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Home My WebLink AboutMiscellaneous - 36 PARKER STREET 4/30/2018Date ,ej(/`/(:) ............. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that v ..... .......... ,........4.v`... ..r .......................... has permission to perform Ao..Z) �rInJp .... :Tf6LnA.F ...... S'k) ......... wiring in the building of 'TTL-............ ...................................... at ...... 5Y ............................. . Aorth Andover, Mass. Fee.. --O.. ' .......... Lic. No . ...... ELECTRICAL INSPECTOR Check # 93201 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the ' \ permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L„o. 143, § 3L. Permits shall -be limited as to the time of ongoing construction activity, and may be_deemed-by-thednspector_of Wires abandoned_and_invalid.if he--.. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or.the installing entity stated on the permit application. . ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on Au 15, 2008 and extending'through August 15, 2012. ❑ Rule 8 Permit/Date Closed: 11 Permit Extension Act—Permit/Date Closed: ** Note: Reapply for new permj� 1 if a Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 3 2r BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] Qeave 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 PRWflV XOR TYPE ALL INFORMATION) Date:— /, —1 -bo City or Town of: NORTH ANDOVER To the By this application the undersigned gives notic of his or her intewio to perform the el� electrical wector ork Wires: described below. Location (Street & N>�er) 3 R C� Owner or Tenant C/ -y A G Owner's Address S ` Telephone No. Is this permit in conjunction with a building permit? n / Purpose of Building Yes No [L (Check Appropriate Box) Utility Authorization No. Eiasting Service 0 V Amps .L p/ A 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: 2 S J L -/A 7 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 . Heaters XW Hydromassage Bathtubs c.om letion of the ollowin table may be waived by the Ins ector ojWtres. No. of CeiL-Stisp, (paddle) Fans No. of Total . Transformers V'% 7p� No. of Hot Tubs Generators KVA Swimming Pool Above ❑ �^ d. o. o mergency lg Bette Units No. of Oil Burners FIRE' ALARMS No. of Zones No. of Gas Burners 0. of Detection and No. of Air Cond. Total Inid tin Devices Tons Heat No. of Alerting Devices umP um ber ons T..F..{... .......—_ O. Of Se f-('nntn:rind Space/Area Heating KW Heating Appliances KW .NO. of Ballasts. No. of Motors Total HP ❑ municipal Connectinn ❑ mer No. of bevices or Data wiring: No. of Devices or Telecommunications No. of Devices or Estimated Value of Electrical Work: Attach additional detail tf desired, or as require -010 the Inspector of Wires. 0 I dV fl (When required by municipal policy.) Work to Stark - —6 Inspections to be requested in accordance with MEC Rule 10, and upo completion INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical ork may issue unless the Iiceasee.provides proof of liability insurance including `,completed operation" coverage or its substantial equivalent The undersigned certifies that such cov ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER I certify, under the pains and penalties o ❑ (Specify:) . fpet7url', that the information on this application is true and complete FIRM NAME: Licensee: f J �] LIC. NO.: /L �' Signa (If applicable, ter ''ex t " 'n he li erase number line.) LIC. NO.: Address: L 2 J c, G�� Bus. TeL No.:Q 7 9 -'7'?/- E` 7 -Z 'a tAi �'�' Alt. Tel. No.: *Per M.G.L c. 147, s. 57 61, security work requires Department of Public Safety "S" License: Te 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: $ 9 The COmmonweafth of Massachusetts Deportment of, ,industrial Accidents Office Of Invesggaiions 11W 600 ffrashincMn Street Boston, MA 02111 www-mff&gov1dia Workers, Compensation Insurance APPlic2nt nformation Affidavit., Buflders/Contractors/Electrir-ians/Plambers Please Print Legibiv Name (Busitims/CqMizationnildividual): 'J '7— Address: City/State/Zip Phone #:_ 112t–,7 Are you an employer? Cheek.the. appropriate box: 1: am R employer with 4. 1 am gL general r Type of project (required): employees (full and/o�W__time).* contractor and 1 6. ❑New construction 2. ED/ I am have hire�d the nstructioh A Yo employees a 10 y �nr f pro 670; ew c Are proprietor. or partner- listed CM the attached sheet r7. El Remodelmig ship and have no employees 7bese ❑ sub-contmctors have working for me in any Capacity. 8. Dernofitior, , )i work=' comp. insurance. [No workers' comp. insurance 9. ❑ Building addition u 5- ❑ We are a carporafion and its required.) I I h officers have exercised their I 0.2,Electrical repairs or additions am 2 homeowner doing all work Tight of n7yself. [NO -Work=*, camp. exemption per MOL Plumbing repairs or additions insurance -required.] t c. 152, 9 1(4),'and we have no 12.[] Roof ' . 4MPIOYees. [No workers) repairs reqU 13.0 Other Any OPPlimint that d=ks bue must also fill out the section their IV -.6. below .-�:U,. rh workers policy compensdioll 4canawwrs it ind'eilt'lig "lay am doing all Wwk and thm like oulside that Check this box Muctalftched M c'"u""' must submit a new affidavit indicating ted, additional sheer showing. the. mom of the subcotiftetc. . 't am an employer that ispravidwg,:W0rJxrx Co 'atio -13. Poftq- in .. won informaiolt We= n iftsurawefor mp em ployem, Belo, is the poacy and job site 'nsimmee Company Name: Policy 4 Or Self -ins, Lie. Expiration Daft: Job Site Address: -------------- Attach atopy of the workers' compeMSati city/statezin: Failure to s oil policy declamtion Mae (showing the policy number and expiration date� secure coverage as required under Section 25A of MGL c. 152 can lead to the i fine up to $1,500-00 and/or one-year imprisonment., as well imposition. of criminal penalties of a, ELS civil penal Of up to S;250.00 a 4ay against the violator. Be advised that ties -in the form of a STOP WORK ORDER and a fine Investigations Of the DIA for insurance coverage verific a COPY Of this statement May be forwarded to the Office of ation. Date .. 3 3./ ........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION v /� t This certifies that .... �. F ��/� /.? �/ ��......... . has permission for gas installation in the buildings of...,?t.!.G............................. . at .. �... ........... , North Andover, Mass. Fee. �. 7: .. Lic. No........... .... ._ z ........ �GASINSPECTOR Check # /G Ti 66 -1 It, ,5� .1 G MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NO.ANDOVER ,Mass. Date APRIL 8 2010 Permit # 2 16 C Building Location 36 PARKER ST. Owner Tel# 978-685-1124 Owner's Name BETTE RALLO Type of Occupancy RESIDENTIAL New F7 Renovation Replacement Plan Submitted: Yet No[:] FIXTURES Installing Company Name Eastern Propane & Oil, Inc Address 131 Water Street Danvers, MA 01923 Business Telephone # 800-322-6628 Name of Licensed Plumber or Gas Fitter ROBERT WHITE Check one: Certificate Corporation Partnership Firm/Co. INSURANCE COVERAGE: I have acur liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No El If you have'''c ecked y s, please indicate the type coverage by checking the appropriate box. A liability insurance policy F/ 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 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 knowledge and that all plumbing work and installations performed under the permit issued for this application wil be in compliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene ws. By Type of -License: •.f'iumber Signature of Licensed Plumber or Gas Fitter Title • -Gas fitter 1,17 —/0732 •tester License Number City/Town • -Journeyman APPROVED (OFFICE USE ONLY) A Date .......... .... ... . ? ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............... 714Z ... . ....................... ........................... has permission to rform ...... .................... wiring in thebuil 9 of .............................................. at A ..0 ....... ..... ............... .........................North Andover, Mass. . ..... Lic. No./,.?.../.. ... t ........ .. ELEcmcAL INSPE&OR Check # - V 854 -C-\ Commonwealth of Massachusetts x Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No, _ Occupancy and Fee Checked ,ev. 1/07] TleavP },1�n1r1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrica41nector C), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of. NORTH ANDOVER To the Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) V b 0,1121eezz -r Owner or Tenant e_/Mk" &6 LIQ _9� � 68S-ir�y Telephone No. Owner's Address 3 re p,�n /Ke/Z 's i` Is this permit in conjunction with a uildin perm} t? Yes ❑ No Purpose of Building UP J71" 6(k, P/3/7p-C. � Oij ❑ (Check Appropriate Box) �o Utility Authorization No. Existing Service /(/'D Amps /•26 /-ZyOVolts Overhead, Und rd g ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No, of Meters Number of Feeders and.Ampacity Location and Nature of Pro osed Electrical Work: —_A�e e N�CtJ ene 177 IVP -w /"/7t4. TO c43my� ' h 00/r (/p No. of Recessed Luminaires of Luminaire Outlets No. of Luminaires No. of Receptacle Outlets No. of Switches No. of Ranges o. of Waste Disposers No. of Dishwashers No. of Dryers No. of Water Heaters No. of Ceil: Susp. (Paddle) Fs No. of Hot Tubs Swimming Poold e ❑ No. of Oil Burners No. of Gas Burners No. of Air Cond. Tot T)tals: I_L= Space/Area Heating KW Heating Appliances KW No. of Na Ballast No. Hydromassage Bathtubs INo. of Motors Total l the following table may be waived by the Tncnprtn „r w: ms No. of Total Transformers V17 Generators KVA in-D rnd. ❑ _-OTEmergency ig g Ba_eEXUnits FIRE ALAWv1Q, No. of Zones No. of Detection and InitiatingDevices is No. of Alerting Devices KW - No. of Self -Contained Detection/Alertin Devices Local ❑ Municipal ❑ Other Connection CW Security Systems: No. of Devices or Equivalent is Data Wiring: No. of Devices or Equivalent TP Telecommunications Wiring: No. of Devices or E uivalent Estimated Value of Electrical Work: Attach additional detail f desired, oras required by the Inspector of Wires. � �d (When required by municipal policy.) Work to Start 3 Q � Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE OVERAGE: . nless 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 and enalties o ) p ofperjury, that the information on this application is true and complete. FIRM NAME: Qi✓j/Z ¢ /_ (� GT/1/ C L C` 5 Licensee: G= (/r- eg,7 jr7 L�n� SignatureLIC. NO.: (If applicable, enter "exempt 11 in the lic nse number line.) LIC. NO.: Address: / 421146 Ln z'u) Bus. Tel. No.:&3— fSL---2775 *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt L cl. No. OWNER'S INSURANCE WAIVER: am aware that the Licensee does not have the liability insurance coverage normally required by lay my siyq ge b o , I hereby waive this requirement. I am the (check one) ❑ owner ❑owner's agent. Owner/Age Signatui Telephone N� PERMIT FEE: r,�,4xoc9k