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Home My WebLink AboutMiscellaneous - 45 HIGH STREET 4/30/2018 ' d i i I I i Welcome to the East Mill Website Page 1 of 1 A AN In Ono 0 o Lu"F T 5mow,, _ �A MOW ftg�, 45 High Street q:. a, 0) 59 ILUO ii V tkt lhh;-TM:d-3-axz:w i;AQwkiu Click on the Links to view Each Floorplan 6 1 a [Q1 • c eu'f'-AtA, J ifi10 i•; 4"1 1 13 a Unit 4 o Unit I Vl ' 113 3!111 „ ilv t111p http://www.eastmillnorthandover.com/loftsrQorplf 2/13/2013 a s 10636 Date..... ...,.- .4..... O� NO°TN 1ti 3j e�tr��-:--•°'e�o� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING VL ,SSACMUS� ' �er- n J� Thiscertifies that .......................................................n................................... has permission to perform r.�. � ' i oo. f7 " .. .... ..1..��.... �t ....��....... wiring in the building of � 6-C f'�P y G.'�....�......... .... .................. ............. �� `` St"'"�� . ,North over,M at..../..z..... .7............................................... as Fee.. Z�......... Lic.No?Z��f`. ....: .. ... .... ... ....mot,�i ........................ ELECTRICAL...MPECTOR Check # ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the 'IJ Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed fJ 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.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and may be_deemed_by-the-Inspector_of_Wses a*doned-and invalid if he—_-. ._ or she has determined that thcrauthorized 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 t� 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 beg);Ping on August 2008 and extending-through August 15,2012. 111 l 8- Permit/Date Closed: ***Note:Reapply for new perm' 0 Permit Extension Act—Permit/Date Closed: yCommonwealth of Massachusetts Official use Only �- y Department of Fire Services Pemut No. 1,// 3 3 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked _ [Rev. 1/07] (]eave blank APPLICATION FOR PERMIT TO �� PERFO ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical C ,ode (Mg4 52 0 y y®RK (PLEA SE PRATMAW OR TYPEALL INFORMgTIO City or Town of: NORTHANDOVFlI.g � Date' �f' By this application the undersi ed To.the Inspector of fires: gn gives notice of his or her intention Location(Street& tuberto perfoim the electrical work described below. ) S"7`' Owner or Tenant • ser r �° ��f l Owner's Address �� Telephone No. ,S'�9_S� S� d a� Is this permit in conjunction with a building�perniit? yes vee C'2 Purpose of Building No ❑ (Check Appropriate Bog) Existing Service Amps Utility Authorization No. NewService volts/ _Volts Overhead ❑ Undgrd❑ No.of Meters - — Amps —_Volts Overhead❑ Undgrd❑ Number .A of Feeders andmpacity No,of Meters Lo tion andNatureof Proposed Electrical Work: i No.of Recessed Luminaires No. Com letion of the followin table may be waived by the Ins ector of Wires. of Ceil:SusNo.of - p.(Paddle)fans Total No.of Hot Tubs No.of Luminaire Outlets Transformers ISA Generators KVA Na of Luminaires Swimming Pool Ab d e El �- 'El o,o I✓mergency ig g No.of Receptacle Outlets nd• Bane Units No.of Oil Burners FIRE ALARMS�� ' No.of Switches No.'Of Zones No,of Gas Burners No,.of Detection and No.of Ranges Total h3ltiu Duces . No.of Air Cond. No.of Alerting Devices � No.of Waste Disposers .Heat rum Tons p Number._Tons KW _ 'No.of Self Contained Totals. Deteetion/Alertin Devices No.of Dishwashers Space/Area Heating Kms' Local❑ Municipal No.of DryersHeatin g Appliances Connection El Other No.of Water pp KW Security Systems:* Heaters �' No._of No.of � No.of Devices or E uivalent - Data Wirin Si s Ballasts. g: No.Hydromassage Bathtubs No.of Devices or E uivalent No.of Motors Total OTHER: HP ecmmun Teloications Wiring; No.of Devices or E uivalent Estimated Value e off Electrical Wor : �U �Ittach additional detail if desired,or as required by the Inspector of Wires. Work to Start: / _0 - (When required by municipal policy.) spections to be INSURANCE requested in accordance with MEC Rule 10,and upon completion. the licensee COVERAGE: •Unless waived by the owner,no permit for the performance of electrical work may issue unless .provides proof of liability insurance including"completed operation"coverage or its substantia undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. The CHECK ONE: INSURANCE 44- BOND ❑ OTHER I certify, under thains and penalties o er'u that the information on o>n this application is true and complete. FIRM N � .fP J - � r / e P Licensee: A � LIC.NO.:12— 1 a li Jo S Signature (} pp 'cable, entein the license numb r lined LIC.NO.: 37 72$ Address: fjt�/f // �y *Per M.G.L c. 147,s.57 61,security work requires Department Bus.Tel.No,:_�c73-T5r_atl3 OWNER'S INSURANCE W q of Public Safety S License: Alt.Tel.No.: WAIVER: I am aware that the Licensee does not have the]iabili Lic.No. required by law. By my signature below,I hereby waive this requirement. I am the(check one)EI coverage normally Owner/Agent Signature ❑ owner's agent. Telephone No. PERMIT FEE:$ 2�� Y ELECTRICAL PERMIT NO. INSPECTION REPORT[': ` ELECTRICAL.INSPECTOR-DOYIG SMALL I.ROUGH IN TION: Passed— Failed—[ ] Re-inspection required`($50.00) Inspectors'comments: (Inspectors'Signature-no initials) Date '3U-- 2VINSPECTION: Passed—[ ] Failed—[ ] Re-inspection required($50.00) Inspectors'comments: -------------------- (Inspectors'Signature-no initials) Date 3.UNDER GROUND INSPECTION: w Passed—[ ] Failed—[ ] Re-inspection required($50.00) Inspectors' comments: ' (Inspectors'Signature-no initials) Date 4-INSPECTION—SERVICE: - -U�IKX E CAA--I EJ-1-NATIONAL GRD: Nom: 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-. • t (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 TS TO BE CHARGED. The Commonwealth of Massachusetts Department of Industrial Accidents Office Of Anvestigations ..600 Washington Street Boston, MA 02111 www meass gov/dia Workers' Compensation Insurance Affidavit: Bu lders/Contractors/Electricians/Plumbers Applicant Information Please Print Ile ibl Name(Business/Organization/lndividual): Address: City/State/Zip: Phone#: FEEJJI employer?Check the appropriate box: employer with 4. ❑ I am a general contractor and I Type of project(required):' ees(full and/or part time).* have hired the sub-contractors 6. ❑New constructionsole proprietor or partner- listed on the attached sheet. 1 7. ❑Remodelingd have no employees Thesesub=contractors haveg for me in any capacity. workers' comp.insurance• 8' ❑Demolition rkers'comp.insurance 5. ❑ We are a corporation and its 9' ❑Building addition 3.❑ required.] officers have exercised their 10.❑Electrical repairs or additions I myself a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(�3),and Buz have no ins,�r.��zce.regi?.irca.]t employees. No�sior_cers' 12.❑Roof rep drs comp.insurance required.] l3.❑Other `Any apphicant that checks box til rm aIsY t 4 BE out the section beloea sho: Date.� L�l!'. . . . o � TOWN OF NORTH A,,DOVER PERMIT FOR PLUM I G CHUS I�O GGl C /-- tf This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . .C. . . . C. C at . . . f-! .S�. . . . . . . . . . ..�ortth Andover, Mass. Fee .7 . .Lic. No OA�. . . . . . . . . .. . . . . . . . PLUMBING INSPECTOR Check „" 2- 2- 3L' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING . d g City/Town: e2_ /Si�•�'J�'y MA. Date• J Permit# a ' Building Location: I/A-j ZZj 6,4.( :57� Owners Name: Ci C42 G G 4f, Type of Occupancy: Commercial Educational _ ❑ ❑ Industrial❑ Institutional❑ Residential[� New:❑ Alteration:❑ Renovation:e Replacement:❑ Plans Submitted: Yes❑ No FIXTURES DEDICATED LU z SYSTEMS F- Z 0 Ln w Y v D W z 0 in a C z �..' Y Q Vf J cQC W C' QO' 2 Q. Q N 2 h LU Q W Z W Z {A C Z �_.. N H W F.W. OWa In a W O a W z W J Z v °. LL Q 3 0 3 a ►- M j = = = ca o W 3 a• F- t=i Z Q p � a Y Z v=i FW- FW- W I a } H oe a m m o o m Y 3 5 _ Cn 3 3 3 o a 3 SUB BSMT. BASEMENT 1ST FLOOR 2"D FLOOR 3RD FLOOR 4T"FLOOR ST"FLOOR 6T"FLOOR 7"FLOOR 8T"FLOOR Installing Company Name: Check One Only Certificate# j cT ❑Corporation Address: 12,9 M-6 City/Town: c.d/—'?6 44, Mate:-Al-114 �-�r�- El Partnership Business Tel: �` ZZI �7-% Fax•-I-7 i /�22 b O ' Firm/Company Name of Licensed Plumber: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YesA No❑ If you have checked Yes,please indicate the.type of coverage by checking the appropriate box below. A liability insurance policy. 'A-' 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owners Agent Owner E] Agent El I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in com liance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of a General Laws. By Type of License: Title ( Plumber Sign ure of Lice lumber City/Town Master APPROVED OFFICE USE ONLY ❑Journeyman License Number: �D `� AL 9979 .... ... .. ...... NON7N .a. TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUS ti This certifies that ..................... .......................... .......................... has permission to perform .......... ......................... ....... ...... wiring in the building of............ ................................. N6rth Andover,Mass. L Fee779..."*..... Lic.NoA/3A?7............ ........... ............. ELECTRICAL INS ECTOR Check it ,. Use Only Commonwealth of Massachusetts Official Department of Fire Services Permit No. I Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK • Al]work to be performed in accordance with the Massachusetts Electrical Co de MEMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Townoh 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. `x Location(Street&Number) Owner or Tenant Telephone Noq�� %Ir-- Owner's Address 17 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Buildin�/gam f �� G Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd No.of Meters l New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters { Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 114 ef Completion ofthefollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA /V/�–f/— No.of Luminaire Outlets No.of Hot Tubs Generators KVA No. of LuminairesSwimming Pool Above ❑ In- ❑ o.o Emergency ig tmg rnd. rnd. BatteUnits No.of Receptacle Outlets No.of Oil Burners FIRE ALARMSNo.of Zones j No.of Switches No.of Gas Burners No.of Detection and Initiatin Devices No.of Ranges No.of Air Cond. Tons Total No.of Alerting Devices121 No. of Waste Disposers Heat Pump Nm 'uer TKW No. of Self-Contained ��'� •�"' Totals: "'o s ' •�••' Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or E uivalent No.of Water No.of No. of / KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: // Na.of Devices or Equivalent l 6 OTHER: r Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Ele trical Work: 1�d lk (When required by municipal policy.) Work to Start: l/ 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 cover ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pain]an penalties of�erjury that the infor tion on this application is true and complete. FIRM NAME: 7(J c LIC.NO.: Licensee: �O40 Signature LIC.NO.: _ (Ifapplicable, enter "e emp "in t e license a ber Bus.Tel.NO.: t17 O Address: � ® 4_0fA Alt.Tel.No.: 9 *Per M.G.L c. 147,s. 57-61,security work requires Department ofprublic Safety"S"License: 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. IIeTSPECTION REPORT: ELECTRICAL INSPECTOR-DOUG SMALL 1.ROUGH INSPECTION: Passed—[ Failed—[ ] Re-inspection re wired($50.00)-[ j Inspectors'comments: 12 (Inspectors'Signature-no initials) Date 2.FINAL]NS CTION: Passed—[bFailed—[ ] Re-inspection required($50.00) Inspectors'comments: ,- � � G 27— A7 L h . 7- %' (Inspectors'Signature-no initials) Date 3.UNDER GROUND INSPECTION. Passed—[ ] Failed—[ ] Re-inspection required($50.00) Inspectors'comments: (Inspectors'Signature-no initials) Date M —SERVICE:NATIONAL GRID: NAME: Failed—[ ] required($50.00)-[ ] ents:spectors'Signature-no initials) Date 5.INSPECTION-OTHER: Passed—[ ] Failed—[ ] Re-inspection required($50.00)-[ j 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. F Y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / M Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zip: iM® p` ne#: Aremployees an employer?Check the appropriate box: Type of project(required): 1• m a employer with 4. ❑ I am a general contractor and It (full and/or part-time).* have hired the sub-contractors 6 ❑New construction2. m a sole proprietor or partner- listed on the attached sheet. # 7• ❑Remodeling 1 ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. E]Building addition [No workers' comp.insurance 5. ❑ We ate a corporation and its required.] officers have exercised their ME]Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4);and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.❑ Other Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 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 I am an employer that is providing workers'compensation insurance for my employees. Below is the policy-and job site information. S Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: � Job Site Address: `/J— 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 do hereby cert#yunder the pains and penalties ofperjury that the information provided above is true and correct. . Signature: Date Phone#: 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.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage Covera erequired." Additionally,MGL chapter 152, §25C(7)states Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants ' Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy.;please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. ` Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 wwwmass.gov/dia TOWN OF NORTH ANDOVER LOCATION--> ELECTRICAL 45 INSPECTIONS HIGH ST PLUMBING GAS BUILDING Date UNIT# ROUGHROUGH 3/29/2011 1 ROUGH PJM 3/29/2011 2 ROUGH P1M 3/29/2011 3 ROUGH PJM 3/29/2011 4 ROUGH PJM 3/29/2011 5 ROUGH PJM 4/19/2011 ( ROUGH P1M 4/19/2011 7 ROUGH PJM 4/19/2011 8 ROUGH P1M SERVICE 3/29/2011 COMMON ROUGH P1M ROOF AC / 't