HomeMy WebLinkAboutMiscellaneous - 201 GREENE STREET 4/30/20181 1 1 - ", r-,
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Date ... .......
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
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This certifies that .............. . ............. ............... ......
has permission to �(C-Y-j
... ....... .... ...
plumbing in the buildings of 1k
at C2 b I (QNro
........................................................ : .................................... North Andover, Mass.
Fee .��5 . ...... Lic. No.
.. ..... .............................................
PLUMBING INSPECTOR
Check #
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TYPE OR
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CLEARLY
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY MA DATE /0 PERMIT # (W -7 I
JOBSITE ADDRESS! %Z s r OWNER' NAME t-"J�
OWNER ADDRESS TELE��FAXE
OCCUPANCY TYPE COMMERCIAL El EDUCATIONAL
NEW: a— RENOVATION: ® REPLACEMENT:
FIXTURES Z FLOOR BSM 1
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR /AREA DRAIN
INTERCEPTOR (INTERIOR)
KITCHEN SINK
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE / MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTIO
WATER HEATER ALL TYPES
WATER PIPING
OTHER A,-, , r/ 'Ai t . i nit I��r
2 3 1 4 1 5 1 6 1 7
RESIDENTIAL [3—' -
PLANS SUBMITTED: YES
8 1 9 1 10 I 11 1 12--F-1-3 14
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES NO
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY [D OTHER TYPE OF INDEMNITY [j BOND E]
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNERE] AGENT E]
I hereby certify that all of the details and information I have submitted or entered regarding this application are tru n u
and that all plumbing work and installations performed under the permit issued for this application will be in com a th II�Pertinent pro s on of theest of my Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME I JEFF HUTNICK -JLICENSE # = IGNATURE
MP[� JP 1 CORPORATIONS # 3532 PARTNERSHIP[]# ' LLCD#[
COMPANY NAME I CALLAHAN AC AND HTG ADDRESS 91 BELMONT ST
CITY I NORTH ANDOVERSTATE MA ZIP 01845 TEL (g7g—ggg_9233
�e _ __
FAX CELL 978 423-6305 EMAIL ,PLUMBING@CALLAHANAC.COM
P
Date .....�C�?� (.�. �. ..................
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that:...
7�-4 ....................................... ....................... . ................... ......
has permission for gas installation..v, 44rnt.............
........................
in the buildings of .....
at ...... 9-M..... PPj.e......��7� ...................... North Andover, Mass.
Fee ...--...... Lic. No. �t21- ........
.....................................................................
GAS INSPECMR
Check # a 11W
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TYPE OR
PRINT
CLEARLY
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
NEW: RENOVATION: 0 REPLACEMENT:
APPLIANCES Z FLOORS -
BOILER
BOOSTER
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM / SPACE HEATER
ROOF TOP UNIT
TEST
UNIT HEATER
UNVENTED ROOM HEATFR
WATER HEATER
BSM 1 1 1 2 1 3 1 4 1 5
PLANS SUBMITTED: YESEI NO
6 1 7 I 8 1 9 1 10 1 11 1 12 1 13 1 14
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES 0 NO
I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY D OTHER TYPE INDEMNITY BOND
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
CHECK ONE ONLY: OWNER AGENT
SIGNATURE OF OWNER OR AGENT
1 hereby certify that all of the details and information I have submitted or entered regarding this application are true an cc a the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in complian i P rti vision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUM BER-GASFITTER NAME DiFF HUTNICK LICENSE # 15212 SIG `URE
MP Ej MGF 0 JP El JGF LPG] CORPORATION []# 3532 PARTNERSHIP # LLC #
COMPANY NAME: CALLAHAN AC AND HTG ADDRESS 91 BELMONT ST
CITY NORTH ANDOVER STATE ZIP
MA 0184 TEL 978 689-9233_ _ _ a
FAX CELL EMAILPLUMBING@C ALLAHANAC.COM