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HomeMy WebLinkAboutMiscellaneous - 155 LACONIA CIRCLE 4/30/2018 155 LACONIA CIRCLE 210/105.D-01 33-0000.0 1 � I I N- 9685 Date.l���r1 N2 NORTM TOWN OF NORTH ANDOVER �? ��tR �•�OCL PERMIT FOR PLUMBING i, This certifies that W,?.e. S -, 1. . . Q e`i . . . . 1. has permission to perform . _ 4- D . . . . . . . . . . . . . . . . . plumbing in the buildings of . .4.(At. '.. . . . . . . . . . . . . . . . . . . at. . �+P►C_.tM t e 34�e... . . ., North Andover, Mass. Fee757' .Lic. No.*:31. . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # � i WHITE: Applicant CANARY: Building Dept. PINK:Treasurer .F k MASSACHUSETTS ;,INIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITYNOU 0 �I MA DF;fE I 1 _ PERMIT# JOBSITEADDRESS_�_..�acoL��l� _ /� /1 i pp OWNER'S NAME OWNER ADDRESS �.11o n l a CACI C TELqq3'SiO'I(P MFAX TYPE OR OCCUPANCY TYPE COUiMERCIAL❑ EDUCATIONAL ❑ RESIDENTIALX PRINT / _ CLEARLY NEW: ❑ RENOVATION: [ REPLACEMENT:x PLANS SUBMITTED: YES❑ NO❑ FIXTURES-1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING 40THER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YE91r�'—NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPI-OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY ❑ BOND ❑ OW'NER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signa.ure on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGE'JT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations,performe:cl under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 14'of the General Laws. PLUMBER'S NAME-7 /» /,JF C-IC-R LICENSE 7 SIGNATURE MP JP❑ COfZPORATION [ #3c 6 3 PARTNERSHIP❑# LLC❑# COA/PANY NAME Pa 6� f(� ADDRESS S� CITY '00 'ed!!?n STATE0!!nn _ ZIP O/S 3STEL � IW 2L� FAX 11' . CELLEMAIL t O i, WYJ I-x2tires,A-A_ UY•-Pj-e- //�G�'1✓ �L� ��/tel/� � _ . . � � . �� ,.4 r Y 1 Date TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION f� This certifies that . . . . . . . .�. . . . . .. . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation ! �? p.�.C `!---fi . -�- in the buildings of (`5�. . . . . . . . . . . . . . . . . . . . . . . . . . . . c ��t at . . . . t 9 , -f tom, -._. k 2.�. - . . . . ,North Andover, Mass. z 3 ,, ,�,A Fee -! . . . Lic. No. . . . . . . .14 . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR Check#� i 8465 MASSACHUS=TTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY m,l` Or U Idovt MA DATE �_-L,�.0-� , lJ�ZPERMIT# JOBSITE ADDRESS .�. ,.Lo'co.n.I I.J. (r JYIJ�.�,s OWNER'S NAME .l�/� l J C7 U,.I,t JJ,.I OWNER ADDRESS ._Il�..I�O-� ...------- TYPE I"PRI OR OCCUPANCY TYPE CON,MERCIAL EDUCATIONAL �„ RESIDENTIAL PRINT CLEARLY RLY NEW ;._]4 RENOVATION REPLACEMENT PLANS SUBMITTED: YES N0,- APPLIANCES 7 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER t BOOSTER CONVERSION BURNER 3 .1 COOK STOVE DIRECT VENT HEATER DRYER I FIREPLACE z FRYOLATOR FUR14ACE GENERATOR IF GRILLE _ INFRARED HEATER - E LABORATORY COCKS MAKEUP AIR UNIT OVEN _ _._ ' POOL HEATER E. _.. _. ROOM/SPACE HEATER ROOF TOP UNIT TEST _ _. ,.... . ._< .. .. �... .. .,.._, UNIT HEATER _. UNVENTED ROOM HEATER WATER HEATER OTyLR _ _. . . INSURANCE COVERAGE I hLye a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES0 I I)`!YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY 'x BOND , OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that Iny signature on this perrnit application waives this requirement. CHECK ONE ONLY: OWNER AGENT SIGNATURE OF OWNER.OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this 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 Perti ent provision of the Massachusetts State Plumbing Code and C'napter 142 of the General Laws. PLUMBER GASFITTER NAME .� ���s LICENSE# gy�7 SIGNAT _. . MP. MGF, JP '_ JGF „ LPGI CORPORATION l/,# 3�p�3 PARTNERSHIP• .r# LLC;r a # COMPANY NAME <ADDRESS` u._m.. ia.rne�� CITY �A. a. d�, STAT :ZIP O/¢;3 S'`� TEL 9 7d? 3>Z Ji FAX '1,L; LLL EMAILIr �d..� I �, _ _ _ __ � �//g�/�/ G�7�/ ��� Division of Professional Licensure: License Search Page 1 of 1 9 The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Mass.Gov Home State Agencies A-Z Topics f Home>Division of Professional Licensure> ONLINE SERVICES .. ............................................................................................................................................................................................................................................... Check a License Check A Professional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change -- -- Contact the Agency SEARCH CRITERIA More... Profession:Plumber License Number:8437 REFERENCES& RELATEDINFO Disclaimer Regarding LIC. BOARD LIC. TYPE LIC. NUMBER NAME CITY/STATE LIC. STATUS Website License Searches Plumbers ti Gasfitters Master Plumber 8437 THOMAS E.WEEKS MERRIMAC,MA Current Enforcement Process �_ ���._A_._� Glossary Your search has resulted in 1 licenses Glossary of License Status Codes More... The page above has been generated by the Division of Professional Licensure web server on Monday,November 26,2012 at 10:50:07 AM. ©2007-2011 Commonwealth of Massachusetts Site Policies Contact Us I http://license.reg.state.ma.us/public/pubLicRange.asp?profession=Plumber&licenseNo=8... 11/26/2012