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Home My WebLink AboutMiscellaneous - 49 COURT STREET 4/30/2018 49 COURT STREET 2101058.0-0022-0000.0 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§.3L,the p 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.Atter a permit application has been accepted by an Inspector of Wires appointed pursuant to M.01 c. lbb,§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 sha Lbe limited as to the time of ongoing construction activity,and maybe deemed_by-the.7nspector_of_Wires Aandoned-and-hwalid-ne 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 August 15,2008.and extending'through August 15,2012. "le 8—Permit/Date Closed:� `l�_�� Note:Reapply for new permife-- , ermit Extension Act—Permit/Date Closed: -5 - - 6'� Date................... 0.......... N°RTM 0 TOWN OF NORTH ANDOVER '' p PERMIT FOR WIRING c b •�,,r.o �'"•h ,SSACMUSfct This certifies that � ._ . � has permission to perform .....:::-4:4<=.1:::..:'..-!-- ... ........... wiring in the building of...., ...... : r.............. .......................... ......... ...../ at...................... � ................................... . ,North Andover,Mass. w C Fee....% ?.......... Lic.No.1!?tv%.................... ELECTRICALINSPECTOR I Check # IGS - 8273 • Commonwealth of Massachusetts Official Use 0 Department of Fire Services Permit No. ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (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: 0 City or Town of: NORTH ANDOVER To the Inspector o .Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) L Co S Owner or Tenant �64'1-A (..JCA&A Telephone No. Owner's Address A Vvt t5 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 x Location and Nature of Proposed Electrical Work: Wt.A_E> A—c } Com letion of the following table may be waived by the.Ins ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets Z No.of Hot Tubs Generators KVA No.of Luminaires Z, Swimming Pool Above ❑ In- 1:1 o.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets l No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices s No.of Ranges No.of Air Cond. Tons TotNo.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent d No.of Water KWNo.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. e Estimated Value of Electrical Work: Z<: �p, (When required by municipal policy.) Work to Start: p S- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 e 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 penalties of perjury,that the information on this application is true and complete. FIRM NAME: v�,i ck.L�1l 6E2 ie—eS LIC.NO.:21 4_5,jo Licensee: lti l G�Qft f�L /� 1 Signature LIC.NO.: (If applicable, enter "exempt"in the license number line) � Bus.Tel.No.: O g� Address: 3 1P(•u s 6J P-AS1yti-G tti`� ��-�.�.L,S 1 ji Alt.Tel.No.: Z *Per M.G.L c. 147,s. 57-61,secu ty work requires Department of Public 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 PERMIT FEE. $ Signature Telephone No. � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 s• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 9V1_l.AkA e Lz-,eCrc�-q E rLN -C6 S Address: 3 V_Lc -s o E L�e Gt�c City/State/Zip: �.�-�+.(�,il��v , �_)IZ 02>S�4 Phone #: q -) 8- Y?S'- ('p F-C Z, Are y"an employer? Check the appropriate box: Type of project(required): 1. I am a employer with �K 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp. insurance. Y P tY 9. ❑ Building addition ` [No workers' comp. insurance 5. ❑ We are a corporation and its 10. lectrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 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.] 13T1 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �AA,J D\1 CR t N S. Ccs , Policy#or Self-ins.Lic.#: Expiration Date: t 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 4 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. 1 I do hereby certify,under the pains and penalties of perjury that the information provided above is true and correct. Si nature: Date: 3 0 (0 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#: �' Date..........4U..... ... r NORTI� °•` °�"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUSEt This certifies that(-?............... 2-G-+ ...;M�........... ... .. .... ............................. has permission to perform ......... .....: wiring in the buildingV at.�./......... .. /'. ............. .North Andover,Mass. Fees ..`......... Lic.No. ............. EL INSPE Check tt VV 64 6 y Commonwealth of Massachusetts Official Use Only Permit No. 1 4, Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (leave blank) N 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 INF RMA TION) Date: 0 City or Town of: To the Inspector of'Wires: By this application the undersig ed gives notice of his or her intention to pefform the electrical work described below. Location (Street& Number) (, n e Owner or Tenant A,, Telephone No. Owner's Address .Lll�n p Is this permit in conjunction withhaa b`uildi permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building //ILi , p,, Gr Utility Authorization No. Existing Service AL) Amps !J-y /a ko Volts Overhead U Undgrd ❑ No.of Meters New Service �tl) Amps / d /ai)t/) Volts Overhead, Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 42 C-0 19 C V o�dv C om le tion of the f bllowing table inay be waived by the!ns ector of lVir•es. 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.o Emergency Lighting 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.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No. of Waste Disposers Heat Pump NumberToI.ns 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 No.of Water KW No.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 E uivalent OTHER: ,attach additional detail if'desired, or as required by the Inspector of 6Vires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: , Q 6 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 0 BOND ❑ OTHER ❑ (Specify:) I I certify,Cruder thep 'is penalties of perjury,that Wthenfoo' rmation on this a plication is true and complete. FIRM NAME: untlG J • l LIC. NO.: i Licensee: Signature LIC. NO.: upplicah/e enter "e.aen: t-in it license ma err ine.)� S.Tel. No.: " Address: t fw �� ?-" Alt.Tel. No.: - r T *Security System Contractor Lice se required for this ork; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee sloes 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: $ Location `l� -- No. 41 h Date NORTH TOWN OF NORTH ANDOVER • O w F p Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ' Check # 441 189 .15 ih Building Inspyctor TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCTREP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING69 5 Now- r r r , BUR DING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Build(aw"Commissioncr,/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: oK��/� Map Number Parcel Number 1.3 Zoning Information: f 1.4 Property Dimensions: Zonin Distrid Proposed Use Lot Area Frans ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required I Provided Required 4--Provided 1.7 Water Supply M.G L.C.40.t 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M 21.1 Owner of Record Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Si ;nature Tele hone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: O License Number Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name m Registration Number r i Address r e Expiration Date Z Signature Tel hone V) SECTION 4-WORKERS COMPENSATION(MGL C 152 § 25c(6) ti Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Pro osed Work check au applicable) New Construction 0cisting'1uilding ❑ Repair(s) ❑ Alterations( ) 7"' Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify ' �Y F Brief Description of Proposed Work: 77 r 1�660� ).a6 a j4r -P,-) 1 Of )3 M eMAJI i 6T&A 9-Ai� . SECTION 6 D CONSTRUCTION COSTS tem Estimated Cost(Dollar)to be OFFICIAL USE pNLY Completed bypermit applicant > 1. Building (a) Building Permit Fee 000 Multiplier 2 Electrical (b) Estimated Total Cost of 0 on Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 b Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby autho ' to act on My behalf, " all att rel eVork thorized by this building permit application. Signature of Owner ZDate SECTION 7b OWNER/AUTHO IZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief J Print Name Si ature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS 1 2 ND3KO SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE NOKTH Town of tAndover 0 00 d/ = over, Mass., ®�� ' A. COCHICHEWICK Cl RATED P" �y S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... k........... .. .......... ............. ........................d .............................................................. Foundation has permission to erect........................................ buildings n ..... .9....... g ....................................... Rough to be occupied led aS Chimney .. ..................................................................................... provided that t e person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTLON STARTS Rough ..........V..vf� . ...a. . .. Service drDINGMSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in. a Conspicuous"-Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. TOWN OF NORTH ANDOVER OFFICE OF 1 BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: as_JA..JD,� JOB LOCATION: ��/ � ,2� 47 Z Z Number Street Address Map/Lot HOMEOWNER 1/,6 A) L_L-A:-Y �Z�L 7 � Z4� rya 73/ QZ;&� Name Home Phone Work Phone PRESENT MAILING ADDRESSV, City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws, rules and regulations. The undersigned"homeowner"certifies that he a nderstands the Town of North Andover Building Department minimum inspection procedures and require nts nd that he/she will coni ly with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Forth Homeowners Exemption tom". i NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL-c 40 S 54, a condition of Building Permit at: V is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. Also, note Permits are required under Fire Prevention laws.-Chapter 148 Section I 0A. The debris will be disposed of in: (Location of Faci ' y) Signatur of Permit Applicant Fire Department Sign off: �4 Dumpster Permit Date MASSACHUSETTS UNIFORM APPLICATION F'OR PERMIT TO D GASFITTINO (Print or Type) t C NORTH ANDOVER Mass. ate -9 lhuilding Location "� '� Permit #/ Owners Name • :� New Renovation D Replacement v�Plans Submitted FIX , UP.=c N - � W o z s vi cc os zus F-• a r x x O F x a m y iw- w w o o Q a uz, tw- y w a x t- in y -t W Lu 0 w z_ a z a c p a w r m t- z c� s j h z f, W wO > tt h U 1 f- w 2 4 w G a .. F- y. fA ci ' O < w O N x d ,u > W = 2 G rL d0 - ct x o u. a c7 ci y c� a 1-- o Sua-13SVIT. BASEMENT IST FLOOR 2ND FLOOR 3110 FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR TTK FLOOR :HltH 8TH FLOOR (Print or Type) Check one: Certificate Installing Company Name t �� orp. Partner. 2 9 6 8 Firm/Co. Date./!q. f TN TOWN OF NORTH ANDOVER hce coverage by checking the p PERMIT FO NKtur 'emnity Q Bond • made aware that the licensee of 1"8�,+ OCT jve three insurance v SSACH SE OCT 2 .i. coverages. g NORTH AUE)OVER / •TREASURER-COLLECTOR 'her Agent This certifies that . . . . . . �-1 !1.-dna,-. . . . . . . . . . . . . . . . . . . . . in above application are true and accurate to the best o!my has permission for gas installation . . . . . . . . . . . . `. .. . : this application will-be in Compliance with ali p=dncnt in the building of . . . . . . . . . . . . . . . . . . . . . . . . . . . . , at �. ? .`. .. .�-. . .. . . . . . ., North Andover, Mass. 'CENSE: Fees.. :-'�. . . Lic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Anature of Licensed GAS INSPECTOR I plumber or Gas fitter WHITE:Applicant CANARY:Building Dept. PINK:Treasurer ,rman License Number