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Home My WebLink AboutMiscellaneous - 538 OSGOOD STREET 4/30/2018 538 OSGOOD STREET / 210/101.0-0012-0000.0 Date.. �NORTH TOWN OF NORTH ANDOVER n PERMIT FOR WIRING 3SACHU5� This certifies that ...............U.C�..�'J..... .��' .. ....................... !!.. �. ... has permission to perform .... .....PAe ISI V • 4P F�-- wiring in the building of...... .. ?..1... .. .� .................................................................... at ............�..�...o.........D S ..... North Andover ss- .............. ..................e, Fee...................... No. rr22 �. ��.......Lic.No. ................. .............. !L....: ............... ,, 2 rrf ELECTRICAL INSPECCTOR'' Check#�' � -7.7' ^ ' i S4. Commonwealth of Massachusetts Official Use Only Permit No. I "l = Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: 3/13/15 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) 538 Osgood Owner or Tenant Carlos Montemor Telephone No. Owner's Address 538 osgood N.Andover Is this permit in conjunction with a building permit? Yes F7 No (Check Appropriate Box) Purpose of Building solar installation Utility Authorization No. Existing Service 200 Amps 120/2/40 Volts Overhea Undgr ✓ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: rooftop mounted solar array PA."ej� Completion of the follou in table may be ii,aived by the Inspector of JFires. 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 Emergency Lighting No. of Lighting hYxtm es Swimming Pool rild. Llrnd. ❑ 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 f InitiatingDevices No. of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I.Number Tons KW No.of Self-Contained Totals:I I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ElOther Connection No. of Dryers Heating Appliances Kir Security Systems: No.of Devices or Equivalent No. of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 38 panels Attach arldUional detail if desired,or ris required by the Inspector•of Wh-es. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: 2500.00 (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 peijrriy,that the information on this application is trite and complete. FIRM NAME: ASTRUM SOLAR LIC.NO.:A21555 Licensee: JASON RILEY Signature LIC.NO.: (Ifopplicable,enter "exenipl"in the license number•line.) Bus.Tel.No.,508-614-0146_ Address: 15 Avenue E Hopkinton, Ma. 01748 Alt.Tel.No.: OWNER'S INSURANCE WAIVER: 1 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. Own nt PERMIT FEE. $ Z� Signature a Telephone No. n y. `�` c I I i G� l- -S �� ACORO® DATE(MM/DD/YYYY) �. CERTIFICATE OF LIABILITY INSURANCE Pa5 e 1 of 1 F03/02/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Willis of Texas, Inc. c/o 26 Century Blvd. PHONNO FxT)E . 877-945-7378 'g 888-467-2378 P.O. Box 305191 E-MAIL certificates@willis.com Nashville, TN 37230-5191 AnngFss, INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: ACE American Insurance Company 22667-302 INSURED Direct Energy and its majority owned INSURERB: Zurich American Insurance Company 16535-305 subsidiaries and affiliates including INSURERC:American Zurich Insurance Company 16535-306 Astrum Solar, Inc. 8955 Henkels Lane, Suite 508 INSURERD: Annapolis Junction, MD 20701 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:22864701 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL.THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPEOFINSURANCE DDL SUB pOLICYNUMBER POLICY EFF POLICY EXPITP LIMITS A X COMMERCIAL GENERAL LIABILITY XSLG27341226 1/1/2015 1/1/2016 EACH OCCURRENCE $ 11000,000 ppgql��,,�tqq��FF TT CLAIMS-MADE X OCCUR PREMISESaENTED occurence) $ 100 000 X SIR: $100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1'.000,000 POLICY � PRO JECT ❑ LOC PRODUCTS-COMP/OPAGG $ 1,000,000 PRO- OTHER: $ B AUTOMOBILE LIABILITY BAP595396601 1/1/2015 1/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BOD ILY I NJURY(Per accident) $ HIREDAUTOS NON-OWNED PROPERTYDAMAGE AUTOS (Per accident) $ $ UMBRELLALIABOCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION WC595396901 1/1/2015 1/1/2016 X PER oTH- AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVEI N/A WC595397301 1/1/2015 1/1/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ffMandatoryjnNH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 ff yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additonal Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Town of North Andover 1600 Osgood North Andover, MA 01845 Coll:4635895 Tpl:1894829 Cert:22864701 ©1988 2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth ofMassachusetts Print Form Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 ' i'vww.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(BusinessJOrganization/lndividuat) Astrum Solar Addiess: 15 Avenue E City/State/Zip: Hopkinton, Ma, 01748Phone#:508-614-0146 Are you an employer?Check the appropriate.box: Type of project(required): 1.❑✓ I am a employer with 15 4. 0 1 am a general contractor and I 6. L]New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. E]Demolition workingfor me in an capacity. employees and have workers' Y p tY• 9. E] Building addition [No workers' comp.insurance comp.insurance.t required] 5. ❑ We are.a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance d.re re uit c. 152,§1(4),and we have no required.] OtherPV Solar Installation employees. [No workers' 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 al I 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 state whether or not those entities have employees. If the sub-contractors have.employees,they must provide their workers'comp.policy number. I aiii aii emplo)ier tliat is providiiig ivoi'hers'coiyipensatioii iiisrrraiice for iiiy eitiployees. Below is the policy aiul job site information. Insurance Company Name:Zurich American Insurance Co. Policy#or Self-ins.Lic.M 59536900 Expiration Date:1/1/2016 Job Site Address: 5 3a �� City/State/Zip: 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 cer undertli anis and penalties Ef2 er'aiy that the information provided above is trrie an11 ci rrect. Si nature: -- - - - - - Date _ 3! L__ Phone#:508-614-0146 Official iise only. Do not write hi 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#: Please visit our web site at http://www.mAss.gov/dpi/boards/EL ASTRUM SOLAR INC JASON P RILEY (EL) 18 HOPKINS ST' WILMINGTON MA 01887-2210 x"v =.a, MMONWE�L'TH OF MA �tkCHITSETT Mt p • I SSU,ES .THE FOLLOWING%�TUNSE ASURN E M 181.E L.ECTR I.C 1 A( i A Uy, RILEY •f"+G `'w' i S {---T.,��5•�,:m�c'�C`�,. � � ' t' .+ + '•d , f'2'. 18 HOPKRt ' 5}fi9rb`s ' MQI �1 NS ST s ; . ? J} M Ctrl f0 % 0188 H; i v, . r:;1'1.� 7-221 OF... .�•.. 13463 <; 1 X7%3 :� °�-80020 Fold,Then Detach Along All Perforations < OMMONWEA H OF M!j "'Uf ?TS,-0-w. B.O"QVp A E, CTFt`1 C I Q �y �K. TSUES TIE. OLLOGII NG r�'I C f $E AS .. _ .. 13G IZI MAS E.1ECTR.I C I SOLAR INC ! I -ASO P•g' (BEY' f ; , • fan' '�:a 7 - Vin[>l_3_LMIN?GTO�j :.. =Mk 01887-2210 z 21 (1114' k=,t �%31/1. M`80019 x: ►�: o Electrical Diagram for Montemor-10.26 IcW DC Photovoltaic Solar Array AC Disconnectwithin 10'of the Utility Meter � o n ti o t Q w � � o w `o > E ? C < 0 j a _ L/SolaTotal 240 Volt,l Phase 388 Modules and Inverter; 240 Disconnect 240 Volt,l Phase Fused Ud6tyDistriDutinn Connection DC wiring from the solar module(typ) Switch Disconnect Switch Eophase Micro Inverter mounted adjacent to the mounted adjacent to Ground Fault Protection integrated wiMin utiffty meter the service disconnen inverter Model:M250,1&211•522W Production Diner HammerModel g Cuter HammerModel b Max OCVOII Racine: 48 VDC Meter DG222URB DG222NRB w Max Power DID 40 degrees C 25OW Enphose RGM 60 Amp 50 Amp Tu:z ArtaY 16 Panel Inverters; AC Voltage 24012xB Une Hdetap } � I Max AC Cuverm 1AAmo .6-Tap o 0 0 16 xlx12S%a . 20 mn 20Amp I „ 0 0 0 Circuit Breaker I Two Ungrounded conductors and one Neoral " 2 per c6cuit of inverters(TwI oro " 2 20 Amp f a.... 'I I 1 c 0 20Amp0 200 (3)06.7HHN•THIUM2Copper Mainbonr� v Amp >1 ry m SS Amp 1 (1)IS-THHN•THWN•2CWHGround 1 Iustallatim of the 1•conduit 175')wi0 have I I 1•PVC dtheCondt or1 three chuits,will consist of: 1•ti4urdtite MCW.tm0uh A (6)010THHN-THWN•bphaseconductors, I 15 Amp I GFOReceptacte Wire Calc 2 I 4 (3)010THHN-THWN-Zisemrals, I torERphaseEmu I J This Array 14 Panephrs(1)48Gmund —————--— �� to Panels Inverters I I (3)p4•THHN•iHWN-2Cappa � 14 x1x125%m • IIS on 20 Amp I Wire Calc I US Amp Win Lug Loadcema ( (1)e6-THHN•THWW2Copper Ground Circuit Breaker PV Combxut Panel i•PVC Conduit or 1 Osla HammerModel 40016112SRP I 1•liquidtite Metal Conduit x Q wrthcAmpbreakerOned breaklower I For tine side Tap Conductors I—— I (1)15 Amp,2 ionic cirwh breaker 1 96 gate CU (2)20 Amp,2-pole circuit breaks I (1)1S Amp,I-pole circuit breaker for EMU 1 #5 Bare CU_ 200 Amp Buss S/8x8'Grww I Sig x6'Ground Rod _L Siemens Itnd IF panel I 1 , v This May 8Panels/Imam 00 0 8 xlx12S%• 10 on 15 Amp ,. < v Chit Breaker 2- 0 p 0O a E m <` Y O L t se Z f6 E u m U a) m U, 0 • PV-3 Electrical Diagram for Montemor-10.26 kW DC Photovoltaic Solar Array Calculation for PV Breaker PV Array Wiring Calculation PV Service Wiring Calculation Calculation for Main PV Breaker&Circuits Minimum Wire Size#10 AWG Wire Calc 1 Minimum Wire Size#6 AWG Wire Calc 2 System Current= 38 X 1 - 38 Amps lAn�SIZING CALCULATION WIRE SIZING CALCULATION '^ 2011/2014 NEC Article 310 201112014 NEC Article 310 ao Design Amperage= 38 X 125% = 47.5 Amps Full Load Amperage.............:16 Full Load Amperage.............:38 ti Main Buss Rating= 200 X 120% = 240 Amps SourceVoltage.................:240 Source Voltage.................:240 J Existing Main Breaker = 200 Amps Length of Run(Feet)...........:75 Length of Run(Feet)...........:30 Max Solar Breaker 240 (-) 200 = 40 Amps Load Duty......................:Continuous Load Duty......................:Continuous A w Circuit#1= 16 16 1 x 125%= 20 Amps Conductor Application..........:Conductors In Raceway,Cable or Earth Conductor Application..........:Conductors in Raceway,Cable or Earth E Circuit#2= 14 14 1x125%= 17.5 Amps Conductor AmpacityTable.......:NEC Table 310-15(8x16) Conductor Ampaclty Table.......:NEC Table 310-15(8)(16) _ > s 12 Conductor Type.................:THHN Copper Conductor Type.................:THHN Copper a Circuit#3= B 8 1 x 325%= 10 Amps Q ti = Conductor Location.............:Dry/Damp Conductor Location.............:Ory/Damp Conductor Insulation Temperature:90'C Conductor Insulation Temperature:90'C Rooftop Installation:NEC 310.15(B)(3)(c) Ambient Temperature............:26-30'C=78-86 IF Distance Above Root............: Terminal Temperature Rating....:60'C Average Outside Temp...........:90 Deg.F Deg,C Circuit Type:Single Phase 3 Wire(2 phase conductors&neutral) Temperature Adder..............:Deg.F Deg.C City.of Circuit Current-Carrying Conductors:2 Y Adjusted Ambient Temperature...:Deg.F Deg.C Conductor Requirement Full Load Amps...........:38.0 w Terminal Temperature Rating....:60'C Circuit Type:Single Phase 3 Wire(2 phase conductors 8 neutral) Load Duty Multiplier :1.25 Qty.of Circuit Current-Carrying Conductors:2 Ambient Temp.Multiplier.:1.0 0 0 0 Additional Current Carrying Conductors.....:4 Qty.Conductors Multiplier:1.0 0 0 0 Total Gly.Current-Carrying Conductors.....:6 Required ConductorAmpactty:47.5 v Conductor Requirement Terminal Requirement Full Load Amps...........:16.0 Full Load Amps...........:38.0 Load Duty Multiplier.....:1.25 Load Duty Multiplier.....:1.25 ° Ambient Temp.Multiplier.:1.0 ti N m Qty.Conductors Multiplier-1.25 Required Terminal Ampaclty:47.5 Selected Conductor. Required Conductor Ampaclty:25.0 Conductor Ampacity.......:55.0 Terminal Requirement Ambient Temp.Derate.....:1.0 Full Load Amps...........:16.0 Gly.Conductors Derate...:1.0 J Load Duty Multiplier.....:1.25 O Adjusted Ampactty........:55.0 FIN 2 Required Terminal Ampacity:20.0 SELECTED CONDUCTOR SIZE:6 Awg Selected Conductor. 2 x Ohms/MilFt x Length x Amps 2 x 0.491 x 30 x 47.5 old Conductor Ampaclty.......:30.0 VD= _ =1.12 N Ambient Temp.Derate.....:1.0 1000 x Qty Wires per Phase 1000 x 1 Ory.Conductors Derate..-:0.8 Volts At Load Terminals......:238.88 Adjusted Ampaclty........:24.0 Actual Percent Voltage Drop.:0.47 Electrical Notes 1)All equipment to be listed and labeled for Its application. SELECTED CONDUCTOR SIZE:10 Awg 2)All conductors shall be copper,rated for 90C and wet environment,unless 2 x OhmS/MiIFt x Length x Amps 2 x 1.24 x 75 x 25.0 otherwise noted. VD v =--2.98 1000 x Qty Wires per Phase 1000 x 1 3)Working clearances around al new and existing electrical equipment shell Volts At Load Terminals:237.02 comply with NEC110.26 Actual Percent Voltage Drop.:1.24 4)All wire terminations shell be appropriately labeled and readily vkable. cat W 0 5)Module grounding clips to be Installed between module frame and module " Q v support rail,per grounding clip manufacturers Instruction. 2 d > 6)Module Support call to be bonded to continuous copper GEC via WEEB Iug per E Oco C v Q NEC 690.4(C). 0 C W O ]if used PV breaker to be located at bottom of bus NEC power source per 690.64(B)(7). 8)AC combiner panels shall be labeled es"Inverter AC Combiner Panel°. N C u O 9) y tlzting agenry name and number to be Indicated on Inverters and modules - per NEC 110.3(8) U O :3 10)PV power source breaker to be suitable for backfeed per NEC 690.64(8)(5). N co W fp U • PV-3.1 Wiring Description Montemor,Carlos.Residence Electrical Review 538 Osgood St.North Andover,MA 01845 Westford,MA Office:Daniel Goodridge m Reviewed By:Seth Cisco(610-253-3112) 'r Financing:Purchase _ o d (38)Suniva 270W Panels with(38)M250 Inverters m "' � c PV meter type:Enphase RGM "' o Emu location:Near the main electrical panel. 2¢ ' a w Internet Connection:Bridge = a Main Electrical Panel: Siemens(200 Amp) Utility:National Grid(Town of Reading) Circuit Calculations:38 M250 inverters x 1/Inverter=38 Amps x 1.25=47.5 FLA. PV combiner with(1)15 Amp,2 pole circuit breaker,(2)20 Amp,2 pole circuit breaker,(1)15 Amp,1 pole circuit breaker(for EMU) E Interconnection calculation:N/A,Line-Side-Tap Interconnection will be a line-side-tap in the gutter space of the existing main electrical panel located in the basement.From the LST install wiring to a 60 Amp fused disconnect switch with 50 Amp fuses mounted adjacent to the main0 o 0 electrical panel.Wiring from this fused disconnect switch will install outside to a 60 Amp non-fused disconnect located next to the utility meter.From the disconnect switch,wire through the PV meter and then into the PV combiner panel. v 20 � � From the PV combiner panel,run exterior conduit up the wall,then follow the rake to a penetration into the upper roof attic.Continue through the attic space to the two soladecks located under the upper roof solar array.From the first o 20 2 2 soladeck,run conduit through the attic towards a penetration near the lower roof array.Continue down the wall,then onto the roof surface to a junction box as shown in the drawing.All roof mounted conduit must be at least V above the roof surface and flash supported properly.There will be three circuits of inverters. c 0 Install an outlet for the EMU at the location where the EMU will be mounted.If this location is in a garage or basement install a GFCI outlet.Wiring for this outlet will be from the PV combiner panel. Circuit 1 (16)❑ pUl I a Circuit 2(14) Circuit 3(8) El Q Junction Box❑ i nnn rrr �, Soladeck Q Enphase End Cap ® y., Enphase Cable , Interior Conduit `jC� illi \ O v Exterior Conduit o -o E o O s 2 \ v" zo q Y p O ^ M v/^'IVV/n 'o m J . ho 0 L -0 Y C N O U w PV-4 MELWJ SUNIUA OPTIMUS° SERIES MONOCRYSTALLINE SOLAR MODULES . of . 1 • o — <. i i 1 I Engineering Excellence Features Quality&Reliability • Built exclusively with Suniva's Contains the latest ARTisun Select Suniva Optimus modules are highest-efficiency ARTisun Select cell technology-over 19% manufactured and warranted to our cells, providing one of the highest Positive only tolerance ensures specifications assuring consistent high power outputs per square meter at predictable output performance and quality worldwide. an affordable manufacturing cost • Marine grade aluminum frame with Rigorous quality management • Suniva's state-of-the art hard anodized coating Performance longevity with manufacturing facility features advanced polymer backsheet the most advanced equipment Industry leading linear warranty p y and technology (10 year warranty on workmanship Produced in an ISO 9001: 2008 and materials;25 year linear performance certified facility • Suniva is a U.S.—based company warranty delivering 80%power at STC) spun out from the Georgia Tech Passed the most stringent salt spray University Center of Excellence in Buy America compliant upon request test(Severity 6) based on IEC 61701 Photovoltaics(one of only two such Qualifies for U.S. EXIM financing Passed enhanced stress tests'based research centers in the U.S.) System and design services available IEC 61215 conducted at Fraunhofer IS • Certified PID free • Ask about our validated PAN files OUR -•. ModulesMonocrystalline OPTIMUS SERIES..cell 19%+efficiency OPTIMUS SERIES 72 cell ModulesMulticrystalline . :• MV SERIES 60 cell Racking,Inverters,Batteries,Energy s Drain Hole Sul],,OM65:265 Wm,0 C,lI S,I,,Module Culm-Mllull(IV)Is I F-al-of I...I,tI (W/mz)and T,,P,,t... 4 A Mounting SW 9 12 r oc t A ----- ----- -4- u1 2-04.2 IF -- Groundi,g ft, 1. 30.0 volage(V) cvuc /-1-/-1-PlIc L19 Hole mleraoas Vary C_ 934 982 073 ELECTRICAL DATA(NOMINAL) The rated power may only vary by-01+4.99"and all other electrical parameters by 15% Power Classification Pmax(Vv) 255 260 265 270 Module efficiency % 15.71 16.02 16.33 16.60 Model Number OPT 255-60-4-100 260-60-4-100 265-60-4-100 270-60-4-100 Voltage at Max. Power Point Vmp M 30.00 30.20 30.70 31.20 Current at Max. Power Point Imp(A) 8.50 8.60 8.64 8.68 Open Circuit Voltage Voc M 37.90 38.10 38.30 38.50 Short Circuit Current Isc(A) 9.05 9.08 9.12_ 9.15 The electrical data apply to standard test conditions(STC).Iffadiance of 1000 WW with AM 1.5 spectra at 25°C. DIMENSIONS AND WEIGHT Cells/Module 60(6x10) Module Dimensions 1652 x 982 mm(65.04 x 38.66 in.) Module Thickness(Depth) 40 mm(1.57 in.) Approximate Weight 17.9+/-0.5kg. (39.5+/- 1.1 lb. CHARACTERISTIC DATA Type of Solar Cell High-efficiency ARTisun®Select monocrystalline cells of 156 x 156 mm (6 in.) Frame Silver anodized aluminum alloy; black frame available by custom order Glass Tempered(low-iron),anti-reflective coating Junction Box NEMA IP65 rated; 3 internal bypass diodes Cable&Connectors 12 AWG (4.0 mm')cable with Tyco or MC4 compatible connectorS3;cable length approximately 1000 mm Hardware(Available Upon Grounding screws: (2)#10-32 12.7 mm(#10-32 x 0.5 in.) Request) Stainless steel flat washers: (4)5 x 10 x 1 mm(0.2 in. ID x 0.394 in. OD x 0.030 in.) TEMPERATURE COEFFICIENTS Voltage 9,Voc(%/*C) -0.335 Current a, Isc(%/0C) +0.047 Power y, Pmax(%/*C) -0.420 NOCT Avg (+/-2 'C) 46.0 LIMITS Max. System Voltage 1000 VDC for IEC (600 VDC for UL) Operating Module Temperature -40°C to+85°C Storm Resistance/Static Load Tested to IEC 61215 for loads up to 5400 Pa; hail and wind resistant SunivaO reserves the right to change the data at any time. View manual at suniva.com. *CEC pending for 270W IUV9O kWh, TIC 400,DH 2000.'Tests were conducted on module type OPT 60.3See sales rep. [SAMD-00101 Headquarters 5765 Peachtree Industrial Blvd., Norcross,Georgia 30092 USA ODI Tel:+1 404 477 2700 1��& Suniva www.suniva.com Please recycle. The Brilliance of Solar Made Sensible- 1017 12 i Enphase®Microinverters Enphase@M250 o a �d i The Enphase® M250 Microinverter delivers increased energy harvest and reduces design and installation complexity with its all-AC approach. With the M250, the DC circuit is isolated and insulated from ground, so no Ground Electrode Conductor (GEC) is required for the microinverter. This further simplifies installation, enhances safety, and saves on labor and materials costs. The Enphase M250 integrates seamlessly with the Engage® Cable, the Envoy® Communications Gateway"', and Enlighten®, Enphase's monitoring and analysis software. PRODUCTIVE SIMPLE RELIABLE - Optimized for higher-power - No GEC needed for microinverter - 4th-generation product modules - No DC design or string calculation - More than 1 million hours of testing - Maximizes energy production required and 3 million units shipped - Minimizes impact of shading, - Easy installation with Engage - Industry-leading warranty, up to 25 i dust, and debris Cable years enphase® rel S� L J E N E R G Y C us 5 s Enphase®M250 Microinverter//DATA INPUT DATA (DC) M250-60-2LL-S22/S23/S24 Recommended input power(STC) 210-300 W Maximum input DC voltage 48 V Peak power tracking voltage 27 V-39 V Operating range 16 V-48 V Min/Max start voltage 22 V/48 V Max DC short circuit current 15 A Max input current 9.8 A OUTPUT DATA (AC) @208 VAC @240 VAC Peak output power 250 W 250 W Rated(continuous)output power 240 W 240 W Nominal output current 1.15 A(A rms at nominal duration) 1.0 A(A rms at nominal duration) Nominal voltage/range 208 V/183-229 V 240 V/211-264 V Nominal frequency/range 60.0/57-61 Hz 60.0/57-61 Hz Extended frequency range* 57-62.5 Hz 57-62.5 Hz Power factor >0.95 >0.95 Maximum units per 20 A branch circuit 24(three phase) 16(single phase) Maximum output fault current 850 mA rms for 6 cycles 850 mA rms for 6 cycles EFFICIENCY CEC weighted efficiency,240 VAC 96.5% CEC weighted efficiency,208 VAC 96.0% Peak inverter efficiency 96.5% Static MPPT efficiency(weighted, reference EN50530) 99.4 % Night time power consumption 65 mW max MECHANICAL DATA Ambient temperature range -40°C to+65°C Operating temperature range(internal) -40°C to+85°C Dimensions(WxHxD) 171 mm x 173 mm x 30 mm(without mounting bracket) Weight 2.0 kg Cooling Natural convection- No fans Enclosure environmental rating Outdoor- NEMA 6 FEATURES Compatibility Compatible with 60-cell PV modules. Communication Power line Integrated ground The DC circuit meets the requirements for ungrounded PV arrays in NEC 69 Equipment y ui Nment ground is provided in the Engage Cable. No additional GEC or ground is required. Monitoring Free lifetime monitoring via Enlighten software Compliance UL1741 - p /IEEE1547, FCC Part 15 Class B, CAN/CSA-C22.2 NO.0 M91, 0.4-04,and 107.1-01 Frequency ranges can be extended beyond nominal if required by the utility To learn more about Enphase Microinverter technology, enp ase visit enphase.com E N E R G Y 0 2013 Enphase Energy.All rights reserved.All trademarks or brands in this document are registered by their respective owner. Date.N...................... 11039, °F"ORr"�ti TOWN OF NORTH ANDOVER 3.t:' -�: :'• °oma ° p PERMIT FOR PLUMBING �B�cHu �J(,j -,D.e._J 0, ,fel Thiscertifies that...................................................................`................................................... has permission to perform...:�A.e.:e-..., .:.................... .� ..M plumbing in th//erbuildings of.....................�............... ..,:....................:.......:....... l ' �.!Q�.................. North Andover, Mass. at..............................::.... ....................... . Feev".....Lic. No. i . .................................................................. PLUMBING INSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 4 CITY ��_ i MA DATE PERMIT# JOBSITE ADDRESS S �S� �,a� —� OWNER'S NAME POWNER ADDRESS S ^`� __ TEL / - 73 76 17 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL RESIDENTIAL [] PRINT CLEARLY NEW: M RENOVATION:® REPLACEMENT: ( 1 PLANS SUBMITTED: YES® NOF-][ FIXTURES Z FLOOR--> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE -i } ( __J ,,,__, I { _., _,_I _. _- I ___ -_; _• _. I i I DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM ! __,.._. 1 � ._._._.1 ___._I —JI..__._ --11- DEDICATED ._._-_.J ._.DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER ! __L ...___1 _[ DRINKING FOUNTAIN FOOD DISPOSER -.� [ ._.--_.I I - _--[ - _ I .._ .. __.._..___.I .__..._._.i _.._-_( __._.( ..__._[ _.___...I 1 _..___.1 FLOOR/AREA DRAIN _i __..._._I __--i ____.1 _.__J I _-.___? INTERCEPTOR(INTERIOR) 1 ___,__( _. ._.� _. _1 .._._.__ I ( _..._._1 ___J ____ i __..__� _.._.__1 ..._•.._..f I . __ ►` _...___i KITCHEN SINK LAVATORY 1 ( __..__..J ___-- _ f 1 _._._.1 ---___.( � .. I __....PF,--Jl ROOF DRAIN.SHOWERSTALL I l J 1 _.__-1 __-_JSERVICE/MOP SINKTOILET I I ! I ! I 1 � I J URINAL WASHING MACHINE CONNECTION .f WATER HEATER ALL TYPES WATER PIPING OTHER ._..[ INSURANCE COVERAGE: " 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YESPO NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW \� LIABILITY INSURANCE POLICY It OTHER TYPE OF INDEMNITY © BOND �]� — OWNER'S INSURANCE WAIVE1 am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and acc to to the best o my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance wit all , inent pr isior�.oithe Massachusetts State Plumbi Code and Chapter 142 of the General Laws. PLUMBER'S NAME -JeVV Scv4-- IILICENSE# I SIG ATURE MPD( JP; CORPORATION # PARTNERSHIP# LLC COMPANY NAME DRESS �( CITY �� — --ESTATE ZIP p/�`�S TEL�17 T��T - ' Il _ FAX L= 1 ____-t CELL �f/3 EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FIN INSPECT NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES tet, Date................. ..................... tto TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION CHU This certifies that .. ? . ..... 40 Lb..I'..,A................................................. .... .... .................. . ..... .... has permission for gas installation ................ ................. in the buildings of........ at .D�� c rt .............. N ....... ...... North Andover, Mass. Fee.:?P........... Lic. No..:�>I's .......................... . ......................................................... GASINSPECTOR Check.# 4 U -` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY n a f/'l/'�m . MA DATEj�j PERMIT# JOBSITE ADDRESS -- " —�=OWNER'S NAME G , OWNER ADDRESS ITEIr FAX -- I O TYPEE R PRINT OCCUPANCYTYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL)p CLEARLY NEW:0 RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES F__jj NOE3 APPLIANCES 7 FLOORS- BSM 1 1 2 3 1 4 5 1 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER = I.�_... J T _ - _ _L—J _ =--i --- 1 COOK STOVE DIRECT VENT HEATERJ t DRYER FIREPLACE ) FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT R__ ... -. I F-� - OVEN _ _7 L— __J=I- POOL HEATER _- _.._ . _ _.._ _ _ I= ( 1 ROOM/SPACE HEATER ROOFTOP UNIT TEST UNIT HEATERS UNVENTEDROOM HEATER ;_ WATER HEATER-dT—HER r J INSURANCE COVERAGE have a current liab- ility insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY h OTHER TYPE INDEMNITY Ej BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER -E AGENT S SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code `and dCChapter 142 of the General Laws. PLUM BER-GASFITTER NAME - - „"''�_1� l a/ILICENSE# } SIGNATURE MP El MGF Ell JP JGF D LPGI M CORPORATION Q#=PARTNERSHIP®#=LLC[J#f COMPANY NAME: c,U�rr s-_. f __ ADDRESS _ _ CITY n o,/�c/� �� STATEWIZIP --- O/ J TEL Y- J FAX CELL EMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION TES Yes No // THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES P ' V' � t The Commonwealth of Massachusetts Department of IndustriqlAcci6nts Office of Investigations 600 Washington Street f Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ,Applicant Information Please Print Legibly Name(Business/Organization/Individual):�, (�d1 �zo f,4✓1 Address: City/State/Zip: /16rA r,�� r Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.D I am a employer with 4. EJI am a general contractor and I ` ❑ � have hired the sub-contractors 6. New construction ,�, employees(full and/or part-time). 20 I am a sole proprietor or partner- listed on the attached sheet. ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g ❑Building addition [No workers' comp.insurance 5. El We are a corporation and its required.] officers have exercised their 10.F1 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 12.0 Roof repairs insurance required.] employees.[No workers' 13.[i Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 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:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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. Ido hereby cert 'd thepai s andpenalties ofperjury that the information provided above is true and correct. Simature: ' Date: 3 Phone#: 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#: - r Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written. � An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retained to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The CoUU!aO wealth,of Massachusetts Department of Industrial Accidents Office ofIovestfgations 600 Washington Street Boston}MA.02111 Tei,#6X7-727'-4900 ext 406 or 1-877 MASSAFE Revised 5-26-05 Fax#617-727-7749 wv W-Mass,govfdia t Fold,Then Detach Along All Perforations :>Om :COMMONWEALTH OF MASSACHUSETTS:<>>_;;;: 0 0 0 • • e BOARD�)F PLUMBElia8':*A'K0:' G:ASF;I,T;T ISSUES THE FOLLOWIl,Pa LICENSE ' L I CENSE.'0 A5 A JOURNEYMAN PLUMBER s � . I :>SHA;WMP S EVO I AN„";>:::; f 2 M; 35 97. € 3 5 '' ':<`'`>'o5'I Q.>>>/:> b:< <;> 208 320 I O 'i 01 Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING VSs^CHU This certifies that ......................................... ..........// . .............................. SGG has permission to perform ..... ......... ....... .. ... . r. r as wiring in the building of ........................................ at.... ...... .... .....-i ............................................ ,North Andover/l/Ni &ee,...�,�............ Lic.No. . ........✓4......... .............C.... . LECTRICAL INSPECTOR Check # 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the sha permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications ll be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time ofongoing construction activity,and may be-deemed-by the.lnspector_of_Wires abandoned.and.invalid_ifhe—_. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending"through August 15,2012. le 8—Permit/[)ate Closed: 2 ***Note:Reapply for new perm, 0 Permit Extension Act—Permit ate losed: Ar �/j�// �q� / _ _.. lfommonwea&of Maijac4aaeth Official Use Only h c� � Permit No. /D ` G apartment o1.}7ire Service, � Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 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: May 9, 2011 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) 538 Osgood Street Owner or Tenant Carlos Montemor Telephone No. 617-233-6797 Owner's Address Same is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building Single family/ Residential Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters V Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of a monitored security system No construction / No builder Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA e No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 No.of Switches No.of Gas Burners No.of Detection and. Initiatin Devices 3 No.of Ranges No.of Air Cond. Total Tons g No.of Alerting Devices No.of Waste Disposers Heat Pump I NumberI.I. Tons KW No.of Self-Contained Totals: Detection/Alerting Devices ' No.of Dishwashers Space/Area Heating KW Local El Municipal F] Other ,t Connection t No.of Dryers Heating Appliances KW Security Systems:* 12 No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: d p�/ Attach additional detail if'desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: $587.00 (When required by municipal policy.) Work to Start.: ASAP 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. CHECKONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Self Insured I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FiRMNAME: ADT Security Services Inc. LiC.NO.: C-45 Licensee: Mark A. Brophy Signature _ LIC.NO.: C-45 (If applicable, enter "exempt"in the license number line.) Bus.Tel.xa ' Address: 410 University Avenue Westwood, MA 02090 Alt.Tel.No.: *Per M.G.L. c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. 00953 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a*ent. Owner/Agent Signature Telephone No. PERMIT FEE: $45.00 : =REGISTERED SYSTEM CONTRACi.JR,:'.`., = :_; _ , = = 'ISSUES THEABOVE LICENSE TO: °;`, Er'. •-_=`�,1DT..�SF�CURiT-Y, SERVICE�S,•:.INC:'.:=. �,•;. ;'BRQPHY<,SR le 41.0`iUN-IVERSITY. r",.tESTWQOD M.A': 02.09,0-2�1.1: �.-., '4 :.45 C" 07/31/13 r.... " .Fold.Than 091aM Alwq•A Pvfan Oohs . Keep top for receipt and change of address notification. UFS-CAI v SSM-10109-10162009LICENSEFORMI l �%/-c•�n>'�rv�u�7ru�cal�•r��7�wur.�t�eel.�a DEPARTMENT OF PUBLIC SAFETY f S-License Number:'SS CO 000953 Expires:02/07/2013 Tr.no: 195.0 S-License: ADT MARES A BROPHY SR 410 UNIVERSITY AVE . i/ G✓ i WESTWOOD, MA 02090 ��, .- DIG SAFE CALL CENTER: (888)344-7233 Commissioner / i ,i Date . . . TOWN OF NORTH ANDOVER z PERMIT FOR GAS INSTALLATION This certifies that . has permission for gas installation . .� 7�✓�"'��-- MM � . . . . . . . . . . . . . . tin the buildings of. . . .1. .1 u 2- ✓(,, , , , at . . . . ,North Andover, Mass. Fee . . . Lic. No.'1(6Z...Y. . M�!. . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR Check# �?7 8526 L' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK I.A CITY MA DATE PERMIT# JOBSITEADDRESS �!1..—� OWN ER'SNAME I�C l�c-Iy� _ ,CS�► mn_ GOWNER ADDRESSw. - C-? TE � Z�3(%�JFAXC�,_ _.^. TYPE OR OCCUPANCY TYPE COMMERCIAL E] EDUCATIONAL ® RESIDENTIAL ' PRINT CLEARLY NEW: ,_- RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES❑ NO APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER _�_�-. , _- 1 _.. ._. I _- { -❑ ... I 1 .Y, f FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS (_-LL I I�-=--� __+I_._ sl J .___ .z ❑ f -I. ___ r__� �- ;_,I MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST U IT HEATER 14NVENTED ROOM HEATER WATER HEATER OTHER F IT �,� I _I C-- — 1 _.- . . INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES I[�__I NO _❑_{ 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY ❑ BOND ]_I OWNER'S INSURAN E WAIVER:I a t the licensee does not have the insurance coverage required by Chapter 142 of the Massachusett 8 IlLaws ign ture on this permit application waives this requirement. CHECK ONE ONLY: OWNER [_ GENT ❑( GNATURE OF OWNER 6 AGENT 14 1 hereby certif that all of the details and info mation I have submitted or entered regarding this application are true and accur to the b f my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance Ph Pertine Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME LICENSE SIG ATU _ # MP❑ MGF C— � JPF-- JGF❑ CORPORATION❑# PARTNERSHIP LLC[�#LPGI --. �� COMPANY NAME: —I1'o - --ADDRESS CITY _ -- . ...._.�__ _.... - STATE ZIP �9TEL _ 2 d FAX CELL L7 "' EMAILF—M(LsAV\ Al __.. .._-. v ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 4 R � r • t 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/I 1): �� Address: < City/State/Zip: �S� r YU Phone#: 0 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I e loyees(full and/or part-time).* have hired the sub-contractors 6 E]New construction 2. am a sole proprietor or partner- listed on the attached sheet. 1 7• ❑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 HE 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. t am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: fob Site Address: City/State/Zip: attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). a ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine 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 )f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insuran coverage verification. do hereby certif u the pa' res o pe ry that the information provided above is true and correct. �i nature: Date: zat�G 'hone#: Official use o ly. 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#: . 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia l .Y f i � a cFold,Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS PQ'MBERS AND GASFITTERS I° LICENSED AS A JOURNEYMAN:PLUNI$E ISSUES THE ABOVE LICENSE TO I MARE • R STEARNS i � 18_ P1*. E-HILL AVE i MANCHECTER NH 03102-1319 05/01/14 T717:1$ = Fold,Then Detach Along All Perforations G t Date...7,17--4 6 NORTI{ TOWN OF NORTH ANDOVER PERMIT FOR WIRING • o •"i SSS^CHU This certifies that ..... ��. a - fir ..,.. . ate ............. .......... has permission to perform ........ a: ... wiringin the building of................................................................................... L at....: ' ..... J`�m© .........5,7.................... .North Andover,Mass. Feer . .... Lic.No.!Y� 7.4.......... ... . ........ j ELECTRICAL INSPECTOR Check # A 6790 .r`'•� Official Use(1111y • _. n _ Cotnmor�uveal>`tt of�assaehuse€�� 72dpermit No. fi •-� - Departmen t of Fire Services.'` Occupancy and I=ee C'hcrked BOARD OF FIRE:PREVENTION'REGULATIONS (Rev. tv9y] t1e:;u�1,1:1111:) APPLICATION:FOR•PERMIT.TC PERFORM ELECTRICAL WORK All work lrrtn lnrtimned in accordance wit6.the Mase1cluiutls.Electrieal_C'enlc(A4F.l'I.> -MIR I?.Iln .. (PLE4S PRINT IN 1jVKOR TI'PE. LL INFORMATION) Date: 0 ©� City or Tonka of Til the!ns/ ecln1•u/'6b'irrs: By this applic than the undersignedglutslotice of Itis:or her inlentk n to perform the electrical work tlescrihed below. Location(Street&:Number) j 5 S- - Orvncr or'I'en.inf Telelihone No. Owner's Address Is this permit in;cc►njunction with a[iuildigg permit� Yes'El No (Cheek Appropriate Box) Purpose.of Building, Utility-Authorisation No. Existing:Service Amps.. / Volta Overhead Q UndgrdQ No,of Meters New Service Amps / Vo1Lti yOverhead❑ tlndgrd ❑ No. of Mciers Number of Feeders and A.mpacity I-Awation and.Nature of...Proposed.Electrical Work: r 1 completion o1711c i►llon in•/able•mut•he uvi n-el hr/he las,c rtur uj 1171-c.%. No:of Recessed FixtureNo of Total s No::ofCcih-Sus.p (Paddle}Fans 'frdnsfi►rmers KVA No.oELighting Outlets No:of Hot:Tubs.. Generators KVA No.of Lighting Fixtures Swimniin Poop Above. Q n- (] n .o mergency ,gig► rng 6 grnd.` Lrnd. Batte Units No.of Receptacle Outlets No.(►fOrl Burners FIRE:ALARMS No.of%)ne% ' (►:o ete�tlbn and No.of Switches No.of:Gas.Burners Initiating Devices Tota No. of-Ranges No.of Air:.C.ond. Ic►ns No.ofAMrting Devices No.of Waste Disposers Heat Pump; Number. .Tons RW: No.(if Self Contained Totals: Detection/Alerting Devices :.Deal i G OtherNo.of Dishwashers Space/Area.Heating Cotlection No.of Dryers Heating Appliances- K,W.r, Security Systems:' No.of Devices or Equivalent No-ofWater KW No..of No.of Data Wirinor• Heaters Signs: Ballasts No.of f)evices or Et rrivalenf 1 No. Hydromassage Bathtubs No,of Motors 7.oL►I HP Telecommunications!AViring: �1 No.of Devices or Equivalent OTHER:: 9auali additional drtrri!ijdc;rirevl,urns re•rlrrir•1vl h1'the hlxpe rear ul'll'irrs INSURANCE COVERAGE: .Unless-waived by lhc:owner;no permit:for the performance work may issue unless the licensee provides proofof Liabili y,in,sLirince itiel.6ding"completed operation"coverigeor ils substantial CClui.Valcnl. '111 e: undcnigitcd u:rtificsahatsuet:cov.• dgc is:in-fcim #nd hds:cxhibitcd proof ofsamc.to the permit issuing office. C'HEC'K UNE: INSURANCEBOND.❑ UTHLR:.Q'(Specify:) EstimatcdValucof'Electrical Work: �� • VU tGzpiratiunU:ue) ,• r (.When required bymunicipa) policy.) Work to Start:�Gt'� InspcUions.to be rcquested:in accordance with MEC Rtdc 10,and upon complelion. /ecru J1, under the pains rind penalties of prjrrrp,Iter I.the inforImn nn th atiois iq)plication is trite and cnrtrplete: FIRM NAME: 'i(l�y�PtiS�Cdv ' �j 2L�{Lr �l U �-� LIC. NO.: Licensee: 0/U C�- Qjo�-\-j Signnt.0 . LIC. NO.: (/(upplicnh/c• Wr "c c rpt"in 111'. irx• her J�+x�l„� N 6 �r1 C� Otis.Tel. No.:"Cdr Address: G ( 0 � %L{� / Aft.'fel. No.: OWNER'S INSURANCE WAIVER: I am aware.thal the Licensee'does not have the liabi[Lily.inxurmceeovcrage nurnlapy required by law. By my signature bia,uw,.l hereby waive'lhis reduircmcnt. I ant the(check one)❑ owner ❑ owner's:Itc'nl. Owner/Agent Si PERlI11T FEE: $ pulture Telephone No. Location/01- - 3 8 No. OWI-7k) Date NORTh TOWN OF NORTH ANDOVER Certificate of Occupancy $ 70: Building/Frame Permit Fee $ /4,05 Foundation Permit Fee $ Other Permit Fee Rr rsstik$ P3)• Sewer Connection Fee $ Water Connection Fee $ 1): TOTAL $ ATO Building In ctor Ck 1` 1, 16:19 t,�M.00 'AID Div. Public Works Locationto TG No. 595A60-7 f3 Date c � TOWN OF NORTH ANDOVER tc�� +3? ��i, •.ppL O o . p Certificate of Occupancy $ ►6' I . 27 3g �' • i ; : Building/Frame Permit Fee $ Foundation Permit Fee $ r)'• 12 z7 3 s�CHust ��_I55u Other Permit Fee t Vh,,T $ it/moo Sewer Connection Fee $ pl): 12-/-,-'7 ,3 Water Connection Fee $ bt- 3 TOTAL $ /!�lv `16 x' Buildin 'In rector * Tt, 8061 Div. Public Works fi PZ&ltiT NO. sysn IZ j. 3, APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 .,NAP +40. LOT NO. 2 RECORD OF OWNERSHIP ;DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. \ ,.eC- LOCATIONS e�s-S1 ki -,�-3S; /$- � PURPOSE OF BUILDING �"' a>�Ily a/I,.e OWNER'S NAME (' V. C y e / r NO. OF STORIES �- SIZE e( OWNER'S ADDRESS 0 u r C c BASEMENT OR SLABfvr,z.M?"' � ARCHITECT'S NAME /��a �J /� SIZE OF FLOOR TIMBERS IST ,�2X)02ND 3RD BUILDER'S NAME C) j�v La 4 wa SPAN // f DISTANCE TO NEAREST BUILDING j ( DIMENSIONS OF SILLS X DISTANCE FROM STREET / ••a "' POSTS •'� �a DISTANCE FROM LOT LINES-SID/ES 3 REAR GIRDERS AREA OF LOT it FRONTAGE /'I f�'^v HEIGHT OF FOUNDATION /pl THICKNESS IS BUILDING NEW 1y -e S SIZE OF FOOTING G� X �J IS BUILDING ADDITION r C/v 0 MATERIAL OF CHIMNEY v IS BUILDING ALTERATION A) T IS BUILDING ON SOLID OR FILLED LAND C2 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE I .P S, IS BUILDING CONNECTED TO TOWN WATER i/ ZOS BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE /V y ONLY a PROPERTY INFORMATION INSTRUCTIONS EGULATED BY PARA. 114.8-& B.C. LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 >�?p��11TE ::::mp Jy �7 EST. BLDG. COST PER SQ. FT..Tlvv EST. BLDG. COST PER ROOM ha PAGE 2 FILL OUT SECTIONS 1 - 12 PERMIT FOR FRAMUBUILDING SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REG//UUALAFFONTI PLANS MUST BE FILED AND APPROVED BY BUILDING INaPETTOR �-/.. FEE Pffl �l DATE FILED 4 elyY BOARD OF HEALTH T SIGNATURE OF OWNER OR AUTHORIZED AGE _y F E E OWNER.TEL. G PANNING BOARD PERMIT GRANTED CONTR.TEL. t9 CONTR.LIC.It__O I QLK IlWlf BOARD OF SELECTMEN !: LESS FDA FE€-.-, AUG 2 41994 DUE FRANCE 'EMM Z� � !0�&BUILDING INSPECTOR f _ k �k t I _ t � BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY s;ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES _- LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT_PLAN: CONSTRUCTION 2 FOUNDATION I 8 INTERIOR FINISH CONCRETE a 1 2 13 CONCRETE BIL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT I AREA FULL FIN. B M T AREA _ '/, 1/2 '/ IN. ATTIC AREA NO B M FERE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I g FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ 4' WOOD SHINGLES EARTH _ ASPHALT SIDING HARD1'J D ASBESTOS SIDING _ COMfA0N __ i tw,l,i b..Ii+riJ?I��•+ ' V� y VERT. SIDING ASPH. TILE _ y^, ( � Qrl,i YE f1]IA,flllil« STUCCO ON MASONRY _ y� i flS V i t U l f STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORPOOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) L • � :i 1 FLAT SHED WATER CLOSET «+^ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR �" f TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS.BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING - RADIANT H'T'G UNIT HEATERS P ►;N�A3 .V Iw 7 NO. OF ROOMS GASOIL B'M'T 2nd _ ELECTRIC f 3��j . 1st 13rd I NO HEATING A CT"J��'inT+•.s Location J � [ �5��r�%l . i d rib No. �y� Date P NORTF� TOWN OF NORTH ANDOVER , Certificate of Occupancy $ S2,d v Building/Frame Permit Fee $ CHUS Foundation Permit Fee � Ss�cMusE Other Permit Fee $ Sewer Connection Fee $ .r Water Connection Fee $ TOTAL $y- 4ee y3 Building Inspector 1 12]/93 14:14 150.44 RAID U 6823 Div. Public Works Location No. Date NORrN TOWN OF NORTH ANDOVER AMOCO „ Certificate of Occupancy $ + #- Building/Frame Permit Fee $ �+s cHus'S Foundation Permit Fee $ s� t Other Permit Fee $ p 676 Sewer Connection Fee $ /Q99 klo 32( Water Connection Fee $ 1ezy TOTAL $ G � c1 -B-W'Idi Inspector 121Z7/33 14:05 P,^ .�”' ,;� 3 Div Oub)c Works � V CQ 1 .. PERMIT NO. �l.� APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /PAGE 1 MAP d40. I LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE — ZONE SUB DIV. LOT N /' LOCATION�u PURPOSE OF BUILDING jjj I OWNER'S NAME Co ,�— NO. OF STORIES SIZE OWNER'S ADDRESS '[J l�Otl KJ BASEMENT OR SLAB fol ARCHITECT'S NAME CC)Cv SIZE OF FLOOR TIMBERS IST � (1MI71 2ND �i/-��v 3RD BUILDER'S NAME `v SPAN J DISTANCE TO NEAREST BUILDING f_ ` DIMENSIONS OF SILLS /JL --- DISTANCE FROM STREET /� / POSTS DISTANCE FROM LOT LINES-SIDES/ 341 REAR GIRDERS AREA OF LOT / AC r-a FRONTAGE j HEIGHT OF FOUNDATION ✓G[ THICKNESS IS BUILDING NEW fA/� �' SIZE OF FOOTING y J�f� r1 X IS BUILDING ADDITION 1/ /l/( / 0 MATERIAL OF CHIMNEYf- IS BUILDING ALTERATION p IS BUILDING ON SOLID OR FILLED LAND cb ` i J WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER Ile S BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER V,e S IS BUILDING CONNECTED TO NATURAL GAS LINE At z INSTRUCTIONS 3 PROPERTY INFORMATION WMT FEE$�LJ LAND COST SEE BOTH SIDES mn D�S. v EST. BLDG. COST •iii `� �O � EST. BLDG. COST PER SQ. FT. b PAGE 1 FALL OUT SECTIONS 1 - 3 irw.�.��r. PAGE 2 FILL OUT SECTIONS 1 - 12 POW wsfw fm V4 X- p EST. BLDG. COST PER ROOM ' OW L:.�S.L SEPTIC PERMIT NO. ELECTRIC M'ETEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 0 6 PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT J "� FEE " C) OWNER,TEL.#G�f�' --// PLANNING BOARD PERMIT GRANT CONTR.TEL 19 /r, CONTR.LIC. BOARD OF SELECTMEN Nti xzw n J BUILDINGINSPECTOR .` 03 V I � � , I BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY J StORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 1 / CONCRETE 81.K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL I FIN. B'M'TAREA _ 1/1 1/I 1/. FIN. ATTIC AREA NO B M FIRE PLACES _7 HEAD ROOM MODERN KITCHEN / K 4 WALLS I g FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE __ •- WOOD SHINGLES EARTH __ _ • ASPHALT SIDING HARDW D ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK N M N Y ATTIC STRS. & FLOOR BRICK ON FRAME I e CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH Q FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT.SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR 8 GRAVEL STALL SHOWER _ f ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 - HEATING WOOD JOIST PIPE LESS FURNA. „ FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GOAL B'M'T 2nd _ ELECTRIC 1st 13rd � NO HEATING E-ZsSut- Of� o�4�a�rC I N��T'' ► 5, 1)T . 12- 2?-93 a •��, o ortiAndover own _ No. i `North � dower, Mass., A�4.0 sT 1Z s. 1994- L o A K �. A_ GOC MI C.IE WICK A0RgrEo PP� ��J BOARD OF HEALTH a Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR S ��'Sgsfuk- Y THIS CERTIFIES THAT.........�t1 ........................................�..........�� 'P.....(��....�.. ........................... Foundation has permission to erect�1>..r'> !41K . buildings on .. _T -.S39 0S.4�a sT�`e' Rough to be occupied as........ I►?! ...Fe w. .i.L.. .... �. '..... ..*� ��/�'Jf ....0.60A��............ Chimney provided that the person accepting this permit s�ll 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, 1Iq Buildings in the Town of North Andover. REGULATED BY PARE 114.8.& &C. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough FEE PAID u7� Final T PERMIT EXPIRES IN 6 I�,�Oi�1TI- T�� CONJ,_�-RtX T ION STARTS ELECTRICAL INSPECTOR 4 '1,411 FOR FRAMEI`� � Rough �� 1lll...f►...... ................. ......................... Service 9-0-9 4 PAf D• s oy ` BUILDING INSPECTOR Final Occupancy Pcrrnit Required to Occupy Buildbig GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y p Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. 4Zl=1A/r:R /IAIATI=R FINAI DRIVEWAY ENTRY PERMIT 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** 1 APPLICANT: ✓PV Phone LOCATION: Assessor's Map Number Parcel Subdivision P P Lots) Street S' /9 C2 St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved (� Conservation Administrator Date Refected Comments �— - �, ---`� Date Approved Town Planner Date Rejected Comments Health Agent Date Approved Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire De art ;t-A� P Received by Building Inspector Date I NORTH Town of 19Andover 0 59 - - � = LA E dover, Mass., Of— . d 1911 COCHICHEWICK 7�S RATEO OPG iC� 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 11 91 BUILDING THIS CERTIFIES THAT...i�i� .rc ... E ....,c.�. .... .. .. FoundationDl I ECTOR P has permission to erect ACONAbuild*ings on .�5 .� r.. !.�.r.... ............ Rough to be occupied ash #... t 0..f/ . t .� ..Mi.. ...:��. �. .. chimney p I ,/ provided that the person accepting this permit shall in every respect conform to ththe i ation on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspe JISF1991 Af Id�6 y0f Buildings in BY PA the Town of North Andover. RA. 114.8-S. B.C. PLUMBING INS ECTOR VIOLATION of the Zoning or Building Regulations Void this Permit. a� Rough DA, . FEE PAID/fir D ^c� 6 Final PERMIT IN ONTHS D�� ELECTRI SP _ r TOR UNLE S CO S ON STARTS '? RMIT FOR FRAME/BUILDING R°ugh ,,.. Service ' FEE..PAID• B.1111110� UILDI G INSPECTOR AT Final Oc a Pe quire to Occupy Building IN Rough � �1 Display in a Conspi us ace on the Premises — Do Not Remove Final \` No La ' g or Dry Wall To Be Done Until Inspected a Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT 55 I / 1 1 IA 1^ / ✓ J J 30 CO fn o J s 3 ^o T' n � I 2 5i � IS f/E.f'EBy CE PT/FY TO TyE T/TLE/NSU.PO.PANO �L O T TD 7AIIE B.4.Ve T./qT TtfE OwELGtuG/S CpC'ATEO O�c/ Tf/E GoT.qS S/,f�/rN qN0 TWAT/T ODES CONFGtPiY! �N !Ylrll Ti :Owe OF•-/? zON/NG PE6!/LATibN$ /� �PE6V0.?D/NG SETBACA,V F•POM S�,��P ETS f GOT Li✓ES. " �%C, �/`�`O v?l� /j ,'' -r FUC/yEP CE.PT/FY Ti! ✓y�ELLti✓G /S.vOT / L0G47E0 /NT.YE FEOE t` .9ZAP0 .4.P---14. Oe.4.4-/11 FOiP 6Iaivn'O G 'c Y-3 ' EL Pot, 7 z-Y.3 � Plies '� ;^ .3 `� PltaS' 4 I•� ..:TE v=�/.S G�C 0�.�/tet/:� r s .STEPHE.d E. S 7is/rS PC.QtV Fa p iY1p.PTGAGE PvPPOS� �E, / .5c=u' A' Bovvo,Py aErE.P�sit/.grio v eor/•v s��.t/FO,Pil!— �E•P�P11W, GE'E.t/GiciEE,P/.c/6 SE.PI�/lES AT/O�(/ TA.�E.y F,Poii E-xrsr�,uc ,ee-co,Pos, �� q,P,E� ST.PEET • ANDDYE�P, �YJASSAC,fi//SETTS O/8/O CERTIFICATEDF USE & OCCUPANCY Town of North Andover Building Permit Number 595A (1993) Date DPCPmbpr ?R_ 1994 THIS CERTIFIES THAT THE BUILDING LOCATED ON 538 Osgood Street - Lot #6 Stevens Crossing Dev. Corp. (Type G) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2 CAR GARAGE IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. -. CERTIFICATE ISSUED TO Stevens rss i ng DL-v, Corp- Turnpike orn_Turnpike Street (A(Q--� ADDRESS - i ding Inspector • tia c.l -..d'.•.- 1 f TO" Of _�� =o � over V0 No. 69S _z' f.'-tiff=� �•i: � a Zo A KNorti � h " dover, Mass., Au,. T 1z-4 199 �A ORATED S r 1 L BOARD OF HEALTH I L D PERMIT T Food/Kitchen Septic System ,, BUILDING INSPECTOR � THIS CERTIFIES THAT.........S�.T��....%......................................!�.............�.�... ....•......�...Y �. ........................... Foundation has permission to erect kP.6..9W!!46. buildings on ..I o- -s3$ e�SQrooa..•ST1zt T".. oug A to be occupied as........ ,.1 ... !!r �.�:. ....' -1.1 ....w02....:.CrA'J12....(717!0 -110 .-............ C imney 2� provided that the person accepting this permit in every respect conform to the terms of the application on file in ina slf�ll j this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Aljqffl Buildings in the Town of North Andover. REGULATED BY PARA. 114." &C, PL BING, I SPEC R j it VIOLATION of the Zoning or Building Regulations Voids this Permit. –tom-sg oug �ls Y PERIvTIT P�I�ES N6 Iv�0��.1�"� " FEE PAID cn� n 1 ,� / �`C� CONSTRUCTION1LDIIG ELECTRICAL LTR�I�cAL IcN'SPE�T,O Q AR S RoughPERMIT FOR FRAMEI1i / I . 1-11.......... .... ..l�........ ....................................... ervt DATE:q�L FEE PAIDASO BUILDING INSPECTOR rx _ final �� Occupancy Pe7'7nit f_Zequirecl to Occltl?y Buildill g 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. `z�ti` Burner f �1 NG 'FINAL CONSERVATION, G IN Street No. �,,;;,.. z.• �.�` � � Smoke Det. _ /WATER FINAL DRIVEWAY ENTRY PERMIT �' l4a ZI 0 1 co_ - r s7q -yn lqQj -mc) �► - �, n� sa s �n � Location �- " �Y ��•c1�S r-055, -C J No. .4�9le—_G �l'�3� Date /0 //, 'AOR01 Th TOWN OF NORTH ANDOVER Certificate of Occupancy $ 4, * Building/Frame Permit Fee $ s Foundation Permit Fee $ sACHuS Other Permit FeeN►A+ut� $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ c K':�' 74-5 Building Inspector 10/11/94 09:31 25.00 PAT + 7551 Div. Public Works ,aORTM KARE` H.P. -NELSON Town of 120 Main Street, 01845 Director (508) 682-6483 NORTH ANDOVER BUILDING CONSERVATIO`: " 9` DIVISION OF HEALTH PLANNINGPLANNING & COMMUNITY DEVELOPMENT CHIMNEY APPLICATION AND PERMIT DATE Jr i 0 r-', RMIT #� LOCATION OWNER'S NAME %1 C IAC j BUILDER' S NAME :'/' MASON' S NAME • Tc. I v MASON' S ADDRESS J0 t3 611-r" 'V✓" /%41' MASON' S TELEPHONE r� MATERIAL OF CHIMNEY d.�ir> Ac // EXTERIOR CHIMNEY INTERIOR CHIMNEY_ (6c /Z2 F� - NUMBER AND SIZE OF FLUES THICKNESS OF HEARTH !L� Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: DATE zf"/ /z l � SIGNATURE OF MASOI �� z� CONTR. LIC. # n/' %�,� EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED L Oz!/rj FEE ROBERT NICETTA, BUILDING INSPECTOR INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES Location= --� , e No. '30 d Date MORTq TOWN OF NORTH ANDOVER f 1 F 9 ` 40 Certificate of Occupancy $ "s„ r �ss,KNuSEc�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ la Check #��IZ7 -- 686 ? �j --Building Inspector s TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT M!AI5 RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING AM M BUILDING PERMIT NUMBER DATE ISSUED. �/ Q SIGNATURE: dQ ..� Building Commissioner/I for of Buildings Date � Z SECTION 1-SITE INFORMATION _, O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number arcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Regaired Provide Required Provided R 'red Provided 1.7 Water Supply M G L.C.40. 54) I.S. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ _J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No m 2.1 Owner of Record Name(Print) Address for Service: S Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O zqq M Signature Telephone SECTION 3-CONSTRUCTION SERVICES go 3.1 Licenrd Construction Supervisor: Not Applicable ❑ LCJ/J G � Licensed Construction Supervisor: License Number Address �� icExpiration Date Signature Telephone r C- 7.1 6 6 '7/(/ 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name m Registration Number r Address z Expiration Date / Signature Tel 1 hone V F SECTION 4-WORKERS COMPENSATION(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.......0 SECTION 5 Description of Proposed Work check all a ticabte New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑. Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify BriefDe 'on of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed bypermit a licant x 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 p p Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT P "� I> as Owner/Authorized Agent of subject property 6' Hereby authorize. to act on �'. My behal 11 atter elativ or authorized by this building permit application. , Signature—ofOwner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION ' I, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB y SIZE OF FLOOR TIMBERS 1sr2ND 3RD SPAN DIMENSIONS OF SILLS DRVIENSIONS OF POSTS DINIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL,OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 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: L-ed (Loca ion of Facility) Signature of Permit Applicant Ph /0--� Dat NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector _ w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 a Workers`Compensation Insurance Affidavit sys Name Please Print Name: Location: City Phone # QI am a homeowner performing all work myself. I am a sole proprietor and have no one woridng in any capacity. I am an employer pfMiding workers'compensation for my employees working on this job. r CompaVy name. Address Q . Phone*. 6 0 3 6 Insurance:Co. Policy# Company name: Address: Insurance Co. Policv# Failure to securer coverage as required under Section 25A or MGL 152 can Lead to�the krVosMm cf c*r*W p' enaftm aF&fine up to 61'.50 and/or one years'imprisonrrust t ash aitles�nl6eScrmitta=p :fine c€LSiQO Q0►�-3me: understand that a copy of this statement may be forwarded to the Office cf Invesbgabons of the DIA for wveiage vergiication. A do hereby cer'tdy under ftq paras and penallres ofpedwy mat fiv MYmatba provxied above is true and emea n Signature Date / a Print name C�6 a p1.Ai I o r,:1 P.hoiseA 9 2 F a-3c Official use only. do not write in this area tv be completed by city or town officiar City or Town Fina. ` Budd/ OCheck Ymnediate response is nequked E%4'�'/JSlng Bpol Selectman's o `. Contactperson: Phone# D Health pepartr D Other I� i 374eana�nanu�ealf/r o litr�sac�raret7d t _ ' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 034539 f T Birthdate: 07/11/1943 Expires: 07/11/2005 Tr.no: 13332 Restricted: 00 CHARLES R ENNION �, // 99 PROVIDENCE RD ZZ.4 WESTFORD, MA 01886 Administrator Y