HomeMy WebLinkAboutMiscellaneous - 277 FARNUM STREET 4/30/2018 (2)1p
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"ORTPI
M TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that
... ...........................
A. as permission for gas installation .................
in the buildings of . .............................
at ....... North Andover, Mass.
Fee..A� Lic. NoZ.'.I..
............
GAS INSPECTOR
Check# e;
3773
INN
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12
MASSAC"USETTS UNWORM APPLICATION rOR 11111MIT TO DO CASr-ITTING,
(Print or Typo.)
'oi
()wnor 's Nat1110
Building I ()(:jlioI1-
YP(l of OccullAncy
New I-1
1XI P mlitled: Yet; 1, 1 No
t0 p C�-1111 V—
FIX11 JRVC,
11WAilling Company Name _ Chock oil(,: Cerli6rato
BRADFORD PLUMBING & HEATING
Lic. #12580 Tel. #(978) 521-0262
P.O. Box 5269
BRADFORD, MA 01835-0269 1-] PartlIvIship
Suc,irtes-, Telephone . --- I-
-1 Firm/Co.
Ninle of Licensed Number oi C)a, rjltf�j
INSURANCt COVIERAM
I h;,Vp a f,-urrept- liability i"Sutan(p tR-iji( y of orpliv,11ent Which nirpf� thr, of M( -,l (-1,, 14).
YN)k_ No F)
lf It-Ot" flavc- rhi6M Yc*s, Plp*e indic,11" Ifir IVpr1 cover,,ipp by (-hpCking tilp jj)pI,jI;i,1jr, 11ox.
A liability imorAnce poli ' Othilt IvIlf, of indpitirdly (I
rv>� Rond I I
OWNIFIR'S INSURANCE WAtVfk- I ain awaw ofit illo lif r1n1PA does not have III,, jr),'J'
la", and that nly Ogmitijn, on tlii,, permit it, plif., I;o Wal , , 1 If""" r' (*ovotagr roquired by Chmilor 142 of Ilift, kjj�q,
Owt � of
I I Ag -nI I I
Signature of ()wnpt of OwhWft Apent
'"Y fl�m 'If 'If the 41mailt vid ImfqfmAtin" I fm,e in flip ej)nvo Appli'M11111 M, 0,,J� j,"I ;,, , mair, in f1m. limi (if iny t"i .... lvdp� an,, Il'if :oll pinnibing, �,A
if- Omnll Appf;, h, With all V�nlnenl M the 10.111V Inke114 StAtp t."', . .....
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Date &: . -. :'�. -. � . I
,40PTIJ
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
CINUS
This certifies that I?. �1. F C. ....... ..............
has permission to perform .... ..........................
plumbing in the buildings of ... I ........ .....................
at . ............ , North Andover, Mass.
............
Fee ... ..... Lic. No. 0.
PLU M*BIN I ;�S
G PECTOR
Check #
4980
MASSACHLISMS UNIFORM APPLICATION FOR PF-RMIT TO W PLUM13ING
Mms. F)ate Permit#
A,
Aullding Location c2 '2
me
Ovytlet'nNa
ypt, of QccujX (:v
t- .
New
ReplacemeMA 01ortant submitted: Y No
9:lv,rl IhL-r- Id -a - � -!!�Q I
111-�Wllng Company Name
"Idirets ------------
BRADFORD PLUMBING & HEATING Check one:
Lic. #12580 Tel. #(978) 521-0262 ��Corporatlon
P.O. Box 5269
"'Oness TMe IVIM V10-:)0-UetD!j .1 alulershilp
pho
",rne Of Lic"Sed Plumber -5-4 /V FS
Cerifficate
----------
""�URANCE COVENACE:
hve Ill curnot 112mity 1"s0ftni policy Or fie, substantW
yes L No 13 equi'valent which meets the reqUIremeniq of MGL Ch. 142.
you hay* C ed Y-0-8. Pluse Wicate the lyt_).,o coverage by checking flie appropt le x
1p ia bo
, liabOfty hUUra" Nicy Other type of indemnity El Bond
�6VNEA'S INSUAANCE WAIWA-
. I am aware that the licensee
fuinter 142 of the Mass. General Uws, Am -90t b,�—vlt. the Insurance coverage required by
and '11"t my sliCIMAture on this permtt aprAjc�3tlon waives this requirement.
Check one.
I U- e oil Q'I'ma .3 1 . ....... Owner (J
t Agent E)
bY 06" ft d Of tho &Wit WW Wi6irmation I havo submRIM lot entered) in above. appiic3tjon
?w -i and thAt A# PWMft work OW intWations r! rmeu A16 We and accurate to the best of my
ndef tht Permit issued for this OPPlictition vvill be in compliance th all
0"i"n't Of0i Of the Masiii� Wta Plumbinp`=id - — Wi
ChlOte't 142 of tho, eye or I -Laws,
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