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HomeMy WebLinkAboutMiscellaneous - 134 Main Street ��_ \� SIJ \. �� i � , 984 /- , Date... .1. .-/...7...... f NORTH, TOWN OF NORTH ANDOVER p PERMIT FOR WIRING • oma+ ����• ,SSACMUSEt This certifies that ............t ........ ................................... has permission to perform ......... 1 ................................................ wiring in the building of............. f : �. .!.S.1............................................ at.... 3.y.....f..'.!. ��1 a.jts.......14:1/.1`...............North Andover,Mass. Fee.... ,S."'".'. Lic.No. 1 > 01LB=CAL INSPWPM--R j Check # 6 © / 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with thaprovisions 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 completion of the work as required in M.G.L.c.143,§3L. Permits shalLbe limited as to the time of ongoing constrction.activity,and maybe deemed bythe,Inspector-of_Wires abandoned.and-invalid.ifhe—. - 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 B—Permit(Date Closed: Z��/(,/ 6�/ Note:Reapply for new permit El.;-- 1 ❑Permit Extension Act—PermitMate Closed: Commonwealth of Massachusetts Official �Use ��Only � t /� "f � Department of Fire Services Permit No. Z, ' BOARD OF FIRE PREVENTION REGULATIONS 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 ININK OR TYPEALL INFOff TION) Date: 1`2-1 1-51 to City or Town of: dw To the Inspector of Wires: By this application the undersi ed gives not' e ofhisor her intention to perform the electrical work described below. Location(Street&Number) 13 Lt M A gL l N q,, E Owner or Tenant k EN N ZT NA CAMIP IS 1 Telephone No. GI7Y- S$Z-7?qZ Owner's Address j a y M A 3 L.1 nl QJ C N . AN bo d t Z, Vel N 01S145- Is 1$45Is this permit in conjunction with a building permit? Yes z No ❑ BLDG PERMIT# Z?7 — 2-t7 1 1 Purpose of Building &A iL N 6 E Utility Authorization No. Existing Service ZOO Amps 1-2,0 / 240 Volts Overhead. Undgrd�& No.of Meters I New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity a Location and Nature of Proposed Electrical Work: w 1 Q%A F o l I-i t,"T I N C •�-- GEN.E� tLNL v;tAeS� PLEC�P`BALL FS 14 N �w G�i�r6 E- Com letion of the following table may be waived by the Inspector of Wires. y No.of Recessed LuminairesNo.of Ceil.-Susp.(Paddle)Fans No.of Total. Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No. of Luminaires I Swimming Pool Above [IIn- ❑ o.o Emergency Lighting rnd. rnd. Battery Units No. of Receptacle Outlets No.of Oil Burners No.of Zcucs No. of Switches S No.of Gas Burners iIFIREALARMS No.of Detection and 1 1 Initiatin Devices I No.of Ranges No.of Air Cond. TotalNo.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons....... 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 Security Systems:* No.of Devices or Equivalent No. of Water No.of No.of KW Data Wirin Heaters Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring No.of Devices or Equivalent t OTHER: i Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 7,YO,0® (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I 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 ❑ BOND ❑ OTHER ❑ (Specify:) I cert, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: H C IAAe L ?5E iZG E"N Signature LIC.NO.: c • J3y y� (If applicable, e ter "exempt"in the license number line.) Bus.Tel.No.: Address: 3 AyyiZN Sr 9 n-,,e rL O 183p Alt.Tel.No.: *Per M.G.L. c.147,s.57-61,security work requires Departmen of Public Safety"S"Licen LIC.NO.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required bylaw. By y si low,I hereby waive this requirement. I am the(check one) owner ❑owner's agent. Owner/A e / Signatur /;1,.>1,ATelephone No..9 751-7.5'2--/9''12. 1 PERMIT FEE: $ ELECTRICAL PERMIT NO. INSPECTION REPORT: ELECTRICAL INSPECTOR-DOUG SMALL ff NSPECTION:Failed—[ ] Re-inspection required($50.00)-omments: (Inspectors'Signature-no initials) Date 2.FINAL INSPECTION: Passed—[ ] Failed—[ ) Re-inspection required($50.00)-[ ] Inspectors' comments: (Inspectors'Signature-no initials) Date 3.UNDER GROUND INSPECTION: Passed—[ ] Failed—[ ] Re-inspection required($50.00)-[ ] Inspectors'comments: (Inspectors'Signature-no initials) Date 4.INSPECTION—SERVICE: DATE CALLED NATIONAL GRID: NAME: Passed—[ ] Failed—[ ] Re-inspection required($50.00)- [ ] Inspectors' comments: Y (Inspectors'Signature-no initials) Date 5.INSPECTION- OTHER: Passed—[ ] Failed—[ ] Re-inspection required($50.00)-[ ] Inspectors' comments: (Inspectors'Signature-no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED. x _ The Commonwealth of Massachusetts Department of IndustrialAccidents Office of-Investigations 600 Washington Street Boston,MA. 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: ]3uilders/Contractors/FIeclriciansIPlumbers Applicant Information Please Print Legibly Name(B.usiness/Organization/Individual): M i G�i A E 1. B E fZG F, flQ i� Address: 3&5Y Au ay Rnl 5—1 . City/State/Zip: H Av 2 w l c_}M r'F C.i 83 Phone#: 9 7 Y- 9 9 `1 -7 S Are you an employer?Check the appropriate box: Type o project(required): 'J.❑ I am a employer with 4. F1 am a general contractor and I 6.�New construction /employees(full and/or part-time).* have hired the sub-contractors 2.YJ I am a sole proprietor or partner- listed on the attached sheet.? 7• Remodeling . 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. ❑ We are a corporation and its ' required.] officers have exercised their 10.❑Elecixical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. e. 152,§1(4),and we have no 12.❑Roofrepairs insurance required.]i employees.[No workers' comp.insurance required.] Un Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeo)yners 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. I am an employer that isproviding Workers'compensation insurancefor my employees. Below is the policy and joh site information. Insurance Company Name: w Policy#or SeIf-ins.Lie.M Expiration Date: Job Site Address: City/State/Zip.- Attach ity/State/Zip: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. I do herehy certify un der the pains andRenallies ofperjury that the information provided above is true and correct. SiPMafore: Date: Phone#: C? 7? - clg q — y 8 7 EE6.Offiher only. Do not write in this area,to he completed by city or town official n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: Location No. / � Date &ORT" TOWN OF NORTH ANDOVER Of « o y,ti " Certificate of Occupancy $ Building/Frame Permit Fee $ s^CHUB Foundation Permit Fee $ Other Permit Fee $ � TOTAL $ �^- Check # 1 8 t 5 / Building Inspector G s t4ORTM '9 ��i�E D IS/ .°�¢ O0 O i- ti a6 ii ey � /coq Coc.iC.O.X.L1. sSpCHUSti TOWN OF NORTH ANDOVER SIGN PERMIT DATE March 9, 2005 PERMIT # - 19-2005 This is to certify that Dr. Richard Lentini for Moore- Tuttle & Co. Real Estate has permission to erect a 2' (Two) foot by 4' (Four) wall sign I I INTERIOR ILLUMINATED SIGNS ARE PROHIBITED on / at 134 Main Street Providing that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-laws relating to the sign regulations of the Town of North Andover. Any violations of the Zoning Regulations regarding Section 6 of the Zoning By-law will void this permit. Jax � March 9, 2005 Inspector of Buildings Date SIGN PERMIT WORKSHEET Property Owner - � ,,Au T 00 �! Business Name OO P _ y.7��'� a ra. Property Owner Address /3 tf 14/1 Sign Location Address S /,1 64-4-,e- Zoning District Allowed Area a Proposed Area Allowed Height /V/4 Proposed Height Allowed Setback /f//� Proposed Setback ,V A Map C� C/ - Lot V 10 Estimated Cost S Fee S 3 Permit Application Received q ' Permit Approved/Hetkd Inspector SIGN PERMIT APPLICATION 400 Osgood Street f-� TOWN OF NORTH ANDOVER r Applicant '�Z � /i�1 Tel Site Owner x'3134 Size of Proposed Sig Site Address /`� � Ste" � - n (� J Illumination: Not illuminated How attached: a) Against the wall J b) Roof b) Internally illuminated c) Ground c) Externally illuminated d) Other _ Materials: Proposed Colors: Background Lettering Border Required Attachments: Photographs of building Note: No permanent/temporary sign shall be erected, or enlarged until an Material sample application on the appropriate form furnished by the Sign Office has been Color sample filed with the Sign Officer containing such information including Site or Plot Plan(Required for all free-standing signs) photographs, plans and scale drawings, as he may require, and a permit Drawings of proposed sign �D girt J � for such erection, alteration, or enlargement has been issued by him. Other, specSuch permit shall be issued only of the Sign Officer determines that the sign complies or will comply with all applicable provisions of the By- j� Law. Will sign overhang any public road or walkway Yes( ) No M__' If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: AS SIGNATURE OF �LICAN f. f� f J /'0/ m cn /bCom' �h-���� _9 4J b 1, Dore- Tuttle U-CAD. Real Estate 978m749 �9600 www.besthomes.cc COMMONWEALTH OF MASSACHUSETTS • TOWN OF NORTHANDOVER 27 CHARLES ST APPLICATION FOR CERTIFICATE OFINSPECTION Date ' / a� 3 Fee Required(Amount) l/ ( ) No Fee Required RV c V 16S 6 N Accordance with the provisions of the Massachusetts State Building code, Section 108,15, I hereby apply foi Certificate of Inspeetlon for the-below-named premises located at-the following dress: Street and / Number 13Y M/q tu Name of i —P'c S Premises Purpose for which Premises isD G tq Used ► S Licenses (s) or Permit {s)Required for-#he Premises by-Ow-Governmena Agencies: License or Permit Aaenc Certificate to bi issued to �O�� Address Telephone Owner of Record of Building )_ J Address W► Ch ate � �� `P Nt ti t Name of Present Holder of Certificate Name of Agency, if any SIGNATURE OF PERSONS TO WHOM CERTIFICATE TITLE IS ISSUED OR HIS A-UTHOIRIZED AGENT DATE INSTRUCTIONS: 1) Make check payable to- Town of North Andover 2) Return this applica#ion with your check#o: RuildanzDePL 27 Charles Street,North Andover MA 01845 PLEASE NOTE: Application form with accompanying FEE must be submitted for each building or structure or part thereof to be cert 3) Application and fee must be received before#Be cer-tifw—ate will be-issued. 4) The building officials shall be notified within ten (10) days of any change in the above information. CERTIFICATE# EXPIRATIONDATE. FORM SBCC-3-74 REMEB 2f99PW ZeY- yz_ � u9a� . �® - .5 TOWN OF NORTH ANDOVER INSPECTOR'S NAME , OFFICE OF THE INSPECTOR OF BUILDINGS MICHAEL MCGUIRE r I NSPECTION-REPORT FORM CLASSIFICATION PASSES INSPECTION yes o no 0 DATED OWNER �k C_ n C- k o,, - 1,,v I� BUILDING NAME Ofd-NO. Z 34J`7 VVI A (it) STREET LOCATION 12 P A t?- TYPE TYPE OF OCCUPANCY.- -Day -Car-e-Center -0 fid. C-I -Cafe -0 -Gyrn �( -Apt. -0 School 0 Common Victualer's 0 Liquor 0 Place of Assembly 0 Other OCCUPANCY NUMBER 4molude-stories-# -and-occuv�ancy -ver#loor - -usefew--se-side EXISTINGS EXIST SIGN yes 0 no 0 LIGHTED EXIT SIGNS -operable .-yes -0 -no EMERGENCY LIGHTING SYSTE M operable 0 dry cell 0 wet cell 0 SPRINKLER SYSTEM operable 0 gage pressure yes 0 no 0 SMOKE DETECTOR operable 0 yes 0 no FIRE ALARM SYSTEM -expira#on-date -yes -0 -no ANSUL SYSTEM yes 0 no 0 FIRE ALARM SYSTEM operable 0 municipal 0 yes 0 no 0 ELECTRIC EQUIPMENT PROPERLY PROTECTED yes 0 no 0 EGRESSES LAWFULLY-DESIGNATE unobstructed 0 -yes -f -no 0 STAIRS PROPERLY RAILED yes 0 no 0 HALLS AND STAIRWAYS LIGHTED yes 0 no 0 RADIATOR GUARDS yes 0 no 0 COMPLIES HANDICAPPED PERSONS LAWS -yes -0 -no -0 FIRE RESISTANT CURTAINS OR DRAPERIES HOW HEATED NO. FIREPLACES yes 0 no BOILER ROOM CONDITION VENTILATION UTILITY ROOM - CLOSETS NUMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS NUMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STORY SHOPS FOR INSPECTOR USE ONLY Revised 2/99 JMc THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER . In accordance with the Massachusetts State Building Code, Section 106.5 this CERTIFICATE OF INSPECTION IS ISSUED TO... I CERTIFY THAT I have inspected the premise known as YOGA PLUS Located at 134 R MAIN STREET in the TOWN of NORTH ANDOVER, COUNTY OF ESSEX Commonwealth of Massachusetts. The means of egress are sufficient for the following number of persons: BY STORY Story Capacity Story Capacity 1 ST 50 Story Capacity Place of assembly Place of assembly Capacity Capacity Location Location Place of assembly Place of assembly Capacity Capacity Location Location 16561-2003 JULY 31 , 2003 July 31,2004 Certificate Number Date Certificate Issued Date Certificate Expires Building Official fir Cl ........................... Jw Location No. Z ' a @ Date asp D-3 NORTH TOWN OF NORTH ANDOVER 3? • •• OC "WNWb 9 y Certificate of Occupancy $ �'�s''••°•E<� Building/Frame Permit Fee $ sACHUs Foundation Permit Fee $ Other Permit Fee rce_t $ _41 TOTAL $ Check # a b� 656 ; Building Inspector