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HomeMy WebLinkAboutMiscellaneous - 34 MILTON STREET 4/30/2018N O W � ?� gZ �� m o ^' 0 Date 121 ate TOWN OF ORTH DOVER PERMIT FOR G INSTALLATION This certifies that .... l.�. f%ww�.{j/r9! .?... r........... has permission for gas installation J-ir f C CAH-' in the buildings of .......................... at '.� ` . e7r ,C % .....'?``........jNofh Andover, Mass. Y 2-PECTOR Check # 135 �, S 6260 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING � � �'�� (Print or Type) o NOW N W126Y6 P . Mass. Date 11 ZOC? Permit # L !e Building Location 34 ` X H I L TLC S-1 Owner's Name LI "@A+4Lti 111A1 Y UV.. 1jorl'-TN A kj Om6p',--, KA Type of Occupancy ka/bUTAL- .� F�hl L� G New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone q 7$-68,7-1105 Name of Licensed Plumber or Gas Fitter Francis X. Corkery Check one: XJ Corporation ❑ Partnership ❑ Firm/Co. Certificate # 1862 INSURANCE COVERAGE: I have a cusrrenntt liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked Vis. please indicate the type coverage by checking the appropriate box. A liability insurance policy X . Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner'sagent Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in abo plication are true and accu to to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (j T e of Ucense: i/ Title Plumber Signature of o used Plumber or Gas Gasfitter City/Town Master Ucense Number 374-5 O IC p Journeyman MEN. ■■ .. OMEN ■utaNONE .. ■NNERNMENNEENMfi NEW sonno■ monism .. • ■I�S��■■�Il���������t�■■fit/■ Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone q 7$-68,7-1105 Name of Licensed Plumber or Gas Fitter Francis X. Corkery Check one: XJ Corporation ❑ Partnership ❑ Firm/Co. Certificate # 1862 INSURANCE COVERAGE: I have a cusrrenntt liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked Vis. please indicate the type coverage by checking the appropriate box. A liability insurance policy X . Other type of indemnity ❑ Bond ❑ 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. Check one: Signature of Owner or Owner'sagent Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in abo plication are true and accu to to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (j T e of Ucense: i/ Title Plumber Signature of o used Plumber or Gas Gasfitter City/Town Master Ucense Number 374-5 O IC p Journeyman N) W S v we x N n r i n z- t - 4. N J n Z O O � N 0 7 } W. � Ir 0 0 z 0.. a a O O U. w 3 7- 0 0 J � W Q m U J a CL. a w w U. N) W S v we x N n r i Date a N2 4010 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...r�i''� ��� �A . 1 has permission to perform ...ff .w .7. **-***-**--*- plumbing in the buildings of . /). r4N...'&/6.?</"t. ie", ...... at. 3. i:.. "w e' */ K...: ,; ...... , North Andover, Mass. ` Fee. a.� ... Lic. No... �1. 5� 3 .� ...... . ,;2 o, . L MBING INSPECTOR 04/27/99 13.28 20-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer �_ ,� . ._? - �..,t;.r-�w�'��-.-�-.:...�=rte.: ^ Rti•;F �-:-..,,:.. _w �J Iie, MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMB (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location349 S% Owners Name Type of Occupancy Date /2 3 /51 ? _ Permit #_6 o Amount 90 New Renovation Replacement [2 Plans Submitted Yes No FIXTURES (Print or type) Check one: Certificate Installing Company Name Corp. Address �D 6e) K Partner. LAlk-114 ✓ ce- Business Telephone q 721K ❑ Firm/Co. Name of Licensed Plumber: % "2 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity ❑ Bond Insurance Waiver: I, 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State bin Code and Chapter 142 of the General Laws. By: Si—gnaure of Licensea iriumner Type of Plumbing License Title � y 33 City/Town License um er Master ElJourneyman APPROVED (OFFICE USE ONLY =i ` 1i i.` I --------------------�---- (Print or type) Check one: Certificate Installing Company Name Corp. Address �D 6e) K Partner. LAlk-114 ✓ ce- Business Telephone q 721K ❑ Firm/Co. Name of Licensed Plumber: % "2 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity ❑ Bond Insurance Waiver: I, 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State bin Code and Chapter 142 of the General Laws. By: Si—gnaure of Licensea iriumner Type of Plumbing License Title � y 33 City/Town License um er Master ElJourneyman APPROVED (OFFICE USE ONLY 3160 Date .. �X-. -? � ? S ... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. �1`? �.1 � :L. ... l ?� f� .............. has permission for gas installation ....U..? -7/.................. f in the buildings of 1'./. ! e�� :...................... at ... �1..la ? �. r .... �'%` ......, North Andover, Mass. ��jp c Fee.. (1 : 04/77_ 49 1d:2�. d. Di1 RpII�AS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 0 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING or print) IvvnIH ANDOVER, MASSACHUSETTS Date : f /2 3 19 '/ '7 Building Locations _3Y /iz,/Tont S i Permit # 3160 Amount $ OZ t7 �- �, AloT;vi M t j Owner's Name New ❑ Renovation ❑ Replacement ® Plans Submitted ❑ (Print or type) � Check one: Certificate installing Company Name ��� �l`D? A a� f�ZL/01 6 �" � Corp. Address A © 60 X S 7 ;t- LAl1A-4eAll Aq- Business Telephone 972P ( X S gs-p V Name of Licensed Plumber or Gas Fitter ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yeslo No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ 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 ❑ Agent I hereby certify that all of the details and intbrmation I have submitted (or entered) in above appucanon are rrue anu accu1a.c LU Lll� best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. itle own ROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber . � Y 2( 3 3 ❑ Gas Fitter Icense umber ❑ Master rZq Journeyman Cn tc jj Wv� v� Cn U z F n C C z'Z z w ZG W w z �^ ^ q T Z C 7 C C iii ^ SUB-BASEN1 ENT B A S E M EN T IST. F L O O R 2ND. FLOOR 3 R D. F L O O R 4TH. FLOOR ST H. F L O O R 6TH. FLOOR T H. F L O O R 8 T H F L O O R (Print or type) � Check one: Certificate installing Company Name ��� �l`D? A a� f�ZL/01 6 �" � Corp. Address A © 60 X S 7 ;t- LAl1A-4eAll Aq- Business Telephone 972P ( X S gs-p V Name of Licensed Plumber or Gas Fitter ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yeslo No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ 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 ❑ Agent I hereby certify that all of the details and intbrmation I have submitted (or entered) in above appucanon are rrue anu accu1a.c LU Lll� best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. itle own ROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber . � Y 2( 3 3 ❑ Gas Fitter Icense umber ❑ Master rZq Journeyman