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2-44—e
Date..................................
AORTH
0 ..... . TOWN OF NORTH ANDOVER
PERMIT' FOR WIRING
ibis certifies that ................. D/O 77
4��() ............. F
.........................
has permission to perform ..................... .....................................................
wiring in the building of ........... ......... P .....................
at ........................ P.2 ... &A.46 z* ....... �17 North Andover, Mass.
Fee..V7�f Lic. No. �W ....................... .....
ELECMCAL INSPECTO
Check #
6597..
I a I . I 1�1'
I d.
A
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official, Use 0 1
Pen -n it No. �, 5-? 7
Occupancy and Fee Checked
I [Rev. 9/051 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Cod��EQ, 527 CMR 12.00
(PLEASE PRJNT IN INK OR TYPE ALL INFORMATION) Date:
CityorTownof- IV04,-�.J 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) 2 -7 57—
Owner or Tenant 'PI46110 tfo4LD Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes �No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead Undgrd No. of Meters
New Service Amps Volts Overhead Undgrd No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Completion of the following ble 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
I
No. of Hot Tubs
Generators KVA
No. of Luminaires q
Above Ei In-
Swimming Pool grnd. grnd. R
IVo—. o-TE—mergency Lighting
Battery U nits
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
Total
No. of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals: I
Number
I'll'ons
I
No. of Self-05-n—tained
Detection/Alerting Devices
No. of Dishwashers
—
Space/Area Heating KW
Local [I Mun'cP�l El Other
Connection
No. of Dryers
Heating Appliances KW
Security ems*
Syst
vic
No. of De es or Equivalent
No. of Water
Heaters KW
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
T—elecommunications Wiring:
No. of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: �t: 2 -2 -Z) (— 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 covera is in force, and has exhibited proof of same to the permit issuing office.
Is
CHECK ONE: INSURANCE ��BOND F] OTHER F] (Specify:)
I certify, under the pains anladpenallies of perjury, that the information on 11 "* li 1i , t and complete.
p, ica ign is rue
FIRM NAME: LIC. NO.:
Licensee: 04w t> 44-e' ;,4 *Z Signature LIC. NO.:
(If applicable, enter "exempt " in the license number line.) Bus.Tel.No.:
Address: ef� Ait.Tel.No.:
*Security System Contractor License required for this work; if applicable, enter the license number here:
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 El owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE. $
D a t e
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that . . ............
has permission to perform .................
plumbing in the buildings of J-:?.
............. .................
at ....................................... North Andover, Mass.
Fee2IQF5-j?. . Lie. No./ -741 .. ............. I ........ &.t �
PLUMBING INSPECTOR
Check #
6944,
,a
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBIN
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Location � 7 lr#114d
Owners Name
Date 7 -V�
Pe
'� 27777 -
Type of Occupancy Ael mount
New Renovation ri Replacement Plans Subm. itted Yes 0 No
FIXTURES
(Print or type) Checkpne: Certificate
Installing Company Name_ k6 4 A I cc KP acorp. >11
Address ov es + q -'."e s 4- Partner.
Business Telephone �7k& k Firm/Co.
Naine of Licensed Plumber: AL—
Insurance Coverage: Indicate the typo"of insurance coverage by'checking77–approp-n!ate box:
Liability insurance policy FEY Other type of indemnity Bond
Insurance Waiver: 1, 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 Mass uset Plu
yp IM, . p;Q�gyode and Chapter 142 of the General Laws-
OVED (OFFICE USE ONLY
Type of Plumbing License
e) 9 k
LICCIISC NUMer -. Master
Ej----/Joumeyman 11
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