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BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:40
P:01
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APPLICATION FOR PERMIT TO PERFORM EL9CTRICAL WORK
All work w be patamed in accoraancA with the Messacnu"IMs elean= Cone 527 C7;2
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(Please Print in ink or type all iftfarmatiant to e(
TO ate the tntsp or of
WIM;
Tow, of Niodh Andover
The Intdm9ned MOW for a permit to perftlxc�m YL"`eivatricai work dasc>a�ed
Loeraaatl ncrr..e A N11MAW a• / alef ( 1 H
Ownw d
OWNW3
is tnls Perim in coquirwagn with a pulidimq permit Yea cy, No C (Chock ApproPrtate Box)
Pufpase of Buda Utilty Authalizatton No. ,i�g 30 31 .
t�t482tftg $erviGe +'�— Ansi � Yens Cvaxttesd ❑ Undgrid Q No. of AAMeM
New Service spa alts Overi'reat's cje/oo� Uncrgrrld Cl No, of Memm
Nurnb r of raiders and
Legation and NaWM Uf P*QOased V401`14d1 Work
TNFR-
INSURANCE COVERAGE. Aur9urnt W cite raowr8menets W huseacnim ns Ganem Laws
I nave a arida l L 406ity Insufines Policy Indualno Com Cperanona Go%wa" or ib substantial rquivalar t YE9 NO
have submittao vylo print at name to me Office YCS NO c If yoU have aneoKeo yea please indlcate the type yr wvurage Wy oneawng the apvmPnats box.
INSURANCE BOND = OTHER (PlaUft 3OU01Y)
r� C� (Bapiratleln Oita)
Estimated Vacua of�W�a'cr�t,r,mai ��a !�C - �-�� ! d
vlbrtc to'Jbrrt —!, `'I MN> on Dow R4*gU4xtsd Rough _Final_.
Signad under the Pertaltlaa of parjury: C 6 r y G
FiRN NAME1
0.—,- .5" . f-. 4" Jl,A LIC. Nt?.
_._...____.�
117 3 ` 9 3
Address Alt Tei. N4. Z-
OWNER'S INSURANCE WAIVER: I am aware that the Liton"ll dose not have the insurance toverags or its substantial equivalent ae airiuired 4Y AfosaacttusaM
General Laws. And that my aignaturo on this pw it application waives this n$qulr*~t. Owner Agent {Pleaaa ChiKk one>
Tsiepnono No PCRfiMfT FEi' S� S�w�
j9q_neturo of Owner or Agent)
05/26/98 12:40 TX/RX N0.9495 P.001 N
Tim
at Transformers hVA
No. or L'Ingm Outlets
Ne, 51 Mot ftmNo.
Above L2
In 17
No. of rmn FfxhHM
svwnmtn Pool o Q
nd C7
c;er+aratore K,�A
No, of E;Mvel l+gh►m$
No. t Rt?C tttcles Outlets
Pio. of Oil Burnam
Batts Units „•-"��
No of G$i Bumers
FIRE ALARMS No. of ZGRe
No. of Switch Oudets
Tolel
No. of Detscoon and
No of Air Cond
Tans
Iratatmg Oavicae
No. of ReNes
Heat
Tatill
Total
Pumps
T
KW
No. of Sounoulg 0"C63
No. of i
Nw of Self Cantwneu
Detsmarisounoing Oevic+Ia
HeaOn KW
No. ur OlshwaWn rs
3 eceiArea
Q Muninapal Cl Other
local Conneelton ..
No. of D
Hw"nq oevFcm KW
No. of
No. of
Low Voltage
Nu. of Wow Heatefs KW
4sions
Badasm
Winn
No, HVOM W 4mme Tude
No. of Motors
Total HP
TNFR-
INSURANCE COVERAGE. Aur9urnt W cite raowr8menets W huseacnim ns Ganem Laws
I nave a arida l L 406ity Insufines Policy Indualno Com Cperanona Go%wa" or ib substantial rquivalar t YE9 NO
have submittao vylo print at name to me Office YCS NO c If yoU have aneoKeo yea please indlcate the type yr wvurage Wy oneawng the apvmPnats box.
INSURANCE BOND = OTHER (PlaUft 3OU01Y)
r� C� (Bapiratleln Oita)
Estimated Vacua of�W�a'cr�t,r,mai ��a !�C - �-�� ! d
vlbrtc to'Jbrrt —!, `'I MN> on Dow R4*gU4xtsd Rough _Final_.
Signad under the Pertaltlaa of parjury: C 6 r y G
FiRN NAME1
0.—,- .5" . f-. 4" Jl,A LIC. Nt?.
_._...____.�
117 3 ` 9 3
Address Alt Tei. N4. Z-
OWNER'S INSURANCE WAIVER: I am aware that the Liton"ll dose not have the insurance toverags or its substantial equivalent ae airiuired 4Y AfosaacttusaM
General Laws. And that my aignaturo on this pw it application waives this n$qulr*~t. Owner Agent {Pleaaa ChiKk one>
Tsiepnono No PCRfiMfT FEi' S� S�w�
j9q_neturo of Owner or Agent)
05/26/98 12:40 TX/RX N0.9495 P.001 N
-26 g8 12:46 PRECOURT ELECTRIC CO. T:5094539934 P:@`
NRY-26`00- TUE 0'_3:l. -S lD*D06JNI=Y 11,4151LIR);NCE
TEL NO: -1508-482-6463
9047 rol
N6
05421198
PnoouceR 09111TIMATE It HWUlW All A OF INFORMATION
ONLY AND COMPFAS NO RIG
UPON THE 015"FICATP
DOWNEY INSURANCE AGCY INC 14OLVER, TWO CERTIFICATE 0098 46T AMEND, AMNO OR
190 EAST MAIN - STREET ALTER ?MR COVIERAM APMRDRD MY THA P"1011861ILOW-
PO BOX 570 COMPANIFM APMRMO
MARLBORO KA 01752 I OOMPANY
COMMERCE INS, .1,010 0
GARY PRECOURT ELECTRIC 6 TRJkVELER*.L&ET_N.H►-�ROS--.CAS —CORP
COMPANY
263 NORTH END BLVD 0 MAY 2.2 1998'
SALIS13URY MA 01952
.. I. ... , ................ . . . ......... ............ '1;'"l'.l"."'l .. .... -11'....- ... -1 .................
THIS 16 To CEIM" THAT YWI POLICIES OF INSURANCE LISTED tlitoW HAVI 13SEM 18$UVD TO THE INSUAF13 NAND ABOVE FOR THE POLICY PERIOD
WDICAT60, NOTWI"'fANCXNG ANY REQUIREMENT, PERM OR 09NDITION OR ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WN10H T141S
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE F`WUCIES DESCRIBED HEREIN 15 81,18JECT TO ALL THE TERMS,
EXCLUSIONS AND OONDMONS CP SUON POLICIES, LIMITS DOWN MAY NAVE SEEN REDUCED BY PAID CLAIMS,
UUT wwoms 001.
SAMY
IN 001140MV) To fAMMMI
L Typs CW Mumma p oucy NUMSM LRAIIIS
T C'Snapt . 1 600 000
A6 L."Itm 0789 1 7/11/97 7 / 11 / 9 8 SEVERAL A0019AGATI III
COMMgROIAL 654WCOMP/0110 A661 & 00
1.000
UAMLII*Y
MANS MAM r_x__j o0ow" 0 300, 000
EACH OWLA = 500,000
rVIC DAMAGE (" WW 11%) 4 501000
Mac MID ww op" ww
AUTOmov" L"L"
I
Mq"&& My or TM AsOVIK at.*oNW PIN-10*6 N CAPMLLM 111MORE
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ANY AUTO
4,.Av* Wwrm NOT" -I* Te "W" mm= TO TRIS wwr.
825 WAVERLY RD
TOMon No COUGATION *It Lud"IWITT
BUT FAUNS OT'"
N. ANDOVER KA. 01810
ALL OWN90 AVT03
^IjM"w=o
SODILY twuRy
G0Nr.Kk4jL#b AUTO$
somy INJURY
Oln" AUTOS
A07011
(pw owwwo
"�Aall U"LffT
AUTO ONLY U10
0 _%o TWAN AULqj=
1
AMY AUTO
a-ML,IE
• �JZA LAABLffV
VSMIORGIA.A FORM
DVHNR THAN Umog!"A FORM
1 WORKAMS CONWEMA"ON AM 7PTB_7 8/07-3lSX1689§7
ZMKOVOW U&Mwrf
5,000
■
100 000
500.000
RPM
Mq"&& My or TM AsOVIK at.*oNW PIN-10*6 N CAPMLLM 111MORE
jr
g%MAhM g^.M "WhaCw, 7M *Wjmo 09WWN W" it"MAVOR TO MAW
4,.Av* Wwrm NOT" -I* Te "W" mm= TO TRIS wwr.
825 WAVERLY RD
TOMon No COUGATION *It Lud"IWITT
BUT FAUNS OT'"
N. ANDOVER KA. 01810
OP ANY KW
^IjM"w=o
WILLI-AM a. DO c
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05/26/98 12:40 TX/RX NO.9495 P.002
COMMONWEALTH OF MASSACHUStt I a
. .
OF EL,E,CTRICIANS
AS A REG JOURNEYMAN ELECTRIC
ISSUES,,THIS LICENSE TO
GARY A PRECOURT n4
100 DEVONSH I rf'iikD
ATTLEBORO A 02703-1505
433843 E 07/31/98 0108627
� Driver's Licenses
01-10-64 01-10-02 M 5'077.,,x, . 0255823,82
Date of Birth Expires Sex Height Class Number
PRECOURT
611Y A
e
16,PINENEEDLE LAND
#MANSFIELD, MA
02048
N2 j U' 4 6
It
Date ..... 3. /c.Z7
"I'll, 0
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ......... ......... EA-�ec.A.A.a ....... C.0 ......
has permission to perform ..... Te -(v --p ....... �5SAI.O.m..Q . .....................
wiring in the building of ...... 3—..e .. T: ....
at ........ (,e- . . ..... P N" it,
... ..... .......
Fee ..... �—L) .. :4)Lic. No. ............ i�i AL INSP . ECTOR .................
C � 0 Ah � 05/27/98 09:08 50-00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer