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HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (23) 2 , Q Date . .�. .'.r. .� "oRT„ TOWN OF NORTH ANDOVER o PERMIT FOR PLUMBING s i ,SSACMUS� This certifies that . . S. . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . .I-:-?! -. . plumbing in the buildings of . . . . . . . . . . . . . . . . . . at ./.` i ':,.: . . .•. . . #!' ! ., ., North Andover, Mass. r Fee. . . .". . .Lic. No.. . .,c .l. . .�. . p t f PLUMBING INSPECTOR t ' Check # 550, 0 7-3 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) Mass. Date ` 2Oo Pe it # �r.3 0 Building Location Q ' Owner's NameZKY--ak Type of Occupancy_ S D E TI YA L_ y r New ❑ Renovation ❑ Replacement (�r Plans Submitted: Yes ❑ No ❑ FIXTURES Pz N Z Y < t- N J > V < z LU W W Y J N < F- N O L7 S S y Z N Q S Q = Z O Z N a O J N W N t• W N F- U < N W z Z V Q m W Q } < �- N Z a C < a < 3 X = p p S Q W Q < W a Q (A Z .CC 4 ¢ 00 U. W 1-I tW- U < ~ S d z = 1 a G ~ i Z d W O V S < F- Q• < = N H < < p Q J J < Q CC a Q O Q 1- 3 O r SUB—BSMT. BASEMENT IST FLOOR r 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name I'S 0 t e-r A S jm M 14 z A e 7 Check one: Certificate Address r? 00/qc 14/Y)An) Ot, ) ❑ Corporation �Y) E TNI.' ) Al A 0 t tf(/LI ❑ Partnership Business Telephone (40-5q7 I ©-rm/Cp, Name of Licensed Plumberf;,� INSURANCE COVERAGE: I have ayes current Jability Insura❑ ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. a NoIf you have checked Vis, 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 permit application waives this requirement. Check one: O Signature of Owner or Owner's Agent 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 installations performed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum 'ng a and qapter of the eras Laws. re o Licensed Plum er Title City/Town Type of License: Master % Journeymalr C]_ APPROVED OFFICE USE ONL License Number q 3 3 5 BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCH , PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 19 PLUMBING INSPECTOR }