HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (68) Iiy��J�, �.� �S' S �7
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Date. . . Q-
No
ti° TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
,SSACMus�
�'--t -+�-�— `-rig. . . . . . . . . . . . . . . . .
This certifies that , . . . . . . . . . . . .
has permission to perform . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . .
. .. . . . . . . . .. North Andover, Mass.
c ,
Fee?-?. Lic. No:F43. . . . .�.
PLUM)NINSPECTOR
Check it
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type
x Mass. Date AW z56 19' v Perfnd # �
Building Location 5�er's NameA
' Gtr^. Zia Q Type of Occupancy t E WTl A C _
y 1r
New ❑ Renovation ❑ Replacement R Plans Submitted: es ❑ No ❑
FIXTURES
z as
_z
N = Y Q
0 O Z > N
N Y J N Q V h<- N O O W ¢
2 N < ¢ ¢ = Z 0 0.
N
J N y dl = W N Y C a d 3 X
V Z O O ¢ N W ¢ S < W z O < N z .¢ a ¢ Q W
¢ W W < N p . J N ¢ ¢ J O ¢ p
W < _ O Z = Y d 0 F- < Y d W W Y W
F- G> > 1- O = a = Z O y _Z _Z W F O V S
< ~ < < S N N Q Q O < J -j < ¢ ¢ ¢ < O < F-
3 o
SUB—BSMT.
BASEMENT
IST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR/�
Installing Company Name f' 01? EeT - �jAr M,4 T A e i7 Check one: Certificate
Address �� ? C'C/-�C H man) Pi ❑ Corporation
jr E TW I')F_ n)- YO Ay t Vuj ❑ Partnership
Business Telephone �11f Z-i97 1 aFirfn/Co.
Name �,f Licensed Plumber T fid S,4 mmtz; rK Oc.,
INSURANCE COVERAGE:
I have a currentliability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes a No ❑
If you have checked yes, please
/indicate the type coverage by checking the appropriate box.
A liability insurance policy 1d" Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAVER: 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:
Signature of Owner or Owner's agent Owner ❑ Agent C3
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 orrned under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum ' g e and apter of the eral laws.
Title
re of Licensed Plum r
City/Town
Type of License: Master g/ Joumeymar ❑
APPROVED OFFICE US ONL License Number q33 5
BELOW FOR OFFICE USE ONLY �--
FINAL INSPECTIONS SKETCHES 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