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Home My WebLink AboutMiscellaneous - 13 KINGSTON STREET 4/30/2018 ,� I� i �~ Date... .......................... NOR7q °f' •�"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING AcMus� This certifies that ........ � �.{ c- has permission to perform ........�FC..;t .�.y S�G�Fr!!... wiring in the building of....... (�L/tii ................................................... at.......... �!v.......�?. ............. ,North Andover,Mass. Fee...7:.>�.....- Lic.No.............. .............. LECTRICALINSPECTOR t e Check # 8611 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit N°. / a 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 OR T PE ALL INFORMATION) Date: rQ() 1613 City o Town f: QNUAn�� _ To the Inspect r of ares: By this applicatio ersigned gives notice of his or her inten ion to perform the electrical work described below. Location (Street& Number) , Owner or Tenant �.�17 Telephone No. 6,97 Owner's Address �5a,&2,P_ Is this permit in conjunction with a building permit? Yes ❑ No x BLDG PERMIT# Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install low voltage security system at above location 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 ❑ In- Elo. 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 Initiating Devices No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices II' No.of Waste Disposers Heat Pump 1.NumberTons 1.KW No. of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local El Municipal Other No.of Dryers Dr Heating Appliances KW urity Systems:* 1 Y No.of Devices or Equivalent No.of Water No.of No. of . in : r Heaters KW Signs Ballasts No.o evices oruivalent No.H dromassa a Bathtubs No. of Motors Total HP Telecommunications Wiring: Y g No.of Devices or E uivalent L 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: 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 penalties of perjury,that the information on this application is true and complete. FIRM NAME: Brinks Home Security LIC. NO.: Licensee: John Holmes Signature 1i LIC. NO.: 749C (If applicable, enter "exempt"in the license number line.) Bus. Tel. No.: 978-657-0443 Address: 155 West Street, Suite 6 Wilmington,MA 01887 Alt.Tel. No.: *Per M.G.E.-c.147,s.57-61, security work requires Department of Public Safety"S"License LIC. NO.: SSCO 001163 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 Signature Telephone No. PERMIT FEE: $ �, TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING r BUILDING PERMIT NUMBER. �3 DATE ISSUED. lcf SIGNATURE: Building Commissioner/InWtor of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Pared Number: O k� �11v`cS�v� Sfi 11uU L e (J2J 0 eooq Map Number Parcel umber 1.3 Zoning Information: 1.4 Property Dimensions: v Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide RegWred Provided Re4jifired Provided Q 1.7 Water Supply M.G L.C.40.§54) 1.5. Flood Zone Information: Las SDisposal System: � Public 0 Private ❑ Zone Outside Flood Zana 0 Muuicipt �ewerage On Site D' System 0 SECTION 2-PROPERTY OWNERSHW/AUTHORIZED AGENT '+ 71+C 7 ti i Ct: 2.1 Owner of Record ' \ Lcll-),(�A I�l$&CIS Name(Pont) Address for Service: 02-2-7 Signature Te ephone 2.2 Owner of Record: rr � Na-�,�� i me Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable- ❑ Licensed Construction Supervisor: fpS e <,, Vz oL License Number Address O /1/1-s ate`' Expiration ae ature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Q Company Name 131 2(a( rn Se�C Registration Number r Address G �7 / A., 7a ` / Expira(tiioonDate ^ Si nature Telephone /'1 a SECTION 4-WORKERS COMPENSATION(KQL C 152 f 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building it. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Prosed Work check a8 a ble New Construction ❑ Existing Building 0 Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. 0 Demolition 0 Other ❑ Specify Brief Description of Proposed Work: .AS0 Kit cz d J2c do SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorizeto act on My behalf,in all matters relative to work adthorized by this builduig permit application. Si tature of Owner Date " i SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION i I, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si afore of Owner/ARent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS MIENSIONS OF GMDERS HEIGHT OF FOUNDATION THICKNESS {� SIZE OF FOOTING X MATERIAL OF CHJMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDJNG CONNECTED TO NATURAL GAS LINE <, North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) ' Signature(of Permit Applicant �3 Ar Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector a The Commonwealth of Massachusetts lug Department of Industrial Accidents Office of lnvsWgaftns . IBoston, Mass. 02111 WorkersCompensation Insurance AfidW blain• Please Print �� v► Locatlon: IS Cb 6� � Phone S I am a hwmwner performing all work myself. 0 am a sole proprietor and have no one working in any caps* I am an employer providng workers'compensation for my employees woridng on We job. C=ot name: Address coz Phone it Inuumme.Co. Poticv! CWWY name: Address CU Phone# Potkar! Fallurs to socias coverape•ra luined under Sedlon 26A or MOIL IN can lead to do impostlfon d ah.6 penaltlas of's fine up to$I.SW.W andlor ane ys 'imprison nerft.m.wd.m.del,peoabnln tw hm dA ST..CP MIDI ORDER.end.a.fkwd.(SIWAM a xhW apehet.maL I underatend that a copy d this stdano maybe forwarded to the Me of InvndgWm of the DIA far covarepa verNlcamm. I db hereby cw*w dbr the pdr*and penury tAaf the Nrlbnrrafbn provlW above Is bva and caned Signaturt� Da* 3 1/ S Pont name Phaw# Oftial use only do not write In this area to be completed by city or town drWW CRy or Town PermMAlcernlno ❑ Budding Dept []Check II Immediate respome la requked ❑ I./Ce m*V Board ❑ Selectmen's 0fte Contact Person: Ph"ave ❑ Health Department ❑ Other From Lauren Holmes to *829783739899 at 3/8/2005 2:32 PM 002/002 VILLAGE GREEN AT NORTH ANDOVER COPS DOMTN:L!ri - �?: * 686-4800 Office (i.3 f`' t[a.Titic,4 iJenue ,f3o-r,-36 1)7(Y_0X6-,I4kl I (Boston, Wassachusells 02110 P9arch I, 'tit)� l.aurcn Holnus 1� Kitir�ton `�trcr:t North Andov-tT,til'A 01R45 Dc Lir N-k. I Io11nes: Plea;c be advised that the Boari of 1'rUSteCS has fi Vic VCJ tic)ur rcqucst for permission tr inslull drywall ,ind 1w ulation in the basct cont arca of Your unit. The 11oard nl'Trustee:, has orantcd prt'titissiutl for you to du such. 5o lt}rt ati ritt has or Maler Iitles MIC Uut inter• li• VU ShOUld rcquirc additional infurrnalion-piease do riot he iliatc to call me at the oflicc- Sincerelti. I'21L1.1'CM fOY& Propervy Manager t-rnd�:.muiliS.:ia:t?t�ieei:.`)4-hasrrirnl JUN-7-2002 FRI 03: 19PM ID: PAGE:1 NORTH Town of t _ 4Andover o r No. dover, Mass., 07 d O S I� COCMICNEW.CK V %d AoRATE0 P"*" �5 7`S BOARD OF HEALTH Food/Kitchen PERMIT T Septic System 14OBUILDING INSPECTOR THIS CERTIFIES THAT....� ............ ........................s.......................... ............................................ Foundation has permission to erect... .... buildings on ..... ..... /. ................................................. Rough to be occupied as jref^......jm.aro. . ........ ��r .. Chimney ....................... ... . ................ ... .... . r ...................... provided that the person accepting this permit shall in every respect conform to the terms of the a plication on file in Final this office, and to the provisions of the Codes and By-Laws relati to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. a � PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permd. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPE(`TOR UNLESS CONSTRUCTION STARTS eRough Service B DING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location "A2 No. Date NOIlTh TOWN OF NORTH ANDOVER •. O • ; : Certificate of Occupancy $ Building/Frame Permit Fee $ l r U sACMuse Foundation Permit Fee $ Other Permit Fee $ ,/() TOTAL $ 0 Check # 1371 18 , 5 7 Building Inspector