HomeMy WebLinkAboutMiscellaneous - 29 WILSON ROAD 4/30/2018Date`U ^.7.. . . TOWN OF NORTH ANDOVER �� �� a _...,.'• �L 41 o PERMIT FOR PLUMBING ,SSACMUS� This certifies that .... .... ........ _ . has permission to perform ...... *. �..ti-'.!:.. ,-..... . ' plumbing in the buildings of ........................ i at . .7.�..�! ................ North Andover, Mass. Fee- Jn...... Lic. No.. * ........... P-lU � � NSPECTOR Check # o7 �'� 62u2 AV MASSACHUSETTS UNIFORM APPLICATIO FOR PERMIT TO DO PLUMBING Pint Flan. Date Pemhit # 4C�- Building Location •- /V �l/ Owner's NameLl J, — f T- of Occupancy 57/ %v G,. New O Renovation O Vftpwcwnwn aC/ Plans Submitted: Yes 0 No C FIXTURES Busmen Te spix e.-,)wK1 Name of Licensed Plumber Check one: O Corporation O PaRnecship P( FmWoo. > INSURANCE COVERAGE - 1 have Y current liabilityNo airy or its substantial equivalent which meets the requirements of MGL Ch. 142 If YOU have cchhedked yes. Please indicate the type coverage by checking the appropriate book. A liability insurance policy -g Other type of indemnity O Bond O OWNEFM INSURANCE W/WER: iam aware that the licensee does not have the irmwance coverage required by Mapter 142 of the Mass. General Laws, and that my signattpe on this pemhii apple mlim - waives this t Check one: sigdtkre of Owner or Owners Agent Owns Agent O l hereby cwft that all of the details and mfoosrfation 1 have mAwd ted lar entered in above aMftation are trkre and accurate to Um best of my Wamedge and that all Plkenbing wak and installations perfcrr ~the Permit issued forthis application will Deb► compliance with all perfinM ppridox of the mmmftfla State Code and Chapter 942 of the General Laws. at TypC of Lk=== master x Jameyman License Number /- -9/Dlg • • r • • • w Busmen Te spix e.-,)wK1 Name of Licensed Plumber Check one: O Corporation O PaRnecship P( FmWoo. > INSURANCE COVERAGE - 1 have Y current liabilityNo airy or its substantial equivalent which meets the requirements of MGL Ch. 142 If YOU have cchhedked yes. Please indicate the type coverage by checking the appropriate book. A liability insurance policy -g Other type of indemnity O Bond O OWNEFM INSURANCE W/WER: iam aware that the licensee does not have the irmwance coverage required by Mapter 142 of the Mass. General Laws, and that my signattpe on this pemhii apple mlim - waives this t Check one: sigdtkre of Owner or Owners Agent Owns Agent O l hereby cwft that all of the details and mfoosrfation 1 have mAwd ted lar entered in above aMftation are trkre and accurate to Um best of my Wamedge and that all Plkenbing wak and installations perfcrr ~the Permit issued forthis application will Deb► compliance with all perfinM ppridox of the mmmftfla State Code and Chapter 942 of the General Laws. at TypC of Lk=== master x Jameyman License Number /- -9/Dlg I i 0 0 i m m m o z m Date. ��... ........ ` TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION \fin_ •. . e_' This certifies that... ...... has permission for gas installation ............... in the buildings of . ................................ at--.' ..t'-!... jr�+p......:.:, North Andover, Mass. Fee�r..�.. Lic. No. 1-,/ .. ' `. �-`� C�AS•INSF; C Check # 4673 MASSACHUSETTS -UNIFORM APPUCATION (Print or Type).. It k,9hAUVas& Date c7 4 G' Business Buldingd ocationr _) l Vu LL,50-rJ 2?f— 6d,?, D New p Renovation. -❑ ep TO DO GASFITTING 7 20OLP . Permit Type of o=PU cy_-J z Plans Submitted: Yes© No p a M.Mraw- Name of Licensed Plumber or Gas Fitter: Check-aw, Certificate ❑ Corporation - 13 Partnership A Firm/Co. INSURANCE: COVERAGE:. I have ayes Wtbltty * a oe V014 or its st I: equivalent 1which -meets he requirements d MGI: SCh .142, If you have:che d pieeen�ndic She a average by checking the ippropriate, boot. A liability Insurance -policy)( Other-type-xkindemcfy.Q Bond ❑ OWNER'S INSURANCE WAhVMI. i am'aware that the licensee :does•not=have- the insurance .coverage requiredby Chapter 142 d the Mass.. Generata.aws..and !*,.my signature -on t ft Permit -applia#ion waives this requirement: Check one: signature ot.Owner.Ary ~:s Agmtt. Owner❑ Agent-❑ I hereby certify that an of the details and information 1 -have submitted (or entered) in above appIkation am true and accurate.to.the heat of my knowledge and that al plumbing work and installations -performed under the permit issued for .this application will be in compliance with al. pertinent provisions of the Massachusetts State Cas Cods and Chapter 142 of the General Lays. 690r' NA 5 ' ■■�i�i�1���ii��-ii�fii�i-�11■ MET. • ■���������si���������i����� .. ■�i�i��i��liiitiii�iii����■ .. �i�i�i�ii��sii�iii��ii����■ a M.Mraw- Name of Licensed Plumber or Gas Fitter: Check-aw, Certificate ❑ Corporation - 13 Partnership A Firm/Co. INSURANCE: COVERAGE:. I have ayes Wtbltty * a oe V014 or its st I: equivalent 1which -meets he requirements d MGI: SCh .142, If you have:che d pieeen�ndic She a average by checking the ippropriate, boot. A liability Insurance -policy)( Other-type-xkindemcfy.Q Bond ❑ OWNER'S INSURANCE WAhVMI. i am'aware that the licensee :does•not=have- the insurance .coverage requiredby Chapter 142 d the Mass.. Generata.aws..and !*,.my signature -on t ft Permit -applia#ion waives this requirement: Check one: signature ot.Owner.Ary ~:s Agmtt. Owner❑ Agent-❑ I hereby certify that an of the details and information 1 -have submitted (or entered) in above appIkation am true and accurate.to.the heat of my knowledge and that al plumbing work and installations -performed under the permit issued for .this application will be in compliance with al. pertinent provisions of the Massachusetts State Cas Cods and Chapter 142 of the General Lays. 690r' NA 5 y 1 J d A . � Z A t O 1 1 1 � 1 •1 1 1 W 1 1 11 J 1 1 1,.. ` 5 i i Id o � O = i C 1 O � 1 O � W O � � 1 1 , W W !i . d A . A t 1 1 1 1 1 •1 1 1 1 � 1 1 11 J 1 1 1,.. . d A . A t O b r