HomeMy WebLinkAboutMiscellaneous - 107 COLGATE DRIVE 4/30/2018 107 C XGATE DRIVE
210/074.0-0016-0000.0
NP '• - � "t Dates. : � -
1 Of NORTM
�? -•��.4,oa TOWN
o - R OF NORTH
ANDOVER
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SACMUS� G
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING- ?_0
(Print or Type) i"
AIVW V�?< , Mass. Date 19_Z2 Permit # q41
Building Location /0'7 Lo 11 Owner's NameIne 9,4 ✓H-0"'� SLA_1-1 VA J
N0 ,f_r(+ !-1Nt70✓Q1Vr_ ) A iA 0 IN5 Type of Occupancy r + E ti i i A L_
y v �
New ❑ Renovation ❑ Replacement 21-11 Plans bmitted: Yes ❑ No ❑
FIXTURES
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SUB—BSMT.
BASEMENT FI
IST FLOOR
2NOFLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
STH FLOOR/
Installing Company Name kt'iEeT Q SP(rM#4TAe7 Check one: Certificate
Address Corporation
17') E%N i!c--Ai ., Al A 0 t,� ❑ Partnership
Business Telephone 59 7 1
Name of Licensed Plumber ,�4 f r3 r=,f?T �r� 5�4,�►�rVl�q 1"r4�c"'
INSURANCE COVERAGE:
I have a currentfiabillity insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checkedrtes, please
/indicate the type coverage by checking the appropriate box.
A liability insurance policy ld 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 C3 Agent❑
1 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 Wormed under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum)i6g Code and apter of the era[Laws.
By vi.L
Title SLOMre of Licensed lum r
Type of License: Master % Journeyman ❑
City/Town
APPROVED O FICE U ONL License Number �33 5
t
BELOW FOR OFFICE USE ONLY
FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
c
NAME &TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE 18
PLUMBING INSPECTOR
Date . . �:. . . . .
No
�4, TOWN OF NORTH ANDOVER
. a
° n PERMIT FOR PLUMBING
SA US
This certifies that . . . . ... . .. . . . . . . . . . . . . ... ' . . . . . . . . . . . . . . . . .
has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . . . . . . . .. . ... . . ..! . . . . . . . . . . .
ss
at .�:!..f . . .-.�. . .,� . . . . . . . . . . . ..... . . . ... . . . . .._North Andover, Mass.
' 1
Fee:,xC. . . . . .Lie. No..�'-�.'. . . . < .r,.T�!:. . . . . . . . . . . . .
PLUMBING INSPECTOR
f y
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING . .
(Print or Type)
132
A/VaOL/Y , Mass. Date_ 1917 Permit #41,
Building Location /0 J ED 19— ✓L Owner's Name 1WRA u�k--D Sdt, i VArJ
A N DO V Q4C , AIA D I NY-Type of Occupancy i 1 E ti tl
y 1r
New ❑ Renovation ❑ Replacement bmitted: Yes ❑ No ❑
FIXTURES
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3 m o
SUB—BSMT.
BASEMENT
IST FLOOR
2N0 FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR/�
Installing Company Name f'�(:�t3EeT Q- ,SP(r ,4TAe-Q Check one: Certificate
Address �� C'C RC H m,3 n) !� ❑ Corporation
It
ly1 E T44 0 _ ) Al t y r L/ ❑ Partnership
Business Telephone -/7��-iq7 915i"/Co.
Name of Licensed Plumber �r3r-,f?T fry �A��1Q Tr4�c"`
INSURANCE COVERAGE:
I have a current(ability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes Er No ❑
If you have checked yes, please/indicate the type coverage by checking the appropriate box.
A liability insurance policy ld 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 El Agent C3
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 narformed under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum ' g e and apter,,11 of the era[laws.
BY 'v(sL
Titre
re of Ucensed Plumber'
City/Town
Type of L)cense: Master % Journeyman E]_
APPROVED(OFFICE USE ONL License Number 3_-5
i
BELOW FOR OFFICE USE ONLY
FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME &TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED `
DATE 19
PLUMBING INSPECTOR