HomeMy WebLinkAboutMiscellaneous - 16 STACY DRIVE 4/30/2018 16 STACY DRIVE
210/091.0-0028-0000.0
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21
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EE
of HO DT e ,ti TOWN OF NORTH ANDOVER o
16 CU
3? '� PERMIT FOR GAS INSTALLATION
�9SSACHUSEt C
LL
CM
This certifies that . . �. . . . . . . . . . . . M
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has permission for gas installation . :t . . . . . . . . . . . . . .
in the buildings of . .r!.( . f?!l . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . . . . . . .. Andover, Mass.
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Fee.?:L.," . . Lic. No. 13.�?. . . . . . .— . . . . . .
4�GAS INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
Z , Mass. Date 19 Permit # 3
Building Location c GSC Owner's Nam/&6v } G
Type of Occupancy E51 -t)N Ti 0 L_
New ❑ Renovation ❑ Replacement Plans Submitted: Yes❑ Nocc
❑
N
N W N
Y Z S N
0 Q 0 C O 0 = f
W W rt O 0 r0
J_ N W t_ o
.4
2 O W a rr 0 0a. 0
N d W 4 = Z ~cc W CC N O C W
W Lt O
W y�j dl J E 4 = W d IL W V J W
Y 4 I—
W =' 4 C F- H >. 0 m 2 O 2 W O N 2
= OCC x 4 4 0 0 W O W P
Y u0. ; O d J U Y p a t" O
SUB-BSMT.
BASEMENT
ISTFLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR I
STH FLOOR
6TH FLOOR
7TH FLOOR
STH FLOOR
Installing Company Name �j��i -(e T A • `ANN M A T 0�0 Check one: Certificate
Address 066 t H mis 1"') `KI. ❑ Corporation
M E T H U E fj ❑ Partnership
Business Telephone /d 92- -9 9"7 f firm/Co.
Name of Licensed Plumber or Gas Fitter "L O E P T A- `5 A M M f1 TA ko(-) --
INSURANCE COVERAGE:
I have a current I' bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checked yes, please Indicate the type coverage by checking the appropriate box
A liability insurance policy 0"" 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 pe i ued for this application be in compliance with all
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ner Laws.
By T of License: .
Plumber 44-nature of Licensed Plu . or Gas riffir
Title itter
'or License Number
City/Town Journeyman
APPROVED OFFIC S NL
BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
NAME d TYPE OF BUILDING
LOCATION OF BUILDING --
PLUMBER OR GASFITTER
LIQ NO.
PERMIT GRANTED
DATE 19
GAS INSPECTOR
i,
i
Date,2/� /mil
2 8:s v
t
of, 5o TOWN OF NORTH ANDOVER
3? �. '• oc
' PERMIT FOR PLUMBING
E ,SSACMUS�
This certifies that . . .1 . . .� .!?.!?�sz><�.�f.`` �/!. . . . . . . . . . . . . .
has permission to perform . . . rir�, 7. . . . . . . . . . . . . . . . . . . . . . . . . .
r � �
f plumbing in the buildings of . .�. !.4. . f'!'?. . . . . . . . . . . . . . . . . j
at. ��4. . .�`!�, ./. . .�?f.? . . . . . . . , North Andover, Mass.
� y i
Fee.,?.D. .'. . .Lic. No.0117. 7 . . . . . . . . . . . . . .
PLUMBING INSPECTOR
03/01/% 10:24 20,00 PAID
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File
R
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(PriinntFor Type)
�/U a J6 d`ei/ . Mass. Date 19—t 4� Permit #
Building Location c <ei Owner's Nam& W
D /J
Type of Occupancy ':2t 51 D E U
New ❑ Renovation ❑ Replacement 2 Plans Submitted: Yes ❑ No ❑
FIXTURES
z
Z N Q
Z Y
~ y J > 6) a •• W W
N � C7
N Z 0 < Cr Q = ~ W Z O Z
CC u. F-
O N W N Vrf = Q ~ V W 0 x C d < a < 3 X
Q m < Z O
rr W O O W < N Q < W N C x J z o G G U.
W = < S Oz = Y d 0 F- < W Y < W S
Y W
f- V >, p. O = 4' N f' Z O O 0 Z Z W O U S
< < < S N H a < O < J J < ¢ Ce a < 0 < t-
3 Y J m 010 o J 3 Y f- N U. I Q G d S Colo
SUB—BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
Installing Company Name 1'A0j'%e"r _Ij4(r M,4?AIef) Check one: Certificate
Address 7,r`? L /q c ti(Y1 r3n) PJ ❑ Corporation
/r E%N o Ent* YO A U r IN-11 ❑....,, Partnership
Business Telephone kf L-ri97 I Lti*ffn/Co. ^
Name of Licensed Plumber '&r3Fe r fil SAMrylr9 Tr4��
INSURANCE COVERAGE:
I have a currentjjability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes a No ❑ '
If you have checked Les, pies indicate the type coverage by checking the appropriate box
A liability insurance policy ld 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 orated under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum g e andapter of the oral Laws.
By L
re o cen Plumber
7
Title
Type of License: Master % Joumeymab❑
Gty/Town ��3
Af'PRONED 0 IC NL License Number
g BELOW FOR OFFICE USE ONLY
v
FINAL INSPECTIONS SKETCHES- PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
I
NAME &TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED `
DATE 19
PLUMBING INSPECTOR