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HomeMy WebLinkAboutMiscellaneous - 10 KATHLEEN DRIVE 4/30/20180 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING -I.. `7SACHUS This certifies that ............. Z. c" has permission to perform /'X ...... plumbing in the buildings of '� r1/1 at ............. North Andover, Mass. FeA. Lic. No J'/R y LUMBING INSPECTOV Check # 6464 'MASSACHUSETTS UNIFORM APPLICATION 0 P*t or Type? IV �M�wt cam-, Masa Date 0 Bddlnp i0 All, New O Ranovation O PERMIT TO' OO PLUMBING L Permit Z0 �"', ,0wnefa Name f44\ d n,!-, ttc Type of Replaaament L Plans Submfted: Yes ❑ No FIXTURES In"Im; Address Buslm= Telephone�g7_9 -- G18 `i - 9 -Nam Of Licensed Plumber Cheek one:. Camnate ❑ corporation MCA 017>116 • ❑ Pip �a 9 X352 mown /Co. INSURANCE COVERAGE ' if have a c wv# IwAfty insurance policy or Its substantiat equfvaler4 which meets the r"Wrofnwt5 of MGL Ch. 142. Yes �- No ❑ If you have checked "s. pfaase indicate the type coverage by the ep the appropriate boot. A Iiabsity, b mmnce policy Gl"'� Other type of indemnity, ❑ Bond ❑ .m ulr umt an OT WMb wo kwW qofffI hav! tWxnieted in above N*Mm m are true and accurate to the best of my knovrlsdDe and tWat aq performed of Dw`for thus application VAI be in aonWwce with d tinent provisions #0 Maasaclwaeds State Plunrbinp Code the Lava. BY TNe auto Of CityRown Type of license: Master (l/ Jowneyman O IWPROVE6't�F1 'Q3`E�RCYi'"'— . Limw 'Nufter s: a► z h p es zw o z i W W Y 2 N d < N a > < V< •~ b z 0 o C a W n a p 1 .0 .. 0 a= a. a s tl W O a Y< W W z d� ,. it Z K a Z" W C 0 m W' y d W O 7� W < •.E h < WW= N G G z W= < H� h h h O >t 0 IL O' i A h .1 2 O C O !+ .OI < Y O a Q a � �+ O azD M a� << O< J 1 << O V Z Sus—e S MT. BASEMENT ' IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR eTH FLOOR TTH FLOOR STH FLOOR In"Im; Address Buslm= Telephone�g7_9 -- G18 `i - 9 -Nam Of Licensed Plumber Cheek one:. Camnate ❑ corporation MCA 017>116 • ❑ Pip �a 9 X352 mown /Co. INSURANCE COVERAGE ' if have a c wv# IwAfty insurance policy or Its substantiat equfvaler4 which meets the r"Wrofnwt5 of MGL Ch. 142. Yes �- No ❑ If you have checked "s. pfaase indicate the type coverage by the ep the appropriate boot. A Iiabsity, b mmnce policy Gl"'� Other type of indemnity, ❑ Bond ❑ .m ulr umt an OT WMb wo kwW qofffI hav! tWxnieted in above N*Mm m are true and accurate to the best of my knovrlsdDe and tWat aq performed of Dw`for thus application VAI be in aonWwce with d tinent provisions #0 Maasaclwaeds State Plunrbinp Code the Lava. BY TNe auto Of CityRown Type of license: Master (l/ Jowneyman O IWPROVE6't�F1 'Q3`E�RCYi'"'— . Limw 'Nufter Z� �5316-5- Date..................... III RTH 0 * 0 TOWN OF NORTH ANDOVER 41 PERMIT FOR GAS INSTALLATION Z This certifies that ... �zt ........... — ........... has permission for gas installa ",0 ... .. ....... in the buildings of Pi� ............... ....... North Andover, Niass.. Fee A ..... Lic. No GASINSPECTOR lk-4heck # 51,121 MASSACHUSETTS UNIFORM APPLICATION FOR IPrin or Type! Ir - _'1H /0V4,1 Mass. Date Permit * �5 Location l h Owner's Name Citµ Gu P `• Type of Occupancy TO DO GASFITTING E -N 0 Building i New p Renovation ❑ C Q� Plans Submitted: Yesp No —'r Installing Company Name Check one: Certificate Address gel ❑ Corporation /�s ©181 ❑ . Partnership Business Telephone--_J'7� cur a o 0;--Firm/Co.�-� Y78 452'9q4 Name of Licensed Plumber or. Gas Fitter _ 1911X0C� r:✓�S INSURANCE COVERAGE: 1 have a current lia � • -insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. �1 liability insurance polis - Other type of indemnity D - Bond O rn OWNER'S INSURANCE WAVER: 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 on Signature of Owner or Owner's Agent Agent ❑ 10 I hereby oertity that all of the details and information l have submitted (or entered) in above application are true d accurate to the best of my knowledge and that all plumbing work and installations performed under the permi t li be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 0l the 8Y TyDeAf tioense: Plumber gn assn umber or as atter Title sfitter ster license Number City/Town Jou eyman I NL 1� I Installing Company Name Check one: Certificate Address gel ❑ Corporation /�s ©181 ❑ . Partnership Business Telephone--_J'7� cur a o 0;--Firm/Co.�-� Y78 452'9q4 Name of Licensed Plumber or. Gas Fitter _ 1911X0C� r:✓�S INSURANCE COVERAGE: 1 have a current lia � • -insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. �1 liability insurance polis - Other type of indemnity D - Bond O rn OWNER'S INSURANCE WAVER: 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 on Signature of Owner or Owner's Agent Agent ❑ 10 I hereby oertity that all of the details and information l have submitted (or entered) in above application are true d accurate to the best of my knowledge and that all plumbing work and installations performed under the permi t li be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 0l the 8Y TyDeAf tioense: Plumber gn assn umber or as atter Title sfitter ster license Number City/Town Jou eyman I NL