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HomeMy WebLinkAboutMiscellaneous - 1055 Salem Street 105TSALEM STREET ` 210/104.D-0069-0000.0 1 o, Date. 4,0 o':1ti TOWN OF NORTH ANDOVER 3: ��_� _. •° OCL �ssACHusf� This certifies that . . . `. . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . .�/o . . . . . . . . . . . . . . . at . . .,/U .)�.� . ...�L G?�. . . . . .(.,4. , North Andover, Mass. Fee. No.1`.1)`?.). . //. .. . � .... . . . . . . t� YLLMBING INSPECTOR Check # Y4 6604 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS e Date OS _ Building Location /®.5,3� 57 Owners Name C ,40✓ Permit# Amount Type of Occupancy ()We I i AJ New Renovation Replacement ©C Plans Submitted Yes No FIXTURES Cr Ct &411'Nr kIJD(�2 3DROM 4MnOM 61I M)N1€J (Printor type) Check one: Certificate Installing Company Name T Pt L L o S A t"l Corp. Address ` 'dO n 5 7�, E] Partner. w fZ ..')C f M O! L{ Z usiness Telephone cj 7 2f &e5-y 5 G y D FunVCo. Name of Licensed Plumber: 7-1-10,,10S Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity D Bond D Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner D 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts StateP PFbing Code and Chapter 142 of the General Laws. By: Signature of LicenseariumDer Type of Plumbing License Title i Y03 3 City/Town r7icense Numoer Master Journeyman (� APPROVED(OFFICE USE ONLY LTJ Date. 1. ..... .. . . NORTH 0 TOWN ORTH ANDOVER S RMIT FOR GAS INSTALLATION CH T! # This certifies that . . 4 . . . . . . . . . . . . . . . . . . . . has permitsion for gas installation . . .. . . . . . . . . . . . . . . . . . . in the buildings of . .11A 5 . . . . . . . . . . . . . . . . . . . . . . . at . . . ... . . . . . . No Mass. Fee. P Lic. No. 3.7 . . . . . . .. . . . . GAS INSPECTOR Check# MASSACHUSETTS UNIFORM APPIUCATON FOR PERMIT TO DO GAS FITTIlVG (Type or print) Date Z1.6 `D NORTH ANDOVER,MASSACHUSETTS �— Building Locations /0573 .S/42le-lif Permit# S�3 Amount$ 'ice Owner's Name New❑ Renovation ❑ Replacement © Plans Submitted ❑ w � a � o94 o �, d a H N z o w x o o H 0 .0 w H � x ' 0 F z d x w x w w rc, Q O 0 o x W. A 6 U a Q off. F0 SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR • 4TH . FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR __+ 8TH . FLOOR t or heck one: Certificate InstallingCom N�am �� Name—7—,1114 L L O rt r/ //���/ Company Corp. Address /0• 0, 13 d X ST;(;( ❑ Partner. e-4Aj4 eetl<P 14 1 e7 Business Telephone 971 6�($- 9 So �/ ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter 7�L/vrr ais W,4//d eq t-J INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. YesE] No❑ If you have checked yes,please indicate the type coverage by checking the appropriate box. 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 Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ 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 Pmnit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ® Plumber � Ya 3.3 City/Town ❑ Gas Fitter License Number ❑ Master APPROVED(OFFICE USE ONLY) ® Journeyman Date. f }. . . . . . . . . .. i F4 776 * NORTH .1 TOWN OF NORTH ANDOVER Ott1`F e• L h� PERMS FOR GAS INSTALLATION SSACHUSE This certifies that .`; aa- . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas Ttallation . . . . . . . . . . . . . . . . . in the buildings ofvA,6 —r !'.{: L. . . . . . . . . . . . . . . . . at .//6/ , North Andover, Mass. Fee. :'. . . . Lic. No. �.�. . . �,.,...., . . �;:-;, . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. ✓ PINK:Treasurer GOLD: File �.� =er++L4JStNi"%t,�Sta.`^' -,�.:.i'�'•"�.:.:.�"atv'�°dJVfl�i�..�-�.�._ 'u - ?`�k���e�3�®t4=wL#4Eei ar4:a4 .ti:.it�reA:LicM�v.'r1z+.:icr�.:.:.a.d:ui:.,e¢C1nte3,.Rsce�saeu�s.: -� MA5"C.HUSETTS UNIFOHN4 APPLICATION FOR (Print or Type) PERMIT TO DO'QASFITTIN(3 NORTH ANDOVER , Mass. Date `' 1 g j/ t Building '" Locatio 1 Permit #_ l Owner's Name _ 6, -"rK New ❑ Renovation p Replacement p Plans Submitted: Yes p No C7 O/ twh<a!; p al aOJC aM 14 t: hC � V �V x, Mwh 01 zLe K Ch 0 aO 0O = ow ti Bws "U Oc Il O v y w 0 19 30 sue-aaaT. DA011MENT i -67 10T FLOOR :ND,FLOOR , SAD FLOOR 4tH FLOOR OTHFLOOR i BTHFLOOR TTH FLOOR k OT14FLOOR Check one: Certificate aping COMM N&me 2L/C/f ` Address 2 L— d Partnership ❑ Firm/Co. Business Telephone 4:�, C,�I— g l Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: Check o ps I have a current liability Insurance policy or Its substantial equivalent. Yes ( No p If you have checked,yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy a I I 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: Signature of Owner or Owner's Van Owner ❑ Agent ❑ 1 hereby certify that an of the details and Information I have submitted (or entered)M above application are(rue and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 0(ft Omer Type of License: Title Plumber Gaslitter gne;� �u�merure o �as �er Ctly/TOW" Q Journeyman Master License Number `3 kTnO'VED(OFFICE USE ONLY) BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME & TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER -• -- LIG NO. PERMIT GRANTED DATE �19 GASINSPECTOR