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HomeMy WebLinkAboutMiscellaneous - 491 SALEM STREET 4/30/2018 491 SALEM STREET 210/038.0-0010-0000.0 Date.....77�........................ TOWN OF NORTH ANDOVER ' 0 0 PERMIT FOR WIRING ACHU This certifies that ............ ST................................................ ................................. .1w has permission to perform ............5 .6x..Aa.eo�p, ............................. /14 0 .... - wiring in the building of................,.....0........ . ........................................ 5A-04P701 -5,77 at.............T............................................................. North Andover,Mass. Tee3q�.... Lic.No.j� �iE......... ... . ...... . ......... ... fE4lc,A*L* NSPEC�Mid Check ,# 470 �doo" 10744 C7 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 uniforin throughout the Commonwealth,and applications shall be filed" " on the prescribed form.After a permit application has been accepted by an inspector of Wires a ointed pursuant to M.G.L c. 166 32 an lY Pp P ,§ , 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 shalLbe limited as to the time of ongoing construction activity,and maybe.deemed_bythelnspector_of_W.ires abandoned.and_inualid.if he.—. . or she has determined that the authorized wort: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 dxtends,for four years beyond its otherwise applicable expiration date,anypermit or approval that was "in effect or existence"during the qualifying period beginning on August 15 -008-and extending'through August 15,2012. O_UleS—PermittDate Closed: / **Note:Reapply for new per ❑Perm' / rt Extension Act—Perm! a Closed: k t vrr7racna/ealth O� a3laCtrxt►¢ Official Use Only C� Permit No. elJePar�inBrtE o� sem Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS play.1/U7] eavebiaok . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL.WORK All work m be performed in accordance with the Massachusetts Electrical Code(N IEC),527 CMR 1200 (PLEASE PRINTW INK OR ME ALL INFO TIOA9 Date: 3 Y--- k Z City or Town of: o� � Z.�� To the Impector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) L�g o.�.QVC., Owner or TenantTelephone No. �'?Y 4-$r- 21-C(b Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 4�1— (Check Appropriate Boa) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps 1 Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Co letion o the ollow' table may be waived by the les oro Wires. No.of Recessed Luminaires No.of CeiL-Sus -(Paddle)Fans o.o otA, Transformers IV-VA, No.of Luminaire Outlets No.of Hot Tabs Generators KVA No.of Luminaires Swimming pool grAbove ❑ d. 0 Batte Units ea� No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS--No.of Zones No.of Switches No.of Gas Burners No.of Detection an Initiating Devices No.of-Ranges No.of Air Coud. ons No.of Alerting Devices - Tons g No.of Waste Disposers eat mp. umber ons o.o outam . Touts: DetectionJAlertm Devices No.of Dishwashers Space/Area Heating KWLocal❑ �� •ou .❑ Other Na of Dryers Heating Appliances KW Security N tyofevioes or E4uivalent 6.ofWater KW 0.0 No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Eanivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications uwgg-•. . No.of Devices or Equivalent ------- -=--r r, Attach additional detail if desired or as required by dw Lispector of Wwe- Estimated Value of Electrical Work: L Too (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 equivaleaL The undersigned certifies that such coverage is in force,and has exhrbited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I cerkfy,under the pains and penalties ofperjui3.that the information on this application is true and completes FIRM NAME: LIC.NO.: Licensee: ��.. _ �`� ��_a�y�ite��►gnature LIC.NO.:_L9f­7 3 (Ifapplicable,ester"exempt"in th licenre mmiw lire) Bus.Tel.No'-221 7-2112 Address- Alt.Tel, *Per NLG.L.c.147,s.57-61,seckity work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE W R I am aware that the Licensee does not have the liability insurance coverage normally required by law.. By my signattaf below,I hereby waive this requirement. I am the(check one ❑owner ❑owner's agent Owner/Agent Signature Telephone No. PERMIT FEE:S 4T1x Cmni nwealth of0fafsadiusettss Depardmint oflndoW.Acidinty OfflM ofinvesfigadow 609 Waftwon tweet Boston MA f1?ul www.rnarssgav/rlia Workeis'Compensation1wwance Affidavit:yrs/Cont efors/ etneians/Plujabe3rs Applicant Information PleasePrint Le lky Dame(Bas mess agm7mAontd¢divictwy,. F1 ' ' kd r c �,,,�C3LC S� -Jii�' t 17 Address---P13 0� i o v e city/Statelzip. G ra ,, t 1 Phone ; 7 -401-1106 Are y2#an employer?Check the appropriate box: Type of project(required): 1.Mama employer witat `- _ '. ©I am a geoeral cmtador aura l 6. ❑I�Tew ct�nsfin2ctioa omployees(full and/or part timet* have Wuedthe sub-conttactms 2.E]I am a sole proptietor orpafter- listed on&a attached sheat t ?- Q Remodeling ship andhave,no employees These sub-contractors have 8. Demolition t,,orlcirig for me in any capacity. WM e comp.bsarance. 9. (]Building addition [No workers'comp.Insurance 5. El ale are a emporation and its g{ r?�d-] amcsas have exeacised their 1©.#fit Blec ical rapairs yr ad vas w 3.❑1 am ahomEovruer doing all work A&of exeaTffonperMGL 11.0 Phunbiagrgvks ar additions UW861 [NO vtt dM'camp. c.1A§1(4),andwebaveno 12.Q Roafrepaim nquim&]i employees.[hro workers' .13.1--1 off= gyp.iftmmm ce regnired_] ''?alta tIe�actt c bmilmustdWJMautThesectiant�Iowst�evu5gf4eff tkers'C0rnp�ssfi=P011oyinfocmetitiors ,6r%AFxT1EeS=sulmit tfus.effidarst nndicatitsg fbey&s domgattwmf:sad Men hhaoufs&conttrednis must submit a m v sTxdavIfHn&ca*g amt tCun.-e fltcuecMauttt=atagabVhedsnionatsPEeetsbovrrrrr� tham�neoft6esubcontrarta�w4tb*wofi='eomp.poftylaformaffft p am art eattFkT,EF lW fsprovmbtg wm*ers'coarper.sadon bLwanceformy enFlo3'em Below is iheptlfty andjob 9k information, 1nsuxww ,Corapaw,Name:. Var l ,CLua. 4 j t-, policy#or Self-ins.Lic.#: Tob Site Add:=s: i 91 4c.�9- A tach a copy of the workers'compensation policy declaration page(showingthe policy number and eviration date). Fad to secure come as rtquked.uudor Secdion 25A of MGL o.152 care leadto the imposition of criminal penalties of a fine up to$1,500.00 audfor oma-year hnpftnment,as welLas eivd penalties infix fonn of a STOP WORK ORDER and a fhe of up to$250.00 a clay against the violator. Be advisedthata copy ofthis statementmay be forwarded.to the Office of Inv 'ons of the DIA for fimuance covv-age,verificatiom.. Irio here-by ctaerte ers crdPetuTl s ofP �Fat#ie rnmmoon bid above xs tme andcorrec4 SiDate- � none#: O-ffWal rase only. Ito noswrke in chis carer:,to he eot WIded by city or sown off=al City or Town: PexgmitaAcense# Issuang AuthoAtg(circle one. 1.Board of]:health 2.Building Department 3.CityfTown Clerk 4.Electrical Impactor 5.Fittmbing Inspector 6.Wher - CoaztactPerscan: Phone#: Date...... ...d..7... i MORT11 °`,"`°:°�"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING 'O�•r�o���� SACHUSEt This certifies that ............................................ ....... has permission to perform ....6�..&a/ 12 G . ............................... u fx wiring in the building of...wG ............© LI �'�9L�iYt S T at..................'...................... ................................ ,North Andover,Mass. �_.� a-12 7�-- Fee....`�................ Lic.No.............. ................................................. - ELECTRICALINSPECTOR rCheck # d�e�G 77 / 2 8,0 Commonwealth of Massachusetts Official Use Only � Department of Fire Services Permit No. 72- 70 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (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: III—a—p 7- City or Town of: D Lyle 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) �q leu s 7— Owner or Tenant �qf / ne' Telephone No. Owner's Address S'e'lf Is this permit in conjursigowe q . h a building permit? Yes 1:1 No (C_heck 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 ` y f, Location and Nature of Proposed Electrical Work: � �A !�� �ji4.j� Zee le< ��J /v0f Completion of the followin 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- El 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. Tons Total No.of Alerting Devices No. of Waste Disposers Heat Pump Number. Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal El El Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water No.o No.of Heaters KW Ballasts Data Wiring: Signs 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 th in and na ties of p�190ry,t/taf�to : he information is ap lication is true and complete. FIRM NA tr-rl' �tVc/0LIC. NO.: Licensee: It—N , Signatu e LIC. NOQ.:'EI �,7 (If applicable, enter " xempt"_T the license number line.) Bus.Tel. No.:/ 6dg' Address: /� � � �� /t.�- '4cwt�s� Alt.Tel. No.. *Security System Contractor License required for this work; if applicable,enter the license number here: 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, 1 hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ Date. . "0RT:1� TOWN OF No HANDOVER ° PERMIT FA PLUMBING i ,SSACMUSE� This certifies that • • • • • • • • • • • • • • • • • • • • • =w has.permission to perform . . . . /3 plumbing in the buildings of . . . . . / ;,. ... q at ... . . . . .�?. .r. . .�r N: . - • - '�__ North Andover, Mass. Fee.-'�:�?.` .Li c. No. r-. . . . . . . -- r - ... . . . . . . . . PLUMBING INSPECTOR r Check # `- 7336 MASSACHUSE77S.UNIFORM APPLICATION OR PERMIT'TO DO,PLIfMB(NG (Print or type) �. lr� 1�c7U Mass Date -- �r Perrnrt �# ` 11 Bu�idmg,;Location ! �/4 � ' �f Owner's Name �, d� x ;... , 1.1—:1 Type of Occ1.upancy_ %s, _ 1. New ❑1. '. Renovation D Replacement �"" Plans;Submitted: Yes ❑ No p . . FiXTU,RES B P T 1. SEWER,— SEPTICS ;' p : z �, Z. ,..4 �' o: z �- 01 ,� ii: 1. s� a z rn .. s z ~ z O z y1.n �' '-' !1! N to J; L 7 lti i Z r O' fl J C C cL y x 'm in: a -� 3' a N s: �;' a - 3 m , �11 l � S UH-SS MT " .. . � �1: .. �: I I .� . : :.. ;� .I �': .: �. � ­. HASEMEAtTc '� 11 : tST,FLOOR 2Atb:FLOOR 3Rb :FLOOR 4THFLOOR . :: 0 ­ I ,­ M , �,`` STN'FLOOr� 6TN;FLOOR" 7TH;FLOOR 8TH';'FLOOR � lnstalf�ng Company Name ('� �(1. C i; -G 1� /Check;one: i.Certificate A1.ddress__^ �/' rlD�'� S, L71. -��.. .11. 11Corporation . : � , ... A - — ` � ' ,�`��� ` 11 I 1 .fi. ❑ Partnership Business Telephone , ': � ? ❑ Firm/1. Co. Name Of Licensed Plumber `s�-i= ; �-„ INSURANCE C01/ERAGE M. i have a current bi. Endurance policy or its substantial equivalent which meets the requirements of MGL Ch. 11 742 Yes No ❑ F. I if you;have checked yes, please indicate the type covera111 ,ge by checking the appropriate box A liabilrty insurance:policyki. Other type of. indemnrty C! Bond .O AOWNER S INSURANCE WAIVER: I am saware ,#hat the licensee does not have tte insurance c1.overage required by Chapter 742 of the Mass..General' Law1.s, and that my ignatu a1. on this pennd app(�cat�on waives this.re1.q1. uirement. ChI.eck gone. 1. Signature of Uvner or Qwner's Agent Qwner ❑ Agent ❑ I hereby cer41y that all of the details and information!have submitted(or entered)'in above:application are true and accurate to the best of my knowledge and that all plumbing.wor1.k and installations performed u e ,the per nn issued for#his::,application will be in compliance with all pertinent pro�sions of the Massachusetts State Plumbing Code and er i42,o a General Laws !4:/:,:� . v � .1. ..,,.,�.I I ,�: �...... title Signature of lice d ber APi L­tD Type of lJcense: Master[ Journeyman ❑ OFFICE USE ONLY) Ucense Number � : -:>- i Date.. � .A z ff 7 p�" `• ,aORTN TOWN OF NOIR ANDOVER PERMIT FOR GAS INSTALLATION •�9SS�ICMUSEt�y• . . . . . . . . . . . . . . . . . . . . . . This certifies that . ��.t.`. r``_�4. ���< has permission for gas installation . . O t . . . . . . . . . . . . . . . �. . r k• in the buildings of . . . ., z`...... . . . . . . . . . . . . . . . . . . . at . . . . . . . ., North Andover, Mass. EL Fee. . . . ! . . Lic. No.. ./ . . Gf:U. GAS INSPECTOR Check# y'- . 5946 * `' MASSAC11 HUSETTS UNIFORM APPLICATION;FQR .PERNSlT TO DflGASFlTTiNG . (F'rtnt,or 7ype1, Mass Da#e".1171, Zt' Perrn}t # ` � Buttding t_ocai}on r'-11 . ^ 5�4h � Ov+rner s Name f � � Type of Occupancy , s//_' i C New' Q Renovation (] Replacement [ P}ans'Submitted Yesp No: y : oc y w ui x ..2 ¢< vi : G. y' ,' cr- O 1/f W �W iZ'. t�' U r , }- - y 1. - % d = c , O O °° Q ''' w to- xn: a c .s �� N a w -z rJ W x: y I ` 1 a o n< ww .c s x ; rc ; ,,r.. s- w chi = N a �zlu i- x -a t- z u' ut o ';n F- w J :w t- — , , . :"...,". I I, , - z ... ... , � - a �'-1�5---1,1'v ,� � --� , , S,UB BSRt. I,, BASErAEN7 ' 11 v.. a 1ST FLOdIt 2ND FLOOR 3,RD FL00R 4Tst{ F LO.O R 6. STt{ FIO.OR '66 , 6TH F.LOt7R 7=.Tf{ FLOOR -.; 6,6�6 :�, ,-] eT't{ FLOOR . }nstalling Company"61-111 FJarne G/�6L f t� ( Check one Certif}tate # x Address646 "LQ � S"�`- C�'6;1-'�orporatlon f dd I ----,A,2 . w� ❑ Rar166 tnersh}p 13uslness Telephone q �' ' `:�� `� J� C Q , Fir !Go ,116 ! . 16 Name of"jLlcensed Plumber or Gas ,Fit#er, � , -,_`�/ j, %' ItJSURANCE QO6.VEI�`.4GE ,6 1 6 6k 1 Have a current abllliy insurance policy or its substantial equivalent "which meets the requirements of MGL Gh 142;. Yes"` No.0 6 .6}f'yoI 1,u have checked, es lease Irxifcale the 1. p type coverage by check}ng the appropr}aie_box A,llabflfty insurance'policy `C3'' Other typ6.e ot;lndemrilt6, 6y❑ % B`ond L7 OYYNER'S lNStJAANCE WAIVER: 11 ,1 am awar1.e that the }icensee does not_have ;the Insurance coverage re,qulred by Chaple""r 142 at the Mass General taws, and that:my:slgnature on;this perinft applcailon waves ihls requfrernent Check ca6.ne QwnerQ Agent Q Signature bl Owner;or Owners Agent % ::, 6,6 1. thereby ce ilty that"aN of th'e details and Ini,rma toi )have submitted{or 1.entered}(}n above application ar"e true and accurate to.the best al rt y knowiadga in. . ,at all plumbing-work`and.III;', - I,-; ariorm-d'up.-'-Al-permit lsssred for thla appilcatlon wlil.be:lR comp(lancs with els petlnenlI -1 .pro�sio"ns of ihe;Massachusetts State GasiCo�e and,chapter,192 of tE?e,Gene al taws6. 7'` g ot.U.cQnse ."66: % �' Trtle6616" 166, 6t lumber1. Srg to e c rise'r um er or Gas• rtter astillor aslcr Ucanse Number Cit-ylTflwn ; Jour6. rieyrnan 11 Af'{'rXrrT€_TOTi Te p