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210/025.0-0016-0005.6
33 9 Date..................................
4 Til
4% TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
-Art o
CHUS
4
This certifies that I,-
......................................................... ... .......... ..........
has permission to perform ...........:<.:... ............I.....................................
wiring in the building of
...........................................
at ........................... ......... ......................... .North Andover,Mass.
Fee ......... Lic.No�zz . ..........
.. ..... .......
-iLE-crRICAL.INSPECTOR.................
Check #
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
_ orrcmortweaCf� o�//Ia�7ctcrtrr elft Ofiici::l Use Only
•� �a�arfncenf o�}ire �eruicz�
BOARD OF FIRE PREVENTION REGULATION Occupancy and ree Cites:..o,'
S (leave olank)
APPLICATION FOR PLERI<1lIT TO PERFORIN ELECTRICAL W
nil work to he prlorn cu in accordance w'l" the:Massachusetts Electrical17
'-'Cock I WORK
(PLEAISE PRINT IN INK OR TYPE ALL hW'01?bL I?ION) lla tc: 1' Cr�tR I_.00
�y�loi
City or Town of: 4�C
To the brspector of GY'ires:
By this application the undersi;ned-Ives notice of Iles or her ince,2tiou to perform the e!ecrrical work described below.
Location (Street t ulltl)er) S tq CC
Owner or TenantlU"T7�
Telephone No.
Owner's Address
Is this permit in conjunctio with a building permit' Yes
e ��.� No (Gh !::\
eeppropriate Box)Purpose of Building �J(/ Utility Authorization No.
Existing Service \taps i Volts O erlre nd Und-rd
No. oC,�Ictcrs
New Scrc ice Amps 1 Volts Overilcad ❑ UndQrd
o No. of:lletcrs.
Number of Feeders and Anipacity
Location and Nature of Proposed Electrical 1-York: !
I
Coarnietiorr vrrlre;o!!ur:r:e rcr�le near•be ucired oc(11C lrrs.cc;ororiVir_-t
No. of Recessed Fixtures No. of Ccil.-Susi).Waddle) Falls r No. oC tot--1 I
Gansformers RV_\
No. of Lighting Outlets No. of Ilot Tubs
Generators KVA I
'Noof Lighting Fixtures Above ( U
t o. of inergencyISsimntia Pool
I rgutcns
arra Batter-;Units
No.of Receptacle Outlet; No.of Oil Burners
FIRE ALARMS INo. of'Zoncs
No.bfSlvitchNo.of Gas Burners of
es �i`o. Dctection and
No.of Rang I ilii1tinQDc�)c^s
�_s No.of Air Coad. Total
' Tons 'No• of Alerting Devices 1
flcatPuuip c`{umber I'or,s i�V No. ofSelf-Contained
I:\'o. oC Waste Disposers r _.._................. -_-.. --
Totals: I I lDetectiocl/Aiertinq Devices
Dishvrashers _
ISpacci:lrea Heatin; KW Local ttiicipai
--- Connection U Other
1No. of Dryers IHeatina.Appliances h :; ISezu:-:% vs-ems:
1 No of'Devices or F.cr
u •:!e1rr
c. �t Nater ItVo. nt No. of
Heotersfiring:
Si-a Ballasts 1 Nn.of Dzvicc a- ��ui• ie:;c
`j,o. Hydre;t:,.^,ssage I3at!rtubs �.,�. of ;,inions Total I'iy
,c,;uniumcn(ions W*irinc-
Nn. of Devices or Eeui>a[ent
!OTHER:
irtsci; ^.curia c __.... erre r or--s rc
IN"SUR.A-tiCE COVEIZ.AGE: n;ess xai•.cd by the iio :.
t[te licensee r r;lance won.. :ss:._ ,.,eSr
crovid_s croo: of . cbi. nsurarcc tnc!udir,_ "ccr,.p ,e ;^� _::cr: coverar>P or as
undersi?ncd certifies that r
SlIC1 Covera' is :n orCe, and has e-hj'-tr?d proofot jC.,, i0 (l;
` y
CiLFCI<ONE. [`:Si.:R.'�.�:"C � �Q`i� �I OfiiER ❑ (Snecif•::)
Estimated 'value of cclr;cc! Work: ('When recuirec b; ..Iu:;icipal polis;.) r _)
`.Nor'.: to Siart: L;isocclicns to be , aueste i: _ corda::ce ;!, Ms !_
r� .i ;� ...'.. Ll.. �u .. O, 1::C .1VCi i1 _�T
..,..viz.:.
Certify, urrdrr r!re fxTias rrrul n< za!ries u''nerlrrrr!rur,ire irrjonnrt;or: It :Iris rnulicativn is frrr aar!cornv(cre.
Ir 1I E.: �! i r1�-S f-iD rotLIC N O.:�✓�y�i
Licensee: C11� Cit1{,Ll St�natur^ PS
LIC. NO_ COI i
&:e. CWC:" .tinh7l •fit:i;c 1i�21r��llrrnrbdr�t1r C.j
Address: t55 \1}051 S{ Sit 1C n NN
Uus.TC1. No.:':j-7 x �!�57-04 q,3
OWNER'S I;�SC [::\tiCE \` ct har ul��')
Alt. Te o.:�1r-[f3 I,
AI VE 1Z: al;,agars the Licets:2 does rto :e.� the itabilit ,n ! } 1?- -ti7.1�
ns cos era,e orn aIIy
recnircu b i:.cv. [3 .rr. sir tlaiure below, 1 ire:eby lvai".z thisr—
c:. nc ❑ occ:ne; mv:.C."s rr.
Si;naturc 'i'c!cphur.c Nu. LPI:R:3IIT FLL: S �