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HomeMy WebLinkAboutWire Permit - Permits #12898 - 111 PHILLIPS BROOKS ROAD 11/12/2014 IMEN \ 4 a • ' °° \ 'M D \ qgm- ate S _ \ IRM \ \ OF ` H I Q '100 Ml ME IMMII woman INSK \ {§ r M Mies that ... .... h1S Gem ... ...,.... \� MNII to eQ IffilEll 101 Ml eT121iss1� 3 \ ' has P ass. goog inn in the building Of. Q pnover, sm . IN 10 - ° 010 IN Lic.No �I E \\ HE Tee...... I V` \\` \` hG \M c .. Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: November 5th,2014 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)I I I Philips Brooks Road(ATKINSON ELEMTARY SCHOOL) Owner or Tenant Town of North Andover Telephone No(978)688-9500 Owner's Address 120 Main Street,North Andover,MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Elementary School Building Utility Authorization No. Existing Service Amps I Volts OverheadEJ Undgrd❑ No.of Meters New Service Amps Volts OverbeadF-1 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:Replace power wiring/connections to four(4)unit ventilators&one (1)Cabinet Heater N—o. T-- Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tr—O ansformers KVA No.of Luminaire Outlets No.of Hot Tubs ' Generators KVA Above ❑ rn- F-1 No.of Emergency Lighting No.of Luminaires Swimming Pool El -d. Battery Units grnd. grn No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones o etect Nf Dion and No.of Switches No.of Gas Burners o. Initiating Devices Tl No.of Ranges No.of Air Cond. Tonsota No.of Alerting Devices Heat Pump Na.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local R Connection El Other Se—curity S No.of Dryers Heating Appliances KW No. vstems:* of Devices or Equivalent No.of Water 0.0 No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs lNo.of Motors Total HP TeTecommunications Wiring: I No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $8850.00 (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 P9 BOND ❑ OTHER �F� ei f *�Mjrcadon is true and complete. f I certify,under the pains and penalties ofperjury,that the trt FIRM NAME: AURORA ELECTRIC,INC. LIC.NO.: 14881-A Licensee: JOSEPH M.DEMELO Signature t LIC.NO.: 29992-E (If applicable,enter "exel 11 in the license number line.)) idepkM.DeMelo,Project Manager Bus.Tel.No.;(400453-0004,Ext 25 Address: 148 SUMMIT ST.,E.PROV.,Rl 0291 V Alt.Tel.No.: (401)639-6044 Robby *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 F owner F1 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE.- $ [A,),vuv-T by 7b "I urora ELECTRIC, INC. Electrical & Telecommunications November 51h, 2014 2- Attn: Building Department Electrical Inspector TOWN OF NORTH ANDOVER 1 w h Cap,I/-i 1600 Osgood Street Building 20, Suite 2035 North Andover, MA 01845 RE: Electrical Permit Applications—Enclosed Dear Electrical Inspector: Please find the attached five (S) electrical permit applications for work associated with energy efficiency contract the Town of North Andover with our general contractor,Ameresco, Inc. I had called your Building Department earlier and they told me the permit fee would be waived. I have enclosed a copy of my license,our electrical license and copy of insurance of certificate. If you have any questions, please feel free to contact me in my office: (401)453-0004,ext. 25 Winerely,0 . D J0 h'le Pr je t Manager P.O. Box 6301 a Providence, RI 02940 • Phone: 401-453-0004 • Fax: 401-453-6822 • auroraelectric@cox.net ISATE(M?It(}�2fYYYYI CERTIFICATE LIABILITY INSURANCE 11-5-14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND ONF'ER NO RIGHTS UPON THE CERTIFICATE HOLDER.,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE.COVERAGE AFI ORDED 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 Ipallcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to they 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). PRODUCER coNTA Michael Dace Dacey Insurance Agency oIIU.E 4Di-3£I8-BD2D FAX E-MAIL 01 Main Street 'INSURER AFFORDING COVERAGE NAIC0 East Greenwich,RI 02818 Selective Insurance.Co.. INSURED INSURER a• Beacon Mutual Ins.Co. Aurora Electric,Inc. 1 CIO Joseph DeMelo INSURER 146 Summit Street INi East Providence RI 02914 COVERAGES CERTIFICATE NUMBER- REVISION NUMBER: THIS IS TO I ERTIFY THAT THE POLICIES OF IN$URANCe LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INE7ICATED.NOTWITHSTANDING ANY,kEQU DEMENT,TEPM 6?k CtON[)ltlO7N OF AI4Y CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE IRSUEC`OR IvIAY'PaRTAIN..THE INSURANCE AFFORDED BY THEFIOLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES:LlmrfS-SHI:iWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DDL UBR POLICY EFF POLICY EXP LTITYPE OF INSURANCE POLICl T t LIMIT$ GENERAL LIABILITY ,. EACH OCCURRENCE. 0 000,00D T TO RENTED A I � co:,COMMERCIAL GENERAL LIABILITY DAMAGE _ $1C11'�©i76 CLAIMS-MADE- pCCUR MEO EXP(An py one Rarson t 10,000 Q60811500 06/27/14 06/27/15 PERSONAL aAOVINJURY s1000,000 GENERAL AGGREGATE s3,000,000 GEN'L A1WiGREGATE LIMIT APPLIES PER3 � PRODUCTS�„�,,,CC3MPtOP AGG s3,000,000 POL:iCY ;h PRO- LOC. S AUTOMOBILE LIABILITY COMBt�IEi3+51N131 LIMIT 1 000,000 S oY 0 A ANY AUTO BODILY INJURY(Re;persnn) S ALL GOWNED SCHEDULED Q60811500 CiODILY IN IURY(Per acc dent} S AUTOS AUTO$ 06/27/14 ,'06/27/1S �„��, NON-OWNED PROPERTY Df MAGE HIREDAUTCrS ,AUTOS 6 a S UMBREULA LIAR X caCcillz eACH ocCLIRRENCE s i A0,000 A EXCESSLIAB iAlr�s.ar.D Q60811500 06/27/14 06/27/15 AGGREGATE s,1,ODD000 DED RETENTION 5. WORKERS COMPENSATION Y✓O$rAFU. OTNW AND EMPLOYERS"LIABILITY tt ANY PROPRIETCWPARTNERIEXECUTIV : $ 00 000 8 OFFICER/MEMBEREXCLUDED7 NIA 12142 06/27/14 96/27/15 E L_EACHA ENT_ (Mandatory In NH) E.L.t4IgEASE-•EA EMPLOYEE A100.000 If yes,describe under CES RIPTIOI4 OF OPERATIONS below I I I I I E.L_DISEASE•POLICY QM11 I S 500,000 DE$CRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach.ACORID IOi.Additional Remarks Sclnrduta,it more spaoa Iu required) Electrical work associated with Town of North Andover's Buildings CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY Of THE;ABOVE DESCRIBE► PEILICIES;:as:CANCELLED EIEIFOkE THE EXP'IRAT16N DATE THERECIP, NOTICE WILL BE DELIVERED IN ACCORDANCE I+SIITH THE POLICY PROVISIONS. AUTHORIZED RePRssizWATII 1988-2040 ACORD CORPORATION. All rlgh reserved. ACORD 2ra(2010105) The ACORD n�mo Sind logo are registered(narks of ACORD . ��, . �:� � - - - . . . . . .g ��% ���.y� , : � ! � � �� �: . ��:�»� ^> ` � \\ ���� � � � � \ � � � � � / �©2 > . :- . . - . - � _ � � y S� . ��.:���<�����«��. »a. , �� � a Fold,Then Detach Along All Perforations Iv LTH ' F.M H�fiS ISSUES .T:HE FOLLOW I N6• L ICENSE AS4 ICI I''JOURNE`�MAN ,ELECTR I C I AN tO 1EOIJ M DEMELtI 36' SWEE"fEERN RD MA i Cl 02888 5326` 07f . t&,... :'7. 282 Fold,Then Detach Along All Perforations tJ1W1MQNW LTH:OF THIS I C, ANS 1>SSUES 7'HEJOL`LOWI0 L�IuE I5E A A RIrG1T'EREp MASTER E"LEEI`R)GIAN" A 100A ELECTR I C IN C , 36, SWEEP FERJ RD WAR WIC`K' R;I 42888, 5326` 1 7 . 07. 1.11x. 73,283