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Home My WebLink AboutMiscellaneous - 156 CHESTNUT STREET 4/30/2018 (9)/ 156 CHESTNUT STREET U-7 210/060-0-0071-OOOO.G \\\ I I Date.� ?��.5. . . TOWN OF NORTH ANDOVER 40 p PERMIT FOR PLUMBING o ♦`q`i 'Ss4cmu'S� J This certifies that . . . .�afG.�. r��rL ` . . . . . . • . . . has permission to perform . . . . . . �. �. . . . .`. . . . . . . . . . . . . . . . plumbing in the buildings of . . . lJ . x. . . . . . . . . . . . . . . . . at . � G. . . . . . . . . . . ., North Andover, Mass. v - ` Fee;,?. Lic. No2.Y.i.�3. . . . . . . . . . .. . . . . . . PLUMBING INSPECTOR Check # 8269 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) ' NORTH ANDOVER,MASSACHUSETTS 0 Date Building Location 15� e11eS7�Ur ,Sr Owners Name O l/P��¢ �DN/�6 Permit# y S Amount �7 L, �r Type of Occupancy jti'G N.ewrl Renovation Replacement ® Plans Submitted Yes No FIXTURES F-F WW a a p w r � a ra A A H � A � a as AR» BASEMENr M FLOOR Z10 FLOOR �m FIDOR 4M FIDOR 5IH HfM 6M FLOOR 7M FLOOR SIH FLOOR (Print orgtype) y jWZLa1r,4N Corp./�Ur�/�/� Check Certificate Installin Company Name Address .57.2 � Partner. �.switP6�� In 4 oiB '� Business Tele p one _I--- g S—O y Firm/Co. Name of Licensed Plumber: insurance Covet-age: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity ElBond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner 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.,State Plumbing Code and Chapter 142 of the General Laws. By: ign�a'u f;c e um er Type of Plumbing License Title 33 City/Town icense lNumoer Master ❑ Journeyman APPROVED(OFFICE USE ONLY Date. .l!/!. LAd. . . . ... . V�ORTM 310ya'..ao ,•1tiOL TOWN OF NORTH ANDOVER' O 3 9 F ` - PERMIT FOR GAS INSTALLATION • • • �9SSACMUSLZ" This certifies that . .' has permission for gas installation . .G!L .� . . . . . . . . . . . . . . . . . . . in the buildings of . �G//�'. G.�. . . . . . . . . . . . . . . . . . . . . . . . . at . ,�a. . .�l�.� �. ."t . . . . . . . . . . . ., North Andover, Mass. Fee. U. Lic. No.2!1).�:�. . . . . nom'U. . . . . . . GAS INSPECTOR Check# 70 ',, 6 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date �� 4 NORTH ANDOVER,MASSACHUSETTS Building Locations / / 6 ,�� jo�' G Permit# a✓ Amount$ Owner's Name New Renovation Replacement ® Plans Submitted dz c W H > z z 0 1- C. > d y w > w a d y m C O w O ° F o SUB -BASEMENT > BA SEM ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR STH . FLOOR zu (Print or type) ll 1'�,��'y Che k one: Certificate Installing Company Name fmle� e�� Corp. Address �� 4� j — L�L��PPivl�' �� ci Partner. Business Telephone 7 — G '9-- -7—5—Pl Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. YesNo� If you have checked Les,please indicate the type coverage by checking the appropriate box. 10 Liability insurance policy ® Other type of indemnity ® Bond 13 Owner's Insurance Waiver: I am aware that the licensee does 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 13 Agent 0 1 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 State Gas Code and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title Plumber City/Town Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) ® Journeyman III l One Beacon I N S U R A N C E 3/14/2002 Building Inspectors Office N. Andover, Mass 01845 Insured: Patricia M. Conroy Property Address: 156 Chestnut St. Apt#7 Policy#: CBSM94861 Loss of : 10/01/01 Claim #: 0133-06322Y BF03 Claim has been made involving loss, damage or destruction of the above- captioned property, which may either exceed $1000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General laws, Chapter 139, Section 313 is appropriate, please direct itto the attention.of this writer and include a reference to the above- captioned insured, location, policy number, date of loss and claim number. Title: Property Claims Adjuster. On this date, I caused copies of this notice to be sent to the persons named above at the address indicated above by first class mail. Sincerely, Dave Brenton Claims,Adjuster- DB/DG OneBeacon Insurance Group P.O.Box 9055 Boston,MA 02205-9055 t 508.851.2500 f 508.851.2699 www.onebeacon.com