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HomeMy WebLinkAboutMiscellaneous - 168 Kingston Street 168 KINGSTON STREET 210/023.0-0006-0168.Z N° ?� � 7 3 Date..."......f"©1:....... NORTH TOWN OF NORTH ANDOVER. PERMIT FOR WIRING SACHUS� ! _ Thiscertifies that ...................................... .................... haspermission to performr. . ..:_z,....r..... ......................................... wiringin the building of...................... - ".'............................................... at rG .......sf .1,, 17�i� ......................... .North Andover,Mass. Fee,/.'.)....-. ....... Lic.No/:4J.��.... .......> ..... ' :...:.................... ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer From ANDOVER ELECTRIC SERVICES INC. PHONE No. 978 475 1192 Jan.04 2000 1:07PPM P01 i -213d :' .?J '?x?Y,aCa�a'>?n...:.:.. \ `.2�'R0.cb$N'd h ummanweait� of l�I s�cr . ZQ �l15P „ t"ski 'a;tlie.>``. M «,.. Rt! Ai tlritlll >3f Public yN'a ! V. & �%Y I� tC L°Atffu 3 h�LZ� i:'' ' `w BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12.00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMA 12:00 (PLEASE PRINT' IN INK OR TYPE ALL (NFORMATIOV) pate ' 12/17/99 City or Town of____11,- Andover To the Inspector of Wires: The, uderslgned applies for a permit to perform the electrical work described below, Looatlon (Street.$ Number) 1 b8 Kingston Street Owner or Tenant Mike Cluvesy _ Owner's Address Same Is this permit In conjunction with a building permit: Yes © No ❑ (Check Appropriate Dox) Purpose of Building r esidenvu Utifily Authorization No. Existing Service„ Amps__/ Volts Overhead Undgrnd No. of Meters New Service __ Amps____1 Volts Overhead ❑ Undgrnd Q No. of Meters Number of Feeders and Ampacity _ Location and Nature of Proposed Electrical Work _ _ y ...... No,of Lighting Gullets No.Of Hot Tubs No.o1 Transformers 101st _ KVA No:of Lighting r-Imutes 25 Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No.'of Racapiacla Outlets of Emergoney UghtinOutlets0 No.of Oil burners^ battery units .No..of Switch Outlets No.of Gas Burners FIRE ALARMS No.of Zones NO.of Ranges No.of Air Cond, T0181 •F No.of Detection ono tons Initiating Devices No.of Disposals No of Moot Total Total Pumps Tons KW No.of Sounainy Dovioos No.of Belt Conratneo No.of Dlshwaeh.rs Goats/Area t Iealiny KW Y_ betectionrSounoino uevices **No.of Dryers Heating Devices KW Local Fj Municipal ❑011ier u Connection No. of No.of T� _ Low Voltage JNo.of Water Heater KIM Signs Ballasts Wiring No.Hydro Massage Tltbs No.01 Motors Total HP OTHER: remove and replace exifating panel INSURANCE COVERAGE: Pursuant 10 the requirements of Massachusetts general Laws-� �� I have 9 current Liability insurance Policy including Completed OperfftionS Coverage or its suoSlanual 4gluivfitonl. YES Ci NO ❑ 1 have submitted valid proof of tomo to the Omce.YES ❑ NO t`I If you havo.cnecxeo YES,please indicate ilia typo of coverage by Checking the appropriate box. INSURANCE IN DOND d OTHER 0 (Please Specify) Estimated Value of Electrical work S 3900.00 (Expiration Date) Work to start—. 12/9/99 inspection Date Requested: Rough a i l l call Firtel Signed uhdor the Penaliles of perjury: FIRM NAME Andover Electric Services tic.No._14302A ueensee kbertJ . Branca L� - -l-r1LKl ` LIC. NO. 206 Andover S Gt3t' Due. Tel,No. 978 475-4995 Address � �ndOver.1 ,,� QL�� All. Tel. No. — OWNERS INSURANCE WAIVEA:1 pm aware thrrt lhu l.icunsoe does not have ilio insuranco coverago or its euostontlei equivalent as re- quirod by MaseaChusolts Ganeral Laws, and that my siguHturt, Un this permit appocnison w;flvps this rppuiremem, Owner AflOnl (PIe880 01100k one) ...... TstAnnnne No. . 1't:TiMn f Ff_ S P1 S• a dv i Be fFinnnurrn lir rlwnAr n, nnn<.n ' Location S/0",, S No. -� / Date NORTH TOWN OF NORTH ANDOVER Of'•• o :�1�0 * ; ; Certificate of Occupancy $ �'�s'•"° Eco Building/Frame Permit Fee $ �S J�cHus Foundation Permit Fee $ Other Permit Fee $ ~_ TOTAL Check # �` Building Inspector P;FLRMIT NO. 14rfV3 APPLICATION FOR PERMIT TO BUILD********NORTH ANDOVER, IIIA / AIAP NO. �3 LOTNO. 2. RECORDOFO\N-NERSIIIP DATE BOOK PAGE ZONE SUB DIV. LOT NO. LOCATION IQ PURPOSE OF BU1LllINC �1 /• // fi�yj i?tom /✓ , qp, O\\'NER'S NA'NIE J � � NO.OF STORIES SIZE, OWNER'SADDRESS �{� BASENI ENT OR SLAB ST ARCIIrrECT'S NAME ", SIZE OF FLOOR TIMBERS" ] 2ND 3RD BUILDER'S NAME c ,' SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS i DISTANCE FROM STREET DIMENSIONS OF POSTS DISTANCE FROM LOT LINES-SIDES REAR DIMENSIONS-OF GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS 1S BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION BIATERLILOFC11IAlNEY IS BUILDING ALTERATION IS BUILDING ON SOLID Olt FILLED LAND WILL BUILDING CONFORM!TO REQUIREMENTS OF CODE IS BUILDING CONNECTE TO TOUT{WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEIVER i IS BUILDING CONNECTER TO NATURAL GAS LINE INSTUCTIONS 3. PROPERTY INFORIIIATION LAND COST EST.BLDG.COST PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM ELECTRICOIETF.RS 111UsT BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. on ATTACIIE4 GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 4. APPIIOVED BY: PLANS MUST 13E FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR DATE FILED OWNERS TELH CONTR.TELH 37d-5-797 �� / T (!✓ CON'FR.LICN z IV SIGNATURE OF-OWOR AUTHORIZEDAUTHORIZED AGENT t FEE 6 IV I PERMIT GRANTED 1.7- 'D 19 Revised 5/5/99 JM i . �.. �le �niza�izonurP.alCf a�'..`Z�tiz�;lacfute�a .•:''. DEPARTMENT OF PUBLIC SAFETY 4M `. � CONSTRUCTION SUPERVISOR LICENSE w i Number: Expires: Birthdate:;M CS 966462 01)0512000 011051970 Restricted To: 00 DAVID J CUNNINGHAM t' ;1 1022 AMESBURY RD '+ HAVERHILL, MA 01830 I fv • .oho\ �• w, The Commonwealth of Massachusetts s Department of lndustrial.Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affi davit Flame Please Print Name C J�C� n naloe,w111 13 Location: ( a,Y, St Gini C :cel / j S Phone y � J�� J—) Cf F7 I am a homeown r performing all work myself. ( � I am a sole proprietor and have no one working in any capacity F7I am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address City: Phone T: Insurance Co. Policv Comoanv name: Address CiN: Phone# Insurance Co. Policv Y Failure to secure ceverace as reouwred under Section 25A or iiiGL 152 can lead to the impes;rion cr criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as'Nell as civil penalties in the form(af a STCP'NCRK ORDER and a Fine of($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Invesrgaticns cf the DIA for coverage verification. 1 do hereby certi l under the gains and penalties or pe,jury that the infcrmaticn provided accve,s true and correct. /1• `i Signature Date.J �—� _ 1 '� Print name 1t�i.i' Phone# 5 )50 Official use only do not write in this area to be completed by cry cr,cwn cfTicai' City or Town Permit/Lcensinc Building Dept QCheck d immediate response is required ❑ Licensing Board Cj Selectman's Office Contact Berson: Phcre"I- Health Department Other BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: Location of Facility 1gnature of Pejit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector r f. f NORTFt Town ow : Andover 0 No. 3 - X= -- LA0 dower, Mass., COC HICHEWICK V ' ORATED P? C2 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System kt, C /0 too BUILDING INSPECTOR THIS CERTIFIES THAT........Al ............. . .. ......................................... .......................................... ......... Foundation ....................... has permission to erect...r . ............ buildings on .......� .. �. .�.�..... ~ � .... Rough ............. .... ........... to be occupied as #y f i I f/ r O F NR. sChimney / .. 4A V. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final .this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STC Rough emo� ............ �... .....................................:................................. Service ' �• BUILDING 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. Date. . . . . . . . . . �� '� 2 ".`R':1tio TOWN OF NORTH ANDOVER t�a . 0 SLOW p PERMIT FOR PLUMBING zz! ull �7 This certifies that/ "� -, . . . .. .1.... '•'- '" �` . . . • . . . . . has permission to perform • . • . .. plumbing in the buildings of .`._. . . . . . . . . . . . at . AA . V • • •!,!, North Andover, Mass. FeO. . . . . . .Lic. o.. . . . . . . . . ,.:':�" . . "/7"Y% . . . . . . . PLUMBING,FNSP,E'CTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERM TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS /-,?/ Date Building Location � -���'�i fla h S,/Owners Name vrf 7 Permit# Amount Type of Occupancy New El Renovation Replacement r-1 Plans Submitted Yes E] No FIXTURES "' w acs; F Lr ►-, CC d �' a >+ d rn tz w w a a P. A acc SCBM R4SD r Isr H M MD HOCR 3M H OCR FLOCK 5M MOM 6IH HlJQt 711i HIoali siHF�a (Print or type) Check one: Certificate Installing Company Name ��c iii C'e..'"i a?- _ Corp. Address _` /�_� �0e ty d s� �j Partner. Business Telephone Firm/Co. Name of Licensed Plumber �,! j �� �T�ty, u OR Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: j Liability insurance policy Other type of indemnity ❑ Bond ❑ -4 Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance - Signature Owner Agent I hereby certify that all 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By: bignavare of 17censeaum er Type of Plumbing License Title' '7 City/Town icense um-Ser-'�'-- Master ❑ Journeyman r/ / APPROVED(OFFICE USE ONLY