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TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies thatJ ......... _g"—
... ................................................
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has permission for gas installation .......
in the buildings of .... ... . .......................................................... ................
. ..... ..... ..... .... .... ..... .
at ............. L...AV6 ......... �.A ...................... . North Andover, Mass.
Fee4nr . ..... Lic. No-.!RJ�� ..... M.(� . ............................. ; .........................
GASINSPECTOR
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Date....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........ &.j T .... 54��4��e/.77,y .... 57ex*zas .......
has permission to perform .... 77Y .. /. ........
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wiring in the building of ............. .......................................
...............
at ............... ............ . North Andover, Mass.
Lic. No..1.09Y,0 .......................... . . . ............... .......
ELE icAL INspEcTo
Check #
7660
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BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No. -7
Occupancy and Fee Checked
I[Rev- 1/071 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL -WORK___._J
MS tri
All work to be perfonned in accordance with the Massachuse Elec calCode(MEC),527CIVIR12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMA TION) Date:
City or Town of:
4&Z-2) e dMAL 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) t -� r-- I- & t 5 C_/
Owner or Tenant le�-_ ?Z2 /.),7 L-6 Telephone No..
Qwner's Address ZF
Is this permit in conjunction with a building'permit?
Yes N o L:�\J (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Over.he2d,7 L'.dgrd No. f.Met.1rs
New 3ervice Amps Volts Overhead Undard No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
No. of Recessed Luminaires
No. of Luminaire Outlets
No. of Luminaires
No. of Recept2cle outlets
No. of Switches
No. of Ranges
No. of Waste Disposers
No. 0 Dishwashers
:ru _._11 A -a- L � 0__� I 11n, a ; Is e_ (2� U
Completion o.f the
No. of Ceil.-Susp. (Paddle) Fans
No. of Hot Tubs
C7 I- r-1 (1-I I -J Lai-ry)
-N 1 1 C_
to . ble m�Z be waived by the '___ - _ _r of Wires.
i ransiormers KVA
Generators KVA
ISwimming Pool gove [] in- 040. 01 bmerge-n-cy-ri-g-ffri—n-
rnd, Yrn d. Battery Units
L
N01. of Oil Burners FIRE ALARMS JNo]f �Zones
No. of Gas B irners 0
No. of Air Cond. otal Initiatin,, Devices
Tons No. of Alerting Devices
0.0 e I f- C o n t a i -n -c -d —
Detection/Alerting Devices
Space/Area Heating KW Local unjcip�l
C nLrtinn D Other
INO. of Dryers H -ting Appliances KW urity. S st
r
He�zters KW 0. 0.0 2 a It -frig:
Si ris 82112St'-Z No. of Dev
No. Hydromassage Bathtubs No. f Motors Total HP e ecommuni
�ER: ;2, of Dev
TH
iv2dent
or Equivnlpnt
i n s FM. n _.g:
or EQuivalent
6--.5-. 4ttach 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: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
INSURANC COVERAG : Unless waived by the owner, no pen -nit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substandal equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing 'Office.
CHECK ONE: INSURANCE 2g BOND [3 OTHER 0 (Specify:)
I cert��, Lzn4(er the pains andpenalties ofperfury,
FIRM NAME: _T "Se -C -Ur( t1lat t1le information On this aPplicafiOn is true and complete, 5_3 3
r Ce,- LIC. NO.:
L
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Licensee:
45 Signatur LIC. NO.:
N opplicable, ent
er e-re,7?Pt in the license num line.)
Address: 19 L I IJ -FM !9 e _'� � ; -s �0,301�?� Bus. Tel. No_�
-Per M.G.L. c. ... I .. 47, d(_� H '00 (� ? AIL Tel. No.:
s. 57-6 1, security work requires Department of Public Safety -S" License: Lic. No. C
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)EI owner [] ,
owt
owner/Agent owne 's aycre
Signature
Telephone No. PEBjWT FEE. S
COMMONWEALTH OF MASSACHUSE�TTS
OF ELECTRICIANS
REGISTERED SYSTEM TECHNICI N
ISSUES THIS UCENSE TO
ARTHUR W PIERCE
I UPHAM ST
SALEM. MA 01970-2516
1024 D 07/31/10
320257
13M
Ion,
DEPARTMENT OF PUEltiC SAFZTv
Lisense.: SEC SYS CERT. CLEARANQ�'
Number: SS CC C160517
birtimidate: 08/30/1945'
Expires: 08/30/2008 Tr. no: 97.0
Restricted: 00
ARTHUR W PIERCE
1 UPHAM ST
-SALEM,
-MA
01970 z�_
Commissioner