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Date.................U.:. ...
HoarM
TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
,SSACMUS�
Thiscertifies that ........ .._..r...... .- - -e..... .......................................
This certifies that ........(�
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has permission to perform - ..r. .-..........................................
wiring in the-building of. .� ..�.... .. - ........................................
at...`. .... .................................... .North Andover,Mass.
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ELECTRICAL INSPECTOR
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Check #
DEAARIM1 WOF)'EN C MFFITY Pontis No. C�3
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Occupancy Fen Checked
APPLICATION FOR PERMIT TO PERFORM ELEcnuCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE Wn'H THE MASSACHUSSTS ELE(MICAL CODE,527 CMR 12:00 n�
(PLEASE PRINT IN INK OR TYPE ALL 0MRMATION) p (/
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number)
Owner or Tenant Iv S
Owner's Address
is this permit in conjunction with a building permit: Yes Q No heck Appropriate Boa)
Purpose of Building 1 ars— l- Utility Authorization No.
Existing Service Ampa�...L.V olts Overhead Underground M No.of Meter _
New Service Amps Volts Overhead Underground C No.of Meter _I
Number of Feeder and Ampacity
Location and Nam of Proposed Electrical Work e
Na of 50ting Outlets No.of Hot Tuba No.of Trandmoer Tout
KVA
Na of Lighting Flumes Swiruming Poor Above BebwOrntmaun KVA
wound rl
No.of Receptacle Oudsts No.of OU Burner No.of Emergency Lighting Battery Unita
r Na of Switeh Oudeta
No.of Ore Burners
No.of Rangy No.of Air Coad. Told FIRE ALARMS No.of law
Tone
s No.of Disposals No.of Hat Tout Total Na of Detection and
Pumps Ton KW INdWog Devices
No.of Dishwashers Space Ara Heathy KW Na of SOWWWg Devices
Na of Self C ntsined
DetectionlSoonrilrig
No.of Dryer Heating Devices Kw Local D Mmddpc4
el a
Connections
No.of Water Heaton KW Na of No,of
Sipe Beilssis
No.Hydro Marge Tabs Na of Motors Total HP
OTHER.
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Telephone No, PMWr FEE �
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DEPARMYrOPMEWW Permit Na 4�63
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APPLICATTONFOR PERIVIlT'T�0 PERFORMELECTRICAL WO
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(PLEASE PRDVT IN I1VK OR TYPE ALL INFORMATION) D .J
Town of North Andover To the Inspector of Wires:
The undertipned applies for a permit to perform the electrical work described below.
Location(Street 3 Number)
Owner or Tenant IV S ' ' ``
Owner's Address
Is this permit in conjunction with a building permit: YesC3 No k Appropriate Boa)
Purpose of Building Zdeew— e- Utility Authorization No.
Existing$emCe � .. Ampps....� Volts Overhead Underground No.of Meters _
New S Ampr� Volts Ovediead Underpound C No.of Metes
Number of Feeders and Ampacity --
Location and Nature of Proposed Electrical Work .Z° Iky-
Na of UjWna oudsu Na ofHot Tube Na OfTaosbrmaa TOW
KVA
Na of usbtins R u= 9wh mina Pod" Above Belowt3tererateea KVA
Na of Receptaelo oudw No.of OB Btteoma Na of Eroegeoey usnms Banery uniu
Na of Switch Outlen
No.of dr Btttttrss
No.of Rands Na of Air Cm& TOW FMZ ALARM Na of Zones
TOW
No.of Dispoub Na of Hsa TOW TOW Na of Ddwdm and
rGum Ton KW tnide ft Devices
No.of Dishwuhmo Space Mea HsUns KW Na of Sono ft Dodoes
Na of Self Cawbud
oftw
Na at Dryers Hoeft Devioea KW Lord C]Mtuddpd C3p-
Cannecdom
No.of Wow Heaters KW Na of Na Of
S Bdlai
Nm Hydro Mousse Tubs of Mom TOW HP
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(Please check one) Owner Q Apo �
Telephone No. Fi�E
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ate. . ... .. . .
NORTH
o= TOWN OF NORTH ANDOVER
F D
PERMIT FOR GAS INSTALLATION
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This certifies that . �e�� ��!'��.�. . . . . . . . . . . . . . . . .
has permission for gas installation . . . 4.!'`H�? . . . . . . . . . .
in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . .Y. . ./?,.A9A/t k. . . . . . . . . . . . . . North Andover, Mass.
Fee.3v.- . . . Lic. . . . . . . . .t �,� ,.�... . . . . . .
�AS INSPECTOR
Check# 2&114
5216
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'' MASSACt�USETTS `UNIFORM APPLI - iQN F R pERMiT TO DC? GAS 1TTii G
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Owner s,:Name11
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6TH FLO.OR
7.Tit t LO.OR
8TH FLOOR
Insta1.liing Company Name G 1 L�} Check one: Ceriiticate
Addreil�ss: t' �' L
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ori
oration
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❑ Partnership ,.:
l�ustness Telep%hone c� (,� � - i p Fir /Co
Name of L#cense1.d P#urnber or Gas°Fitter 59 I zx�L -
INSURANCE COVE#;;AGE,
t have ti:curie`11, ` ilii #nsurance: vice or ifs subs#ant a
�U�b .Y P y_-: 1 i equivalent which meets the requiremen#s of, - Ch .142
Yes_=L1 No 0
li. ou.
y1. have checked yes pie_ase Indicate the tyae coverage bj►checking th1.e appropt#a#e_bow
A ilabtttty Insurance pocky ( ''--` Other#ype of Indemnity O Bond tD
QWNER S itDSURANGE WAiVEf# "# am aware that ihe'Ilcer#see doss not have the insurance coverage requ#rej.d by
Chapter 142 ot'tfie Mass General taws, and that my signstue on t>.1s permit appitcatloi;waives chis:requirement
::
Check.,ane
Si
nature of '
-F7 owner❑ Agent=C7
9 ONner of Owners Agent
t hereby certify that alI of the details and M#otmation!have submitted lot enteredf#n above.appitca{ion ora true'anil atxuraiii{o tha best of rn
knowledge and That sit lumbin y
P g work and instal#attons poi ormed uniier:ihe arctic(Issued<lor chis appllcattoR whit be to cornpitance:with ar'.
per{lnent provtsriins of 3heMassachusgtts State Gas Cade and plop{1.et.t42:ot the-C3en atyvs
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., � , - ,-T` a of Ucense
Title ('(umber i u e o c nse;_ um e- or Gas Qter__
I . . .1-,''''I,..... , � , as{fitter -L _. ' _'__ . -� , �. , 1. - -:�� . ., -,.,__.::�, .;.,.�, �
City/Towri aster Cleanse#Dumber {
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