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Date. 3-- / �� - �- .2
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ... //
has permission to perform ... I ..............
plumbing in the buildings of ... .................
at ... .................... North Andover, Mass.
Fee Lic. No.. ... ... ........
Check # PLUMBING INSPECTOR
5551
-3 91 Val) 6 e 5-7-�
MASSACHUSETTS UNEFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print) I
NORTH ANDOVER, MASSACHUSETTS Date q/ /�e)33
Building Location 34444a?V� Owners Name Permit
TWe_of Occupancy_ _/�jt r�l Amount
New 13 Renovation
(Print or type)
Installing Company Name
,�ddress L6 PL
619
Name of Licensed Plumber �Ijc-t
Insurance Coverage: Indicat e type i
Liability insurance policy
Replacement 1:3
F]DffURES
'ance coverage by checld
Other type of indemnity
Plans Submitted Yes [] No
Check one: Certificate
VW" -
L�orp.
11 Partner.
0--Fum/Co.
appropriate box:
. Bond
Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does
three insurance not have any one of the above
Slignature Owner 0 Agent
I hereby certify that all of the details and information I have submitted (or entered) in above appli . cation are true and accurate to the
best ' of my knowledge and that all plumbing work and insWns perfiDffqed under Permit Issued for this application will be in
)t� St
compliance with all pertinent provisions of the Ma tc State Plq1]qKt4F*d6-
_and 6apter 142 of the General laws.
7 -
D (OF+ICE USE ONLY
'yYpt of- Plumbing license
')j 13V
License f4umMr' Master Journeyman
-1 1 '-- -?
Date. . I.-. . . /. ?. : ...........
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that '1.(114.11x ! .....................
has permission for gas installation ./-. ('. �'.4 � �� �'. -. '/. 1-:. 1//
in the buildings of ... C. . I ........................
at ............. I North Andover, Mass.
Fee.. 14 Lic. No.. 2. Q. .. .... � ........
G 'ASINSPECTOR
Check#
4320
j6 A Al
MASSACHUSETTS UNIFORM APPLICATION OR PERMITITO [DO GA-St-ITTING
(Print of Type)
NO.ANDOVER,MA Ma 5. Cate
-19 permit
----------
Building Lccatlon --Owner's Name C C- Ra A)E-7
- PALk�
I
I
NO.ANDOVER,MA - Type at Occupancy
New 0 Renovation o Replacement E--- . Plans Submitted: YesC] No []
Ins-tziling Company Name CALLAHAN AI R CONDITION I NIG
Address 91 BELMONT S7'RFFT
NO.ANDOVER,MA. 01845
Business Telephone
508-689-9233
Check one: Certfflcate -71
15-<crporatlon 1 0-1-,5- C
[] Partne,,shlp
El Firm/Co.
Name of LIcensed Plumber or Gas Fitler JOSEPH KEVIN C:-.LLAHAN
INSURANCE COVERAGE:
I have a cur -rent Ilablifty Insur-ance poilcy or Its substantial equNale��t which meets the requirements of MGL Ch. 142.
Yes R3 No 0
It you have checke-d yes, please Indicate the type cover -age by checking the appropriate bc)c
A IIabflIty Insurance policy Z Other type of Indemnftly E' Bond D
CWNER'S INSURANCE WAIVER: I am aware that the licensee - does not have the Insurance coverage required by
Cll%aptcr 142 at the Mass, Generzi Laws, and that my signature cn '�)]s permft application waives this requirement.
Check one:
OwnerC3 Agent C]
S;gnature of Cwner or Cwner s Agent
1 hereby certify that all of the details and information I have submitted (or entefe c r ". 3op ('ication are true and acc-urate to the best of my
d I app Czu
kno,wiedge and that all plumbing wcfk and lns(aJlaUcn5 pe,,fornned unca( L�e to, thi it U IMII b In Qnanca with all
'Lie
P-ciUnent proyi.ion3 of the Massac,�uzens State Gas Code and C:')apter 142 o� Itle a] Lz WY
rrIe o License:
&y T ( I,
Flumoe r ��-,(Ufdol-Lic6n5erPru-m—b—e—r'or �Gaz
Title G.�sritler
Mzistcr Number m - 3 4 ,, 0
City/_Tcwn Ei"Guineyman
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SUB—BSMT.
BASEMENT
T7
1 ST FLOOR
2 N D FLOOR
I
3 R 0 FLOOR
—J
4TH FLOOR
5 7 H FLOOR
8TH FLO 0 R
7TH FLOOR
8TH FLOOR
Ins-tziling Company Name CALLAHAN AI R CONDITION I NIG
Address 91 BELMONT S7'RFFT
NO.ANDOVER,MA. 01845
Business Telephone
508-689-9233
Check one: Certfflcate -71
15-<crporatlon 1 0-1-,5- C
[] Partne,,shlp
El Firm/Co.
Name of LIcensed Plumber or Gas Fitler JOSEPH KEVIN C:-.LLAHAN
INSURANCE COVERAGE:
I have a cur -rent Ilablifty Insur-ance poilcy or Its substantial equNale��t which meets the requirements of MGL Ch. 142.
Yes R3 No 0
It you have checke-d yes, please Indicate the type cover -age by checking the appropriate bc)c
A IIabflIty Insurance policy Z Other type of Indemnftly E' Bond D
CWNER'S INSURANCE WAIVER: I am aware that the licensee - does not have the Insurance coverage required by
Cll%aptcr 142 at the Mass, Generzi Laws, and that my signature cn '�)]s permft application waives this requirement.
Check one:
OwnerC3 Agent C]
S;gnature of Cwner or Cwner s Agent
1 hereby certify that all of the details and information I have submitted (or entefe c r ". 3op ('ication are true and acc-urate to the best of my
d I app Czu
kno,wiedge and that all plumbing wcfk and lns(aJlaUcn5 pe,,fornned unca( L�e to, thi it U IMII b In Qnanca with all
'Lie
P-ciUnent proyi.ion3 of the Massac,�uzens State Gas Code and C:')apter 142 o� Itle a] Lz WY
rrIe o License:
&y T ( I,
Flumoe r ��-,(Ufdol-Lic6n5erPru-m—b—e—r'or �Gaz
Title G.�sritler
Mzistcr Number m - 3 4 ,, 0
City/_Tcwn Ei"Guineyman
A1rr1_x_111T07=1 177S�-�c� I
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