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N° 2443 Date...% 4? yl.`.f�.
V NORTH
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Q � TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
�'MAcMusE�
This certifies that V 2.'.�''.a (. (� e C . �`
....... .............. ...........................J.`...................
has permission to perform 4.f F / �'' S..' Z
......l,.,..,.,. ................. .......................................
r wiring in the building of......... y........................................
at..........��.....` ......... (ii..:.............. . Orth Andove ,Mass.
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Fee.. /l ....00.... Lic.No..r...... ltit....,. ..
LECTRICALI SPECTOR
Check #
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
_ THECOMMONWE4LTHOFMgS, a-]U,SE77S Office Use only
1,P9RTfffi�NTOFPUBLIC&4= Permit No. dl
BOARDOFFIREPREVEMONREGM4770NS527CM 12.09
Occupancy&Fees Checked
M APPLICA TTONFOR PFJ?A�flT TO PERFORMELE=(TAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 2
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below. AP PARCEL
Location(Street&Number) C L--,J
y �-
Owner or Tenant C p
Owner's Address —Skv-tC
Is this permit in conjunction with a building permit: Yes a No (Check Appropriate Box)
Purpose of Building 1c�S �ti1 � Utility Authorization No.
Existing Service 7-L-30 Amps I`2/ 2Y�lolts Overhead Underground No.of Meters
New Service Amps / Volts Overhead = Underground No.of Meters
Number+a of Feeders and Ampacity
Location and Nature of Proposed Electrical Work _F- 19(Ac 7 8-7 P777,
No.of;L ighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above Below Generators KVA
ground ground
No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Local Municipal a Other
Cormcctions
No.of Water Heaters KW No.of No.of
_ Si Bailasis
Nai.Hydro Massage Tubs No.of Motors Total HP
OTHER-
htaaanoeCo�Putst>anttotheteqmar� da>serisGalaalLaws
Iba-,eaw=ILtabdlyhm m=PbhL'zdxbrgCmTide ComaWoritsaabsorlWapvaial YES NO a
Ila-,est hn&d%WpcdefsarnetArOffm YES r7 If)aulmedmlodYES plemmdc*dre pect=eraFbydtaddngthe
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Il`1SCJRAl�10E BOND a �Spa*)
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FIFtIvINAME ,�,� P \ Gu{-`'•.J�C LioatseNa /���l,�
LicermeIv��C�l��MAt��JAr2 (, Sigtrahae Lioa�eNo 2�7g
nl�JO� S --J d3�t AIL TeLNa
OWNER'S INSURAM WAIVER,Iamaw&edrideLio wdmnothmthei> crilsGmialLaNks
andthatmysigt>abtuernthispan tappha_Wantsthism artam l
(Please check one) Owner a Agent C�
Telephone No. PERMIT FEE
Signature of Uwner or Agent
BAY STATE ADJUSTMENT SERVICE
45 New Ocean Street, Swampscott, MA 01907
Telephone Numbers
24 Hour Emergency Number(781)858 1075
(781)599 9922
(800)865-2206
FAX(781)599 9099
Town Fire Department
Inspector of Buildings Board of Health
Town of North Andover Town of North Andover
Town Hall Town Hall
North Andover, MA 01845 North Andover, MA 01845
Re: John and Julie McElroy Company: Patrons Mutual
Insurance Company
Property Address: 54 Cedar Lane Date of Loss: 05/07/02
North Andover, MA 01845 Cause of Loss: water damage
Policy Number: HMA2030997
File Number: 2130
Claim has been made involving loss, damage, or destruction of the above captioned property,
which may either exceed $1,000.00 or cause Massachusetts General Law, Chapter 143
Section 6 to be applicable. If any notice under Massachusetts General Law, Chapter 139,
Section 3B is appropriate, please direct it to the attention of the writer and include a reference to
the captoned insured, location, policy number, date of loss, and file number. This is not a
request for a report, this is to comply with Masschusetts notification laws as set forth above.
Paul R. Nestor, Jr.
Adjuster
On this date, I caused copied of this notice to be sent to the persons named above, at the
addresses indicated by first class mail.
&,Y-11" May 9 2002
Signature Date
Member of the National Association of Independent Insurance Adjusters
I ✓�
QHONN
OFFICES OF: 3: "o Town of 120 \titin Slrc r l
BUILDING ° N011li Afldovcl-,
CONSF_RVATION
NORTH ANDOVER \I<)�� 1ChuSc IIS 01845
HEALTH DIVISION OF (508) (i82-648.
sCMUs
1 PLANNING
PLANNING & COMMUNI"I'Y DLVL'LOPMLN'1'
KAREN H.P. NELSON, DIRL CTOR
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JANUARY 2 1996
To: Bruce Schurmann
54 Cedar Lane
North Andover, MA
From: North Andover Building Department
Res Woad Stove Installation
This is to certify that I have inspected hind zipprr-ived the
installation of a woodburning stove at your residence, located at
the above address. The installation meets all the requirements
of the State Building Code.
Yours truly,
Assistant Building Inspector
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