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HomeMy WebLinkAboutMiscellaneous - 228 DALE STREET 4/30/2018 228 DALE STREET 210/064.0-0013-0000.0 4� i Date.. ........................ x .hi f NORTH 1 "�,� TOWN OF NORTH ANDOVER ''R p PERMIT FOR WIRING SS�cHusE� i This certifies that .... .....t.... ............................................. . has permission to perform .. , "Y I wiring in the building of... `."*`------ .............................................. �J t/ ... ,North Andover,Mass. Fee.�I. .e ...... LIc.No. ...... �2—..... . ............ .... . . .. ELECTRICAL I SSPECTo, "n j Check # _- 77 `1 5 y Official Use Only Commonwealth of Massachusetts Department of Fire Services Permit No. ,77/� Occupancy and Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS [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 IN INK OR TYPE ALL INFORMATION) Date: 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) �� V2�eGY—' Owner or Tenant 0�54141t-a1 J-- /7�pd pz 2 A Telephone No. Owner's Address --V Z S— Dap/� -d-.4q- -. A- m,.,1/® ?,a- Is this permit in conjunction with a building permit? Yes �No ❑ (Check Appropriate Box) Purpose of Building 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: f/ � PC00 Completion of the ollowin 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.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets '3 0 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches S No.of Gas Burners No.of Detection and Initiatin Devices No.of Ranges r No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers J 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 Equivalent ms, j No.of Water KNo.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 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: 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 andpenalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: 131472- Licensee: 31472- Licensee: Signature LIC.NO.: 53 2 �5 (If applicable enter "exempt"in the_license number line.) ION Tel. No.: Address: 1„2 C4� EAA� Kc ION Ci/4w;2!j Alt. Tel. No.: 0-0/ *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S" License: Lie.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 a Signature Telephone No. PERMIT FEE. $ ���� i �1•f. S: �\ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contracto Applicant Information rs/Electricians/Plumbers Please Print Le ibl NaMe(Business/Organization/individual): Address: CC City/State/Zip: Cie MAITUy phone.#: �� �Q- ®j Are you an employer?Check the appropriate boz: 1.❑ I am a employer with 4. ❑ I am a general co]rke or and I Type of project(required):. employees(full and/or part-time).* have hired the sutractors 6. ❑New construction 2.[ I am a sole proprietor or partner_ listed on the attaceet. 7. ❑Remodeling ship and have no employees These sub-contraave working for me in any capacity. employees and harkers' 8. 0 Demolition [No workers'comp.insurance comp.insurance.i9. ❑Building addition 3.❑ required.) 5. ❑ We are a corporatd its 10. Electrical repairs or additions I am a homeowner doing all work officers have exertheir myself.[No workers'comp, right of exemption 11.❑plumbing repairs or additions p GL 12.❑Roof ai s insurance required]t c. 152,§1(4),and ve noemployees.[No w ' 13.❑Other comp. insurance red.) Any applicant that checks box#1 must also fill out the section below showing their workem'con;M ration Policy information. t Homeowners who submit this affidavit indicating they are doing an work and then hire outside contractors must submit a new affidavit indicating such. tContracton:that check this box must attached an additional sheet showing the nam of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their worker'co trip.Policy number. I am an employer that is providing workerscompensation insurance for my employees Below is thepolicy information, p llcy and job site Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: re Job Site Address: tAttach a copy of the workers'compensation policy declaration page(showingthe policy number and ea � Failure to secure coverage as re expiration date). y g 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 c Invests ations of the DIA for insuran a covers a verification. oPy of this statement maybe forwarded to the Office of I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct Si lure• ��s_//� Date / � Phone#: OffJcial use only. Do not write in this area,to be completed y city or town offlciaL City or Town: Permit/Licease# Issuing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: - Phone#: Ph. (978)663-1770 Fax(978)663-8097 ALL Service Plumbing • Heating Gas, Inc. Master Lic.#11330 Phil Stevens Commercial 310 Salem Road Residential "` -V Billerica, MA 01821-2121 Date !t! �� �• TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING Ss�cMUSE� This certifies that 4/ wet. '0.74 . . . . . . . . . . . . . . . . . . . . has permission to perform . •l•`,.• 4 ,.,dlit/4r/� J O.,r7. . . . . . . . . . . plumbing in the buildings of . . f71/.� . . . . . . ... . . . . . . . dale.J./. . . . . . . . . . . . . . . North Andover, Mass. Fee �''� . . .Lic. No�l�l3( . PLUMBING INSPECTOR Check # l MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS ..{.. 11 Date /0//o jo Building Location 2 24 11_�ca.Nc_ \ Owners Name f(\ol`G0.� . �c�. Permit# Amount o' Type of Occupancy e.S t New rj Renovation Replacement Plans Submitted Yes No FIXTURES W. CIF W. Go SIDER 9C M KLM { l M EBB 3iR KDM 4M Float S KOM 6MFloat 7IH ROCR s}H Roar (Print or type) Check one: Certificate Installing CompanyName ��� Sec Q N,cc�x V-ci �''Cc, • �,QS ® Corp. Y Address ge•.,. �� � p��, �� d Sacc" X9 Z Business Telephone T2e elQ e 3 E] Firm/Co. Name of Licensed Plumber. �"� ��C�r• Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ® Bond ❑ Insurance Waiver. I the undersigned a been made aware that the licensee of this application does not have any one of the above threeinsuranc gn rature Owner Agent qz_��� I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations pArformed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus S in apter 142 of the General Laws. r By: Signarure of Licensea Flump.er Type of Plumbing License Title City/Town rcense um er Master Journeyman El(OFFICE USE ONLY 1. RECEIVED .,`, I -s of �%oRTil q DANIEL LONG �,n,� e, TOW14 CI FfigK tl 32 5° NOR7 I ANDOVER`^.:, ( 'irk 0 Ol p ( ' �. in the orrice of. the Town �; .�, MAR 10 �� 59 AM 80 Clerk. ��SSACHUSE�� TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS Edward Morgan * PETITION: #122-88 t228 Dale St. N. Andover, MA 01845 * DECISION The Board of Appeals held a public hearing on March 8, 1988 on the application of Edward Morgan requesting a Special Permit from the requirements of Section 2, Paragraph 2.371 of the Zoning ByLaw so as to permit construction of a family `suite(in-law apartment) in existing garage for use by his mother, Mary Claire Morgan on the premises located at 228 Dale Street. The following members were present and voting: Frank Serio, Jr. , Chairman, William Sullivan, Walter Soule, Raymond Vivenzio and Louis Rissin. The hearing was advertised in the North Andover Citizen on February 18 and on February 25, 1988 and all abutters were notified by regular mail. Upon a motion made by Mr.- Wm. Sullivan and seconded by Mr. Rissin, the Board voted, unanimously, toGRANTthe Special Permit as requested, subject to the following conditions: 1. The premises be occupied by Mary Claire Morgan. 2. The Special Permit shall expire at the time Mary Claire Morgan ceases to occupy the family suite. 3. The Special Permit shall expire at the time the premises are conveyed to any person, partnership or corporation. 4. The applicant, by acceptance of the Certificate of Occupancy issued pursuant to the Special Permit, grants to the Building Inspector or his lawful designee the right to inspect the premises annually. The Board finds that the petitioner has satisfied the provisions of Section 10, Paragraph 10.31- of the Zoning Bylaw and the granting of this Special Permit in particular will not derogate from the intent and purpose of the Zoning Bylaw nor ' will it adversely affect the neighborhood. Dated this 10th day of March, 1988 BOARD OF APPEALS9 I3 Frank Serio, r.� MAR ( J- Chairman <° : e b9N5DVR U-LDH`,,!!G DEPT. /awt ,►'Nqa:h ,r o�.•• ?ti RECEIVED �• •� E DANIEL Lbr?G 3:r°°er°gyco Q:,AMIL�A ;� TOWN CLERK � 's'•. Baas ;�� NORTH ANDOVER MAR 10 10 59 AM 88 TOWN OF NORTH ANDOVER ('.oMASSACHUSETTS Gc,:L;v. 'Che 1OWC1 in 01, 01e BOARD Of APPEALS Clerk. NOTICE OF DECISION Edward Morgan 228 Dale St. Date • • .Marc-h •10; • 1988 . . . . . . • • • N. Andover, MA 01845 Petition No.. . .122-88. . . . . . . . . . . . . Date of Hearing. .March, 8, 1988. . . Petition of . . . . .Edward .Morgan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Premises affected . . . . .228,Dale. .St.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . Referringto the above petition for a R �from e p tli requirements of IM.S e e Pion .2, . . , . . Paragraph 2.371 of the Zoning Bylaw . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . so as to permit construct-lon -of- in-law-apartment• for- mother.,. Mary•Cla•i•re -Morgan (family suite) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . After a public hearing given on the above date, the Board of Appeals voted to . GRANT : the Special Permit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and hereby authorize the Building Inspector to issue a permit to Edward. Morgan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . for the construction of the above work, based upon the following conditions: 1. The premises be occupied by Mary Claire Morgan. 2. The Special Permit shall expire at the time MARY CLAIRE MORGAN ceases to occupy the family suite. 3. The Special Permit shall expire at the time the premises are conveyed to any person, partnership or corporation. 4. The applicant, by acceptance of the Certificate of Occupancy issued pursuant to the Special Permit, grants to Aigned Building Inspector or his lawful designee the right to inspect the premises annually. Frank Serio, Jr. , Chairman William. .Sullivan. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . Walter Soule Raymond. Viv.enZi4. . . . . . . . . . . . . . . . . . . . . Louis Rissin . . . . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Board.of Appeals