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HomeMy WebLinkAboutMiscellaneous - 102 PENNI LANE 4/30/2018N 10 North Andover Board of Assessors Public Access E pORTM °+'y "+ono •''�4`� SSACHUS� Click Seal To Retum Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 IM I Sroperty Record Card Parcel ID :210/107.D-0065-0000.0 FY:2012 Community: North Andover SKETCH Click on Sketch to Enlarge PHOTO Click on Photo to Enl EMU i WWWW 102 PENNI LANE Location: 102 PENNI LANE Owner Name: HEBLE, MILIND S. HEBLE, PRIYA N. Owner Address: 102 PENNI LANE City: NORTH ANDOVER State: MA Zip: 01.845 Neighborhood: 7 - 7 Land Area: 1.07 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2520 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 483,200 483,200 Building Value: 257,000 257,000 Land Value: 226,200 226,200 Market Land Value: 226,200 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=1896680&town=NandoverPubAcc 5/17/2012 NO U` c UEU; cu N wN Nk c O.'N � �a N N>UC�laFc O N a t' 3 V k 4 P � t F- `(L �2 s N r j C p 1 � N U •� k t' o U- 00'Uk�s�P ' f0 C) UTNE V1 Z ui �°W J � Z Z W �' t IL MM O M o m 0 1 U) -"k E -a Q U Q ' w Z ` W' o CL No O a LO OF o a0 (� yUiNIN"O O O -p � O O _Ni_NEN.N N N to U' (6 "N N �- U);(o V) U) (D Of 0 1 O Y F-iN�� k cc O N"tp�+Q co J'0 tq Q 'd ;' m m 10'N c"c Q U U'.!=; E Nj(OOIO X F- jF- F-, I w d Q O Z O Q p F- ' QLO N O co V- 1? O o O Z � ti O J G' W T- 0 oQ z> N m :i O J a �a Za J WW ••W= w JJ �0. Lmm c cWW �'p0 Q 2 2 Z d 0 Q 0 N m co OO N N N N N ' r ? 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TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......�� has permission to perform .........,&744.r,�... wiring in the building of ............ .......(�%, i ............................ ........................... at .....1...D..L.... % / /............ ......... ........ , North Andover Mass. r Tee... J.,...;� .... Lic. No. lab'o7, ......... .............. < .. ........ ELECTRICAL INSPECTO v Check # 2D0 41 19-707 b Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. l Z7 0 Occupancy and Fee Checked (eV. 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 WINK OR TYPE ALL INFORMATION) Date: 3 / / 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) zN Owner or Tenant 1*1 1 Ll'�fd p t bl.e Telephone No. a? 3 M4— Owner's Address S Is this permit in conjunction with a building permit? Yes ❑ No �" (Check Appropriate Box) Purpose of Building./A i f 'QcfrW l l�(14!cH L S F 1SW C ,Utility Authorization No. J,- h Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: SWEVI (ae,- VA/f r l 0,f � �'l�[�1,-roc C t4L P -e eeC{ rZ L,, srA/t ot eocrlvl) It Completion of the ollowing table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans Total Trsformers KVA Trans No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- El rnd. rnd. o Emergency Lighting BatteKy 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 g No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers p Heat Pump Totals: Number . Tons .. . [Tons KW ..... .... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security De icl s 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 E uivalent OTHER: - Attach additional detail if desired, or as required by the Inspector of Rres. Estimated Value of Electrical Work: (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 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 [4 BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties ofperjury, that.the information on this application is true and complete. FIRM NAME:n/1 0Z� LIC. NO.: 10-90 Licensee: -'Ta Signature s CLIC. NO.: (If applicable, enter "exempt," in the license number line) Bus. Tel. No.• Address: '?3/hA _- OD Alt. Tel. No.: *Per M.G.L c. 147 s.-57-61 security work requirds Department of Public Safety "S" License: Lic. No. the Licensee does not have the liability insurance coverage normally this requirement. I am the (check one) ❑ owner ❑ owner's agent. phone No. PERMIT FEE: $ OWNER'S INSURANCE WAIVER: I am awi required by law. By my signature below, I hereb, Owner/Agentf f Signature -:. "f` ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, �3L, the r permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed r , 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- lyJ 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 completion of the work as required in M.G.L. c. 143, § 3L. Permits shall -be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not 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: *** Note: Reapply for new permit ❑ ❑ Permit Extension Act—Permit/Date Closed: Trench Inspection Pass 0 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE 9PECTION: Pass V Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: G ,� o. Inspectors Signature: 1, ' Date: ..�j PARTIAL ROUGH INSPECTION: Pass 0 Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: e Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ... TOWN OF MERRIMAC, MA........dweinhold@townofinerrimac.com V The Commonwealth of Massachusetts Department of IndustriqlAccidints Office of Investigations 600 Washington Street Boston, MA 02111 u4p www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name (Business/Organization/Individual):5�� Address: ,� 3 I'-tA-r`S 0 City/State/Zip: ,�&UA l P51`o � +,�A 01?_ cj- Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub -contractors �• ❑Remodeling 2. [ T am a sole proprietor or partner - listed on the attached sheet. # ship and'have no employees These sub -contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. El We are a corporation and its 10.1N Electrical repairs or additions required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL 11. ❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12,F] Roof repairs insurance ] ired. re q u ► employees. [No workers' 13. ❑ Other comp. insurance required.] *Any applicant that checks box #I must also fill out the section below showing their workers' compensation policy information. 1 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached anadditional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. 6,d ~T -e r_Cf-e Policy # or Self -ins. Lic. #: 6G p�X z Expiration Job Site Address: ge✓ ur I - I the , An, City/State/Zip: N04 A. N-DoUQ � Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder 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. I do Hereby certtfy under the pains and penalties of perjury that the information provided above is true and correct. Simature: Date: � �� / � y Phone #• `;F- a( g q4( <:y, ty5 I 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 -w V Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their 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 of an 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 of 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 commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this 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 certificate(s) 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 an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be 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 returned 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 workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate he. 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 (if necessary) 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 Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Con ozlwealth ofMossachwetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel, # 61.7-727-4900 ext 406 or 1-87T MASSAIFE Revised 5-26-05 Fax # 617-727-7749 wwt�.mtass.gavfdla R CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) J-312-01-2-0.14— __THISCERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the 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 CONTACT NAME: Thomas Quinn Jr Quinn of Lynn Insurance COrp. PHONE (781) 581-6300 FAX (781)581-9070 152 Lynnway Suite 1D E-MAIL .tomquinn@quinnoflynn.com ADDRESS P.O. Box 789 INSURERS) AFFORDING COVERAGE NAIC # Lynn MA 01903 1N SURERA:Commerce Insurance CO. INSURED INSURER B: Estuardo Maldonado INSURERC: 23 Manson St INSURER D: Lynn MA 01902 1 INSURER F: I I COVERAGES- CERTIFICATE Nl1MRFR-CL1432000776 ocvrcrnur w reacco. THIS IS TO CERTIFY THAT THE POLICIES 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 OR 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF M /D YI POLICY EXP IMM/DD/YYYYJ LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_1 OCCUR BGDPXZ 2 /15/2014 /15/2015 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrenceAMA ET RENTED $ 300,000 P MED EXP Anyoneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: rx-1 POLICY JECT PRO LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY Per accident $ ( ) PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) (508)799-8544 inspections@worcesterma.go City of Worcester Inspectional Services Department 25 Meade Street Worcester, MA 01610 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION [.ATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH(TFIE POLIL?Y-PROVISIONS. AUTHORIZED ACORD 25 (2010/05) ©1988.2010 ACORD CORPORATION. All rights reserved. "WS025 (201005).01 The ACORD. name and logo are registered marks of ACORD 0 RP$OOTT RIA; 01902-1W.-.-' 10807":.:., e.. 0�131.i.16... .... 204328 I TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 1600 Osgood Street, Suite 2-36, North Andover Ma 01845 NOTICE OF VIOLATION Date: a -- 2-0 -' M k«MQS Address- 102- )mfr �10RT�y oF�t�ec ,6 g4, o Building 10 Zoning Bylaw ❑ Stop Work Order ❑ Certificate of Inspections Electrical Plumbing ❑ Gas Violation observed:��:T/I,�l E L ezcrn,,44r_ S,i = J -y L/&P F/Z C,QaUlt I Failure on your part to comply with this notice within 10 days may subject you to penalties prescribed by Massachusetts Law 780CMR or Nortb And verIs Zoning y law. Please ntact the Building Department for further informations at 978-688-9545 Inspector Home Owner` r Contractor 0 ro i 0 0 Z .c, O .O ;:SC1 n S o C_ v N� O t(DiFFy El --7 ro� c� aCD c 0:0 (D 0D) O TO O cyN CD CDG Li Z Co WQ Oc0 z cz �N (D _ O b co to 0z Z L TO ,1 'm0 N ° L D Z Nmc �?o Z � � ❑� U) C O K N a r x r ^ t tt ,� ' e y v Al t w€ S f tr ,iAI 4 � Ai Nft'RLo a dye r 9 .t Date l-ln#..b........ e �o\ TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ....... Q..........o.................................... has permission to perform / .` A-7 ........................................................... wiring in the building of .... Fes- /` .............................................................. c�n/.t/ I� Olt ........ - .................. �.2..x........ ....................... , North Andover, Mass. 04 00, Fee ...�.�............ Lic �No.....1�....... ......... .............................................. t ELECTRICAL &SPE 7ORt::�> Check # 6777 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 7 .% Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] 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: City or Town of: &A-14-11 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 D OR ii A I Owner or Tenant k'cy, Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building �'�� Utility Authorization No. Existing Service Amps,, -;v7 y Volts Overhead Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:--- Completion ork:Completion ofthe following table rnav be waived by the bisoector nf'Wire.c No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lununaire Outlets No. of Hot Tubs Generators KV No. of Luminaires - Swimming Pool Above In- %nnd. rnd. ❑-_ o. o Emergency ig m Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. o Zones No. of Switches No. of Gas Burners No. of Detection and Initiatin Device No. of Ranges No., of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Dispos rs Heat Pump Totals: N . der Tons I.KW No. of Self-Contai ed Detection/Alerti Devices No. of Dishwashe S ace/Area eatin KW p g Local Munic' al ❑Conn ction El Other No. of Dryers Heating A pliances KW Security Syste s:* No. of Defices or Equivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wirin : No. of evices or Equivalent)Aiuni No. Hydromassage Bathtubs No. of Motors Total HP��-� _ cations Te1No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (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 the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cover e 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 idpenalties of perjury, that the information on this application is true and complete. FIRM NAME: ,� LIC. NO.:A019? i Licensee: Signature LIC. NO.:j��' (If applicable r)er "ex pt " iri the liceriseer line.) Bus. Tel. No.:Z�' Address:�s ,i' �' - Alt. Tel. No.: *Security System Contractor License required for this w rk; if applicable, enter the license number here: 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: $ L ._UI March 12, 2003, N O , - CABLE ON OUTSIDA OF BUILDING Air Condition s: $40.00 each Alarm Systems eurity: (for fire systems see smokeat detectors) Residential: $40.00 Commercial: up to 10 vices $60.00 additional devices er 10- $1.00 each Carnival Equipment: $50.00 ch Ceiling Fans: $1.00 each Commercial New Construction o Alterations: ' $100.00 per 1,000 Sq. Ft. of Construction Space Commercial Service Change/ Repair: dust have Utility :authorization Number $100 (first 100 amperes or fraction, one meter) a) each additional 100 amperes capacity or fraction. $30.00 b) each additional meter $25.00 Commercial Temporary Service: $100.00 Must Have Utilitv Authorization Number Commercial Repair and/or Maintenance Permit: (Blanket Permit) up to 2 Electricians $1 .00 per pair of Electricians over 50.00 Data/Telecommunication: Residential: $1.00 per po Commercial: $30.00 u o 10 devices over 10-$1.0 each DishwashJEch s: $5.00 Each Dryers: $1Emergencattery Units) $ 1.00 eacFeeders o each 100 a p capacity of fraction thereof Reside ial: $5.00 each Com rcial: $15.00 each Gas/ it Burners: Res' ential: $20.00 each Co mercial $20.00 each I Generators Residential & Commercial: a) including photovoltaic & generating Equip Per KVA $1.00 b) un -interruptible power systems, per KVA $1.00 c) batteries over 100 amp. hours, per cell $1.00 Heat Devices: $1.00 each Heat Pumps: $40.00 each Hydro -Massage Bathtubs/ Hot Tubs: $20.00 each Lighting Fixtures $1.00 each Lighting Outlets: $1.00 each Major Appliances: (not listed) $20 each Motors: (per hp or fractio part thereof) $2.00 Oil /Gas Burners: Residential $20.0 each Commercial $20 0 each Office Furnis ngs: per circuit $10 (Relocatable artitions/Cubicles) utlets & ixture: $1.00 each %yens ilt in/Counter Top Units: .0 each Pa Change/Circuit Breaker: 7si ntial. $20.00 0mArcial: $25.00 Phonecks: See data/telec unications Ranges $lN0 0 each Receptacle O tlets: $1.00 each Recessed Fixtu s: $1.00 each Re -inspection Fe • $25.00 Repair to Service sidential: $20.00 Residential New Const\amp (Dwelling): $220.00 (with service up to 200)\•fust have Utility :authorizfor services over 200 ama) for each 100 amps ca fraction add $20.00 b) each additional meter $10.00 c) each additional panel/sub panel $25.00 Residential Additions/Alterations: $220.00 maximum Residential Service Change or Underground Service: $40.00 Must have utility Authorization Number a) one meter, up to 100 amp capacity $40.00 b) each additional 100 amp capacity or fraction $20.00 FA c) each additional me r . s 1.0.00 Sewer Ejection Py& $25.00 Signs: $25.00 ch ballast Smoke & H t Detectors & Initiatin ti/ Reside ial: $1.00 each Com ercial: $60.00 up to 10 devi es over 10 - $1.00 each Xea ceHeaters: heating $1.00 each Sub -Panel: $25.00 Swimming Pools: Residential: Above Ground: $25.00 Inground: $50.00 Commercial Pool: $100.00 Switches: $1.00 each Temporary Service: Must have Utility Authoriz atiota Nuniber Residential $25.00 Commercial $100.00 Transformers: a) capacitors, Per KVA $1.00 b) ducts, conduit & conductors (Associated w/ Padmount Transformers)J25 c) each manhole $10.00 d) each handhold $5.00 f e) per KVA $1.00 f) primary feeders, $25.00 each (over 600 volts, non-utility owned) g) vaults and equip. $25.00 each Washers: $15.00 each Waste Disposals: $5.00 each Water Heaters: $30.00 each Folz Multi-Famil-r Large Commercial Project see Wiring Inspector for pricing: Paul Kennedy (375) 623-81,6'(Office Hours A alai to l.0 Ili) *.Inspection. Schedule: I ROUGH FINAL L I XRENC.H (if applicable) INSPL TIONS $25.00 (if applicable (revised 07 Date........ N�RTN- �'.,.�4, TOWN OF NORT ANDOVER PERMIT FOR PLUMBING ,SSACMUS� + This certifies that .. -' ...... has permission to perform .. .. ..... .............. . plumbing in the -buildings of .................... . at %`�' . ..... North Andover, Mass. Fee Lic. NoP�a// 41 ... :... � .. ..... . PLUM If�G INSPECTOR Check # '-��� 7317. 'U MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type print) NORTH ANDOVER, MASSACHUSETTS �%,,� Date Building Location�� J �T i &- Owners NamePermit # Amount Type of Occupancy' New Renovation 1:1 Replacement FIXTURES Plans Submitted Yes 1:1 No (Print or type) �/%� (� Check one: Certificate Installing Company Nam Corp Corp. Address Partner. usiness Telephone 0 Finn/Co. Name of Licensed Plumber: Insurance Coverage: Indicate th ype of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity a Bond ❑ Insurance Waiver: I, the u dersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent 11 I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and install Eipns performed under Pe'Issued for this application will be in compliance with all pertinent provisions oft ;,State Plum _5,e 142 of the General Laws. y: OVER (OFFICE USE ONLY Type of Plumbing License 0 Licensei�m6'M' Master Journeyman 1 77le Commonwealth of Massachusetts "'t1se U''' t M1•relt Vin, 7M IV VIA Department of Public Safcty II Occupancg S fee Checked BOARD OF RE PREVENTION REGULATIONS 5ZT CMR(leave00 �/90 ;te,� blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3-4-97 City or Town of Ale/Zr-y /Ee To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street b Number) /0.2 ;EkA1,V1 LANE Outer or Tenant_ Owner's Address S,q/HE 6986 Is this permit in conjunction with a building permit: Yes ❑ No ® (Check Appropriate Box) Purpose of Building Utility Authorization 110. Existing Service Amps ! Volts Overhead ❑ Undgrd n No. of Meters _ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Installation of Alarm System No. of Lighting Outlets No. of Not Tubs 'No. of Transformers Total No. of Lighting Fixtures Swimming Pool Above ❑ In- grnd. grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners , Batter Emergency Lighting Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding g Devices No. of Self Contained Detection/Sounding Devices Local ❑ Municipal❑ Other Connection No. of Ranges No. of Air Cond. Total tons No. of Disposals No, of Heat s Iotal Total-Pump Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No, of No. o Si ns Ballasts w Voltage Wirin GH No. Hydro Massage Tubs No. of Motors Total HP OTHER: C0 s MO kE De-moz e INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO ❑ I have submitted valid proof of same to this office. YES ❑ NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work S �4000 Work to Start -?- G -97 Inspection Date Requested: Rough Expiration Date Final Signed under the penalties of perjury: FIRM NAME A.D.T. SECURITY -SYSTEMS NORTHEAST INC. LIC. No. 1231C Licensee DONALD A BROOKS Signat a No. 1231C Address 60 William Street, Wellesley,8 s• el. No. 413-732-4400 Alt. Tel. No.617-431-5831 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit -application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S JU D o Signature of Owner or Agent -�...+.�-�,..v..-'..+vr..�w��.�,...,_etar•..�wtnr�kbv�••.�j•�...y"•-. ...._r-�....,�-` �.-A/7 Date ..... 7..... 42 782 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......-.. r...�:.......51� .r:'...... ..................... has permission to perform .......... Ak� . M......... S� S ............................. wiring in the building of .......f ....................................................... at ....�d. 1PA 4I.h.s......Lt ............................. . North Andover, Mass. ,... Lic. No. 113i � . .................................... ... ........................... ELECTRICAL INSPECTOR �t'35.00 03/13/9713:55 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer