HomeMy WebLinkAboutBuilding Permit #3360 - Fountain Drive 10/26/2000 . 9 d"i
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
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Building Owner's
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Plans Submitted Yes ❑ No
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BASEMENT
1ST FLOOR
2ND FLOOR
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3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
�. 7TH FLOOR
8TH FLOOR 21 I-H
(Print or Type) Check One: Certificate
Installing Company Name -?�03ER`r W '=avir4E A>,b S0145 YNG• C7✓ Corp. 20y LD C
Address %2. ALLEY 5'r. _ ❑ Partnership
1.,-(Nnl MA. otgoz, ❑ Firm/Company
Business Telephone(L*1-7 555 t- 0%1(o4 Name of Licensed Plumber or Gasfitter
'CERRlaNGE M -t)E.SMONI>
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General taws.
I have informed the owner or his agent that I do not have liability insurance including completed operations coverage.
Signature of Owners Agent /
I have a current liability insurance policy to include completed operations coverage. F1(
By TYPE LICENSE 41e'JZ
Title [� Plumber Signature of Licensed
Plumber or Gasfitter
City/Town ❑ Gasfitter
APPROVED (OFFICE USE ONLY) L� Master O LD9�
❑ Journeyman License Number
BELOW FOR OFFICE USE ONLY
• FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
NAME & TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
PERMIT GRANTED
DATE 19-
GASINSPECTOR
i'
336E
NOR-?'h TOWN OF NORTH ANDOVER
OF t.,,aD ,•,'1.O
o? '• • p� PERMIT FOR GAS INSTALLATION
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�9SSACHUSEt
�. . . . . , ' . . . . . . . . . . . . . . . . . . . . . .
This certifies that/.ir. �_�'�--=`C~r`°-'
has permission for gas installation �-.�=f:�-:� •
. . . . . . . . . . .
in the buildings of . . . . . <,G, / `� . ..� .-*!• : q :`',
at '-...:,'. . . . . . . .. North Andover, Mass.
Fee . . .I. . . Lic. No.��'yr- -.
r _.. . . . . . . . . . . .
i l'�`—GAS INSPECTOR
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer