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HomeMy WebLinkAboutMiscellaneous - 1820 TURNPIKE STREET 4/30/2018 (10)�' � �' ?'4 ���. l,i s��r CJ) a� - --.= r GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600, Osgood street No.Andover, Ma Reg: 1820, Turnpike Street, Unit - 207 12-07-2010 Metal Stud work, -100% complete. Wall Insulation complete. Electrical Rough work complete. Rough Plumbing --Complete Work co forms to the Mass Building Code & is acceptable. /am a rasa 'sIASASTRY`S� /,T i'APRA,SAD 28095 : r: S/ONAl ENG 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net J GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600, Osgood street No.Andover, Ma Reg: 1820, Turnpike Street, Unit - 207 11-16-2010 Metal Stud work -100% complete. Wall Insulation complete. Electrical Rough work started. Work conforms to the Code & is acceptable. R SatYap rasa.E" 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net 982:' Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING J This certifies that 4tial-S .................. ao� has permission to perform [1,U�T % 9 -77/ .........................I............................................... wiring in the building of ..... � .... !n .............................................. at. zD T2N k ai ................... North Andover, Mass. Fee :Jf r. ©. o � .... Lic. No.227M)e ......... .... ............ D E�crR►c�u. Its Check # ! �� Commonwealth of Massachusetts Oficial Use Only IF Department of Fire services Permit No. 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 (MEC), 527 CMR 12.00 (PLEASE PRINT ININKORTYPE ALL INFO TION) Date: f O City or Town of:Ar To the Inspector of Wires: By this application the undersi ed gives not, e of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Yes Purpose of Building�� L� Telephone NoG11 J77g" No ❑ BLDG PERMIT # Utility Authorization No. Ezisting Service%L;VD Amps .Overhead ❑ New Service j Amps 02qVolts Overhead ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: - Undgrd R_ Undgrd ❑ 7— Completion of thefollowing table may be waived by the Inspector of wins, No. of Meters No. of Meters 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 El In- El o. o mergency ig mg rnd. rnd. Batte its ceptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones itches No. of Gas Burners No. of Detection and Initiatin Devices nges rNo.of No. of Air Cond. Tons No. of Alerting Devices ste Disposers Heat Pump Number Tons KW ........................................................... No. ofSelf-Contained Totals: Space/Area Heating KW Detection/Alertin Devices Local ❑ Municipal ❑ Other hwashers Connection No. of Dryers Heating Appliances KW Security Systems: No. of Water No. of No. No. of Devices or Equivalent Heaters lam' of Signs Ballasts Data Wiring: No. of Devices or Equivalent Iivo. Hydromassage Bathtubs INo. of Motors Total HP telecommunications Wiring: No. of Devices or Eauivalei • 1 ' 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: 1,1 •- / D — / 0 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 � OND ❑ OTHER ❑ (Specify:) I cert, under th pains and Ities ofperjury, that the information on th' lication is true and completes FIRM NAME: C3 -C t v5 LIC. NO.: / fj?f/ SR Licensee: c� Z C `� Signature LIC. NO.: 7 M (If applicablenter "exempt" in the license number line.) Bus. Tel. No.: &26? `L SfL-ln Address: Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requ es Department 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 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. $ ELECTRICAL PERMIT NO. INSPECTION REPORT: + ELECTRICAL INSPECTOR - DOUG SMALL 1. SPECTION: Passe — Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: (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: b (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. The Commonwealth ofMassachusetts Department of Industrial.Accidents UOffice of Investigations 600 Washington Street Boston, MA 021X.1 www.mass.gov1dia Workers' Compensation Insurance davit: Builders/Contractors/JEleciriciansfrIumbelrs Applicant; Information Please Print Legibiy Name (Business/Organization/Individual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: 1. ❑ 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. x 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. C] 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 . &. ❑ 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. lam an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy # or SeIf-ins. Lic. #: Expiration Date: Job Site Address: 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I tido hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Si ature: Date: 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. CitylTown CIerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone pc► CERTIFICATE OF USE & OCCUPANC Fee: 100.00 previously Pg W: Receipt: 21628 /-0 9 7 *l i 110 ,\ ti '(�o Date ......1.7.7/ .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .............. ��.....L.......... C-z..�� %....... �..... � ........ has permission to perform ..............................................................'�O 9 .. ...... wiring in the building of ......�..F/yl......�'�f F at ... ........ h:............5.:` ........ North Andover, Mass. Fee .... Lic. No./.L..(3.... (21..................�� / ELECTRICAL INSPECTOR Check # _ i <r0 inmonive' t/1 o c,'Ot!Q.S'SCIC�IU.SL'/tS ---- - Official Use Only /Permit No. epartmen] o(Sertrzces --- BOARD OF FIRE PREVENTION REGULATIONS [ROccupancy and Fee Checked [Rev. 11071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thMassachusetts Electrical Code (ME ), 527712.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ( C S' 0 City or Town of: !!i. F i.,, - To the I nspe for of Wi res: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) (> a�C l Owner or Tenant l % %'� �_,..:rT �'=' Telephone No.��r_� Owner's Address r.c Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building�,�� i_ Utility Authorization No. Existing Service IP01v Amps l /'Volts Overhead ❑ Undgrd No. of Meters New Service Dip Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters_ Number of Feeders and Ampacity Location and Nature of Pr oposed Electrical Work: rmml.�tinn of tk-f.JI. .;---L.I--. .�-.-._:.._ .i..-.. No. of Recessed Luminaires v„y No. of Ceil.-Susp. (Paddle) Fans .."Il ll Id ur vvdlvtfu u tii Ins eCiOr Or VVIr No. o Tota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA, No. of Luminaires Swimming Pool Above ❑ In- ❑ o. o mergency ig ing rnd. rnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS _ No. of Zones No. of Switches No. of Gas Burners No. o Detection an Initiatin Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Num.., er Tons KW No. o Se-Containe Totals: .................. Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipa ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Water Heaters KW No, of No, -OT— No. of Devices or Equivalent Data Wiring: Signs Ballasts No. of Devices or E uivalent r' No. Hydromassage Bathtubs No. of Motors Total HP I e ecommunications Wirin : �— No. of Devices or E uivalent OTHER: Attach additional detailif desired, or as required by the Inspector of Wires. Estimated Value of E ectric I Work: �(�� (When required by municipal policy.) Work to Start: f( to Inspections to be requestd in accordance with MEC Rule 10, and upon completion. INSURANCEC611AGE: Unless waived by the owner, no permit for th(performance of electrical work may issue unless the licensee provides proof of liability insurance including "compled operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, alihas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ef 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 Signature LIC. NO.: 14 3 6 1 A (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: _(9781 685-0301 Address: R0. Box 2062 Salem NH 03079 _ Alt. Tel. No.: (978) 809-2600 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenseedoes not havethe 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 �. • - Sinnature ----------------Telephone No._ I PERMIT FEE: $ es. PA -1 cT—O�&-e-oae�w /q�RM L>5 Z—� 4