HomeMy WebLinkAboutMiscellaneous - 30 HIGH WOOD WAY 4/30/2018 (2)C'S
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3404
TOWN OF NORTH AN
PERMIT FOR GAS INSTALLATION
This certifies that . .... 7-) f .� !.�. ��% ...........
has permission for gas installation ... 1,1-1-3 ...................
in the buildings of ... �7- ............................
at
North Andover, Mass.
Fee. Lic. No.. .. ..... i.
,/GAS INSPECTOR
WHITE: Applicant - CANARY: Building Dept. PINK: Treasurer
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
. . . . . . . . . . Mass. Date Permit yo
Building Locatio,30 Owner's Name
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Type of Oc ncy
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New Renovation E Replacement F-7
FIXTURES
Plans Submitted: Yes El No El
Installing Companv Name
GL1MATEU,-.,,,,,,
Address 7 StewaFt Street
Haverhill, MA 01830
(9/8) 372-9999 ---
Business Telephone Lic. Plum! --- -
Name of Licensed Plumber or Gas Fritter
Check one: Certificate
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#��:Corporation q /1 (-..) ---
a r t n e rs h i p
Firm/Co.
INSURANCE COVERAGE:
I have a curr 3� bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes -2 No 7,
If you have checked yes, please indicate the type coverage by checking tile appropriate box,
A liability insurance policy n� Other type of indemnity C, Bond 0 '
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.
Signature of Owner or Owner's Agent
Check one:
Owner 'I-- Agent E
I hereby certify that all of the details and intormation I have submitted or entered) in the above application are true and accurate to the best or 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 M"sach etts State Gas Code and ha er 1 2 or theCen rall aws.
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massac" en
,Typ)/of License
By �Vlumbe,
�: Gastitter
Title k-fia s (e r Sign re or . Licensed Plumber or a Fii ef
Journeyman
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City/Town License umILer
APPROVED iDFFICE USE ONLY)
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Installing Companv Name
GL1MATEU,-.,,,,,,
Address 7 StewaFt Street
Haverhill, MA 01830
(9/8) 372-9999 ---
Business Telephone Lic. Plum! --- -
Name of Licensed Plumber or Gas Fritter
Check one: Certificate
, �z r
#��:Corporation q /1 (-..) ---
a r t n e rs h i p
Firm/Co.
INSURANCE COVERAGE:
I have a curr 3� bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes -2 No 7,
If you have checked yes, please indicate the type coverage by checking tile appropriate box,
A liability insurance policy n� Other type of indemnity C, Bond 0 '
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.
Signature of Owner or Owner's Agent
Check one:
Owner 'I-- Agent E
I hereby certify that all of the details and intormation I have submitted or entered) in the above application are true and accurate to the best or 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 M"sach etts State Gas Code and ha er 1 2 or theCen rall aws.
4e s
massac" en
,Typ)/of License
By �Vlumbe,
�: Gastitter
Title k-fia s (e r Sign re or . Licensed Plumber or a Fii ef
Journeyman
he
City/Town License umILer
APPROVED iDFFICE USE ONLY)
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Date. 4
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ............
has permission to perform .... ...........................
plumbing in the buildings of i .....................
at ....
North Andover, Mass.
Fee. Lic. No.. W?.� .. ..... ......
PLUMBING INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
AdkkWmass. Date /1//
Permit # Y,( 413
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Building Location "SO Name Ro/w/c/sr'o rc I
Ill Owner's
Type of Occupan,� lde,),t, o -
New..-' Renovation 11 Replacement EJ
FIXTURE
ns Submitted: Yes E' N o Et
Installing Company Name
Address :7 Stewart Street
Haverhill, MA 01830
(978) 372-9999
Business Telephone Lir- PlyiMher- Michnall H Nalltg&
Name of Licensed Plumber
Check one: Certificate
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<®rporation q">(Z —
LE Partnership
.INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes C,,-' NO [I
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity 7— Bond 71
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,
Signature of Owner or Owner's Agent
I hereby certify that all of the details and information I have submitted (or entered) in the above appi . . d
'c too r 'nu f
and ins allation performed under the permit issued for this application will be i ian I all fine',
General Laws.
Signature Ae I Plumber
Title Type of License: 'A
M., 's lournevman f—
CitvfTown License Number
APPROVED (OFFICE USE ONLY)
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Check one:
Owner -- Agent 1—�
accurate to the best of mv knowledge and that all plumbing work
of the Massachusetts State Plumbine C(Ae and Chapter 142 of the
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Installing Company Name
Address :7 Stewart Street
Haverhill, MA 01830
(978) 372-9999
Business Telephone Lir- PlyiMher- Michnall H Nalltg&
Name of Licensed Plumber
Check one: Certificate
'-e I
<®rporation q">(Z —
LE Partnership
.INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes C,,-' NO [I
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity 7— Bond 71
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,
Signature of Owner or Owner's Agent
I hereby certify that all of the details and information I have submitted (or entered) in the above appi . . d
'c too r 'nu f
and ins allation performed under the permit issued for this application will be i ian I all fine',
General Laws.
Signature Ae I Plumber
Title Type of License: 'A
M., 's lournevman f—
CitvfTown License Number
APPROVED (OFFICE USE ONLY)
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Check one:
Owner -- Agent 1—�
accurate to the best of mv knowledge and that all plumbing work
of the Massachusetts State Plumbine C(Ae and Chapter 142 of the
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that . IIJ X, / .....................
has permission to perform .�rt:7-. . . D ....
plumbing in the buildings of ...................
at. L-t./'/.Y ....... North Andover, Mass.
r—
Fee Lic. No.. ... ........ .......
PLUMBING INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NOR'IH ANDOVER, MASSACHUSETrS
Date 40'2�7—c'o
Building Permit W q Cd?
Amount SCA
of
New Renovation Replacement No F�
(Print or type) Check one: Certificate
Installing Company Name —7- V- 1,
o 11 Corp.
Partner.
Firni/Co.
Name ofLicensed Plumber. -Tnvin C �'7 ['.'s Y -k'
Insurance Coverage: Indicate the ty of insurance coverage by checking the appropriate box:
Liability insurance policy ,per' Other type of indemnity Bond
[a 11 , 11
Insurance Waiver: L the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner El Agent []
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations perfibuaed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachus EiP �inand Chapter 142 of the General Laws.
ype of Plumbing License
/ 9196 67
License NumbFr— Master
OVED (OFFICE USE ONLY
Journeyman
Er
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(Print or type) Check one: Certificate
Installing Company Name —7- V- 1,
o 11 Corp.
Partner.
Firni/Co.
Name ofLicensed Plumber. -Tnvin C �'7 ['.'s Y -k'
Insurance Coverage: Indicate the ty of insurance coverage by checking the appropriate box:
Liability insurance policy ,per' Other type of indemnity Bond
[a 11 , 11
Insurance Waiver: L the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner El Agent []
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations perfibuaed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachus EiP �inand Chapter 142 of the General Laws.
ype of Plumbing License
/ 9196 67
License NumbFr— Master
OVED (OFFICE USE ONLY
Journeyman
Er