- ---- -- -- 'nn l: Address _� C v_IrY�►s -- -- --- ❑ I'artncrship -- ---- - ❑ Firm/Cnmpafly L'1 Ilusincss'Ieicphone _—__.---.-----.-------------.____-- Nate of Licensed 1'11 nlI or(las fit I I l,cicb coli( 11'ilk all of the details and information I have submitted or entered ill Mimi:n„lication ore u ltuc 111111 accurate ,the bmest of ! 1nu�iledge and that al!plumbing :olk and installations pet(otmed tmdct Pctmit issued((if-Ibis application kill be in coutplianct:with all pcttineul ' rnnvi.i.mc uI the Kb, :1ebnsclls Slate(ins('ode 11nd C'haplcr 1.12 of the Ucueml laws. t1 h:nc inlonnc;l Ibc Sr,ener urhis agcul thul I do not huv,:liability iruwanee including completed uperations.cu,rtugc. ,} ft I h•rec it eutic„t liai,:Iity n,tini tncc policy to include cony,lucd operations cosclagc.. a r _ - — -- - �(� WI1— .._. . ... Ili; 13y ._- ignaturc of Licensed 1,1111 cr _ Title } City/Tosalh ----..------ . --- ------ �j'A .� I Yhc of Nluneh Ig I.iccnsc E Master ❑ Journcymall APPROVED (OFFICE USE ONLY) License Number ('. �i 1,mnn 1240 1 I<,nm.p a Wnn:+eN.ltu:.1989 RN �j a 1 v CERTIFICATE OF USE & OCCUPANCY Torn of North Andover Building Permit Number Dated THIS CERTIFIES THAT THE BUILDING LOCATED ON �oi'27'3 /`�G� B1,00// pol �� � MAY BE OCCUPIED AS ! ��'� IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. lavl&5 e�%7yd CERTIFICATE ISSUED TO ADDRESS O• (�O uPl� 01, 9s:gC"„SBuilding Inspector I 1 i 1 ,tAORTH Town of Andover ®. 6 -7�, CON LA 0 COC dover, Mass., HICHEWIC Of?A T E D iP"? BOARD OF HEALTH E Food/Kitchen P RMIT T D Septic System 712-- BUIL THIS CERTIFIES THAT.........../....... W fft. f)ININSPECTOR 'G ..... . . . ......................................................... ............................................. Voundation has permission to erect...............I. buildings on .l. 03 8*50...? 140 ...p!4 ............................ ............. ......YY...W.5Tb gh to be occupied as.%rPPk1. .....0-42-C Chirnne, ..... .4 ................................ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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. 01 0 Glow TOR PLUMBING INSPECTOR 9W CPA 1 r) x VIOLATION of the Zoning or Building Regulations Voids this Permit. 0_1 -7- 2 6 C.- JA PERMIT EXPIRES IN 6 MONTHS 191 --A9� ELECTRICAL INSPPCTOR UNLESS C0NSTRU=i0q** S 0 .............. ... .... .....&- �e�'.. ' e �e - BUILDING INSPECTOR Fina�-x-, Occupancy Permit Required to Occupy Building GAS INSPE TOR Rough '7; Display in a Conspicuous Place on the Premises — Do Not Remove Final /f/ No Lathing .or Dry Wall To Be Done FIRE aPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. A- or s Town of North AndoverNORTy O� t�eo 1 fir Building Department �? gt h°•e -O� 27 Charles Street North Andover, Massachusetts 01845 * (978) 688-9545 Fax (978) 688-9542 �` r O <o<M�wiw.w:w 1 4 ��SSACHUS���y APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS Jr �"' LOT NUMBER 23 SUBDIVIS ON DATE REQUEST FILED 7 I DATE READY FOR INSPECTION 7/ Z �o 0 FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIG OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSP I N FEE OF TWEN Y IVE ($25.)DOLLARS WILL BE CHARGED IF THE C DOES N ET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING ✓�t Ir �. CONSERVATION DATE PLANNING DATE T". ( l D� D.P.W. —WATER METER oZ ATE � / D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR 7 INSPECTI N O REQUEST TE. SIGNATURE/DPW AUTHORIZATION 1 0 N° 2373 Date.....✓�...f I of NORTH Ati TOWN OF NORTH ANDOVER c PERMIT FOR WIRING ,SSACMUS� I This certifies that ......l:...... ��1.�. �. .�.�..........��....�!°.cA ��d?..!... ................ has permission to perform �`.. �. l v "'� ............... ...... . ............................................ wiring in the building of..... J P.v ..................................... at... ....0......... ........... . .. .North Andov r,Mass. Fee.... Lic.No. ..((j.8111........... f LECTRICALINSPECTOR Check n _ WHITE: Applicant CANARY: Building Dept. PINK:Treasurer TRE COAIOAW LTHOFALV"QJUSE77S Office Use only DLV4R7A1ZAT OFPUBLIC,SA)= Permit No. BOAROOFF7REPREVFV770NREGUTA770ANS27CMR12M Occupancy&Fees Checked • APPLICATIONFORP RAWT TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACI-IUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date J Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. AP PARCEL Location(Street&Number) -5—o 4o 4,t,� --i 5 rQ d �(1� Owner or Tenant Owner's Address ril Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. 66 v Existing Service Amps / Volts erhead r7 Underground r7 No.of Meters New SAmps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Le dation and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground around No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Bumcrs No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No Nf Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other • Comcctions No.of Water Heaters KW No.of No.of Si s Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- . h>StaarloeCoura�:.I'tasuat�totheragtmanais�Galerallaws IhawaamatLrabtlltyh>,st==Fbbymrhd%Ca Ca�aageoritssibs�alegivalart YES NO Ibareaibrr NWidpoofofsa=totheOfoa YES [2'I Yyubmdui<cBYES,pkmmdcalethetypeafcowWbydmdarrgthe appropriatebm NKRANCE,P BOND OTHER a (base Spac�Y) Estirr> Va1wafIlear�lWc�rk$ WaktoSart �� �S— hWecfimL.MRmfid Ratgfl 401t( (0 (.t F"mal s>g u N ofpajtuyFffUvRqAlvE L-6(k) rQAAC Z-,-' C `ce-1 //97-2z LkaBX (;A!7.s On t.,_C L Sigtrahue Lioa>seNo - AIL TeL Na OWNF SINSURANCEWANEI2 l awarethatt rLioaw"nothaNetlleitsLrarseeotemWQitssuhMntalNm%ukxtasragmedbyMassadmseb . Iaws andfEinysignattuemlhispatr>itapphcab rwaiveslhisregmanart (Please check one) Owner Agent �t�U Telephone No. PERMIT FEE$ U Signature of Uwner or Agent i 2537 Date...... 0 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING lo ,SSA CHUS This certifies that ..... ......sw- ..C..... ........................ has permission to perform .....:��al.......... ......................... wiring in the building of........G A v................................................ at..... ...............c .. L -Ull:r11h Aund_ver, s- v ..... ... ..................................... Fee... Lic.No. .J. . ... . ........ NSPECTOR Check # 6615v Y WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts. FERe� Official Use Only Department of Fire Services 3 BOARD OF FIRE PREVENTION REGULATIONS d Fee Checked eave blank) APPLICATION..FOR PERMIT TO PERFORM .ELECTRICAL WORK All work to be p*mfotmed in accordance with the Massachusetts Electrical Code 041.Cl 527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: City or Town of: A.10I-T14 4,VDa vee To the bispecto of Wires. By this application the undersigned gives notice of his or her intention to pP,rform/t�he electrical work descnbed below. ` Location(Street&Number) Owner or Tenant �'�/? �� � /Cfi�� Telephone Na_9 7,— 7 91/ Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No Q (C eck Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Und;rd❑ . No. of Meters New Senice Amps / Volts Overhead❑ Undb d❑ Na of Meters Number of Feeders and Ampacity.. . Location and Nature of Proposed Electrical Work: ;r 4 Com letion orthe follawing table may be waived by the Inspector of T res. Na of Recessed Fixtures Na of Cel-Susp.(Paddle Fans Na of Total Transformers KVA Na of Lighting Outlets Na of Hot Tubs Generators KVA Sn immin Pool Above n- a o Emergency ignting Na of Lighting Fixtures,. g grnd. ❑ grnd. ❑ Batten Unites' a Na of Receptacle Outlets .. Na of Oil Burners FIRE ALARMS No. of Zones No.of Snitches `Na of Gas Burners �No. of Detection and _ initiating Devices Na of Ranges !Na of Air Cond. Total No,of Alerting Devices Tons e s Na of Waste Disposers Heat Pump I Number I Tons JKWNo.of Self-Contained Totals: (Detection/Alerting Devices No,of Dishwashers Space/Area Heating b'WLocal ❑ Municipal ❑ Other Connection No.of Drvers Heating AppliancesLey n 'Ste Iva o •ater KW Na o No.'of Data Wiring Devices or Eouivalent Heaters Signs Ballasts Na of Devices or Equivalent Na Hydromassage Bathtubs Na of Motors Total BY Telecommunications WirinD Na of Devices or E uivalent OTHER: .Attach additional detail if desired,or as required In,the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the oumer,no permit for the performance of electrical work may issue unless the Iicensm provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work �99 � (Wl,=required by municipal policy.) (� Work to Start /i 7�,XO Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,lhrrt the information on this application it true and complete Y FIRM NAME: ADT Security Services 111 Morse Street,Non o MA 02062 LIC. NO.: 1533C Licensee John S.Bassett Signatu LIC. N0.` 25336 (If applicable,drier'•exempt"in the license number line.) Bus Tel. No.: Addre= Alt Tel.No.: 603-594-5928lresi 0,"YNT'ER'S INSURANCE WAIVER. 1 am aumre that the Li ensee does nor hme the liability insurance coverage normally ONLY required by law. By my signature below.I hereby%give this requirement. 1 am the(check one)El oozier ❑ o«'ner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: .SLS. �� No 2094 Date.....�..:...f�`.... ..:...... + f NOR7M'1 o o � TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,SSACHUS� This certifies that .... :. ...:..: I .................................................`........................ has permission to perform �..:..!'..:.... ...................... wiring in the building of k.... .:. `. �� ..... .... ... . ..................................... at................. r.....�....... ............................................. ,North Andover,Mass. �. Fee......-........`...... Lic.No. L........ .................... :... .........:.....<........ .,, ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Office Use Only Permit N4 6 T E e0h17K4�1r10'� ?"�� ,S'Sr��>�ISG?7.S Occupancy&Fee Checked D.�c 4 Shy BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK - M work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 1200 (please Print in ink or type all information) 0atB l `/C-;2 To the Irmpector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number � j L<6 -1Z3<Je-C,1 Owner or Tenant /�C� "DQ V Owner's Address is this permit in conjunction with a building permit Yes No ❑ (Check 4pf°priate Bore) Purpose of Build' _ A, i A1,1114a Utility Authorization No. E)d9 Service Amps Voits Overhead ❑ Undgmd ❑ Na of Meters NLhw Service Amps Voits Overhead ❑ Undgrnd No.of Meters I umber of Feeders and Ampaaly A Location and Nature of Proposed Electrical Work Total No.of li Outlets No.of Hot hue No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool gmd Q gmd Q Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil 8umers SatteryUnft No.of Swdch Outlets No of Gas Sumers FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devic es Heat Total Total No.of Diposall NO. Pumps Tons KW No.of Sounding Devices Self Contained f Dishwashers Soace/Area Head KW NOJ NoJ of of oNSounding Devices '"No.o r ❑ Municipal ❑ Other No.of Heade Devices KW Local Connection No.of No.of Low Voltage No.of water Heaters KW Signs ftlases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the mgwremenets of General laws 1 have a Liability I nce PONk�r 1 ompieted Operations Coverage or its substantial equival YF.S NO = h su valid of same ro OHi Y = NO = R you have checked YES please indicate the coverage try checking the appropriate tmox URANC = 80 OTHER = (P14!eAscim (Expiration Date) Estimated Value of World Final Work to Stmt /" 2—" inspection Date ResquesWd Rough Signed under the ftnaitles of perjury.���G 4 C nI / UC.NO. 9�� FIRM NAME //[-aiAJ r QAC o•- i r l� Licensee �C("(� ��^'t`Q rJtSt� $Ignatureti� ,L� UC.NO. Bus.Tel No. t Address o 5'cl: / K`!r� Ao 1A LIQ�� Alt rel.No. Massachusetts OWNER'S INSURANCE WAIVER: I am award that the Licensed does not have the Insurance coverage or its substantial equivalent as required by General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check ones ----- --u.. PERMIT FEE /©f a33 ,� Location /� No. J Date d v 4 �7�',a TOWN OF NORTH ANDOVER ►° % i Certificate of Occupancy $ Building/Frame Permit Fee $ f s�cNus Foundation Permit Fee $ Other Permit Fee $ n TOTAL $ —31 7 Check # t Building Inspector J f