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HomeMy WebLinkAboutMiscellaneous - 115 CARLTON LANE 4/30/2018 115 CARLTON LANE 2101106.C-0085-0000.0 Date. ..�..`� ? ...... NORTH hQ '° TOWN OF NORTH ANDOVER O F • w POW PERMIT FOR GAS INSTALLATION ,SSACHUSEt This certifies that . . . ... . . . . . . . . . . . . . . . . . .. . .. has permission for gas installation . . . . . . . .. . . . . . . . . . . . . in the buildings of . . . . . . . at . . . . . . . . . . . . North Andover, Mass. 7 it 4 1.. G ov Fee. . . .' . . . Lic. No.. . . . . . .. . . . . . . . . . . . . . .. . . . GAS INSPECTOR Check# / ) J ' 4450 r yam\ M1.ASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Mass. Date permit # Building Location / �5 CARL7?W S Owner's Name %/J2 O lU / Hoo UE/` Type of Occupancy__ IC New ❑ Renovation ❑ Replacement S—/ Plans Submitted: Yes❑ No ❑ N N Q X W vi X tr Vj N N Va v1 K 41 K 0 M rn x r W W N a Q U m F� S 11 Z O LA =' .d Y W 0 O O = F. v ura. NW W d X U W N Vl a W d 1' .t W 0 W Z O 2 a O X W T K W :DX. < Cr d rt 'x O c7 z u D o tl U ¢ > o a F- 0 SUB—BSMT. BASEMENT 1ST FLOOR 4 t. 2ND FLOOR 3RDFLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR BTHFLOOR Installing CompaAtLAc�7- Name t�lt�L/ / �/16010 1-117-,( Check one: Certificate # Address Qf 9 7- 0—Corporaticn 6-A C - ` '-b©Upy� ❑ Partnership Business Telephone 4/ �d �1 4�7-_) 3 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter 7L�i��jf� INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes D--- No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. A 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 perma application waives this requirement. Check one: Signature of Owner or Owners Agent OwnerO Agent El 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 Permit Issued for this application will be compliance with ell pertinent provisions of the Massachusetts Slate Gas Code and Chapter 142 of the Gen ral laws. By T e of Ucense: /� ` Tills Plumber rg lure o cense Plumber or Gas filer sfiltor � ;aLLsler Ucense Number City/Town Journeyman NrrxritnTofiic_ o BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION FINAL INSPECTION SKETCHES FEE NO. APPLICATION FOR PERMIT TO DO CASFITTING NAME & TYPE OF BUILDING LOCATION OF BU1LDINd PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE ZO GA3INSPECTOR Date. 01 "ORT" 41 TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING Thi' certifies that . . �` . ��. '. .�. . . ���. ��. . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . ./7^'! . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . .. North Andover, Mass. Fee.?. . .Lic. No !.J. t... . Q-. . . .�:c�. . . . . . . . PLUMBING INSPE TOR Check # t }^ 5741 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) _ P. Mass. Date 1671, �3 Permit # 7 �l Building Location��a ( f n % Owner's/V- Name-922( .Aiu wu i� -.� Type of Occupancy New ❑ Renovation ❑ RepiacementrEj Plans Submitted: Yes ❑ No ❑ B•P SEWERS FIXTURES SEPTIC# :zy ID Y C co t- cn y +n OT. F- 0 LU 14 14 LU y Z cn Q ¢ a U t zd N O _ Cr x-J 0 _ o z u v Z c m ¢ <I F- w z ¢ Uj O O s d N rt I a W — ° C of Z c a ¢ O rsa r r w9)9) Q -j a' LU x a = 3 O Z = J c r a g ° c ° U. o a rv- y r- o y N ° W z 0 o y z z W rte- o x 'x > .- a' a x _ _ Q Q o a J a c c x, a 0 O b .0 SUB—BSMT. BASEMENT y 1ST FLOOR 2ND FLOOR a 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR + STH FLOOR installing Company Name G -- Check one: Certificate # Address L. W te 72 ❑ Corporation ❑ Partnership Business Telephone 1 Q+Irm/Co. Name of Licensed Plumber -LT— U— Gl INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0—" No ❑ If If you have checked Yes, please indicate the type coverage by checking the appropriate box A liability insurance policy 0---- Other type of indemnity p 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 ente ed)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfo a nder t e. ermit issued for this application will be in compliance with all Laws- pertinent provisions of the Massachusetts State Plumbing e d Chi General laws_ By �' Title 5i9nZi rcensed Pumber City/Town se: Master Journeyman 3-- APPROVED OFFICE USE ONLY) License Number BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES (� PROGRESS INSPECTIONS FEE a NO._ A APPLICATION FOR PERMIT TO DO PLUMBING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE ZQ PLUMBING INSPECTOR