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Home My WebLink AboutMiscellaneous - 1820 TURNPIKE STREET 4/30/2018 (9)104 0. 976; Date......l. °:,``° '• ."� TOWN OF NORTH ANDOVER 5 p PERMIT FOR WIRING This certifies that ....................... . ......SSL C7 / .0 4 ................. has permission to perform ............. ......T!/P................f/fv!. ....�I' .�.. wiring in the building of .......Cr....6,1�!i ........................................ at ... 4 �� 2 w P<h.1............ � i.. orth Andover, Mass. ....... �Zsae r Fee .............. Lic. No... il...................... ................... . t �7 ELE ICAL INSPECTOR Check # 1 2- o 0 Y wpi1 nom-veQIfII Op c %'D/I CISb'Cl(:�C�LSCIIS BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked lev.11071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with th(Massachusetts Electrical Code (MEC 527 CMR 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ( f City or Town of: ;!� - r,,.,, �.r>;. To the I nspec or of i res: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street 8 Number) '3 C.� --; <•` - Owner or Tenant Owner's Address5 "' 4/'� Telephone No. f9''>"' r �; Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building L,�:;�.%C. ? Utility Authorization No. Existing Service /rv7`/%j Amps4PZLI r ^ Volts Overhead ❑ Undgrd,�. New Service %C Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Pr oposed Electrical Work: No. of Recessed Luminaires No. of Luminaire Outlets No. of Luminaires No. of Receptacle Outlets No. of Switches No. of Ranges No, of Waste Disposers No. of Dishwashers No. of Dryers No, of Water Heaters No, of Meters No. of Meters �— on of the following table maybe waived by the Inspector of Wires. No. of Ceil.-Susp. (Paddle) Fans No, of Hot Tubs ISwimming Pool grd 'Dove ❑n - i ❑ e,> I No. of Oil Burners No. of Gas Burners No. of Air Cond. Totals: 7,— ota Tons Space/Area Heating KW Heating Appliances KW INo. o No. o KW I Sicins Ballasts No. Hydromassage Bathtubs ie OTHER: No. of Motors Total HP No. or Tota Transformers KVA Generators KVA III I o. oi meI IT: ig ing Battery Units_ FIRE ALARMS No, of Zones o. o Detection an Initiating Devices No. of Alerting Devices % No. o Se Containe Detection/Alertin Devices Local ❑ Municipa Connection El Other Security Systems:* No. of Devices or Equivalent Data Wiring: No. of Devices or Equivalent I e ecommunications Wiring: No. of Devices or E uivalent Attach additional detailif desired, or as required by the Inspector of Wires. Estimated Value of E ectric ,Work: � ��_(When required by municipal policy.) Work to Start:( (' ( ® inspecti ns to be requestd in accordance with MEC Rule 10, and upon completion. INSURANCE COVE AGE: Unless waived by the owner, no permit for th(performance of electrical work may issue unless the licensee provides proof of liability insurance including "completl operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, ahhas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 9 BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that th e information on this application is true and complete. FIRM NAME: CKB Electric Inc. LIC. NO.: Licensee: Ernest R. Hart LIC. NO.: 14361 A Signatu re c.---- (If applicable, enter "exempt" in the license number line.) — Address: P.O. Box 2062 Salem NH 03079 Bus. Tel. No.: 978 685-0301 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: AIt. L c. No.o (978) 809-2600 OWNER'S INSURANCE WAIVER: I am aware that the Licenseedoes not havdhe liability insurance coverage normally required by law. By my signature below, I herd:)y waive this requirement. I am the (check one❑ owner ❑ owner's agent. Owner/Aaent Telephone Na_ I PERMIT FEE: $ 27_;�A �Y2_7 H b GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600, Osgood street No.Andover, Ma Reg: 1820, Turnpike Street, Unit - 201 Metal Stud work, Dry wall work -100% complete. Wall Insulation complete. Electrical Rough work complete. Rough Plumbing -50 % complete HVAC ductwork -50 % complete Painting -50 % complete Work conforms to the Mass Building Code & is acceptable. D aamatyaprasad,P.E j : ., Y." V4ASm TRY � ��. ,.7YAf R%=,S�D NO. 28096NAL Y �� 12-07-2010 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600, Osgood street No.Andover, Ma Reg: 1820, Turnpike Street, Unit - 201 Metal Stud work -100% complete. Wall Insulation complete. Electrical Rough work started. Work conforms to the Code & is acceptable. G��"ter � d �•'��...Ei �--- ..,-" ,, Ram Satyaprasad,P.E 7= � OFF L ENC\Nc 1.1-16-2010 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net Ig Date ... `7-- IP -140 ............................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............Lr- ........... Lr -E.. 8ue,21.s ....... . ...... .............. '9 has permission to perform .... .... � N - — ------ ;ff .479,? ............. wiring in the building of ... ..... (�Kt ............................................... ........................ . North Andover, Mass. Fee..:s ..& c.... Lic. No. SUAIX ........... Check# / 0-5 / v 3 9''Q ELEcmcAL I;6ii; Commonwealth ®f Massachusetts Official Use Only IF Department ®f Fire services PemutNo. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11071 (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 (P LEASE PRINTM INK OR TYPEALL INFORAkTION) Date: 4,_ !() _ / 0 City or Town of-"iTo the Inspector of Wires: By this application the undersi ed gives no/*ef his &or her intenton to perform the electrical work described below. Location (Street & Number) `'6,c)O T\, Owner or Tenant ( I; Telephone No 7 T]`7 Owner's Address ) V) `� '0 T Is this permit in conjunction with a building permit? Yes 5ir No 0 BLDG PERMIT # Purpose of Building . Q (I c—, �P Utility Authorization No. Existing Service IA!-O_()Amps Q / Volts Overhead ❑ Und rd g R— No. of Meters New Service 1 06 Amps I OM / btF�Volts Overhead ❑ Und rd 1 g ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: —�� . .. uuucc u -4t uetuti y aeszrea, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: I 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 cert, under thr pains and ties of perjury, that the information o application is true and complete- FIRMNA Q Z t NS LIC. NO.: f Licensee: Signature LIC INTO.: (If applicable enter `exe in the lic nse number ine.) Address: g ,! Bus. Tel. No.: to *Per M.G.L. c.147, s. 57-61, security work requires Dep ent of Public Safety "S" Licen Alt. 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 Signature Telephone No. PERMIT FEE. $ Ca-Ov,P6/-ir 8%2 'ftp ELECTRICAL PERMIT NO. INSPECTION REPORT: ELECTRICAL INSPECTOR -DOUG SMALL f 1. ROUGH INSPECTION: Passed — [ ] Failed — Inspectors' comments: JVyL �Z-2�/l� (Inspectors' Signature - no initials) Date . FN SPECTION: ssed — Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: (Inspectors' Signature - noinitials) _ Date L 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: (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. I The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/FIectricians/Plumbers Applicant Information Please Print Leggibly NaMe,(B.usiness/Organization/Individual): Address: City/State/Zip: Phone Are you an employer? Check the appropriate box: I. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. i ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] i employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction. 7. ❑ Remodeling . 8. ❑ Demolition. 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T Homeowners 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 is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Policy # or Self -ins. Lic. #: Expiration Date: Job Site City/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. De advised that a copy of this statement maybe forwarded to the Office of Investigations of the DTA for insurance coverage verification. X do Hereby c ertify under the pains andpenaldes of perjury that the information provided above is true and correct. Signature: Date: Official use only. Do not write in this area, to be completed by city or town official City or Town: PermitUcense # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. EIectricaI Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: