HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (55) i
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�'<<"•��T:��a TOWN OF NORTH ANDOVER
�a 0
PERMIT FOR PLUMBING
,SSACHUS�
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This certifies that
has permission to perform . . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of%�!– �. . ...:Y. . .'' . . . . . . . .
at . �`��. . '. .`. . . . .�. .- '. . .. . . . . North Andover, Mass.
Fee�-:�. . . . . .Lic. No./",.", .y. . . . . .;: . .�. .� . .
PLU�INSPECTOR
Check H G l
5 6
MASSACHUSETTS UNIFORM APP ICATION FOR PERMIT TO DO PLUMBING
(Type or print) CO
�� �NORTH ANDOVER,MASSACHUSETTS
Location C Date ��`� �� 0
Building q b 0`A`f1J Owner. Na e t",-n(QA S S V--f't-/ Permit# y—
^ 1 F,ary. �y Amount
Sv�`�a�v nt
Type of Occ anc Owrl):✓t
New Renovation 1-3 Replacement Plans Submitted Yes No ❑
FIXTURES
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w a
Cn x
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M COD Cn 06o
x
Exy
SLRBM.
x as
BASEV yr
M Hf=
M Boaz
M lMC
41H HOOR
51H l-goat
61H lZOOR
7M KOOK
s]x H-00
(Pr,,'',nt or type) /� Check one: Certificate
Installing Company Name it ai2o Lo p�—��!}rte ❑ Corp.
Addr Ss _ U( `10,c-L
0 Partner.
Busmess a ep one q-) a i _ a t- Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 0-� 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 El 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 Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts St to Plumbing Co and Chapter 142 of the General Laws.
By: e--�--art--e
v.b..ufw�,vi i,i,cuaGu r1U111VGi
Title Type of Plumbing License
City/Town Q 9 q
APPROVED(OFFICE USE ONLYicense RUMMY Master Journeyman ❑