The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 13 ARDMORE COURT 4/30/2018 i I i �� i � 'I s f` f i' Date... w 11313 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that........................... ......................................... .. to perform... has permission ........I............ .. ...... . . ......................................... plumbing in the buildings of...................... ......a.U tr.. .... ..... .........4rth Andover, Mass. at.LI Lic. No. ........ ........... ................... PL Check Date... �. ... 1.)............... I r - 0ORYN o� '�m TOWN OF NORTH AND`O ER PERMIT FOR GAS INSTAL ATION t o "i•, » 'a CHUS�� This certifies that ...................0 ............................. ................................................ { �.has perm issionfor gas installation ... •' er'./d '�................................... inthe buildings of......................:............................................................................................ NoAh Andover, Mass. at ?.. .... U .r'� . k Ag INSPEC R ;.1 Check# 102 �' X99 3&0ocf� til MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY L- -- ,^ _ MA DATE A PERMIT# JOBSITEADDRESS_ OWNER'S NAME . G OWNERADDRESS TE t TYPE OR OCCUPANCY TYPE COMMERCIAL[] ICATIONAI� RESIDENTIALIQ PRINT CLEARLY NEW.0 RENOVATION:[] REPLACEMENT: PLANS SUBMITTED: YES .®.t- NOD,,'.' APPLIANCES 7 FLOORS-- BW 1 2 3 4 5 6 7 8 9 10 11 12 13 14 - BOILER — �J _ _ _J BOOSTER CONVERSION BURNER ! COOK STOVE DIRECT VENT HEATER DRYERi FIREPLACE FRYOLATOR ! FURNACE — GENERATOR GRILLE - INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN � POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT __j TEST UNIT HEATER UNVENTED ROOM HEATER `WATER HEATERA1r= �__ _ --- .- __.1 _f f F----_,}E-----j _.J — OTHER ._J �._ ��•- - --_. .,, .._-- -------- — . a_ INSURANCE COVERAGE - _--- --_- - - --- ---- ---- e -- - - I have a current Itabiiif insurance policy or Its substantial equivalent which meets the requirements of MGL.Ch.142 YES)Q NO YOU I IF � U C NECKEO YES,PLEASE INDICATE THE TYPE OF COVERAG Y CHECKING THE APPROPRIATE BOX BELOW LIABILITYINSURANCE POLICY Imo'' OTHER"TYPE INDEMNITY E-1 BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application MghM this requirement. CHECK ONE ONLY: OWNER Ej AGENT 0' SIGNATURE ER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true d accurate to the b f my knoWedge and that all plumbing work and Installations performed under the permit Issued for this application%0 be In comp va'th all Pertinent Massachusetts State plumbing Code and Chapter 142 of the General Laws. \ PLUMBER-GASFITi'ER NAME[. LICENSE# SIGNARE{�/� MP .,'MGF JP( JGF LPGI® CORPORATION Q# PARTNERSHIP Q#� LLC r-_ -1 COMPANY NAMIE-L.A ADDRESS CITY - STATEB&AZIP _ TEL t _^ FAX CELL LL .. _ r` � 9 { r _ - _ - - 1 4 � �� CITYN)6 1 0101'r •E C^- i , JOBSITE ADDRESS 12) ACrAM)fr ,c4__oWNWS NAME OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAV hA 71 KITCHEN SINK INSURANCE COVERAGE: - s the requftements of MGL CIL 142. YWd NO 0 Massachusetts GamWLms.and ..; nW sWk-dureon tidspemiltapplicationthis nquIremwt F F • { t OWNER . AGENT-SIGNATURE OF . OWNER ORAGENT iM- • is i f{//J�s�� f� �n.� 3551 Date..................... NORTH TOWN OF NORTH ANDOVER 3r O B. �� PERMIT FOR GAS INSTALLATION 9 41 • SACMUSES q This certifies that . . . ... . . ....1.. . . . . . . ... .. . . .. . . . . . . . . . . . . . . . . has permission for gas installation -: .'- - :�.:. . . . . . . . .. . . . . . /17 in the buildings of ... . .... - -f`',,'"�?'� .' . . . . . . . . . . . . . . . . . . . . at C�1. . _r" ... . . . . . North Andover, Mass. Fee: . . .^. . Lic. No j`.�tf�.`p. . . / ? C,. . . . . . . �'"WHITE:Appliewt CANARY:Building Dept. PINK:Treasurer ii. MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTIlYG or print) Date It t—,9ORTANDOVER, MASSACHUSETTS Building Locations / -3 4—IP—r),-ii Permit# �J Amount S /1/D . A/YDzo y *\,,-q 9tkyJOwner's Name �J t � C- . New❑ Renovation ❑ Replacement Plans Submitted ❑ A of L � _ L n F Z z c, In m n v w _ n z 'r rn C Z -t a %r, z C C C t wZ z — ^ t C C a SUB-BASENI E :NT BASE .M ENT I ST. F L O G R 2ND . FLOUR 3 R D . F L O O R 1'r if FLOGR 5'r 1i FLOG R 6'rit . FLOG R 7T 11 . F L O O R .3T 11 . F L O O R q# l (Print or type) Check one: Certificate Installing Company Name Al C IS 14A -rP,ffa/2 (J' ❑ Corp. Address z y6� S✓4 L M ❑ Partner. AN-AoV�2 Business Telephone .9 ;�L-,Nr [� �e�— �i -g Firm/Co. f Name of Licensed Plumber or Gas Fitter �`2��1s //✓� �� f INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalgnt. Yes No❑ If you have checked ves,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 ivlass.General Laws,and that my signature on this permit application waives this requirement. Check one: Sienature of Owner or Owner's Agent Owner ❑ AQent ❑ i hereby certify that all of the details and information I have su itted(or entered) in e application are true and accurate to the 1 best of my knowledge and that all plumbing work and in •ion orr led-�uttdgr f' d For chi's application 1 ' e in compliance with all pertinent provisions ofthe l4assach tts S [ Code,/a ' ptei!1 1? of the General L ws. Bv: Signature of Licensed Plumber Or Gas Fitter Title Plumber / v'88 City/Town �❑ Gas Fitter (cense INumoer iVlaster APPROVED(t)FFICG uSE ONLY) Journeyman I i