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Date .....
tORT"
0, .... ...
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
SAC U
This certifies that ........ ......... ...... ....... <..rA
................
has permission to perform ........... J00"s% ..... s�.. ..................... k
............................
wiring in the building of ... 5R. .... Py. ... 0 ......
AWK .... i� North Andover, Mass.
at ....... � .....
Fee..57 Lic. N0.14�7197 . .... .............
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Check #
5 8 L 11
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DEPARINWOMBLESAFETY Perrnit No.
BOARDOFFMPREVEV71ONRBGVLA77OM527(MIZW
Occupancy & Fees Checked
APPUCATIONFORPERNff �IFRFORMELECMCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WT MT ACHUSSTS ELECTRICAL CODE, 527 cmR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMAnON) Elate
Town of North Andover To the Inspector of Wires:
-Cal o�
The undersigned applies for a permit to perform the eleA ;�rid below.
Location (Street & Number) '2R r7- ra
Owner or Tenant 5TP--Ue
Owner's Address
is this permit in conjunction with a building permit Yes " No Llf (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service A� Amps )2,�,' 1 O�Molts Overhead r—(,'V-Underground No. of Meters
New Service ,200 Amps.L,2E I AlVyolts Overhead MUnderground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work 20/962Zj6�
No. of Lighting Outlets
No. of Hot Tubs
E=mdVa1xdEbcoEdwak $
No. of Transfornmers
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Total
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FMNAME
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2-1M ),22,4�-
Lic� A14 04 6AZat
KVA
Nob of Lighting Fixtums
Swimn-dng Pool Above
Below
Generators
KVA
ground
� , T No.
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Around
NO. of Receptacle Outlets
No. of Oil Burners
1
No. of Emergency Lighting Battery Units
PERMFr FEE $
No. of Switch Outlets
or AgenE
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 TOW Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating Kw
No. of Self Contained
Detection/SoundinS Devices
Local Municipal
Other
No. of Dryers
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HIP
OTHER -
YES ]F)cuhmd-mJw—dYMpkw
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NKRANM �N7BGM OMM r7 ftm**) IYLO yy Ll -�al
E=mdVa1xdEbcoEdwak $
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lh;VchMD*F=sbd Rough
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FMNAME
UmNa
2-1M ),22,4�-
Lic� A14 04 6AZat
-4,
K Siff Mo
2�7
Licawr4o
Add=
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03e 25�,
� , T No.
OWMCSMURANCEWAIYER;IammmdgtdoLimwdDesnothmdzhummwwmWcrgsltgxMeqVMUasmgimdby&tsmdumCardLam
andddmysigr�cnhsPmn*
(Please check one) Owner Agent
[::] I
1
Te lephone No.
PERMFr FEE $
, Signature of Owner
or AgenE