HomeMy WebLinkAboutFP-006 - Permits - 304 CHESTNUT STREET 9/4/2019 06
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Application for S r Permit
(Rev.12applicationReturn
Permit Number. DIG SAFEBE .
City or Town: A*(4W
Start Date:
Date: . �m
In accordance with the provisions of M.G.L.
Captr 148,as provided in Section application is hereby made t .
by
u'a)GX4-A�,1g,
162
(Full Name of Person,Firm OT Corporation) (Phone Number)
of *� ArcotA I* UL4 ��l
(Address:Street or P.O.Box,city r Town,Zip dodo)
for permission to(state clearly purpose for which permit is requested) alp L4 �
q6, ►
Name of Competent Operator if epplicah[e rt. N o.
Date Ie --rejected By .
{ igna re of Applicant)
Date of expiration Fe � Amount Paid
F P-00
PERM11
City or gown:
�DIGSAFENUMBER
Date: C&A%(k
Start Date:
Permit Number ber 1 applicably):
In accordance with the provisions ofM.G.L.Chapter 148,as provid'ed in /A thispermit it i
p granted .
to
...........
(Full Name of Parson,Firm or co oration)
for
Restrictions. I iv ,fir � � �, Vv #
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(Street and 4 or Describe Loefion for Adequate Identlfiatio .� -
Fee Wald 1 �� wlrl expire err
Signature of Official Granting Perm t Title
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Narrative Report
Fire Alarm System
Laureen Fuller
304 Chestnut St
North Andover, MA
01845
SCOPE of WORK
With the approval of the building owner,ADT's licensed technicians will install supplemental supervised
low voltage wireless smol e detectors, and combination smoke/CO detectors, as captloned in fire floor
plan. New Control Panel will supervise fire and life safety components. Installation will be compliant
with 2019 Fire Code. LPL and fire code approved components will be installed.
4 BUILDING DESCRIPTION
. 7o"s construction single family residence with under 3,000 sq ft. living space, with four bedrooms
on the second floor.
FIRE PROTECTION TIO SYSTEMS To BE INSTALLED
The alarm fire,panel is provided by ADT Se urity:ADT 7"'Touch Screen Command Panel, wireless
combination burglar and fire alarm control panel will be used.
4
SEQUENCE of OPERATION
The fire alarm control panel will signal two types of alarms.Supervisory alarms will be silent(tone at the
panel). A signal will be sent via the Cell Guard wireless signal to the ADT Customer Monitoring Center.
The system when triggered will notify all floors.ADT will, upon receipt of a supervisory signal, notify the
call list on file and dispatch the appropriate safety personal. Fire alarms, if activated either manually ally or
automatically will sound audible devices along with sending a signal to ADT's Monitoring Center. Upon
receiving the fire signal, ADT will immediately contact the customer per NFPA 72 sec - . . .ADT will
contact the forth Andover Fire Dept after receiving confirmation of the alarm or after getting no
response from the premises.
o ,
4
TESTING CRITERIA
ADT will perform a complete system pre--test prior to scheduling and arranging the final test with an
inspector from the North Andover Fi re Department.ADT wiII have technicians and all necessary
eq u ip me nt available. Upon successful completion of the acceptance test,ADT wiII furnish the i nspector
Frith all documentation that has not already been supplied.
SUMMARY A L CONCLUSION
We take our positions and responsibilities in situations such as the design, specification, and installation
f Fire Alarm Systems very seriously. If there is anything I left out of this narrative, please let rye know w s
soon as possible. My responsibility to my client is to make the approval process go as smoothly a
possible. I will endeavor to do everything i can to fulfill any request for information.
Sincerely,
Brett Ryan
ADT Security Services
Custom Home Services Sales Consultant
FOIE: 781832 0955
EMAIL: brett[yan@adt.com
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Mcowners who Subrni*t this affidavit,
indicatmig they allvillr6rk and then Hire outside GontTiaefors
tractors that check this b ox mus t attMhed an additi onall shleetshowing the
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to y m m and xplir ) .
o secure coverap as requiTed ender Section 2A of MGLl c. 152 can lead to the-imposition
Ip to $ ,5 .00 air one-year,
Imp-risionment> as well as civil es Ill tilt fbim of a STOP'WO RK ORDER and a fm, le,
. oy of tlu's statement mayhfn .rd o the Office of
�gations of the,DlIA forl ffilisu ap-verificatio,11,.
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Ac"R" DATE(h1NVDD1YYYY)
CERTIFICATE OF LIABILITY INSURANCE 10/01/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND COFFERS NO RIGHTS HT UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY CAR 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 ), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certificate holder is are ADDITIONAL INSURED,the polle (ies) must have ADDITIONAL INSURED provisions or he endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require are endorsement. A statement o
this certificate does not confer rights to the certificate holder In Ilea of such endorsement .
PRODUCER CONTACT
Marsh U,9A inc.
1660 Sawgrass Corporate PktV,Suite 300 PHONE
1 Ex : No
Sunrise,FL 33323 E-MAIL
Attn:FtLauderdale,Cer s@marsh, om ADDRESS:
INSURER AFFORDING COVERAGE NAIC
Chit 41 288-ACT- AW-1 -1
. _ _. INSURER A.lid Republic Insurance Co 24147
INSURED
AST Lt. INSURER B
ADS"Securlty Services INSURER O:
245 Winter Street,Suite 200
Waltham,1 A 02451
INSURER E
NS RERF:
COVERAGES CERTIFICATE NUMBER: ATL-00480 00-07 REVISION NUMBER: 3
THIS IS TO CERTIFY THAT THE P LiCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED CAR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
iNSR TYPE E) INSURANCE ADDL UBi 1 OLICY EFF POLICY EXP
LTRINS€] WVD POLICY NUMBER N1r'1
1J3DP( YY WAAMNYY LIMITS
A COMMERCIAL GENERAL LIA131LIT-Y # W Y3143 8 10101/201 10/01/2019 EACH OCCURRENCE ,00 ,000
- --
CLAIMS-MADE OCCUR DAMAGE TO DENTED
R MI E Ee occurrence 1,000,000
SIR:$500,000 MBD EXP(Any on person)
Professional Liab Included PERSONAL&ADV INJURY P000,000
_. _.._. __.............. _
ENT AGGREGATE LIMITAPPLkES PER: GENERAL AGGREGATE m 4,0 0,000
POLICY[::] PI G- LOB PRODUCTS-COMP1OP AO 4,000,000
JT
OTHER:
A AUTOMOBILE LIABILITY MWTB314319 1 101/201 10/ 112019 COMBINED SINGLE LIMIT 11000,000
Ea accident)
r ANY AUTO BODILY INJURY(Per person)
OWNED SCHEDULED BODILY INJURY
AUTOS ONLY AUTOS (Per accident)
HIDED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident
$
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS L AC CLAIMS-MADE AGGREGATE
DED =RETEN TION
WORKERS COMPENSATION MWC31431700 10109 018 10101/2019 X PLR OTH-
AND EMPLO ERS°LIABILITY TA ER
ANYPROP I ETO WART NERJEXEDU i IV E YIN ,000,000
OFFI I✓P EMBER EXCLUDED? N!�► F.L.EACH ACCIDENT T
(Ala ndatory Ire NIA) E.L.DISEASE-EA EMPLOYEE ,000,000
If yes,describe under ,0��,��0
DESCRIPTION OF OPERATIONS �-below B.L.DISEASE POUGY LIMIT
DESCRIPTION OF OPERATIONS f LOCATiONS I VEHICLES (ACORD 401,Additional Remarks Schedule,maybe attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
ADT t.LC dl a ADT Security SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
245 Winter Sifeet,Second Fier THE EXPIRATION MATE THEREOF, NOTICE WILL BE DELIVERED I
Waltham,IAA 02451 ACCORDANCE WITH THE ILA PROVIS 10 NS.
AUTHORIZED RE PRE ENT'ATWE
of Marsh USA Inc.
Vincent Zolia
1988-2016 ACORD CORPORATION. All rights reserved.
AGGRO 25(201 10 The ACCORD name and logo are registered marks of ACORD
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ADD SECURITY
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