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Home My WebLink AboutMiscellaneous - 2 Scott Circle !`�' n , . f MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ,,. UNInt or Type) DI NORTH ANDOVER, , Maas. Date Building Permk ilt,;�/-,7/2— Location Location S 0-,0 �- Owner's Name C�,,j y v--c y� (o n.S �- New Renovation ❑ Replacement [l Plans Submitted: Yes❑ No.❑ FIXTURE$ ......... at M = Z rt « M • r 11 J M31 0 V M M fl i soul : M 116 — a — f N i t o i i t s 5 1 a ' M s 9 a j s ►' M o ~ 0 1eM-e a s t06 N t 30 0SY ' � o $ i moo° s � >< � • M o o S >, a �. M � o a o � >s i es o sua—rimy. eAsaYaNT 7. IST FLOOR SHOFLOOR SAO FLOOR 11 T 4TH FLOOR ITH FLOOR ITH FLOOR. TTH FLOOR 4TH FLOOR - \ n Check one: CedKlcate Installing Company Name Y o:- Gam- �Y d' �{ 0 Corp, Address_ `a �v� o� v� ❑Partnership ❑Firm/Co. Business Telephone �r12 1 O 4 .Name of Licensed Plumber V—/� INSURANCE COVERAGE: chec e I have a current Ilabli ty Insurance policy or Its substantial equivalenLO No ❑ If you have checked y", please Icate the type coverage by checkin the appropriate box A liability Insurance poilc ❑ Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 am aware that the Ilcenies does not have the Insurance coverage required by Chapter 112 of the Mass. General laws, and that my algnature on this permit application waives this requirement. Check one: ❑ Ninatuts of Owner or Owner's Acent Owner El Agent I hereby cerilty that all of the details and Information I have submitted for entered)In above application we true and soauate to the best of my knowledge and that all plumbing work and Installations performed under the pem-A Issued for this application will be h pertinent provisions of the Massachusetts State Plumbing General umbing Code and Chapter 112 of the laws. compliance with aM M UraUcensed rr er TRIG Gty/Town Ucense Number_�`� b MF'riUVED(OFFICE USE ONLY) Type of Plumbing Lkense: Master ❑1 Journeyman < Date. . . . . . . . . . . . . r i t 1 pt No°T:1�o TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING �,sSACMU NOV Z 6 1993 This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . . . . . . . .Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File -��.. ... "slat %itlevr I1r-l-a.N./111u1V tr%jn rmnm11 Iv uv ra.vma+uw IPdnt or Type) NORTH ANDOVER, , Mass. Gate .,_10� Building ii�- Permit # �� Location - -� G� Owner's Name L�j v c-&,A, CQY)4 T New p/ Renovation p Replacement ❑ Plans Submitted: Yes❑ No p FIXTURE$ ra « « « o s ►«- w" rr W a « 10. 0 44 « � 4 � s Vvv V s O O « « «K Id s S 1;� W1« 0 ! et « c� H V s Y Is 1a. : `` O It K r `` S J r M O O r S a��—eaMT. SAGIMINT 1111T FLOOR 2N0 FLOOR 11«12 FLOOR ITN FLOOR LITH FLOOR eTHFLOOR. ITH FLOOR ITH FLOOR - _ Check one: Certificate Installing Company Name ❑Corp. Address b W ❑Paonetehlp Irm/Co. Business Telephone 0 `6 .Name of Licensed Plumber �►`�C��a�S�. ��„�,n,� INSURANCE COVERAGE: E;heck one I have a current liability Insurance policy or Its substantial equivalent. Yea No ❑ If you have checked y”, please Icate the type coverage by checking thirappropriate box A liability Insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the Ilcens'ee 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: N—Paluts of Owner a Owner's Aqent Owner p Agent p I hereby certify that 0 o1 the delaMs and Information I have submitted for entered)in above appkatkm are trw and accurate to the best of my knowledge and that all plumbing work and Installations Wormed under the p mit Issued for this application will be In compliance with aft pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of fit Garmai This Signature City/Town License Number APPr"VED(OFFICE USE ONLY) Type of Pkumbing License: Master ❑� Journeyman Date. . . . . ... . . . . . ,40RT" TOWN OF NORTH ANDOVER RMIT FOR PLUMBING SSAC This certifies that r.. . . . . . . . . .. ... . . . . . . .I. . . . . . . . . . . . . . . . . . . has permission to perform . . . . ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PYM I bing in the buildings of . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Fee.,' Lic. No.. . .f . . . . . . . . . . I . . . . . . . . . . . . . PLUMBING INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: Fila