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HomeMy WebLinkAboutMiscellaneous - 85 FLAGSHIP DRIVE 4/30/2018 (13)w Date ..... . 3----.7-16 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies has permission to perform ...... ...... .. . . . .......... wiring in the building of....... at ...... 64A. 'N ...................... 4orth Andover, Mass. Fee , N�Ri-/ ............. .................................................................................... ELECTRICAL INSPECTOR Check 4t 3h& Commonwealth of Massachusetts Official Use On a Department of Fire Services Permit NO. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked v. ] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfonned in accordance with the Massachusetts Electrical Code EC),.527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Invpec or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number)_ 5 `G t15,111- /',���'_ U t Owner or Tenant100 Telephone No. Owner's Address . ex )K -c Is this permit in conjunction with a building permit? Yes �No ❑ (Check Appropriate Box) Purpose of Building -0 Utility Authorization No. Existing Service 1400 Amps /Q / Volts Overhead ❑ Undgrd ©� No. of Meters IN_ p New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity +# �on and Nature of Proposed Electrical Work: r �/D C•t �r �"1 hoc �`Z e•rr� c T S `r3".S�✓iTcH: \ ,r riaucn aaataonai aetan tf desired, or as required by the Inspector of Wires. ,d Estimated Value of Electrical Work � JV66 , 6 O (When required by municipal policy.) Work to Start: 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 �k 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 applic 'on is true and completes FIRMNAME: LIC. NO.: Licensee: JO S •�c c�. � %/� Signature '�' LIC. NO.: i (If applicable enter exempt" in the license. numb r Zine.) Bus. Tel. No.: Address: Gi! i ! Z1 LJ Alt. Tel. No.: %gJ- "f c'3- S/ 7 *Per M.G.L c. 147, s. 57-61, security work requires Departme 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 a ent. j Owner%Agent Signature Telephone No. PERMIT FEE: $ e.�..�.. uJ tf,v junuwu� iaote may be watvea by the Ins eetor of Wires. No. of Recessed Luminaires No. of Ced. Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of LuminairesLJ ool Swimming PAbove ❑ In- ❑ o. o mergency ig mg d. rnd. Batten Units No. of Receptacle Outlets ,Q No. of Oil Burners FIRE ALARMS No. of Zones No. of SwitchesNo. of Gas Burners No. o Detection and Initiatin Devices No. of Ranges No. of Air Cond. onTots No. of Alerting Devices No. of Waste Disposers Heat Pump Number ............................................................... Tons KW No. of Self -Contained Totals:.. Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW ecurity Systems:* No. of Water No.KW No. of of No. of Devices or E uivalent Sipans BBalallasts Data Wiring: No. of Devices or, E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: riaucn aaataonai aetan tf desired, or as required by the Inspector of Wires. ,d Estimated Value of Electrical Work � JV66 , 6 O (When required by municipal policy.) Work to Start: 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 �k 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 applic 'on is true and completes FIRMNAME: LIC. NO.: Licensee: JO S •�c c�. � %/� Signature '�' LIC. NO.: i (If applicable enter exempt" in the license. numb r Zine.) Bus. Tel. No.: Address: Gi! i ! Z1 LJ Alt. Tel. No.: %gJ- "f c'3- S/ 7 *Per M.G.L c. 147, s. 57-61, security work requires Departme 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 a ent. j Owner%Agent Signature Telephone No. PERMIT FEE: $ The Commonwealth of Massachusetts F Department oflndustrialAccidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 o�t www mass.gov/dia M Sy�y Workers, Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FMED WITH THE PERMITT'NG .A,UTHORITY. Name (Business/Orga*ation/lndividual): to S � Ill Address: City/State/Zip:_ Are you an employer? /%- 6d&.6 Phone 4; cic the appropriate box. 1. ❑ I am a employer with employees (full and/or part time).* 2. am a sole proprietor or partnership and have no employees Worl ng for me in any capacity. [No workers, comp. insurance required.] 3. r] I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no,employees. S.I]I am a general conizacfor,and I have hired the sub -contractors listed on the attached sheet. 'These sub -contractors have employees and have workers' comp. insurance.t c. 6. ❑ We are a corporaiiori and its, officers have exercised their right of exemption per MGL l52 §1(4) and'we Have iio employees. [No workers' comp. insurance requirerL] /- �,S-.7-P/2 Type of project (> ec'uixed); 7. ❑ Nevsi c6nstr6dilon 8. E] Remodel3iig 9. ❑ Demolition 10 ❑ Building addition 11.[] Elecixica11 Tpp,*s or additiogs 12. g.P1uu-mbing repairs or additions 134j Ro6f repairg 14.[] Other ' fi lic information *Any applicant that cheolcs box 4ii mus t Homeowners who suBmit;this afidav: TContractors that checkths box must a o,, InvPPc iftha sub contractors have also fill out the section below showing their workers compensa on po y indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. rched an additional sheet showing the Warne of the sub -contractors and state whether of not those entities, have mnlovees_ thev must provide their• workers' comp. policy number. lam an employer that is providing workers' compensation insurance for° my employees. information. Insurance Company Policy # or Self -ins. Lic. #:. .Below is the policy and job site Expiration Date, City/State/Zip: Job Site Address: pensation policy declaration page (showing the policy number and expiratxoxa. date). Attach a copy of the vc�oxkers' com Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a frn.e up to $1.,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a to the OOfPfi a O Ian ORDER ons of the DIA for '50.00 a day against the violator. A copy of this statement may be forwarded coverage verification. 'ded "hove is true and correct. T do hereby thep ins a penalties ofperjury that tlae informaiton prova 1_ . nate- 2/7A, only. Do not write in this area, to he 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 Phone Contact Person- Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for them 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 ofan 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 & 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 commonvc;ealth for any applicant,whti! has not produced -acceptable evidence of compliance with the insurance coverage requI red." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter intp any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements ofthis 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 carry workers' compensation insurance. If au LLC or LLP 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 retained to the city or town that the application for the permit or license is being requested, not the Department of Industrial=Accidents. Should you have any questions regarding the law or if you are required to obtain a wokkers' compensation. policy, please call the Department at the number listed below. Self-insured companies should enter their Self-insurance license number on the appropriate liue. 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 (ifnecessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia p C �'lMWi }NWEALTH CSF' l"r�ACHtU ET T S} x , r BOARD OF ELECTRICIANS ISSUES THE "FOLL0WrNG LICENSE, , AS A REG JOURNEYMAN ELECTRIICIAW .'OSEPH P GRAMOLINI Jf ' 9 AMER S -T WAI(VtELD MA x188.0-3727 1 26794(' E 07/31/16 5728.9 ;� �. This certifies that .....1 1 .......................................................... . has permission to perform ...... t�—. V........ ................:............................... wiring in the building of.....,: ` :Lt— at ......... `. J......`. ,,,,,, ,......... .,,, V Nl ; North Andover, Mass. Fee.... .1.2.�...... Lic. No. {�'�........................................................................................ ELECTRICAL INSPECTOR Check # lj Date ...3 11..�.................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING U -20t, 4� 4 N _t Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 13191-1 Occupancy and Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -,3rj -- /� City or Town of NORTH ANDOVER To the Inspector of Wires: By this application the undersigned.gives notice of his or her intention tQperform the electrical work described below. Location (Street & Num Owner or Tenant it Owner's Address Telephone No. Is this permit in conjunction wi uilding 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 a d Nature of Proposed Electrical Work: C% Completion of the followingtable may be waived by the Inspector of Wires. 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 E] In- E]o. rnd. grnd. o mergency Lignting Batte Units N,o. 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 Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KW ..........Detection/Alerting No. o Self -Contained Devices No. of Dishwashers Space/Area Heating KW Local El Connection El Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water, Heaters No. of No. of Sians Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent O'T'HER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of I)lectroical. Work: (When required by municipal policy.) Work to Start:* -21f,0 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVE GE: 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 aims and penalties of perjury, that the information on this application is true and complete FIRM NAME: �0 , G t-- LIC. NO.: Licensee: 01-C-- Signature LIC. NO.: (Ifapplicable, e r" empt" in the license number ne) Bus. Tel. No.• /' Z? �G1 Address: 1(�1 �, �•, r—C i� -t- S"SO-.��+ UZ!(�(� Alt. Tel. No.: 37 *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 a ent. Owner/Agent PERMIT FEE: $ Z Signature Telephone No. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual):---. Address: City/State/Zip: SeR) Lt,yt, pl i(6 6Z/990 Phone #: 20- eL? Are u an employer? Check the appropriate box: I a employer with 4. F1 am a general contractor and I employees (full and/or alt -time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ i am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. Q New construction 7. ❑ Remodeling 8. ❑ Demolition 9. Q Building addition 10.❑ Electrical repairs or additions I I .Q Plumbing repairs or additions 12.❑ Roof repairs 13�Other�'e�5 -nny nppnu+m tna[ cnecKs oox a m must also uu out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors. that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: S .� �C kC�j '���-�� ✓ 1 C Policy # or Self -ins. Lie. �.�" ��� ' S��'S'1 Expiration Date: Job Site Address: C 7 ! City/State/Zip: 1 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains an�genalties of perjury that the information provided above is true and correct 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 #: '9862 Date..... /n. 0 '0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING 3 Thiscertifies that ....................................... ............................................... '56!Fr—L-!?Z .... 5v.s ..................... has permission to perform ............................. $ wiring in the building of .......... ....................................... �..... at �-............ A� ......... / North Andover, Mass. Fee..:�S.......... Lic. No... C67 ............... Check# •U 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance-with the provisions of M.G.L. c. 143, § 3L, the Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of coilipletion of the work as required in M.G.L. c.143, § 3L. Permitsyall_be limited as to the time of-ongoing construction activity, and Iaybe.deEmed_by the_Inspector_of _Wires abandoned_and_invalid-if he—.. _ .. or she has determined that the authorized work has not commenced or has r.tt progressed during the preceding 12-month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or.the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012. Rule 8 — Permit/Date Closed: -- * Dote: Reapply for new per ' 0 Permit Extension Act — Permit/Date Closed: / J41 l.,ammonruaalf�t n� /�a1lac/uUeff .� —. I`�-� �eParfinenf o��}r're Jrrvicel `17BOARD OF FIRE PREVENTION REGULATIONS Official (.'se Only I � Permit No. '% Occupancy and Fee Checked [Rey. 1 07] de;ne blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .AII work to be pert'ormed in accordance Keith the \IasSuchusetts Electrical Code (NIECi. '' CNIR 1100 IPLF4.CEPRI.N'TIN'I,N'KOR TI'PE.4LL I'r:O, IL-ITIOY) Date: City or Town of: 6iX0(&LA41L-` To [he InV)ccror oI fFire.s: By this application the undersign' ed gives notice of his or her inten�ion to perform the electrical work described helo%e. Location (Street ONiner or Tenant Owner's Address Is this permit in conjunction with a buildin permit' Purpose of Building Existing Service .amps Volts New Sen ice Amps Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical ;:ark: l es Fi No (Check .Appropriate Box) L tility Authorization No. ONerhead 1 t_ ndgrd Overhead F i'ndgrd L t No. of deters No. of deters No. of Recessed. Luminaires CC( 1.s l- the rnsoector of rt,res INo. of Ceil.-Susp. (Paddle) FansNo' of Total Transformers KV A No. of Luminaire Outlets No. of Hot Tubs I• Generators K`'A No. of Luminaires Above r In- t— �Swimmina Pool ;rnd. a grnd. E-' o. of mergence tg ting 113atten• Units No. of Receptacle Outlets No. of Oil Burners IFIRE ALARMS No. of Zones No'. of Switches No. of Gas Burners I` No. of Detection and Initiating Devices No. of Ranges INo. of Air Cond. TonsTota) No. of alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons K.Yt' I No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection ❑Other No. of Dryers No: of Water Heaters KW Heating Appliances KW No. of No. of Signs Ballasts Security Svstems:" D No. of bevices or E uivalent p Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: d ?81 -D.2 a 5-1 Attach additional detail rii'desired. or as required by the Inspector of 1Vires. Estimated Value of Electrical Work: 9o7S(When required by municipal policv.) Work to Start: Q� Inspections to be requested in accordance with NfEC 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 undersiened certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK CNI E: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Self Insured certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: A_DT Security Services ( LIC. NO.: Licensee: Mark A. BrotphV Signature LIC. NO.: C-45 /Uaoplicable, enter "exempt " in the license number rine.) Bus. Tel. No.. 603 -594 - 5922 .-address: 18 Clinton Drive Hollis DIF Alt. Tel. No.: *Per tiI.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. 00953 ONVNER'S INSURANCE WAIVER: I am aware that the Licensee does no., have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owners agent. Owner/Agent Signature Telephone No. PERMIT FEE: S Date .//�';.-.—/U TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that /�xltoq .......... has permission to perform plumbing in the buildings of .................... at ............... North Andover, Mass. ic. No .......... .......... Fee/Q L .......... PLUMBING INSPECTOR Check # _ -_ iV ACI USETT U 'ORM APPEZCATION POP. PE ]MT TO JQ 0 P�,�1�4DING (Type or print) NOF, -M AND OVER, MASSACMSETIS Dafe %!' Zolo Owners Name Building Locatidn ��� Amount a T e o£Occu ancy 0 -Plans Submitted Yes No � - New Renovation Replacement Check one: t cr�xu�a `G oint•or typo) Corp. Installing CompanyNaln 1144C.1-- El jj ff Address ' '' FirmlCo. Business 'Telephone 91i Name ofUcetised Plumber: lc 16f �yera-e by checlung the appropna - box: Insurance Coverage. Indicate the e of usuran g Bond Liability insurance policy Other type of indemnity. fai ,Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one o£the above three insurance n Signature • - Owner 0 Agent daccuiate to in Ihereby certify that all of the details and information I have submitted (or entered) in abo ruled for this application will be ince best of my.lmowledge and that all plumbing work and installa e P rfo d er 1.42 of the General Laws. compliance with all pertinent provisionsoftheMassae • Type of Plumbing License Title S1 q -71 F]roume ant CiWown. r-Lcense um er Master ym . APPROVED (OFFICE USE ONLY Location �� �� c� Sx ,v Date ?A/� I— No. S0 S3- -�)(- / 2 Check # ? ") 2- 25486 25486 TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee S TOTAL 114 Building inspector M w b. CD u ,-* 4 3*> 0 U) 0 40 0p U) > 0 U ) < 0r— 0 0 z -7- CC 4-- m C.) 0 E m 0 O -C a) E �- -C 4- -1-, 0 cn E cn a) 0 :3 CU M .w 0 CD a) NO 4.1 E LU LO -2) E 0 x n 42 c (n " cri 1q" LO 0 a) Uta -C to z 0 W cn 0 -C -1-1 LO C, Ij (1) tm U) V) < -j 00 T- (1) c L- Z-- O LU o cl) a ,n F- < U) U) < a) > z 0 U) (Dm > > -Fu = Cl) Co Q -C �!E Cl) %v C: 0 0.0 (D LP En z -0 CU CY cu 0 o LL (L) U) L- 4- > C: -C LO 0c) 0 L 0 CL 0 04 a_ MCl) .0) U) C 4- .0 0 CN c: U) CY U) CD o > C: (C) > a L (1) CU 0 :3 W-*, o a) -i LO CL N. I CII) O LL 0 06 0 (D < w 0 CL fv "M < o a. o "u g N bI(,:, o cd c O �tb 9� 10 ca 044,cd 0 � a cd q . Fi �.� Z CSS 9J PN 8 2 W 16 �. ® �1 0 0, bI(,:, o cd c O �tb 9� 10 ca 044,cd 0 � a cd q . 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F . Y raltla•.i pauo,s algnoP 8L x.£ x.bi t i ll) uaa�a 346ri pained - stwd6I.W06 x,£x.b/t Z(Z) .h Al aixlM palued siegwoM ..... �'— a8uma Z-3 Vit Z x.*Z x.b (oo - —10 igon Pslued xxgwoM I .8 ]y. j�'–J� ,T,06ue43 Z-3 -tit Z x So t is x.b(t) uaaiD ipso Polmd+egwoM 1fT .Z/lb aBaa4o Z-3 �b/tZx.st/tt t5x.9(t) .E .bb .&2 t9 MOLA opts twig W6n Pelumd iaddol tuntwxye l adow uxnsTa ,$Z I' X.bb x.Z/t b (L) dap $ a Opts Itt Pzq Lopa wl 6u vmp on •ea4m Lo '(OI9SN S19d) tIMM *90'(DLZSS4 SWd) wawa W 6n pe wRd eruauodwoa u6W Iltl s uw MuN W peps to etuauodwoo u6ry Ily -WN Bul—a Maty dol Vstutj Paluted woisno'eoej a(gnoo'isod aldpi aegpaoM aBueyo Z-3 Date. /� - I e-%: '0 '7 TOWN OF NORTH ANDOVER PER�IyiOR GAS INSTALLATION This certifies that .. �. 'r�.: ���- - .............. i ........ has permission for gas installation ..--?� in the buil-diiings of .. `�.� ., ..:. . North Andover, Mass. Fee � . L�ic. No. ......... GAS INSPECTOR Check # A G MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) r� / A�,')DyE�� ,Mass. Date i ! 20 OP Permit # Building Location 6146 S/�/a' Owner's Name S«7r C r usl-7- Owner Tel# New Renovation ❑ Type of Occupancy C cv— Replacement ❑ Plan Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name_CAUA Ap & 4 /4T6 Address qt /�&L-/VU/07- — jk. Jy74SS Business Telephone # 7 Name of Licensed Plumber or Gas Check one: R-C-Orporation ❑ Partnership Certificate] 7 INSURANCE COVERAGE: I havea cu a ility Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No El If you have checked rtes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ 1 hereby c4 knowledge By. Title an or the aetans ana mrormation I have submitted (or entered) in above a all plumbing work and installations performed under the permit issued for of the Massachusetts State Gas Code and Chapter 142 of the General L City/Town APPROVED (OFFICE USE ONLY) Type o nse: •<WMbeQ SignatuO er aster License • Journeyman are true and accurate to the best of my ration will be in compliance with all t7f�; Ilum er or Gas Fitter Date..Z ...... ....... &ORT#1 1 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING 7 This certifies that ................................................................... has permission to perform .... ............................. ....................... wiring in the building of .... z .......... ............... at......................................................................... North Andover Aass. Fee v...... . . X ..... Lic. No . ............. ......... J, .............. ELYdIfICAL INSPECIrOR Check # C'ommonwealg o f Maisac"M Official Use Onl� c� Permit No./ 1j aUePartment o/.}c� ire �erviced Occupancy and Fee Checked 90 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12,00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I (a-1 O City or Town of: fyorA-fin An �jJ e �Z 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) 96 !1001 Sk \r) nrtt)p Owner'or Tenant C lk OAC kP SDe vy-\cp Telephone No. Owner's Address f la. Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Location and Nature of Proposed Electrical Work: Completion nfthe fnllnwino tnhlo mm) ho .-A-d h,, ih. 1--o— .,f iy; 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 ❑ In- ❑ rnd. grnd. No'o mergency Lighting Units No. of Receptacle Outlets —.BaffM No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pum Totals: Number TonsKW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal [I Other Connection No. of Dryers Heating Appliances KW, Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: 611'710E? 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 9 BOND ❑ OTHER ❑ (Specify:) I certify, under th�ains and penalties of perjury,' ^that the information. on this application is true and complete. FIRM NAME: f �� r lb L_ LIC. NO.: Licensee: Signature LIC. NO.: (If applicable, enter "exempt " in the license number line.) Bus. Tel. No.•_603 Address: 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/Agent Signature Telephone No. PERMIT FEE: $y. � � N a c� � n � ro a a r 8.04 jtO r i v O, EDF z� 7077 77 � L F7 COMMON REA�IOTAL AREA-1)200SQF �1 A -14 rn (00 o -4 �0 P z wii WEEN . o0 cn z r z m om X� X�ns m ��cn ( o to DDo z�C � zCQoc- 0 °0-m ® m 0 m mo G� mozC) L Km 171 K<�_ Dm � 0 i �I Town of North Andover Office of the Conservation Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Ahson�McKay Interim Conservation Administrator April 23, 2004 Champagne Realty Trust Lawrence Lyons 85 Flagship Drive North Andover, MA 01845 Telephone (978) 688-9530 Fax(978)688-9542 RE: ENFORCEMENT ORDER: Property at 85 Flagship Drive Violation of the Massachusetts Wetland Protection Act (MGL c.131 s.40) and North Andover Wetland Protection ByLaw (c.178 of the Code of North Andover). Dear Mr. Lyons: During an inspection conducted by the Conservation Department on April 21, 2004, several excavating vehicles were observed on the above referenced property to the far rear of the parking lot to the north west of the site. Active excavating just beyond the parking area in this location was observed from the street and several photographs of this unpermitted activity were taken. In-house records, plans, and wetland maps indicate that a large wetland resource area is located just beyond the parking area in the location were work was being conducted. These activities were conducted without an Order of Conditions from this Department and are in violation to the state Wetlands Protection Act (the "Act") M.G.L. c.130, s.40 and the North Andover Wetlands Bylaw (the "Bylaw") Section 178. An Order of Conditions is required for any work activities performed within 100 feet of a protected.wetland resource area pursuant to the Act and the Bylaw. In addition, the Bylaw enforces a 50 -foot no -build and a 25 -foot no - disturbance zone from the edge of the wetland resource area (Section 3.4). Specific wetland resource areas affected by the activities include the following: • Bordering Vegetated Wetland (MWPA Regulations Section 310 CMR 10.55 and the North Andover Conservation Commission (NACC) Regulations Section 1.3.); • 25 -Foot No Disturbance Zone (NACC Bylaw Section 3.4); and • 100 -Foot Buffer Zone (NACC Bylaw Section 1.3.) ORDER: Acting as an Agent of the Commission under MGL C.40, S.21D and the Act (310 CMR 10.08(3)), enclosed please find an Enforcement Order mandating a cease and desist on all unpermitted activities within 100 feet of the wetland resource area and the submission of the following documents as described below. BOARD OF APPEALS 688-9541 BUILDING 688-9545 COINISERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 1. Wetland Field Delineation The property owner shall have all wetland resource areas within 100 -feet of the work activities delineated by a qualified wetland biologist. 2. Wetland Restoration Report A report shall be provided to the NACC in narrative form that includes a detailed description of existing conditions, all unauthorized activities, and the proposed restoration (wetland resource areas and 25' No -Disturbance Zone) including the sequence of work, resource area plantings strategy, anticipated future construction and landscaping activities, current and future sedimentation/erosion control measures and site stabilization measures. The report shall address all impacts to the wetland resource areas protected by the Act and Bylaw as well as the proposed mitigation measures in detail. 3. Plans Existing Conditions Plan: The existing conditions plan shall include all information required for a Notice of Intent application filed with the NACC. This plan shall include the wetland alteration area, structures, facilities, storage area, etc., within 100 -feet of the delineated wetlands, as well as the location of the 100 -foot buffer zone, 50 -foot No - Construction Zone and 25 -foot No -Disturbance Zone. This plan will serve as the base plan for the proposed wetland restoration plan described below. 4. Restoration Plan: The restoration plan shall include all information required for a Notice of Intent application filed with the NACC. The restoration plan shall show the proposed mitigation measures including, at a minimum: • The proposed planting and grading plan for the Bordering Vegetated Wetland and 25 -foot No -Disturbance. + Proposed erosion and sedimentation control measures to be employed on-site. • Any other mitigation measures deemed necessary to restore the wetland resource areas on the property. 5. Notice of Intent A Notice of Intent filing application under the Massachusetts Wetland Protection Act and North Andover Wetland Protection Bylaw. The Notice of Intent application and all of the information as requested above must be filed with the Conservation Department by no later than May 13, 2004. The violations as documented herein are subject to a $100 per day per penalty' until such time as the impacted resource areas have been mitigated. Each day or portion thereof during which this violation continues shall constitute a separate offense. At this time this Department has elected to levy a fine in the amount of $100 per day (from the date the violation was identified) until the resource area and buffer zone has been restored in accordance with the approval granted by the Conservation Department and/or Conservation Commission. 1 In accordance with the provisions of MGL c.40 s.21D and Section 178.10 of the North Andover Wetland Protection ByLaw (REV May 1993/ REV October 1998/ Amended 9/10/03) However, we reserve the right to take additional action in the future should this Enforcement Order not be complied with retroactive from the date we were first made aware of the violations. Failure to comply with this Order and the deadlines referenced herein will result in the issuance of additional penalties. MGL C.131 S.40 and the North Andover Wetland Bylaw, C.178 authorizes the Conservation Commission to seek injunctive relief and civil penalties per day of violation. In addition, a violation of the Massachusetts Wetland Protection Act and the North Andover Wetland Bylaw constitutes a criminal act, which is subject to prosecution and the imposition of criminal fines, also per day. This Enforcement Order shall become effective upon receipt. Attached is a list of consultants who can assist you with bringing the site to compliance. Your anticipated cooperation is appreciated. Sincerely, J- �%' % Alison McKay Interim Conservation Administrator Encl. CC: NACC Ms. Heidi Griffin, Community Development Director Bob Nicetta, Building Commissioner Michael McGuire, Building Inspector DEP-Northeast Region file C Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands Ll I WPA Form 9A - Enforcement Order Massachusetts Wetlands Protection Act M.G. L. c. 131, §40 Provided by DEP B. Findings The Issuing Authority has determined that the activity described above is in violation of the Wetlands Protection Act (M.G.L. c. 131, § 40) and its Regulations (310 CMR 10.00), because: ® the activity has been/is being conducted without a valid Order of Conditions. ❑ the activity has been/is being conducted in violation of the Order of Conditions issued to: Name File Number wpaform9a.doc . rev. 12/15/00 Dated Condition number(s) Page 1 of 3 A. Violation Information Important: When filling out This Enforcement Order is issued by: forms on the North Andover 4-23-04 computer, use only the tab Conservation commission (issuing Authority) Date key to move To: your cursor - do not use the Champagne Realty Trust c/o Lawrence Lyons return key. Name of Violator 85 Flagship Drive, North Andover, MA 01845 Address 1. Location of Violation: ' SAME Property Owner (if different) 85 Flagship Drive Street Address North Andover 01845 City/Town Zip Code .1 07C 24 Assessors Map/Plat Number Parcel/Lot Number 2. Extent and Type of Activity: Excavating activities within a bordering vegetated wetland resource area and associated buffer zone without an Order of Conditions. B. Findings The Issuing Authority has determined that the activity described above is in violation of the Wetlands Protection Act (M.G.L. c. 131, § 40) and its Regulations (310 CMR 10.00), because: ® the activity has been/is being conducted without a valid Order of Conditions. ❑ the activity has been/is being conducted in violation of the Order of Conditions issued to: Name File Number wpaform9a.doc . rev. 12/15/00 Dated Condition number(s) Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 9A - Enforcement Order Massachusetts Wetlands Protection Act M.G. L. c. 131, §40 Provided by DEP B. Findings (cont.) ❑ Other (specify): See attached Enforcement Letter C. Order The issuing authority hereby orders the following (check all that apply): ® The property owner, his agents, permittees, and all others shall immediately cease and desist from the further activity affecting the Buffer Zone and/or wetland resource areas on this property. ® Wetland alterations resulting from said activity should be corrected and the site returned to its original condition. ® Complete the attached Notice of Intent. The completed application and plans for all proposed work as required by the Act and Regulations shall be filed with the Issuing Authority on or before May 13, 2004 Date No further work shall be performed until a public hearing has been held and an Order of Conditions has been issued to regulate said work. ® The property owner shall take the following action to prevent further violations of the Act: See Attached Cover Letter Failure to comply with this Order may constitute grounds for additional legal action. Massachusetts General Laws Chapter 131, Section 40 provides: "Whoever violates any provision of this section (a) shall be punished by a fine of not more than twenty-five thousand dollars or by imprisonment for not more than two years, or both, such fine and imprisonment; or (b) shall be subject to a civil penalty not to exceed twenty-five thousand dollars for each violation". Each day or portion thereof of continuing violation shall constitute a separate offense. wpaform9a.doc • rev. 12/15/00 Page 2 of 3 4 Massachusetts Department of Environmental Protection DEP File Number: LL7/lBureau of Resource Protection - Wetlands WPA Form 9A Enforcement Order Massachusetts Wetlands Protection Act M.G. L. c. 131, §40 Provided by DEP D. Appeals/Signatures An Enforcement Order issued by a Conservation Commission cannot be appealed to the Department of Environmental Protection, but may be filed in Superior Court. Questions regarding this Enforcement Order should be directed to: Alison McKay, Interim Conservation Administrator Name 978-688-9530 Phone Number 8:30 - 10:00 a.m. Monday, Tuesday, Wednesday, and Friday Hours/Days Available Issued by: North Andover Conservation Commission In a situation regarding immediate action, an Enforcement Order may be signed by a single member or agent of the Commission and ratified by majority of the members at the next scheduled meeting of the Commission. Signatur s: °7 00i i C) tip (-) Cao l a7f?/ 7V / `l Signature of delivery person or certified mail number wpaform9a.doc - rev. 12/15/00 1 Page 3 of 3 I TOWN OF NORTH ANDOVER NOTICE OF VIOLATION OF WETLAND BYLAW 0191 DATE OF THIS NOTICE NE OF OFFENDER IDnXC ADDREst s END 'S r C��II,T{{Y, ST TE, ZIP ODEt 4 f AWVaP. DATE OF BIRTH OF OFFENDER (}� MV OPERATOR LICENSE NUMBE MV/MB REGISTRATION NUMBER OFFEN(�SE: �f J ( //, f- _� �4 it iYlB t fiC jl 1i1Lf illli� CSl wlln 41 �� L,AI,,?C�-ate Cl t' i l�C„w� i{�jSt�LV Z4?. G°f Ali Drier TIME AND DATE OF VIOLATION (A.M.)(P.M.) ON &,J J 200it LOC ION OVF jOLATION 11 AT i' i SIGNA OF ENFORCING FORCING DEP�??RTMENT cc, z- �fCl`� loh I HEREBY ACKNOWLEDGERE IPT OF THE FOREGOING CITATION X// U able to obtain signature of offender. Date Mailed .2 0Y LR"Citation mailed to offender tt .4 THE FINE FOR THIS NON -CRIMINAL Of FENSE IS $� YOU HAVE THE FOLLOWING ALTERNA,jtVES WITH RE ARD TO DISPOSITION OF THIS MATTER. (1) You may elect to pay the above fine, either by appearing in person between 8:30 A.M. and 4:30 P.M., Monday through Friday, legal holidays excepted, before: The Conservation Office. 27 Charles Street, North Andover, MA 01845 OR by mailing a check, money order or postal note to the Conservation Office WITHIN TWENTY -*E (21) DAYS OF THE DATE OF THIS NOTICE. This will operate as a fins disposition of the matter, with no resulting criminal record. (2) If you desire to contest this matter in a non -criminal proceeding, you may do so by making a written request, and enclosing a copy of this citation WITHIN TWENTY-ONE (21) DAYS OF THE DATE OF THIS NOTICE TO: The Clerk -Magistrate, Lawrence District Court 380 Common St., Lawrence, MA 01840 ATTN: 21 D non -criminal (3) If you fail to pay the above fine or to appear as specified, a criminal complaint may be issued against you. ❑ A. I HEREBY ELECT the first option above, confess to the offense charged, and enclose payment in the amount of $ ❑ B. I HEREBY REQUEST a non -criminal hearing on this matter. Signature WHITE: OFFENDER'S COPY YELLOW: CONSERVATION COPY PINK: POLICE COPY GOLD: COURT COPY n Town of North Andover Office of the Conservation Department Community Development and Services Division 27 Charles Street Alison McKay North Andover, Massachusetts 01845 Interim Conservation Administrator April 23, 2004 Champagne Realty Trust p� r�ence L ons 1 `� �' # R5 Fla shi Drive North Andover, MA 01845 Telephone (978) 688-9530 Fax (978) 688-9542 RE: ENFORCEMENT ORDER: Property at 85 Flagship Drive Violation of the Massachusetts Wetland Protection Act (MGL c.131 s.40) and North Andover Wetland Protection ByLaw (c.178 of the Code of North Andover). Dear Mr. Lyons: r During an inspection conducted by the Conservation Department on April 21, 2004, several excavating vehicles were observed on the above referenced property to the far rear of the parking lot to the north west of the site. Active excavating just beyond the parking area in this location was observed from the street and several photographs of this unpermitted activity were taken. In-house records, plans, and wetland maps indicate that a large wetland resource area is located just beyond the parking area in the location were work was being conducted. These activities were conducted without an Order of Conditions from this Department and are in violation to the state Wetlands Protection Act (the "Act") M.G.L. c.130, s.40 and the North Andover Wetlands Bylaw (the "Bylaw") Section 178. An Order of Conditions is required for any work activities performed within 100 feet of a protected wetland resource area pursuant to the Act and the Bylaw. In addition, the Bylaw enforces a 50 -foot no -build and a 25 -foot no - disturbance zone from the edge of the wetland resource area (Section 3.4). Specific wetland resource areas affected by the activities include the following: • Bordering Vegetated Wetland (MWPA Regulations Section 310 CMR 10.55 and the North Andover Conservation Commission (NACC) Regulations Section 1.3.); • 25 -Foot No Disturbance Zone (NACC Bylaw Section 3.4); and • 100 -Foot Buffer Zone (NACC Bylaw Section 1.3.) ORDER: Acting as an Agent of the Commission under MGL C.40, S.21D and the Act (310 CMR 10.08(3)), enclosed please find an Enforcement Order mandating a cease and desist on all unpermitted activities within 100 feet of the wetland resource area and the submission of the following documents as described below. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 638-9540 PL NI NNG 688-9535 11 1. Wetland Field Delineation The property owner shall have all wetland resource areas within 100 -feet of the work activities delineated by a qualified wetland biologist. 2. Wetland Restoration Report A report shall be provided to the NACC in narrative form that includes a detailed description of existing conditions, all unauthorized activities, and the proposed restoration (wetland resource areas and 25' No -Disturbance Zone) including the sequence of work, resource area plantings strategy, anticipated future construction and landscaping activities, current and future sedimentation/erosion control measures and site stabilization measures. The report shall address all impacts to the wetland resource areas protected by the Act and Bylaw as well as the proposed mitigation measures in detail. 3. Plans ',Existing Conditions Plan: The existing conditions plan shall include all information required for a Notice of Intent application filed with the NACC. This plan shall include the wetland alteration area, structures, facilities, storage area, etc., within 100 -feet of the 'delineated wetlands, as well as the location of the 100 -foot buffer zone, 50 -foot No - Construction Zone and 25 -foot No -Disturbance Zone. This plan will serve as the base plan for the proposed wetland restoration plan described below. 4. Restoration Plan: The restoration plan shall include all information required for a Notice of Intent application filed with the NACC. The restoration plan shall show the proposed mitigation measures including, at a minimum: • The proposed planting and grading plan for the Bordering Vegetated Wetland and 25 -foot No -Disturbance. • Proposed erosion and sedimentation control measures to be employed on-site. • Any other mitigation measures deemed necessary to restore the wetland resource areas on the property. 5. Notice of Intent A Notice of Intent filing application under the Massachusetts Wetland Protection Act and North Andover Wetland Protection Bylaw. The Notice of Intent application and all of the information as requested above must be filed with the Conservation Department by no later than May 13, 2004. The violations as documented herein are subject to a $100 per day per penalty' until such time as the impacted resource areas have been mitigated. Each day or portion thereof during which this violation continues shall constitute a separate offense. At this time this Department has elected to levy a fine in the amount of $100 per day (from the date the violation was identified) until the resource area and buffer zone has been restored in accordance with the approval granted by the Conservation Department and/or Conservation Commission. 1 In accordance with the provisions of MGL c.40 s.21D and Section 178.10 of the North Andover Wetland Protection ByLaw (REV May 1993/REV October 1998/Amended 9/10/03) However, we reserve the right to take additional action in the future should this Enforcement Order not be complied with retroactive from the date we were first made aware of the violations. Failure to comply with this Order and the deadlines referenced herein will result in the issuance of additional penalties. MGL C.131 S.40 and the North Andover Wetland Bylaw, C.178 authorizes the Conservation Commission to seek injunctive relief and civil penalties per day of violation. In addition, a violation of the Massachusetts Wetland Protection Act and the North Andover Wetland Bylaw constitutes a criminal act, which is subject to prosecution and the imposition of criminal fines, also per day. This Enforcement Order shall become effective upon receipt. Attached is a list of consultants who can assist you with bringing the site to compliance. Your anticipated cooperation is appreciated. Sincerely, d6'�' Alison'McKay Interim Conservation Administrator Encl. CC: NACC . Ms. Heidi Griffin, Community Development Director Bob Nicetta, Building Commissioner Michael McGuire, Building Inspector DEP-Northeast Region file M J Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: 'r WPA Form 9A - Enforcement Order Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Violation Information Important: When filling out This Enforcement Order is issued by: forms on the North Andover 4-23-04 computer, use Conservation Commission (Issuing Authority) Date only the tab ' key to move To: your cursor - do not use the Champagne Realty Trust c/o Lawrence Lyons return key. Name of violator 85 Flagship Drive, North Andover, MA 01845 Address 1. Location of Violation: ' SAME Property Owner (if different) 85 Flagship Drive Street Address North Andover 01845 Citylrown Zip Code 107C 24 Assessors Map/Plat Number Parcel/Lot Number 2. Extent and Type of Activity: Excavating activities within a bordering vegetated wetland resource area and associated buffer zone without an Order of Conditions. B. Findings The Issuing Authority has determined that the activity described above is in violation of the Wetlands Protection Act (M.G.L. c. 131, § 40) and its Regulations (310 CMR 10.00), because: ® the activity has been/is being conducted without a valid Order of Conditions. El the activity has been/is being conducted in violation of the Order of Conditions issued to: Name Number wpaform9a.doc • rev. 12/15/00 Dated Condition number(s) Page 1 of 3 Y Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 9A - Enforcement Order Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings (cont.) ❑ Other (specify): See attached Enforcement Letter G. Order The issuing authority hereby orders the following (check all that apply): DEP File Number: rrovlaea oy utP ® The property owner, his agents, permittees, and all others shall immediately cease and desist from the further activity affecting the Buffer Zone and/or wetland resource areas on this property. ® Wetland alterations resulting from said activity should be corrected and the site returned to its original condition. ® Complete the attached Notice of Intent. The completed application and plans for all proposed work as required by the Act and Regulations shall be filed with the Issuing Authority on or before May 13, 2004 Date No further work shall be performed until a public hearing has been held and an Order of Conditions has been issued to regulate said work. ® The property owner shall take the following action to prevent further violations of the Act: See Attached Cover Letter Failure to comply with this Order may constitute grounds for additional legal action. Massachusetts General Laws Chapter 131, Section 40 provides: "Whoever violates any provision of this section (a) shall be punished by a fine of not more than twenty-five thousand dollars or by imprisonment for not more than two years, or both, such fine and imprisonment; or (b) shall be subject to a civil penalty not to exceed twenty-five thousand dollars for each violation". Each day or portion thereof of continuing violation shall constitute a separate offense. wpaform9a.doc - rev. 12/15/00 Page 2 of 3 Massachusetts Department of Environmental Protection L7/ I Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 9A - Enforcement Order Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP D. Appeals/Signatures An Enforcement Order issued by a Conservation Commission cannot be appealed to the Department of Environmental Protection, but may be filed in Superior Court. Questions regarding this Enforcement Order should be directed to: Alison McKay, Interim Conservation Administrator Name 978-688-9530 Phone Number 8:30 - 10:00 a.m. Monday, Tuesday, Wednesday, and Friday Hours/Days Available Issued by: North Andover Conservation Commission In a situation regarding immediate action, an Enforcement Order may be signed by a single member or agent of the Commission and ratified by majority of the members at the next scheduled meeting of the Commission. Signatur 7 603 i o t0 0 b0 l 0791 74// � Signature of delivery person or certified mail number wpaform9a.doc - rev. 12/15/00 . Page 3 of 3 TOWN OF NORTH ANDOVER NOTICE OF VIOLATION OF WETLAND BYLAW 0191 DATE OF THIS NOTICE I e NJp,�'AE OF OFFENDER j ' t .�t OF --- r7C',T i 1 1 iL,7 i l// c1 re-- C.0 r)ck.'tc;' 'lt�i T4\ L t� V0_I I Ci order L't TIME AND DATE OF VIOLATION ij ^ (A.M.) (P.M.) ONCic i 1 fX I 20 f LOC ON OF VIOLATION AT X, �� �l f" Dr r v e - SIGNA ��7OFe ENFORCING �q/ry P %�iIFORCING OEP RTMENT t X �ble to obtain signature of offender. Date Mailed 3 �f [9 Citation mailed to offender14, JJ `1 THE FINE FOR THIS NON -CRIMINAL Of FENSE IS YOU HAVE THE FOLLOWING ALTERNAT, tVtS WITH RE ARD TO DISPOSITION OF THIS MATTER. (1) You may elect to pay the above fine, either by appearing in person between 8:30 A.M. and 4:30 P.M., Monday through Friday, legal holidays excepted, before: The Conservation Office. 27 Charles Street, North Andover, MA 01845 OR by mailing a check, money order or postal note to the Conservation Office WITHIN TWENTY44IE (21) DAYS OF THE DATE OF THIS NOTICE. This will operate as a finaT disposition of the matter, with no resulting criminal record. (2) If you desire to contest this matter in a non -criminal proceeding, you may do so by making a written request, and enclosing a copy of this citation WITHIN TWENTY-ONE (21) DAYS OF THE DATE OF THIS NOTICE TO: The Clerk -Magistrate, Lawrence District Court 380 Common St., Lawrence, MA 01840 ATTN: 210 non -criminal (3) If you fail to pay the above fine or to appear as specified, a criminal complaint may be issued against you. ❑ A. I HEREBY ELECT the first option above, confess to the offense charged, and enclose payment in the amount of $ ❑ B. I HEREBY REQUEST a non -criminal hearing on this matter. Signature WHITE: OFFENDER'S COPY YELLOW: CONSERVATION COPY PINK: POLICE COPY GOLD: COURT COPY N2 2356 0 Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......0) 0 ......... ... ............................................. has permission to perform ...... �f............ wiring in the building of ..... A.01! ... ..... 3'�,c ........................................... A at ......... ...... ....... OR . . .......... , North Andover; . ass. Fee. Lic. No. ....... ............ ELECTRICAL 166 INSPECTOR Check # j WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Corn»tonw�alllt o %/%ad�acltuda�! For Office Use Only (Rev. 11/99) �- cc�� cc77 Permit Number: I' 1J�Pa►1�msna` o` }ira �iwccsli Occupancy & Fee hVCJ,7. dQ BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (ALL WORK TO BE PERFORMED WITH THE MASSACHUSETTS ELECTRICAL CODE 527 CMR 12:00) PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: City or Town of: / W —ANDOVER To the Inspector of Wires: By this application th undersigned gives notice of his or her intention to perform he electrical work described below. Location: (Street & Number)`% ) I Owner or Tenant: Owner's Address: Is this permit in conjunction with a Building Permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building: -7jV p g: Utility Authorization #: y , Existing Service: 410 Amps/Volts Overhead ❑ Underground. 19e # of Meters �} New Service: LPO Amps & St/y277 Volts Overhead ❑, / Underground. f # of Meters: ` Number of Feeders and Ampacity: ,P P®/Z � ©lam F�� 'f Pi, W�� �y U + LAm"I O o� Location and Nature of Proposed Electrical Work: ® --�% L . No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Transformers Total KVA No. Of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool: Above ground a In Ground ❑ # of Emergency Lighting .Battery Units No. of Receptacle Outlets No. of Oil Burners Fire Alarms # of Zones # of Detection & Initiating Devices # of Sounding Devices: # of Self Contained Detection/Sounding Devices Local ❑ Municipal Connection ❑ Other ❑ No. of Switches No. of Gas Burners No. of Ranges No. of Air Conditioners TOTAL TONS: No. of Waste Disposals Heat Pump Totals: Number: TONS: KW: Security Systems: No. of Devices or Equivalent No. of Dishwashers Space /Area Heating: KW Data Wiring, No. of Devices or Equivalent: No. of Dryers Heating Appliances KW Telecommunications Wiring: No of Devices or Equivalent: No. of Water Heaters KW No. of Signs: # of Ballasts: OTHER; # of Hydro Massage Tubs No. of Motors Total HP 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 b-" BOND ❑ OTHER ❑ Please specify: Estimated Value of Electrical Work $ (When required by municipal policy) Work to Start: 6 ry" 04C 6 Inspections to be requested in accordancewith MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the Information on this application is true and complete. Firm Name: /LIC. # /7 L67 Licensee:�l ``'l o Signature: Cd�LIC. # I (ifapplicable, enter "exempt' in the license number line) Address:1 f �Nrl /� i� � �/ Y ��� ✓Mi/[� f L'1 r '-wig + Bus. Tel. # k Ci &113 1�1Tel. # 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 a OR Agent a Signature of Owner/Agent: Telephone # PERMIT FEE: $ .(j Location No. Date V- o � el TOWN OF NORTH ANDOVER Certificate of Occupancy $ ,r 01, U1i41n rgr, TYil,Permit Fee $ Foundation Permit Fee $ Other P,6rmltjFee $ Sewer Connection Fee $ 14 . Waidr�Connection� Fee $ C) -- TOTAL Building Inspector Div. Public Works PERMIT NO.. C2,e APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP d40. LOT NO. I 2 RECORD OF OWNERSHIP JDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. LOCATION o PURPOSE OF BUILDING. -'o ff cD)v t A4M oven 2 A4i I h e - OWNER'S NAME mc NO. OF STORIES SIZE I I OWNER'S ADDRESS chi . G Ior U r BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN h"f' DISTANCE TO NEAREST BUILDING DISTANCE FROM STREET DIMENSIONS OF SILLS POSTS DISTANCE FROM LOT LINES — SIDES REAR " GIRDERS l` `J%� AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION ��1 THICKNESS ,�` IS BUILDING NEW SIZE OF FOOTING,/1 /+V X V IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATIONyells IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM Td REQUIREMENTS OF CODE i / A� NL 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 INSTRUCTIONS y SEE BOTH SIDES � PAGE 1 FILL OUT SECTIONS 1 PAGE 2 FILL OUT SECTIONS 1 12 0� ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING /ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED n SIGNATURE OF OWN OR AUT RIZED FEE -�/Q-:,— PERMIT :,— PERMIT GRANTED 19 OWNER TEL. #4:'9'7--370,0 CONTR. TEL. # CONTR. LIC. 2 3 PROPERTY INFORMATION LAND COST EST. BLDG. COSTD EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY ti BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN S W fo p A � n dpJ.• � H 0 A H z a H SL CL H O C a �c C21� Z O 3 r a O c m 0 z A N 0 D 00 c v Zr �a � p+ Vl• o, M X 0 .m► � V1 � 0 W ��r-M � b T/ M A 1 �3 %� ` O O s z mn C Z C �• a n c v � O 0 p � 3 1 W ° x a S W fo p A � n dpJ.• � H 0 A H z a H SL CL H O C a �c C21� Z O 3 r a � c m 0 z A N 0 D 00 c 0 Zr �a m p+ o, M X 0 .m► zT V1 m'^ VO , d QA ��r-M ZR W T/ M A 1 �3 %� ` O S W fo p A � n dpJ.• � H 0 A H z a H SL CL H O C a �c C21� Z 3 � c S W fo p A � n dpJ.• � H 0 A H z a H SL CL H O C a �c C21� ol 3 � c m m m c p+ c co') o ��r-M s z mn a n c v p W ° x > z v m Z n � '" 0 v *99 T 19 = Z Z H -i T T n D C f1 2 70 ol p+ co') ol lip 2'Y- I Z—,' gr, �J -kr //L, � )e6 -s Ar LIZ lip 2'Y- I Z—,' gr, �J -kr //L, � )e6 -s Cyt COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY {/ OF t 1010 COMMONWEALTH AVE. MASSACHUSETTS GOSTON, MASS. 02215 I ,.. ? r ENCLOSE CHECK OR MONEY OPOER I EXPIRATION DATE �I 1' ICONS TRLI SUPERVISOR FOR REQUIRED FEE, if 06/30/1991 i MADE PAYABLE TO RESTRICTIONS EFFECTIVE DATE LIC-NO.� o sr "COMMISSIONER OF PUBLIC SAFE'iY NONE 06/3 s` 0/1989 001724 , KEVIN ,J SMITH (DO NOT SEND CASH). 3022 110 NIGH STRE1845 S S 024-48— __ ANDOVER MA EASE NOTE FEE tIWCREA 'i �,,t,�.i',•., �FHOTG (BLASTING 3114 ONLY} FEE: 1 t. i I 100.00 4FECTIVtEfq 1, .1959 HEIGHT: ,j a NOT VALID UNTIL SIGNED BY LICENSEE AND ICTALLY i STAMPED OR - SIGNATURE OF TN COMM0 SIGNER ! iii��� DOB: J�;S* 03/05/ 195 V L r i' THIS DOCUMENTT MUST CARRIED ON THE PERSOf,G1I SIGNATURE OF LICENSEE SIGN NAM L(L ABOVE SIGNATURE LINE THE HOLDER WHEN ENC " 'rr t'• r"• 25 RIGHT THUMB PRINT ED IN THIS i OCCUPA C ' ` Y` OMMISSIONER 2000, ?.87-81429 i p , 3 c .,:TS t� �, ;: a,�J;i^«'1 d � fji' e _ ,. e.1• J11, � rw ?ws�'."�qt 1 t ! {��f'� 7 �`'}•r 1��S i�t.1-r�' 7 '«ir • �, +.,�g e `' lrtl T {AV I 4 ii f2' l , a1 )V, iF`�Y ra f Location I/No. 2 r v Date �u �- NORTN TOWN OF NORTH ANDOVER • OR O � 9 Certificate Occupancy $ of Zo 'ss�cMusE` Building/Frame Permit Fee $ a Foundation Permit Fee $ Other Permit Fee $ _ w TOTAL $ c �, Check # -3 154'1 1 Building Inspecto b 0 0 �d CL M W i O Fes! � u o � �3 0 UQ �. 0 cn �3 . cu 'moi' cin o �—► W CD CD 0 o 'CD " CD Np woo 0 N N 0 N ((DD CD CD CSD 41 � arQ o �r*0 oil CD ocz° CD CD CD ° EQ. 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