HomeMy WebLinkAboutMiscellaneous - 11 Liberty Street L4
3 U J �i
Date.. �j ••••• •
0
„OeTI, TOWN OF NORTH ANDOVER 9
o p PERMIT FOR GAS INSTALLATION$
s � a
SACHUSEt m
m
1
This certifies that . . !y,.".?9!L. .`:r. . . . . .. . . . . . . . . . . . . .
�.
has permission for gas installation . . . . . '.. . . . ` . :!. . . . . . . . . M
in the buildings of . . .F. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . .`!. .�:.� :. . . . . . . . .'. .. . . . . . . . . . . .. North Andover, Mass.
Fee. Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GAS INSPECTOR
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
f 19
City, Town
Permit # d D Z
BuildingI L / f'� k 1 7 ? I mer s
AT: Location
Type of Occupancy: d
>: New ❑ Renovation ❑ Replacement ❑
Plans Submitted Yes ❑ No
Z tY to
0 U m t— K
to cc UI ¢ 0 to r F
r w j to W O 0 m V-
S to
C7 cc F Z
�-
Q z O
0 c
to W Q M o 0 o z
W a X Z t— y a a j Q
r_. . .. N W 2 tJ W N W Q cc O0 0 W W > X
Lu
to
q W W N J Q Y CC x t7
z ,� F- z W w QQ O > w f- V t I.. w
t a w > cx7 x � z Q o c9 m z 0 z 0 N x
c Q O O W O w F-
cc x o W 3 tr > Gl a l— o
,;'.. SUB—BSMT. :
BASEMENT) '
IST FLOOR
r., 2,ND FL',OOR`
3RD FLOOR;
1 4TH FLOOR`
'n.`. STH FLOOR
6TH FLOOR
"c. 7TH FLOOR
STH FLOORTT
.' ..: (Print or Type) Check One: Certificate
Installing Company Name �r/I/C)IL) ISL U/� 2,1&x- Corp. �.S 7
A -
Address ❑ Partnership
,/1
El Firm/Company
.Business Telephone ��J,7�� 7— Y V Name of Licensed Plumber or Gasfitter
t ;
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
s provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurance including completed operations coverage.
rt. tl
y,,t�-zp'1'L•�,ti Signature of Owner/Agent
I have a current liability insurance policy to include completed operations coverage.
+y `V,
sc By _. TYPE LICENSE:
Title. ❑ ignature of icensecPlumber
'Plumber or Gasfitter
City/Town ❑ Gasfitter
^APPROVE
>+" � (OFFICE USE ONLY) ❑ Master Y
X:�['QCT;;/•x:'
` : "• " ❑ journeyman License Number
.�f�'.{"•`�..;�• 1243
`,�•.a,,"; "�7 '' FORM HosBs d WARREN,INC.1989
Fold,Then Detach Along All Pellor,lhons
4:• 4
COMMONWEALTH OF MASSACHIJSF-17c;
BOARD IN PLUMBERS AND GASFITTERS IMPORTANT NOTICE
' P.L LICENSED AS A JOURNEYMAN PLUMBER
ISSUES THIS uCa r,l;F Ic PERMITS FOR PLUMBING AND GAS FITTING
INSTALLATIONS ON STATE OWNED OR USED
FACILITIES MUST BE FILED AT THE
TYPE THOMAS R GAGNON OFFICE OF THE STATE BOARD.
—J
PO BOX 8860
• SALEM MA 01971-8860
572487 18597 05/01/00 572487
Fold,Then Detach Along All Perloralions
COMMONWEALTH OF MASSACHUSETTS
W BOARD IN PLUMBERS AND GASFITTERS IMHORTANTNOTICE
PL LICENSED AS A MASTER PLUMBER PERMITS FOR PLUMBING A6v0GAS FITTING
ISSUES THIS I ICFN�1- 10 INSTALLATIONS ON STATE OWNED OR USED
FACILITIES MUST BE FILED AT THE
? OFFICE OF THE STATE BOARD.
TYPE THOMAS R GAGNON
—M
N PO BOX 8860
0
Co SALEM MA 01971-8860
572485 10136 05/01/00 572435
r
® Nam=
Fold,Then Detach Nrnin All f'nrtru,tu•.: -
t Fold,Then DeUirh.Alonr1 0•II n
i
COMMONWEALTH OF MASSACHUSETTS
BOARD IN PLUMBERS AND GASFITTERS IMPORTANT NOTICE
PL REGISTERED AS A PLUMBING CORP PERMITS FOR PLUMBING AND GAS FITTING
t: ISSUES TI11F,I-K:f cl:;r j() PERMITS
ON STATE OWNED OR USED
FACILITIES MUST BE FILED AT THE
TYPE THOMAS R GAGNON OFFICE OF THE STATE BOARD.
—C
PO BOX 8860
Co SALEM MA 01971-8860
57\2486 1524 05/01/00 572486
Fold,Then Detach Alonq All Pellnnhnnt
GTS -
t ;
DEPARTMENT OF PUBLIC SAFETY �estr c:ed To: 00
SPRINKLER CONTRACTOR LICENSE
Numbers Expires: Birthdate:
SC,,-:� 002265:'08%31/1999 08/3t/10�?
ReAr 00
THOK GNON-�
PO BOX 88fia`"
SALEM, MA 01970