HomeMy WebLinkAboutMiscellaneous - 68 JEFFERSON STREET 4/30/2018 (2) 68 JEFFERSON STREET
J � 2101023.0-0004-0060.H
2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accozdance-with the provisions of M.G.L.G.143,§.3L,the
�v \\ permit application form to provide notice o£installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed'
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,fum 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_belimited as to the time ofongoing construction.activity,andmayhe.deemed_bythoJnspector_of_Whes abandoned_and-invalid.ifhe—.
or she has detennined that the aufhorized worl�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•pemut application.
The Permit Extension Act was created by Section 173 of Chapter 240 ofthe 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—tern 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 ofreal property.With
limited exceptions,the Act automatically dxtends,for four years beyond its otherwise applicable expiration date,any permit or approval that was
p "in effect or existence'during the qualifying period beginning on August 15,2008-and extending'through August 15,2012.
e 8—Permit(Date Closed: / *Note:.Re ly for new perm
"` er it-Extension Act—Permit/Date Closed: l
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` TOWN OF NORTH ANDOVER
` p PERMIT FOR WIRING
�7SS^CNUSEt
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This certifies that
............
ahas permission to perform .. ... .�C' c! *�
,,t;RLa .
wiring in the building of..` '�� -nI_,P�... .... ............
at...�A........ 1 .�f` .%........ ..... .North Andover.,.Mass.
Fee.. `� ��
,-$ ........... Lic.No....7......
ELECTRICALINSP oR
Check #
8906
Lommonwea.k ol Ma66achu6ett6 Official Use Only
(�6 Permit No.
c� ��o�
2epartment ol5re Service6
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),521 CMR 12.00
(PLEASE PRINT AT INK OR TYPE ALL INFORMATION) Date: July 14, 2009
Citi' or Town of: N. 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). Building H 68 Jefferson Street
Owner or Tenant Village,,Green Condo Association Telephone No.
Owner's Address. PMA 978 683-4101
Is this permit.in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
a➢ps l Volts UVC,..;e�" r j Lnk dSru ❑ iv U. of i�'i ei�.T's
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
t Location and Nature of Proposed Electrical Fork: Install' 2–circuit'panel
E
A �. Completion of the following table may be waived by the Inspector of 6hires. f
No.of Total
No.of Recessed Luminaires No.of Ceil.-Susp:(Paddle)Fans an rmers KVA
Tr afo
No.of Luminaire Outlets No.of Hot Tubs (Generators KVA
Above In
'o.o Emergency Lighting
No.of Luminaires Swimming Pool arnd. ❑ Qrnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No. I Detection and
Initiating Devices
No.of Ranges No,of Air Cord. TonaTotal !No.of Alerting Devices �I
Meat Pum Number Tons K4'i No.of Self-Contained
No.of Waste Disposers P ................................................................................ g
Totals: Detection/Alertin„Devices �
Municipal i
,i No.of Dishwashers Space/Area(Heating KW Local❑ Conne cio ❑ Other
--
Heating Appliances KiV Sec`
No.of Dryers No.of Dei es or Equivalent �
No.of WaterKms, No.of No. of Data Wiring:
r Beaters Signs Ballasts No.of Devices or Equivalent
i 1�' iTeIeEOFrtta,4irtiCatI0Z5�'irnb:
No.Hydromassage Bathtubs No.of Motors Total H..P ;vo of.Devizes or E-,u;valent
f
OTHER:
Attach additional detail if desired, or as required by the Inspector of ij'ires.
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 U BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties ofperjury,that the information on this application is true and complete.
FIRMN'AME: Crowe 8: Sons Electrical COrD . LIC.NO.--i 7-f&8 A _
Licensee: James B. Crowe Signature LIC.NO.: 1 11 —A
(Ifapplicable,enter "exempt"in the license number line.) Busy
.Tel.No.: ` / `*5 3–6 6 9 6
Address: 576 Middlesex Street , Lowel , Ma. 01852 A1t.Tel.No.: -6696
*Per M.G.L. c. 147,s.57-61,security work requires Departmen of Public Safety "S"License:. Lic.No. SS Co 001051
OWNER'S INSURANCE OVAIVER: 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 PEdZ16lIT FEE: S 55.00
Signature Telephone No.
f
Date... .. . . .
0."'." '4, TOWN OF NORTH/ANDOVER
o: 0 ,,//''
PERMIT FOR//PLUMBING
� f
,SSACMUS�
This certifies that . . . . . . . . . . . . . . . . . .
has permission to perform
plumbing in the buildings of . . . . :`'. . . . . .��^-.���0
at . . . . . . . `�''�� i :'-"" .' . . . . . . . . ., North Andover, Mass.
Fee����. . .,. .Lic. No /Gy/. . . ��,.. . . . . . . . .
PLUMBING INSPECTOR
Q
Check # fP
\
72U5 t
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
y� Date � �
_ L�G
Building Location's�� kkA Li`l � Owners Name V 3�`Q' �� � C"yS Permit# c,,5"
Amount
Type of Occupancy QC)
New Renovation Replacements Plans Submitted Yes No
El
FIXTURES
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A
sup3 VIC
BA4RV1H1YI'
ISI:ft"
M MaR
3M FL(M
M FLOM
5IIi HIM
6IH HO R
7IH FIOat
SIH F10(R
(Print or type) \ Check one: Certificate
Installing Company Name Corp.
Address
Business Telephone "'] jj�,, , �, Firm/Co.
Name of Licensed Plumber.
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy M. Other type of indemnity Bond ❑
insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner11 Agent El
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts Stat, umbing Code and Chapter 142 of the General Laws.
BY:
Signalurgoltcens um er
Type of Plumbing License
Title \l WAl
City/Town License NOW' Master Journeyman
APPROVED(OFFICE USE ONLY
60
Date..` :! o6. . . . .. .
TM ,ti0
-- °` TOWN OF NORTH ANDOVER
' PERMIT FOR GAS INSTALLATION
h
�9SSACMUSE�S
This certifies that. *! ;..;z.�. .-f�-��_. . . . . . . .
has permission for gas installation
in the buildings of
r Cf`
at . �r� . . . . .�Li
North Andover, Mass.
Fee.A t ` -. c No.,�/.<.'.�!�. . . �. . �.%� �r. . . . . . . . . . . .
,! '' GAS INSPECTOR
Check# l�
r
5834
MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTIN
G
(Type or print) Date
NORTH ANDOVER, MASSACHUSETTS
Building Locations � 5� , -Ij� Permit# 3
Amount$ —11d C9('ZtL� � Owner's Name
v
New Renovation Replacement ® Plans Submitted
x z a
x o H a
COO
W w a a j d
w o U w a w d z c Fr x
C7 E- z F z x w x w w x
m 7
CA O z w p x
w > w z d x d d O O w x
SUB -13ASEM ENT
BASEM ENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR
4 T H . F L O O R
5T H . F L O O R
6TH . FLOOR
7 T H . F L O O R
18T H . F L O O R Ed
(Print or type) i v ` Check one: Certificate Installing Company
y C N\V qA<,0,\ Nr�.`7\J1y Co
Name
Corp.
Address `��\� �L� D Partner.
0)
Business Te ep hone ne �% �,_ k—�E � Firm/Co.
' Name of Licensed Plumber or Gas Fitter
' INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes D No 13
If you have checked,yes,please indicate the type coverage by checking the appropriate box.
Liability insurance policy T Other type of indemnity D Bond D
Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass.General Laws,and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner D Agent D
1 hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusett State_Gas Code and Chapter 142 of the General Laws.
By.
Signature of Licensed Plumber Or Gas Fitter
C
Title � Plumber
City/Town D Gas Fitter License Number
Master
APPROVED(OFFICE USE ONLY) 0 Journeyman