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HomeMy WebLinkAboutMiscellaneous - 20 EMERSON COURT 4/30/2018 �. �� 6 I ' Date fQ 61. . "pR'M TOWN OF NORTH ANDOVER p� ,.•o ,•bhp PERMIT FOR PLUM ANG • t � i ,SSACMUSE� y: This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform ! . . . . . . . . . . . . plumbing in he buildings o at-40. . . .. . . . . . . . . . . . . . !l. . . . .. North Andover, Mass. Fv-&. . . . . . . .Lic. No�,PL - . . . PLUM ING INSPECTOR Check # 3 7135 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO .DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS BuildingLocation Date (� r wners Nam ,� Permit# Amount Type of Occupancyi - S New ❑ Renovation �_ Replacement � Plans Submitted Yes ❑ No u — 411114 � � 5 9 .3& v -Q0(4 c)-. batX- C k�'� a N [T n yam` /// ��(� � J �,, ll`�71�r1\1 AeaK e- Ci , MA -- e,,l 76 `r" _"I �V•1�� e isr H ooR M1`1� IR 4 t.{ .Udl i 3RD ELO R 41H HDGR l9J AAA— SM FOOR 6Ui FLOOR 711H HOOK - - — - �H (Print or type) r Check one: Installing Company Name / Certificate ( El Corp. Address r rC` Partner. Business Telef hone t o. Name of Licensed Plumber: Insurance Coveraee: Indicate the type of insurance coverage by checking theappropriate box: Liability insurance policy Q- Other type of indemnity [:] Bond El Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance tgnature Owner ❑ Agent ❑ I hereby certify that:ill of the details and information 1 have submitted(or entered)in * ove application are true and accurate to the dust of my knowledge and that all plumbing work and installations perform- un emlit Issued Iort is a • tion will he in .ompliance with;ill pertinent provisions of the, fassachusCtts State Phu ins _o an a c I :_of ,� rneral.Laws. By: Signature 01 LICCIISC(Ium er Title Type i;f Plumbing License City Town tcense um er (aster ® Tourn, yman �kPPROVED(OFFCE USE oNLv 14 MASSACHUSETTS UNIFORM APPLICATION .FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date 0 Building Location `- wners Nam ,� Permit Type of Occupancy Amount RNA New Renovation Replacement Plans Submitted Yes ❑ No u - FIXTURES FE F ' \ r O z z a, r J O f z Q ® I a Q �Tp m 3 r O 0 p.71��14 A � 1��l**i��T1�ry1\�1 f JSr HDCR 4t.{lHl.IlyA-d�l 4M FUM Ste)(HD(R 6M FI)CR 7MHOM i gm FItO(It (Print or type) Check one: Certificate Installing Company Name ( ❑ Corp Address rrC` Partner. r` Business Telephone C Co Name of Licensed Plumber: Insurance Coverage: Indicate the type of ins rance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El El❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance ignature Owner 11 Agent ❑ I hereby certify that all of the details and information 1 have submitted(or entered)inove;application are true and accurate to the nest of my knowledge and that;all plumbing work and installations perfvml un ermit Issued for t is a tion will he in :ompliance with all pertinent provision;of the MassachuscttS State Plu ins o an -'a e I rpt' ic _eneral Laws. By: igna ore c; acense um cr Title Type of Plumbing License City,Town iL cense umcyman APPROVED(OFFICE LSE ONLY um Lr Master io❑ �--- w Date. . .y—/..0� . ... .. r ,ORT/f 3=py` „ao ,e1tiOL TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION s a 'y9SSAC HUSE' r This certifies that . . .. . . . . .. . . . . .'-*w.' :: . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . ::. :. ' : ' . . . . . . . . . . ,,in the buildings of .. . .. . . . . . . . . . . . . . . . . . . at .::'. . . . . . .-. . .: " . . . . . . . . . . . . . . ' North Andover, Mass. y Fee. Lic. . . . . . . . . . . . . GAS)M PECTOR Check# it 40 : 5 MASSACflUSEM UNIMRM APPUCATON FOR PERIVIIT TO DO GA(SNT FTrr] JG �y (Type or print) /Date� yA NORTH ANDOVER,MASSACHUSETTS Building Locations a � �� rocs �0 "'P -4- Permit# Amount$ Owner's Name ©� `�Sf y � Cts New❑ Renovation ❑ Replacement Plans Submitted 0 04 oy U E+ W F d pp r� o w A LIv o A a F SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR STH. FLOOR (PrintQON)jjDi t 1 one: Certificate Installing Company Name l ` t)v1nlU��� (/�' �ol� r I.` Corp.ILI Ad �� � ��f� ❑ Partner. 0 370 7 91 Business Telephofie, ❑ F Co. . s Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check on I have a currant liability Insurance policy or it's substantial equivalent. Yes El No❑ If you have checked M pl dicate the type coverage by checking the appropriate boic Liability insurance policy Other type of indemnity ❑ Bond ❑ i Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 ofthe 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 ofthe 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 ed der Permit Issued for this application will be in Ycompliance with all pertinent provisions ofthe Massachusetts Sta Chapter a General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title Plumber / ZZ- 9 9 CitylTown Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) Journeyman