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HomeMy WebLinkAboutMiscellaneous - 145 BEAR HILL ROAD 4/30/2018 J 145 BEAR HILL ROAD 210/064,x.0087_0000.0 i i z MASSACHUSETTS UNIFORM APPLICATION FOR PERM,/TO DO PLUMBING r y (Type or print) Date NORTH ANDOVER,MASSACHUSEM / / Building Locations G / / ` / I/Permit #--I? ? Amount Owner's Name y New LJ Renovation Replacement Plans Submitted FIXTURES F cr A AG W a d w W SL]3- >JSr RDQt 21sn Rfm 3M RDM M RfM 5111 RfM 6M RDM 7M F)OC E 9111 RIM (Print or type) Check one: Certificate Installing Company Name C3 ► SLS'►- !�� -k 1 /�d- l� ❑ Corp. Address -52 Ila X-�� n-� J , ❑ Partner. 'i U F Yq-,-y-() t,J-Q 2 �e ' -• Business Telephone 1T7p (-Zo ©--Firm/Co. Name of Licensed Plumber: / 3,i 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 ignature Owner Agent ❑ 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 install tions p ormed under Permit Iss d for this application will be in compliance with all pertinent provisions of the Massach Sta u bing e and CC ha r 14 the General Laws. By: Signarure orui-c—enseci PIUM7 �� Plumbing License Title so City/Town License NUMDer Master Journeyman ❑ APPROVED(OFFICE USE ONLY t. .may Date 3734 f NOR7 a TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUS� This certifies that . . . . . . . . . . . . . . . . . has permission to perform . . �? �".��. . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of 6.<. .i?. . . . . . . . . . . . . . . . . . at. 3K. .Fv. .Sa3. . . c� . . . . . . . . . . . . . . .. North Andover, Mass. Fee/.).-.'. . .Lic. No.9:.G�t� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 06123/98 08:40 15.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer