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TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that A..0.7
has permission to perform ........................................
wiring in the building of ....... ..... ...................................
at.S�Ue ...... ........ i ..................... . North Andover, Mass
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Fee .............
....... Lic. Na�.!�.. ................... ..
ELEcrRicAL INSPE6UR
Check #
655z
Commonwealth of Massachusetts official use only
Department of Fire Services,, Permit No.
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIO [Rev. 9/051 (leave blank)
APPLICATION FOR PERMIT TO PE ORM ELECTRICAL WORK
All work to he performed in accordance with the Massachusetts Electrical Code (ivIEC). 527 C NI 12.90
(PLEASE PRLVT ItV IIVK OR TYPE ALL 1AFOR 4TIO/V) 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 & Number) s>)/4e, �� Z.-
Owner or Tenant
Owner's Address
Telephone No.F-XPV-b0d-
Is this permit in conjunction with a building permit? Yes ❑ No � (Check Appropriate Box)
Purpose of Building
Existing Service Amps / Volts
New Service Amps / Volts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Utility Authorization No.
Overhead ❑ Undgrd ❑ No. of Meters
Overhead ❑ Undgrd ❑ No. of Meters
Sys r
Completion of the followin.Q table may be waived by the Insnectnr of Wirvc
No. of Recessed Luminaires
;No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Luminaire Outlets
INo. of Hot Tubs
Generators KVA
No. of Luminaires
Above In-
Swimming Pool arnd. ❑ und. ❑
o. o Emergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
of Detection and
No. Initiatin Devices
No. of Ranges
�No. of air Cond. TonsTota
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Number
. .......................................................
Tons
KW
No. of Self-Contained
Totals:
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating A Dances
b PP KW
Security Systems:" i
No. of Devices or Equivalent
No. of Water
KW
No. of No. of
Data Wiring:
Heaters
Signs Ballasts
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or E uivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value f EI ctr'ca] Work:9 (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
INSURANCE OVE AGE: 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 anti penalties of perjury, that the information on this application is true and complete.
FIRM NAME: ADT Security Services. Inc. LIC. NO.: 1533 C
Licensee: C ,2 � 0d,
I Signature LIC. NO.: 3 �(� �� L'
(If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 60 3-594-5900
Address: 18 Clinton Drive Hollis N.H. 03049 Alt. Tel. No.: 603-594-5930
"Security System Contractor License required for this work; if applicable, enter the license number here: Q 0 1 q.7. 1
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 .
;�'
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
n-\ (Print or Type)
NORTH ANDOVER Mass. Date 7/29 19 97 Permit # 3 3
IN
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Building Location 216 Foster St. Bauear
g 's Name
Type of Occupancy Residential
New ❑ Renovation ❑ Replacement N Plans Submitted: Yes ❑ No ❑
FIXTURES
Installing Company Name Heritage Htg . &Plg. Co. Inc. Check one: Certificate
Address35 Pleasant Street LX Corporation 714
Stoneham, Ma 02180 (] Partnership
Business Telephone 617-438-7776 () Firm/Co.
Name of Licensed Plumber Gordon Switzer
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalentwhich, meets the requirernents Of MGL Of -I. 142.
Yes ® No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy 0 Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
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 the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbing Code Nd Chapter 142 oft General Laws.
By
Title Signature of Licensed Plumber
Type of License: Master [X Journeyman ❑
City/Town 8322
APPROVED OFFICE�ISE ONLY) License Number
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Installing Company Name Heritage Htg . &Plg. Co. Inc. Check one: Certificate
Address35 Pleasant Street LX Corporation 714
Stoneham, Ma 02180 (] Partnership
Business Telephone 617-438-7776 () Firm/Co.
Name of Licensed Plumber Gordon Switzer
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalentwhich, meets the requirernents Of MGL Of -I. 142.
Yes ® No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy 0 Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
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 the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbing Code Nd Chapter 142 oft General Laws.
By
Title Signature of Licensed Plumber
Type of License: Master [X Journeyman ❑
City/Town 8322
APPROVED OFFICE�ISE ONLY) License Number
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Date
343A.
TOWN OF NORTH ANDOVER
—PERMIT FOR PLUMBING
This certifies that . /,.". , . . 6'e
has permission to perform
I plumbing in the buildings of . AA�e;W? .....................
Z
at. .0. .... North Andover, Mass.
- nNP ............
Few. ?,.7 .... Lic. No.e?��.� ... .. ...
PLUMBING ECTOR
08/08/97 12:07 27.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer