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N2 2317
Date...... 914!:.7A6...
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TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
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This certifies that ..........Ct.Q.l................ ....... �(cin........
has permission to perform ..J<< ...... ^! ,%
�.!� e.......... G 'e- .................
wiring in the building of ...... /I ...........................................
at .......��.�.....Da.��........ �............... . .North And r,
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Fee.......... �/v.. U Lic. No.4. f. �� . .........,rt��...........................
` LEMICAL MpECTOR
Check # S^�
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
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DEPARTAMWOFPUBLICS4MY Permit No.
BOARD OFFMEPREYEMONRWU ATIOAS527CMR 1200
Occupancy &Fees Checked
APPLICATION FOR PERMiT 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 � v
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant
Owner's Address
62 1� tST
To the Inspector of Wires:
Is this permit in conjunction with a building permit: Yes Q No M (Check Appropriate Box)
Purpose of Building
Utility
Existing Service A00 Amps/zoo/ ?L10 Volts Overhead Underground No. ofMete�--__7'�
New Service 06D Amps/Z` Volts Overhead M Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work ��G EL�Gi72ic�tC 5'J/lam
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool Above
M
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
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
LocalMunicipal
^
Other
No. of Dryers
Heating Devices KW
Connections
U
No. of Water Heaters KW
No. of No. of
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Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
TnslrxtoeCo�a RosuattliDthett�qunana��G Laws
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INSURANCE BOND 0UER M (ma y)
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FIRMNAME
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Re* I Final
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OWNER'SINSURANCEWANFR;Iammm ttheL=wdoas�iheitnuratneoaa arils asir medby�Genaal
aod�atmysa�semthsp�a�waiwsttns��art. � 1
(Please check one) Owner Agent E]
Telephone No. PERMIT FEE '