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Home My WebLink AboutMiscellaneous - 282 WAVERLY ROAD 4/30/2018Date.(F -/-? - - - 0 - - / ...... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION Tiih certifies that .... / '-"" /"" .................... has permission for gas installation A /-V in the buildings of ................... at -2 ... L,,L. / i J ......... North Andover, Mass. Fee. Lic. No.. A 2J. . . ....... GASINSPECTOR Check # Ll -%4j 7 2 2 fMAS-1kACHUStI1TS UNIFORM APPLICATION FOR PERMIT TO DO GASFiTTING _p Print or Type) 4 Y(/ �,�tvtass. Date 20 Permit # Z t ^r% Building Location 2- - �� J e f `3 1 et . Owner's Name j� "A / " 1 C (7/ cGlc i ) � Type of Ocean S. New C Renovation L Replacement O Plans Submitted: Yes U No LA -1 FIXTURES lallint; Company Name Uptack Plumbing & Heating, Inc. Check one: Certincate 32 Rochambault Street 1x1 Corporation Haverhill, MA 01832 f-1 Partnership _. �11'.1lIC}} Telephone 508 372-8503 U Firm/Cil. _ • init• of Licensed Plumber or Gas Fitter Leonard A. Hall i INSURANCE COVERAGE: i ,.iw- a current liability insurance policy or it> substantial equivalent which mi -el% the icqulremt•nt, of IrtGl. Ch. 141. Yry (ni No F! !i am tt,i:e checked yes, please indicate the type ravt•ragi- by checking the appropriate box. • ,:llnlay insurance Policy t n Odx r typt. al mdenunty i; (tontl , OWNER'S INSURANCE WAIVER. I am aware that the licensee does not have the insurance coverage rt,quattil by Chapter 142 ul the r . no.il taws, and that my signature tin tilts pontil application walve.. tilt% wtitlirt•nu•nl. check one: -- --- -- _. Ownt'l i . Agent ,4n.r:nv of Owner or Owner's Agent • -i.. teddy Ihat all ui die doitK and mltnntattun 1 hatr limit llnl Wt vtni•1t%l1 tit 11k• .dktu• .ggdu.nuw .uv Inn• .4118 ai curav tr1 Ili• 11l•,l la illi S.nWilrltpl• .aul ih.a .JI I'luudung u••,:. •• •••1.141.,!t,kh fk-flulttlt if Wtdf•t flit• fil-mill mwf for (lu ilit'l alim %"If Ill• tit irmilllltilwe W1111.111 Iii-altit-19 1"ims-4h •1t Itis• &:. —flits -ft, stalf• 1 •.h t Wi- afllt i 11.,pl •f )41 Ill till- { r/'nl•1.11 t,it+, Itik' lit Iar".• .. —.._ _ ._...,..—�—,-. •✓DIaHw 1 till' id EKtOtVtl-htU6ltkv iu i..4, f al.' --� .._ Lnnlavnan - frond— .B.b 7 8 'WPHOVID 111011E U)1 UtYtl'1--- • z Ac ac Z OC bid Q9 all U. 2 at .. D ac.. ..W) rff -r1V■###i#####�##########��#; FLOOR■��t############�###### • , M■#####ii#��#############�� lallint; Company Name Uptack Plumbing & Heating, Inc. Check one: Certincate 32 Rochambault Street 1x1 Corporation Haverhill, MA 01832 f-1 Partnership _. �11'.1lIC}} Telephone 508 372-8503 U Firm/Cil. _ • init• of Licensed Plumber or Gas Fitter Leonard A. Hall i INSURANCE COVERAGE: i ,.iw- a current liability insurance policy or it> substantial equivalent which mi -el% the icqulremt•nt, of IrtGl. Ch. 141. Yry (ni No F! !i am tt,i:e checked yes, please indicate the type ravt•ragi- by checking the appropriate box. • ,:llnlay insurance Policy t n Odx r typt. al mdenunty i; (tontl , OWNER'S INSURANCE WAIVER. I am aware that the licensee does not have the insurance coverage rt,quattil by Chapter 142 ul the r . no.il taws, and that my signature tin tilts pontil application walve.. tilt% wtitlirt•nu•nl. check one: -- --- -- _. Ownt'l i . Agent ,4n.r:nv of Owner or Owner's Agent • -i.. teddy Ihat all ui die doitK and mltnntattun 1 hatr limit llnl Wt vtni•1t%l1 tit 11k• .dktu• .ggdu.nuw .uv Inn• .4118 ai curav tr1 Ili• 11l•,l la illi S.nWilrltpl• .aul ih.a .JI I'luudung u••,:. •• •••1.141.,!t,kh fk-flulttlt if Wtdf•t flit• fil-mill mwf for (lu ilit'l alim %"If Ill• tit irmilllltilwe W1111.111 Iii-altit-19 1"ims-4h •1t Itis• &:. —flits -ft, stalf• 1 •.h t Wi- afllt i 11.,pl •f )41 Ill till- { r/'nl•1.11 t,it+, Itik' lit Iar".• .. —.._ _ ._...,..—�—,-. •✓DIaHw 1 till' id EKtOtVtl-htU6ltkv iu i..4, f al.' --� .._ Lnnlavnan - frond— .B.b 7 8 'WPHOVID 111011E U)1 UtYtl'1--- �` V1 z W 6. 4A z C z V z S m i W d W z O z V I •< m Ir u W LL W) z Ln W l,7 O ac C. �` V1 z W 6. 4A z C z V z S m i W d W z O z V I •< m Ir 0 Date .... �/��O:� 'AORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ............... . ............. ..... has permission for gas i stallation, / ....... in the buildings of ........... /- 6 - V! a t Aw - ..,North Andover, Mass. Fee. Lic. No.. .......................... J Check GASINSPECTOR 4765 MASSACHUSETTS -UNIFORM APPUCATI0N-FOff:PEFWMfr TO DO GASFITTING.. or Type). // j &0 M— MDate 2 O Permit # 7v�� / �r BuldkV locatiocr' l dC��j j; Owners Names � o , � e Type of OcwPaney , New ❑ Renovation: -Q RePlans Submitted: Yea© "W:U `4 Installing Company NatneZdc�a�2Cr� Business Telephone 2 L -�- ?,5 Name of Licensed Plumber or Gas Fitter. Check,own Certifiate- Q Corporation ❑ Partnership A Firm/Co. INSURANCE: COVERAGE: I have a urreliab11ty �irtsuranoe �pd4 or Rs substantial: egUhWei�t-1whkh-meets the requirements of MGL- Ch: 142, yes No 13 If you have chedceda2&4ftm*diaaWj&e4ypesx vmge-by :the appropdate..box A liability insurance :po ft � Other -type o indemnity. EL Bond ❑ OWNER'S INSURANCE WAP*%R:,1 am,awwe Md,thelkensee:does.not:have- the insurance .coverage requiredby. Chapter 142 of the.Mam Generafaaws, and V*.fny signature on this permit applkatbn waives ..this requirement Check one: Signature of-.Owner.orAwnw:s ONR1er❑ Agent.❑ I hereby certify that all of the details and information I have submitted (or entered) inabove application am true and accurate.to.the heat of my knowledge and that all pluming workand installationrPerformed urKW the permit issued foMi 11 be in com with all pertinent provisions of the Massachusetts State Gas Cods and Chapter 142 of the General wa T of License: Plumber Signature of Ucerf Plumber or Fitter Tille Gasfittor Master License Number 1 31 GYn. Cit�/Town Journeyman MEN MH VIM Installing Company NatneZdc�a�2Cr� Business Telephone 2 L -�- ?,5 Name of Licensed Plumber or Gas Fitter. Check,own Certifiate- Q Corporation ❑ Partnership A Firm/Co. INSURANCE: COVERAGE: I have a urreliab11ty �irtsuranoe �pd4 or Rs substantial: egUhWei�t-1whkh-meets the requirements of MGL- Ch: 142, yes No 13 If you have chedceda2&4ftm*diaaWj&e4ypesx vmge-by :the appropdate..box A liability insurance :po ft � Other -type o indemnity. EL Bond ❑ OWNER'S INSURANCE WAP*%R:,1 am,awwe Md,thelkensee:does.not:have- the insurance .coverage requiredby. Chapter 142 of the.Mam Generafaaws, and V*.fny signature on this permit applkatbn waives ..this requirement Check one: Signature of-.Owner.orAwnw:s ONR1er❑ Agent.❑ I hereby certify that all of the details and information I have submitted (or entered) inabove application am true and accurate.to.the heat of my knowledge and that all pluming workand installationrPerformed urKW the permit issued foMi 11 be in com with all pertinent provisions of the Massachusetts State Gas Cods and Chapter 142 of the General wa T of License: Plumber Signature of Ucerf Plumber or Fitter Tille Gasfittor Master License Number 1 31 GYn. Cit�/Town Journeyman rn r a N z H O - W iL a s � � D z O O O W d O ~ U� 16 U. O W O = s C C O O W z O O .1 H W < m V J d 6 4f W rn r N O - W s � � D 1" z; W d 0 0 N 4*1 Date. . �o/ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ............... has permission to perform ............. plumbing be buildings, f at .......... North Andover, Mass. Fee/'��./`.' . Lic. No . . ..... .............................. PLUMBING INSPECTOR .Check # 6L57 e, 1^ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO (Print� Type) 0) Gl"` M /1 C7 ass. Date (� it I Builth Lxat ' WA- L_r �13 Owner's Name Type of Occupancy New D Renovation D Reptacxment Pians Subm' IN DO PLUMBING toed. FIXTURES Yes D No D Check mm c,«fificae lnstaltitfg Company Name 11fnh; ,Q Ad 4L1- * o.._o,no 'Zf. D - (7� APD 11114 1- C, - Business Te mphone 1- - � � --- NamofUcmmWplumbW14eu.e,A INSURANCE COVERAGE: 1 have Y cstrerlt liabilNo policy Or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have cchhecked yes, Please indicate the type coverage by dledtirg the appropriate boa. . A liability insurance policy OtlW type of indemnity D Bond G OWNWS INSURANCE WAIVES I am aware that the licensee does not have the i by Chapter 142 of the Mass. General Laws, and that my sigrt�p on this Defmance coverage ree t t application nernaives this t Check one: SWaum of Owner or Owner's Agent Owner t� Agent D Ca ti(y that all Ot the details avid mtorrnation I have wjwm ted (or &am* in above apD�ioa arc true and accurate to the beg of my knowledge and that all pkrrrrbing wcxthe and in�sWlattioSrss DertoPmM unurberthe paird issued torr" appiiation will be in pertinent pwisions of the m"mft S� n _ ",pO and Cly 742 of the Genual Laws. Type of UcOrftm MasterA bran i License Number 13,Ip.1p y V • A �_-�eeeeeeeeeeeeeeeeeeeeeeeeee - ■eeeeeeeeeeeeeeee■®eeeeee■ •• - ee��eeeeeeeeeeeee��eeeee■ •- ■eeeeeeeeeeee■ -"'- �e��eee�e�eeeieeeeeeeeeee ..- ■eeeeeeeeeeeeeeeeeeeeeeeei ..- ■eeeeeeeeeeeeeeeeeeeeeeee■ ..- ■eeeeeeeeeeeeeeee.eeeeeee■ ..- ■eeeeeeeeeeeeeeeeeeeeeeeee ..- ■eeeeeeeeeeeeeeeeeeeeeeee■ Check mm c,«fificae lnstaltitfg Company Name 11fnh; ,Q Ad 4L1- * o.._o,no 'Zf. D - (7� APD 11114 1- C, - Business Te mphone 1- - � � --- NamofUcmmWplumbW14eu.e,A INSURANCE COVERAGE: 1 have Y cstrerlt liabilNo policy Or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have cchhecked yes, Please indicate the type coverage by dledtirg the appropriate boa. . A liability insurance policy OtlW type of indemnity D Bond G OWNWS INSURANCE WAIVES I am aware that the licensee does not have the i by Chapter 142 of the Mass. General Laws, and that my sigrt�p on this Defmance coverage ree t t application nernaives this t Check one: SWaum of Owner or Owner's Agent Owner t� Agent D Ca ti(y that all Ot the details avid mtorrnation I have wjwm ted (or &am* in above apD�ioa arc true and accurate to the beg of my knowledge and that all pkrrrrbing wcxthe and in�sWlattioSrss DertoPmM unurberthe paird issued torr" appiiation will be in pertinent pwisions of the m"mft S� n _ ",pO and Cly 742 of the Genual Laws. Type of UcOrftm MasterA bran i License Number 13,Ip.1p I O O 9 A N A 7 A _ A O A. � A 9 � O > � + v O Z O A O I O O 9 A N A 7 A _ A O A.