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HomeMy WebLinkAboutMiscellaneous - 100 ANDOVER BY-PASS 4/30/2018 (2)cit �O Date ..�/�0/%Z . 9544 TOWN OF NORTH ANDOVER ° . PERMIT FOR PLUMBING �O�•no ,SSACMUSE� This certifies that ......... . . has permission to perform .. 0 .......... G plumbing in the buildings of ...Y .......46 at ...� .. %� ... �� ... �? .. � ....... , orth Andover, Mass. Fee ,00 Lic. No.. ...... PLUMBING INSPECTOR Check ." / 7.fa � MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK UVCITY I North Andover I MA DATE 108108/2012 PERMIT # JOBSITE ADDRESS 1100 Andover By -Pass OWNER'S NAME J Alliance Imaging POWNER ADDRESS I same I TEL[— _ _ I FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONALE] RESIDENTIALE] PRINT CLEARLY NEW: F-1 RENOVATION: 0 REPLACEMENT: 0 PLANS SUBMITTED: YES NOE] FIXTURES 7 FLOOR— BSM 1 2 3 1 4 5 6 7 8 9 10 11 12 13 14 BATHTUB L—j CROSS CONNECTION DEVICE Ed DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK -LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER I Demo of 6 sinks and 1 toilet INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q OTHER TYPE OF INDEMNITY F-1 BOND F_] OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT n SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 0 PLUMBER'S NAME I Edward D Kent ir --------]LICENSE # F1 1240 SIGNATURE MPF1, JPEI CORPORATION F—,]#F2-57-9----lPARTNERSHiPF"-l# LLCO#�� COMPANY NAME I B.E.C. Plumbing & Heating inc. ADDRESS I p.o. Box 507 CITY I West Warren - STATE F—p7a ZIP 101092 1 TEL 1413-967-0076 FAX 14139670112 CELL1413-204-7 FM0 EMAIL [Tdbep@vehzon.net O c C'1 x Q z z H O z z 0 H m = ' � r z m � � O -4 121 x �. z m 0 3 C�2J ag � z a r z b H 0 z 0 H Cif FJ Date ... �' 2 /. /4 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... �.�A14U...FL has permission to perform .. ............... .......... . wiring in the building ofG B at...... �.-...�.... `P SS ..... , ort Andover Mass. Fee Lic. No ��� �44 ....... . ..,. �. . , :... 1, ELECTRICAL INSPECT 7 Check # �` Z I F 11036 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official UseOnly -7 Permit No. 6 ly � ` Occupancy and Fee Checked [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT W INK OR TYPE ALL INFORtY�ATION) Date: 1 Job # 163-36) City or Town of: e 2� ti I o V 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)_ 1-0 p AkyJ0AtErL L4 NS -5 Owner or Tenant Alt j R A1n M AR 1 ":e Telephone No. L2-9J71�� Owner's Address !bb a r% K , _� c Is this permit in conjunction with a building permit? ' Yes X No X❑ (Check Appropriate Bog) Purpose of Building p F: -E, L S e ip, C_ F Utility Authorization No. Existing Service NA Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters - New Service NA Amps / Volts Overhead ❑ Undgrd [I No. of Meters Number of Feeders and Ampacity NA Location and Nature of Proposed Electrical Work: £NoV �, ► o N _T (o b F l= I s N K3 Cl em vv\ tel o N 60 R3 �uJ 1 t,�z nt A U4 PU_v S `: k, . Comnletinn nfthe (nllnwina table mm, ho —4h A„ th. T. -,f- r M.— 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 PoolAbove ❑ In- E] rad. und. No. o mergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and - Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: 1Number 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 E uivalent No. of Water KW Heaters No. 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: ,jQM , (When required by municipal policy.) Work to Start: V4 ' Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE eO RAGE: 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 penaldes of perjury, that the information on this application is true and complete. FIRM NAME: Renaud Electric & Communications Inc. LIC. NO.: A-17459 Licensee: Thomas Renaud Signatur LIC. NO.: E-24023 � (yapplicable, enter "exempt" in the license number line.) � Bus. Tel. No.: 508-865-1300 Address: 18 Providence Road PO Box 36 Sutton Ma. 01590 Alt. Tel. No.: 508-865-3513 Per M.G.L.c 147, s 57-61,security work requires Department of Public Safety "S" License Lie 4 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 1 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. $ ; 19 Date. ,,ORTM TOWN OF NORTH ANDOVER PERMIT FOR MECHANICAL INSTALLATION 9 • ft This certifies that ..�v�� ':. ...... . has permission for mechanical installation ... �V. f,.9-77 ............ in the buildings of . !q/!f. ri...?.!............ at �� ..!�fi.�?'d ................. . North Andover, Mass. Fee..%.,?— .. Lic. No...'7114-" ... ............... ...... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer r Commonwealth of Massachusetts Sheet Metal Permit Date: Permit # Estimated Job Cost: $ 1 0�) Permit Fee: $ /00--00 PIans Submitted: YES NO Plans Reviewed: YES NO Business License # Applicant License # Business Information: Property Owner / Job Location Information: a 1 Name: 411 �� i '1�c, Street: Cd Street:/C��i�:�Qo e•+�/34/,�r5 �a�ic:, City/Town: , CI i LSA% Cityrrown: A A rtcv -y- PtA 01M .— Telephone: Yt3-93 3 /S Telephone: 'y/3 -n%- i& ����� a�vl Photo I.D. required / Copy of Photo T.D. attached: YES X NO _ SlatfinUtal J-1 AOunrestricted license J-2 / M -2 -restricted to dwellings 3 -stories or less and commercial up to 10,000 sq. ft. / 2 -stories or less Residential: 1-2 family Multi -family Condo / Townhouses Other Commercial. Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. X over 10,000 sq. ft. Number of Stories: Sheet metalwork to be completed: New Work: Renovation: -)i — HVAC X Metal Watershed Roofing Kitchen Exhaust System Metal Chimney / Vents Air Balancing Provide detailed description of work to be done: Pr©Vio Mia, -?� `--Xi tirv" 4t M E COVERAGE: INSURANC I have a current i bi t insurance policy or its equivalent which meets the requlrements of M.G.L. Ch.112 Yes( No El if you have checked YY_s. indicate the type of coverage by checking the appropriate box below: ftl Other type of indemnity ❑ Bond El liability Insurance policy Chapter 112 of the nce Coverage OWNER'S INSURANCEWAIVER:L, d that my signatuI am aware that hre iicensee Apes not DAVO on this permit application vat a athis requirement.urred by Massachusetts Gen Check One Only Owner ❑ Agent' ❑ Signature of owner or Owner's Agent sy checking this bo, I hereby certify that all of the details and Information I have submitted (or entered) regarding this application are true and accurate to the best Kly knowledge and that all shoot metal work and installations performed under the permit issued for this application will be In compliance with all pertinent provision of the Massachusetts Building Code and chapter 112 of the General Laws. Duct inspection required prior to insulation In YES NO Pate r Date ny Type Master Ei•o>7ress inspections Comments Final ins ection Title I ❑ Master -Restricted Cityrrown Permit # Fee $ inspector Signature of Permit Approval ❑Journeyperson ❑Joumeyperson-Restricted 11 Comments Signature of Licensee License Number: Check at www mass 1 P'1 ii'l'..c+v �3�✓ � i r�3 $ Sheet Metal Commercial Guidelines / Life Safety / Critical Systems Inspection Checklist Yes Mo NN/A. Set of stamped engineering documents and detailed description of mechanical system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper journeyperson-to-apprentice ratios Fire dampers with access door properly installed and checked for operation Smoke and combination fire / smoke dampers with access doors properly installed - actuator checked for proper operation (May also be verified by fire department during fire alarm testing) Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) /J Smoke /atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm testing) Stair pressurization systems installed (where required) and operation verified (May also be verified by fire department during fire alarm testing) � Grease / kitchen hood exhaust system installed with all seams and connections welded airtight with properly located cleanouts. Proper oledances, fire rated enclosures and pressure testing required. 1 Seici:riY xes�raint ial=ilite'x u' _ 5 installed sq fired bh equipment IVIA Duct penetrations in fire'ratQ walls and f cors sealed " - Metal roofing systems installed watertight using proper materials and fasteners �C Flexible duct nuns installed 6'-0" maximum length JC Ductwork installed using proper hanger spacing, hanger stock, threaded rod and angle iron Ductwork / plenum connections sealed substantially airtight _ Ductwork insulated by means of external covering or internal lining Volume dampers installed for each supply air branch duct °mow New/clean - properly sized filters installed (final inspection) ' Testing and Balancing report complete (final sign -off) S Sheet Metal Residential Guidelines / Inspection Checklist Yes No N/A Detailed description and sketch of sheet metal system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper journeyperson-to- apprentice ratios Equipment sized per heating / cooling load calculations Duct work sized per manual "D" calculations Bath / shower rooms contain mechanical exhaust fan vented outdoors Electric dryer exhaust properly installed maximum total run 35'-0", maximum flexible run 8'-0" )flexible duct runs installed 14'-0" maximum length Volume dampers installed for each supply air branch duct Ductwork installed using proper gauges and hangers Ductwork / plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining New/clean - properly sized filter installed (final inspection) Testing and Balancing report complete (final sign -off) -,--ACORD ,� CERTIFICATE OF LIABILITY INSURANCE=DjAIMEY" 012 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY 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 su WVD IMPORTANT: If tlIe certificate holder is an ADDITIONAL INSURED, the polis -Ries) must ba endorsed. I SUBROGATION 13 WAIVED, subject to the terns and conditions of the policy, certain policies may require an endormement- A statement on this set tate does not confer rights to the certificate holder In leu of such endorsemerd(s)- POIJt.'TEFF 01/0112012 WOOMER Webber & Grinnell Ins. Agency, Inc. 8 North King Street Northampton, MA 01060 CONTACT NAME: (413)586-0111 F N, (413)517-0019 E.rwL ADDREss: PRODUUEER RrD - NSURER(S) AFFORDING COVERAGE NAIC I INSURED Hurley & David, Inc. 90 Fisk Aveue Springfield, NA 01107 NSVWRA: Peerless Insurance AvromoGMELJA UTY ANYAUTO ALL OWNED AUTOS X SCI IEDULED AUTOS X HIRLDAUTOS X WM-OWNEDAUTOS INSURER B: Netherlands/Peerless 24171 WSURERc: A.T.M. Mutual 01/0112012 NsuRM D: tt Slt�uNtr $ Ea aoldanQ 1 000 00 INSURER E: BODILY MUURY (Per aoad6M i Nst mm r: s n--ftA.•ee Y-_FRTT 1C ATF M1WRFR- FTrn_ 1/13 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I INDICATED. NOTWtTHSTAND(NG ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, occu ncn v�mi cam rl ellldC R A TYPE OFMSURANCE GEN9IALLTAS"Y X. comuERCIALGENERALm%jrY C AIUS4AADE � 00CUR NSR su WVD POLICYNUNDER CBP823SS1 POIJt.'TEFF 01/0112012 POI.N:YEXP 01/01/2013 �� EACNo L 1,000,000 DAMAGE TO $ 100,00 01 MED M VM one perswO $ S'00 PERSONAL& KN N AIRY s 1,000,000 GENERAL AGGREGATE S 2,000,000 PRODUCTS-oahproPAGG 2,000 OO GTTILAGGREGATELMT APPLIES PER: POLICY X M El Loc $ B AvromoGMELJA UTY ANYAUTO ALL OWNED AUTOS X SCI IEDULED AUTOS X HIRLDAUTOS X WM-OWNEDAUTOS BA82303 01/0112012 01/01/2013 tt Slt�uNtr $ Ea aoldanQ 1 000 00 8OOLYNJURY(PerpWW) S . BODILY MUURY (Per aoad6M i PROP�f1Y DW&W _ � s s A c X UMBRFILALIAB CESS LIAs X D�IR aAn�.AAoE NIA 0823611 W14ZSOOS60101200 01101/2012 01/01/2012 01101!2013 01/0112013 EACti000(IPfaBJC£ t 5,000 00 AGGREGATE i S'000:000 $ DEDUCTOLE X RETENTION i 10, 00c,s WORKERS COMPENSATWN AM EMPLOYER -T UMUfY YIN =M=Mp(g11oED? a M ufyyeesSdssameurder DESCRI 1 OF pPHiATiOf1S belay Ttti WC STATU- X OER Ey, EAM ACgD@rT f 1,000,000 E.LDISFAM-EA SAMLOM i 1,000,000 eL.tTISEASE-PoucrLaar i 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addl ro [ Remarks Schedule, It mare space Is requlrod) CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Ware AUTHORIZED REPRESENTATIVE Building Department Ware, MA 0108Z William Grinnell, CPCU/CINDY ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2909109) The ACORD name and logo are registered marks of ACORD COMMONWEALTH OF MASSACHUSETTS • :•• •• .AS A BUSINESS ISSUES THE ABOVE LICENSE TO: WARD C WOODRUFFs HURLEY AND DAVID INC 90 FISK AVE 1„ SPRINGFIELD MA 01107-0000 92 10/29/12 968469 J F COMMONWEALTH OF MASSACHUSETTS SHEET METAL WORKERS AS A MASTER -UNRESTRICTED ti r; ISSUES THE ABOVE LICENSE TO: ... WARD C WOODRUFF HURLEY AND DAVID INC 90 FISK AVE SPRINGFIELD MA 01107-1071 804 06/28/13 3637 STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION Be it known that WARD C T WOODRUFF 230 SIC A 1 ICs D E WIR, C'ir 0&88 has been certified by the HEATING, PIPING License#- Effective: 09/01/2012 Expiration: 08/31/2013 COMMONWEALTH OF MASSACHUSETTS fU►Y�_ -'1 L•J�!•171:1:toll�cf.'f[tlih_lU�[.I��E•'i11:1�oI:I.1_1:i�X�7X ' PLUMBERS AND GASFITTERS LICEN ;ED AS A MASTER GASFITTER [: ISSUES THE ABOVE LICENSE TO: VARD C T WOODRUFF IJ ti 2;0 SCAIITIC RD iu • z j WA.IEHOUSE: POIN CT 06088-9735 3581 05/01/14 15456a"� Protection as a licensed CONTRACTOR S1 William M. Rubenstein, Commissioner COMMONWEALTH OF MASSACHUSETTS 141CIS 1011K:171;iii!J,'17'�'-ALei 0L3umLei B,t,Wal :..1• • PLUMBERS AND GASFITTERS REGISTERED AS A GAS CORPORATION, ISSUES THE ABOVE LICENSE TO', WARD CT WOODRUFF S1 HURLEY & DAVID INC M 3581 90 FISK AVE v7 SPRINGFIELD MA 01107-1050`- 23 05/01/14 138894 `.