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HomeMy WebLinkAboutMiscellaneous - 10 STACY DRIVE 4/30/2018Date ... 7 c7U.. a.... . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that........... ..- ....... ...... has permission for gas installation_.---., ._ . ...., in the buildings of . -. f f� `�............................. at . 1�..r - :-s .t,. t�s � !..... , North Andover, Mass. Fee �!� . Lic. N o ' !? ; liM - �. �.,•�....... . C' GAS INSP�C�OR Check # i� 5335 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING —� (Print or Type) y' �.a��rc✓ c.. Mass. Date Q) 06- Permit # - Building Location ✓�/�� f�. Owner's Name �i'�2 Cy CG Type of Occupancy Gy<�ie�� New O Renovation �. Replacement Z Plans Submitted: Yes[] No p CLIMATE DESIGN HEATING and AIR CONDITIONING, LLC _ Installing 5 South Summer Street Address Bradford, MA 01835 — 978-372-9999(phone) 978-372-0882(fax) Business Telephone Lic. Plumber: �iLi i�% �•i�3u Name of Licensed Plumber or Gas Fitter Check one: Certificate �y` ?eCorporation 6 rc = Partnership Firm/Co. I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 10 No [] If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Z 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 O Signature of Owner or Owner s Agent 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 the per t issued for this applicab n will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ttae I eneral Laws By. Type of License: �{y' Plumber gn ture of Ucehv6d'PlOmberof Gas Fitter Title i Gasfitter Master License Number/02?0" 4G City/Town .ourneyman APPRC7VED IOFFICE USE ONLY) 2� • • Y mo .. ��o������i��������«�■ SEN CLIMATE DESIGN HEATING and AIR CONDITIONING, LLC _ Installing 5 South Summer Street Address Bradford, MA 01835 — 978-372-9999(phone) 978-372-0882(fax) Business Telephone Lic. Plumber: �iLi i�% �•i�3u Name of Licensed Plumber or Gas Fitter Check one: Certificate �y` ?eCorporation 6 rc = Partnership Firm/Co. I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 10 No [] If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Z 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 O Signature of Owner or Owner s Agent 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 the per t issued for this applicab n will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ttae I eneral Laws By. Type of License: �{y' Plumber gn ture of Ucehv6d'PlOmberof Gas Fitter Title i Gasfitter Master License Number/02?0" 4G City/Town .ourneyman APPRC7VED IOFFICE USE ONLY) 2� Date.1?-, 41-0.. .6y.. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .. J. .. ��1fi'?`�.�!'`�.! l� ............... has permission to perform ....�.�-�. u . ....1 k.. . plumbing in the buildings of �0.:............. . at .. ..2 ................................. . North Andover, Maass. Fee:3-. ?.... Lic. No... (,'P3/.0 .........................d1i,4'i PLUMBING INSPECTOR Check 4� Fo' . l ._ i ..: _. ... .. � .-,t e''.I , n-• } Ir- � I roti rr.. (`Ai q Ne -SUB -Osis T BASEMENT 'EST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR GTN FLOOR eTH FL r0Ft Installing Company Address Business Telephone D R. .(::t="vmnaUr St R-�"is'f r�4-.o $L r,R� tr'i?� t l'ES CLIMATE DESIGN HEATING and AIR CONDITIONING, LLC . Name 5 South Summer Street Check one: Lertrficate Bradford, MA 01835 978-372-9999 (phone) - orporation 978-372-0882 (fax) Partnership Lic. Plumber: ',1a!►r�! r - /j/-Ij Vr j (1 Name of Licensed Plumber INSURANCE COVERAGE: - - - I have a current liability insurance policy or its substantial equKralent which meets the requirements Of MGL Ch. 142. Yes p No O It you live checked,, please! In Icate the type coverage any checking the apprep-mte box. F A liability insurance, policy 0 Other type of indemnity L Gond 0 OWNER'S INSURANCE YVA-WER: 1 am avvare that the licensee does riot_ have bhe insurance coverage required by Chapter 142 of the Mass. General i. ws, artd that my fiigriature on this hermit appilcation waives this requirement. Check one: Owner Q agent C l Signature of Cwner cx Owner's Agent --- t hereby Oellify that €Jl of the ddtails and infoanation I have aubmiarid (or entered) in above application We true and = ate to thr, is�st of r-ny r n©v-Aardge tnd Uuat idt plumbing work and insWations ped under the rr.�rtrrit iso ae d for this sppli�Gon e�✓iil be in cnm Rance Ht- all pert n®nt pro�isic?rgs of tlua E�Y.ass cr5tasgtts SWe Plumbing 0:0 el ar,4 Chapter 4ofgeneral Iowa. p .�gria r ref lsr�•r;sed 'tun�G�r ---•-----------�-__�. -- Title I19e of i.scense: halter _k>urne--Man t-icensaw Nuinber �� �Q i M S €11 0 z W Get a ?- F � � ice' :• Ey O ��'% � � R-�"is'f r�4-.o $L r,R� tr'i?� t l'ES CLIMATE DESIGN HEATING and AIR CONDITIONING, LLC . Name 5 South Summer Street Check one: Lertrficate Bradford, MA 01835 978-372-9999 (phone) - orporation 978-372-0882 (fax) Partnership Lic. Plumber: ',1a!►r�! r - /j/-Ij Vr j (1 Name of Licensed Plumber INSURANCE COVERAGE: - - - I have a current liability insurance policy or its substantial equKralent which meets the requirements Of MGL Ch. 142. Yes p No O It you live checked,, please! In Icate the type coverage any checking the apprep-mte box. F A liability insurance, policy 0 Other type of indemnity L Gond 0 OWNER'S INSURANCE YVA-WER: 1 am avvare that the licensee does riot_ have bhe insurance coverage required by Chapter 142 of the Mass. General i. ws, artd that my fiigriature on this hermit appilcation waives this requirement. Check one: Owner Q agent C l Signature of Cwner cx Owner's Agent --- t hereby Oellify that €Jl of the ddtails and infoanation I have aubmiarid (or entered) in above application We true and = ate to thr, is�st of r-ny r n©v-Aardge tnd Uuat idt plumbing work and insWations ped under the rr.�rtrrit iso ae d for this sppli�Gon e�✓iil be in cnm Rance Ht- all pert n®nt pro�isic?rgs of tlua E�Y.ass cr5tasgtts SWe Plumbing 0:0 el ar,4 Chapter 4ofgeneral Iowa. p .�gria r ref lsr�•r;sed 'tun�G�r ---•-----------�-__�. -- Title I19e of i.scense: halter _k>urne--Man t-icensaw Nuinber �� �Q