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Home My WebLink AboutWiring Permits - Alarm system & Kitchen - Correspondence - 5 GREENWOOD EAST LANE 12/30/2014 i Date ... . ................ NoarN o�• . .'• °o� TOWN OF NORTH ANDOVER * PERMIT FOR WIRING QACHUS� r This certifies g rtifieS that, ............... .. . . has permission to perform wiring it3 the building of ...;:- ' � ...... at ....... i "s .................,NorthAndover,Mass. Fee............ .....Lic.No. Check#+`-= ^Ia _� ELECTRICAL INSPECTOR ! �� `�=� �� Letter View Page 1 of 1 Official Use Only om.monwealM o ar►yaeLie " c�, ��]7 Permit No. ,. ��, pat«t.d W�`iwe ervice3 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),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION)_____Date: December 15,2014 ----City or Town of: North Andover,MA_ 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) 5 Greenwood East Ln Owner or Tenant Jessica Carnevale Telephone No. (518)210-8785 Owner's Address 5 Greenwood East Ln Purpose of Building � with a building permit?_____ Yes[,""I_ .____No[A.--_._.___..,(Check Appropriate Box) Is this permit in con�u�coon� p —t1 �-j�(,�, Utility Authorization No. Existing Service Amps / Volts... Overhead[ ._______,Undgrd INo.of Meters New Service .__.. Amps / Volts_ __._.Overhead I .) - -._._Undgrd[ J_____.__---No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of a low-voltage,wireless burglar alarm system. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Trans 'total sformers KVA o.of Luminaire Outlets No.of Hot Tubs Generators------.------ KVA__,,,,___, No.of Luminaires Swimming Pool Above In I V o.of Emergency Lighting rnd. rod. atter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS o.of Zones o.of Switches No.of Gas Burners o.of Detectionand _ Initiatin D Dand o.of Ranges o.of Air Cond. Total o.of Alerting Devices g Tons o.of Waste Disposers eat Pump umber ons KW o.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local Municipal Other p g - Connection No.of Dryers Heating Appliances KW Security Systems:* y g PP --.- -- No,of Devices or Equivalent o.of Water KW o.of No.of Data Wiring: Heaters Signs Ballasts __No.of Devices or Equivalent elecommunications Wiring: o.Hydromassage Bathtubs o.of Motors__.._.-.._,-__,,-_Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $850.00 (When required by municipal policy.) Work to Start: December 15,2014 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE[ I BOND[- OND[_ OTHER[r] (Specify:) I certify, under the pains and penalties of perjury,that the information on It' ap -c tiot '-tru o id complete. FIRM NAME:Defen ecurit Co LIC.NO.:C 1355 Licensee: m. _ " .. ""' Signature LIC.NO.: D 434 (If applicable,enter"exempt"in the license number tine.) _ _Bus.Tel—No.:800-689-9554 Address: 3750 Priority Way S Drive,Suite 200,Indianapolis,IN 46240 Alt.Tel.No.: 866-502-3559 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic. No. SSCO-001258 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)[`.._l owner []owner's agent. 1"Owner/Agent Telephone Signature No, PERMIT FEE:$ � https://www.citizenserve.com/Admin/WorkOrderpocuments?Action=ViewDocument&D... 12/17/2014 The Commomvealth of Massachusetts Department of IttdustrialAccidettts Office of Itivestigatioits 1 Congress Street, Suite 100 Boston, MA 02114-2017 wFVw,titass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Con'tractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationllndividual): ` Defender Security Compan.y,: Address:3750 Priority Way S Drive Suite 200 City/State/Zip: Indianapolis, IN 46240 Phone 9:800-689-9554 Are you an employer? Check the appropriate box: Type of project(required): 0 I am a employer with 3 4. ❑ 1 am a general contractor and I 6. Q New construction employees (full and/or part-time). have hired the sub-contractors ..❑ 1 am a sole proprietor or partner listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have g; Q Demolition working for me in any capacity. employees and have workers' 9 Q Building addition [No workers' comp. insurance comp. insurance,x required.] 5. Q We are a corporation and its 10.�Electrical repairs or additions 1.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12.Q Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13,0 Other comp, insurance required.] Any applicant that checks box M I 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. Con:ractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have mployces. ff the sub-contractors have employees,they must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for sty employees. Below is the policy and job site nformation. nsurance Company Name:MJ Insurance Inc _ 'olicy N,or Self-ins. Lic. 9:TC2JuB1108L22613 _Expiration Date; 10/7/20" lob Site Address: l�'�1 V (l V � _City/State/Zip: 1�l V Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). b — =ailure to secure coverage as required under Section 25A of MGL c, 152 can lead to the imposition of criminal penalties of a. ine up to S 1,500.00 and/or one-year imprisortment, as well as civil penalties in the form of a STOP WORK ORDER and a fine )f up to 5250.00 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. l do hereby certify under the pains and penalties of perjury that the information provided above 14 trite and correct. Signature 4� � _ Date: i Phony 8665023559 Official rise only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License 4 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 n: Commonwealth of Massachusetts Department of Public Safety S<<urit�S.chmc-ti-Lkcnre License: SSCO-001258 STEPHEN C EHRLICH 3750 PRIORI17V WY S DR#206 INDIANAPOLIS IN 46240 1 Expiration: Commissioner 12/03/2016 PIcase 'visit our web site at liLLp://%tindw.niass .gov/dpl/boards/EL DEFENDER SECURITY CO / PROTECT Y STEPHEN C EHRLICH (FA) 3750 PRIORITY WAY SOUTH STE 200 INDIANAPOLIS IN 46240-3815 Fold,Than Detach Along All Perforations COMMONWEALTH OF MASSACHUSE:TTS Ir!l`t1?I DOARD OF ELECTRICIANS ISSUES THE FOLLOWING LICENSE AS A REGISTERED SYSTEM CONTRACTOR Q a DEFENDER SECURITY CO / PROTECT Y N STEPHEN C EHRLICH W 0 3750 PRIORITY WAY SOUTH W STE 200 INDIANAPOLIS IN 46240-3815 1355 C 07/31/16 38220 1=': OMMONWEALTH:OB M $SACHUS�TTS , . e e ® e +- �•,80AR[,,OF ;y ISSUES THE FOLLOWING, L'iCENSE ?' A REC I`STERED ,S(S7 M fECHN i C I.A STEPNEN C EHRL I CH � :< 369: CENTRAL"STREET ( ` FOXBOUC�H t MA 02035 RO 26 `7 434; D 0 7/3,,1:%16ti 45560 C1ffeTiFK�3f�(91; : .. o .. ....... ..................... Date.... IRTH -rO VVM OF M-OR.-rH ANDOV5-R 0 0 5OR WlRlt4G A _?E:RM"r J'L k .......................... . ................... ........... This certifies that .......... .......... i�� .................................... ........................ perform ...... ...................... has, ...... 'DertniSS'011 to ........... in the building Of..... Andover,Mass.. N�o Ajido, wiring ............... ........ ....... at ..... 4-2�.... f.........11 ELECTRICAL INSPECTO !I Lic,No. Fee........................ p'�' Icc_ Commonwealth of Massachusetts Official Use Only Permit No. Department of Fire Services Occupancy and Fee Chocked BOARD OF FIRE PREVENTION,REGULATIONS [Rev. iwl (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEQ,527 R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:T( - - ' ,?j , , J 7 1// r City or Town oh, NORTH ANDOVER nspjqee�t�' 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: Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No F1 (Check Appropriate Box) Purpose of Building ck ul Utility Authorization No. Existing Service Amps Volts Overhead [] Undgrd F1 No.of Meters New Service Amps Volts Overhead El Undgrd [I No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: , Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires J No.of Ceil.-Susp.(Paddle)Fans No.of Total V Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above ❑ In- ❑ No,of mergencyLiglitang No.of Luminaires Swimming pool grnd. grnd. 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. Total Tons No.of Alerting Devices Heat Pump Ton KW` No.of Self-Contained No. of Waste Disposers Totals: ............ ....................... Detection/Alerting Devices <-- No.of Dishwashers Space/Area Heating KW Local Municipal n Other Connection Securit y - Systems:* No.of Dryers Heating Appliances I(W No.of Devices or Equivalent No. of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts . No.of Devices orEguivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: 6 Attach additional detail if desired,or as required by the Inspector of Wires. r6 t--%i E s t im ate d V alu o of Ele ctri al Work: 0. (When required by municipal policy.) 0 Work to Star.. V Inspections to be requested in accordance with MEC Rule 10,and upon,completion. INSURANCE OVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless I 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 [I BOND [I OTBERE] (Specify:) I certify, undef the pains and peilallies Of e nay,that the information on this application is true and complete. FIRM NAME: 'eel VA-LLL "i — LIC.NO.: Licensee Signature LTC.NO.: : Of applieabl�e,--I'er t" ' the license num r line)e7x1np �in Bus.Tel.No.: 5�, Address: ) Aoi Alt.Tel.No.: Z� 177�41 I�I*olej I / *Per M.G.L c. 147,s.57-61,security work requires'DqpartmbPdofPdblfc 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)0 owner []owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ ❑ 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 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,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 maybe 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 v Failed Re-Inspection Required Pass ($.)❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: � Failed 0 Re-Inspection Required Pass ($.)❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: � Failed Re-Inspection Required($.) ❑ Pass 0 Inspectors Comments: IST' ® Inspectors Signature: Date: FINAL INSPECTION: � Failed Re-Inspection Required Pass ($.)❑ Inspectors Comments: Inspectors Signature: Date: '8 WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweInhoId@townofinerrirnac,com v COMMONWEALTH OF MASSACHUSETTS. { BOARD Of 4 L E.GI`R I C I ANS ,= ISSUES THE, FOLLOWING L.IGENSE `AS A REGISTERED MASTER :ELECTRICI.AN i i -:SEACOAST ELECTRICAL SERVICES LLC AM S EATtIN 1001 Bi6AUWAY HAVE`RFII LL MA 01832 1106 11' MR 0 1 .l:b 20 82