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HomeMy WebLinkAboutBuilding Permit #1375 - 19 CANDLESTICK ROAD 11/18/1993 Date/. . .. . . . ... .. ...... �3 ' 7 N0RT" TOWN OF NORTH ANDOVER 0 � ° op PERMIT FOR GAS INSTALLATION s � a SAC US This certifies that . ..). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . . . .'. . . . Lic. No.. . . . . . . . . . 11/30/93 12:37 22,550 *#INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTINO 4.1 (Print or Type) NORTH ANDOVER Mass. / Date_Z • 4uilding Location 91,e-5 T7 Permit"# i 25 .� Owners Nam /�n r' r' Kp S lF • New -We_ Renovation D Replacement Plans Submitted FIXTUP,_IS LU Qf J p V Gt r t x N F Q o z yr G1 Z im W Q W U O. O Q W 4 r to > W W o W z_ Q z a rn W `c CC r0- a r z cc a a W W v Y! Q O F- x �t f' Z W us d ? W h- W .t F- W 2 4 W G cc .. r Y- N m :. O Z W O N = Q u > tr W = 2 Q G d d O O W _ O W }- tz x 01 0 x u. a 0 ,1 Q x > 10 Q. r o SUR-13SIAT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR TTH FLOOR STH FLOOR (Print or Type) Check one: Certificate Installing Compa/n�y Name 8¢b I4"�. Q Corp. Address 5 0TTrP_ Partner. s Ve_V4.-b r, . 1-- - Firm/Co. Business Telephone: 66 5j 451Z>LSA ti Name of Licensed Plumber or Gas Fitter cj /G ,D/ eCfD Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond E] Insurance Waiver: I , the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 17 Agent El 1 hereby certify that all of the details and information I have submitted (or entered)in&bore application are true and accurate o the t of my knowledge and that all plumbing work and installations performed under Permit issued for this application will-be in eomiZ. a sL ti ent provisions of the Massachusetts State Gas Code and chapter 141 of the Ganem laws. By TYPE LICENSE: Plumber Title Gasfitter Sign Lure of Licensed Master Plumber or Gasfitter City/Town: yg�/O Journeyman APPROVED (OFFICE USE ONLY) License. Number ml 00-SZ ��:E,1 £; + Date... ... .. . . ... .. .... .. a NORTH TOWN OF NORTH ANDOVER ` °p PERMIT FOR GAS INSTALLATION t �,SSACHUSEt4 This certifies that . . . . . . .r. . . . . . . . . . . . . . .r. . . . . . . . . . . . . . . . . . . . . has permission for gas installation . .). :.'. . . . . . .: . . . . . . • • • • •i • • in the buildings of . . . . . . . . ... . . . . . . . . . . . . oil . . . . .. . . Fee..l... . .-. Lic. NO.. . . . . l. . . ., North Andover, Mass. WHITE:ApplicantRYGAS INSPECTOR CANA :Building g Dept. PINK:Treasurer GOLD:File