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Home My WebLink AboutMiscellaneous - 66 CIDERPRESS WAY 4/30/2018 (2) � I ti ,y ILI B UG FILE E CE HORTM 1* p3r o•ria.•••Cc •o M �/1 brans r�,19 SSACMISE CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 718-14 on 4/16/2014 Date: September 1, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED at 64 Ciderpress Way MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Meetinghouse Commons LLC 78 Great Pond Road North Andover, MA 01845 Building Inspector Fee: Prepaid $100.00 Receipt: 27459 Check : 3992 Town of t _ ndover O T No. h ver, Mass, A (� C0C"1C„ewrcw �1- S U BOARD OF HEALTH Food/Kitchen N PERMI Septic System 1A THIS CERTIFIES THAT .......... r... ... . ...1.. . .... . t4! !�I!�!�.•,Oh.......',( .... ..... BUILDINT D G,IN PECTOR ati has permission to erect .......................... buildings on ...� ..... .1. ..� .... ... .O tobe occupied as ..........&. . . .......... .... .v&.:w.............................................. chi ey provided that the person accepting this p rmit shall in every respect conform to the terms of the application on file in 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,INSPE T,�R RougF� VIOLATION of the Zoning or Building Regulations Voids this Permit. ��,r� Final G1 1 �*asp(o PERMIT EXPIRES IN 6 ON HS ELECTRICAL INSPECTOR 100 CONSTRUC 0 ST S 4_/ P Service ............ ........ ........ ............... Fin E� BUILDING INSPECTOR 7- f GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Finale aYJ No Lathing or Dry Wall To Be Done FIRE DEPART ENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. <He 7M1 SS[NUSEt CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 718-14 on 4/16/2014 Date: September 1, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED at 64 Ciderpress Way MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Meetinghouse Commons LLC 78 Great Pond Road North Andover, MA 01845 Building Inspector Fee: PrePaid $100.00 Receipt: 27459 Check : 3992 � Cf NORTH�� I 3AA,• '.. cL Tib^++n.✓'t19 fSACsf CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 718-14 on 4/16/2014 Date: September 1, 2015 j THIS CERTIFIES THAT THE BUILDING LOCATED at 64 Ciderpress Way MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Meetinghouse Commons LLC 78 Great Pond Road North Andover,MA 01845 Building Inspector Fee: PrePaid$100.00 Receipt: 27459 Check : 3992 0 Town of s n over 0 ». - 0 No. h ver, Mass, q1j(.11 ' 'Qp COC NIG NlwKN CVS• �,� �RATEO ►.PP�,�� ' S IJ BOARD OF HEALTH PERMI Food/Kitchen Septic System THIS CERTIFIES THAT ..........V1 !R.. T D f... .. .... .. . �,. �,,!��1�N.,�h,,,,,,,`�, ,,,,, BUILDIN5INSPECTOR -�6 F f,. dati has permission to erect .......................... buildings on ...� ..... .I.. �� .... .... ....... to be occupied as ..........� ............... Chi ey provided that the person accepting this p rmit shall in every respect conform to the terms of the application final r on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING,INSPE T 5 /J'C Roug VIOLATION of the Zoning or Building Regulations Voids this Permit. Final h'" / a o�� PERMIT EXPIRES IN 6 ON HS ELECTRICAL INSPECTOR 1 ()0 UNLESS CONSTRUC 0 ST S Service ............ ........ ........ ............... BUILDING INSPECTOR 7 GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final fil� � No Lathing or Dry Wall To Be Done FIRE DEPART ENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. . NoerN q 0� TLED I 616 CA APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION T �� R^rED 01 .�y BUILDING PERMIT # SACHU51 / n ADDRESS/LOCATION OF PROPERTY: Map Parcel 3 Lot Number SUBDIVISION: Ah�ei�LJf�,c Gmv► s DATE REQUESTED FILED/READY FOR INSPECTION: B' S CLOSING DATE ON PROPERTY: ! C 2- FIVE 5 DAYS NOTICE PRIOR TO CLOSING DATE IS RE UIRED ALL WORK AND SIGN-OFFS MUST BE CO LE WITHIN THIS TIME FRAME. A REINSPECTION FEE OF TWENTY DOLLARS ($ 0)WILL BE CHARGED IF THE-STRUCTURE DOES NOT MEET ALL APPLICAB CODE . APPLICANT SIGNATURE Permit Issued to: Address: 7F N . r dda ROUTING TOWN ENGINEER, SITE PLANS -WAY REVIEW" CONSERVATION PLANNING P1 A 0 C4A. p� DPW-WATER METER SEWER CONNECTION S� DPW MUST INDICATE PUT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL F T CCUP CY/INSPEC TION REQUEST DPW SIGNATURE le:Application for OC form revised Jan 2007/2011 Date . 2 7J' _ I oma • TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . .! .�. . . .�_. .! ./C . n-. . . . . . ... . . . . . . . has permission to perform A,1 R:Q -- .S. P!?V f'u- wiring in the building of . J�.•4: . . at .�-�'�� C . �:!. - .�S. . . . . . . . . .North Andover, Mass. Fee�.Lu-"". Lic. No. .� ./0.. . . .. . . ELECTRICAL INSPECTOR Chedk# //3`/- 0 11311 Commonwealth of Massachusetts Official/Use Only Department of Fire Services permit No.�YI � Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] eaveblank 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 ININK OR TYPE ALL INFORM TIOA9 Date: I Z I ('l J 1 'L-- 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) Owner or Tenant 1 v — Telephone No. [o'T'? 2h 3�' Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. m ?Ngo � Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service p O Amps l-Zb/ Zy LVolts Overhead❑ Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: l�1 S �-y1 N Gam'' Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell: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 InitiatingDevices No.of Ranges No,of Air Cond. Total Tons 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 ❑ Other Connection !No.of Dryers Heating Appliances KWSecurity 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: '-f-goo.03 (When required by municipal policy.) \ Work to Start: IL �� Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless N, the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE OND ❑ OTHER ❑ (Specify:) X certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: . ki A4 A--C- LIC.NO.: /L Licensee: Xq A-et- Signature LTC.NO.: Z k (If applicable,enter-"exempt"in the license number line.) Bus.Tel.No.- k it ';k .S�i --Z ,ci V Address: K/ _ Alt.Tel.No.:Z�� 2s" -6 *Per M.G.L c. 147,s.57-61,s urity work requires Department of Public Safety'S"License: Lie.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. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c. 143,§3L,the 'r permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed U� 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 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 August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass 0 Failed❑' Re-Inspection Required($.)❑ Inspectors Comments: e. Inspectors Signature: Date: SERVICE INSPECTION: Pass(] Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass M Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: e Inspectors Signature: Date: ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass Failed ❑' Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com z � w 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 Please Print Leizibly Name(Business/Organization/individual): ,4-e Address: .(J.,u� 1/ �D,,t v City/State/Zip: /l� .�.�S�,�., 01;��Whone#: C� 7��(� M Z__ Are you-an employer?Check the appropriate box: Type of project(required): 1.b4 I am a employer with_(� 4. ❑ I am a general contractor and I 6. E91 ew construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I'am a sole proprietor or partner- listed on the attached sheet. # ? F]Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. workers'comp.insurance. Y p n'• 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I 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 12.0 Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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. cpm an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site zformation. isurance Company Name: olicy#or Self--ins.Lic.#: Expiration Date: :)b Site Address: G2 - b(a C-t�ty �+ S -t&4 City/State/Zip: JO• A:n tau,per 01 .ttach a copy of the workers' compensation policy declaration pag (showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ne 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 f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ivestigations of the DIA for insurance coverage verification. do hereby cer ' under thepains andpenaldes ofperjury that the information provided above is tree and correct. i nature: Date: lone#: 9 -) ,8- Official ,8-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#: r 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 required." 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 burn 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 1877-MASSAFE evised 5-26-05 Fax#617-727-7749 www.mass.Rov/dia