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HomeMy WebLinkAboutMiscellaneous - 52 EMPIRE DRIVE 4/30/2018 (2) `or ��- ./ f I i t r l/g 0 �9 Date. f � JJ . . . TOWN OF NORTH ANDOVER f a • PERMIT FOR PLUMBING ,SSACMUS� n/ G � F ,. This certifies that . .�1. . . . . . . . . . . . . . . . . 4.(�. . . . / ..o has permission to perform . . . . . . . . . . . va. . . . . . . . . . . . . . . . ro: plumbing in the-buildings of . . . . . . . ..Z at. . . , ,.y . . . ? �- , . ., North Andover,,Mass. Fee. ;��4,,Aic. No.. . . ,/ PLUMBING INSPECTOR Check # 7 -r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:_ MA. Date: 1'�- �l Permit# Building Location: Owners Name: Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential New:® Alteration:❑ Renovation:❑ Replacement:❑ Plans Submitted: Yes❑ No FIXTURES DEDICATED LU Z SYSTEMS I.- z W Y z } H W Q W 2 H z a W z H kA x to Q cQ W l7 Q Q oe W a 3 h 2 to a W Z. f- W z 9 to C Q z F N to W � h N Q , Q N C Q z a}c p ac Z u n ,—� a 16L 1�Y 2 3 O 3 W ~ W w J z Ga 0 W 3 2 Y a 2 W W 4 W Q Q h in O H > > O 30 Q Z Q Q Q LLJ 2 G to W a m m c o LL = Y J J °a S 3 3 3 0 a 3 SUB BSMT. BASEMENT -TT-FLOOR f I 2" D FLOOR ' Z r FLOOR 4'"FLOOR 441 �. 1 5'FLOOR FLOOR ! FLOOR 8'FLOOR Check One Only Certificate# Installing Company Name: GA L.1 MSKY PLk)M 3!W •4 Kj ATI4 0 [ Corporation Address: P-0- CSX 11701,17 i Ci NRcJCR" tyf Town. �tLl. State: M.A- Business Tel: 47$- 3N- OL13 Fax: q1&-5011-ell 1,l ❑Firm/Company Name of Licensed Plumber: STEPKEA G. GiALI1 !I py_lf! INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes R No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy 20, Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:1 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 Owner's Agent Owner El Agent E] 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 compliance with all Pertinent provision of the Massacousetts State Plumbing Code and Chapter 142 of the General Laws. f By,0& Type of License: Title []Plumber Signature of icensed Plumber City/Town °Master APPROVED(OFFICE USE ONLY ❑Journeyman License Number: iO3y5� I I I FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S) I FEE: $ PERMIT# r i i i APPLICATION FOR PERMIT TO DO PLUMBING 1 i NAME&TYPE OF BUILDING I I LOCATION OF BULLDIN SKETCH I I PLUMBER I i LICENSE NUMBER: I i i II PERMIT GRANTED❑ DATE: i I i i i PLUMBING INSPECTIOR i I I, i 7801 Date.. 1,y . ... ... . HORTM pF �.ao ,e,'1r0 3? �` 6 OL TOWN OF NORTH ANDOVER O � 9 t PERMIT FOR GAS INSTALLATION �,SSACHUSEt � This certifies that has permission for gas installation .! �?-. . . . . . . . . in the buildings of . . . 0113 411 41c,. . . . . . at . . . z . . �'?dr�?!! -Q . .�i�'!'! , North Andover,Mass. Fee. .A ,G?Lic. No/q-� . . . GAS INSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO GAS FITTING q CITY/TOWN: 0[3.i ?l.il��_._ _ _. .._i STATE:MA APPLICATION DATE: n } JOB ADDRESS �� ,���.!�'�'p!.:Iti(_,,..._t✓t��.._._ GOCCUPANCY TYPE: COMMERCIAL RESIDENTIAL PLANS SUBMITTED: YES O NO❑ NEW® ALTERATION REPLACEMENT[] - REMOVAUDEMOLITIONE] T NATURAL& LIQUEFIED PETROLEUM GAS: PIPING-EQUIPMENT—APPLIANCES—SYSTEMS Z ENTER TOTAL AMOUNT FOR EACH SELECTION LIMITED TO FIVE(5)NUMERALS AIR ROTATION UNIT FURNACE: ALL TYPES TEMP HEATING EQUIPMENT BOILER:ALL TYPES GAS PIPING THERMAL OXIDIZER BOOSTER GENERATOR STATIONARY ENGINE TURBINE BROILER ILLUMINATING APPLIANCE UNIT HEATER BURNER: ALL TYPES INCINERATOR WATER HEATER: ALL TYPES CO-GENERATION UNIT INDUSTRIAL AIR HANDLER EQUIPMENT OVER 12 500MBH COFFEE ROASTER INFRARED HEATER TOTHER NOT LISTED-1 COOK APPLIANCE HOUSEHOLD KILN I GLORY HOLE I CRUCIBLE COOK APPLIANCE COMMERCIAL LABORATORY COCKS DECORATIVE APPLIANCE MAKEUP AIR UNIT DIRECT VENT APPLIANCE MECHANICAL EXHAUST EQUIPMENT DRYER: ALL TYPES OVEN: ALL TYPES FIREPLACE:VENTED _ POOL HEATER FRYOLATOR ROOF TOP UNIT FUEL CELL ROOM HEATER-VENTEDNENTLESS 0 PLUMBING/GAS FITTING FIRM INFORMATION CHECK ONE ONLY Galins Plumbin &Heating Inc I aCorporation Business# s7ss NAME: �' 9 9 ADDRESS: P O Box 1701 .01831 ®Partnership Business#== CITY: Haverhill `STATE: MA ZIP: _ r _ ❑LLC Business#C� -- TEL: 978-374-1743 FAX 978 521-41 EMAIL:; mrplumber@aol.com i DBA/Unincorporated NAME OF LICENSED PLUMBER/GAS FITTER: INSURANCE COVERAGE 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES El NO If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy R 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 OWNER a AGENT Signature of Owner or Owner's Agent OWNER'S NAME: TEL: FAX L I hereby certify that all of the details and information I have submitted(or entered)regarding this permit application is true and accurate to the best of my knowledge.I certify that all plumbing work and installations performed under the permit issued,will be in compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code,and Chapter 142 of the General Laws. 2C/E;77L�jType of License: Permit# Q✓ Plumber E]Gasfrtter Q✓ Master Journeyman Signature of Licensed Plumber/Gas Fitter Inspector ---- ---- ❑Undiluted LP Installer License Number: 10348 ,�s� Fee: E]Limited LP Installer � Y F ROUGH GAS INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 0346 Date... TOWN OF NORTH ANDOVER PERMIT FOR WIRING S. A US This certifies that .... has permission to perform ......../ ........ ....... wiring in the building of..... -e......... ........................ ,Af North Andover,Mass, .. ....... Lic.No.�.. .. . ............ Fee. -ELECTRICAL � SPECTOR Check # A? Official Use Only Commonwealth of Massachusetts Department of Fire Services Permit No. / Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank I 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 OR TYPE ALL INFORMATION) Date: 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) A,- J` / 2- — 5 Z C_ Owner or Tenant s , . Telephone No. Owner's Address 2 7 7 Gti S- c u•. Is this permit in conjunction with a ' ding permit? Yes ©�No ❑ (Check Appropriate Box) Purpose of Building � -c Utility Authorization No, J/ J3 L7 a Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service dam/ Amps /.20' /2.,/ y/Volts Overhead❑ Undgrd CJ No.of Meters r Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: rjc � /41 t Completion of the following 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 El 'In- ❑ o.o Emergency Lighting d. rnd. Batte 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 I Number Tons KW No.of Self-Contained Totals: _...._ - µ -- 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 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: JQ- %- / 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 the pains and penaltiesof perjury,that the information on this application is true and complete. FIRM NAME: Z' f� /t � LIC.NO.: i�3 Licensee: v,�, S i / Signature IJC.�N�O.:log (If applicable,a ter"exempt"in the license number line.) Bus.TeiNo.: 4,r_7-2- Address: Address: G Alt:Tel.No..• *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. ' CE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normall OWNER S INSURANCE ty g y 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. cy The Commonwealth of Massachusetts ! Department of Industrial Accidents E p:. Off of Investigations//���� 600 Washington Street`T"''` r;aa: Boston, MA 02111 www mass gov/dia . workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(BusineWorganization/Individual): Address: ' City/State/Zip: Phone#: . Are you an employer?Cheek.the appropriate box: Type of project(required): 1.❑ It am a employer with 4, ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have Hired the sub-contractors 2.E] I am.a.sole proprietor or partner- listed on the attached sheet x 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me.in any capacity. workers' comp.insurance, g, ❑Building addition { [No workers'comp.insurance 5. ❑ We are a corporation and its 10. Elairs or additions required.] officers have exercised their ❑ ectrical repairs 3.❑ 16n a homeowner doing all work right of exemption per MGL 11.M. Plumbing repairs or additions myself.[No•workers'comp. c. 1.52, §1(4);and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 13.❑Other comp. insurance required.] "Any applicant that checks bo)'#l 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. lContractors that check this box mustattache'd an additional sheet showing the name of the sub-contractors and their workers'camp.policy infnrmador. am an employer that u.pro informafinm viding:workers'compensation insurance for my employees. Below is the policy and job site Insurance Company Name: ' Policy#or Self-ins.Lie.#: Expiration Date: k 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 WORT{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 certify under thepains andpenalties ofperjury that the information provided above is true and correct: Signature: Date: Phone#: Official use only. Do not write in this area,to be conVleted by city or town official City or Town: Permit/License# lssuing 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....�.�� ..��:.. �... t HORTq, 4, TOWN TOWN OF NORTH ANDOVER PERMIT FOR WIRING ��SSACHU This certifies that .............: ?1.*...... �- 1............... has permission to perform ......... &— ...................................................................... wiring in the building of.�Er; --..AAZe-?..... .. V—*--*** at.5f... .` 11........................... North Andover,Mass. Fee......... ........ Lic.No ?a . ........./R-:4RICAL .. �/.. NSPECT(dR Check # —A, f` t 10447 _ eoftwwnweahlr.oI Ma66acluaelh Official Use Only ryc�r�� cc77 Permit No. V eL.leParl�netil o�}ire�eruiced 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), 27 CMR 12.00 (PLEASE PRINT IN INK 04 JYPE L INFORMATION) Date:_ City or Town of C7 ,/ n To the Inspect of ires: By this application the undersigne gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant 1G Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building g Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters r Number of Feeders and Ampacity ~ Location and Nature of Proposed Electrical Work: j'� 1� t/Le-e i Completion of the follotying!able to be waived b)the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.o Tota 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 etection an Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers eat Pump umber ons K o.o -el ontaine Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ unicipa ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: rY No.of Devices or Equivalent . No.of Water No,of No.of Data Wiring: Heaters. KW Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP e[NomfDevictso r Wiring- No.of Devices or E uivalent OTHER: t "i res. Attach additional derail of desired,or as required by the L spedor o f 13 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 inpwance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover is in force,and has exhibited proof of sayie to the permit issuing o ce. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) �� j .sI /� under the pains andpenalties o er•u that the information on d is a licatio i is true and co nple -� I certify, rtid r P P fp J rye f PP FIRM NAME: -i v e L (>1 C LIC.NO.: 59. Licensee: S rh;evi -,-57W Signature LIC.NO.: (If applicable,enter'exem at the!'c nse rruniber line Bus.Tel.No.• Address: 1 . Vit? fit 't•tAlt.Tel.No.: *Per M.G.L.c. 147,S.57-61,security workJequires Department of ub is 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. LAWRENCE H. OGDEN,P.E. 198 EAST MAIN STREET 978-352-8318 fax 978—352-2858 cell: 978-502-5921 September 28, 2011 Mr. Robert Messina Orchard Village LLC. 277 Washington Street Groveland,Ma 01834 RE: THE WALLOW GB# 6213 Lot 12 Empire Drive,North Andover,01845: Dear Mr. Messina As you requested I visited the site 9/28/11 to review the installation of the Engineered Materials consisting of LVLs and Engineered Joist utilized in the framing of the above project. These are shown on plans prepared by G.J. Bruno and Associates A- 1 to A-5 Dated 7/30/09 with the framing sheets certified by me 6/15/10. The following items require additional work as discussed at the site with Mr. Jeff Horne. 1. The Simpson LCC3.5-3.5 cap as shown in sketch SK-1 dated 2/15/11 requires nailing to the LVL Beams. 2. Insure that 3-16d nails from the plate to the rim are installed I noticed these were not in place at some walls. Based on the above site visit and based on what I could visibly see provided the above additional work is completed I can certify that to the best of my knowledge the LVLs members and Engineered Joist utilized in the framing as shown on the drawings are installed properly and meet the loading conditions of the7th Edition of the Massachusetts State Building Code for 1&2 Family Residences. All other framing requirements of the drawings and code, including but not limited to materials, nailing schedules,blocking, connections and other details are the responsibility of the licensed construction supervisor responsible for the project. Should you have any questions please do not hesitate to call. Yours truly, ZH OF M� L wrence H. Ogden P.E. Structural 27765 LA RENa Cc: Mr. Gerry Bruno Mr. Jeff Horne Copy mailed to Mr. Robert Messina saes o y C'/STE�� � ��NAI ENG��