HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (25) ' fc f� a,� ��� � 3 3 � �
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?�.,� •°„•_1tiooLVTOWN OF NORTH ANDOVER
}� p PERMIT FOR PLUMBING
SSACMUS�
This certifies that . . . . . . . . . . . . . . . . . . . . . .
has permission to perform . .'.D.G(i . . . . . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . .1�-e ��G` (�
I . . . . . . . . . . . . . . . . . . . . . . . .
at . .1 y ./I?f?.iH. . . .C.. . . . . . . . . . . . . . . North Andover, Mass.
Fee. Lic. No.. . . . . . . . . . r^ ,
J
)PLUMBING INSP CE TOR
Check #
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66405
1WIAbbACHUSETTS UNIFORM � "r
(Pri t or T e) APPLICATION FOR.PERMIT TO DO PLUMBING
as Date AE#
_ Building Lo ationOw
i a
Type of Occupancy
New 0 Renovation 0 Replacement
Plans Submitted: Yes❑ No 0
FIXTURES
B.P. # SEWER #
SEPTIC # .
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z LD Lu of LLJ
.J NLLJN N O Z CE w
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ce z
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SUB-
BAS ENT
UB-BASEMENT
IST FLOOR
2ND FLOOR
ti 3RD FLOOR
4TH FLOOR
5TH FLOOR
y 6TH FLOOR
7TH FLOOR
STH FL00
(stalling Company Name
ddress
Check one: Certificate
0 Corporation
isiness Telephone 2 '' ❑ PPartnership
ime of Licensed Plumber or Gas Fitter 'fT Firm/Co.
NSURANCE COVERAGE:
have a current Il blllty insurance policy or Its substantial equivalent, which meets the requirements
Yes No . 0
. 7th
f you have checked es please Indicate the type of coverage b
g y checking the appropriate box.
. liability Insurance policy� Other t ype of Indemnity ❑ Bond ❑
WNER'S INSURNACE WAIVER: I am aware that the licensee does not have the insurance cove42 of the Mass.General Laws, and that my signature on thspermitapplicatlon waives this requirrage re
gnat ire of Owner or Owner's Agent Check one:
Owner ❑ Agent 0
•eby certify that all al the details and information i have submitted (or entered)In shove ap lice I
cnowiedge and that all plumbing work and Installations performed u
ertinent provisions of the Massachusetts State Plumbing Code4andh-
p ton are true end accurate to the best of
r the permit Issued for thi a plication will be in compliance with
to 42 of e G oral Law .
3y
title of Licensed Plum er
:itylfown
�PPROVEb(OFFICE USE ONLY) Type of License
F].Ntdster 0 Journeyman
License Number_ �� 3
BELOW FOR OFFICE USE ONLY
i
FINAL INSPECTIONS �K!?CMEs
PROGRESS INSPECTIONS
i
FEE
NQ ,
APPLICATION FOIL F1611YIT TO 00 PLUMOINO
i
NAME i TTK OF GVMI INO
I
LOCATION OF DI IL01N0
FLUNIN I
MOUNT OQANUD
1 9 w
r
INO INSFECT011