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HomeMy WebLinkAboutMiscellaneous - 20 KINGSTON STREET 4/30/2018}�fq;�.: �`-, i �3�^ ^�v �' a _� ""� P ,.�"1 Date ...... i.-. .?��� %.Z: . TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ..........0. ...........:f:......... yt%............. ...............a/li. has permission to perform .Sv,-st d� wiring in the building of ...4��. .!a � 4-/ e,� ........................................................ at ..................... .................. ,North Andover, Mass. c F'ee.s...�..�... Lic. No.L 7f�.�� .......... . ............... I.ECI'RICAL INSPE Check # '10629 'a �narrwnureaLth o f �a.�sac�eff� ��a� o�� series BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 'r Occupancy and Fee Checked ev. 1/071 eave 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 WINK OR TYPE ALL INFORMMON) Date: City or Town of: 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 & Owner or Tenant Owner's Address Is this permit in cc Purpose of Building'ii Aey-NN- i r. U I Utility Authorization No. Existing service Amps • / volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 03' f C_t "A- :a -'G�f Ove; head ❑ Un-dgrd Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Comaletion ofdw followine 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- ❑ 917nd. gmd. o. of Emergency Lignting Butte 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. TotalTons No. of Alerting Devices No. of Waste Disposers Heat Pnrap Tatais: Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area HeatingKW Local Connection ❑Other No. of Dryers Heating Appliances KW Sectio f Systems:* or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. -of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP elecommunications WirinL. Ivo t t Devices o, F t:ivalc� t OTHER: Attach additional detail 1 desired, or as required by the Inspector oj 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 :C] BOND ❑ . OTHER ❑ (Specify:) I certify, under the pains and penalties of erfury, that the information on this application is true and complde FIRM NAME: Crowe & Sons Electrical Cor LIC: No. L17 -168A Licensee: James B. Crowe Signature I LIC. NO: A (If applicable enter "exempt" in the license number line) Bus. Tel. No .• 453-6696 Address: 576 Middlesex Street, Lowell, a 01851 AIt.Te1.No.: -6696 *PerMCT- c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 001051 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. c Signatureg Telephone N==M PERMIT FEE. $5J a� a ti V— Aor h +✓�( Coo- w i q,- 1%, �7� TONM OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCTREP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1z BUILDING PERMIT NUMBER:-� DATE ISSUED: �0—/� .. A SIGNATURE: , • 1 1 i "-- I 0--' Building Commissioner/I r of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: wOi ,TOw I 1 r (� N. � k J 0 V e� Map Number arcel Number 1.4 Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided 1.7 Water Supply M.G I -C.40. 34) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: - Public ❑ Private ❑ zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record � s I L fi S e vA vl,� o�KA leo l/ �2 0 e/ "I I7-0,t— Name -0,t-Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: VEITP (0leto «w Licensed Construction Supervisor. 3,G— /C c� n Address t M Signature _ 4 " � /f W. /.1'' ` r 7 /� Vs- 552 � ,( Telephone Not Applicable ❑ C ©(-// License Number O / R/C5 7 Expiration Date 3.2 Registered Home Improvement Contractor k. I (COV &A le ar (m w S %"• Not Applicable ❑ iZ KF Name Regrstration Number / 40/1 Address 9 p Expiration Date Si store Telephone SECTION 4 - WORKERS COMPENSATION (NLG.L C 152 § 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 permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Re rl Ce tul eH.T f w ct 6 W SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant N UFFICIAti USE e 1. Building 3 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) �i 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OW NE S AGENT CONTRACTOR APPLIES FOR BURDING PERMIT I,fez4t-�as O r/Authorized Agent o ject properly Hereby authorize o act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 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 Signature of Owner/A ent Date IBM NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIvMERS 1ST2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i W Cd H� c a UJ zCL w a ci) U z o w m o w v X U a u. � a m o u: c u. O W w a W a w chi u. x a w G w' o rA z V) o U) H� c a UJ zCL • A Mel., O L �O 67 Z d O CO) C C O Om CO) O D _ MO) O O E m m CL ~ 3.0 O L o C . d CL cMQ c Ca Cc c C3 •C Z s CL C� V! � C _ C c CO3 J o� W W Ce W U) cc o C N O ' r=+ = O V V •dam dC e0 eo 1=0 c ; O 0 L 61 Ea o � C FA ES :,moo m :oma 43 $ C CD c E CL= � m3 s r... y cO H = : y O CLU m Me m ; "'`•g = C O C Ce W mor m Z V N OCm O ' O O C d C m : CLS W =O ��-_ S S .E at = rr Z W ���� O CO) a mL. ��ACo :S g �.c a*..mZIP • A Mel., O L �O 67 Z d O CO) C C O Om CO) O D _ MO) O O E m m CL ~ 3.0 O L o C . d CL cMQ c Ca Cc c C3 •C Z s CL C� V! � C _ C c CO3 J o� W W Ce W U) r Board of Building Regulations and Standards � � T HOME IMPROVEMENT CONTRACTOR Registration: 125049 Expiration: 10/1/2007 ` Type: DBA K.J. Cormier Construction Keith Cormier 35 Maplewood Ave i Methuen, MA 01844 Administrator ` `J sze -Caamamarzurea� a�✓!�%wv¢c%uae�6 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 081948 Birthdate: 08/18/1956 Expires:. 08/18/2007 Tr. no: 623.0 Restricted: 00 KEITH J CORMIER 35 MAPLEWOOD AVE METHUEN, MA 01844 s Commissioner PROPOSAL ' D 1g A. PROPOSAL SUBMITTED TO: WORK T ERFORMED AT: r ,� NAME ADDRES ADD ESS Z / Aq S Al 14 U DATE OF PLANS PHONE N0. �} ARCRtIECT 1. I f r DATE /I / O tV amms NU 3818-50 MADE IN USA a 'PROPOSAL Iw Location No.Date �6 _66 Nom.._ TOWN OF NORTH ANDOVER Check # 6 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL $ n� 18662 'Building Inspect6