HomeMy WebLinkAboutMiscellaneous - 15 NORTH CROSS ROAD 4/30/2018 (2) 15 NORTH CROSS ROAD
210/038.0-0188-0000.0
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Date. �/.�6 `. . . .... ..
Of NO DTIy
o? �` TOWN OF NORTH,AN OVER
PERMIT FOR GAINSTALLATION
SACMUSEt�
This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . .
has permission for gas installation . . . J`lj�t.�: . . . . . . . . . . . . . .
in the buildings of
at . . . . orth Andover, Mass.
�.Fee. 3 . . . . Lic. No..,r.�!�.`:. . . . . .T. � 1°�✓J\.�-��,�.. . . .
GAS INSPECTOR
Check# 1,c, Q Pow
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6751
MASSACHUSETTS Uwmm APPUCATON FOR PERM TO DO GAS FITTING
(Type or print) Date f , ^ o
NORTH ANDOVER, MASSACHUSETTS `cL
Building Loqations 5 �Srj
Permit# C', 7� /
Owner's Name Amount
New Renovation ❑ Replacement ❑ Plans Submitted ❑
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SUB -BASEM EN
BASEM ENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR
4TH . F L 0 0 R
STH . FLOOR
r 6TH . FLOOR
7TH • .FLOOR
8TH . FLOORIla--
(Print or type)
Name__ fid /� 2 S- �� C Check opw Certificate Installing Company
rvTCorp.
Address
❑ Partner.
csusmess ►elephone C �r o� a.� +
❑ Firm/Co.
Name of Licensed Plumber'or Gas Fitter
FINSURANCE COVERAGE
a current liability insurance p "cy or it's substantial equivalent. Yesck onehave checked Ls,please i icate the a cove No❑
y insurance policy Ty Other type of indemnitygED the appropriate box. Bond
Owner's Insurance Waiver: I.am aware that the licensee does not the Insurance coverage required by Chapter 14the]
Mass. General Laws,and that my signature on this permit application waives this requirement.
Signature of Owner or Owner's Agent Check one:
wner
I hereby certify that all of the details and information I have submitted(or entered) in above application gt1:3 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 State
as Code d Chapter 142 of the General Laws.
By: D Si re f Licensed Plumber Or Gas Fitter
Title umb f J� �J
c '1
CitY/Town•: Gas Fitter Icense Ium er /
❑ Master
APPROVED(OFFICE USE ONLY) ❑ Journeyman
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
,SSACNUS� /I /
This certifies that . . . T ��.�. !. ?.� . . . . . .�)�. . . . . . . . . . . . . .
has permission to perform . . . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . . .R V. . . . . . . . . . . . . . . . . . . .
at. . ?. . . !� . .�'.(�.c, s s. . . . . . . . .�. North Andover, Mass.
� u
Fee. Lic. No.1f l. .`. . . . . . . . . v
/ PLUMBING INSPECTOR
Check # 5 � ,
5588
3L
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print
1orr Type) f
, Mass. Date Permit # (�
Building Location/` N1' Owner's Na
Type of Occupancy Resideritl
~~ New L Renovation U Replacement N Plans Submitted: Yes❑ No ❑
FIXTURES
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3 x J m o o 3 r r m LL o m P4
SUB—BSMT.
1
BASEMENT
IST FLOOR
P F
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOn !3E
Installing Company Name IIeritage Htg. &Plg. Co. Inc. Check one: Certificate
Address_ 35 P14 Street CX Corporation 714
Stoneham, Ma 02180 C7 Partnership
Business Telephone 781 -A-U-=— rl Firm/Co. _
Name of Licensed Plumber Gordon Switzer
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes N No Ll
It you have checked Vis, please indicate the type coverage by checking the appropriate box.
A liability insurance policy l; 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:
Owner ❑ Agent❑
Signature of Owner or Owner's 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 issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbing Code and Chapter 14 of the General Laws.
Si ature of L-u �c4�d Phrnibor
Title _____—_
—_-- Type of License: Master fY Journeyman❑
City/Town 8322
APPROVES T ICE l7SE NLY) License Number____
BELOW FOR OFFICE USE ONLY
FINAL INSPEC71ONS SKETCHES PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME&TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE 19
PLUMBING INSPECTOR