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Home My WebLink AboutMiscellaneous - 25 STACY DRIVE 4/30/2018Date. . ...... TOWN OF NORTH ANDQNER Pot PERMIT FOR PLU6eNG This certifies that ..... -S. ................. has permission to perform ..... ................. 7" Plumbing in the buildings of ... ....................... at . .0. ......... . North Andover, Mass. . . Fee. .7.Lic. No.:? ?A ....... LU IVIBING INSPECTOR Check # 7407 MASSACHU ETTS UNIFORM APPLICATION FOR PERMIT TO D® PLUMBING :(Priat.or Type) 'Mass. Date _ ?0Permit Building Location_ _s em De Owner's Name �� Owner Tel# I" gs7` /.?Q11 Type of Occupancy A2-SifiG�NT/'9 / New ❑ Renovation ❑ Replacement pe Plan Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name. JD/!/iya/itlC.%1Er(/� Check.one: Certificate Address J-7- ❑ Corporation ❑ Partnership Business Telephone ## 179 / 353.1, ❑ Firm/Co. Name of Licensed Plumber .S%Evert/ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of biGL Ch. 142. Yes j4L No ❑ If you have checked ycq, please indicate the type coverage by checking the appropriate box. A liability insurance policy 1�1 Other type, of indemnity ❑ Bond ❑ OWNER'S INSURANCE \VAINER: 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. Signature of Owner or Owner's ;Agent I hereby certify that all of the details and information I have and that all plumbing work and installations performed under the Massachusetts State Plumbing Code and By. Title City'Town_ _ APPROVED (OFFICE USE ONLY) Chapter 142 oft) Check one: Owner ❑ Agent ❑ (or entered) in above application are true and accurate to the best of my knowledge issued for this application will be in compliance with all pertinent provisions of Laws. of Licensed Plumber Type of License: blaster �❑'') Journeyman P< License Number / �3 ■■■■■■■■■■■■■■■■■■■■■■■■■■ �■■■■■■■■■■■■■■■■■■■■■■■■■■ •' ■N■■■MN■■■■■■■■■■■■■■■■■■■ ' • ' ■■■■■■■■■■■■■■■■■■■■■■■■■■ ' ... ■■■■■■■■■■■■■■■■■■■■■■■■■■ ...■■■■■■■■■■■■■■■■■■■■■■■■■■ ...■■■■■■■■■■■■■■■■■■■■■■■■■■ ..'■■■■■■■■■■■■■■■■■■■■■■■■■■ Installing Company Name. JD/!/iya/itlC.%1Er(/� Check.one: Certificate Address J-7- ❑ Corporation ❑ Partnership Business Telephone ## 179 / 353.1, ❑ Firm/Co. Name of Licensed Plumber .S%Evert/ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of biGL Ch. 142. Yes j4L No ❑ If you have checked ycq, please indicate the type coverage by checking the appropriate box. A liability insurance policy 1�1 Other type, of indemnity ❑ Bond ❑ OWNER'S INSURANCE \VAINER: 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. Signature of Owner or Owner's ;Agent I hereby certify that all of the details and information I have and that all plumbing work and installations performed under the Massachusetts State Plumbing Code and By. Title City'Town_ _ APPROVED (OFFICE USE ONLY) Chapter 142 oft) Check one: Owner ❑ Agent ❑ (or entered) in above application are true and accurate to the best of my knowledge issued for this application will be in compliance with all pertinent provisions of Laws. of Licensed Plumber Type of License: blaster �❑'') Journeyman P< License Number / �3 TOWN OF PERMIT FOR Date. ..2.... ... WSTALLATION This certifies that . . . .�. .)P.0 ....0 ..................... has permission for gas installation .............. in the buildings of .... 1.4.el A.r\,. at d. /62 1A .......... North Andover, Mass. Fee. Lic. No. .7 G INSPECTOR Check # /'/ I L T 6026 MASSACHUSETTS UNIFORM APPUCATON FOR PERNffr TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date ;,I- T 0 '7 Building Locations Oys— 27-A [ V /) /1? G 61 = -6 Permit # Owner's Name Amount $ ; 6 ) /�� New ❑ Renovation ❑ Replacement ® Plans Submitted❑i` (Print or type) one: Certificate Installing Company Name A%tiV113ri+�G i E-�4�'.rJ C k Corp. Address 2 Cc�n/«2g 4'.7" ❑ Partner. usiness a ep one q ; / 3 �� 77 _ ❑Firm/Co. Name of Licensed Plumber or Gas Fitter 5,7E-Vze/V INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. Yes M No❑ If you have checked Les, please indicate the type coverage by checking the appropriate box. L' b' 1' �ai qty insurance policy � Other type of indemnity 13Bond13 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 ❑ I hereby certify that all of the details and information 1 have submitted (o ntered) in above application are true and accurate to the best of my knowledge and that all plumbing work apd installations pe under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State as ode and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Sigtidture of Licensed Plumber Or Gas Fitter ❑ Plumber X70-? < Gas Fitter License Number Master Joumeyman Date ........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTAL ION ��j /Ir This certifies that .. P//. P.../7f 5 .......................... has permission for gas installation . . . P.14 /.-- li .. ............... in the buildings of ... weo--t................................. at ............ . TIorth Andover, Mass. Fee.G Lic. No.. Y .. ....... ....... GASINSPECTOR Check# 3026 5356 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO CASFITTING (Printof Type) l 0 Vtk Mass. Date 06 O� Permits �! 3 jf Building Location S S 4CL- )Yz Owner's Name ~ c• Type of Occupancy It ,-j f �7//i L. New ❑ Renovation ❑ Replacement 9,-' Plans Submttted: Yesp No O-" 6 Installing C Name'1 AA-) 11�t'YIY�it(l�P Business Telephone Li -/?5 Name of Licensed Piumber or Gas Fitter Check .one: ❑ Corporation.. C3. 'Partnership Firm/Co. I Certificate INSURANCE COVERAGE: I have a cu2ckedlability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YeNo 11If you have yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 ❑ 1 hereby certify that all 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 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 Genera w .� Plumber Ngnature of Licensed Plumber or Gas i ter r tle Gasfitter ��jMaster License Numbery�ll ty/Town Joumeyman PPRC1VED (0 I S. NL N N 6 W N NU; Y = V ¢ ¢ F 2 W W N. ¢- O U m ¢ < m a C a c s ►- < W h UJ W Q U V F. Z! F Z F W O > LL H W SUB—HSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR BTHFLOOR Name'1 AA-) 11�t'YIY�it(l�P Business Telephone Li -/?5 Name of Licensed Piumber or Gas Fitter Check .one: ❑ Corporation.. C3. 'Partnership Firm/Co. I Certificate INSURANCE COVERAGE: I have a cu2ckedlability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YeNo 11If you have yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 ❑ 1 hereby certify that all 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 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 Genera w .� Plumber Ngnature of Licensed Plumber or Gas i ter r tle Gasfitter ��jMaster License Numbery�ll ty/Town Joumeyman PPRC1VED (0 I S. NL C r fOf _ D � M m � O O Z O m _ O s � I p