HomeMy WebLinkAboutMiscellaneous - 10 CARRIAGE CHASE 4/30/2018 (2)p IS
Date.
74�6
TAORTH
0 TOWN OF"NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that z.
............ !� ............
has permission for gas installation
in the buildings of ..........................
at .... North Andover, Mass.
Fee. �� ..... Lic. No.P .........
GASINSPECTOR
Check# 9 ) L `7
FIXTI IRFSR
W LUN
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
City/Town: /r/GfZ W
&VA , MA. Date: /,-2 _ j -�U Permit#
Building Location: %f/,f�v e ZA,6wners Name: _ � /V U
Type of Occupancy: Commercial '❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑-�
Cd
New: Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑
FIXTI IRFSR
W LUN
Cd
W
M W w W
to
O
L)
O
=
=
fA in
m= W
Z
W
U
to
W
F-
O
= W
Z F-
U) W
0
m
W
Q
W
w
O
� 7
W X
w W
w~ V W
W
IL
O
H
W
F
_
W
> V W Z O J H
Z
1—
O
Z
=
--I
0
LL
Cl)
W
W
W W
v o o z=
O
a
a
H>>1
O
c9
n>
SUB BSMT.
BASEMENT
1 FLOOR
2 No FLOOR
'3"u FLOOR
41m FLOOR
5 FLOOR
6 FLOOR
7 FLOOR
8 FLOOR
Installing
}
L_
Check One Only Certificate #
Company Name:
j-
j�/
/� q
Address:3(� �G( d(%UZ/' Town:
0
State:
C�-Csor�oration
Business Tel: / �G
Fax:
❑Partnership
_?ZV57 (j
❑ Firm/Company
Name of Licensed Plumber/Gas Fitter:
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [�—N,�❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
Check One Only
Signature of Owner or Owner's Agent Owner El Agent F-1
By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and
accuIaLe w LIMP uesL or my nnowieuge ana mai an piumomg worK ana mstanations perrormed under the permit issued for this application will be in
compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
Type of ense:
By LAMmber
Title ❑ Gas Fitter Signature of LicQffsed Plumber/Gas Fitter
aster
CiCity/Town❑Journeyman License Number: laj ,
APPROVED OFFICE USE ONLY ❑ LP Installer
RE
H
w -
O
N
NUMBER t
r FEE
THE COMMONWEALTH` OF MASSACHUSETTS'
TOWN*' of ....... _..NORTH ANDOVER
This is to Certify that.........I?AV er ...Iivne. ...... ...:.. --.'.y ... ............
NAME
Northeast Water Wells, 2 Tolles St:` Hudson, N. H.
.............................................................................................................:...............•-•-.............----.........
ADDRESS
IS HEREBY GRANTED A PERMIT.
For ...............Well_-_Dri-lling_. Permit --__10- Carriage_•___ Chase ---Road_,___----_
....... Nnrth..Andover_,. f_..MA..__Q1845..................................................•---..........................---------....._.
-------------------------------------------------------------------------------------------------•-•-...-•••-••--•-------•••--••-•...........
This permit is granted in conformity with the Statutes and ordinances relating thereto, and
expires ........ December 31, 1991 unless sooner susofide*;� revoked.
...................................oA.................. 19 ..... 1
FORM 481 HOBBS & WARREN, INC. / -
a
i
t
NUMBER t
r FEE
THE COMMONWEALTH` OF MASSACHUSETTS'
TOWN*' of ....... _..NORTH ANDOVER
This is to Certify that.........I?AV er ...Iivne. ...... ...:.. --.'.y ... ............
NAME
Northeast Water Wells, 2 Tolles St:` Hudson, N. H.
.............................................................................................................:...............•-•-.............----.........
ADDRESS
IS HEREBY GRANTED A PERMIT.
For ...............Well_-_Dri-lling_. Permit --__10- Carriage_•___ Chase ---Road_,___----_
....... Nnrth..Andover_,. f_..MA..__Q1845..................................................•---..........................---------....._.
-------------------------------------------------------------------------------------------------•-•-...-•••-••--•-------•••--••-•...........
This permit is granted in conformity with the Statutes and ordinances relating thereto, and
expires ........ December 31, 1991 unless sooner susofide*;� revoked.
...................................oA.................. 19 ..... 1
FORM 481 HOBBS & WARREN, INC. / -
0M
C
.
. . . . . . . . . . . . . . . . .
rn
0
It
OWN 1
1
jjjjji
1 z
;z
2 Ed 3,
I m
m
1'{'�+ill
t�}}
��.�.,
��l
;�
.. �
0
Ul
14
rn
0
OWN 1
1
jjjjji
1 z
rn
0
0
m
1'{'�+ill
t�}}
��.�.,
��l
;�
.. �
-- --77