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HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (56) 148 MAIN STREET J C / / 210/040.0-0004-0002.G Date....L.l..:... AORTN 3:°; TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACMUS� -- ' This certifies that ......... has permission to perform ....... ............................ wiring in the building © 'o) � � � S�" . . ., .. .... ............ ...0 orth Andover,Mass. Feel 2 '' Lic.No.�.D ��l�........ a LECTRICAL INSPE R Check # t 2 10 4 51 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions 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 shall.be limited as to the time of ongoing construction activity,and maybe deemed bythe 7nspector_of_Wires abandoned.aad_inxalid-i£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 pn the.permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Se6tions.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 certairrpermits 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. l lie 8—Permit/Date Closed: +� 2 � Note:Reapply for new permit ❑Permit Extension Act—Permit/Date Closed: � J Commonwealth of Massachusetts Official Use only Department of Fire Services Permit No. 1 nys,-1 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 (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: 11/3/11 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) 148 Main Street Osgood/Abbott Building Owner or Tenant Great North Properties(Sutton Pond Condos.) Telephone No. 978-278-4000 Owner's Address 148 Main Street Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building Multi-dwelling Utility Authorization No. 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: Install I new fire alarm control panel with new initiating devices and annunciator. Completion of thefollowing table may be waived by the Inspector of Wires. 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 Pool Above ❑ In- ❑ o.o mergency ig mg rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 16 No.of Switches No.of Gas Burners No.of Detection and 121 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals .""' """........." ........"""""" 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 Equivalent Heaters No.of Water KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 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: 25,000 (When required by municipal policy.) Work to Start: 12/1/11 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 ® BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: K&J Integrated Systems,Inc. ` LIC.NO.: 20771 A Licensee: Timothy Beckwith Signature LIC.NO.: 20771A (If applicable,enter "exempt"in the license number line) Bus.Tel. No.:- 877-687-2299 Address: 123 Captains Row Chelsea,MA 02150 Alt.Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: 001494 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 —7 Signature Telephone No. PERMIT FEE: $ 0272 Date.... .......................`. r N°RTM °�<"`°;•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �SSACMUS� This certifies that 05; � has permission to perform........ ................. wiring in the building of......:.1.t<?.�'l.U�4.... ....... . at...... ��./l .. .. 44MV..........5./�............................... .North Andover,Mass. Fee... Lic.No../Y ............ ... ,,f E . 1CAL INSPECTOR Check # 201219'Iassachusetts Electrical Code.Amendments 527 CM1a 12.00§Rule 8: In accordanee-with thepzovisions of M.G.L.c.143,§,3L,the pemut application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shaII be filed' bn 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 e ectricat permit shall b.e 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 construction.activity,and maybe deemed by-theJnspector_of-Wires abandoned-and.inxalidEhe—. 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 omplstioh 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 mid extdnded 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 15 008.and extending-through August 15,2012. ule 8—Permit/Date Closed: t **Note:Reapply for new permit \ ❑Permit Extension Act—Permit/Date Closed: ti Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. r 2, '7 �. BOARD OF FIRE PREVENTION REGULATIONS Date issued: r` 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: 8/29/11 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) 148 Main St Map: Lot: Owner or Tenant Sutton Pond Condominium Association Telephone No. Owner's Address same Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building Residential Condo's Utility Authorization No. 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: 5th Floor Electric Rm,furnish and install 110-volt circuit to radio master box. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- 11o.o er mgency Lighting rnd. grnd. 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 No.of Alerting Devices Tons No.of Waste Disposers Heat Pum Number J.Tons J.KW No.of Self-Contained Totals: 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 Equivalent No.of Water KW No.of No.of Data Wiring: Heaters I Signs Ballasts No.of Devices or Equivalent 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: $ (When required by municipal policy.) Work to Start: 8/29/11 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 licen- see 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 ypermitissuinoffice. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (SpeI certify,under the pains andpenalties of perjury,that the informaplication is true and complete. FIRM NAME: Andover Electric Services Inc LIC.NO.: 14302 Licensee: Robert J. Branca Signature LIC.NO.: *Per M.G.L.c. 147, s. 57-61,security work requires Depa Public a ety"S"License: LIC.NO.: S: (If applicable, enter "exempt"in the license number line) Bus.Tel.No.: 978-475-4995 Address: 19 Dale St Andover MA Zil): Alt.Tel.No.: 978-423-8350 OWNER'S INSURANCE WAIVER: I am aware that the LWfisee does not have the liability insurance coverage normally required±y law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Phone: Permit Fee: The Cortmionwealth of Massachuseas - Depart Wui of IndusbilalAccidena Office of Investigations 600 Washington Street Boston,MA 0211.1 www,mussgov/dna Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legblp Name (Business/orgammtionaa&vidual): Andover Electric Services Address: .19 Dale. St City/State/Zip. Andover, MA 01810 Phone#: 978-475-4995 Are you an employer? Check the appropriate boa: Type of project(required):. 1. I am a employer with 5 4. ❑ I am a general contractor and I employees(flL and/or part-time)-* have hired the sub-,contractors 5. []New const<uction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• Q Remodeling " ship and have no employees 'These have 8. Demolition, workingfor mein c employees and have workers' a�capacity.- 9. ❑Building addition r [No workers' Comp.insurance comp.m6M=ceJ . required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions t 3.n I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions ' nd a myself [No workers' comp. �of exemlnd per MQ. 12.❑Roof repairs employees.[No wor insurance required.]t c. 152, §1(4), ad have no 13.❑ Other kers _ coup.insurance required.] *Any applicant that checks box#1 const also fill out ft-sectim below showing their wades'compensation policy mdmadon. I T Homeowners who submit this affidavit indicating they are doing all wodr and then.hire oataide contracttus const submit a new aTdavit indicating earth. ;Contractors that check this box must attached an adrManal sheet showing line name of the sud state whether or not those entities have "employees. If the sub-contractors have employees,they arnst provide them warps'camp•Ply nmmbcr• I am an eMloyer that&providUzg workers'comPmatmn mancefor m1P�1ees Below is thepo&y md1ob site i information. Insurance Company Name: Chartis f WC 9763814 Expiration Date: 4/28/12 Policy#or Self-ins.Inc.#: �P� Job Site Address: City/StateMP: 6 70 Attach a co of..the workers' compensation policy declaration a(showing the policy number and tion date). � PY P P cy P� ( owing P cY ) 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 andlor one-year"imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against olator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for' e coverage verification. Ido hereby certify urn ,,paws at ofperWU the the information provided above is and correct Si e: Phone#: '-f 0X 3 - 9 3 J-0 _Off cial de only.•Do not write in this area to be completed by city or town offid Z --City or Town: PermitUcense# ' IssiLing Authority,(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk Onectrical Inspector 5. Plumbing Inspector 6. Other Contact Person: r Phone#:i Date.... ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING "$A US This certifies that .... has permission to perform Jc. �/Zr-- . ....................................................................... wiring in the building of at North Andover,Maw ol Lic.No.020.7.7/d...........AA McmicAL NspEcTuR Check # 10452 2012 Massachusetts Electrical Code Amend*ients 527 CMR 12.00§Rule 8: In accordance withA-se provisions 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 shall-be limited as to the time of.ongoing construction activity,and may be-deemed by thelnspector_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. C�j�nle 8—Permit/Date Closed: ***Note:Reapply for new permit �0 Permit Extension Act—Permit/Date Closed: Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. C� S— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 3 [Rev. 1/071 (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: 11/3/11 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) 148 Main Street Bradstreet Building Owner or Tenant Great North Properties(Sutton Pond Condos.) Telephone No. 978-278-4000 Owner's Address 148 Main Street Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building Multi-dwelling Utility Authorization No. 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: Install 1 new fire alarm control panel with new initiating devices and annunciator. Install one new radio master box to commumca a wt ire epa men. Completion of thefollowing table may be waived by the Inspector of Wires. 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 Pool Above ❑ In- ❑ o.o mergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 10 No.of Switches No.of Gas Burners No.of Detection and 100 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: '".'".................. ' '""""' """"""' 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 No.of No.of Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent 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: 35,000 (When required by municipal policy.) Work to Start: 12/1/11 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 ® BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: K&J Integrated Systems,Inc. LIC.NO.: 20771A Licensee: Timothy Beckwith Signature LIC.NO.: 20771A (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.: 877-687-2299 Address: 123 Captains Row Chelsea,MA 02150 Alt. Tel.No.: *Security System Contractor License required for this work; if applicable,enter the license number here: 001494 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. $ : ..: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: l cag �c�CJr{Y��• _ p�,,, City/State/Zip: 'J&0ASQC& M)o 2l sn Phone#• $77 — Co&-1— Ci Are you an employer?Check the appropriate box: Type of project(required): 1.YIJ_am an employer with 2,-- 4. : 1 am a general contractor and I 6.'1 New construction employees(full and/or part time).* have hired the sub-contractors ❑Remodeling 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ship and have no employees These sub-contractors have 8. 1;Demolition working for me in any capacity. employees and have workers' 9.L Building addition [No workers'comp.insurance comp.insurance. required] 5. We are a corporation and its I0.14 Electrical repairs or additions 3. CJ I am a homeowner doing all work officers have exercised their myself [No workers'comp. right of exemption perm MGL 11.LI Plumbing repairs or additions insurance required]t c. 152,§ ](4),and we have no 12. Cl Roof repairs employees.[no workers' 13. ❑Other • comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tllomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach an additional sheet showing the name ofthe sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,thEl must provide their workers'comp.Policynumber. 1 am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: Q ("n h cA !>Q Use,, Policy#or Self-ins.Lic.#: Expiration Date: 31 i 1 Job Site Address: I Ll� W-;n St . City/State/Zip: r lr1Cjo Ln[JC)Vj-og 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 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 $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do her y cern under the painsai enalties of perjury that the fnfor n provided above is true and correct. Si nature: Date: I l j Print Name: B'H(Z Phone#. - 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 Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#•