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HomeMy WebLinkAboutMiscellaneous - 14 EMERSON COURT 4/30/2018 1 f Date.14:. c HORTM �'. '° •'tio TOWN OF NORTH ANDOVER �� .�.r - '• o� 1. 40 PERMIT FOR PLUMBING . 5 SSACMUS� This certifies that . . . . . . has permission to perform . ....j��,.!-�'. .T.!. . . . . . . . . . . . . . . . . plumbing in the buildings of ,at . .j . � . . . . . . . . . . . . . . . . . . . . . .f..� . . . . ., North Andover, Mass. Fee . . . . . .Lic. No-44,),5:3. . . . .. . .c.. . . . . . . . . . t,r PLu M N INSPECTOR Check ,, / l 7136 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location G � -- // Chi /U�U' ,' (Q /ASO Comets Name �/ Date. # Type of Occupancy Amount —2Ji New Renovation ❑ Replacement plans Submitted Yes ❑ No FIXTURES Hz H z w ° Cl)w a x wz a zARBM A a v 3 H LST.FLOOR M 4IH FIOOR 5M FLOOR 6116 FLOOR 7tx FLOOR s>�-><FLocR (Print or type) ZL.�5 Check one; Installing Company Name ' Certificate ❑ Corp. Address C 'r'C Partner. usrness I e ep one o. Name of Licensed Plumber: Insurance Coverage: Indicate the type of ensu an coverage bychecking the�appropririate box: Liability insurance policy Other type of indemnity 0 Bond F Insurance Waiver: I, the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information 1 have submitted(or entered)in a4ve application are true and accurate to the best of my knowledge and that all plumbing work and installations �Plun it Issued for sap 'ca[i n will be in compliance with all pertinent provisions of the Massachusetts State and ate 4 f[ e ral Laws. By' igna um Ot LICUSCU-1-lujilour Title Type of Plumbing License City/Town 2 5�09-L3 ense um er Master ❑ Journeyman APPROVED("OFFICE USE ONLY Date. . . . ",O P': �tio TOWN OF NORTH ANDOVER PERMIT Fok PLUMBING �SSCHUS This certifies that . . . . . . . . . / . . . �!. ./. . . . . . . . has permission to perform . � lC. ... . . . . plumbing in the buildings of��1.,.c . .. .... ��. . . . . . atNorth Andover, Mass. Fee, Lic. No.% ! � . . .�{'� Az' PLUMBING INSPECTOR _ V Check # t/ 6382 MASSACHUSETTS UNIFO APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date �' d Building Locatio CLc Own s ame / Q Permit#��_ ecce-1 Amount -- Type of Occupancy New 0 Renovation 11 Replacement 54 Plans Submitted Yes No FIXTURES ro S�BflNC II 1SlC)HIDCR 3�II)FLO(R �FIDQt 4IIi PIO(R 5M HDM 6M HDM M HOM gm 110M (Print or type) Check one: Certificate Installing Company Name /G ? Corp. Addr ss Partner. S 0�R, a ` Business Telephone ,—<D/61 Firm/Co. i Name of Licensed Plumber: /1��/(//� (tj,/LS o n Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy � Other type of indemnity Bond Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent El I hereby certify that all of the details and information I ubmitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work install 'ons rformed under P 't Issued for this application will be in compliance with all pertinent provisions of the sachuse s S Plu ng o d Chapter 142 of the General Laws. By Signature of Licensea Type of Plumbing License Title 6 3 City/Town License um er Master Journeyman APPROVED(OFFICE USE ONLY