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HomeMy WebLinkAboutMiscellaneous - 23 FRANCIS STREET 4/30/2018 (2) 11� A n [r� (v Date.. . . J ...... .. ... . t pf.NORTH 1ti o� TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION SACMUSE�h This certifies that . . , . . . . . . . . . . has permission for gas installation . . ! ..'. . .. .... . in the buildings of . 9. h}�.4.4 . . -. . �L. . .: . . . . :'�/ . . . . . . at North Andover, Mass. Fee./(?U. . . Lic. No.. y .� . . ._ . .4�- �'� !� .. . . . . 'GAS INSPECTOR' Check# r7 j 'r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) �D�TH At�00UEfc —. Mass. Date /l 8/',iZ Permit # Z Building Location_4430 23A-,25,a5A rKA1..QS ST Owner's Name AIQP_TH AAJDDV6f NSC A01 !JD(UE2 11A Type of Occupancy/ffUYVT/AL New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes[] No ❑ cc - N W N {O x z 0 WN WOC OH V z V � cc 0 m N FO WQ, 0 0 , a W zV z �>aC WN < a D W N J = M Wr- Q u�yc'c z < W J Q N' 1- !W- N O 4 z W J l.. W z o z a o N x Q W > W O z. Q K 0 0 W0 �y 0 .x O d z LL a 3 G d J V C; y D 6 F- O SUB—BSMT. BASEMENT 1ST FLOOR • 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET X7 Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone q 71B-68,7-1105 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked yes. please Indicate the type coverage by checking the appropriate box. A liability Insurance policy JK 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 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner'sAgent Owner❑ Agent ❑ , 1 hereby certify that all of the details and information I have submitted(or entered)in abo knowiedge and that all plumbing work and installations performed under the permit iss f r plication application will d a n��mpl ance with all te to the best of my pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (� ; T of License: Title Plumber Signature of Licensed Plumber or Gas 9 Gasfitter Qty/Town Master License Number 374-5 O IC SE ON Journeyman BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING c NAME A TYPE OF BUILDING LOCATION OF BUILDING • 3 PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE ��9 GASINSPECTOR Date. . . . . . . . . . . . . . . . . . . . . NORTH TOWN OF NORTH ANDOVER 0 fD a op PERMIT FOR GAS INSTALLATION 9D'��TfD P•`� �,SS�CHuSEt This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . . . ... . . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File NORTH ANDOVER , Mass. Date ID L 19 96 Building PermR #_ .S 95 Location {- __YI�Ot�4-I, I�n�oyex- I'Y1ass owner's • Name I :kfk i H_dA 2•nOycrt gcsjsw& A0 i NfJ2i T� New D Renovation Replacement D Plans Submitted: Yes Cl No D n M M r V K I- 0 0 M z C h w 0 0 d H y x U X O M H ~ < O s a 0 z Iw- < �a K O X Nn c! u s a N a = I O h : AtL si0 O .. O „o tl st r�i. it, t► ac y o� a o sus–esMT. — iAAEMENT + taT FLOOR ( 2ftO FLOOR I 3110 FLOOR 4tH FLOOR 0TH FLOOR ATH FLOOR ► 7TH FLOOR -1-1--- - ___ -1-L. :1- I -i -. i- --d- + STH FLOOR , // , Check one: Certificate Installing Company Name Toler+ 10, � V, � �* �vnsZnC_ Corp. Address All SE-ref-+. d Partnership n n ►SSS. C)rio D Flrm/Co. Business Telephone toI-1-Sfs/- o4y Name of Licensed Plumber or Gas Filter_ #lobar+ (,t). _L r v►'�e. INSURANCE COVERAGE: Check one I have a current liability Insurance policy or its substantial equivalent. Yes j4 No D if you have checked yes, please Indicate the type coverage by checking the appropriate box. A Ilabli ty Insurance policy ® Other type of Indemnity D Bond D 011 ims INSURANCE WAIVER: I am aware that the licensee doej not haylL 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 Omer of owner's Agent Owner D Agent D 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 Imovrtedge and that all plumbing work and Installations performed under the permit Issued for this application will be In compliance with all partinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. T e of Ucense: Plumber Signature o cense Plum er ' as er Master Title f3asnita CIty/Town Q Joumeyman License Number M ?`x155 ApmioVEn(orricE USE ONLY) �-•• • �••••••• • v vv VryVI 11 1 11Ill � (PtlntofType) • NORTH ANDOVER, , Mass. Dale D 19 96 Building permit #f Locatlon_za lg ram .is rep+ Owner's n over m qsS Name _ Cbg�N A,c 7'I1ou.Y�_�ojswa A0�Nc,R,Tr New O Renovation Replacement Ll plans Submitted: Yea L] No 0 N N xK b u 9 t- 0 N s 0 0 b H 7hC N tl d�ayy w ~ IN X t a It p C a Q X W N b E tl = N R h N �`�, a2. C ' tl 0 f1 ar f x C " � F h sl 4 O 0 q i 'i o d ski. Itg v e0t Y a a o suet—asMT. • 111A1lEMEHT IST FLOOR 2"o.FLOOR I 'RDFLOOR ITH FLOOR 0TH FLOOR f ATH FLOOR r 7TH FLOORH71 ------ 1 'til FLOOR // ' Check one: Certificate Installing Company Name +pert 10. e- nS�d7nC- q4 Corp. Address /�Ieq Free+. d Partnership n n asS. ())904-- p Firm/Co. Business Telephone (o)-7-Sic/- 04- Name of Licensed plumber or Gas Filter Tr v►ne� insunANCE COVERAGE: Check one I have a current liability Insurance policy or Its substantial equivalent. Yes P( No O If you have checked yes, please Indicate the type coverage by checking Ilia appropilale box. A liability Insurance policy ® Other type of Indemnity 11 Bond L] OW HER'S INSURANCE WAIVEn: I am aware that the licensee doe14 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: Owner L] Agent Ll %nature of Owner or Owner's Agent I hereby certify that all of the details and Information I have submitted lot entered)In above applicalion are true and accurate to the best of my kravrfedge and that an plumbing work and Installations performed under thepermt Issued for this application will be In compliance with all "tirw,nl provislons of the Massachusetts State Gas Code and Chapter 112 of M.Oenerd Laws. Hy Te of tkenae: Plumber Signature of LicensedPlumber or Gas nHer "Is Gasltter Master License Number m 7d,55 City/Town Q Joumeyman Amin-n(orFICE USE ONLY) u-nnror type! . ' .. ' . NORTH ANDOVER, , Mess. Date—1219 1g 96 Building Permit I Vor-f-�, p c� Owner's n over YYl ns5 Name —��o� N A,c 7 nou t6obru k Ao;WiR, r New O Renovation Replacement D Plans Submitted: Yea d NoX 04 U h K rr r p d J M w x Q K H < � _ X O h K < b N ac o or ' a x MK A t7 tiq ad _ X H 1+! 0 XK p k i i 'o d «�. a v 0 SUR—saIMT. aASKMENT + 1!T FLOOR !ND FLOOR I 21113FLOOR 4TH FLOOR OTHFLOOR I ATH FLOOR r TTN FLOOR + !TH FLOOA , Check one: Certificate Installing Company Name �oLar+ to. Sryl yre- .Svrns�enCorp. toyt C Address A l SF-(e e-- -. d Partnership n n Mass. 0)904— u rlrm/Co. Business Telephone to I-7-Ski- o4y Name of Licensed Plumber or Gas ritter_`Kober-f (,O. r v►nr2, IMSURANCE COVERAGE: Check one I have a current Ilabllfty Insurance policy or No substantial equivalent. ' Yes R No U ,It you have checked"a , please Indicate the type coverage by checking Ilia appropriate box. A liability insurance policy N Other type of Indemnity d ' Bond O OWNER'S INSURANCE WAIVER: I em aware that the licenseed9ee not hays 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: Owner O Agent O %natute of Owner or Owner's Agent 1 hereby certify that all of the details and Intormallon I have submitted(or entered)M above application are true and accurate to the best of my knovrfedge and that aH plumbing work and Installations performed under the permit Issued for this applicatlon will be In compliance with all partImnl provisions of the Massachusetts State Gas Code and Chapter 142 o1 the bene Laws. By_ TSof License: Plumber slinaluis of I kensedPlum- er or as er THIS tlas"tter Dmaster License Number__M 7.Z ab'Rown U Journeymen Mr'r10VED(OrricE USE ONLY) ju11-lintor YP . NORTH ANDOVER, , Maas. Date 0 1g 96 Building Permit # J�CI5 Location�5/� >�ra�nCiS &red- • _1 V or-4 1�kdLye {'�r�ss Owner's 4 Name __ I)ork H A,r ynoy n 90osruk Ao ,H0pj rr New ❑ Renovation Replacement ❑ Plans Submitted: Yes ❑ No Ej x lc tl -j h w H u p ~ N ppa >w s a Mp 4 x N rf tl !i w w a ar = u x d IL � a r i z ad o d w a o 3 v W > a o aua—esMT, — •AtEMENT ifT FLOOR 2NO FLOOR 1 SRO FLOOR 4TH FLOOR 0TH FLOOR I ®TH FLOOR r TTH FLOOR_ 0TH FLOOR ' / Check one: Certificate Installing Company NameSrV,h Corp. _ Address AI SErec+. d Partnership n n KISS. O �p ❑ Flrm/Co. Business Telephone to1-7-5kl- ()46 Name of Licensed Plumber or Gas Fitterober-+ (,t). —Tr v,ale, INSURANCE COVERAGE: Check one have a cement IIabMHy Insurance policy or He substantial equivalent. Yes J$ No ❑ If you have checked yes, please Indicate the type coverage by checking Ilia appropilate box. A liability Insurance policy ® Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee doer# 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: owner ❑ Agent❑ %nature of Owner or Owner's Agent (hereby certify that all of the details and Information I have submitted(or entered)M above application are true and accurate to the best of my knovdedgo and that ah lumbing work and Installations performed under the permit Issued for this application will be In compliance with all partincnl provisions of the Massachusetts Slate Gas Code and Chapter 142 of the Gorwal Laws. Hy Te of 1.1" e; Plumber signature ure o cense um er or as Fitter WGaster asfllterTitle License Number—M 7155 City/Town D Journeyman 11i'1'x vE0(OrricE USE ONLY) Ititntor Type) - . " "" '",•"• •• • "•" NORTH ANDOVER, , Mass. Dale D tf1 96 Building PermitVj Location__o?'1 ' OY'�-� �►dover- owner's ' NameAPO iN 14,c9nay.aJaosiur. Aa-,Hak,-r New Q Renovation Replacement Q Plans Submitted: Yes Q No U '1111kit h f nX K M a V a h K „ Wh a: 0 , M = h d -+ as "' ►' >N p 11s I x a < b M V I Xft p o ' 0 x /w W0 - ' N � g s V z s Nh A � � � � h sr v IL J r 'i o d w 7 u evt s a Gula-1181WIT. — •AGEMENT f IOT FLOOR 2ND.FLOOR I 3RD FLOOR 4tH FLOOR GTN FLOOR f ! ®TN FLOOR r ` TTN FLOOR f GTN FLOOR ' 1 A --1 1-1 �. /I , Check one: Certificate Installing Company Name_ToLer+ 10- Sryirlle, �` ns �nC. ;4 Corp. loy� �. Address_2_,,\_ Allf4 31rec+. d Partnership V1 n Ass. Q rirrrt/Co. Business Telephone o 17-5isl- o4( q Name of Licensed Plumber or Gas ritter_Va"+ (,t). _1 r v►ne. INSURANCE COVERAGE: Check one I have a current IlablIRy Insurance policy or Its substantial equivalent. ' Yes J9 No O If you have checked yea, please Indicate the type coverage by checking Ilia appropriate box. A liability Insurance policy ® Other type of Indemnity Q Bond 0 OWNEWS INSURANCE WAIVEn: I em aware [list the licensees not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my slgnature on this permit application waives this requirement. Check one: Owner O Agent El SIgnalute of Owner or Owner's Mani I Imeby certify that all of the details and information I have submitted(or entered)M above application are true and accurate to the best of my lmowled a and that an plumbingbe work and Installations performed under the permit Issued for this applicallon will In compliance wllh all partinentprovisions of the Massachusetts State Des Code and Chapter 112 of the General Laws. gy Te of license: Plumber Signature of Licensed Plumber or Gas Fillet Title 038111ter DMaster License Number M T�55 City/Town D Journeyman Af'i"UVED(OrFICE USE ONLY) "Intor Type) —. . —..1.159 . V YV u1V / g II I�rr� NORTH ANDOVER. , Mass. Dale JQ 10 96 Building Permit _ S�5 Location o?r7)4 Sfree�f / Owner's Name _ -V6jkj7H IJA -Mv_rt goos„u(. Ao;H0Ri New ❑ Renovation Replacement ❑ Plans Submitted: Yes ❑ No [) h 1 h ic h n N C oIC „ s x O J M w M if d F x M X o app H t >. X X p h a S M M it 90 C p p n f- X "r at d �11yC" X i IL X J M <p 0 q J M 1Y o d sC w n .1 u ape r o a 1- o sun—dsMT. BASEMENT 1sT FLOOR 2ND,FLOOR I 'RD FLOOR '- 4TH FLOOR 0TH FLOOR i 0TH FLOOR 7THFLOOR r sTH FLOOn 1 / Check one: Certificate Installing Company Name ber+ (,(), e, nZnc. Corp. y, Address Alleq 3 re -4-. El Partnership nn ►ass. C)rio� ❑ Firm/Co. Business Telephone (o)"l-Sk/- L)4��{ Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: Check one I have a current liability Insurance policy or No substantial equivalent. ' Yes J4 No ❑ It you have checked yes, please Indicate the type coverage by checking Ilia 6pproprlate box. A Itablfty Insurance policy Other type of ktdemn ty ❑ Bond ❑ OWNER'S INSURANCE WAIvEn: 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 wolves this requirement. Check one: Owner ❑ Agent ❑ %naturs of Owner or Owner's Agent I hereby certily that an of the details and Information I have submitted(or entered)In above application are true and accurale to the best of my knewfedge and that an plumbing work and Installations performed under thepermh issued for this application will be In complienoe with all partlmnt provisions of the Massachusetts Slate Gas Code and Chapter 142 of the Genera)Laws. Hy Te of Wense: Plumber "fig Qasniter Signature of LkensedPlumber or Gas Filter DiVastet License Number C(ty/Town U Journeyman 11PPt"vEn(OrrICE USE ONLY it-tintor YPe NORTH ANDOVER, , Maas. Date D 1g 96 Building1/ RasL Permit # ocationoqOwner's1VOr+A 5�� ' Name - VojkVH A,c 9•n0vcr2 Vousruk Ao 4 HoR,tr AV New ❑ Renovation Replacement ❑ Plans Submitted: Yea ❑ No n 1 _ X le h V0 a M = « Q J h w 0 V b x M OppG 10AX aC t M H Zrl tic p 0 a Q Z ►�- t o 0 y d = � �, H .� W p N 1W = e ae .4u Q [S!'! x d > iC Z d O 1� p z o tl 1�. 7 le. n u at r a a o suet—esMT. • •ASEMENT 1ST FLOOR 2ND FLOOR I 3RDFLOOR 4TH FLOOR STHFLOOR ! 9TH FLOOR 7THFLOOR r + STH FLOOR / / Check one: Certificate Installing Company Name bort i ). ill el � Svns �nc: � Corp. Address A I JEr'ef-+. u Partnership n V1 . lgss. ❑ rirm/CO. Business Telephone Io 1-7-,S&/- O46 Name of Licensed Plumber or Gas riper oberi W. —Tr y►•her IMSuRANCE COVERAGE: Check one I have a current Ilablllty Insurance policy or its substantial equivalent. Yes J$ No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. A Ilablifty Insurance policy ® Other type of Indemnity L1 Bond L] OWNER'S INSURANCE WAIVER: I em aware that the licensee dgeq not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit applicallon waives this requirement. Check one: Owner ❑ Agent❑ %naturte of Owner or Owner's hent I frareby certify that all of the details and information I have submitted (or entered)M above application are true and accurate to the best of my knorrbedge and that all plumbing work and Installations performed under the permit Issued for this application will be In compliance with all partlncnt provisions of l e Massachusetts Slate Gas Code and Chapter 142 of the Gw wel laws. Ry T e of lkenae: THFe Plumber gns urs o nae number or as er ctasfiller Master Ucense Number M 7CZ55 aty/To ❑Joumeyman A MOVED(OrrICE USE ONLY) Il'Tlnl or Type) NORTH ANDOVER, , Mass. Data---JD 19 96 Building Permit #— Sq6 Locallon_2 �p r7Oa<< �S4 t U '�'n H rid Owner's Or o✓etr, n'IAsS • Name -.__Obik,H &yNo✓ar2 ��5►uc. /���+aaR��r New ❑ Renovation ReplacemerA ❑ Plans Submitted: Yee ❑ No (p h IC I- „ sc h r 0 0 „ = h Id tl J ppa >N x a < 0ah « p 0 0 4 X tw- N a of d V w = 7 „ a: •� I d h X J F 7! �. M 0 M J M o 0 16 5 0 aOe r ami o sun—seMT, • YASIRMEHT —' tOT FLOOR END FLOOR I SADFLOOR 4TH FLOOR 0TH FLOOR ATH FLOOR r 7T14FLOOR r OTHFLOOR 1 // ' Check one: Certificate Installing Company Name_�ybeft 10. 5► yr ns�ZnC.: 9 Corp. y Address �I� J�reef-. �l d Partnership 4n pas. 0) Oa.. ❑ rlrm/Co. Business Telephone Name of Licensed Plumber or ass rRter_ ober-+ (�. ..Tr✓►yr e, INSURANCE COVERAGE: Check one 1 have a cement Ilablilty Insurance policy or Its substantial equivalent. Yes jS No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVEn: I em aware that the Ilcensee 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, Owner ❑ Agent ❑ %nature of Owner or Owner 9 en I hereby certify that all of the details and Information I have submitted(or entered)M above application are true and accurate to the best of my knowledge and that allplumbing work and installations performed under the permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gomel Laws. Ey T e of License: Plumber THIS Signature o cense Plumber or as Fltler (3aspUet Master License Number M 55 CftylTown ❑Journeymen llf'I'rm-n(OrriCE USE ONLY) wentor type) - .. . _....... . .. .... ...yv� �rvu NORTH ANDOVER , Maas. Date 0 19 96 Building Permit #_Locallon — S &rce � SClS GrQver I �I ' d Owner's Name Aoj-krH_dAfnaygngoostaik Ao;Hoo,,Tr New ❑ Renovation neplacemeri ❑ Plans Submitted: Yes ❑ No ❑ a a X C r1 K w w C O IS h d J = 0 °pC H < 14 x 0 H a: t a s ! Kp :3O x N a a X U w = « M H n o x ri p O h X J O oul�—eaMT. . NAOEMENT + i11T FLOOR 1ND,FLOOR I SRD FLOOR 4TH FLOOR i 0TH FLOOR f 1 0tH FLOOR 7TH FLOOR r + 0TH RLOOn , Check one: Certificate Installing Company Name�C Z-V,V1 Corp. _ 19 1�- Address N I eA4 3(-ree+ . [i Partnership n n ►ass. O►oro ❑ rlrm/Co. Business Telephone (o 1'1-5V- c4y Name of Licensed Plumber or Gas rftler_ober-+ (,O. 1 ry►yr F, INSURANCE COVERAGE: Check one 1 have a current Ilebllfty Insurance policy or its substantial equivalent. Yee R No ❑ If you have checked yes, please indicate the type coverage by checking the approprlate box. A IlabMfty Insurance policy ® Other type of Indemnity ❑ Bond ❑ OWNER'S INSUnANCE WAIVEn: I em aware that the Ilcensee 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: Owner ❑ Agent 11 %nature of Owner or Owner's Vgant (hereby certify that all of the details and information 1 have submitted (or enteral)In above application are true and*murals to the best of my knowledge and that all plumbing work and Inslallellons performed under the permN Issued fer this application will be In compliance with all "tir►ont provisions of the Massachusetts Stele Des Oode and Chapter 112 of the Gerwal Laws. Hy T a of Ucense: 2<9611L11-,VDze Plumber na un ce o nse as er Title Plumber Master CitylTown El Journeymen lJcense Number M 7 .55 Af'r'r own(OfrICE USE ONLY) (Nnt or Type) —.5 • —slowest • W vv �ar��7r r1 1 11Its NORTH ANDOVER, , Maas. Date jD h 96 ' BuAding Permit Location 3l ,� r Y'CWI Gi S . 6r4- / _I Owner's 'i L�' rtQo v� � cS Name _ Il�o,r�--H �d 91�oIr.A��(➢osruk Ao;Nokt T� New O Renovatlon Replacement O Plana Submitted: Yes O No U h 1 _ ac h h K N r 0 M = adt J apt H 94 _ X � s a n r s J F z d IL � J � Id r ! '' t~ w 4 0 o H w o d i w #. a u a°e r ; 0 o ave—naMT. . • iAIRMEHT 1sT FLOOR 2h0.F L 0 0 R I SNO FLOOR JJ 4TH FLOOR ATH FLOOR aTH FLOOR r 7THFLOOR aTHFLOOn FT, /I , Check one: Certificate installing Company Nameyb (,(), V,�, an ,1 nC: Corp. y �. Address A I 3 ree.-f-. d Partnership V1 n qSS. ())904— ❑ Firm/Co. Business Telephone to 1-7-59/- o4 �( Name of Licensed Plumber or Gas Fitter_ober-i (,c), -r Vj me IMSURANCE COVERAGE: Check one 1 have a current liability Insurance pollcy or Re substantial equivalent. Yes J4 No O H you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy ® Other type of Indemnity d bond O OW/,NER'S INSURANCE WAIVER: I em swats that the licensee does not haYa 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: Owner O Agent O %naluts of Owner or Owner's en I Ireteby certily that all of the details and Information I have submitted(or entered)In above application are true and accurate to the best of my kt►ovrled a and that all plumbin work and Installations performed under the permit Issued rot this application will be In compliance with all pertinent provlslons of the Massachusetts Stele ass Code and Chapter 142 of the General Laws. BY Te of License: z Z(/ THIe Plumber signature of Lican"dum eroras Met Gssfiller DIJaster License Number M 7-Z55 CitylTown D Journeyman Ar'i F"W-0(OfrICE USE ONLY) Irfilntor Type) - . . ..... . .r .... ....a NORTH ANDOVER, , Maas. Date 0 1g 96 a Building Permit Location c� ren G�� -�- . I /,�,, Owner's ' doj/cdr, /'/►45S Name _ Ili°off NA,r�110��.��o�suu� /��9;alaR�it New O Renovation Replacement d Plans Submitted: Yes d No U n ax K k h K N r 00 M = K >• X a b M h K p O O X Iw- Z 0 i z o d o v a0e > a sul�—esMT. — NAeEMEHT 1sT F100R �• 2ND.FLOOR I 31110FLOOR 4TH FLOOR 8TH FLOOR 0TH FLOOR r TTH FLOOR •THELOOR ' I I Check one: Certificate Installing Company Name o1 ). —Tr yr " Corp, Address AeA4 .31-rev—+. [J Partnership V1 n O Firm/Co. Business Telephone to I-7-5&I- c4 `{ Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: Check one I have a current ilabNRy Insurance policy or its substantial equivalent. Yes P4 No p If you have checked yes, please Indicate the type coverage by checking the appropriate box. Alliablity insurance policy ® Other type of indemnity L1 Bond 11 Ok1WWS INSURANCE WAIVER: I em aware that the licensee doe>t_not have the Insurance coverage required by Chapter 112 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner Cl Agent O %natute of Owner or Owner's en I= hereby certify that all of the details and Information I have submttled(or entered)In above application are true and accurate to the best of my knevrfedOs and that all pplumbing work and Installations performed under the permit Issued for this application will be In compliance with all parltrvenl provisions of the Massachusetts State Gas Code and Chapter 112 of the General Laws. Ey T e of Ucenae: Plumber t333111ler Signature o cense Plumber or as Fliler TNIe Master lkense Number- M 7d,55 CityRo Mourneyman IU'PrK1V-n(OrricE USE ONLY) 111rintor Type) - . . . .. .,.. ...�.,� r r�r.0 NORTH ANDOVER, , Maas. Date D 19 q6 Building y� Permit __ q� Location a3 A I Owner's A. -ti �ndolr� fess Name Qysss�_boosrut, Ao z"Os j r New ❑ Renovation Replacement D Plans Submitted: Yea [] NoX 4C [Q h 4C h at M C Ou M = a: tl J h w H l>f p N y s M z q p H t- >' Z s 0 ►- �ayC 't b M !- at O 0a 0 >K !- t d y t = Xh a7 O y ? yt ! nrtc j F " asn ~ x r h w O w -s w i i o d w Z R. o 3 0 u 0:0 y a o 9U�1—dtMT. . SAtIEMENT + 12T FLOOR r1110 FLOOR I 'AO FLOOR 4TH FLOOR i OTHFLOOR ! aTH FLOOR r 7TH FLOOR + !TH FLOOR // II Check one: Certificate Installing Company Name rpt e. ans�Znc: * Corp. _ 109�? �. Address A l 3trec+. [i Partnership nn ►ass. OIQo�— ❑ Flrm/Co. Business Telephone (o)-7-5 V- p4to y Name of Licensed Plumber or Gas Fitter_ober+ (.A)- _..L r v►,n e. IMSURANCE COVERAGE: Check one have a current liability Insurance policy or its substantial equivalent. ' Yes j4 No D If you have checked yea, please Indicate the type coverage by checking the spproprlate box. A liability lnsurence policy ® Other type of indemnity D Bond ❑ OVIINER'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: Owner ❑ Agent O Signature of Owner or Owner's Mont hereby certify that an of the details and Information 1 have submitted(or entered)In above application are true and accurate to the best of my knowledge and that all plumbing work and Installallons performed under the permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts Slate ties Code and Chapter 142 of the General Laws. py Te of license: Plumber Signstuis of LkensedPlumber or as Filter Title Gasfilter Dmaster License Number M ` -�55 City/'Town Cl Journeyman AP1110VEb(OFFICE USE ONLY)