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HomeMy WebLinkAboutMiscellaneous - 55 HARWOOD STREET 4/30/2018 55 HARWOOD STREET 210/007.0-00140000.0 E i Date.t.-z"., . 14�� .... ............................ OF NOri7h,� TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING �sSACHU This certifies that .................................. ................. .. .................. ................................... has permission to perform PNA.12...................... .................. .... ......... wiring in the buil 'ng Of.......!.... .. ........... .................................................!...... at ......... ..... .............................................;North Andover,Mass. ...................... Fee.....I...4....1...5................Lic.No� .... ....................... ........................................................... ELECTRICAL INSPECTOR Check Vivint Solar 29 Draper St Woburn,MA 01801 Phone: (781) 350-3065 North Andover Building Department c/o Donald Belanger September 14,2016 Dear Mr.Belanger, Please cancel the associated permits and close them out in your system.If there are any additional steps needed to secure a refund,please let me know and I will be happy to complete them. 55 Harwood St PN# 709-2016 34 Berkeley Rd PN# 872-2016 20 Foss Rd PN#870-2016 Thank you. Best regards, Kyle Greene Construction Supervisor 108068 I ,1 F 1 �mmorauiealth o�///a,�achue¢ Officia41 se Only Permit No. I tom'�if 71- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [ReV. 1/07] leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cod C), 7 Cly 12.00 (PLEASE PRINT I1V INK OR TYPE A INFO TIO Date: City or Town of: To the Inspector ofWires: By this application the undersigned 'v notic or erint ti 10 perform the electrical work described below. Location(Street&Numbe ) Owner or Tenant M, Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Boz) Purpose of Building (Yl Utility Authorization No. Existing Service a� Amps ta.c> /84c) 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: �- Com lesion of the followingtable may be waived by the Ins ector of Wires. 4 of No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans s Tota TransKVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above - o.o Emergency Lighting No.of Luminaires Swimming Pool d. ❑ d. ❑ 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 g No.of Waste Disposers eat urn ....,um.,er. Tons o.ofSelf-Containedt Totals: -` Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 11 Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW o.of o.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunicationsuing No.of Devices or E uivalent OTHER Attach additional detail if desire64 or as required by the Inspector of Wires. Estimated Valu E e 'cal Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with NEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 cov -in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains an penalties of perjury,that the information on this application is nd complete. FIRM NAME: V�V1 nt Yn LIC.NO Licensee: Zam \Ol Signatur LIC.NO.: Jaj[ L1 I A- (If applicabl , enter ' empt"in the Tice a number line.) Bus.Tel.No.: ISI- Address: Alt.Tel.No.:(o 4-1�1,1.5q oa *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my siMAtup below,I hereby waive this requirement. I am the(check one El owner ❑owner's agent. Owner/Agent � ' q"� PERMIT FEE: Sionatore Telenhnne Nn_ I ' 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):- _�t V i ei'f` Sr/ Art J-n L - Address:--3301 h-) - hen 1G5 q, v� 1�✓.r 5 u/� �`o d City/State/Zip: i..t7— q Y o Ll 3 Phone#: TV I - Are you an employer?Check the appropriate box: Type of project(required): 1.E3'11 am a employer with lo 4. ❑ I am a general contractor and 1 employees(full and/or part-time). * have hired the sub-contractors 6. E]New construction 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. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.[3 Electrical repairs or additions required.] officers have exercised their 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&6ther comp.insurance required.] *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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 4 I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. . r Insurance Company Name: N r'.4,4 /.rtes, SAN :;7"S -Of to c C, Gs'"Vwn c� Policy#or Self-ins.Lic.#: VV L S-0 r1 (y U / Lf O Expiration Date: I I 1 1 / 7014; Job Site Address: City/State/Zip: Attach a copy of the workers 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. lie 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 thepains and penalties of perjury that the information provided above is true and correct. Sienature: Date: ! - Z - 1 Phone-#: _ _ YU I` 7 Lq - to K S `( Oficial 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#: VIVINT SOLAR DEVELOPER LLC PHILIP F ZAMPITELLA JR (EL) 4931 N 300 W - PROVO UT 84604 j W Then DOWN**JWW#A F1fmalto.� OF VA ON MMMM FL ICIAVG z ISSUES TWE FOLLOWING WORSE AS- a MRM MAST SRLECTRICIAN VtWfWt SOLAR DEVELOPER LLC P`NIL10 E� WLLA Jt 4931 N• 360 N fWWO U' 84604 13141 .k 07A tfi r. 1015& i U 0 C a Nim Cwt: PV SYSTEM SIZE: > ZQ 12.480 kW DC - J 48)Trina Solar TSM-260 PD05.08 MODULES I co JUNCTION BOX ATTACHED T ARRAY USING ECO HARDWARE TO KEEP JUNCTION BOX OFF ROOF I I 0 I O 11 I 120'OF 1"PVC CONDUIT N FROM JUNCTION BOX TO ELEC PANEL I I OO m Or--1 8 I I I I I I I I � I O N I ^ a0 C 5 Dpe - - - - -� LU ' ice ZVINTERCONNECTION — — — — Z � QI > Z WZ in POINT, & � in INVERTER,ANSI METER LOCATION, w w Z m LOCKABLE DISCONNECT SWITCH, < w Q &UTILITY METER LOCATION O Q J Z Z g p 55 Harwood St, North Andover MA 01845 SHEET + NAME: n I CL I SHEET NUMBER: PV SYSTEM SITE PLAN 'I SCALE: 3/32"= V-0" a I EL � I I O Conduit and Conductor Schedule DC Safety Switch Notes: Solar PV System AC Point of Connection Tag Description Wire Gauge #of Conductors Conduit Type Conduit Size AC Output Cu rent Rated for max operating condition of inverter Accoding to N. 59.38 Amps 1 Solar Edge Cable 10 AWG 2(V+,V-) N/A-Free Air N/A-Free Air NEC 690.35 compliant 690.8(B)(1) U o Nominal AC Volta a 240 Volts 1 Bare Copper Ground(EGC/GEC) 6 AWG 1 N/A-Free Air N/A-Free Air 9 C 'opens all ungrounded conductors THIS PANEL FED BY MULTIPLE SOURCES N 2 THWN-2 8 AWG 2(V+,V-) PVC 1" U (UTILITY AND SOLAR) 2 THWN-2-Ground 8 AWG 1 PVC 3 THWN-2 6AWG 3(L1,L2,N) PVC 1„ Notes: SE10000A-US-U Inverter Spec: o �9aW �m 3 THWN-2-Ground 8 AWG 1 PVC 1„ Wire size and breaker calculations dependent upon CEC Efficiency 97.5% -5 inverter Continuous Maximum Output. AC Operating Voltage 240V x"e? Example:SE38000A-US-U Max Output=16A (a a`Z <20A. Therefore a 20A solar breaker will be needed for Continuous Max Output 42A o each SE380OA-US-U inverter. Wire Gauge should also DC Maximum Input Current 30.5A N Z v be determined with 16A Max for each inverter. - > a Solar Edge Optimizer Specs: I- ALL CONDUCTORS P300 DC Input Power 30OW g SHALL BE COPPER DC Max Input Voltage 848V DC Max Input Current 12.5A Design Conditions: DC Max Output Current 15A ASHRAE 2013 Max String Rating 5250W L Highest Monthly 2%DB Design Temp 35.6°c. Module Specs: t 6 48 PV MODULES PER INVERTER=12480 WATTS STC Lowest Min.Mean Extreme DB -17°C Trina Solar TSM-260 PD05.08 1 STRING OF 16 PV MODULES VOC Temp coefficient V/°C Short Circuit Current(Isc) 9.00A 0 1 STRING OF 16 PV MODULES Open Circuit Voltage(Voc) 38.2V • s 1 STRING OF 16 PV MODULES System Specs: Operating Current(Imp) 8.50A ' Max DC Voltage 500V Operating Voltage mp) 30.6V •C 2 F-16-1 Nominal DC Operating Voltage 350V Max Series Fuse Rating 15A Cc; Max.DC Current per String 15A STC Rating(Pmax) 260W •= Nominal AC Current 47.5A Power Tolerance ' _ _ *CONFORMS TO ANSI C12.1-2008 EXISTING SUPPLY-SIDE L1 U N ENTRANCE JUNCTION BOX SOLAR TAP CONDUCTORS WITH IRREVERSIBLE r° GROUND SPLICE SOLAR2DGE NEC 705.12(A) M RATED:200A 1 3 0 0 0 15 16 S INVERA-US-R 0 m o 1 INVERTER' N � U Z m Q SOLAREDGE Sq.—D#D222NRB DC SAFETY /2 60A/240V FUSED NEMA3 EQUIVALENT 200A Z IL N SWITCH w W 2 m J 60A Z Z -®r OV EXISTING SHEET 1 2 15 16 w i NAME: 1 240V/200A AC W �, _ _ ll` ------- D LOAD-CENTER Z — — L VISIBLE WITH 1-60A FUSED � Q wiFac DISCONNECT `n O / -PL IBJ a DISCONNECT 3 r — — — SHEET t\ SOLAREDGE NUMBER: \P300 OPTIMIZERS r w ROOF SECTION V 0 Az:304 Ti:16 c 8 MODULES CANCELED ROOF SECTION BELOW MINIMUM REQUIREMENTS. (MODULES RANGE FROM 780-788 SUN HOURS) 10 oL m >Z (Bz C o za J_ I ROOF SECTION 4 ,+ Az:304 Ti:22 7 MODULES \/ O i+ OOF SECTION 2 Az:124 Ti:22 N 12 MODULES REMOVED DUE , iti,. 10 MODULES +.. _ TO USAGE BEING REACHED. 78 , 3 a J W N Q O m O N V Of aD m O C ULu 4 N � U Z co = ` Y d' U T W W Z m J J W Z U • COMP.SHINGL r r 3 rn n ¢ � SHEET NAME: ROOF SECTION c O Az:124 Ti:22 23 MODULES SHEET NUMBER: C) USAGE CONSTRAINT 91%CUSTOMER USAGE OFFSET > a EcolibriumSolar Customer Info Name: 4703928 Email: Phone: Project Info Identifier: 57178 Street Address Line 1: 55 Harwood St Street Address Line 2: City: North Andover State: MA Zip: 01845 Country: United States System Info Module Manufacturer: Trina Solar Module Model: TSM 260-PD05.08 Module Quantity: 48 Array Size (DC watts): 12480.0 Mounting System Manufacturer: Ecolibrium Solar Mounting System Product: EcoX Inverter Manufacturer: SolarEdge Technologies Inverter Model: SE1000OA-US (240V) Project Design Variables Module Weight: 43.0 lbs Module Length: 65.0 in Module Width: 37.0 in Basic Wind Speed: 100.0 mph Ground Snow Load: 50.0 psf Seismic: 0.0 Exposure Category: B Importance Factor: II Exposure on Roof: Partially Exposed Topographic Factor: 1.0 Wind Directionality Factor: 0.85 Thermal Factor for Snow Load: 1.2 Lag Bolt Design Load - Upward: 820 Ibf Lag Bolt Design Load - Lateral: 288 Ibf EcoX Design Load - Downward: 722 Ibf EcoX Design Load - Upward: 765 Ibf EcoX Design Load - Downslope: 297 Ibf EcoX Design Load - Lateral: 233 Ibf Module Design Moment—Upward: 3655 in-Ib Module Design Moment—Downward: 3655 in-Ib Effective Wind Area: 20 ft2 Min Nominal Framing Depth: 2.5 in Min Top Chord Specific Gravity:0.42 EcolibriumSolar Plane Calculations (ASCE 7-10): Roof 2 Roof Shape: Gable Edge and Corner Dimension: 3.0 ft Roof Type: Composition Shingle Stagger Attachments: Yes Average Roof Height: 15.0 ft Include Snow Guards: No Least Horizontal Dimension: 22.0 ft Roof Slope: 22.0 deg Truss Spacing: 16.0 in Snow Load Calculations Description Interior Edge Corner Unit Flat Roof Snow Load 42.0 42.0 42.0 psf Slope Factor 0.88 0.88 0.88 Roof Snow Load 37.0 37.0 37.0 psf Wind Pressure Calculations Description Interior Edge Corner Unit Net Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Net Design Wind Pressure Downforce 11.4 11.4 11.4 psf Adjustment Factor for Height and Exposure Category 1.0 1.0 1.0 Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Design Wind Pressure Downforce 16.0 16.0 16.0 psf ASD Load Combinations Description Interior Edge Corner Unit Dead Load 2.6 2.6 2.6 psf Snow Load 37.0 37.0 37.0 psf Downslope: Load Combination 3 13.8 13.8 13.8 psf Down: Load Combination 3 34.2 34.2 34.2 psf Down: Load Combination 5 12.0 12.0 12.0 psf Down: Load Combination 6a 33.4 33.4 33.4 psf Up: Load Combination 7 -10.2 -17.7 -27.3 psf Down Max 34.2 34.2 34.2 psf Spacing Results(Landscape) Description Interior Edge Corner Unit Max Allowable Spacing Between.Attachments 57.7 57.7 57.7 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 48.0 48.0 48.0 in Max Cantilever from Attachment to Perimeter of PV Array 19.2 19.2 19.2 in Spacing Results(Portrait) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 43.5 43.5 43.5 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 32.0 32.0 32.0 in Max Cantilever from Attachment to Perimeter of PV Array 14.5 14.5 14.5 in EcolibriumSolar Layout Skirt o Coupling Note: If the total width of a continuous array exceeds 35 ft, break array to allow for thermal expansion and contraction. See Installation Guide for details. Clamp Warning: PV Modules may need to be shifted with respect to roof trusses to comply with Bonding Jumper maximum allowable overhang. I EcolibriumSolar Root Weights In Conformance with Solar ABC's Expedited Permit Process Module Quantity: 10 Weight of Modules: 430 lbs Weight of Mounting System: 220 lbs Total Plane Weight: 650 lbs Total Plane Array Area: 167 ft2 Distributed Weight: 3.89 psf Number of Attachments: 110 Weight per Attachment Point: 6 lbs EcolibriumSolar Plane Calculations (ASCE 7-10): Roof 3 Roof Shape: Gable Edge and Corner Dimension: 3.0 ft Roof Type: Composition Shingle Stagger Attachments: Yes Average Roof Height: 15.0 ft Include Snow Guards: No Least Horizontal Dimension: 13.0 ft Roof Slope: 16.0 deg Truss Spacing: 16.0 in Snow Load Calculations Description Interior Edge Corner Unit Flat Roof Snow Load 42.0 42.0 42.0 psf Slope Factor 0.99 0.99 0.99 Roof Snow Load 41.6 41.6 41.6 psf Wind Pressure Calculations Description Interior Edge Corner Unit Net Design Wind Pressure Uplift -19.4 -31.9 47.9 psf Net Design Wind Pressure Downforce 11.4 11.4 11.4 psf Adjustment Factor for Height and Exposure Category 1.0 1.0 1.0 Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Design Wind Pressure Downforce 16.0 16.0 16.0 psf ASD Load Combinations Description Interior Edge Corner Unit Dead Load 2.6 2.6 2.6 psf Snow Load 41.6 41.6 41.6 psf Downslope: Load Combination 3 11.7 11.7 11.7 psf Down: Load Combination 3 40.9 40.9 40.9 psf Down: Load Combination 5 12.1 12.1 12.1 psf Down: Load Combination 6a 38.5 38.5 38.5 psf Up: Load Combination 7 -10.2 -17.7 -27.3 psf Down Max 40.9 40.9 40.9 psf Spacing Results(Landscape) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 52.8 52.8 52.8 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 48.0 48.0 48.0 in Max Cantilever from Attachment to Perimeter of PV Array 17.6 17.6 17.6 in Spacing Results(Portrait) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 39.1 39.1 39.1 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 32.0 32.0 32.0 in Max Cantilever from Attachment to Perimeter of PV Array 13.0 13.0 13.0 in EcolibriumSolar Layout � Skirt Coupling Note: If the total width of a continuous array exceeds 35 ft, break array to allow for thermal expansion and contraction.See Installation Guide for details. • Clamp Warning: PV Modules may need to be shifted with respect to roof trusses to comply with Bonding Jumper maximum allowable overhang. EcolibriumSolar Roof Weights In Conformance with Solar ABC's Expedited Permit Process Module Quantity: 8 Weight of Modules: 344 lbs Weight of Mounting System: 220 lbs Total Plane Weight: 564 lbs Total Plane Array Area: 134 ft2 Distributed Weight: 4.22 psf Number of Attachments: 110 Weight per Attachment Point: 5 lbs EcolibriumSolar Plane Calculations (ASCE 7-10): Roof 4 Roof Shape: Gable Edge and Corner Dimension: 4.2 ft Roof Type: Composition Shingle Stagger Attachments: Yes Average Roof Height: 15.0 ft Include Snow Guards: No Least Horizontal Dimension:42.0 ft Roof Slope: 22.0 deg Truss Spacing: 16.0 in Snow Load Calculations Description Interior Edge Corner Unit Flat Roof Snow Load 42.0 42.0 42.0 psf Slope Factor 0.88 0.88 0.88 Roof Snow Load 37.0 37.0 37.0 psf Wind Pressure Calculations Description Interior Edge Corner Unit Net Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Net Design Wind Pressure Downforce 11.4 11.4 11.4 psf Adjustment Factor for Height and Exposure Category 1.0 1.0 1.0 Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Design Wind Pressure Downforce 16.0 16.0 16.0 psf ASD Load Combinations Description Interior Edge Corner Unit Dead Load 2.6 2.6 2.6 psf Snow Load 37.0 37.0 37.0 psf Downslope: Load Combination 3 13.8 13.8 13.8 psf Down: Load Combination 3 34.2 34.2 34.2 psf Down: Load Combination 5 12.0 12.0 12.0 psf Down: Load Combination 6a 33.4 33.4 33.4 psf Up: Load Combination 7 -10.2 -17.7 -27.3 psf Down Max 34.2 34.2 34.2 psf Spacing Results(Landscape) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 57.7 57.7 57.7 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 48.0 48.0 48.0 in Max Cantilever from Attachment to Perimeter of PV Array 19.2 19.2 19.2 in Spacing Results(Portrait) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 43.5 43.5 43.5 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 32.0 32.0 32.0 in Max Cantilever from Attachment to Perimeter of PV Array 14.5 14.5 14.5 in EcolibriumSolar Layout 1 F-71 1 11 Skirt o Coupling Note: If the total width of a continuous array exceeds 35 ft, break array to allow for thermal expansion and contraction. See Installation Guide for details. Clamp Warning: PV Modules may need to be shifted with respect to roof trusses to comply with Bonding Jumper maximum allowable overhang. I EcolibriumSolar Roof Weights In Conformance with Solar ABC's Expedited Permit Process Module Quantity: 7 Weight of Modules: 301 lbs Weight of Mounting System: 220 lbs Total Plane Weight: 521 lbs Total Plane Array Area: 117 ft2 Distributed Weight: 4.46 psf Number of Attachments: 110 Weight per Attachment Point: 5 lbs EcolibriumSolar Plane Calculations (ASCE 7-10): Roof 1 Roof Shape: Gable Edge and Corner Dimension: 4.2 ft Roof Type: Composition Shingle Stagger Attachments: Yes Average Roof Height: 15.0 ft Include Snow Guards: No Least Horizontal Dimension: 42.0 ft Roof Slope: 22.0 deg Truss Spacing: 16.0 in Snow Load Calculations Description Interior Edge Corner Unit Flat Roof Snow Load 42.0 42.0 42.0 psf Slope Factor 0.88 0.88 0.88 Roof Snow Load 37.0 37.0 37.0 psf Wind Pressure Calculations Description Interior Edge Corner Unit Net Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Net Design Wind Pressure Downforce 11.4 11.4 11.4 psf Adjustment Factor for Height and Exposure Category 1.0 1.0 1.0 Design Wind Pressure Uplift -19.4 -31.9 -47.9 psf Design Wind Pressure Downforce 16.0 16.0 16.0 psf ASD Load Combinations Description Interior Edge Corner Unit Dead Load 2.6 2.6 2.6 psf Snow Load 37.0 37.0 37.0 psf Downslope: Load Combination 3 13.8 13.8 13.8 psf Down: Load Combination 3 34.2 34.2 34.2 psf Down: Load Combination 5 12.0 12.0 12.0 psf Down: Load Combination 6a 33.4 33.4 33.4 psf Up: Load Combination 7 -10.2 -17.7 -27.3 psf Down Max 34.2 34.2 34.2 psf Spacing Results(Landscape) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 57.7 57.7 57.7 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 48.0 48.0 48.0 in Max Cantilever from Attachment to Perimeter of PV Array 19.2 19.2 19.2 in Spacing Results(Portrait) Description Interior Edge Corner Unit Max Allowable Spacing Between Attachments 43.5 43.5 43.5 in Max Spacing Between Attachments With Rafter/Truss Spacing of 16.0 in 32.0 32.0 32.0 in Max Cantilever from Attachment to Perimeter of PV Array 14.5 14.5 14.5 in EcolibriumSolar Layout , Ll Skirt o Coupling Note: If the total width of a continuous array exceeds 35 ft, break array to allow for thermal Clam expansion and contraction. See Installation Guide for details. p Warning: PV Modules may need to be shifted with respect to roof trusses to comply with Bonding Jumper maximum allowable overhang. EcolibriumSolar Roof-Weights In Conformance with Solar ABC's Expedited Permit Process Module Quantity: 23 Weight of Modules: 989 lbs Weight of Mounting System: 220 lbs Total Plane Weight: 1209 lbs Total Plane Array Area: 384 ft2 Distributed Weight: 3.15 psf Number of Attachments: 110 Weight per Attachment Point: 11 lbs EcolibriumSolar Bill Of Materials Part Name Quantity ECO-001_101 EcoX Clamp Assembly 110 ECO-001102 EcoX Coupling Assembly 64 ECO-001_105B EcoX Landscape Skirt Kit 10 ECO-001-105A EcoX Portrait Skirt Kit 6 ECO-001_103 EcoX Composition Attachment Kit 110 ECO-001_116 EcoX Flat-Tile Flashing 0 ECO-001_117 EcoX S-Tile Flashing 0 ECO-001_118 EcoX W-Tile Flashing 0 ECO-001_363 EcoX Lower Support-Tile 0 ECO-001_109 EcoX Electrical Assembly (optional) 4 ECO-001_106 EcoX Bonding Jumper Assembly 11 ECO-001_104 EcoX Inverter Bracket Assembly 0 ECO-001 338 EcoX Connector Bracket 0 ECO_001-359 EcoX Lower Support- Low Slope 0 14'-0"� i. A I a ' i o N I V � 2_ "x 6,_ �I o b I f T-0�-- �! T-0" r 5 4—� A �- 5'4111 42.0" 4'-0" b: 4,-0" 2-6"x 4,-0" 3'-1" 6'-9' 15'-0" _ 1'-�1 4b 2'-6"x 4'-0"'-6"x 4'-0" 2-4"x f 0" 2=6"x 4 fQ. ai m � '� I I g o ti-6,-6„_AL3,-7” w ' BEDROOM 0, T (JV - 'BATHROOM \ V MASTER X BATHROOM i[[VVV + I BEDROOM aJ I ----/ 2=" 2��x _6 °i 4 an LNINO ROOM 14'-7" 542_2" =34" 810 6'- 3'-0"x6'o-2N b T - 8'-2" 6' 7" T-7" r14,-3, 2.6"� —3'•f0' w X FOYER W 9 j� I ,• �h MASTER Ot O" KITCHEN N X BEDROOM I DINING ROOM X00"A j'10"./ �"x 6�'2'-6"x 3'-82'-6"x 3'-8 2'6"x 4'-02'-6"x 4'-0" 2'-0"x 4'03-4"x4'-0'2'-0"x4'-o" °x/6�-8" 21-6'x 4'-02'6"x 4'-0" 2'-6"x 4'_0" _ �F 4.-2",}-2'41-+--3'-T— T-0"-- +X-2"-4=-5'-7"—� 6,_7" 3.2" I• T-8" 0, 4-6" 24'-0" X42'0" Date. . ... . . . . . . . NORT" �,.• •° .'�, TOWN OF NORTH ANDOVER �j ' PERMIT FOR PLUMBING ,SSAC14us This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . ... . . . . . . . . �9 plumbing in the buildings of . . . . : . . . . . . . . . . . . . t ✓AL#..— at. .'q. . . .`t. . . . . . . . . . a . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee`3 Lic. No.. . . . . . . . . .. . .. .y!. . . . . . . . . . . . . . . . . . . . '� PLUMBING INSPECTOR Check it 8065 _.. . . - 1 1 !. i � 4 1 � MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS t— / Date Building Location .� �1 l-��f WOOG Owners Name Lo LAI CG ©f� Permit# Amount Type of Occupancy New Renovation Replacement1;1 Plans Submitted Yes11No ❑ FIXTURES z � E" a o z U W F W x O Z Z z U a a w (4 �' w z a � x SLB-FM MSE"M IST>L ma)H-OCR M>HLOOR 4M MOOR 5-"I ffiDCR 6M HADOR - 7II3 FLOOR Sm HDM (Print or type) j Check one: Certificate Installing Company Name Corp. �(� j, I_P/9d1L1� f ❑ Address 1 t l W►/�tin C fS �,y ❑ Partner. Business02 Telephone /nO oo - 9( � O Firm/Co. Name of Licensed Plumber: L e N � Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,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 ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachu e and Chapter 142 oft General Laws. By: Tgnptffe o i ens jum5er Type o 1 mg License Title 8' City/Town icense Tum er Master Journeyman ❑ l APPROVED(OFFICE USE ONLY The Commonwealth of Massachusetts j ! Department of Industrial Accidents i 1,4 Office of Investigations 600 klrrrshington Street Boston, MA 02111 www_murs.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eiectricians/Pium A>plicant Information bers Please Print Legibly Name (BusinessforgettizaEion/Individual):_ J O�, eb i,1 0\1r cl Address: (� Gt City/State/Zip: y"� rf`S�'r/uh� U O?f Phone#: . O "200 " 03 Are you an employer?Check.the appropriate box: 1.❑ 1 am a employer with 4. Type of pre'ec' (required): ❑ 1 am s general contractor and I _ ymployees(full and/or port-time).* have lured the sub-contrractors ❑Naw trvctiotl 2. %am.a-sole proprietor or partner- listed on the attached sheet.= 7• ❑ Remodeling ship and have no employees These sub-contractors have g, Demolition working for mein any act workers' comp.insurance. capacity, 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 11.❑ Plumbing repairs or additions myself.[No-worke'rs'comp, c. 152, §1(4),and we have no required.] 12-El Roof repairs insurance re 8 I .employees. [No workers' 1317 Other COMP. insurance required.] 'Any applicant that checks botC#l =also flit out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work end than hire outside contractons must submit a new affidavit indicating such. tCcntractors brat chest this box musta7eched an addttiocal shaetshowing the name of the sub-contractors and their woticers'c_r- i'—, F. a.r a rn F � mmfirn. !am an employer that is providiwrworkerscompensation insurance for nV..employees: Below is the policy and job site . informs on, Insurance Company Name: ' Policy#or Self-its.Lie.#: 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 fa of up to$250.00 a day against the violator. Be form of a STOP WORK ORDER and a fine e advised that a co of this state InvestigationsPY statement may be forwarded to t of the DIA for insurance coverage verification. he Office of I do hereby certify under the pains q —nApenakies of perjury that the information provided above is true and correct Si Date: Phone#: Q ficial use only. Do not write in this•area,to he completed by city or townn official f City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health Z Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone#: I i I Information and Instructions Massachusetts General Laws_chapter 152 requires all emp I oyers 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." i An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'foreping engaged in a joint enterprise,and includirig 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 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 cordracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contracto(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,notthe 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 numberlisted below. Self.-insured companies shoLlid 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 fi&= 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 bum leaves etc.)said person is NOT.required to complete this affidavit The Office of Investigations would file 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 Intvestibations 600 Washington Stmet Boston, MA 02111 TeL#617-727-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax#617-727-7744 www.mass.gov/dia Date. . . . . . . . . . . . . HORTp TOWN OF NORTHANDOVER. o p PERMIT FOR PLUMBING 41 SSACMUSE� This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . ... . . . . . . . . . . . . . ... . . . . . . . . . . .. North Andover, Mass. Fee. . . . . . . . .Lic. No.. . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # r f C�s MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING CitylTown: 111o�2 1, �n/c%,vP MA. Date: Permit# l� Building Location:', Owners Name: v9 U.'.G� - l Type of Occupancy: Commercial Educational Industrial Institutional J,--Residential New: Alteration:: Renovation ✓ Replacement: Plans Submitted: Yes 7/No FIXTURES z z O Y to to N Z _a aam aFm yN } W z 2 gn W afaaA z w z z rn 0n I— w a } WZvv ioaaI- LLgOmWWpI- zl Noli z CL O = a = LL Z = WWF` oc5 ° = ° Qy ° a Ygo u. wo rn I- 3 3 3 0 1 1 SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 41H FLOOR 5 FLOOR 6 1H FLOOR 7 1H FLOOR 8 IHFLOOR Check One Only Certificate# Installing Company Name f'/ ;L I c<,t /C✓, ' Corporation Address fcr %�vt/fSSGL>, yZC/.City/7own /�f/n�S7�A<f ',State MA _. Partnership Business Tel C63 Yd I f,Z Fax: Firm/Company Name of Licensed Plumber: �< INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes.'. No If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy , Other type of indemnity Bond OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts u efts General Laws and that m signature on this permit application waive , Y 9 Pe PP s this requirement Check One Only Owner . Agent Signature of Owner or Owner's Agent I 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 Chapter 142 of the General Laws. By _ - Type of License: �? Title; ✓ Plumber of Licensed Plumber Master cityrrown Journeyman License Number: ��/�`/S /rte► APPROVED OFFICE USE ONL -/� Date.................................. MORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING 4P • This certifies that . ................. ...... ................................................... has permission to perform,.. . ........... ......... ................. wiring in the building of ................................................................... ............. ..........................i.................... North Andover,Mass. Fed-.-:�.................... Lic.Noy. :— .................i. LECTRIC;AZL iN;PiECTOR Check # -,&-N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. O J BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ' [Rev7073 Qeave 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 PMT ININK OR TYPE ALL INFORMATION Date: City or Town of: NORTH AND, G B this To.the Inspector of ire By application the undersigned gives notice of ' for her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant Telephone No. Owner's Address 0--, Is this permit in conjunction with a building permit? yes Purpose of Building NO ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps __L_Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: / Completion of the ollowin table ma be waived bV the Inspector Of Wires. No.of Recessed Luminaires No.of CeiL-Sus No.of gi.(Paddle)Fans Transformers Tota! No.of Luminaire Outlets , KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming pool Above In- o.o mergency ig d. ❑ rnd. ❑ Batte Units ' - No,of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones ' No.of Switches No.of Gas Burners No.of Detection and No.of No.of Air Co Ranges . Initiatin Devices g nd °� Tons No.of Alerting Devices umb No.of Waste Disposers Heat umP Ner ons KW o.of elf-Containe Totals: - "-"� "" Detection/Ale Devices No,of Dishwashers Space/Area Heating KW LOcalunicI al No.of Dryers HeatingA ❑ Connection ❑ Other Appliances KW Security Systems:* No.of Water No.of No.of Devices or E uivalent Heaters KW No.of Data Wiring: Si s Ballasts . No.Hydromassage Bathtubs N°.ovices or E uivalent g No.of Motors Total Hp Telecommunications icing: OTHER: No.of Devices or Equivalent Estimated Value of_Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires, (When required by municipal policy.) Work to Start /--) "l'7'D 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 including"completed operation"coverage or i substantial equivalent The undersigned certifies that such cove ge is in force,and has exhibited proof of same to the peraii issuing office. CHECK ONE: INSURANCE (✓BOND ❑ OTHER I certify,under the pains and penalties o ❑ (Specify') .� ' fP�7ut1',that the information IBM NAME: .est th' licadiItrue and complete ; ,_ Yh" Licensee: ' LIC.NO.: Signature (If applicable, enter " mp "i th license nu b lines LIC.NO.: .?Jj J Address: 1,fS - Bus.TeL No.: *Per M.G.L c. 147,s.57-61,security work requires D ©) 3 Alt.Tel No.:97�2 3�< � = OWNER'S INSURANCE WAIVER: I am aware that�erci fee does Safetyot "S the Lice Ii Lic.No. required by law. By my signature below,I hereby waive this requirement I am the(check one) ❑ower cov❑etaeorm gent Owner/Agent Signature Telephone No. PERMIT FEE: $ ,� � ���- ���� M The Commonwealth of Massachusettr s~j ! Department oflndustri ilAccidents t Office of Investigations 600 If-ashington Street ,{ Boston, MA 02111 www.n2=s gov/dia . Workers' Compensation Insiurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeQibl Name(Business/prganization/Individu : - Address: City/State/Tip: Phone 7 ��� 276 Are y fu an employer?Check.the appropriate box: L.❑ am a t] 1 am a er with 4, general contractor and 1 employer Type of project(required): P Y employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2. I am a.sole proprietorr or partner- listed on the attached sheet._ 7• ❑Remodeling ship and have no employees These sub-contractors have 8. Q Demolition working for mem" any capacity. workers' comp.insurance. [No workers comp, insurance 5. 9. Q Building addition ' P ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.7 Plumbing repairs or additions Myself [No•workers'comp. c. 152, §1(4),and we have no 12. Roof insurance required.]t ❑ repairs q ] employees. [No workers' comp. insurance required..) 13.70ther Any applicant that checks borf#f 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 worlxrs'comp.policy information. f am an employer that is providingWorkers'compensation iWsurance for my employees: Below is the inforpolicy and job site . mation. Insurance Company Name: Policy#or Self-.ins.Lie.#: 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 cov tag as required.under Section 25A of MGL c. 152 can lead to the irrlposition of criminal penalties of a fine up to$1,500.00 and/or one-year i prisonment,as well as civilenalties in the form of up to$250.00 a P of a STOP WORK ORDER and a fine day against the vio� r. Be advised that a copy of this statement may be forwarded to the Office of Investigations the DIA,fior insutastp cov ge verificati Investigationson. I do hereby and the at d penaikes o er / i f p fury that the information Prov' above is true and correct Si lure: / ufe¢ � r Phone#: offxia1 use only. Do not write in this area,to be completed by city or town official C' or Town: rt3 i 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#: 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 requiredto 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 of idavit. The affidavit should be returned to the city or town that the.application for the permit or license is being requested,notthe 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 dine. 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 bum 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 as 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#617-7274900 ext 446 or 1-8.77-MASSAFE Fax 4 617-727-77491 Revised 5-26-05 www.mass.gov/dia r Date.............2... ...GZ�.. f ,LORTH, "�o� TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING ,SSACMUSE� This certifies that ... 1-.�.V t /, � l ................. ........ .......... ....................... has permission to perform ...r�G ............................ ............. ........................ wiring in the building of qL , ........................ �1'/ — ............... at......5..'�. i?.luGJ,...... '........... ...... ,North Andover,Mass. Fee.. 0 Lic.No. ..... .,, ' .../2�1. ELECTRICAL INSPECTOR Check # i ---o---- A%AVAw .vnAa.AMrAW9 Lrmnd*t BQAIPDOFFIREPREVF11t1'ilDilVRBGVLAMM527CoRla•� 3 Fees Checked �•�+ now A.PPIUCA77ONFOR PE WTO PERFORM ELECTRICAL WORK Ail.WORK To BE PERFORMED IN ACCORDANCE WTM THE MASSACHUSSTS ELECTRICAL CODE,527 CMB 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street h Number) SE P AQ W00 b -!�'T '�? 7 dP,(,o'-? DO Owner or Tenant 1 =L.L. Owner's Address. Is this permit in conjunction with a building permit: Yes[n No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 0 Amp@J1LL1%L.VoIts OverheadUnderpound a No.of Meters New Service Amps..../ Volta Overhead Underpound Q No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outfits No.of Hot Tubs No.Of Trz rl Tow No.of Ligbthtg Rumse Swimming Pod" Above Bebw KVA rd � KVA No.of Ou" No.of 08 Buse �°�M No.of ERICrgeoey Lighting Battery Units No.of Switch outlets No.of Des Borneo No,of Ranges No.of Air Cord. TOW FIRE ALARMS No.of zoom Toes No.of Dispasis Na of Het Total TOW No.of Datxdios sod Panys Ton KW Initialing Devices ••� No.of Dishwashers Space Amer Heating Kill N0.of Somdittg Devices NO.of stir Canubnd �• Detecti Devicep No.of Dryee Hating Device KW LoaOthw MwdcipdNo.of water Haters Kw Na Of No,of Connections Sims Bdiasi No.Hydro Mausp Tubs No.of Motors Total HP huff G?AVV I OOMWIAN Iha►eaa=tLsd*Ju==FbiymckdngCbr>p* cdit ubettitlqiWst YMIhtnes*rr>�edvaldp>�ds>rnebfeOmm Y$9 )ryouhnedniotdYB4,pkraeidMNO he4F0f A UIC4� BCM ams ED �1b Z'.. �� I FseQieledVai�of�ic ll Wakb�WFRtnftsofpq* � S;VrWJZ RRMNANZ LioalteNin Lo3ttst ee J-.Cil!t C �� b Lim=Nb Zn A &*=X rn ALTel.No, GWI,MSMRAN EW •IamawaeindzLicasdmmg dria==cDvwVOr62bWWe�iv�t����, fi>s�GerniilLavrt ardt1vtov iBmmon appic:dQt direquiut (P ! k one) Apo 20 71 FTelephone No. q nu 0( - BRA,FEE � 6:wr'Ifc ✓ lam a , r , 1 i