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HomeMy WebLinkAboutMiscellaneous - 231 WAVERLY ROAD 4/30/2018Xv Location Z, No. Date 40RT" TOWN OF NORTH ANDOVER Certificate of Occupancy $ L5720, d C) Building/Frame Permit Fee $ C) Foundation Permit Fee $ C U Other Per mit Fee $ --------- Sewer Connection Fee $ 7099 Water Connection Fee $ TOTAL $ Building tnspector Div. Public Works Location 7o 19 Date ;" - -� ' / Z TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector Div. 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CZ O C Z m C., m •N O CW.D •`d p m= C CODO' m :2 O '� 2 tyv co) •� O Sam �lm OE� J Q Z LL W Q w W J o z E U- coL 0 o � Z CD d O 0 y CD cm z o O •= Q co yo m W z CO 0_ o s O� O i Co co R 0 Q CL Ca y CD cccc .0O2G CD Z Z CD U CO) O G .G t� _a CA � r U z z fs OE� J Q Z LL W Q w W MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTiNG (Print or Type) 9 C t C NORTH ANDOVER Mass. Date Ihuilding Location Permit # • Owners NameS�� d�+T Tze Z 244 • New .7 Renovation D Replacement IN Plans Submitted FIXTURPS (Print or Type) Check one: Certificate Installing Company Name C4eege P/(J41Corp. Address c-(. C HfR f / �w��r,r L] Partner. 0&t I Firm/Co. Business Telephone: 90S 6�S Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the .appropriate box: Liability insurance policy 0 Other type of indemnity Q Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this pplication oes of have any one of the above three insurance coverages. Signature of o er/age t of property Owner 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 fox this application will -lx In compUanca with all pertinent Provisions of tho Massachusetts Slate Gas Code and Chapter 142 of tho General Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber- L' <� !'- -" Gasfitter- Signature of Licensed Master Plumber or Gasfitter Journeyman _ Licens Number Y • 0000 000n MENNEN MM000000 .. - o0000000000■ MENNEN00MEESE . ., . ■0000000000■ 000000toot00000 .. ... o0000000000000000000000000 ... ■0000000000000000000000000 ... o000000000000000EMEME0000 . .. - 0000000000000000000000■»�' .. ■0000l000000000»�����»»� .. - o000000r00000000000000000■ (Print or Type) Check one: Certificate Installing Company Name C4eege P/(J41Corp. Address c-(. C HfR f / �w��r,r L] Partner. 0&t I Firm/Co. Business Telephone: 90S 6�S Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the .appropriate box: Liability insurance policy 0 Other type of indemnity Q Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this pplication oes of have any one of the above three insurance coverages. Signature of o er/age t of property Owner 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 fox this application will -lx In compUanca with all pertinent Provisions of tho Massachusetts Slate Gas Code and Chapter 142 of tho General Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber- L' <� !'- -" Gasfitter- Signature of Licensed Master Plumber or Gasfitter Journeyman _ Licens Number TO 2216 AORTN 0 * 1 0 Date... -4? <-, - I. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that.. (214. .............. has permission for gas installation . ...................... in the buildings of. Z':� .............. - 44?. - at .. .. ..... PK04..., North Andover, Mass. Fee. PAID GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File Claim # 2509859 Advantage Claim Services Adjuster Assigned: Glenn Guarente 522 Chickering Road #B North Andover, MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings Town Hall North Andover, MA 01845 Re: Insured: Carmelina Dagata Property address: 231 Waverly Road North Andover, MA 01845 Policy #: 2509859 Loss of: 2011/06/07 File or Claim No. AD 9483 Board of Health op! Board of Selectmen Town Hall North Andover, MA 01845 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. _Gen._Laws,_Chapter_143,_ Section _6 to be applicable. If any notice under Mass_Gen_Laws,_Ch._139_Sec._-3B is appropriate please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Glenn Guarente Title. Adjust«:r On this date, I caused c=opies of this not -ice to be sent to the persons named at the addresses indicated above by first class mail. 06-13-11 Signature and date