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Miscellaneous - 667 FOREST STREET 4/30/2018
667 FOREST STREET 210/105.D-0020-0000.0 Date.�.D.. . . .1. � ......... �F NORrh TOWN OF NORTH ANDOVER 9 PERMIT FOR WIRING gSACMUs� 1 This certifies that .. �Q'J..... has permission to perform .. Q.-Q:Cs,,�, , j . ................................................................ wiringin.the building of............................................................................................................... at .........................................................................................................North Andover,Mass. Fee.... 15^ :.......Llc.No. U.3, ... ELECTRICAL INSPECTOR s Check# '2757 k A _ { �'°'� C�a►nnrwreTuea�Iiz o�Illaaalt�taa Official Use Only �s Permit No. I� - -_ �a�oar�iuuzE o��ira Jarvica� Occupancy and free Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the h1assachusetts Electrical Code(MEC),527 CMR 12'.00 (PLEASE PRINT IN INK OR TYPE ALL IA'FORMATION) Date: 16 -Fy I City or Town of: A JgEL h Wpaou e r- 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) (e1 Owner or Tenant 2 Q I 1 G t o Telephone No.4_2�-GIS&-41/l r Owner's Address Is this permit in conjunction with a building permit? Ves ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No, Existing Service Amps / Volts Overhead ❑ Ilndgrd❑ No.of Meters New Senice Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work, Install Solar Electric - Photovoltaic (PV) system _panels rated fq. JA kW (cD STC Grid Tied In conjunction with a Building Permit Cam Icdont of the ollotrin table nnay be traired by the Inspector of/fires. �— No. of Recessed Luminaires No.of Ceil.••Susp.(Paddle)Fans No.of Total Transformers KVA -- _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ n- E] No.of Emergency Lighting rnd. grnd. BatteKy Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners e.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tags Tl No.of Alerting Devices Na.of Waste Disposers Hist P11mp umber 'I'oas K o.of elf ontained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating Iii' Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW ecarity ystems: No.of Devices or Eguivalent No.o aterKW o. of o.o Data Wiring: Heaters Signs Ballasts No,of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total RP Telecommunications Wiring: No.of Devices or E uivalent OTHER: Abash additional detail if desir ed,or as required by,the Inspector of(fires. Estimated Value of Electrical Work: �0 Od (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. CHECK ONE: INSURANCE © BOND ❑ OTHER ❑ (Specify:) ' I certifj,,under thepains andpenalties ofperjuty,that the htfortnatiou on this application is true and complete FIRM NAME: SOLARCITY CORPORATION LIC,NO,:1136MR Licensee: MATTHEW T.MARKHAM Signature LIC.NO.:1136MR (If applicable. enter"exempt"in the license nimlber line) Bus.Tel. No.-1115"180 Address: 24 ST MARTIN oRIVE(BUI DING'2.UNff 11)MARLBOROUGH.MA 01752 Alt,Tel.No.:774-258.8505 *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: l am aware that the Licensee doer not hate the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement_ I am the(check one)Ej owner ❑owner's agent Owner/Agent i Signature Telephone No, f PERMIT FEE.' $ i2 4 t, �- i Office ofConsumer Af*fc�ii. �illd Business Rcgulatlon 1 10 Park Plaza 4 Suite 5170 Boston, MassachLISOS 02) 116 f lomc Improvement Contractor Registration Registration: 168572 Type: Supplement Card Expiration: 318!2017 SOLAR CITY CORPORATION MATT MARKHAM 3055 CLEARVIEW WAY SAN MATEO, CA 94402 Update Address and return card-Mark reason for change. Address Renewal Employment Lost Gard F .."q's' �riM/W+hw.r'•f(fle ,'` 7/fly.w+�rilysl . Office of(.sumer A f1'rilri A 1lusinewt Rriluin ifm License or registration valid for individul use ooly ' HOME IMPROVEMENT CONTRACTOR before the expiration hate. if found return to: 1 ` Office of Consumer Affairs and Business Reetilation Rogistration: 168572 Typo= 10 Park Pla m-Suite 5174 I_xttiralion: 7;2u7 Supplement Card Roston.11A Q116 SOAR C1i f CP TIQRI+iiJi': MATT NIARI<tW S 24 ST MARTIN S1 RLL 13LU 2UN6 UALBOROUGIi.Mj\01752 Ml�ndcrsecretar� Not valid without sigat,atttre E[,1><CTRECtAliS ISSULS THt, FOLLOWING LICENSE AS A\ RIG I STERIED MASTER EUCTR I C I AN `r . TY CDRPORA1ION aJi.AEtC# t1ATTHLW T MARKHAM 114 SAINT MARTIN OR SLOG, 2 t1NI'I 11 h0l,BOROUGH MA 01752-qo6o I �NA ' Tke Coninwnwealth of fassachusevs Department of IndastrialAccidents Ogee of Ins esdgations kv I Congress&ree4 Suite 100 Boston,MA 021-14-2017 ilritow.mzs gov1dt',a Workers'Compensation Insurance Aftlavih Branders/ContractorslElectricisns/Plumbers A Iic nt Information Please Paint Le ib Nametausincseorgwzotiontindividualj: SolarCit Corp. Address: 3055 Clearview Way C%ty/State/Zip: San Mateo CA. 94402 Phone 1: 888-765-2489 Are you an employer?Check the appropriate box: Type of project(requited): 1.0 am o employer with 5,000 4. © I ata a general contractor and I employacs(full and/or part-ftme).*)une have hirt:d the sub-contractors 5. ❑Now construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling .ship and have no employees Those sub-contractors have yt� a. 0 DCtitolitiot] working for me in any capacity. employees and have workers' 9. Wdition [No workers' comp.insurance comp.insurance? ❑Building required.[ 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their I I 3. 1 am a ltorttt:atfimer dot all work Plumbingairs or additions S't-1L i7f G]CCDT-11i11i pox 1`+nfzL � :aybelf. [No workere comp. r P po I2.E]hoof repairs insurance requimd.)t c. 152,§1(4),and we have no employees. [No workers' 13�htr Solar/PV eomp. insurance required.] `Any applicant that cheeks box N t most also&U out the section below showing their wockgo,compeoaation polity intarmeton. I Homeowners who submitthis affidavit imticatingfty are dicing all work nod ftn hircoutsittc contractors mast submit a new atrWevit ladicatingsuch, tContmaors that duck this hox mug mtached art addWond shat showing the nme of the sub-cantractors and state whether or not those entities have unployt rAs. If the sttb-contractors have amployan,they must provide their workers'comp policy number. J'afn an employer that isprovWing workers'Compensation insurance for my eniployees. Below is tl:epolicy and job site information. Imut'amCompanyName. Zurich American Insurance Company Policy 9 or Selr4ns.Lic.#: WC0182015-00 Expiration Date: 9/1/2016 Job Site Address:--A7 R"5f7 OV/State/zip:AJ Qr4-h RM(.QM r' Attach a copy of the workers)compensation poCay declaration page(showing the polity number and expiration date). Fa=ilure to secure coverage as rcquired corder Section 25A of MGL c. 152 can lead to the imposition of edninal penalties of a fine up to S 1,500.00 andlar one-year imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a fine of ton to$250.00-a day against the violator. fle advised that a copy of this statement maybe forwartted.to the Office of Investigations of the DIA fin'insurance coverage verification. X do hereby certify under the pains anidpenaltles ofperjary that Ilse tufor madden provided above is true and correct st hire: l�tt; - 87 l`� Phone Offidd: r oz* Leo not wrka i:r tkis area,to be crrnlpletr.d by city or tory.offssdal. City or Town: Permi0 icense li Issuing Authority(cit-de ane): I.Beard of Health 2.Building Departnicat 3.City/Town Clerk 4.ElectricalInspector S.Plow"Inspector 6. 4ther Contact Person: Phone N; AC4t7R17� DATE(MMtDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 0 i7r4iq. 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 poticy(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). CONTA T PRODUCER MARSH RISK 8 INSURANCE SERVICESA!U --.......... .... ._... ... ._.-........ . .. . . ... .. --. .._. PHONE •PAX 345 CALIFORNIA STREET,SUITE 1300 AZC.tiQ.J"xt);.........__.... ...... .. ... ... ..... . . ...... . L/!!e,N?I:.......... ._...... ..........._..... CALIFORNIA LICENSE N0.0437153 rm'MAIL SAN FRANCISCO,CA 94104 _apos?Fss:. ..... .... ....... ... ...... .. .......... .... ........... ................ .._.T..........._._...... - Attn:Shamlon Scott 415 743 8334 _. . .........INSURERS]AFFORDING COVERAciE.. ... - .. ._ ... -.._ NAIC# 998301 STND•GAWUE-15.16 INSURER A:Zurich Arnarican Insurance Company 115535 INSURED INSURER 0:NIANIA SohdrClly Corprnahon INSURER C.:.NIA INA 3055 Clearview Way _ .-... ._........_'..-....._._ ..... ......_...... + ._ ..... ..... .. .... San Mateo,CA 94402 INSURER n:American Zurich Insurance Company '40142 INSURER E•:... ......... . INSURER F: 1 COVERAGES CERTIFICATE NUMBER: SEA-002713836.08 REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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. R -'TYPE OP INSURANCE L B T POLICY NUMBER I MWDCDI YYY ' DI YYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY 1131.00182018-00 00112015 :0910U2018 EACH OCCURRENCE $ 3,00a,aaa X i :DAMAGE 7 Q RENTED 3,0OO,000 CLAIMS-MADE f l OCCUR X SIR:$250,000 I F MED ERP(Arty oneperson),,,,. S -..__ ..._..._......__._.._... .._. PERSONAL&ADVINJUR S Y 3,000,OOa GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE g 6,000,000 PRO. r..., 1 :--. ..... X 1 POLICY IJECT i. ...:LOC PRODUCTS•COMPIOA AGG :S 6000,000 i OTHER S A AUTOMOBILE LIABILITY VAP0182017A :0910111015 0910112016 COMBINED SINGLE LIMIT $ 5,000,000 r ,.IEa 1!11........... . ... ..: ..... .. .... ..- -.._ X ANY AUTO BODILY INJURY(Per person) $ v ALL OWNEDSCHEDULED X �X i BODILY INJURY(Per accident);S F.. AUTOS �_..._..-.-.....__. . ...._... .... .,.......... ._ .. ,AUTO NDN OWNED PROPERTY DAMAGE x, HIRED AUTOS X AUTOS F(Peracc(dent). .... . _... _...-+5 . f.... COMPICOLL DED: :$ $5,000 UMBRELLA LIAR : ( `EACH OCCURRENCE $ F_... OCCUR r. .._. _... — +. ..._... EXCESS LIAB :CLAIMS-MADE! AGGREGATE $ DED :RETENTIONS I S D ;WORKERS COMPENSATION ?WC01820140(AOS) 0910112015 0910112016 i X PER OTH• i :AND EMPLOYERS'LIABILITY F...-..i STAME.,......i .....F... _. A : Y I N` -"1820154(MA) :09101IM15 ;09/01/1016 ,ANY PROP RIETORIPARTNERIEXECUTWE E.L EH ACCIDENT 5 1.000,000 OFFICEWMEb18ER EXCLUDED? �:N I A I r - -ACi000 000 (Mandatory in NH) WE)}EDU(:f IBLE: :� 1 E.L DISEASE-EA EMPLOYE 'S HYes, descnbe under i ' _._. .. DESCRIPTION OF OPERATIONS below E L DISE.-ASE-POLICY LIMIT 1 S 1.000,000 i DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Evidence of insurance. CERTIFICATE HOLDER CANCELLATION Sow ity cowaf'ron SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3655 CleaMew Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN San Mateo,CA 99402 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk&Insurance Services Charles Man=lejo ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD - , ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID—INTERTIED VIA A AC ALTERNATING CURRENT UL—LISTED POWER—CONDITIONING INVERTER. BLDG BUILDING 2. .THIS SYSTEM HAS NO BATTERIES, NO UPS. CONIC CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING DC DIRECT CURRENT LABORATORY SHALL LIST ALL EQUIPMENT IN EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. (E) EXISTING 4. WHERE ALL TERMINALS OF THE DISCONNECTING EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE GALV GALVANIZED HAZARDS PER ART. 690.17. GEC GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY HDG HOT DIPPED GALVANIZED PHASE AND SYSTEM PER ART. 210.5. I CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(B). Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER kVA KILOVOLT AMPERE BUILDING OR ARE RUN IN METALLIC RACEWAYS OR kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAIN (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY NEUT NEUTRAL UL LISTING. NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE PL PROPERTY LINE MANUFACTURER USING UL LISTED GROUNDING POI POINT OF INTERCONNECTION HARDWARE. PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. S STAINLESS STEEL STC STANDARD TESTING CONDITIONS TYP TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT VOLTAGE AT MAX V cp VOLTAGE AT OPENPOWER CIIRCUIT VICINITY MAP INDEX W WATT 3R NEMA 3R, RAINTIGHT PV1 COVER SHEET PV2 SITE PLAN PV3 STRUCTURAL VIEWS PV4 UPLIFT CALCULATIONS LICENSE GENERAL NOTES _ PV5 THREE LINE DIAGRAM Cutsheets Attached. GEN #168572 1. ALL WORK TO BE DONE TO THE 8TH EDITION, ELEC 1136 MR OF THE MA STATE BUILDING CODE. 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE INCLUDING MASSACHUSETTS AMENDMENTS. MODULE GROUNDING METHOD: AHJ: North Andover REV BY DATE COMMENTS REV A NAME DATE COMMENTS r UTILITY: National Grid USA (Massachusetts Electric) CONFIDENTIAL — THE INFORMATION HEREIN JOB NUMBER: -0182701 PREMISE OWNER: DESCRIPTION: DESIGN: J B-018 2 7 01 0 0 CONTAINED SHALL NOT USED FOR THE PALLADINO, JOSEPH PALLADINO RESIDENCE Bertha Paz -- =SolarCity. PART TO OTHERS OUTSIDE THE RECIPIENT'BENEFIT OF ANYONE EXCEPT SOLARCITY INC., . �.,, NOR SHALL IT BE DISCLOSED IN WHOLE ' MOUNTING SYSTEM:IN Comp Mount Type C 667 FOREST ST 9.69 KW PV ARRAY ►r S ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES: NORTH ANDOVER, MA 01845 TMK OWNER: THE SALE AND USE OF THE RESPECTIVE (38) TRINA SOLAR # TSM-255PDO5.18 AR MM * z4 St. Martin o�I�,Building 2,unit tt SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: RVAI N: PAGE NAME: SHEET: REV: DATE 52 T: (650)838-1028 F:A(617 638-1029 PERMISSION OF SOLARCITY INC. SOLAREDGE SE760OA—US002SNR2 9786884115 COVER SHEET PV 1 9/29/2015 (Bea)—SOL—CITY(765-2489) ,w,.soIo«I►ycom PITCH: 38 ARRAY PITCH:38 MP1 AZIMUTH:228 ARRAY AZIMUTH: 228 P� F MATERIAL: Comp Shingle STORY: 2 Stories PITCH: 22 ARRAY PITCH:22 MP2 AZIMUTH: 228 ARRAY AZIMUTH: 228 RIUKi MATERIAL: Comp Shingle STORY: 2 Stories O ST UCTURAL U Front Of House No,51933o �FGISTE��C� ssrorvAt.� STAMPED & SIGNED FOR STRUCTURAL ONLY Digitally signed by Humphrey Kariuki AC AC Date: 2015.09.30 L—=J 0 07:45:50 -04'00' LEGEND — ' \ D (E) UTILITY METER & WARNING LABEL INVERTER W/ INTEGRATED DC DISCO Inv ,' InS & WARNING LABELS FDC DC DISCONNECT & WARNING LABELS AC DISCONNECT & WARNING LABELS - MP1 DC JUNCTION/COMBINER BOX & LABELS DISTRIBUTION PANEL & LABELS ® ® Lc LOAD CENTER & WARNING LABELS o O DEDICATED PV SYSTEM METER Mpg Q STANDOFF LOCATIONS A —•i CONDUIT RUN ON. EXTERIOR --- CONDUIT RUN ON INTERIOR 6 GATE/FENCE Q HEAT PRODUCING VENTS ARE RED INTERIOR EQUIPMENT IS DASHED L--'J SITE PLAN Scale: 1/8" = 1' 0 1' 8' 16' PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL HA THE INFORMATION HEREIN NUMBER: JB-0182701 00 PALLADINO, JOSEPH PALLADINO RESIDENCE �``' SO'af��t CONTAINED SHALL NOT BEUSEDFOR THE Bertha Paz '! BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 9.69 KW PV ARRAY �0, 667 FOREST ST rr PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES NORTH ANDOVER M A 01845 ORGANIZATION, EXCEPT IN CONNECTION WITH , 24 St. Martin Drive, Building 2, Unit 11 THE SALE AND USE OF THE RESPECTIVE (38) TRINA SOLAR # TSM-255PD05.18 SHEET: REV: DATE: Marlborough,MA 01752 ''SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME: T: (650)638-1028 F: (650) 638-1029 �. PERMISSIONbOF SOLARCITY INC. SOLAREDGE # SE760OA–US002SNR2 9786884115 SITE PLAN PV 2 9/29/2015 (888)-SOL-CITY(765-2489) www.soiarcitv.com S1 S 1 8' 00, (E) LBW 4" '°'-3" SIDE VIEW OF MP2 NTs (E) LBW 6 SIDE VIEW OF MP1 NTS A M P2 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES MP1 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES LANDSCAPE 64" 23" STAGGERED LANDSCAPE 64" 24" 1 STAGGERED PORTRAIT 32" 15511 PORTRAIT 48" 19" 1 ROOF AZI 228 PITCH 22 ROOF AZI 228 PITCH 38 RAFTER 2X6 @ 16" OC ARRAY AZI 228 PITCH 22 STORIES: 2 RAFTER 2x8 @ 16 OC ARRAY AZI 228 PITCH 38 STORIES: 2 C.J. 2X6 @16 OC Comp Shingle C.). 2x6 @16" OC Comp Shingle F. PV MODULE 5/16" BOLT WITH LOCK INSTALLATION ORDER o2 K. & FENDER WASHERS LOCATE RAFTER, MARK HOLE 0 ST UCTURAL. ZEP LEVELING FOOT (1) LOCATION, AND DRILL PILOT .Q NO.51933 ZEP ARRAY SKIRT (6) HOLE. crams (4) C(2 SEAL PILOT HOLE WITH ZEP COMP MOUNT C POLYURETHANE SEALANT. STAMPED & SIGNED ZEP FLASHING C (3) (3) INSERT FLASHING. FOR STRUCTURAL ONLY (E) COMP. SHINGLE (1) (4) PLACE MOUNT. - - (E) ROOF DECKING (2) INSTALL LAG BOLT WITH 5/16" DIA STAINLESS (5) (5) SEALING WASHER. STEEL LAG BOLT LOWEST MODULE SUBSEQUENT MODULES INSTALL LEVELING FOOT WITH WITH SEALING WASHER (6) BOLT & WASHERS. (2-1/2" EMBED, MIN) (E) RAFTER STANDOFF PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL A THE INFORMATION HEREIN NUMBER: JB-0182701 00 PALLADINO, JOSEPH PALLADINO RESIDENCE CONTAINED SHALL NOT E USED FOR THE Bertha Paz SolarCity. BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 667 FOREST ST 9.69 KW PV ARRAY '►�� PART TO OTHERS OUTSIDE THE RECIPIENT'S ORGANIZATION, MODULES NORTH ANDOVER MA 01845 THEALE AND SE OF INCONNECTION RESP CTIVE�TM (38) TRINA SOLAR # TSM-255PD05.18 9 24 St. Martin Drive, Building 2, Unit 11 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME: SHEET: REV: DATE: Marlborough, MA 01752 PERMISSION OF SOLARCITY INC. [INVERTER: T. (650)638-1028 F: (650) 638-1029 SOLAREDGE SE7600A-US002SNR2 9786884115 STRUCTURAL VIEWS PV 3 9/29/2015 (aBBrs�-aTY(765-2489) www.salaraity.cam UPLIFT CALCULATIONS - i SEE SEPARATE PACKET FOR STRUCTURAL .CALCULATIONS. I i PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL — THE INFORMATION HEREIN JOB NUMBER: JB-01 82701 00 . CONTAINED SHALL NOT BE USED FOR THE PALLADINO, JOSEPH PALLADINO RESIDENCE Bertha Paz �:,,SolarCity. BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 667 FOREST ST 9.69 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS ODULES NORTH ANDOVER MA 01845 ORGANIZATION, EXCEPT IN CONNECTION WITH24 St. Martin Drive, Building 2, Unit 11 THE SALE AND USE OF THE RESPECTIVE (38) TRINA SOLAR # TSM-255PD05.18 SHEET: REV: DATE: Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME: T. (650)'638-1028 F. (650) 636-1029 i PERMISSION OF SOLARCITY INC. 11SOLAREDGE NVERTER: 978688411 5 PV 4 9/29/2015 (888)—SOL—CITY(765-2489) www.solarcity.com SE760OA—US002SNR2 UPLIFT CALCULATIONS s - GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS MODULE SPECS LICENSE BOND (N) #8 GEC TO TWO (N) GROUND Panel Number: Inv 1: DC Ungrounded INV 1 -(1)SOLAREDGE ## SE7600A-USO02SNR LABEL: A -(38)TRINA SOLAR ## TSM-255PDO5.18 GEN #168572 ODS AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:12806885 Tie-In: Supply Side Connection Inverter; 760OW, 240V, 97.57.; w/Unifed Disco and ZB, RGM, AFCI PV Module; 255W, 232.2W. PTC, 40MM, Black Frame, H4, ZEP, 1000V ELEC 1136 MR Underground Service Entrance INV 2 Voc: 38.1 Vpmax: 30.5 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 200A MAIN SERVICE PANEL E� 20OA/2P MAIN CIRCUIT BREAKER (E) WIRING CUTLER-HAMMER Inverter 1 Disconnect CUTLER-HAMMER 200A/2P 4 Disconnect 3 SOLAREDGE - - - - A 40A SE760OA-US002SNR2 MPT: 1x19 B0 Z -- -------- ------------+G --------- ------ A L1 -------------- B L2I I DC+ I I N DG I 2 I (E) LOADS GND - ---- GND ------------------------- - EGCI --- DC+ 13 13) GEC N DC, C MP1,MP2: 1x19 EGC--- --------------------- ------------- G N (1)Conduit Kit; 3/4' EMT _ -J o EGGGEC_ z � � I I I I - GEC-r- 1 - TO 120/240V SINGLE PHASE I I UTILITY SERVICE I I I I I I I I I PHOTO VOLTAIC SYSTEM EQUIPPED WITH RAPID SHUTDOWN Voc* = MAX VOC AT MIN TEMP P0 (2)Groygd Rod A (1)CURER-HAMMER bG222NRB �� PV (38)SOLAREDGE Soo-2NA4AZS D� 5 8 x B, Co per Disconnect; 60A, 24OVoc, Fusible, NEMA 3R PowerBox Optimizer, 300W, H4, DC to DC, ZEP -(2)ILSCO !IPC 4�0-#6 -(1)CUTLER-�IAMMER /! DG100NB Insula{ion Piercing Connector; Main 4/0-4, Tap 6-14 Ground eutral Kit; 60-100A, General Duty(DG) nd (1)AWG #6, Solid Bore Copper S SUPPLY SIDE CONNECTION. DISCONNECTING MEANS SHALL BE SUITABLE -(1)CClassRR FuseEKit# DS16FK -(1)Ground Rod; 5/8' x 8% Copper AS SERVICE EQUIPMENT AND SHALL BE RATED PER NEC. -(2)FERRAZ SHAWMUT# TR40R PV BACKFEED OCP N ARRAY GROUND PER 690.47(D). NOTE: PER EXCEPTION NO. 2, ADDITIONAL Fuse; 40A, 250V, Class RK5 ( ) B (1)CUTLER-HAMMER #DG222URB ELECTRODE MAY NOT BE REQUIRED DEPENDING ON LOCATION OF (E) ELECTRODE Disconnect; 60A, 24OVac, Non-Fusible, NEMA 3R -(1)CUTLER-�iAMMER #DG10ONB Ground/Neutral Kit; 60-100A, General Duty(DG) 1 AWG /6, THWN-2; Black 1 AWG #8, THWN-2, Black (2)AWG #10, PV Wire, 60OV, Black Voc* =500 VDC Isc =15 ADC ® (1)AWG 16, THWN-2, Red O IgF(1)AWG #8, THWN-2, Red O co (1)AWG #6, Solid Bare Copper EGC Vmp =350 VDC Imp=13.66 ADC (1 AWG /6, THWN-2, White NEUTRAL Vmp =240 VAC Imp=32 AAC (1)AWG #10, THWN-2, White NEUTRAL Vmp =240 VAC Imp=32 AAC (1 Conduit Kit; 3/4' EMT -(1 AWG - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . #6,,Solid Bare.Copper. GEC. . . , . (1)Conduit.Kit;.3/47 EMT. . . . . . . . . . . . . . . . .-(1)AWG #8,.TFIWN-2,.Green _ . EGC/GEC.-(1)Conduit.Kit;,3/4'.EMT. . . . . . . (2 AWG #10, PV Wire, 60OV, Block Voc* =500 VDC Isc .15 ADC O (1)AWG #6, Solid Bore Copper EGC Vmp =350 VDC Imp=13.66 ADC (1)Conduit Kit;.3/4' EMT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PREMISE OWNER: DESCRIPTION: DESIGN: . CONFIDENTIAL - THE INFORMATION HEREIN l06 NUMBER: JB-01 82701 00 PALLADINO, JOSEPH PALLADINO RESIDENCE � t, I I CONTAINED SHALL NOT E USED FOR THE Bertha Paz CO �� BENEFIT OF ANYONE EXCEPT SOLARCIIY INC., MOUNTING SYSTEM: �.��J NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Comp Mount Type C 667 FOREST ST 9.69 KW PV ARRAY ►�� PART OTHERS OUTSIDE THE RECIPIENTS MODULES NORTH ANDOVER MA 01845 ORGANIZIZAl10N, EXCEPT IN CONNECTION WITH , 24 St. Martin Drive,Building 2,Unit 11 THE SALE AND USE OF THE RESPECTIVE (38) TRINA SOLAR # TSM-255PDO5.18 SHEET: REV: DATE Marlborough,MA 01752 SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME T: (650)638-1028 F: (617 638-1029 PERMISSION OF SOLARCFlY INC. SOLAREDGE sE760oA-us002SNR2. 9786884115 THREE LINE DIAGRAM PV 5 9/29/2015 (868)-SOL-CITY(765-2489) www.solarcity.com CAUTION POWER TO THIS BUILDING IS ALSO SUPPLIED FROM THE FOLLOWING SOURCES WITH DISCONNECTS LOCATED AS SHOWN: - Address: 667 Forest St AC DISCONNECT AC DISCONNECT -------------- --- -- ---, TILITY SERVICE INVERTER AND DC DISCONNECT r--------------------------� SOLAR PHOTOVOLTAIC ARRAYS) l L-------------------------- PHOTOVOLTAIC -------------------- —PHOTOVOLTAIC BACK—FED CIRCUIT BREAKER IN MAIN ELECTRICAL PANEL IS AN A/C DISCONNECT PER NEC 690.17 OPERATING VOLTAGE = 240V JB-0182701-00 JB018 2 7 01 0 0 PREMISE OWNER: DESCRIPTION: DESIGN: CONFIDENTIAL — THE INFORMATION HEREIN JOB NUMBER: ���� CONTAINED SHALL N �;SO�af Ci OT BE USED FOR THE PALLADINO, JOSEPH PALLADINO RESIDENCE Bertha Paz .� ty BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: � NOR SHALL IT BE DISCLOSED IN WHOLE OR IN Com Mount Type C 667 FOREST ST 9.69 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENT'S MODULES NORTH ANDOVER MA 01845 ORGANIZATION, EXCEPT IN CONNECTION WITH , 24 St. Martin Drive, Building 2, Unit 11 THE SALE AND USE OF THE RESPECTIVE (38) TRINA SOLAR # TSM-255PDO5.18 SHEET: REV: DATE: Marlborough,MA 01752 SOLARCIIY EQUIPMENT, WITHOUT THE WRITTEN PAGE NAME' T: (650) 638-1028 F. (650)638-1029 PERMISSION OF SOLARCITY INC. INVERTER: SOLAREDGE SE760OA—US002SNR2 9786884115 SITE PLAN PLACARD PV 9/29/2015 c666>-SOL—CITY(765-2469) N,rv,.solaraitycam Label Location: . _ Label Location: I Label Location: (C)(CB) © _. (AC)(POI) ® (DC) (INV) Per Code: ° Per Code: • ._ Per Code: NEC 690.31.G.3 n o ® _ NEC 690.17.E e ° ® ®_ ® ® NEC 690.35(F) Label Location: - • o o • ° - • • • •- TO BE USED WHEN � Chi= �M • ® (DC) (INV) ° ° ° ' o'� :° ° ' • ® INVERTER IS • Per Code: UNGROUNDED NEC 690.14.C.2 Label Location: Label Location: - ° • ° -° ° (POI) -• - (DC) (INV) ,_ • ° o ® Per Code: -o Per NEC 690.17.4• NEC 690.54 e Code: .-. ,e ® e , ® NEC 690.53 • Label Location: •' • ' ® (DC) (INV) _ Per Code: ® ° • NEC 690.5(C) °- "• ® ® Label Location: -• . . • ® . • (POI) • -• _• Per Code: ® ® ® NEC 690.64.B.4 Label Location: ® (DC) (CB) Per Code: j{ Label Location: .• • • NEC 690.17(4) (D) (POI) • =° ° Per Code: •.° ® - ® - • e • • NEC 690.64.B.4 Label Location: ® (POI) _ Per Code: Label Location: ® • ®- NEC 690.64.B.7 • • • ' • (AC) (POI) •e • - • (AC): AC Disconnect ® Per Code: °� - (C): Conduit NEC 690.14.C.2 (CB): Combiner Box (D): Distribution Panel (DC): DC Disconnect (IC): Interior Run Conduit Label Location: (INV): Inverter With Integrated DC Disconnect (AC) (POI) •• � Per Code: (LC): Load Center (M): Utility Meter NEC 690.54 (POI): Point of Interconnection CONFIDENTIAL — THE INFORMATION HEREIN CONTAINED SHALL NOT BE USED FOR `����tj 3055 gearview Way THE BENEFIT OF ANYONE EXCEPT SOLARCITY INC., NOR MALL IT BE DISCLOSED San Mateo, ie 94402 IN WHOLE OR IN PART TO OTHERS OUTSIDE THE RECIPIENT'S ORGANIZATION, Label Set T:(650)638-1028 F:(650)638-1029 �.u` EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE ASOlarCit (888)-SOL-CITY(765-2489)www.solarcity.com SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN PERMISSION OF SOLARCITY INC. o ,r. `� . ''^SOlafClty I ®pSOlar Next-Level PV Mounting Technology 'kSOIafCity ®pSolar Next-Level PV Mounting Technology Zep SystemComponents for composition shingle roofs I. "Z,-Up-roof- �w cw Ground Zep Intertock I 4eHee(ng coat �'1, - Y Zep Compatible PV Module i .�.... ..» ZepGroo a ,.. - - Roof Attachment Array Sklrt N Description SFA PV PV mounting solution for composition shingle roofs c 11e Works with all Zep Compatible Modules 0 PP M • Auto bonding UL-listed hardware creates structual and electrical bond • Zep System has a UL 1703 Class"A"Fire Rating when installed using U� Comp Mount Interlock Leveling Foot LISTED modules from any manufacturer certified as"Type 1"or"Type 2" Part No.850-1382 Part No.850-1388 Part No.850-1397 Listed to UL 2582& Listed to UL 2703 Listed to UL 2703 Specifications Mounting Block to UL 2703 Designed for pitched roofs 7-- .. Installs in portrait and landscape orientations • Zep System supports module wind uplift and snow load pressures to 50 psf per UL 1703 • Wind tunnel report to ASCE 7-05 and 7-10 standards • Zep System grounding products are UL listed to UL 2703 and ETL listed to UL 467 Zep System bonding products are UL listed to UL 2703 Engineered for spans up to 72"and cantilevers up to 24" • Zep wire management products listed to UL 1565 for wire positioning devices Ground Zep Array Skirt,Grip,End Caps DC Wire Clip • Attachment method UL listed to UL 2582 for Wind Driven Rain Part No.850-1172 Part Nos.500-0113, Part No.850-1448 Listed to UL 2703 and 850-1421,850-1460, Listed UL 1565 ETL listed to UL 467 850-1467 zepsolar.com zepsolar.com Listed to UL 2703 his documen does no crea a any express warran y by Zep Solar or abou i s produc s or services.Zep Solar's sole warran y is con ained in he wri an produc warren y for This document does not create any express warranty by Zap Solar or about its products or services.Zap Solar's sole warranty is contained in the written product warranty for each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely each product.The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solely responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. responsible for verifying the suitability of Zep Solar's products for each use.Specifications are subject to change without notice.Patents and Apps:zspats.com. 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf Page: 1 of 2 02 27 15 ZS for Comp Shingle Cutsheet Rev 04.pdf Page: 2 of 2 T solar ' ® P solar=@0SolarEdge Power Optimizer Module Add-On for North America P300 / P350 / P400 SolarEdge Power Optimizer ..... __.. _ . ...... 1 P300 P350 P400 Module Add-On For North America (for 60-cell PV (for 72-cell PV (for 96-cell PV - modules) modules) modules] _ P300 / P350 / P400 ® INPUT -:. Rated Input DCPowerO) 300 350 7 400 W r Absolute Maximum Input Voltage(Voc at lowest temperature) 48 I 60 80 Vdc :, I',I III !� MPPT Operating Range 8 488-60 8 80 Vdc 1 Maximum Short Circuit Current(Isc)............................ ..... ........... 30 ..............................I Adc Maximum DC Input Current 12.5 Adc ... .I..... ........ .. ..........................I....... ............ ..... Maximum Efficien - 99.5 % n....................................................L........... Weighted Effiaency ..98:8...... .................... % . .... ... ............ ......... .. ..... .Overvoltage Category 1 II _OUTPUT DURING OPERAT_I.O__N(POWER OPTIMIZER CONNECTED TO OPERATING INVERTER) _ Maximum Output Current 15 Adc - ,_.; Maximum Output Voltage .-1 60 Vdc OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) x os - >. _Safety Output Voltage per Power Optimizer 1 . Vdc STANDARD COMPLIANCE _ _ 7 FCC Part15 Class B IEC63000 6 2 IEC 61000 6 3 Safety �„r .. ... .. .. ............. .......... .. .. .... RoHS Yes ,. INSTALLATION SPECIFICATIONS _ > - r ,,„ 3, -�, Maximum Allowed System Voltage 1000 Vdc t ..... ..... ..................................... .. ....:....... .... ... ........ .... . Dimensions x L x H) 141x212x40.5/S.SSx834x159 mm/m ............... .. ., ...................... ............. .. .. ............... ..................... Weight(including cables) 950/2.1 ....................I....... gr/Ib___ Input Connector MC4/Amphenol/Tyco ' �. :�� Output Wire Type/Connector Double Insulated;Amphenol - v .. .. - ................ ................. -� Output Wire Length 0.95/3.0 j 12/3.9 m/ft - .................................... .... .. ........................ .................... .. Operating Temperature Range......................................i.,............... ....-40 +85/-40 +185......................... 'C/'F .. ..... Protection Rating _ IP65/NEMA4 -w ......................................... .. ......... .. .... ... .... .. ..... ................................. .... Relative ...........0.1.00.. ............... ...... % .... - �'�Rated sT<power of the module.Module pf up to power tolerance allowed. PV SYSTEM DESIGN USING A SOLAREDGE - - --THREE PHASE - THREE PHASE SINGLE PHASE `• - - "INVERTER _ 208V _4_80V — ......t PV power optimization at the module-level Minimum String Length(Power Optimizers) � 8 10 - ' .. ... . .nth( ... ...... .. .... .. ... ..... .... Up t0 25%more energy Mawmum Stnng Length(Power Optimizers) 25 25 50 Maximum Power per String5250 6000 12750 W 4 Superior efficiency(99.5%) ........ ........... I ......... [ Parallel Strings of Different Lengths or Orientations Yes Mitigates all types of module mismatch losses,from manufacturing tolerance to partial shading [ ""•""' ..... ......... .......... -- ........ ........ ....................................... Flexible system design for maximum space utilization Fast Installation with a single bolt Next generation maintenance with module-level monitoring Module-level voltage shutdown for installer and firefighter safety USA GERMANY ITALY -' FRANCE JAPAN - CHINA ISRAEL - AUSTRALIA www.solaredge.us THE Irreammount MODULE TSM-PD05.18 Mono Multi Solutions ---.._._........_...._........_.__........... ..........................._ _._..._._._.. _._._......_._ _.....__......_._.._.._...... ---........... -_.._..._._.__... DIMENSIONS OF PV MODULE ELECTRICAL DATA @ STC unit:mm Peak Power watts-P.-(Wp) 245 250 255 260 941 i Power Output Tolerance-PMnx(%) 0-+3 -" THEm�� o N M Maximum Power Voltage-VMP(V) 29,9 30.3 30,5 30.6 u O UNC ION O wa Maximum Power Current-IMrr(A): 8.20 8.27 8.37 8.50 ^eP1^TE J Open Circuit Voltage Voc(V) 37.8 38.0 38.1 38.2 0 s auiNCNo1E 7 Short Circuit Current-Isc(A) 8.75 8.79 8.88 9.00 Module Efficiency 1l,,,(%J 75.0 15.3 15.6 15.9 MODULE STC:Inadiance 1000 W/m'm',Cell Temperature 25°C.Air Mass AMI.s according to EN 60904-3. Typical efficiency reduction of 4.57.a1 200 W/m'according to EN 60904-1. UnUn 0 ELECTRICAL.DATA C NOCT " IMaximum Power-PMnx(Wp) 182 186 190 _193 600" CELL 1 Maximum PowerVoltage•Vw V) 27.6 _ 28.0 28,1 .. 28.3 MUtTICRYSTAILiNE MODULE 04.3GROUNU,NGHOLE Maximum PO Wer Current-IMrv(At 6.59 6.65 < 6.74 6.84 A A r WITH TRINAMOUNT"FRAME � S 6z-oanwxore Open-Circuit Voltage(V)-Voc(V) 35.1 35.2 35.3 35.4 l Short Circuit Current.(A)-Isc(A) 7.07 7.10 7.17 7.27 - 1 NOCT:Irradiance at 800 W/m'.Ambient Temperature 20°C,Wind Speed 1 m/s. Z.945-260'4 PD05.18 ata so Back View POWER OUTPUT RANGE MECHANICAL DATA Solar cells Multicrystalline 156 x 156 mm(6 inches) Fast and simple to install through drop in mountingsolution Cell orientation ,60 cells(5><10) 1 - Module dimensions 1650 x 992 x 40 mm(64.95:39.05 x 1.57 inches) - _ I. � ,.• Weight 21,3kg(470lbs) • Glass 3.2 mm(0.13 Inches),Hlgh Transmission,AR Coated Tempered Glass MAXIMUM EFFICIENCY - A A )Backsheet White f Good aesthetics for residential applications Frame Black Anodized Aluminium Alloy with TrinamounTGroove I 1tIP 65 or IF 67 rated' - � t I-V CURVES OF PV MODULE(245W) J-Box 1 Q/ Photovoltaic Technology cable 4.0 mm'(0.006 inches'), Q Cables M. 1200 mm(47.2 inches) POWER OUTPUT GUARANTEE 9°° 100°"F"' - Fire Rating Type 800W/m �_ Highly reliable due to stringent duality control '_6- Over 30 in-house tests (UV,TC,HF,and many more) `5� 600wrm As a leading global manufacturer ! • In-house testing goes well beyond certification requirements 4°' 400W/r,2__ TEMPERATURE RATINGS MAXIMUM RATINGS of next generation photovoltaic . .,,'' 3.`O 200w/m _ NOminalOperatin Cell Operational Temperature -40-+85°C _...,._____:.a.....,....� products,'we believe dose Temperature(NOCT) cooperation with our partners 14D Maximum System 1000V DC(lUQ o.m ;Temperature Coefficient of PMnx -0.41%(°C. : l Voltage 1000V DC(Uq is critical to success. With local 0.. to.- 20 W 30.00 40.°° presence around the globe,Trina is Voltage(V) Temperature Coefficient of Voc -0.32%/°C Max Series Fuse Rating 15A able to provide exceptional service Temperature Coefficient of Isc 0:05%/°C to each customer in each marketf. Certified to withstand challenging environmental ' and supplement our innovative, Conditions reliable;products with the backing • 2400 Pa wind load WARRANTY of Trina as a strong,bankable . 5400 Pa snow load partner. We are committed 10 year Product Workmanship Warranty to building strategic,mutually 25 year Linear Power Warranty F benficial Collaboration with ..,., a installers,developers,distributors (Please refer to product warranty for details) <i and other partners as the backbone of our shared success in CERTIFICATION �' driving Smart Energy Together, LINEAR PERFORMANCE WARRANTY PACKAGING CONFIGURATION 10 Year Product Warranty•25 Year Linear Power Warranty `,ISTED � a @IS Modules per box:26 pieces w Trina Solar Limited --"'_-��"' ��� N � .Modules per 40'container;728 pieces va ww ,9rinasc)la[.com ;,100% Addifionollr EUU-9 EE oaloe from Trin orifi COMVLI Nr a 4` 90% ° �111!n-_,Warr CAUTION:READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. paMP4Ti y `a Y ® ®2014 Trina Solar Limited.All rights reserved.Specifications included in this datasheet ore subject to < e rr��rnl�l C`olar 'rin n-aSOlar change without notice. _ if Lf(1(QJJ `d l9 80% Y ata[ Smart Energy Together rears s 10 1s zo zs Smart Energy Together W a0MPP1 . ❑ Trinastandard •❑ Il alu suy,a "=a=d _ _ solar,=@a Single Phase Inverters for North America solar ® SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ SE760OA-US/SE1000OA-US/SE1140OA-US ......................................................-............................ ........ ...................................................................................;............................................ I SE3000A-USI SE3800A-US i SESOOOA US SE6000A-US 1 SE7600A-US sE10000A-US�SE11400A US OUTPUT S o I a C E d g o Single Phase Inverters Nominal AC Power Output I . 3000 .l 3800 5000 6000 7600 9980 @ 208V !1-14.?0 VA 10000(�1240V Max AC Power Output ( 3300 4150 5400 @ 208V 6000 8350 10800 @ 208V 12000 VA ......... For North America ..... . .. .. ..i.. ... . ....... ............... 5454.�29DY. . ............. ...... ..... ... .10950.@Z4oy. ...... AC Output Voltage Min:Nom.Max.111 _ ✓ _ 183-208-22 9 Vac SE3000A-US/ SE380OA-US/ SE5000A-US/SE6000A-US/ C..................Min.-....... ax.(.. ................ .........,... . ................. ................ .. ............. .................. .................. ..:........ AC Output Voltage Min.-Non-M1) SE760OA-US/ SE1000OA-US/ SE1140OA-US 211-240-264 Vac . .......... . . .. .. . . .. AC Frequency Nom:Max..tl 59.3-60 60.5(with HI country setting 57 60 60.5) Hz 24 @ 208V 48 @ 208V I................. Max.Continuous Output Current 12.5 16 I 25 32 47.5 A , .............. . ... i. zi @_z4ov . ... ...., ,.. . ... . . . . . . .. 4z,@ zaoy...i.. .. .... .. ... GFDI Threshold .. ... ... ...... ......... ......... .............. .. ..... .1 .. .. A ..... . t��e .may Utility Monitoring,Islanding Protection,Country Configurable Thresholds _Yes - - Yes INPUT Maximum DC Power(STC) 4050... . ... _5100_.,. .....6750...., .. . 8100 .., 10250 • a,_ ......... Transformer less,Ungrounded . . ... ......I.................. . . . .. .. Yes. ............ . . ........................ ..... .. ......... 1= Max.Input Voltage 500 - Vdc a+a H ............ . . . . ... . ........ ........ . . . . . . . . . . . lea mt .............. . .. ........ Nom.DC Input Voltage 325 .208V 350 @ 240V ,Vdc. ..... ... �Y ... .... .. .. �'16.5 @ 208V.I ...... ,.. .... ...33 t �ef2a�u,, Max.Input Current(') 9.5 13 18 23 34.5 Adc .� P ... ,.15,5„ia 240V. . . . ..... ..30S.1a 240V_. .. ,, .... .. .. .. .. ............... .. .. . . ....... ... ......... ................ .... . ..... .... ... Input Short Circuit Current . .... .... .............. .... ..... .......... 45............ . . .... ................... ... .Adc. . ._...,,� ....... .... .. ity Pl...eE. .......... .. . .e .. ! � Reverse.Polarity Protection .. ... .. ......Yes. . .. . . . ...... .............. ..... .......... .. .. ..Isolation Dee ..... . Ground-Faultlsolation Detection ,,. .. ., _,_ .. 600kaSensitivrty . ,,. .... „_ ... .. ... ..... .r t� - ..Maximum m.u.m InverterEhcie.... .. ......... .. I' . 98.3 ,., 97 5 @ 208V. .. .. ..� 97 @ 208V.. . . ..... .... .. . CEC Weighted Efficiency 97.5 98 97.5 97.5 97.5 % 98. 240V 97 5 240V ............... .. ... ... ..... ................ ... .. ... .... .�°......... .... . . . ........... ....@........ .............. - r Nighttime Power Consumption 42.5 -... <4 W N. ., ADDITIONAL FEATURES Supported Communication Interfaces .RS485 RS232 Ethernet ZigBee(optional) _........ . . .......... y ..................... ......... ........ Revenue Grade Data,ANSI C121 optional(3) ... .......... ................... ...... . ........... .. ..... ... .. ....... ......... .. .. ...... ............... ....... ... . y Rapid Shutdown-NEC 2014 690 12 Functionalit enabled when SolarEdge rapid shutdown kit is installed(4) ®...,E.,_ i , w _ STANDARD COMPLIANCE - i UL1741,UL16996,UL1998 CSA 22 2 Safety ...... .......... ............ .......... . . ....................... ... ..... .. ... .............. . .. .. ... .. E Grid ConnectionStandards ..................... . JEEE1547 ,., ........ ,,.,... .......... .... - 3 ... .. ....... .. .. . Emissions FCC part15 class B INSTALLATION SPECIFICATIONS ..... ..... ...... AC output conduit size/ range 3/4"minimum/16-6 AWG Y 3/4"minimum/8-3 AWG ... ... .... .. .. .. ..... ..... .... ... ...... ... ..... , ..... I s;�.... .. .... .... ,......... ....... DC input conduit size/ft of strings/ 3/4"minimum/1-2 strings/16 6 AWG 3/4"minimum/1-2 strings/ r AWG range.,.., .... 14 6 AWG .. . _;.. Dimensions with Safety Switch in 30.5 x 12.5 x 7.2/775 x 315 x 184 30.5 x 12.5 x 10.5/ /. ............................... ........... ................... 775 x 315 x 260.......... .mm.... .. Weight with Safety Switch............. ..........51:2./23:?..........I....................54.7/24.7. ................. .I.............88.:4/40:1............ .lb/.kg... Natural .. .. convection - Cooling Natural Convection and internal Fans(user replaceable) fan(user The best choice for SolarEd a enabled systems L..... ..... ..... . replaceable). ......... ... ...................... . Q .. .. .. .. . O � ... .... - Integrated'arc fault protection(Type 1 for NEC 2011690.11.compliance Min.-Max.Operating Temperature isi F C p � yl3 ' � �., 13 to+14.0/-25 to+60(-40to+60versionavaifable ) /" Superior efficiency{98%) Range. . .... . . . . .... .... ..... ..... . lightweight and easy t0 install On provided bracketProtection Rating SmallNEMA 3R F other regional settings please contact SolarEdge support. tai A higher current source may be used;the inverter will limit Its input rent to the values stated. Built-in module-level monitoring j3l Revenue grade inverter P/N:SExx xAUSODDNNR2(for 76DDW inert SE760DA-US002NNR2). Is'Rapid shutdown kit P/N:SE1000-RSD-SS. Internet connection through Ethernet or Wireless 40 version P/N:SE-A-USOOONNU4(for 760OW inverter SE7600AUS002NNU4). Outdoor and indoor installation i -• Fixed voltage inverter,DC/AC conversion only -• Pre-assembled Safety Switch for faster installation Optional-revenue grade data,ANSI C12.1 SurxsaEc • USA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-ISRAEL www.solaredge.us i _ Date. iy�.�. '. f' r 94 5 TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING �,SSAcmuS� ..s .t This certifies that . .�. . , . . . . . . . . . . • ... i . . . . . . . ` f has permission to perform . �`v'`' �'�. �`�• plumbing inthebuildings of (0 ! . . � °^� . . . . . . . . . at . . . . . trQs . . . North Andover, Mass. Fee d!' .Lic. No;?-Olgq . . :?/. . . . PLUMBING INSP CTOR i Check # ti �I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE ! /Z PERMIT# JOBSITE ADDRESS (96I-e,!'-�- S �� OWNER'S NAME R �Q ��-t o POWNER ADDRESS TEL 11FAX TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: ®1 RENOVATION: REPLACEMENT:® PLANS SUBMITTED: YES[I NO FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE i DEDICATED SPECIAL WASTE SYSTEM J DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER FOUNTAIN ®r— DRINKING FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) ^ _( Q�Z � KITCHEN SINK _ LAVATORY J ROOF DRAIN SHOWER STALL l SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING J OTHER INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES®'NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Ka""' OTHER TYPE OF INDEMNITY E] 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 F AGENT 0 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 accurat o t e best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli with all erti ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME ® s /� `Zc� LICENSE# 2a ° SIGNATURE MPD JPQ-, CORPORATION F# PARTNERSHIP F-1 LLC©# COMPANY NAME Nlq rd Z® ( ADDRESS CITY —]STATE G, ZIP ( 3 TEL q3 FAX ------- CELL 9( Q5' ^7 ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 'w The Commonwealth of Mlassachusetis . - Department ofXndustriglAccidents Office of Investigations UT 600 Washington Street Boston,MA 02111 www.massgov/ilia Workers'Compensation Insurance Affidavit:Builders/Contractor8/Electrician,s/Plumbers Applicant Information Please Print Lealbly Name(Business/Organization/Individual): My .3 M C 5 // rF Address: /L b Q 19 - City/State/Zip: 6kS-G,?-�4ft�o(T Y4hone#: 2 Y ) Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I ' 6. [J New construction employees(full and/orpart-time)* have hired sub-contractors 2. am a sole proprietor or partner- listed on the attached sheet.x 7• odeling _ ship and.have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'comp.insurance. g, Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its ME]Electrical repairs or additions required.] officers have exercised their 3111 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we,have no 12,❑Roofrepairs insurance required.] employees.[No workers' •13.❑Other comp,insurance required.] NAny applicant that checks box#1 must also fill outthe section below showiingtheir workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they Sie doing all work and then hire outside contractors must submit anew 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. 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.#: ExpirationDate: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation 13 olicy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL 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 maybe forwarded to the Office of Investigations of the DIA.for insurance coverage verification. X do hereby certo unde ins an Ien lies ofperjury that the information provided abov'is tr e and correct. - Simature: Date: ( 2 — Phone#: 5-3 2d 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.EIectrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: Information and Instruction's 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 wxitten." 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 j oint 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 ofits 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-contractor(s)name(s),address(es)and phone number(s)along with their certificates)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. Han LLC orLLP does have employees,a policy is required. Be advised that this affidavit maybe 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. Anew 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; Tho Commonwoalth ofMassod'usotts Dep.aftea of fhdusWal,Accideuts ofte of W-0stigati o-M 60 Wasbiagtoa fteet Boston?MA,p2X IX TQL#617727-4900 oxt 405 ox 1-$77cMA.SSAFE Revised 5-26-05 Fax#617^727-7749 www.xaaagovlcha Date.. Of NORTH 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SA(cmuS This certifies that ..............0 ......................................... has permission to perform ...... .... ...5 r ......................... wiring in the building of.......... .................................... at.........6Zp---7- ........ North Andover,Mass. �K Ago, 1 -1 Fee.... Lic.No./.1-3-!P 7154.... �E- .. . ........ LECTIU IN PEC40R Check # 10845 Official Use Only Commonwealth of Massachusetts 0 0? �� a Department-of Fire Services Permit No. t ------- occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.11/99] (leave blank) APPLICATION FOR PERMIT TO PERFOeRMctrical�ELECTRICALode(�� WOR Allwork to be performed in accordance with the Massa chusetts Date: Q MR f Z (PLEASE PRINT INPVK OR TYPE ALL INFO TION) To the Inspector o Wi es: City or Town 0E.- By this application the undersgned gives notice of his Qr_her intention to perform the electrical worMaepscribed below- By (Street&Number) '7 es Telephone No. Owner or Tenant Owner's Address �/ (� Building Permit# Is this permit in conjunction with a building permit? Yes L� No (" Utility Authorization No. Purpose of Badding >� Und d❑ No.of Meters Existing Service Amps / Volts Overhead❑ d❑ No.of Meters New----� ice Amps / Volts Overhead❑ Und� Number of Feeders and Ampacity A dfm �- Location and Nature of Proposed Electrical Work: t re, Completion o the follmvin table m be waived b the Inspector of Wires. No.of Total No.of Recessed Fixtures No.of Ce"usp.(Paddle)Fans Transformers KVA RVA No.of Hot Tubs Generators No.of Lighting Outlets ❑ o.o mergency 1 ting (, Above ❑ Tn- No.of Lighting Fixtures 7 Swimming Pool d. d. Batte Units FIRE ALARMS No.of Zones No.of oil Burners No.of Receptacle Outlets � No.of Detection and No.of Switches p"l No.of Gas Burners Initiatin Devices Noof kir Cond. Tono�s No.of Alerting Devices . No.of Ranges Tons KW No.of Selfcontained Number Heat Pump Detection/Alertin Devices No.of Waste Disposers Totals: Local ❑ Municipal [] Other No of Dishwashers Space/Area Heating KW Connection Security Systems: Heating Appliances KW No.of Devices or E uivalent No.of Dryers No.of Data Wiring: N&of Water KW No.of Ballasts No.of Devices or E aivalent Heaters Signs Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or E uivalent OTHER: Attach additional detail 721esired,or as required by the Inspector of Wires. u n"cove a or its substantial equivalent. The undersigned certifies that such INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee "completed o erari r provides proof of liability insurance including P ermit issuing office. coverage is in force,and has exhibited proof of same to the p c�� w L CHECK ONE: INSURANCE Ltd BOND ❑ OTHER ❑ (Specify=) ffi on Date) (When required by municipal policy.) Estimated Value of Electrical Work: P letion. Work to Stam Inspections to be requested in accordance with MEC Rule 10,and upon comp I certify,under tliepains andpenaWes vfper�uty,that the information on this application is true and complete: �3�2 _ j LIG NO.: , FIRM NAME: J ;n i ` / �-:' IC.NO.. Signature ./__�- 'r 7l' Licensee: Lo-i a, , D1,71 S Bus.Tel.No.. (If applicable,enter e�n� the license number line.)Q�L� 1� OI�7 Fl� Alt.Tel.No.: Address: // /`j �� �� �� (� does nit have the liability insurance coverage normally required by law. OWNER'S INSURANCE WAIVER: I am aware that the i.,�Gu���u� ❑ owner ❑owner's ent. By my signature below,I hereby waive this requirement I am the(check one) PERT FEE:$ Owner/Agent Telephone No. Signature f .. , r � . i � E -m The Commonwealth of Massachusetts -= - Department of Industrial Accidents Office of Investigations ,14 600 Washington Street Boston,MA 02111 www mass govMa Workers' Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 1J j tli C, �j P Nr!e_ Address: P o. 6ny- 375 City/State/Zip:----Joe A 0111#(.-,o Phone#: `���• ,,�31.�}y`7/ Are you an employer?Check the appropriate box: Type of project(required): 1.[I rl am a employer with 7 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance. 10[]'�lecirical repairs required.] 5. E] We are a corporation and its or additions �.❑ I am a homeowner doing all work officers have exercised their l I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer tliat is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Ruc le S", Y*t & t-art e e, Policy#or Self-ins.Lic.#: jA)C, 23912 3 --),b Expiration Date: ZS/ZI)IZ F T Job Site Address: (o S+ 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 certifyer the pains and penalties of perjury that the information provided aboveistrue and correct Signafore: Date: G 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#: • Date..... ..... ... .... :°'"° TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHU This certifies that .......... ............... ... ..... ... ............ has permission to perform ... wiring in the building of......... ....................................... at......66 7 f—.olV��57— 5 2— ..........I.............................................................. North Andover,Mass. ........... .. ....... Fee...?,eP:777--. Lic.No. .. .. ..... Elf CrRICAL INSPEM0 Check # 7 7`11 rl►' -� Commonwealth of Massachusetts Official Use only Department of Fire Services Permit No. I I BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07) leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: 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) �7 Izze Owner or Tenant %j.e✓ at Jp-e_ ��f Q�� Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: f- Ph � Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Luminaires S No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets /4W No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Pool Above In- o.o mergency ig g Swimming nd. � rnd. LE-J] Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones I No.of Switches No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Tonsotal No.of Alerting Devices No.of Waste Disposers eat Pump Number Tons KW No.of Self-Contained Totals: -._. ........................................................ Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Municipal p g Local❑ Connection El other No.of Dryers Heating Appliances KW Security Systems:* No.of No.of No.of Water No.of Devices or Equivalent Heaters ' Data Wiring: Si s Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: S Attach additional detail if desired, or as required by the Inspector of Wir6 s. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 0— —I f 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 coy rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and enalties of perjury,tha h in ormation on this application is a and complete. FIRM NAME' { p o LIC.NO.: 490 3"Y Licensee: d r/ LC,lgt_Ao r� ��� Signatur Y7 If LIC.NO. ,F.30 S.S— (If applicable, enter"ex em t"in the license er h e.) Bus.Tel.No.:Ak Address: / it/ / �� 0,3o Alt.Tel.Nowt 3 815"3od_6 *Per M.G.L c. 147,s.57-61,security work requir Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: f am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 1 U- l Z . z The Commonwealth of Massachusetts k ! Department of Industrial Accidents Ogee of Investigations kN - 600 Washin n Street % Boston, MA 02111 1 c j www.massgov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A�P icant Information Please Print Legibly Nanne(Business/Organization/individual): Address: /y at a.v ��i// Al- City/State/Zip .� �( Phone#:_. Go 2 Are you an employer?Check the appropriate box: Type of pro}ect(required): ( eR + : 1.❑ I am a employer with 4. ❑ I am a genera[contractor and I - 6, ❑New construction employees(fu 11 and/or pail-time),* have hired the sub-contractors 2. I am a.sole proprietor or partner. listed on the attached sheet.t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. [J Demolition working for me.in any capacity, workers' comp.insurance. 9, [] Building addition [No workers'comp, insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL l Ln Plumbing repairs or additions Myself.[No•workers'comp. c. 1.52, §1(4),and we have no 121-1 Roof repairs insurance required.)t employees. [No workers' comp. insurance required.] 13.❑Other *Any applicant that checks bo)t*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 eontnukors must submit a new affidavit indicating such. ;Contractorsthat check this box must attached an additional sheet showing•the name of the sub-contractors and their workers'comp,policy information. I ant-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. 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$4500.00 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 de hereby err n r th of nd p o perjuryltat the 'formation provided above is true and correct. Si afore Date: Phone#: 1".0d of j`Icial use only. Do not write in this area,to be completed by city or town afficiat City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.Cityfrown Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 4 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- ersons 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-contractors)name(s),address(es),and phone number(s)along with their certificates)"of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with.no employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. 8e 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 numberlisted 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 permittlicense 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 indicatingcurrent 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 us a call. The Department's address,telephone and fax number' , The Commonwealth of Massachusetts Department of Industrial Accidents Off ce of Investigations 600 Washington Street Boston, MA 42111 Tel.#617-7274900 ext 406 or 1-8.77-MASSAFE Fax#617-727-7744 Revised 5-26-QS www.mass.gov/dia - tic . - - COLLOPY ENGINEERING CONSULTANTS 65 AYER STREET METWEN, MA 01844 . FRANCIS H.COLLOPY RESIDENCE� 685-7969 RECLPROFFESIONALENGINEEER OFFICEIFAX:1�, 685-8069 CIVIL STRUCTURAL DYNAMICS October 17, 2007 Mr. Gerry Brown Building Commissioner North Andover Building Department 1600 Osgood St North Andover, MA 01845 Dear Mr Brown: I am writing in regards to the renovation project at the Palladino Residence at 667 Forest Street in North Andover, MA. This project is being constructed by Blackdog Builders of Salem NH. Earlier this year they provided your Office with the required documentation and drawings for this project, and obtained a Building Permit from your Office. I provided the Structural Engineering for the construction of this project. Included in the submitted information by Blackdog Builders were some framing details shown on Page 1 & 2 of the submitted drawings, and which I placed my PE stamp thereon. Earlier today, I was requested by.Blackdog Builders to make a site inspection of the final construction and to ascertain to your Office that the construction was in keeping with the intent of my stamped drawings. During the course of the construction there were some minor changes required that the Blackdog Builders personnel consulted with me on. Those were: I. Changing the placement of the W10 x 26 steel beam from under the existing support purlins to a"flush framed" detail so as to provide more headroom in the vicinity of the beam. This was accomplished and the purlins do have the proper joist hanger support brackets installed_ 2. My drawing of 8/7/07 showed the use of lally columns under the steel beam at the end supports. The as-built construction resulted in the placement of 4 2 x 4 wood stud members ganged together by adequate nailing as the end supports. I have calculated the resulting compression stresses on the multiple stud support columns, and have found them to be adequate to support the design load. 3. The original plans called for a double 9 '/4 LVL beam spanning 8'-4' in the bath room area. In order to match the depth of the existing purlins that framed into this beam,the framer made a field decision to use a deeper LVL beam, namely a double 117/8"LVL beam, which is stronger than that specified, and therefore acceptable. Based on my final inspection today, it is my professional opinion that the as-built framing viewed today is in keeping with the intent of the previously approved drawings that were stamped by me, as shown on those drawings. If there are any questions in this regard, please feel free to contact me at my Office. �P�� Sincerely, COLLOPY ENGINEERING a FRANCIS H. in X COLLOPY 20172 �4 131 Francis H. Collopy, PE �s�1aNA1.��� Structural Engineer i } Location ; No. Date TOWN OF NORTH ANDOVERlil � A ` Certificate of Occupancy $ C �'�s'• Etn Building/Frame Permit Mus Fee $ = '� ,G Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # ` 6 '-1, 7 7 / Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING �� d�z� w h��� ��-.' a ....,..,. ,-� .rte•;,:. �.f; .,� a .;t s�. `� ��� a -�, wr "' BUILDING PERMIT NUMBER. DATE ISSUED: 9(--09—°j ao03 X� SIGNATURE: cC -- Building Commissioner/InsXector of Buildings Date z SECTION i-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 2 �a ¢" Sir`.- 61 o Map Number arcel Number 1.3 Zoning Information: 1.4 Property Dimensions: /v Zoning Distrid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided + 30 -4 .3S r o A004 O 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone B-' Municipal ❑ On Site Disposal System 9-111, J SECTION 2-PROPERTY OWNERSHIPIAUTHORIZEDAGENT Historic District: Yes No M 2.1 Owner of Record o Name(Print) Address for Service: RJ A \\^) A- e TelephoneIf of Record: Name Print Address for Service: k z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3 Licensed Construction Supervisor: Not Applicable ❑ G&f Licensed Construction Supervisor: License Number Wn Address / e� od? (� icgExpiratio Date Signa Telephone Registered Home I provement Contractor Not Applicable ❑ A)/� Company Name yL3 /e4oAz,,e n2 Registration Number r Address41 6 Expiration Date re T hone Y 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 applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition B---- Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: J N — C.L7 ID ON o- SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be �� Y }F C� TSE ONLY Completed b rmit a licant ;,.. k� r z 1. Building (a) Building Permit Fee '-30 coo Multiplier 2 Electrical (b) Estimated Total Cost of ° Construction paD 3 Plumbing Building Permit fee(a)X(b) 4 Mechanical HVAC V a0 5 Fire Protection �l 6 Total 1+2+3+4+5 Check Number SECTION 7a OW R AUTHORIZATION TO BE COMPLETED WHEN OWNERS Al R CONT O IES FO ING PERMIT 1, A as Owner/Authorized Agent of subject property He auorize- )fit, ® jt .�T to act on My behal ' all ma =1work authorized by this b6ilding permit application. ti /4-a3 -Signature d Owner 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 Si ature of Owner/Agent Date al i '131 MIKE NO. OF STORIES SIZE O ' BASEMENT OR SLAB 61, SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS ,2 DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS p HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING 0 X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND p ,� IS BUILDING CONNECTED TO NATURAL GAS LINE iU 0 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION o ' `'T APPLICANT , 31 - 1,¢�„ Afff PHONE4>.3— F-?6— C 7 7 LOCATION: Assessor's Map Number Z45?15-- PARCEL OCL2�0 SUBDIVISION LOT(S) STREETy frf- ST.NUMBER ************************************OFFICIAL USE TEC MENDATIONS OF TOWN AGENTS: SERVATION ADMI TRATOR DATE APPROVED DATE REJECTED COMMENTS si .TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED ---------------- i DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED 2 0 DATE-REJECTED. COMMENTS �prc. PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm S I } w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Q< . Boston, Mass. 02919 °+M 5y• Workers'Compensation Insurance Affidavit Name Please Print Name Location: City 061z6,.. Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity am an employer providing workers'compensation for my employees working on this job. Company name: AM daft 14 i` ga f >O(.f�i2 at.�h4 Address ''•%� City Phone#- Insurance.Co. /1. f Poli> # C 4 Company name. , Address - Crv: Phonb#k Insurance.Co. Policy# Faire to secure coverage as required:under Section 25A or MGL 151 can lead to the impcs10m of criminal penalties.cf a fine ifi to 51500.t)tl and/or one Years'imprisorurcent �telt�s �aBte4s�n�heSmn �S?DP]IIORK oR!]ER and_afine�if1110 QD�tlag►�g� per;. 1 understand that a copy 6f thin statement may be ed to the Office of Investigations of the DIA for 9 image verification. /do hereby dY Pins�► / that the k#arrradw povkW above is dors and coffa:t Signature date o 3 Print e 46 , r D2 Pbone-#_&j Official use only do not write in this area to be completed by city or town official' City or Town PenT&Aicensingo : []Check d immediate response is required D BuiloSng Dept_ -0 Lkensing Boarsf p Selectrnan's office contact person: Phone# Health Department Other 7-18-03; 7—:25AM; ;781+594+9H33 # 2/ 2 j dix� 1Y€Zt a , .. .• 12932 • it//F dabs �J��!^ aiDO&I60 P Acari� .i Ab 667 4. N5.7 3 ' a1g,� AIIA illav9 as t'9.69 _ �0,2,ES7y` �,�T. MORTGAGE SURVEY PLO?PLAN' MORTGAGE SURM CONSULTANTS.INC. .SCALE:'1 inch`= 6o feet P.O.sox m N.lWarlcm;Mw.em I,cecated rtify that the cdodas stances shmm.on this pian are DATE; March 15, 1977 iothe tot de dgaated is comps sum with the aypti It 1, zoaim bylaws of the mwWp ft wberda twastructed. LOCATION_NORTH AMVM, MASUCHUSETTS Offtiet ameosims am trot to be'used for astablishimm property cry Qoa T , .Swc FL DEED AND AN REFERENCE. ' a` R &sex Alorth DistriCt,� � ,, a •a...i.•>.try ►Cls,,,'; . Opml g�k= tl 2 .18 . : C., .• pk„'If"6 gue t i� 7 t z prat, i r I certify that the$trtrcture shown'ori this p6n 13 NOT located within a SPECM,FLOODMAZARD AREA as delineated i z OII ft'rasp "'h ', Canrwmty No.'G560 98 Effective data- 66284 by ;~' by tlut U.S.Uepartnmt'of.HotWag g Urban Development, Registered Ltutd Su Federii Insurance Administration. NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-95 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S. 150 A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant -6 9— Date NOTE: Demolition permit from the Town of North Andover must be obtained for this projec through the Office of the Building Inspector a "SYSTEM .8 VICTORIAN CONSERVATORIES rJ ► A (30 DEGREE CORNERS) ENGINEERING AND STRUCTURAL 50005 VETERANS MEMORAL HkNY. LOADING INFORMATION HQLBR00}(N.Y.`+1741 EFFECTfVE CATE 6.02 LD ;) SYSTE818 NO TRANSOM HEIGHTS 1tl"TRANSOMF.EIGNTS JV'TRANSOM HEIGH f3 . 30 DEGREE ALLOWABLE 8X MDOEL 0,BN MOCF_LS BV,BO,BY MODELS VICTORIAN TRUSS&GLAZING WOOD GLAZIND ROUP LIVE LOAD EXPOSURR EXPOSURE 900SURE CONSERVATORY BAR O.C.SPACING OAR YYPR bamB G D B I C D Bim— C 0 MODELS (mp) lm,h) fmo) 00) Ino) (mph) )mph) Vvh) 00) 4910 2'-E 518" 3"BY 8" ?2G 215 185 T i45 285 •180 i40 165 140 125 1912 2'-5518". 3"BYg^ JLL140 ':205,. ;80•>,'. .' 140...... '..SOu..< .. 1s0:•:'•", :125 .85: : t gt g 2'•8 5J8" 3'BY a" As 200 150 195 180 145 t±0 184 14c 125 j�t91T'•'... 2'-bdlE'. BY-B' =r�'� J 9C ' d6!.'. 110... ..185_ A40..: S24 1,5 135. 110. t9z9. 2' a 51P 40 125 175 195 120 TO r0 115 6920 2'•8 5!8" 3'BY 8' Ytl ,Its ' 35. '! 938 115-I 140 ' ,2< i 1t0 77 5-77!�.h +�i,=yr;z; };:ystw;.°-t•,iL ' t.,+'..r.'a!!` r ; ; .s .r a1,?VY?�'!ix• kl.qr:,l',•..1�.�Y.-�*�iti�:xyri§.: I ,2112 3'-0 518' 2"SY 8" 75 .Oc 166 136 190 1A$ 190 175 136 120 i 2315.: . :'•'. '^• :3:...p:518". . ....": 3^l1Y.8»•, ... ?.,:::";1S"`,'::,;d. :>,g.':'100<..`b'r',*„£'145.::d�:,'.,.'.130:;,.,.,.:'t;.155'".•'",; ')<0:',^::':11;."i,2Si:"">5;;'.a7/'::,:;';; °;13�: :: :;r 12Q•r;'�! 2916 9'-0 918" 3"BY 8” 75 185 140 125 1`4 124 120 170 130 115 ' 2721(.: 3"'456" 3'!8Y8" > :..50- ue, 135 120"'•. ,.'..y.TO.' t3A'`i::;;'.(°1i5.. -It0`i'.! :'.12s'.'!•i":laa0: 2S2d 3'•0!512^ 3"BY 6" d0 170 130 `.,115 188 126 110 155 _ i20 lag 2327... 3::p.6/8" .:. 3`8Y 8r' 4a ". 18p': , 12& 110'.; 466'' 10v:. 3E4"•`.";.'143. 0':;` tqD.;" NOTE:EXPOSURE H•1tEWVF,NTIAL AREAS,EXPOSU kE C.OFEN TI!RM UN AREAS,'EYF • 'EA$Wl7i,IN OCEAN III • 1 n N '1 sq=x• r;Cn�t?2T+, 7e',:'Ir "";. � :•,. yJ an e; " ,i 4j "' .1 rnTG g�S,7�'y,�L 2• r,w.lr�ra�1 rio,cYsu�°.. 4—�� ' s dLj f r � - t��2f+4� �. �•t�')p Lfi..+'1�i •u.��LL. .w• tnr sp�+�� � a ~L"�. A•;:moi:. ;ry,nC:`t „��, p1 \r,' ""' .,� �� i° V ✓f f ALxBAh�-W-W ARIZONA AR GAIL IrORNIr° COL09,100 CONN6CT!Cl1T p r FLC??tIDA GEOROJA - !DAWO :.WtN6 ,e, Ad°' aye• .d /`. F.•..'�`• •\' u.. ,...-,;� Yd."`.w'i:..'. 3/ar., ) g a t :.tv� (:�„ \� _; �.... I y { .,;.��`,.d.. nrdlveiws„v •.e�,•�. l +e. ,,;, 'ysV 'rG �r t ma• �T 1..�w p l x:i \.vw v ;�'•„Oi;` '�.�.awn• '" i ar'+��' \ r �!,W: YWi=�. ' �Tr. ,::1fp �i �.;_�, ?..'1:,."`��i,�n.._/e'dJ i�'m;+�;�t'� :M^•.,,u �,i` ys..,,,<..' �4�s.�' 'u"M�r'G�3' ,.._:...,..,r.•.: �,��, `"t:w:«.s=f- ,i1tiVA 1\NI;,A3 KENTUCKv L,GU191]NA a!,,u,e at�41� tJA694CkU3 H::,N!G:AN aMF>FSGTa tirsns2rhPa An88CURl N,� A.. D ,�;me:r:r5; atunt9 rr.:5.'"e •+"'"'" �e"u. J.•`v�\� �+Sw"�; :�j •'�i;N!�,�o-d �4•d?^4�'� _��'1' ..YS/1',�?al'�}�' ' v.,. F ,ydr.,....`;^ ' \ UalOn: K :�.wnuft '1'G. Y t!� elw V•J9iM u0sj"�M " !J"a, i•�l } f =HtsC. Wvr,twj�. lRLrt tWv:�; "L.�, S1 14'lf p��• ! l!{�•4� 1 ' S. 4�.•P'` ";. ,� � ;';: !... 4'{�a �`' S";e'�1� A�r"Jluw° f QN,`'`'.t y, �,.•,� , ,,k,-.I ���/� h,N,LL?� s'°hr "'!•', �r'� 'p2'"..E�? 4^•Inp%f' kpF "la,�' MONTANA NE9r•ASKA NEVADA NEWHAMPSHIRF NEWJERaEY NkWME•XICO •NEIVYCRK .NDRTHCAROLINA 'NDRrNcwxoTA ONIO OKLAN.:''MA', .• }ROOF RAFTERS ARE GLUE-LAMINATED NORTHERN PINE' , �'k\r �. 1,;.,,.,.—.._• s' a L'EAG LOAD OF ROOF 9YS79t!!S T PBF ' ORFGON P�+PiGVLVANIA PURRTO NICO R..IODE ISLAh'G 30u7H•f:AROLINA$O:iTH DAKOTA ' 31 ALL UNITS SHCWM ON THIS AGE ARE AG0EPTA6LE FOR OONSTRUCTIUN IN "f„�.rK'•.r, �t.e`�l'�a �\ �� rr' n,: a�?'+ 9EI&!N�C.'ONEI, - i GYP” L 41 A LOCAL PROFSSSICNALENGINEER SHOULD OET6RM114E THE S!TE SPECIFIC °�+`„ F7 +'c• ?r`: ��� ' �•�� LOADING ANO PERFORM AN ION LOADS X118 D 3Y LOCAL A'ION.,V1H!CN •:�`r. d§`iu•� � -ti',na U1"f �.Ae+•�r r..... e,, •^ 1"i.....� MAY INCLUD��.1uNIMUM CESI(dN LOADS REQLIIRED 8Y LOCF,L L.±'JMClF,ILIT)_S,, TENNESSEE TEXbS UTAH VERMONT v)R:31N;A YypPiNINUTON ORANY DRI;"T;NGORUNBALANCEDSNOW LOADS^ROOUC06t'AD.)A.Cr;W' STRUCTURES. ' » '•V n; i 1 \• r j K `' ��-,,,„—,,,�"4 S)YNIS SLWMARY F'ERTAINST07WR STRUCTU!LA:INTeaRl 'C�WRUN17 UP TO TN=CONNECT!0hk5TRTN£E%LSTING3TP.UC:TUREP.NDI:•'RANYNEW ' CON8TRVC'ION. TH_GOMNECTIONS TO7HE EY.iSTlNG ANOlORANY NEW W=NSIN n'YC1rtM0 p,G CONSTRUCTION MUST BE ANALYZEDACCORD!NQ 1'O COhIDITI7NS&P£CIr!C 70 •EACH.106,BY ALOCAL PROFESSICNAL ENGINEER. 6)ENGINEERS CEP,T!F1W1ON:I LAL1!RENCF FISCHER CERT!PYTHAT TKESE E'NGSNEER!NG SPECIFICATIONS HAVE BEEN PREFARED U•,-,-A MY CIRECT SUPERVISION ANM TIM 1.AIM AAiGISTEREO PROFFSSIONAI.ENGINEER IN 7ME STATES SHOWN. FILE:30FENG4l.COR + IUOIIQO9L v i1HL GI%,i; i'POOG rr f Coo 4/ �'f g, •'; t t? {rs l�r' • �' e�;�#'z�`��r'�ufi7 , 'r � - ._ 1;_.` a�' �'� � rS.�• 'FOo- i�'r $0.00° 90.00° _ i V 1 t un LO to 2 0 IN \,, s t .�-62 1/4' 232 31b" Ir i Oro t- LAN LU 0 DRAli4NBY;GP SC�u.E:u4�=' ` FOUR SEASONS SOLAR PRODUCTS,LLC BY CFffiQCED BY .... 1 ix r t� a 5005 VETERANS WWORM EIIGHWAY ba71Vi.0liTtl1l00i YAOB 1 OF1 V xoLSRoox NINYORKl1741 DEMGNERS AND MANUFACIVREROF FOT REASONS SLMOOMS c , o Wk ' 1 JIM SMART DECK INSULATED.FLOORING SYSTEM ALLOWABLE LIVE LOADS 5005 VETERANS MEMORIAL HIGHWAY EFFECTIVE DATE:1-99 HOLBROOK,NY 11741 MAXIMUM ALLOWABLE PANEL TYPE SPAN LIVE LOAD DEFLECTION=U360 PSF KG/M..._ s 7It t FT 12.13 M 174 84_9 " 7/16OSB µ 9 FT 12.74 M 130 635 5 5/8"EPS(1 LB PER CU/FT) 11 FT 13.35 M 71 347 7116"OSB ; 13 FT 13.96 M 42 2055 15 FT 14.57 M 27 132_ INSULATED FLOOR PANEL DETAILS 7/16'THICK ORIENTED STRAND BOARD TOP AND BOTTOM GIRDERS CAN BE SPACED AS NECESSARY TOACHIEVE RLODING i o LOADING z -Zy .Ifo '4y 2 x 6 JOISTS AT T �'''• PANEL SEAMS 1A CU/FT EPS FOAM AVAILABLE HATH f=�' (NOT SUPPLIED) ALUMINUM SKIN ON ONE SIDE FLOOR PANELS AVAILABLE IN FLOOR PANEL LLEDGERS I 4'x IT OR 4x16'. CROSS SECTION t ' I 1 f ----- LOCALLY ENGINEERED UNDER STRUCTURE GIRDER DESIGN BY OTHERS (POSTS AND GIRDERS) it oACG/ pCeMNEC E�[FI, �1EGE FLEE, O (•`� 3aE.P;CF.� u •1 y04';aC(i���' :a+'GE r\ - + raT +sqsw a� ytrr�9 T .users ' � \ Ef..•9� PFv 1 8 s J�. 3KT 9 r Aee was* �!' rws •.� ucE au � J+ t;o� 11. ��� t i "aEisc.s rraw.w . ENMMNO! _ nartnwua rla 231 i - ��_ 6��r[ e, aal rout 9 ALABAMA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA ILLINOIS 4RocEaa uwp/F t��q � - \`ta !P-' 3�„e•u�nI rsarwzcF«�r/��Etcrr'�•)=nq/� .�. ]f �t a�w 'y�1 w.a«w. "te!a�= .IEcMr�•ae6e� ��► •,te•r...... ...q,.E.,.i�, g uR•�DutFmYru�aI�.` , >'�..t�°aENna�to.r"�',`+p.e M.��.r..�_I.N.•e-.oN�I«nWFESf'c.r•"e+O`�.f•.T.`+wA M4JQ1IS�� owl, MASSACHUSE S�IS�OSIfPtfiP I MARYLAND TTS MICHIGAN LOUISIANA MARE KANSAS KENTUCKY �}tCE F •••••,• a of ryb twy sero- •...,�. `o.«iw.t4 � �c�` •cam ♦ � . •�s ; .w� �Oeu tc `Fv ��:s`cF'<,•L+� FE•�'0 9 � '" '� f 'sme. •3»rs x;. 10W5 1750E .Loa a r 3� u3zzx i ti aw B .`F'cr*i c!'a �Q, �F Mt���a °•+a�:`+e t� F°°EMa taC rF"rurM�, kfat �'ia«�� '�arEssp�' vynF�° 4'C[EFs MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA OHIO MATERIALS: cF F, Er-oE\ POLYSTYRENE CORE a �FGFE"y, aaa°►pO c .y °"�E'.`-�5'' "` ti TENSILE STRENGTH•18-28 psf. . I T s•Na.cF s " I lw-..Eft s`5ra rC7s a Q -SHEAR•18-Yl Pel. - . ren. £ --- rma -SHEAR MODULUS(Gc)•280-320 Pal. my_ r 0AMN `1_tom,^. . T- y �+ ., *„,.p -MODULUS OF ELASTICITY•180-220 pat. T l e`MN�:.fit.' •r» �E' ssc� °ks.«•a* B+E M.rr•as ^� qso CE ORIENTED STRAND BOARD(OSB): �' ENEE pa t° OKLAHOMA ORE ON PENNSYLVANIA PUERTO RICO SOUTH CAROLINA SOUTH DAKOTA -MODULUS OF RUPTURE•Baa Pat.MODULUS OF ELASTICITY•T238t0 Pa MOR-AD M4W SERIES ADHESIVE: `'at«cE f4 sF ��`.E \ y •sth }r' '�k- -TENSILE SHFJ3t 80ND•SO pal. . s .1�JL3E� ./ rae76 S k• J. �s NOTES: 7 sws.x�• ��� 4 u ,,_.ei �t� t)DEAD LOAD: 13.5 pd-PANEL CONSTRUCTION. Trate ;w% F T'�AV.. c o ?iia ( ) Fra!S°� ,RmQ,J pat n✓ At 2)ENGINEERS CERTIFICATION:ILAWRENCE FlSCHER CERTIFY THAT THESE ENGINEERING SPECIFlCATONS NAVE BEEN PREPARED UNDER MY :CT i -TENNESSEE TEXAS UTAH VIRGINIA WASHINGTON WESTVIRGINIA SUPERVISIONZ-.T1AMAREGISTEREDPROFESSIONAL ENGINEER IN THE STATES SHOW � ♦ l«rtl«Q Er �are�` - r 7' a� °�Gx•s t✓ A'YOMFrIU WISCONSIN WYOMING ire FILE:FLORENGI.CDR P151 SMART DECWm ?' DEAD LOADING OF FLOOR PANELS = 5 LBS SQ/FT. INSULATED FL00R PANEL 'DETAILS NAIL OR SCREW s (FLUSH) x FLOOR PANELS AVAILABLE 4' x 8' OR 4' x 16'. A ,-0" FOR'PANELS WITH ALUMINUM SKIN USE PART No'sL WIDTH 7W6FIE4X8 OR 7W6FIE4X16 AND FOR PANELS13/16 TO 7/8" WHITHOUT ALUMINUM SKIN USE PART No'SON BOTH SIDES 7N6FIE4X8 OR 7N6FIE4X16. .� C PERIMETER SE TION A FLASHING (BY OTHERS) FACIA 1 x 6 I-t-6" MAX (BY OTHERS LEDGERS BOTH SIDES) 8' p - �0'�•G (SE ' �.. SECTION B E) SECTION C INSULATED f Np1 ION A GIRDERS OPTIONAUNDER SIDE WHEN (SEE NOTE) LOCALLY ENGINEERED GROUND LEVEL IS CLOSER THAN 18" TO UNDER UNDER STRUCTURE SIOE OF DECK OR CODES REQUIRE A PRESSURE NOTE: GIRDERS CAN BE SPACED TREATED UNDER STRUCTURE. AS NECESSARY TO ACHIEVE REQUIRED LOADING. ALLOWABLE LIVE LOADING WHEN (SEE LOAD CHART) USED AS FLOOR PANELS v FACIA 2 x 6 CJt INSULATED (BY OTHERS) SPAN (FEET) LIVE LOAD (PSF); OEFL,=L/360 FLOOR PANEL PERIMETER FLASHING EXISTING ADAOUATE FASTENERS AS REQUIRED 5 86 (BY OTHERS) HOUSE (BY OTHERS) 8 47 6 1/2- STRUCTURE FOAM SET BACK STRUCTURE 10 34 1 5/8" ON ENDS 12 25 4 x 4 NAIL OR SCREW 40 LBS IS TYPICALLY REQUIRED BY MOST (BY OTHERS) 6" MAX 6 1/16" RESIDENTIAL BUILDING CODES. AS REQUIRED �oa scaEw SUITABLE JOIST CLIPS —SPAN (BY OTHERS) CUT,BOTTOM O. S. B. 2x 4, 6OR8 (BY OTHERS) LEDGER 2 X 10 MIN. ' (BY OTHERS) I 2-2 x 10 CONCRETE PIER do POST L SPAN SUGGESTED MIN. TO MEET CODE REQIREMENTS. (LOCALLY ENGINEERED) (BY OTHERS) SECTION C SECTION B NOTE: FOR ROOF APPLICATIONS SEE DRAWING 4-21. NORT#q r . ED / over Town - of ti 1 F' N ......... . .... No. 3 _ o� o�M��� dover, Mass., !� ADRATED PP��'`y S H BOARD OF HEALTH Food/Kitchen PERMITT. D Septic System • BUILDING INSPECTOR .. T THIS CERTIFIES THAT... 0$ ............ �.V ./ I��.N ............. Fou ... ................. ...... Foundation has permission to erect...�..9.�. al��..... buildings on .....4 4.... ......... ..... ...r. ...... .......�............... Rough to be occupied as...... DAP ^r Chimney Ch' provided that the person accepting this permit shall in every respect conform to the terms of the application file in Final this office, and to the provisions of the Codes and By-Lawsr lating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. /b S OZd $ ,Uo •► PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final 1V I UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough W . ....."000.. ..... ............................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove IFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Ctrr�t Nn D o .... ate..... .... ..... + TOWN OF NORTH ANDOVER PERMIT FOR WIRING 1 • � +D��TID��"� ,SSACNUS� This certifies that .................. ...........:................ ....... .................................... has permission to perform...�-(................ .... ................... i wiring in the building of.... . ... . . .... . ........ .......... .. ............... at.. � �� /.. ...�.. _. .. ..:.:................................... .North Andover,Mass. Fee... :.........�... Lic.N063Z............................................................ 1 l ELECTRICAL INSPECTOR Check 5068 Commonwealth of Massachusetts Official Use Onl Z� Department of Fire Services PB it No. /Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO P FOR ELECTRICAL WORK All work to be performed in accordance with the Massac usetts El ctrical Code(MEC),52 CM 12.0 (PLEASE PRINT IN INK OR - ALL FO ATION) Date: City or Town of: /To the Inspector of ires: By this application the undersigned gives noti o is or her intenti t6 perform the electrical work described below. Location(Street&N er) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with`a building permit? Yes. ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion qf the ollowin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above In- o.o Emergency Lighting rnd. ❑ rnd. E] No. Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No:of Zones ' No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kit Security Systems: No.of Devices or Equivalent No.of WaterKit 0.0 No.of Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent f OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under t e pain and penalties of perjury, that the information on this application is true and complete. . FIRM NAME: LIC.NO.: -1 53qC Licensee: John S. Bassett Signature LIC.NO.: 1533C (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.• 603 594 5928 Address Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lic, see does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. c Owner/Agent Signature Telephone No. PERMIT FEE: $ , r Location �� No. 3 Date t119 i. ��. NOR7N TOWN OF NORTH ANDOVER 4' p Certificate of Occupancy $ • : ' Building/Frame Permit Fee $ F O +,Ss+1CMUE Foundation Permit Fee $ 5 t P Other Permit Feet} $ 0 Sewer Connection Fee' $ Water Connection Fee $ TOTAL $ —�--+� � a Building Inspector o T^ p74A y+ 6 p Div. Public Works PERMIT NO. � APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 `MAP K-40. I LOT NO. 12 RECORD OF OWNERSHIP DATE BOOK 'PAGE 'ZONE SUB DIV. LOT NO. yLOCATION PURPOSE OF BUILDING OWNER'S NAME ,e �`1 t �0 NO. OF STORIES J-Lfi� SI E Com• OWNER'S ADDRESS d ,�} BASEMENT OR SLAB -- � ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST 2ND 3RD BUILDER'S NAME .AAY _42e/O^�� �A✓1, �f�oGtr� 1 SPAN --- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION z, w4 IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS 00 CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE 3 PROPERTY INFORMATION INSTRUCTIONS 4--T?-3� LAND COST f� SEE BOTH SIDESLK� Z EST. BLDG. COST EST. BLDG. COST PER SFT' PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILEDt tAND APPROVED BY BUILDING INSPECTOR DAT E r ?4 wuILDINQ INGPECTOR ` SIGNATURE OOR AUTHORIZED AGEN FEE OWNER TEL.# PERMIT GRANTED Q CONTR.TEL.# •/���L ■ LS CONTR.LIC.Ii H.I.C.N ®Qt ®Z L 1 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S ES 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 _ _ 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D _— PIERS PIASTER _ DRY WALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. 8'M'TAREA _ 1/ 1/2 14 FIN. ATTIC AREA _ NO B M FIRE PLACES _ HEAD ROOM _ MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH __ _ ASPHALT SIDING HARD11J O _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME j 3 BRICK ON MASONRY. 7 ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES` KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR ' TILE DADO 1 1 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE L 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 GAS OIL Bst^T 13 d I NOCHEATING rN ORT Of I f over �, port dower, Mass., UG 19 q,� 0 -- LAKE ' 'QA CO CMI CME • t� £t .ilQ A_ Q �9 R ATE D P 'L BOARD OF HEALTH H ;t Food/Kitchen ;.E RMIT Septic System DING INSPECTOR. t .. BUIL R. �.�[PSL RMLAb l 1J THIS CERTIFIES THAT �0,.s �.c.!1.!..�......................... ........*111*1................... ............................................................. Foundation has,permission to ereet !..........:......... buildings on Wil....T.b. .....%T...................................... Rough � ' r to+be coupled es ZZ4 , .14 . ..SkO.�,h1..4..........'°:'" _.... .......... ....... ......... Chimney providedAthatthe person accepting this perAk shall in every respect conform to the terms of the application on file In Final this office;,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings.in the Town of North Andover. PLUMBING INSPECTOR , VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PER.MIT EXP 6 MONTHS y ELECTRICAL INSPECTOR UNLESS CON Rough .......................................... ... ................... ... Service BUILDING INS TOR F Final t Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough i' t Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry, Wall To Be Done r FIRE DEPARTMENT 4 Until Inspected and Approved by the Building Inspector. 1; Burner " { x Street No. PLANNING FINAL CONSERVATION FINAL y 1: .�� Smoke Det. `- SEWER/ kER FINAL DRIVEWAY ENTRY PERMIT The Commonwealth of Massachusetts -` Department of Industrial Accidents ' Office Of11 MstY2017S 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit loc tion: L-e- D Vr, phone#' I am a homeowner perfohning all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. company nam address: city phone#• insurance co ev poli # .�. ..a,� .i�' : ^�;A' I`.' ,U. v'�✓ r.tf3�'� ."nt'�%'� � l".t.x �'e �r '�v's'nil E] 1 am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company nam address: city phone#• .. {insurance co_. Policy H: �ii"fG•'��sE'3r �� ;�,: _vow . a. er r. . ^{. s�.� s..+;r, fv, i, C�`^ ,. "Y ,�' ihY7. Y; (q-.. 3'. r,. „,�m,�at, caninany na J Q till U 02— addr phone# 2 1 2X_S- '6-3V 0 insurance c PQ i # ,. .�:...>... .�. -. r ,� ;. � '»r�.ss�' 3"" * ,, xi;�jt �?,'S!,;f ', ,� ;.�6r ,�°,."'y*A7 rN�.r�G�by 't�a",giMd$thonJilxhcefJtf necessa, � �y. �� Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a nue up to st,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. l do her y e iand tl ains 'nd nasties of perjury that the information provided above is true and correct. Signatu e Date Print name � Y ��' t"�3� Phone# �����T ig ::- Official use only do not write in this area to be completed by city or town official city or town: pennit/license# -Building Department v C]Liccasiog Board ❑check if immediate response is required c3Sclectmen's Office C]Hcalth Department " contact person: pYwnc M; rlOther ::;� Tt' Irevucd 3/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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, 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. ✓ r 1 s$.,,, y .a� F ZS, �1vS. yam- au,e ,N 1 -r. i. {9l•$ ¢:3'. 3f`.. ;;xw } 11: - r4".:. ,?er.tAaf '•Z,...$; '�"a^.�5 i?.r� ¢e*' ���Lz„ Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. a•,'}"�.`S"« Si'"riIT _..t` �s>'xfi x .o-'sa ...:"'J vr.lf a csY`a Sa';'{�, MT� .�>M. � � - ...�x , n... , str ,.,,rn ;. �s ,. .,.3 tt•' City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. .t 7x3 ir$ti far.➢ 5� �a v �,t -r v � '�rrx � lrY�X°r 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 fax #: (617) 727-7749 phone 9: (617) 727-4900 ext. 406, 409 or 375 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number 3gU is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in which City or Town • STREETD[RES i � fcc G TYPE OF CONTAINER FOR TRANSPORTATION i ✓1i 5ignat re of Permit A plicant Date ► Suggested Affidavit for Home Improvement Contractor Permit Application For omce Me only N G OF CITY !'OWNp, / Pcrn►ll No. Z/ - l)d is AFFIDAVIT Houle Ituprovctuent C ontructor Uw Supplement to Pcrmit Application MGLc.142Arequim that the rfcnnslruction alteration.renewntion,retuiir,mcKtemii:Hinn,ennvenion,jnt)nwetncnt,remnvut,demolition, „,,aonstriction of an addilion to any tarcai%ling owiler-414,cif lied uihtior conrainin,1J Lvi.t aur hul nen nuur heel(otir dwrlling uniiti....nr In ul uclur"which 1.1e adil.cent to Much Irinten('e or bu_ild_inL"t c ULOSIC by lCgialereal ColliluClLdJ,will)4u19411 uca:l)4wus,along Willi UdICC lCcl41(CUICUI�. 7pe of Work: Est. Cost Addreas of Work Owner Name: Date of Permit Application: I hereby certify that: 'Registration is not required for the following reason(s): _Work excluded by law _Job under $1,0W 11uildine, not owner-occupied _Owner pulling own permit _Other (specify) 4 Notice is hereby given that: OWNERS PULLING TI iE1R OWN PERMIT OR DEALING WITH UNREG ISTERED CONTRACTORS FOR APPLICABL1_:11OME lM1'14.OVLMCXII WORK UO NOT HAVE ACCESS'1'O'I'l ll�ARl ITR'ATION PROGRAM Olt GUAI:ANTY FUND UNDF-.R MGL c. 1•t2A. Signed under penalties of perjury: 'le / �,�� t�►n^ I hereby apply for a permit as the agent of the owner: e Dale Registration No. Olt: NotwiMstanding the above notice, I hereby apply for a Permit as the owner of the above property: Date Owner Name ✓lze -Poorvnoouuea� ryJ//,i'�aaoac�ucael�i 0EPAPLNEt.T _ ti:. i :ONSTRUCiTON i;'PEP TC0r"", ", '.it S= �UOIGQ �,(pli2 v1 t i1date: Ir IIasouy uli zc CS v4O301 I 18 2 un,p �wL y � fiRic! ;� ;iii �.,•: 1/7e ate\ HOME IMPROVEMENT CONTRACTOR Registration 100502 Type - PRIVATE CORPORATION Expiration 06/18/96 AMERICAN REMODELING INC Charles Cook L�ce�F�o 7�i 4585 NORTH STEMMONS 45102 ADMIWS-MATOR DALLAS TX 15241 1 it •)f,.,t .f ,'�,� _ a ; ; ° Y ` i'..' ,° t Y s t � �.f' .') i <� ti `�r� afi:. 1 . _ Date.. .. ...... 2479 111 0 NoT;°�"a TOWN OF NORTH ANDOVER { i PERMIT FOR WIRING 7SgACHUSEt N7 This certifies that A4 . ...... �r..1-2.................................................. {- has permission to perform wiring in the building of +�..5...!.x.<«:::'.....!.:...' m at....... i:. ..... .. .......:':::�...........T................................. .North Andover,Mass. Fee ............ Lic.No. - " '�' '-� ...... :... ............................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File -WE! The Commonwealth of Massachusetts Office Use Only _ Permit No. a �_=r' Department of Public Safety Q��`,� BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee CheckedT 1211 r c, fl 3/90 (leave blank) APPLICATION FOR_PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INF F1 TIO Date City or Town of—A/a �'K To the Inspector of Wires: -The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) rte szA ` Owner or Tenant Owner's Address Is this permit in conjunction with a building permit yes no ❑ (Chi*Appropriate Box) Purpose of Building Utility Authorization No. Existing Service -----Amps_J 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 TOTAL No. of lighting Outlets No. of Hot Tubs No. of Transformers KVA Above In Nr. of Lighting Fixtures Swimmin Pool rnd.❑grnd❑ EG3enerators ? No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets INo. of Gas Burners FIRE ALARMS No. of Zones TOTAL No. of Detection and No. of Ranges No. of Air Conditioners TONS Initiating Devices HEAT TOTAL TOTAL No.of Sounding Devices No. of Disposals No. of Pumps TONS KW No. of Self Contained Detection/Sounding Devices No. of Dishwashers Space/Area Heating KW Municipal r No. of Dryers HeatingDevices KW Local ❑ Connection L.J Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. of Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requi ements of Massachusetts General Laws / I have a current Liability Insurance Policy in ing Completed Operations Coverage or its substantial equivalent.YES1Q-1g6 ❑ 1 haave submitted valid proof of same to this office. YES O ❑ If you have checE ed YES please indicate the type of coverage by checking the appropriat box. INSURANCE BOND ElOTHER -J (Please Specity) - CZc 4xpiratio*nate) Estimated Value of Electrical W rk $ Work to Start A Inspection Date Requested: Rough Final Signed under th penalties of perj ry: FIRM NAM QQ� LIC. NO. Licensee _ '''' ,,e� 14 i`�,'«lenature _LIC. NO .3� Address 2� � 1_,_'� Uy �'1��>?? Bus. tel6N,o� ej _-J__- 3Q Alt. TeC�t�6. -C��? �4��` 06 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $_- Date... ` ...."...3...... O�M0 oTM �h0 3: , -.._�. TOWN OF NORTH ANDOVER AL p PERMIT FOR WIRING ssAcmUS r Thiscertifies that ... ....:!,............................................................................. }has permission to perform.......-K- ru - ---- ................................... wiring in the building of.... .-- .. 'E' - � -+ ......................................... �� V at........ ............................................... .... .../....�. ,North Andover,Mass. Fee= .. . .... Lic. ELECMCAL INSPEC MR Check # 4800 Official Use Only Permit No. ' Dy:a o�Pic Sa6dy Occupancy&Fee Chec�Ced BOARD OF FIRE PREVENTION ReGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance'with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date 1 2 13 f b3 To the Inspe Toror oct f Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number_ f(v FO oC E'�,T Snt ELFT Owner or Tenant PA L L,A Y); tin Owner's Address SAM V Is this permit in conjunction with a building permit Y No 0 (Check Appropriate Box) Purpose of Building 5�1 n!P-00 M Utility Authorization No. Existing Service `2-6h Amps ��10 J246 Voits Overhead 4 Undgmd 0 No.of Meters New Service Amps Voits Overhead 0 Undgmd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work W(2C 90CU S(4- R o PIA ` Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above a In 9 No.of Lighting Fixtures 2 Swimminq Pool gmd 0 grnd 0 Generators KVA n No.of Emergency Lighting No.of Receptacles Outlets ( No.of oil Burners Battery Units at No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Pumps Tons KW No.of Sounding Devices NoJ of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices 0 Municipal 0 Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Si to Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws • I have a current Liability Insurance Policy includin mpleted Operations Coverage or its substantial equivale YES NO = h .�G6m` valid proof of same to the Offi YES- NO - If you have checked YES please indicate the type o coverage by checking the appropriate box. INSURANCE BOND - OTHER - (Please Specify) IM S Wf.A.4 Ce )0 1 0 1 (Expiration Date) Estimated Value of.El ctrical Work$ Work to StartAl l Inspection Date Resquested k7-1410 Rough Final Signed under the Penaltfes of perjury: FIRM NAME G&wrrM K aS C ECT r2i L n LIC.NO. I ng S Licensee �� Signature / ',�,`�yh/_' F LIC.NO. dv1 y Bus.Tel No. Address VUR�V^l �V L Jf� , I IJ R Q SG19 Att Tel.No. n 3 8:10 4 7 2 OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachuset General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE (Signature of Owner or Agent) The Commonwealth of Massachusetts b , Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers`Compensation insurance Affidavit r Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. Q I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees woridng on this job. Company name: Address city P Insurance Co. Policy# Comgg!N name: Address. :' f�ktorre#k lrmmnM.Co. Policy.# Faikwe to secure coverage as megtured under SeCbon 26A or MGL tat can lead to,the impos*n of cYiminal up t and/or one years bT*mwnent-as xn4 pwaWs-bl6eSarmAta fic�e.,pf:(,ZUD_O*aA r understand that a copy of this statement may rte:ftwarded to the ofrice of knoesbgations of the DIA for CaVeirage verifP mon. /do hemby cW&wxAw Bre pam and pennies of pegwy M&the blfarrnabw prm*kd above b true and aarnect Signature Date Print name Pbom- Official use only do not write in this area to be completed by city or town o 5cW City or Town �. E]check ifmnediate resp=e is required lt.Slrl Contact person: Phone,#. Health L F1 Other