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Home My WebLink AboutMiscellaneous - 100 VEST WAY 4/30/2018 (3)N J r Date. .....::.:. ` ...... . ,tpRTH TOWN OF NORTH ANDOVER 0*`'- to '6'6 i� p PERMIT FOR OAS INSTALLATION This certifies that . �::..:.... - ... r . ! . �...................... has permission for gas installation . ? ! !.................... ......... in the buildings of.::'... `... !.............................. . at �-A. /- .......... North Andover, Mass. Fee......... Lic. No.......�.... .................... ......... I GAS INSPECTOR r WHITE: Applicant CANARY: Building Dept. PINK: Treasurer G A �L c VV Vf- . Mass.}} ,, Date smiting Location. V w Owners Nam � n '$,New p Renovation Penvdt # T Occupaaicy C Pians Submted: iwmin9 C«qmny Name ZZ1� . G c tock one: awmawn ❑ PathNm easiness Teleptwne 272 - 7 i Y- 2760 ❑ FMWCo Now d Lioansed Pkm*w or Gas Fitter /% /Srtt &K =i5 Cedilicate INSURANCE COVERACIE: I have a Turret+ Bab y inwaance poky or Rs =bats" ewivaient wl" meets the requiremwft of MGL CIL 142. Yes � No ❑ if you have checked jM& please Ind We the We coverage by d the appropriate boat. A liaMity Mu anoe policy S4, OUw type of indemrgy ❑ Bond ❑ OWNER'S INSURANCE WAIVER: i am aware that the NOWU gee does rat have the bsurarWe age tequlred by Chapter 142 of the Mass. General taws. and that my skpdt a on this pone armor vvaNes this requitement. Check one: vwner❑f arc D SignaUas of t7wner or Owaet s Agit 1 hereby oer* that aq of the details and information I have wNsitted for eatwWw goi�dnl� n almae app�ion ae UM and aa�xn% ttto tto best of my �wit p� EEs �Ga�Chapter 14d the Iiwa a� By T Of MGM er or Go Hft 7ft Phamber tioense Nunes CitylTown .foun�eyman L ..... . . . . . ■rrrrrrrrrrrrrrrrrrrrrrrr■ rrrrrrrrrrrrrrrrrrrrrrrr rrrrrrrrrrrrrr�"�rrrrrrrrrr � fit, ,. rrrrrrrrrrrrrrrrirrrrrrrr � ■rrrrrrrrrrrrrrrrrrrrrrrr■ Clrrrrr■rrrrrrrrrrrrrrrrrrr■ - �rrrrrrrrrrrrrrrrrrrrrrrrrr, s ' rrrrrrrrrrrrrrrrrrrrrrrrrr ,. ■rrrrrrrrrrrrrrrrrrrrrrrr■ ■rrrrrrrrrrrr�rrrrrrrrrr■ iwmin9 C«qmny Name ZZ1� . G c tock one: awmawn ❑ PathNm easiness Teleptwne 272 - 7 i Y- 2760 ❑ FMWCo Now d Lioansed Pkm*w or Gas Fitter /% /Srtt &K =i5 Cedilicate INSURANCE COVERACIE: I have a Turret+ Bab y inwaance poky or Rs =bats" ewivaient wl" meets the requiremwft of MGL CIL 142. Yes � No ❑ if you have checked jM& please Ind We the We coverage by d the appropriate boat. A liaMity Mu anoe policy S4, OUw type of indemrgy ❑ Bond ❑ OWNER'S INSURANCE WAIVER: i am aware that the NOWU gee does rat have the bsurarWe age tequlred by Chapter 142 of the Mass. General taws. and that my skpdt a on this pone armor vvaNes this requitement. Check one: vwner❑f arc D SignaUas of t7wner or Owaet s Agit 1 hereby oer* that aq of the details and information I have wNsitted for eatwWw goi�dnl� n almae app�ion ae UM and aa�xn% ttto tto best of my �wit p� EEs �Ga�Chapter 14d the Iiwa a� By T Of MGM er or Go Hft 7ft Phamber tioense Nunes CitylTown .foun�eyman L