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Home My WebLink AboutMiscellaneous - 10 FRANCIS STREET 4/30/2018 (3)4ft Date. A�5 0 q 40 . T#1 -14, TOWN OF 11TH ANDOVER 0 I T7 0 Imm OR P4RM PLUMBING 40 SACHUS This certifies that ..... ............ has permission to perform ��71 ................. plumbing in the buildings of :-110. ................... at. . .. ..... Nortb AndVo/7, Mass. A Fee Lic. No. /S. ......... ............ Check# L 0 2 0 "1 PLUMBING INSPECTOR N, MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) ,Mass. Date .2009 Permit # Building Location 10 )FRANC/ -s J'T Owner's Name AA Owner Tel# New ❑ Renovation ❑ Type of Occupancy L- [S Replacement e-- Plan Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name C'&(A �, A-) f C %t'' Check one: Certificate Address/.� J' � �t1 f S7 6Corporation '1y"ur )�- I!A I'm-yI ❑ Partnership Business Telephone # ��, �% ` ❑ Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes k7 No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy dF 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certifv that all of the details and information I have cnhmitte_d (nr entere111 in ahnve nnnlieatinn nrn ttne and arr.,ratn to the h—t .,f i.,v lrnn.vlrvin - - - --=e and that all plumbing work and installations performed under th t issued for this application will be in compliance with all pertinent provisions of City/Town APPROVED (OFFICE USE ONLY) I Chapter 142 ofth al S. i Signa ' e ceased 1 Type of license: Master`iT Journeyman ❑ License Numbet_ Date.... 0� ,,% �. 0 �0\ TOWN OF NORTH ANDOVER 0 PERMIT FOR 4 1 L 0 X GAS INSTALLATION ACH This certifies that ..... .......... has permission for gas installation .... 4�) ................ in the buildings of ...................... at ........ Norp A dover Mass Fee".j,',J). 9�.. Lic. No.?.��A.( .... ... / GAS INSPECTOR Check # INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes 0 No ❑ 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 By checking this box ❑; 1 hereby certify that all of the details and information i have submitted (or entered) regarding this application are true and ��• •� •� •..� . �, ...y 9= 01m u1ai an pIurnomg worK ana mstauations perrormea under the permit issued for this application will be in _...�.._.................... ....�... p.,,...�.,,.. ,,, w.v rvwaaau w�rua male rnlmoing %,oue ana l.naplpr 14L or me General Laws. By [TPlumber Title ❑ Gas Fitter Q --Master Cityrrown ❑Journeyman APPROVED (OFFICE USE ONLY) ❑ LP Installer SigrfW.;V,of Licensed Plumber/Gas Fitter / ''`3 License Number: l . a MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING x -- City/Town: & d (J�,� _ ,��Q MA. Date: IT91 Permit# 4� Building Location: "' / �d 1`%Z4�UCl. �I Owners Name: &061 `34 Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ institutional ❑ Residential [�- New: ❑ Alteration: ❑ Renovation: ❑ Replacement: [4 --•--Plans Submitted: Yes ❑ No ❑ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes 0 No ❑ 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 By checking this box ❑; 1 hereby certify that all of the details and information i have submitted (or entered) regarding this application are true and ��• •� •� •..� . �, ...y 9= 01m u1ai an pIurnomg worK ana mstauations perrormea under the permit issued for this application will be in _...�.._.................... ....�... p.,,...�.,,.. ,,, w.v rvwaaau w�rua male rnlmoing %,oue ana l.naplpr 14L or me General Laws. By [TPlumber Title ❑ Gas Fitter Q --Master Cityrrown ❑Journeyman APPROVED (OFFICE USE ONLY) ❑ LP Installer SigrfW.;V,of Licensed Plumber/Gas Fitter / ''`3 License Number: l . a FIXTURES I Lutu a tri Z Dw I—IX CC N ix W V re W ® uJ N O= 0 Lu im V ilf Z C9 J F- O Z J Lu 0 � W = W col o owu) cc W t' a w� M a> o x� a SUB BSMT. BASEMENT — IST FLOOR 2 FLOOR i'—FLOOR 41H FLOOR 5 FLOOR -0—FLOOR 7 FLOOR S FLOOR Installing Company Name: .,tW41,�t? jL, 4 Check One Only Certificate # _ _ e � . -Corporation �. Address: t.,r 1 pF=%¢� .fy CitylTown:�y �' .d State: ElPartnership Business Tel: zt.' CLIC-1-)-- Fax: ❑ Firm/Company Name of Licensed Plumber/Gas Fitter. 7� L;7-p ,,i C_ -- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes 0 No ❑ 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 By checking this box ❑; 1 hereby certify that all of the details and information i have submitted (or entered) regarding this application are true and ��• •� •� •..� . �, ...y 9= 01m u1ai an pIurnomg worK ana mstauations perrormea under the permit issued for this application will be in _...�.._.................... ....�... p.,,...�.,,.. ,,, w.v rvwaaau w�rua male rnlmoing %,oue ana l.naplpr 14L or me General Laws. By [TPlumber Title ❑ Gas Fitter Q --Master Cityrrown ❑Journeyman APPROVED (OFFICE USE ONLY) ❑ LP Installer SigrfW.;V,of Licensed Plumber/Gas Fitter / ''`3 License Number: l . a