HomeMy WebLinkAboutMiscellaneous - 135 AUTRAN AVENUE 4/30/2018 r / 135 AUTR,4NAVENUE U-A
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Of`NORTH ,H
3? �` TOWN OF NORTH ANDOVER
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//�� • - • PERMIT FOR GAS INSTALLATION
SACHuSEA _
This certifies that . /V. . f?�!�?.' <�� &
has permission for gas installation . . . . . . . . . . . . . . . . . . . . .
in the buildings of . . 5" L ! C 1-t
at . . f. r. . l.4 .�.� °.fir. . ? .�. �: . . ., North Andover, Mass.
Fee.-2.? '. . . Lic. No../ ?,?. . . . . . . . . . ... . . . . . .
GAS INSPECTOR
Check#
617
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO CASPITTING
(Print or Type)
�.. tr � r� s__►• Mass. Date Permit
Building Location /3_ /4 L4-1 I,- OrieneesName S� a
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Map: —_ Lot: done: Type of occupancy_.,_. 7 7
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New CJ Renovation,❑ Replacement 4 Plane Submitted: Yes J No L7, .
Fee:
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SUB-8SMT.
BASEMENT
1ST FLOOR
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2ND FLOOR
3RD FLOOR ;.
4TH FLOOR
5TH FLOOR
i
6TH FLOOR
7TH FLOOR
aTk FLOOR
Installing Company Name
Check one: Certificate
Address
Caoporauon
Estimate Value of Work:
-- - -_ _
—�-ar >r� F� r! stir .----�t Z ❑ Partnership
Business Telephone ?_
a—Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE:
. have a current li ility insurance policy or its substantial aquj aleni which meets the requirements of MGL Ch. 1.42
Yes No ❑ .
If you have checked M, please indicate the type caverage by checkingthe:appropriate
b
_ ox.
A liability insurance policy �'r Other type of Indemnity ZI:
Bond ❑
OWNER'S INSURANCE WAIVER,.- I am aware that the licensee kgs 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:
— Owner U Agent U
Signature of Owner or Ownees Agent
I hereby certify that all of the details and information-1:have submitted.(or entered}in above:application are true and accurate tort a bebt of
my knowledge and that all plumbing work.and onstailations performed under the permit issued for this application will be in compliances with
all.pertinent provisions of the Massachusetts Skate as Code and Chapter 142 of the General eras Laws.
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Plumber Signature of Licensed Plumber or Gas Fitte
Title Gasfitier
ter License Number P �.7
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City ATown Jo4rneyman.
APPROVED (OFFICE USE ONLY)
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Date.
HORTM
.�4, TOWN OF NORTH ANDOVER'
PERMIT FOR PLUMBING
,SSACHUS�
This certifies that . . Ate. �-I ?'h . . .� �� . �� . . . . . . . . . .
has permission to perform . . . . .!.' . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . . . .Y-. �. {.1. GQ
. . . . . . . . . . . . . . . . . . . . . .
at. . ./ . . . . . . . . . . . North Andover, Mass.
Fee. ,.?Jr. . . .Lic. No... ./2-2. .`V . . . . . . . . h.�.
PL M13ING INSPEGfOR
Check # ) ))
7729
MAS,,;ACHt;SETTS 1L)NIFORM A.PPLICA'Tit' N FOR PG RMI T Tom:,. DO Pi.A"N,111ING
U'rint or Type;
20
Permit #t
f ,
C� Building LoCa!ian_ 1 3 `t g owner'sPVarr3e��ar�p��_.S;�l V
Type of Occupancy-Lc S 1 qLe.�d
New ❑ Renovation ❑ Replacement F4-- Pians Submitted. Yes 1i No �?
FIXTURES
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p aASZMENT
1STFLOOF
.y
2ND FLOOR
q7
3RD FLOOR
4TH FLOOR
STH FLOOR
6THFLOOR
7TH FLOOR
STH FLOOR
1E I LJ
installing Company Name. rt�r7�a,,,�o T �/ Check ooe: Certificate,
Address - _ Corporation
---- er A-1 grs ng ❑ Partnership
Business Telephone ?e-- � —p yr:3-b �-
Name of Ucensed Plumber
INSURANCE COVERAdE:
I have a current liability insurance policy or Its substantlai equivalent which meets the regtilrements ref MGL Ch. 142.
'yes ' No 0
If you have checked Vis, please indicate the type coverage by checking the appropriate box.
A liability insurance policy CcY� Other type of Indemnity ❑ Bond Q
OWNER'S INSURANCE WAIVER:I am aware that the licensee., -00s W brvpe the insurance coverage required by
Chapter 142 of the Mass. General laws, and.that rriy signature on this permit application waives this ragviremer:t. t.
Check one:
_ Owner p Agent❑
gni re o.CMner or Oraner a . eZt
i hereby certify that all of the detslis and Into minion I have Mwbndtted(ci onlared)in above
knowiA and that Wl plumbing rFwrk and tnstaflations peifo{mad funder the application are taus and accurate to Ns��O al r:y
Dl 8 permit issued for this application wilt be in rompGance wii sit
penin provisions of the Massachv5aM$We Murmbing C*de W grapier 142 of the General Lx"
Sy '- n
gnatWe 0 cense um r
Titin
- -- Type of Ucense:MaAer '" 'Journeyman L3 s
Gt !•i'own
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