HomeMy WebLinkAboutMiscellaneous - 116 Kingston Street 116 KINGSTON STREET �- - - - --- - ---210/023.0-0006-0116.W
- The Commonwealth of Massachusetts C14e u't
Department of Public Safety r••relt Vin. 65
Oc<„1.. C., S ree Cheeked
BOARD OF FIRE PREVENTION REGULATIONS S27 CtdR 1200 3/90 tt,, a 01anM)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
NI Work to be performed In accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /2-.22 -97
City or Town of 4Iyoct/E�tlff To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street 6 Number) //G K/aG57-dAl S77eC67"
Otrer or Tenant ly7?weGoT L- 7PAG4/44UL0
Owner's Address SAME [478) 577J--,PVFS,
Is this permit in conjunction with a building permit: Yes ❑ No X❑ (Check Appropriate Box)
Purpose of Building Utility Authorization 110.
Exisring Service Amps / Volts Overhead ❑ Undyrd❑ Nr„ of Meters _
New Service Amps / Volts Overhead ❑ Undgrd❑ Ito. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work Installation Of Alarm System
No. of Lighting Outlets No. of Hot Tubs ' No. of Transformers Total
KVA
No. of Lighting Fixtures SwimmingAbove In-
Pool grnd. ❑ grnd. ElGenerators KVA
No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting
t Batter Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
No. of Ranges No. of Air Cond. Total No. of Detection and
tons Initiating Devices
No. of Disposals No. of pte�ats Total Total No. of Sounding Devices
Tons KW
No, of Dishwashers Space/Area Heating KW No. of Self Contained
Detection/Sounding Devices
No. of Dryers Heating Devices KW Local❑ Municipal ❑Other
Connection
No. of Water Heaters KW No, of No. o w Volta
Signs Ballasts r gkne AZA,c n
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES❑ NO ❑ I have submitted valid proof of same to this office. YES❑ NO ❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify)
Expiration Date
Estimated Value of Electrical Work S-36,0
Work to Start /.2-eP2-97 Inspection Date Requested: Rough Final /2-29-97
Signed under the penalties of perjury:
FIRM NAME A.D.T. SECCURITV SYSTEMS NORTHEAST INC. LIC. NO. 1231C
Licensee DONALD A BROOKS Signat a NO. 12 31 C
Address 60 William Street, Wellesley, rA I Iffes. Ul. No. 413-132-4400
Alt. Tel. No.617-431-5831
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
Telephone No. PERMIT FEE S
Signature of Owner or Agent �=��
4 1 3 6 3 Date..... o�. ... ....... .....
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°�<<``°;•�"° TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
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This certifies that .. i......!..//./.......JCC............ .......... 5.............. ;
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has permission to perform ......../T a W.. S s�
..........
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wiring in the building of.......�.s~�.� ..................... .. ......................................
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at......1.16 ..J..... ..`.�j.`,�1.. ......5 ........................ .North Andover,Mass.
Fee...:n.... lN.... Lic.No..p�/�'...............
ELECTRICAL INSPECTOR
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WHITE:Applicant CANARY: Building Dept. PINK:Treasurer