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Date ...... 7.1-3VI
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .... C.R.0
has permission to perform . e:'.jT .......
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wiring in the building of ...... 1Vd ...... 4 ..... ht ...... . .............
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Fee.7 J.d.. Lic. No-fl,71 .. ........ ... ... ....... c� ?. ... .. ............
ELE IC NS CMR
Check#
4424
The Commonwealth of Massachusetts Office Use Only
GAESM
Permit No.
Department of Public Safety
Occupancy & Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date March 19, 2003
N. Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) One.High Street
Owner or Tenant North Andover Mills
Owner's Address Yale 900 Chelmsford Street, Lowell (978)453-6666
Is this permit in conjunction with a building permit:
Purpose of Building Commercial
Existing Service Amps e
New Service Amps
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work _
Yes ❑
Volts
Volts
No (Check Appropriate Box)
Utility Authorization No.
Overhead ❑ Undgrd ❑ No. of Meters
Overhead ❑ Undgrd ❑ No. of Meters
Installation of wallpack on Water Street right
side
No. of Lighting Outlets
No. of Hot Tubs
Total
No. of Transformers KVA
No. of Lighting Fixtures
Above In -
Swimming Pool grnd. ❑ grnd. ❑
Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No. of Gas burners
FIRE ALARMS No. of Zones
No. of Detection and
Total
No. of Ranges
No. of Air Cond. tons
Initiating Devices
Heat Total Total
No. of Disposals
No. of pumps Tons KW
No. of Sounding Devices
No. of Self Contained
r
No. of Dishwashers
Space/Area Heating KW
Detection/Sounding Devices
Municipal
Local ❑ Connection ❑Other
No. of Dryers
Heating Devices KW
No. of No. of
Low Voltage
No. of Water Heaters KW
signs Ballasts
Wiring
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
1 have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ® aN,O ❑
I have submitted valid proof of same to this office. YES ® NO 11.RECEI RECEIVED
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE [R BOND ❑ OTHER ❑ (Please Specify)
Estimated Value of Electrical Work $
Work to Start
Signed under the penalties of perjury:
FIRM NAME CROWE & SONS
Inspection Date Required: Rough
LIT G'rTAT(`AT. (1r)PT)
Licensee JAMES B. CROWE Signature
MAK 2 .(ExpZr@1' Date)
1C a:J3
LIC. NO. 1716 8A
LIC. NO.1716 8A
8)453-6676--
Address 543 MIDDLESEX STREET, LOWELL, MA 01851 Alt. Tel. No. (978)251—t95
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial 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.
(Sianature of Owner or Aqent)
PERMIT FEE $ 75. 0 0