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Home My WebLink AboutMiscellaneous - 83 SURREY DRIVE 4/30/20180 Date ... /e77:.:.3 . // TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......... �j ......... ��.y .... ( ..... . . .. . . ... ................ has permission to perform ....... PAKI . ..... 5 .. wiring in the building of ................. ........................................... at. :?T7� ......... '-'A(:* ......... North Andov , Mass. pe _ F0,7 - Lic. No . ............. Fee ..... ......... ........... ......... .......... 4 &. �,---vl rA ELEcrRicAL INSPE R 11, Check 10426 A Common -wealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. -Iry � Occupancy and Fee Checked [Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINTININKOR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspegtor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 9-3 S ✓„ ✓ -e _Z/: ,-,, y e� Owner or Tenant A- _.j ✓car 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 /,00 Amps Volts Overhead 0 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:r Completion of the following table may he waived by the Inspector of Wires. Recessed T uminai a No. of __�_�s _ �_� .._re f! 1 c . d ) n No. of eia: cusp. (Paddle) pans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool nd. Above ❑ 'In- ❑rnd. Bat—Oo ter Units cy ig g No. of Receptacle Outlets No. of Oi_1 BUrners FTX 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 Tons No. of Alerting Devices . No. of Waste Disposers Heat Pump Totals: Number -*-I'--**-- Tons ....-.'.... KW **"" No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* - No. of Devices or Equivalent No. of Water KWNo. . Heaters of No. of Signs Ballasts . Data Wiring: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: rte/%% (When required by municipal policy.) Work to Start: p Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (- BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: /,t %, / j r� ,rr , �„ Signature LTC. NO.: (If applicable, enter "exempt" in the tens tuber line.) Bus. Tel. No.; Address: �,'l ��,, ,,(� /� Alt: Tel. No.• *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/AuPnt I ____ The Commonwealth opfassachusetts Department of IndustridAccidents Office of Investigations 600 Washington Street Boston, MA 02111 { r w}vw hwss gov/dia . Workers' Compensation Insurance Affidavit: Builders/ContractarsXlectricians/Plumbers A icant Tnfnr....f:..a Narrle (Business/C)rganization/Individual); Address: City/State/Zip: Phone #:. Are you an employer? Checit.the appropriate -box: ' 'T'ype •a em to er with p Y ___ 4 ❑ I am a general contractor and Ioyees of project (required): (full and/or part-time).* proprietor. have hired the subcontractors listed 6• ❑ New constructiona.sole %• or partner_ and have no employees on the attached sheet. # These sub -contractors have❑Demolitioning ❑ Remodeling for me in any capacity, com ,insurance p Lma workers' comp. insurance.orkers' 5. ❑ We are a corporafion and itsred.] 9• ❑ Building additicn homeowner doing officers have dxercised their 10.❑Electrical repairs or additions all work f, [No workers' camp, right of exemption per MGL' c. t.52, § I(4);and we have no 11.(]Plumbing repairs or additions nce re uired. t q ] .employees, [No workers' 12.[] RoofrePairs comp. insutancerequired] I3 ❑purer ---------------- °Any applicant that checks bo,'# I must also fin out the section below showing their workers' bompensation policy information, t Homeowners who submit this affidavit Indicating they am doing all wo!* and then hire outside contractors must submit a new af{davit indicating $Conhactars that checic this box mustcttached such. an edditicnal sh5et shotvi" FhC rfne of the sub -contractor and Theis sverka 'comp. pricy infe,;,adon. info✓inadoap�nyortlifdlf5yA9Y®v.Ss°�fd�P:Ec&i�rtEP.a'IC®e's1 inforraaatinva. El4sda iZinsuPancefo,-Wemplopeces. Below istlaepolicy-andjobslte Insurance Company 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 Iead to the imposition of criminal penalties of a- fine up to $1,500-00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a fine Of up to $250.00 a day against -the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. • I do hereby certify under the pains and penalties of pao;ury that the infor mation provided rabnve is true and correct Siemture: • Date: Phone #: Official use only. Do not w. rite l tris area, to be completed by cu`•y or town rrf�cial City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Cit3gT'own Clerk 4. Electrical Inspector 6.Other S. Plumbing Inspector Contact Person: Phone t%ORTH OL O O cocnuwew�cw 1• �X40 Pay a RATEo CONSERVATION DEPARTMENT Community Development Division MEMORANDUM DATE: October 4, 2013 TO: Amit Kumar FROM: Heidi Gaffney, Conservation Field Inspector SUBJECT: 83 Surrey Drive, North Andover, MA - Site Visit On October 2, 2013 the Conservation Field Inspector visited the above referenced property at the request of Amit Kumar (potential buyer) and permission to access the property was received from the owner of 83 Surrey Drive, Armando J. Vera in writing dated October 1, 2013. Wetland resources were not observed on the property of 83 Surrey Drive. Soils were checked on the property by auguring and upland soils were observed. Wetland resources appear to exist on the neighboring property of 75 Surrey Drive and may cast a small portion of buffer zone onto the property of 83 Surrey Drive, however the property of 75 Surrey Drive was not entered and no confirmation of the location of potential wetlands or any distances to the subject property were made. Mr. Kumar stated that he is interested in the possibility of adding an addition, expanding the lawn and possibly installing a pool in the future. After conducting the site visit it appears that this work would be permittable under the MA Wetlands Protection Act and the Town of North Andover Wetlands Protection Bylaw. Please do not hesitate to contact me if you have additional questions or concerns. 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 918.688.9530 Fax 918.688.9542 Web www.townofnorthandover.com Armando J. Vera 83 Surrey Drive North Andover, MA 01845 October 1, 2013 To Whom It May Concern: I hereby give permission to Mr. Amit Kumar and family, employees of the Town of North Andover, and any other parties designated by Mr. Kumar, to inspect my property and land at 83 Surrey Drive in the Town of North Andover, Massachusetts. Mr. Kumar and family are prospective buyers of this property and land. Sincerely, f Armando J. Vera Date , Zimbra: Permission for conservation to inspect the lans at 83 Surrey Drive, N.A. Page 1 of 1 1 Foye, Linda 644A3 Me of 1,000 M0 Back to Inbox X Delete I Move to.. , Move I Actions � -Go -sp.. I T Folders edd From : Libby Webb 41bby.webb@nennves.00m> W Inbox (223) Subject : Permission for conservation to inspect the lans at 83 Surrey Drive, N.A. w Sent To : Linda Foye <inda.foye@nemoves.corry Drafts (4) r ( Reply I O!. Reply All Fomard Print Junk Trash Hi Linda, Let me know when you plan to have conservation visit the property and I will try to be there. Thanks, Libby Notes �asearches ede_ From: "A. J. Vera" <falconajv@gmail.com> �T Tags edit To: "Libby Webb" <libby.webb@nemoves.com> Sent: Tuesday, October 1, 2013 6:00:28 PM Subject: Re: Aerial view of 83 Surrey Drive Tue, Hi Libby, Attached is the signed approval letter for Mr. Kumar and other parties to inspect my property and land at 83 Surrey Dr. in North Andc Regards, A.J. Vera Approval to impact 83 surrey Dr.pdf r^:) 302 Ke View View As Ji Download 13 Back to Inbox I X Delete I Move to... Move I Actions _� -Go I tp Spam https://email.newenglandmoves.comlhlsearch?si=16&so=0&sc=16715&st=message&id=3... 10/2/2013