HomeMy WebLinkAboutMiscellaneous - 175 SULLIVAN STREET 4/30/2018N
Date. . ?�. .. 7. G"7.4 ....
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that ... .....................
has permission for gas installation ........... ...............
in the buildings of...
at ..................... North Andover, Mass,
Fe-e-�6 .7 . Lic. No/ -/'723 ...
G SOSP , TOR
Check # & '?'I �- 4/
4.0/60
E
I
MASSACHUSETTS UNIFORM
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations 175 Sulli
Andrew Rossi
New ❑ Renovation
was elec ric
$25.00 .. s 1
a
x Q z
SUB -BA SEM ENT
BASEMENT
1ST.
FLOOR
2ND.
3RD.
FLOOR
FLOOR
4TH.
FLOOR
5TH.
FLOOR
6TH.
FLOOR
7TH.
8TH.
FLOOR
FLOOR
s Name
Replacement ❑
ME37MUM
FOR PERMIT TO DO GAS FITTING
Date __12/6/04
Permit # ((J 0
978 682 7198 Amount
Plans Submitted ❑
U w
U � m
a
0
a O � O Ew»
F a c a > a
(Print or type) Eastern Propane Gas Check one: Certificate Installing Company
Name
El Corp.
Address 131 Water S t .
❑ Partner.
?�anvar� MA Cll ��3
Business Telephone i F00 3?? 6pq ❑ Finn/Co.
nT i i
Name of Licensed Plumber or Gas Fitter
er\ n-, � 'aGv
INSURANCE COVERAGE Check
I have a current liability Insurance policy or it's substantial equivalent. Yes ff No ❑
Ifyou have checked � pleff
'dicate the type coverage by checking the appropriate box.
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 ❑
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 Gas Code ary.9apter 142,0f�he General Laws.
VED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter 9
Plumber / 7
Gas Fitter License um er
❑ Master
❑ Journeyman