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HomeMy WebLinkAboutMiscellaneous - 22 IRVING ROAD 4/30/2018N O O N N N O G . 8 � N' A OO D � p � I O Date. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that �tA! .5101. .............. .. has permission for gas installation . . P. ......... in the buildings of .( ............. ....... at 1. A 1,, 1. tI' . I .................. North Andover, Mass. Fee. 1-0 Lic. No../IVY/ .. .... ��. (Df.- -'r .. . ....... �AS INSPECTOR Check# 5757 MASSACHUSETTS UNUMM APPUCATON FOR PERNU TO DO GAS FrrnNG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations 00, LSy \rl \tel Permit # j-? Amount $ (�� •� Owner's Name � � C�1, swe�L New ❑ Renovation ❑ Replacement ® Plans Submitted ❑ (,Print or type) Check one: Certificate Installing Company Name __ �� (�\VSO.>y M�j\�C� Corp. Address S 5�r�� �1�\\� Partner. Business Te lep one -�g� _ 31 _ (.wb Firm/Co. Name of Licensed Plumber or Gas Fitterp� INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 No If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ® Bond 0 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 13 , .j -- «„ - -, —.. " "., u ,111,,IIII'MU11 I 11"VU suunuueu kor enterea) 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 and Chapter 142 of the General Laws. is y: Title City/Town IAPPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber Gas Fitter License Number ® Master 0 Journeyman k n O x �;) cn E- z a o F w F GW W Z w � E~ � O � Q x a a O w7 3 A c7 a 0 a > SUB-BASEM ENT B A S E M E N T 1ST. FLO O R 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR MM 5TH. FLOOR 6_T H. F L O O R- 7 T H 7TH. FLOOR 8TH. FLOOR Lfll I (,Print or type) Check one: Certificate Installing Company Name __ �� (�\VSO.>y M�j\�C� Corp. Address S 5�r�� �1�\\� Partner. Business Te lep one -�g� _ 31 _ (.wb Firm/Co. Name of Licensed Plumber or Gas Fitterp� INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 No If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ® Bond 0 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 13 , .j -- «„ - -, —.. " "., u ,111,,IIII'MU11 I 11"VU suunuueu kor enterea) 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 and Chapter 142 of the General Laws. is y: Title City/Town IAPPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber Gas Fitter License Number ® Master 0 Journeyman Date./! TOWN OF NORTH AN ER OR BING 40 PERMIT F 4ri�� This certifies that A, I (I. ................ has permission to perform ..... Y" f (� — ....................... plumbing in thejbuilding��of .( .( ................. at .... 2.7 North Andover, Mass. L Fee ... ..... Lic. No..//.O'r. ... ......... . P��L�UeIMBING INSPECTOR Check # 7185 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS " � Date Building Location 'aq TS L'tins, Owners Name�� & Q.06k : L Permit Amount l'L Type of Occupancy n��- .�Chm�� New ri Renovation 1:1 Replacement 0 FIXTURES Plans Submitted Yes 1:1 No (Print or type) \ Check one: Certificate Installing Company Name t )nw U" Corp. Address :7 '5 A\\\ Partner. Business Telephone -�� j _ 3i bti ��jiC ® Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 11 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 El Agent 0 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 Massachusettf State Plumbing Code and Chapter 142 of the General Laws. By Signature ot Lq,ensea Flumner Type of Plumbing License Title 1��1 City/Town License Numoer Master ® Journeyman ❑ APPROVED (OFFICE USE ONLY Date./'O// 01, "o TOWN OF NORTH ANDO ' R 6 0 PERMIT FOR PLUM; rNG .. .... .. . SACHUS This certifies that S A7. k�/ . . . . . . . . . . . has permission to perform ... L-4— ...... f3 ................... plumbing in the buildings of ............... at. ................. North Andover, Mass. Fee. ..... Lic. ...... Y.P L . . 5D UMBING INSPECAG Check # 7152 'I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS _ Date Building Location a �v n 5 (ZA Owners Name 7�& aSWQA1 Permit Amount !� 3 Type of Occupancy New ❑ Renovation ® Replacement Plans Submitted Yes No (Print or type) Installing Company Name �1nxU y6c5 \ Address '55 �-Or-WA \\\\\ AVS, Business Check one: Certificate 0 Corp. 11 Partner. ® Firm/Co. Name of Licensed Plumber: �:0, Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy [a 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 ® Agent El 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 PlWbing Code and Chapter 142 of the General Laws. BY 1gna ureicens um er Type of Plumbing License Title \ N O-\\ City/Towncense TNum5er Master ® Journeyman APPROVED (OFFICE USE ONLY -J, i • • • i • • I (Print or type) Installing Company Name �1nxU y6c5 \ Address '55 �-Or-WA \\\\\ AVS, Business Check one: Certificate 0 Corp. 11 Partner. ® Firm/Co. Name of Licensed Plumber: �:0, Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy [a 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 ® Agent El 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 PlWbing Code and Chapter 142 of the General Laws. BY 1gna ureicens um er Type of Plumbing License Title \ N O-\\ City/Towncense TNum5er Master ® Journeyman APPROVED (OFFICE USE ONLY