HomeMy WebLinkAboutMiscellaneous - 22 IRVING ROAD 4/30/2018N
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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
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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