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Home My WebLink AboutMiscellaneous - 20-22 Charlotte CrossingThis certifies that Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING .. ... ........ ............... has permission to perform ... -,7 ........................ plumbing in the buildings of ........ .............. at .7�o ......... I ................ ..... �t A�..--.D—rth An er, Mass. v Fee Lie. No j� mal c; 17 _u ICUMBI�G S K,.R Check # 4988 MASSACHUSETTS UNIFORM APPLICATION FOR PERMI•T•TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS 11 Date �U—�~ • y/ Building Location _U -14 CIIAQ w1 Owners Name AY\ 0- C Corm i f( � ry Permit n Amount A65,61 d s AJ, ✓ n ��f, Type of Occupancy K-fS New ri Renovation Replacement Plans Submitted Yes 0 No (Print or type) Check one: Certificate Installing Company Name j L( ��g n ❑ Corp. Aidress -76 44,16- t 4 -4,,e— � Partner. Basiness Telephone ) jj 9,5-77&W� Firm/Co. Name of Licensed Plumber: �i CI Oir I Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ 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 Signature Owner E] Agent F1 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus�State Plumbing Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY Type of Plumbing License 11yO❑License um eT r — Master Journeyman i' •M -..M ..................... ` Y Y ®........ �. ® ............. MIMI (Print or type) Check one: Certificate Installing Company Name j L( ��g n ❑ Corp. Aidress -76 44,16- t 4 -4,,e— � Partner. Basiness Telephone ) jj 9,5-77&W� Firm/Co. Name of Licensed Plumber: �i CI Oir I Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ 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 Signature Owner E] Agent F1 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus�State Plumbing Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY Type of Plumbing License 11yO❑License um eT r — Master Journeyman Date ...../,?J . . . Of `NORT � TOWN OF NORTH ANDOVER D • PERMIT FOR GAS INSTALLATION t SS^CMUSE This certifies that .......... e-- ...................... ' . has permission for gas installation .....:... ............. in the buildings of ..... ... .............. . at�..... .....' ...... North -Andover, Mass. Feei2 .. .. Lic. No.�i,� .% .......... GAS INSPECTOR Check # MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date 10—j5-6 l NORTH ANDOVER, MASSACHUSETTSVT Building Locations a �� C�,��hai MYI (; f?1S5JYIQ Permit # c��y jqv- Amount $ a Y F� J4-hNULf Y Owner's Name New [a Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type), , r C one: Certificate Installing Company Name �iC,� -1,.n ��f7 Corp. Address �%6 wtW1r�f e lC c /� ❑ Partner. L % Out Business Telephone arm/Co. Name of Licensed Plumber or Gas Fitter hri fj ;TR r1 jr, a!lSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ I�you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy [3' 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 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 nereny cemty that an or me aetans ana tntormation t 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_Qas Code and Chapter 142 of the General Laws. Title City/Town VED (OFFICE USE ONLY) _-,Signature of Licensed Plumber Or Gas Fitter lumber ilyif9 ❑ Gas Fitter T71cense Number Master ❑ Journeyman 7TH. FLOOR (Print or type), , r C one: Certificate Installing Company Name �iC,� -1,.n ��f7 Corp. Address �%6 wtW1r�f e lC c /� ❑ Partner. L % Out Business Telephone arm/Co. Name of Licensed Plumber or Gas Fitter hri fj ;TR r1 jr, a!lSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ I�you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy [3' 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 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 nereny cemty that an or me aetans ana tntormation t 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_Qas Code and Chapter 142 of the General Laws. Title City/Town VED (OFFICE USE ONLY) _-,Signature of Licensed Plumber Or Gas Fitter lumber ilyif9 ❑ Gas Fitter T71cense Number Master ❑ Journeyman S NORT,y Ot ,SSACNUSE� Date. �./.......`.. i TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... P.k(.��+.. has permission to perform .................. plumbing in the buildings of .... .. ? `. `-- at..,North Andover, Mass. C Fee. A0 Lic. No.. .. ........I v �;Y1....... . PLUMBING INSPECTOR Check # - I 5040 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) J O Y v NORTH ANDOVER, MASSACHUSETTS Date t1la (1 Building Location iAj / q it hl+ A— A, Owners Name A{^�o,m- (� rmirr a:mS1' Permit # C°1i ,a, tia m 0 YrK i �� Amount _ °�. � 'g h a Type of Occupancy New Renovation Replacement Plans Submitted Yes ❑ No ❑ (Print or type) 'f Check one: Certificate Installing Company Name \ ,iC`� 'Xm l j� /7 ❑ Corp. Address C1 VYi ? l�+ x.9,/2 '04- A'4 6/ �(a ,d ❑ Partner. Business Telephone qt -1—W3 Firm/Co. I Name of Licensed Plumber: I n yl Tr' Insurance Coverage: Indicate the type of Insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ 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 Signature Owner 1:1 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 Massachus s StatSYlunibin Code and Chapter 142 of the General Laws. By: Signature Or icenseaWrmoer Title Type of Plumbing License 1/y�q City/Town icense um er MasterJourneyman ❑ APPROVED (OFFICE USE ONLY i i it ------------------------- • ` D -...---.-M-.-.-.-.MMM MM- RnNMMRRNMWMMMWMMMMM MM =Mn0nM.-"---------------- -W-.-..-N---------------- ......................... MMMMMMMMWWWMWWWWMWMMMN MM (Print or type) 'f Check one: Certificate Installing Company Name \ ,iC`� 'Xm l j� /7 ❑ Corp. Address C1 VYi ? l�+ x.9,/2 '04- A'4 6/ �(a ,d ❑ Partner. Business Telephone qt -1—W3 Firm/Co. I Name of Licensed Plumber: I n yl Tr' Insurance Coverage: Indicate the type of Insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ 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 Signature Owner 1:1 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 Massachus s StatSYlunibin Code and Chapter 142 of the General Laws. By: Signature Or icenseaWrmoer Title Type of Plumbing License 1/y�q City/Town icense um er MasterJourneyman ❑ APPROVED (OFFICE USE ONLY