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Home My WebLink AboutMiscellaneous - 29 ROYAL CREST DRIVE 4/30/2018a - Date (--2 ................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING 'This certifies that D ..................................................... �*..�.'.*.*.S.C—.V:;.>.C).a.�'.j ... .... ?— .......... has permission to perform ..... .. .... .. .... wiring in the building of .... A.^- C, 1) . ............. I ................................................................................ at N h Andover, Mass. ............... t ... . ............. ......................... , �. -? . ........ . . ... .. ................... Fee .... ...... Lic. No. �?r.)S.03 ...... ELECTRICAL INSPECTOR Check# 33 70 =j E official IJ%e Only Permit No, Occupancyand rzee Chocked BOARD OF FIRE PREVENTION REGULATION5 L)tcv� 1/07) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfbrined in iccordanco with the Massachusetis U-1cetrical ('odo (MEQ, 527 CMR 12,00 (PLL, ASE, PR17VT.1AT INK OR TYPE A LL XT, ORMA TION) lbte: City or Town o -F: �JQM _6!�L"P_y 7i) ihe ln.�peclor q Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below, Location (Street & Number) go C,\, CM5N _V)�Ve Afy0mc S\M\Alo!� OwnererTenant Telephone No. 1:2_6'3q-�C5,�k Owner's Addresq Is this permit in conjunction with a building permit? Ves F� No 9 (Check Alipropriate.Box) Purpose of Building—zW—Wit! §S � Utility Authorizatinn No. Existing Service Amps N1_j I Volts Overhend I.Judgrd No. of Meters New,5ervice Amps Volts ' Overhead [I Undgrd L7 No. Of Meters Number of Feedlem and Ampacity Location and Nature of Proposed Electricni Work: M (70mi2leth)n o0hc,fi;1T11'11)inp, table may be waived hy the Inspeclor e�f wires, UsTQU No. of Recessed Lumin No. of Ccil,Susp. (Paddle) Pans No. Of Total Transformers KVA No. of Luminaire Outlets o. of ill FNo.of Hot Tubs Generators KVA No. of Luminaires "wimIni Atiove Swimming Pool grnd. 0. 0 Emergency Ug Battery Units. No. of Receptacie Outlets No. of Oil Burners FIRE ALARMS INo. of Zones No. of Switches No. ofGas Burners W. of Detection and Initinting Devices No. of Ranges No. of Air Cond. Total 'Tons No. of Alerting Device -q No. of Waste Disposers I -lest Pump Totalq.,] 11 fli—m— ...................... No. of Se ff-Conts—nned betection/Alertingl3evices No. of Dishwashers Space/Area Heating KW Local E] Mlln'C'Pal Otber Connection No. of Dryers Heating Appliances KW Seeurity Systernq.,;� No. of Devices or E guivallent No. of Water KW No. of Data Wiring: Heaters Signs Ballasts I No. of Devices or EguivnIent No. Hydromassage Batlitubs No. of Motors Total HP 11'ele ommu"Jentions wirink., No. of Devices or Eguivalent OTHER- Affachaddiflonaldelail fldesirrd, oras requiredki; the 1nxpgc1orqfR,11res. Eqfirnated Value of Electrical Work, �000 (When required by municipal policy.) Work to Start; 11 inspections to be requested in accordanoL with NIEC Rule 10, Find upon completion. INSURANCE COVERAGE: 51less waived by the owner, no permit for dic performance of electrical work may issue unless the licensee provides proorof liability insurance including "completed operotion" coverage or its substantial equivalent. The undersigned certifies that such covctagc is in forec, snd has exhibited pmofolsairm to thr. permit issi-iing office. CHECK ONE: TNSURANCE� [Ix BONI) E:1 OTHER [I (Speciry;) I certify, tinder thepains andpenalfies qrPerjuny, that the iqformation on this oplyfication is true and conWleta FIRM NAME: No -port Eloctric Licensee, David McMullen Signature (1fapplicable, enter "exempt " in the ficensc number Une) Rus. Address, 200, hpoint Ave, Portsmouth, Ri.02871 Alt. *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: LIC. NO..' A20803 LIC. NO.- 11608U Tel. No.:24.0.- L929L.�__ Tel. No- 617-908-4193 Lic, No. OWNER'S INSURANCE WAIVER: I arn aware that the Licensee does nof have the Iiibility insurance coverage normally required.bylaw. By mysignature below, I hereby waive this requiretnent, I nni the (checkonel,L_xLowner Elowner's a 'ent owner/Agent L Signature Telephone No. PowarEE., s /c�_,f- 3 f7 ate . ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING "�O"O'j L�-('Av-t 0-/:>f'n4 00- �Av L'� This certifies that, . ....... . .................. I ............................................. y .......................................................... has permission to perform 0 .......... wiring in the building of ..... .............................................................. at ...... Z�i ...... �In -4 A Cu S . .......... M North Andover, Mas�. (OE- FeJ Lic. ...... ....... ..... Et CPGICALINSPECTOR� Che&4�%. e e) r7 COmmonwealth Of Massachusetts Official Use Only Department of Fire Services Permit No, e Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Fr.Rev'-,i i/99J Cleave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance (PLE14SE PRINTIA1 INK OR Tyl)r, .4L4 INr, 0 with the Mlssachulletts Electrical Code (MEC), 527 CMR 12.00 TION) Date: City or Town of: Or By this application the u A To theInspector of *res: ndersig es notice of is or er intention to perform the electrical work described below, Location (Street & Number) M RE� �� ( Owner or Tenant 4 -T��c —6- NDY7�\ OWOCrN Address -- C TelephoneNo-, 97f� 61��, 7aOC Is this permit in conjunction with a - t- ri 0)1545 1 \CX - building permit? Yes No 9-11- (Check Appropriate Box) PurPOseof Building_ Dweu Utility Authorization No. Volts Overhead Existing Set -vice Amps El Undgrd No. Of Meters Amps Volts Overhead Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work, Tkp!- uv.- 'V1 i�— - , iTs I K) 0 U —" Ll 0 I-VWJ No. of Recessed Fixtures No. of Ccil--Sllsp. (Puddle) Fans No. of Lighting Outlets No. Of Hot Tubs No. of Lighting Fixtures Swimming Pool ove n rnd. rnd. No. Of Recessed Fix —,--Jr,,,k\ v\g, kUyM*j C 00 L" No. of Receptacle Outlets No. Of 011Buirners No. of Switches v v4 vil DI No. Of Gas Burners e No. of Ranges f No. of Air Cond, otal i9posers 'a --Tl�� -o-... No. of Waste ump um Tons er (I Disposers Heat Purnp um er be .0 Generators -kV—A . ALARMS JNo. of Zones 0, of Alerting Devices Wires, . � ..A I b -i - JNo. ofDIshwa --t� - I I C shers 0 Oc On/Alertipj_pevices No. of Dryers SPace/Area Heating KW Local 0 U�lclp 0.0 ater Heating Appliances KW ecur onnect n 0 Other Heaters KW .0.0 0.0 No. OMevices or Egulvalent 'Signs Ballasts Data Wirin No. Hydromassage Bathtubs No. of Motors N-0t,911URN&TY!c�es orEguivalent . ARWTWNT OTHER: Total HP TTeccommun catFo—ni-Wiring: 6 r-�kar�<- --Lo--Of DeAc�� or Equivalent eocky-J- lie-O-Tvw% v -N irs 3 UJ Gi� INSURANCE Anach a- ddltional detail VVeilred, or as required py me inspector oj, Wires, COVERAGE: Unless waived by the owner, no permit for the Performance Of electrical work mny issue unless the licensee provides proof of liability insurance including as exhibited proof of same to the permit issuing office. undersigned ccrtifies that such coverage is in force, and h, 't'ompleted operation" coverage or its substantial equivalent. The CHECK ONE: INSURANCE P�r BOND n OTHER [] (Specify: -!imated Value Of Electrical Wor Work to Start: (When required by municipal policy,) Tl-�'x-Plration �Date) -- �1 Inspections to be requested in accordance with MEC Rule 10, and uPO11 completion. cel"16, 14 n der ti, V=0 Y— lie pains andpenalfies p FIRM NAME, -. tJ 9elW of erJury, that the Information on this application is true and co mplere. Licensee: LL LIC. NO..-.612a03� (1fapplicable en ter "&ernpt "in the lic Te number line,) gnatur LIC, NO.:, Address: '�b lox� L PC, r Bas. Tel. No., Is ')-� 0A OWNER INSURA-�NE�VVAIVER; ensoo does n Alt. Tel, No. -e below I hereb oi have tile liability insurance coverage normally required by low. BY my signatul 14411 aware that the Owner/Agent Y waive this requirement. I am the (check one owner Signature Telephone No. owner's agent' PERMIT FEE: $ 1W 41 111le ("011synon)pealth 00fosachasemy IMEMIM DeParflftenf OfIlIdUstrial Accidents Office of Investigations I congpess street, suite mo Bostoi�, MA 02114-2017 W7141I)IMaSsIgOvIdia Workers' Compensation Insurance Affidavit. BuildersIContractorsiFIectricians/Plumbers 3nliv..qnf Tnfr%,-rna"__ NaML' (Btisiness/Organi7,ation/Iiidividual): Address: C_ Co City/Stat- ip: 0 "W -A 1?TQn:I Phone4: 02 27's — A WIVY01] an employer? Check the appro arn a employer wig, 4. D I am a. general contractor and I T p of pr Type of project (required): CMPIOYees (full and/or pait-time). 2,[1 1. orn a*sole have hired the sub -contractors a o listed the 6, New 6, LI New construction proprietor or partner, ship ai)d have no emplo yees on attached sheet, These sub -contractors have �rs have Remc 7. Remodeft worki�j7 for mc in any capacity, Mployees ancl have workers' work 8 Dem( 8, D Deffiolition [No workers' comp. insurance comp. insuranceJ 9, Building addition VAI 9 M required.] 1 arna homeowner doing all work LJ We are a corporation and its officers have exercised their I Electrical repairs or additions mYs(ff [No workers' cornp, right'Of exemption per MQL I Plumbing repairs or additions insurance required.] t c. 152, § 1(4), and we have no 12 -El Roo-frepairs cnIPlOYees. (No workers' 13.0 Other '-Any ipplioant thit chdcks box .1'14onieowners whosubmil his �fl 1`0143ta-ISO fill 011ttlIcsectiort below showing thcir workers' vompensation policy information, , affidavit indicnting thcy are doing all WOrkand thon hirc outside tContraotors that check this box must atta cOntractOrS Must submit a new ftffidavit indicating such, ubr'd an ael�ijtiOnftl sheet 5110wing the name of the wb-cojitractot,� and sttm; whother or not those cnfltial have CmPlOY"s, Ifthe sub-controutors have employees, flicy must provide thGir Workers' col-np, Poliey number, lain an eftlPloyer that isprovidilig Vorkers' compensation jn$IIrr*Mcef0r lily aniployces. Below isthepolic in 00 y andiob site Insurance Company Name. 'pi t�i r7 I' C 4 Policy # or Self -ins. Lic. 4: ra on ate, Expiration Daft: 0/ Job Site Address:; 4!1jr City/State/Zip:.,"A Attach a copy of the worl�ers, compensation Policy declaration page (showing the policy nu Avg0__,_tM Failure to secure coverage as required under Section 25A of M mber and expiration date), fine up to $ 1,500.00 aad/or one-year imprisonment, aq GL c, 152 can lead to the imposition of criminal penalties of a of up to $250.00 a day against the violator, Be , , Wellr4s civil Penalties in the form of a STOP WORK ORDER and afine "'VestigatiOns of the DIA for insurance cOverag advised that a COPY Of this statement may be forwarded to the Office of e verification. I do hereft cerfifi; imlie- oior_�._ ___ _V Provided above i.y true and correct. Ofricial U -Te only. Do not nritg in thrs areq, to be con, 'pleted by &. ty or tOwn of .ricial City or Town: Vermit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4, Electrical Insp c r 6. Other e to 5- Plumbing InSpector Contact. Person: Phone#- � �. r NEWP013 OP ID: LS CERTIFICATE OF LIABILITY INSURANCE DATE ( M)- 01/1" '" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND C' 081D2C014 4 ONFERS NO RIGHTS UPON THE CERTIFICATE H ER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE- 'HOLDER. IMPORTANT* If the certificate holder Is an ADDITIONAL INSU RED, the pollill must be endoibt;U. IT but3ROGATION IS WAIVED, subject to the terms and conditions of the policy, certain Policies may require an endorsement A certificate holder In Ileu of such endorseme . ntil statement on this certificate d PRODUCER oes not confer rights to the DIF Dwyer A ncy 38 Bellevue Conus D.F. D p .. - Y_ ce Agency Newport, RI 02840 !1 . �p, CIIII. 401 -o4u_V52_9 Daniel F. Dwyer III A_W__q§§: GTCI�Wdfdwyer,corn (AIC �LO)L 6-9629 INSURENS) AFFORDING COVERAGE NAIC # ___�ewPil Electric 7Nsul INSURER A. Foremost Corp LPLSURER13: Scottsdale 200 Hlgh Point Ave, Suite B5 INSURER c: Beacon Mutual Insurance 41297 Portsmouth, RI 02871 INSURER - 0 : ---------- THIS IS TO CE1!lT11::,l', . ......... ..... .......... munrl .............. 1-1 AT THE POLICIES OF INSU 1:� ill WE REVISION NUMBER: INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM i TISSUEO "TOTHE INSL' i ll:: E: FOR THE POLICY PERIOD CERTIFICATE MAY OR CONDITION OF AlNY CONTRACT OR OTHER D'OCUMENT!l1iWlTH RESPECT TO WHICH THIS BE ISSUED OR MAY PERTAIN, TH'E INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ML:��EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM TYPE 0 F INSURANCE ...... ------ -- &ENFKMALL LUA13UTY NUMBE UNTS A COMMERCIAL GENERAL LIABILITY SCP006046448 EACH OCCURRENCE $ CLAIMS -MADE I . 1 12/30/2013 12/30/2014 20( 1,000,0 I A I OCCUR Ea OCCUrr-1 & nnn n LIMIT APPLIES PER: AUTOMOINLE LIAll A '7 ANY AUTO ALL OWNED AUTO$ HIRED AUTOS UMOMLLA LiAB A A 7 H A AA L U IR L T TWM Y 0 0 e A L W U U AL T N U0 8 L TD 0 A B X ExoEss LiAs D 0 TE I r WORil COMPENSATION AND EMPLOYERS, LIABILITY R 11 ( C ANY PROPRIETOR/PARTNERII I _R OFF7ICER/MEMBER EXCLUDE[ v ry (Mandatory in NH) f A 7.�L . d b "e, A JEmpl Prac Llab 5CF`005046448 I SCHEDULED 11111121111111,,12014 J1O1x;yTN,,,1RY, ALIT Pl ""on, NON?OSWNED AUTOS 3 PR PER Y 0 I I ACCI, T, CE $ ( I OCCUR I I I I . . . ........ ... .... . .. ..... .... .... . -'Ji ------------ J_ . - T$ MADE B80019598 Ill OCCURRENCE $ Ill OCCURRENCE $ 12/30/2013 12/30/2014 A-GGREGATE $ 6,000 Y/N WC STKAkT—U 68861 1 18 0 N/A 01/18/2014 01/18/2016 E.L. EAC .H ACCIDENT $ 600, E.L. DISEASE - EA EMPLOYEE 4 500 3 SCPO 0 013 /30 0 E.L. DISEASE - POLIC� I Iii— - 600, UDU404413 ;12/30/2013 12/30/2014W - 60, DESORPTION OF OPERATl`"` 1 L-VUATIONS I VEHICLES (Attach ACORD 10i, Additional Rillifindriks Schedule, I If more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPI Iii ATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Insured's Copy ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOIRIZED REPRES TVC Daniel F, Dwyer III ACORD 6a �� ' I ,�j za, -r / IV" I 9966 ,�i Date ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING I �. This certifies that .......... IAe�� ....... ........................ has permission to perform ...... &..?. 4.e. ... x2s�/ ........ wiring in the building of ............. ................... at j ........... -.)P North Andovei, Mass, 75 Fee ... ...... Lic. No. 16.7 f ;2,6( ........... ..... .. ...... .. L ssp 0 rti OCA - L I iNSPECTOR Check # tg (fommonwea& ol Mamac4ajeffi Official Use Onlv Perm it No. 2epartment olJire Service.4 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS I [Rev. 1/07] (leave blank) S 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 PRINTININK OR TYPE ALL INFORMATION) Date: margh 14, 2011 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) 50 Royal Crest Ddye Building # 29 Owner or Tenant Roval Crest Telephone No. 978-681 AS22 Owner'sAddress 50 Royal Crest Drive North Andover, MA01845 Is this permit in conjunction with a building permit? Yes [:] No Z (Check Appropriate Box) Purpose of Building Commercial - Apartment BuildingsUtility Authorization No. Existing Service Amps Volts OverheadEl Undgrd L1 No. of Meters New Service Amps Volts Overhead Undgrd [:1 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install 6 Gell Packs! Completion of tho foltnivincy tnhlp niny hP ivaivod hv tho Inmoomr nf Uli,ov No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above Ei In- E] grnd. grnd. No. of ergency Lighting Battery Units 6 No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: J.NqTP!�FJX.0.qs .......... J..K.W ........... .... ...... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Ei Municipal [I Other Connection No. of Dryers Heating Appliances KW -Security Systems:* No. of Devices or Equivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivale t No. Hydromassage Bathtubs No. of Motors Tota I HP Telecommunications Wirin : No. of Devices or Eq uivalent OTHER: Attach additional detail if desired, or as required by the Inspector qf Wires. Estimated Value of Electrical Work: $600.00 — (When required by municipal policy.) Work to Start:_03/1 4/2011 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 [i) BOND 0 OTHER [I (Specify:) I certify, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: The Electricians & Co., Inc. LIC. NO.: A10737 Licensee: — Michael J. Parzialle Signature IC. NO.: F20969 (If applicable, enter "exempt " in the license number line.) Bus. Tel. No.: 781-322-93" Address: — 50 Branch Street Maiden, MA 02148 -0 Alt. Tel. No.: 791-1129-11nn *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. -,s nf) 001021 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)E] owner Downer's a nt. Owner/Agent Signature Telephone No. PERMIT FEE.- $ 12.5-00