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N2 2271 Date ..... tlIXA 61 ......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ....... E-INSPECION"',- ...... ***'****
has permission to perfo* *r'm" R .... . .............................................................
wiringin the building of ...................................................................................
at ...... ......... ...... /—.V ......... . North Andover, Mass.
Fee...'—,)..� ... :�P Lic. No . ............. ...............................................................
ELECrRICAL INspEcrOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Office Use only
THECOMM0AWE4LTHOFMASS40ff SE77s
DEPARTMFNTOFPtBLICSA=�.
Permit No.
BOARD OF FIRE PREVENTION RW UL A7701 uS S27 CMR 120
� Occupancy &Fees Checked
APPUCATTONFOR PERMIT TO PERFORMaECTMCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(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.
Location (Street 8
Owner or Tenant
Owner's Address N
Is this permit in conjunction with a building permit: Yes m No a (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead Underground No. of Meters
New Service Amps Volts Overhead Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Hot TubsNo.
of Transformers
Total
KVA
No. 4f Lighting Fixtures
Swimming Pool Above
%el.V
Generators
KVA
nd
ground
No. of Emergency Lighting Battery Units
No. of Receptacle Outlets
No. of Oil Bume
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municipal
Other
No. rtf Dryers
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
_I
NoYHydro Massage Tubs
No. of Motors
Total HP
OTHER•
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Iha%e%hn&adNWidproofofsantetoftOff= YES 1._.J NO r7 IfycuharedvdWYES,plemnhc&thet WafmcaWbydakirtgthe
INK ANCEE M BOND GUiR E] (PleaseSpeffy) EViatim Date
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Sig}tedta�da�iePe3taltiesofpetjtey: - - -
FIRMNAME
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OWNER'SINSURANCEWAIVER;Ianawaaethatthelioensednesglkwtheitwato awmr.Cr aks&tale*nWdtasm inWbyMassadxsMCeierd am
andiatmys�t mcnftpanitWpkationwanesthism Kancm
(Please check one) Owner Agent
Telephone No. PERMIT FEE $