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Home My WebLink AboutMiscellaneous - 167 GRANVILLE LANE 4/30/2018 (2) 167 GRp,NVILLE LANE 2101106._ 0-0061'0000.0 -� - - - -- �! r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type /77 L9 O , Mass. Date Q 19� Permit # Building Location d � Owner's Nam al ��C�//LG� y Type of Occupancy New ❑ Renovation p Replacement Plans Submitted: Yes❑ No ❑ N N � N N U � N u) Q N Q O N = �- y� W O V ca Z O u ¢ _ O r W 4 tt O O Uj 07 N F" y W O dC a( N yNj 2 V W N W < = 10- a f, _ W W y J = 0: Q O ¢ W W Vto tl f. 2 J H 2' F., W W O > U. 1- W J Z a a. us m Z 02 Q O to s oC W 2. < cc < t O O W O 1y F- ¢ '= O tl Y U. 0 3 G tl J U 9 a s M- O SUB—BSMT. BASEMENT I 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name t`i r'i le T on MA T r1 Check one: Certificate Address 3%? ao A C H lh fa l") ❑ Corporation (�1 7 H U E tJ Al ,A C 1 k y ❑ Partnership Business Telephone /z.!?2 —2 9 7 1 2-Firm/Co. Name of Licensed Plumber or Gas Fitter -RI)a E P T A• >A MM H 7A — INSURANCE COVERAGE: I have a current I' bility Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes V No ❑ If you have checked res, please Indicate the type coverage by checking the appropriate box. A liability insurance policy 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: 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 knowiedge and that all plumbing work and installations performed under the pe ' i ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ner laws. By Tg of Licenser Plumber 1,WhAture of Ucbnsed Pluml%ror Gas Fitter Title tter ter License Number 933 City/TownI N Journeyman BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. ' APPLICATION FOR PERMIT TO DO GASFITTING NAME& TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIG NO. PERMIT GRANTED DATE —X19--- GAS INSPECTOR b .. a_.aY;�`�F-Kt.�-�`'"_�4.'l.M''.-+�.,�.""`. _ � -r-,.J::i'�.,=.,�+-....�+..�^-..-..-.- ...-,_ •�.n..-..cam .. _ - � J � i i r « 2528 a Date. . . ... . . . . ;�. A cF Na oT s1ti TOWN OF NORTH ANDOVER 8 0 � oA �. PERMIT FOR GAS INSTALLATIOA , w SACHUSEtAh d � . d This certifies that ./��/d�" '. . . . . '`'.. . . .4�.91 has permission for gas installation in the buildings 77of . . . CR. . . ,J . �� . . . . . . . . . . . . . . at North Andover, Mass. Fee. J.5. . . . . Lic. No.. . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer GOLD: File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) Mass. Date &a 19-Z7 Permit # �3 Building Location U/6!/� 7 Owner's Nam - Type of Occupancy,2t 51 17 E."1 -(I 4\(-_New ❑ Renovation ❑ Replacement R Pians Submitted: Yes ❑ No ❑ FIXTURES z Z N a Z Y N O z Z W W O Z W F• W rt = cc z 4 cc H z Z z 4 J y H = CC F- U W N Y ` N a X Q m CC W a Z c a c� a < W Cr OO W < N Q a W N J p p a W = < S 3 3 o z = Y d GF- a z a W W Y W f V > H o = a p w F- ZOOWZ z W H O u S < ~ < < S H N a a O a J J a 2 CC a a o a t- 3 Y J m N p p J 3 Y F• M W O p < S Ct m O SUB—BSMT. BASEMENT i IST FLOOR 2NOFLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR , Installing Company Name f 0t'>Eie? Q - S,4grm4 T A Q Check one: Certificate Address C'O R c N M4 tj y.�J ❑ Corporation /r E%N o _ n J , it A 0 tTc L1 []]Partnership Business Telephone ��Z-C197 1 L�Flrm/Co. Name of Licensed Plumber &e3 Fe T 4 SA mrvl,4 reoo"` INSURANCE COVERAGE: I have a current ability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes a No ❑ ' If you have checked ves, please /Indicate the type coverage by checking the appropriate box. A liability insurance policy ►d 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: Signature of Owner or Owner's Agent Owner ❑ Agent❑ 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 owned 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 oral laws. By L re o cen Plumber Title Type of License: MasterZr-' Joumeymah❑ City/Town APPRMEff 0 I N License Number 13 3-; . i BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES 1 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 1-�*..nye-�.y_,- ..:s^* ,;: ..r -..,, u.,a;. �v ..s... -.F, - - - '" � •-,r-.- -.._- ._,;., / Date. . 3329 A NORTH 3 �'< �� •�� TOWN OF NORTH-ANDOVER PERMIT FOR PLUMBING ,SS/1CH This certifies that . . L . . ? . .4S!:�. . . g has permission to perform . . . . . . . . . . plumbin in the b ildings of ./. ,. . . . . . . . . . . . . . . . . at. / .?. . .11�1��4. ,I�f. , North Andover, Mass. w 333. Fee.��. . . . .Lic. No.X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer