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HomeMy WebLinkAboutMiscellaneous - 165 BOSTON STREET 4/30/2018 / 165 BOSTON STREET 210/107.B-0047-0000.0. X14 i II I I i t 49 Date....l ........................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING Ax .............Ir . This certifies that ............................... .. ............ ............................. has permission to perform ........ c......... ...... "'e�..... wiring in the building of....... .................................... at.../ .r........ ....................... .......................... .North Andover,Mass' Fee... ........ Lic.No. ........ .... ....... A�- �LE��crmcAL INSPECTOR R ............ Check , � Z_�''' /// Commonwealth of Massachusetts Official Use Only - Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. ]/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 IN INK OR TYPE ALL INFORMATION) Date: (r — 7a /r 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) 165' G®5kvs S4-- Owner or Tenant Ect� (, rye Telephone No.97 full® Owner's Address S - LaL Is this permit in conjunction with a buildm permit? Yes ® No ❑ (Check Appropriate Box) r Purpose of Building 07vt r1X& 6q_r .�i t0.( Utility Authorization No. Existing Service Q00 Amps / Volts Overhead W 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: a(c Com lesion of thefollowing table may be warned 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 AboveIn- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. El Units No.of Receptacle Outlets 17 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. I Tonal p� No.of Alerting Devices No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals Detection/Alertin g 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 Kms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eq uivalent OTHER: ,i Attach additional detail if desired, or as required Uv the Inspector of Wires. Estimated Valu�eDf Electrical Work: ! . GU (When required by municipal policy.) Work to Start:fft Ar! dI I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA E: 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 9d BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. S FIRM NAME: t < Q04 r. �,/t LIC.NO.• Licensee: �G Ntt?i Signature LIC.NO.: (Ifapplicable.enter ' zein in the license numb r I'm.) Bus.Tel. No.:1j78 4� 28,-3G�d Address: Z 0 6,es e- YZ /¢�`1r'vt'sN mi OR�7 Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"Licen e 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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ a Signature Telephone No. l ��. v��/I G � Ly �// 2 `""� f .- a v �� �� 0227 Date............./2.....//.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING US This certifies that .........S............. . ............. has permission to perform .......... .......... ............ wiring in the building of............. ................................................. SJR at.......................................................................... North Andover,Mass. Fee............:Tr:7.-77r Lic.No%3-7��n ........ 9 .� RICAL IN�SP�ECTO' Check , � Z3S— fl\ Commonwealth of Massachusetts OfficialRNJEIE� Use only Ell Department of Fire Services Permit No. I � L 2 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MTC),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ' City or Town of. NORTH ANDOVER To the Inspe for o ices: IL By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 16�j A :.� Owner or Tenant , ¢ Z5�41-5-& L`„ii.,i✓ Telephone No. Owner's Address S ii.,sti� Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building /f' e Utility Authorization No. 11335(50' Existing Service ''^ Amps a / `4D VoWs Overhead© Undgrd❑ No.of Meters New Service s Amps a, 422!!2: Volts Overhead© Undgrd ❑ No.of Meters Number of Feeders and Ampacity / d`, 6_67 14C Location and Nature of Proposed Electrical Work: iz 1 t /e Completion o the following table fnav be waived hv the Ins eetor 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 c Above In- o.o mergency Lighting ( No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ BatterV Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and y.. No.of Switches No.of Gas Burners No. Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: ...•. ........................................ ........`............. Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local E] Municipal Connection El other i No.of Dryers Heating Appliances KW Security Systems:* \ No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent q+� � OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. p Estimated Value of Ele trical Work: (When required by municipal policy.) c Work to Start: / Inspections to be requested in accordance with MEC Rule 10,and upon completion. cv ` INSURANCE OV 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 pe it ids 'ng office. CHECK ONE: INSURANCE 9 BOND ❑ OTHER ❑ (Specify:) GtG CL /. � I certify,under the pns and enalties oIerIur ,that the information on this aPPlica�tiolnGtilsJtrue uI!e dnd complete. '� FRNAME: LIC.NO.: 113 _ � Licensee: Signature LIC.NO.: a:(Ifapplicable, enter "exempt,in a lice a nut ber 'ne.) Bus.Tel.No.:978-_'!�3;2-47W y v Address: a 6C Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security Wvrk requires partment 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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ c4—' Signature Telephone No. ,) i �� l P 901 1Date NORTH TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSAC14US R �/ i This certifies that . . d/e��j . . . r+,,�7i. . . . . . . . . . . . . . . . has permission to perform . . . !''� . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . �.� . llJ'f7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., ort Andover, Mass. Fee. -.�.�.Lic. No.. .I fh?-. . . . . . . . .4 PLUMBING IN OR Check # MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO PLUMBING - CITYITOWN: ,NORTH ANDOVER _3 APPLICATION DATE:16-20-2011 p� 165 BOSTON STREET JOB ADDRESS:_.__. ._BOSTON- .._-.._ PLANS SUBMITTED: YES N0Li POCCUPANCY TYPE: COMMERCIAL RESIDENTIALQ NEW MV ALTERATION 7' REPLACEMENT � REMOVAUDEMOLITION T PLUMBING: PIPING—FIXTURES-FIXED APPLIANCES—APPURTENANCES 1 ENTER TOTAL AMOUNT FOR EACH SELECTION LIMITED TO FIVE 5 NUMERALS ALTERNATIVE TECHNOLOGY DISPOSER SINK: MOP SERVICE Lj ASPIRATOR DRINKING FOUNTAIN STERILIZER DRAIN: AREAD FLOOR EJECTOR STORAGE TANK BACKWATER VALVE 0 EMBALMING AUTOPSY TT URINAL BAPTISM:FONTO SACRARIUM FOOD CHEST MISTING SYSTEM VACUUM DRAINAGE SYSTEM BAR SINK 0 GLASS WASHER WATER CLOSET BATHTUB ✓I WHIRLPOOL ICE MAKER 0 WATER HEATER:ALL TYPES 0 BIDET 0 INTERCEPTOR:ALL INTERIOR 0 WATER PIPING: 0 CROSS CONNECTION DEVICE KITCHEN SINK r OTHER NOT LISTED Z DEDICATED: ACID WASTE SYSTEM LAUNDRY CONNECTION DEDICATED: GASIOIUSAND SYSTEM LAVATORY 0 DEDICATED: GREASE SYSTEM PIPE RELINING WORK ONLY I �] DEDICATED:RECLAIMED WATER ROOF DRAIN DENTAL FIXTURE I EQUIPMENT SINK: 1-2-3 BAY PREP. DISHWASHER 0 SINK:CLINIC FLUSH RIM0 PLUMBING INSTALLER-FIRM-COMPANY INFORMATION CHECK ONE ONLY r` A CORELLI &SON 3 CANTERBURY CIRCLE— ®✓ Corporation Business#0 NAME: __w.-. .. --- ADDRESS:1 BEVERLY MA (0�19`15Partnership Business#� CITY: — ----- - STATE:� ZIP:1.= v 5--_ - - 978-922-4410 LLC Business#� TEL: -a= _ FAX: - EMAIL: DBA 1 Unincorporated NAME OF LICENSED PLUMBER: INSURANCE COVERAGE I have a current liability insurance policy or,its substantial equivalent,which meets the requirements of MGL.Ch.142 YES M,/- NO If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy 0 Other type of indemnity � Bond 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 OWNERFIAGENT Lj Signature of Owner or Owner's Agent OWNER'S NAME: _ _ - ----- - --- _ TEL: _ r FAX:I. .. I hereby certify that all of the details and information I have submitted(or entered)regarding this permit application is true and accurate to the best of my knowledge.I certify that all plumbing work and installations performed under the pe it issued,will be in compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code,and Chapter 1A2" th General Laws. (OFFICE USE ONLY) TYPE OF LICENSE: Permit# Plumber Signature of Licensed Plumber Inspector �✓ Master 11962 License Number: - Fee: F-I Journeyman 05121%2011" 17:57 FAX 978 922 2328 CARMEN KIMBALL INS 2111 AC-ORD CERTIFICATE OF LIABILITY INSURANCE 06/2 NCE r) a�rz1/2012011 i PRODUCER (9713) 922--0006 THIS CERTIFICATE_ 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ca=an-Ki.wball Tnsurance Agency, Encs HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 49 Beoktasd Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Bose 73 - 1 Beverly _ NA 01915- — INSURERS AFFORDING C©VLRAGE _ NAIL 0 INSURED INSURER A:I3csr£01k & Dedham Mutual Aldo Coralli dba INSJRER B: CD, rlls Plumbing I u�suRER _—. c: 3 Canterbury Circle i INSURER D; ��+Vxly N.A 01915- i INSURER E: _ COVERAGES _ I"HF_POLICIES OF INSURANCE LISTED BELOW HAVE BEEN iSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITH5TANDfNG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TW.S CERFIFICA1 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY I"NE POLICIES DE=RISEp HEREIN IS SIJ9JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION$ OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAYHAVE 9_EEN REDUCED BY PAC CIAIIVS. _ INSR AD>a'L - POLICY EFFECTIVE POLICY EXPIRATION Nt IN AD TYPE OF iN3URAtJCE POLICY rIUMEEK DATR MMIDDIYY RATE E!22 YY LIMITS A 004GRAL LIADILI'IY' R05=150A 08J04/2010 08/04/2011 EACH 40CURRENCE � _ 1,000,000 DALIAGE TG f ENTED COMMERCIAL vENERAl11;ABIt17`t' PREMI&Eo E000c rrenal R Ct.AiMS rAAUE X i QGCUR / / r MED EAP An Qne I PERSONAL&AOV INJURY g — GENERALAGGREGATF: S 2,000,000 CEN'L AGGREGATE LIMIT APPLIES PER: I PR(:tDL;CTS.C_OMPftIP AqG P)L1QYr7 JECT _ LC ._-� .A AUTOMOBILE LIABILITY 90B3oz95 06J30/201b WAVI/7011 CUMRINEDSINGLr-LLMIT 1 ANY AUTO (Ea rdeddant) B ALL OWNEDAUT03 06/3o/2051 tJt;/30J2012 BODIL),INJURY 100,000 r (Pat a6roon) X SCHEOULEGhL�T03 HIREDAUTOS BODiLYINJURY NON-OWNED AUTOS (Per,lccid9M) 340,0017 ! PROPERTY DAMAGE Y 1o0,Ooo LGARAGE.LIABILITY AUTO ONLY-EA ACCIDENT -_ ANY AUTO EAAC4 UNLYt AGO EXG.ESsiUMBRELLA LIABILITY I I / I E/+CH OCCL•FRENGS $ _ OCCUR CLAiM15 I4A0E j AGGREGATE I F1 DEDUCTIBLE RETENTION S ATWORKRRSCOMPENSATIONAMD 26WEtm5051100 -- A�/2pJzolo Oij26JsObL �{ TORY IkAl'S� TP7 EIW.PLOY6FS'LIABILITt' �ANYPROPRIEI'ORIPARTNER/EXECUT''JE E.L�EACHACCIDENT S _ 100,®C0 j C'P'PIOERJIAEMB=RExCLUGED? E.L,NSIIASE-EA EMPLOYEE$ 500,000 byes,JaeGnW under SPECIAL PROVISION'S belerH __ _ _ _ _ F.L.016EASE-PP0LOY UMIY $ 100,000 OTHER DESCRIPTION OF OPERATIOtJSrLOCAiIDN 4NEHICLEVEXCLUSIONS ADDED BY ctiDURSEPAENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION_ ( ) '" �• ( -' �r-_��a� SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORE THE Plumbing Inspector EXPIRATION DATE THEREOF, THE ISSUING INSURER MILL ENDEAVOR TO MAIL 010 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT",@IJT Town of North Andover FAILURE TO DO E0$HALL IMPOSE NO OBUGAYION OR LIABILITY OF ANY KIND UPON 1I1E 1600 OSi3GC}d StZ'B®tINSURER,ITSAGEN ,C REPRESENTATIVES. AUTHORIZI!D REP TIL North Andover Ng� 010 35- _ _ ACORD 25(2001108) - -- CI ACORD CORPORATION 1988 INS025(orce),ca Pcac of M to ►-� r n m v x mr` w ;o m A Z � C? r a m I• cn z COMMONWEALTHOW NIASSACHUSETTS o. ;u r m OEM Z T D 1—j m BOARD IN PLUMBERS AND GASFITTERS IMPORTANT NOTICE PL LICENSED AS A JOURNEYMAN PLUMBER PERMITS FOR PLUMBING AND GAS FITTING —� f +�, {.=bt !.S t t I% '4143,00 i..ic tr f 1 t,. INSTALLATIONS ON STATE OWNED OR USED m + FACILITIES MUST BE FILED AT THE i OFFICE OF THE STATE BOARD. F A t,i y'; TYPE ALDO P CORELL I n . . >. ti {; 0 -J 3 CANTERBURY CIR J7_ > vl Z BEVERLY MA 01915- 1483 .d6C) W r b C „ 77097523,1.77. 0,5/0,1/12 4 ._ 770975 Siryt-:.?ter. ' t:_b. qtr.J1.., :i'. •=.!`:, u.,.,.. . wOMq ON :AtTH OrMAS;AEE !.OFIS BOARD IN PLUMBERS AND GASFITTERS IMPORTANT NOTICE PL LICENSEQ,AS A MASTER.PLUMBER PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. TYPE ALDO P CORELLI JR -M 3 CANTERBURY CIR BEVERLY MA 01915- 1483 770974 11.962. 05/01/12_ 770974, i Office Use Only P Il£ raJUJJJ JJWeaItll Qf �ca5atdrJ1Ug2tti Permit No.if , - ' `` I' iD'cpartment Df IJublic afetg Occupancy Z.Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 Ch1R 12:00 1 3190 11eave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code. 527 C!"IR 12:00 (PLEASE PRINT IN IN 0 T PE ALL INFORMATION) Daze City or Town of L1iJl 4.i . To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) I Sentry Vendor Code Owner or Tenant 'P KYl�tC1 �X/h l Circuit Owner's.Address —, -YY�O , Location Phone #q�c-?�l43�Q Is this permit in conjunction with a: building permit: Yes ❑ No IJ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing service Amps —J wits Overhead ❑ Undgrnd F7 No. of Meters New Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work LOW VOLTAGE ALARM SYSTEM No. of Lighting Outlets No. of Hot Tubs No.of Transfor.-ners Total KVA No.of Lighting Fixtures I Swimming Pool Above In- grnd. ❑ grnd. ❑ ! Generators KVA No.of Emergency Ugh;ing No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outiets I No.ui Gas Burners FIRE ALARP.1S No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No.ot Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Sell Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers HeatingDevices KW tfunici li Local t Other Connection No. of No. of Low Voltage Burg Fire No. of Water Heaters KW I Signs Ballasts Wring Card Acess CCTV ] No. Hyero Massace Tubs I No.of Motcrs Total HP I P;o. of Devices OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Uabiiity Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES — NO C; I have submitted valid proof of same to the Office. YES ❑ NO ❑ If you have checked YES. please indicate the type of coverage by checking the appropriate box. INSURANCE )C BOND G OTHER C (Please Specify) Frontier Insurance Company 10/8/98 Estimated Value of Electrical Work S_ � (Expiration Date) Work to Start Inspection Date Requested: Rough Signed under the Penalties of perjury: FIRM NAME Security $ Stems Inc. d/b/a Sentr Protective SYS ems 1109 C LIC_NO. Licensee James W. Lees Signature UC.NO.0-M (Public Address 110 Florence St. P.O. Box 250 Malen MA. 02148 dus. Tei_No. (781) 388-9700 Safety) Alt. Tet- No. 14115–L,505 OWkER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws,and that my-signature en.this permit.,applicauon waives this requirement. Owner Agent (Please'check one) Telephone No. PER::IT FEE s , (Signature of Owner or Agent) x-6565 c� .1 424 /f((,� HORTM TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUS� L This certifies that .. �.�''1.��� �/ `� '�p ��` ............................................. ...r................... has permission to perform ........1�.� ECS......... ......................... wiring in the building of.... .tl..c..:. a...... ........................................... at..... .5.� ..f !.. d ...... :.................North Andover,Mass. Fee,�.'5..:v�.... Lic.No...//.(/qC............................................................. c � ELECTRICAL INSPECTOR C �/ d4 O�a�1 35.00 PAID WHITE:Applicant CANARY:Building Dept. PINK:Treasurer