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Date....
0
'0
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
This certifies that ................. ........................
has permission to perform ...............................................................................
wiringin the building of ...................................................................................
/0 ./� . . ............... . Northtudover, Mass.
at ... . .......................... ... .......... / ......
Fee.... . Lic. No . ............. ...............................................................
iELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
7HE00Ml110NWE4LTH0FA"MCHVSE77S Office Use only
DEPARTWNTOFPUBLICSAFM Permit No. 0�
BOARD 0FFIREPREVEN770NREGUL4TT0N5527CMR 12.00
Occupancy & Fees Checked
APPLICATION FOR PERMU TO PERFORM ELECTRICAL 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 S
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit: Yes M No a (Check Appropriate Box)
Purpose of Building
Existing Service Amps / Volts
New Service Amps Volts
Number of Feeders and Ampacity
Logation and Nature of Proposed Electrical Work
Utility Authorization No.
Overhead Underground a
Overhead Underground
No. of Meters
No. of Meters
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No! of Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
groundground
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas
FIRE ALARMS
No. of Zones
No. of Ranges
No. 0 1 Total
Tons
No. of Detection and
Initiating Devices
No. of Sounding Devices
No. of Disposals
0
eat Total Total
Pumps Tons KW
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local f7-1 Municipal
Other
No. of Dryers
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
1'4No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER•
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Telephone No. PERMIT FEE