HomeMy WebLinkAboutMiscellaneous - 87 MAYFLOWER DRIVE 4/30/201897 yS
(1-.,. (190
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .......'V. . z ......... . 'P ....//.........................................
..... .... .......... .
has permission to perform .... . ....... Ale ....... ...... 'C''........
.......
wiring in the building of .....
..............................................................
at ....................... ...... ............. 9.x .... I North Andover, Mass.
... .. .
Fee.53.�A .... Lic. No. . ........ .......
U 'tmcnucAL imspwwR
Check # 12
.a Cearnnaonwealth Of Massachusetts Official Use Only
Department of Fire Services Permit No.
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
Rev. U071
leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All wt,rk t0 be lxxf(xmed in accordance with the Massachuse ns Electrical C,xle (MEC). 527 CMR 12.(X)
(f'I. ��t.S'f ' PRINT' IN INK OR TYPE ALL INFORMA770N) Date: f/ ' 2 3 — la
City orTown of: NORTH ANDOVER
By this applicattccn the undersigned give~ notice of his or her intention to perform then ethe lectrical wctor � dtescribed below,
Location (Street & Number) 7
Owner orTenant
t)wtter's :#duress
Telephone No.
Is this permit in conjunction with a buil ng permit?Yes
do (Check Appropriate Box)
Purpose of Building_.�_�
Utility Authorization No- /e/ Z
Existing Service A
--� ps / Volts Overhead ❑ Undgrd ❑ No. of Nteters
liew Service �Ul% Amps 12z- / Zjj c Volts Overhead
l,ndgrdNo. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
No- of Recessed Luminaires
NO. of luminaire Outlets
R
No. of Lutninaires
No. of Receptacle Outlets
No. of Switches
No_ Of Ranges
No- ;if Nk,a,te Disposers
No. of Dishwashers
No. of Dryers
—0 o a ter
#!eaters
—_ Cotrtplefi�n n the
No. of Cell.-Susp. (Paddle) Fans
No. of Hot "Tubs
Swimming Pool ove n-
grud ❑ err
No, of Oil Burners
No. of Gas Burners
No, of Air Cond. t otal
Tons
eat ump um er ons
Npaee/Area Heating KW
Heating Appliances KW
h; W Sto. o o. o
Signs Ballasts
No. Hydromassage Bathtubs
OTiIFR:
o. of Motors Total HP
in table rna he wai ved b,• the
Generators KV A
RE ALARMS INo. of "Zones
No. of Alerting Devices
:vtuntctpal ❑ Other
Connechan
Data Wiring:
No. of Devi
No. of Devices or
H'irc
attach at/e/rtienol do>[ail iftlesir-ccL ar as required by akt In,,t:ccarruJ'jj'ire.)
1.stttnateci Value, cit I-lectrieat Work:
Work to
_ (When required by municipal policy.)
Stall:/%— 2 j . �U inspections to be requested in accordance with MEC Rule I0, and upon completion.
INSURANC'F; COVERA€;E: Unless waived by the owner, no permit for the performance of electrical work may issue unleas
the ltccnxwc pTovIdes proof of liability insurance including "completed operation" coverage ),nits substantial equivalent. rhe
undersigned certifies that such coverage is in force, and has exhibited proof -of, same to the permit issuing office.
c. HEC'IC ONig: INSURANCE OND ❑ OTHER L1 (—� (Specify:)
1 certify, under the painx and Penalltes of perjury, that the information on this application is true and complete.
FIRM NAiNIE:
Licensee•�
c LIC.NO.: ,�E99'3S
l Signature
tt ry,Jrlr<,tt>tr <w •r .{.�z ntJrl in thc� /icrnve number line 1 �--- T ` L�(C. NO.: 9 y 3 3
lddrecs:
"PET fb1.O I c. 147, s. 5, -ill, security work requires Departm- of Public Safes c," t_icense: Alt. -rel. No.:_
o.
OWNEWS INSURANCE WAIVER: i am aware that the 1_ic ensee clues tui /�tvc the liability insurance coverage normally _
required by Ja%k. 13v my signature below, I hereby waive this
Owner,'Agent requiretitent. t amthe (c ttec:k c+ne) ❑ tticner owner's a Jens.
Signature
R $�jA
ELECTRICAL PERMIT NO. INSPECTION REPORT:
ELECTRICAL INSPECTOR - DOUG SMALL
2. G SPECTION:
ed J Failed – [ ] Re -inspection required ($50.00) - [ J
Inspectors' comments:
(Inspectors' Signature - no initials) Date j —a.�/_
2. FINAL INSPECTION:
Passed – Failed – ( J Re -inspection required ($50.00) - [ .)
Inspectors' comments:
(Inspectors' Signature - no initials) Date
3. UNDER GROUND INSPECTION:
Passed – [ J Failed – [ ] Re -inspection required ($50.00) - [ )
Inspectors' comments:
(Inspectors' Signature - no initials) Date
4. INSPECTION – SERVICE:
DATE CALLED NATIONAL GRID: –02(0 _/t7 NAME: i/ t
Passed – §4Failed – [ ) Re -inspection required ($50.00) - [ }
Inspectors' comments:
(Inspectors' Signature - no initials) Date
J
5. INSPECTION - OTHER:
Passed – [ } Failed – ( ] Re -inspection required ($50.00) - ( ]
r
Inspectors' comments:
(Inspectors' Signature - no initials) Date
DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT
ACCESSIBLE AND A RE -INSPECTION OF $50.00 IS TO BE CHARGED.
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 163-2011 Date: January 24, 2011
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 87 Mayflower Drive, North Andover MA,
Lot 14, Old Salem Village
t MAY BE OCCUPIED AS residential single-family IN ACCORDANCE WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER
REGULATIONS AS MAY APPLY.
Certificate Issued to:
10.00
23355 previously paid
Key Lime Inc.
10 Hepatica Drive
North Andover MA 01845
Building Inspector
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APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPECTION
Building Permit # %Za<3-- 02®6/
ADDRESS/LOCATION OF PROPERTY: 8 7 VVl4v F(,o,,u eres�.C..'�t�
Map 1&7-6 Parcel 1(Q Lot Number 14
SUBDIVISION
DATE REQUESTED FILED/READY FOR INSPECTION_
CLOSING DATE ON PROPERTY: I
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-
INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THF I*;Tpf 1rTi IPP
UutS NU I MttT ALL APPLICABLE CODES.
.9..6r- .'.= 1� • =G�1 Lam.
1 G11111t ITJJI.IGd tV.
Address
SIGNED
CONSERVATION
Y\PLANNING
DPW. WATER METER
SEWERMATER CONNECTION
NOTE
RO TING
F C701 fx7o
0 v�G/
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO
SUBMITTAL OF THE OCCUPANCYANSPECTION REQUEST
DPW
Fife: Application for OC form revised Jan 2007
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LAWRENCE H. OGDEN, P.E.
198 EAST MAIN STREET
GEORGETOWN, MA 01833
978-352-8318 fax 978 —352-2858
cell: 978-502-5921
November 16, 2010
Mr. Benjamin Osgood fax to 978-685-1099
Key Lime Inc.
10 Hepatica Drive
North Andover, MA. 01845
RE: Unit "E", Lot 14 Old Salem Village, North Andover
Dear Mr. Osgood
As you requested I visited the site to review the installation of the Engineered
Materials consisting of LVLs and Steel Beams utilized in the framing of the above
project. These are shown on plans prepared by O'Sullivan Architects Dated 7-20-06,
revised 1-8-09 with the framing sheets certified by me 1/8/09.
Based on the above site visit and based on what I could visibly see; I can certify
that to the best of my knowledge the installation of LVLs and Steel Beam members
utilized in the framing as shown on the drawings are installed properly and meet the
loading conditions of the 7h Edition of the Massachusetts State Building Code for 1&2
Family Residences.
This certification assumes that all other framing requirements of the drawings and
code, including but not limited to materials, nailing schedules, blocking, connections,
material manufactures recommendations and other details were properly complied with
by the licensed construction supervisor responsible for the project.
Should you have any questions please do not hesitate to call.
Yours truly,
P�SF+ OF
AWRENCE
g kvLD
Lawrence H. Ogden P.E. Structural 27765 D'
.o A 7765 p
t( IIbIz,)/v
742 2- Date. 1/0 C0
pORTM
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p y,� TOWN OF NORTH ANDOVER
AO
: PERMIT FOR GAS INSTALLATION
This certifies that ...l!�Q%1`j„ �-SC! �% A41'1,- —�
has permission for gas installation �`.7
in the buildings of .. �. �'� `�, .��.,,��1l ............. .
at _ ......,14...x; North Andove , Mass
Fee , ..0 U Lic. No..J 7G. 7. d .
GAS INSPECTOR
Check #
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or T pe)
000el - Mass. Date dc7` 20 Cd Permit #
Building Location �� a Owner's Name – Z -"l
Telephone Type of Occupancy"
New a Renovation Replacement 1:1 Plans Submi4d: Yes F-1 No❑
M
Installing Company Name EnergyUSA Propane, Inc. Check one: Certificate
Address 100 Myles Standish Blvd., Suite 101 0 Corporation 132 C
Taunton, MA 02780 Partnership
Business Telephone (800) 822-1300 X8055 Mike Smith Cell (508) 922-7891 El Firm/Co.
Name of Licensed Plumber or Gasfitter William Kent Corson (800) 822-1300 X8051 Cell (508) 294-6660
INSURANCE COVERAGE: EnergyUSA Propane, Inc.
has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142.
YesX❑ No
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
liability insurance policy X❑ Other type of indemnity D Bond
VER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
pter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owner 1:1 Agent
Owner or
1 hereby certify thalt 0 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 the permit
issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code
and Chapter 142 of the General Laws.
Type of License:
By ElPlumber
Title XD Gasfitter
City/Town XD Master
APPROVED (OFFICE USE ONLY) Journeyman
Signature of Licensed Plumber or Gasfitter
License Number 3707
11
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1
1'
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1
Installing Company Name EnergyUSA Propane, Inc. Check one: Certificate
Address 100 Myles Standish Blvd., Suite 101 0 Corporation 132 C
Taunton, MA 02780 Partnership
Business Telephone (800) 822-1300 X8055 Mike Smith Cell (508) 922-7891 El Firm/Co.
Name of Licensed Plumber or Gasfitter William Kent Corson (800) 822-1300 X8051 Cell (508) 294-6660
INSURANCE COVERAGE: EnergyUSA Propane, Inc.
has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142.
YesX❑ No
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
liability insurance policy X❑ Other type of indemnity D Bond
VER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
pter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owner 1:1 Agent
Owner or
1 hereby certify thalt 0 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 the permit
issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code
and Chapter 142 of the General Laws.
Type of License:
By ElPlumber
Title XD Gasfitter
City/Town XD Master
APPROVED (OFFICE USE ONLY) Journeyman
Signature of Licensed Plumber or Gasfitter
License Number 3707
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TOWN
°' . •.'�° TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ... W. ...9. ......
.lam /�., ...
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has permission to perform .. ,� C4(1).t. . ..........
plumbing in the buildings f .!t ... t%`.(. f 6,
at ........ `� ..... , North Andov r, Ma s.
f 5-at.4. NO.. ' /�% �j .. + .. �
PLUMBING INSPECTOR
Check # -�^� (�) [�!('
FIXTIIRFS
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town: MA. Date: �` �'� Permit#
Building Location: g ? M�JRQ GVC-rOwners Name: s4 i`g=
Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ['
New: 73Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑
FIXTIIRFS
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes tR No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy in 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 El Agent E]Signature of Owner or Owner's Aaent
I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my
nnowieoge ana tnat au piumoing work and installations performed under the perrnit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws,
BY Type of License: C.
Title Plumber Signature of L censed Plumber
City/Town Master O 3 Li
ElMaster
License Number:
APPROVED (OFFICE USE ONLY
DEDICATED
SYSTEMS
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SUB BSMT.
BASEMENT
1' FLOOR (
1
2ND FLOOR
1' FLOOR
4T" FLOOR
5' FLOOR
6' FLOOR
7T" FLOOR
8T" FLOOR
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Check One Only Certificate #
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Address: r'bt 13 a 1'701 City/Town:
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State: M4.
Business Tel:
Fax:4(3(
❑ Firm/Company
Name of Licensed Plumber:
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes tR No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy in 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 El Agent E]Signature of Owner or Owner's Aaent
I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my
nnowieoge ana tnat au piumoing work and installations performed under the perrnit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws,
BY Type of License: C.
Title Plumber Signature of L censed Plumber
City/Town Master O 3 Li
ElMaster
License Number:
APPROVED (OFFICE USE ONLY
742-6
Date.
l)C.r..
o? TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
�,SSACMUSE4
This certifies that .. Qe-z i/'w. ... .............. .
has permission for gas in(stallation�, / .
in the buildings of ..!.. ....�,/�.`/.
at.. (.1GL .... North Andover ass -7
4
Fee'./P.0.. Lic. No.. �. .. .. ...,.%
&S INSPECTOR
Check #
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FIYTI IRI=C
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
Cityfrown: Wit A441-"� -,MA. Date: q- l -f, O Permit#
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Building Location: Owners Name: 6lrlrc. SSLtv�► UJ�/i„L�
Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ®'
New: [7 Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑
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BASEMENT
15T FLOOR
2 No FLOOR
3 FLOOR
4 FLOOR
--&
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6 1FLOOR
VH FLOOR
8 FLOOR
Installing Company Name: G4 lia"
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Check One Only Certificate #
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(Corporation l b
Address-
yrown:4411J_WLL,
State:NA
- - ----i-V.._...__._
-
Partnership
Business Tel: 74 ` 3� L( -1 Z l43
Fax:
W- - 6 Lfl
❑ Firm/Company
Name of Licensed Plumber/Gas Fitter:
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes t�D No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy (P 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 ❑ Agent ❑
Siqnature of Owner or Owner's Aaent
By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and
accurate to the pest 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 Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
Ty of License:
By umber _0
d
Title Gas Fitter Signat a of L tensed Plum r Gas Fitter
(� Master
Ci /Town ❑Journeyman License Number: 03��
APPROVED OFFICE USE ONLY ❑
LP Installer
f�t
08/09/2010 13:10 9786833147
A,C CERTIFICATE OF L144BILITY INSURANCE
PAGE 04/05
�-[E (fp�iI1DLJiYYY"Y i
R/Kiln
TM CERiiFK ATIz iS ISSUED AS A IIIiATi R OF iIFORUTION WILT( AND CONFERS NO RIC3M UPON THE C ERrI KATE HOLDER TM
CMRCAIE DOES NOT AFF MATIVELY OR NEWTIVIMY AM UMND OR ALTER THE COVERAGE AFFORMO 8Y THE POUC M
BELOW. TM CraffIRCATE OF MURANCE DOES NOT CONS7InM A CONTRACT BETWEEN THE ISSUING INSURER19), AUIMWED
REPRESENTA71VIE OR PROMPIM, AND TIE GEMIMATE NOUML i•
IMPORTANT- Ilse
the tBrrlts and cd►rfitiolss oft#Le Pai>kY. asAein pD maty tit+. att
cerliftala bolder M ku of such a
must be atdatlsad. i ATION 13 WAIVED, subject to
gdorsemeel, A data ont on this ceffmte does not corer 60ts % 01e
kr < _ ----------
.--M.P.
M.P.P.aba.•rts rrs'+=mcm Agamay t
1060 Osgood Street
North Andover, ice► 01845
MM LnM INC
10 HEPACTYC.,A. Iait3'VS
AMTH AMOVZR, MA 01845
j 978 683-8073 Nd,. (978) 683-3147
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THIS IS TO CERTIFf THAT THE POLICIES OF INSURANCE LISTED BELOW VE BE.G4 ISIBUI D TO THE INSURED NAMED ABOVE FOR THE POLICY PTPIOD
INDI.ATI D. NOTVYtTHSTAN01413 ANY RZOU EMEYT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Wi'T'H RESFECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOF40ED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUaSICRNS ANDGONOMCNS OFSUCH POUCIES. LWr3 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
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DAMIAGE TO RENTED $ 50 000
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1 0 7asa-DOB AGORD CORPORATION. An rfgpts mmerved.
AG(RD 25 (2001101) The AICORD romn and lino Ire regieWmd marks of.ACORD
SHOULD ANY OF TME ABOVE DESCRIBED POLICIES BE CANOFLLE.D ®E1¢ORre.
TIE. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE W!'M Tme POLICY PRmsioN8.
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1 0 7asa-DOB AGORD CORPORATION. An rfgpts mmerved.
AG(RD 25 (2001101) The AICORD romn and lino Ire regieWmd marks of.ACORD
Massachusetts - Depar timent of Public Safet%
Board of Building Relulations and Standards
Construction Supervisor License
License: CS 75302
Restricted to: 00
Ash
BENJAMIN C OSGOOD
69 OLD VILLAGE LANE ;
NO ANDOVER, MA 01845
Expiration: 12/4/2010
( onunissiuner Tr#: 6955
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