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HomeMy WebLinkAboutMiscellaneous - 35 MILLPOND 4/30/2018MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Typal NORTH ANDOVER, . Mass. Data BuildingAni61 Permit ti 2 �� Locatlon �/�� l✓h + �� , Owner's Name -^-% New 9d Renovation ❑ Replacement ❑ Plans Submitted: . Yes (R( No ❑ FIXTURE6 / Mock one: Certificate Installing Company Name / �1�2/I �C��'iQ� ❑ Corp. Address ❑ Partnership els4 `U] Firm/Co. i3usiness Telephone d]5-,OP-ZIKj Name of Licensed Plumber �/�%.�^ /1��/'/^Gt ✓� INSURANCE COVERAGE: Chacx 1 have a current liability Insurance policy or Its Substantial equhWent Yes one No ❑ If you have checked y", please Indicate the type coverage by checking the appropriate box A liability Insurance policy AN Other tyP-e of indemnity O 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 Ws permit application waives this requirement. Check one: SignOwner ❑ Agent ❑ Nttr• o Owner a Owners ant ' I hereby csrtIty that all of Sha details and information I have submitted (or enteredl In above application are true and accurate to the best of my knowledge and that as plumbing work and installations performed under the permit Issued for We application wilo�n PwIlnent provisions of the Massachusetts State Plumbing Code and Q%War 142 of tM at un" �ppana with aA Two bigna u• of /per Clty/Town Ucense Number / / 67 Type of Plumbing License: Master fg Ai'f'f:JViD (OFFICE USE ONLY) Journeyman 0 si w = w z tc •• , V w Y t M t t~ at p w p .61 w w = w f' V w it -41 M t r O a t w i 2.4 y w 0 F�4-t s S n z !w- V>els O w 4 Y �44 rti Nnzi e szi s� w is i a e s i sus-asSST. s�ateasNT itT FLOOR 3NOFLOOR IAO FLOOR 4y"FLOOR ITH FLOOR ITH FLOOR YTH FLOOR ITHFLOOR — / Mock one: Certificate Installing Company Name / �1�2/I �C��'iQ� ❑ Corp. Address ❑ Partnership els4 `U] Firm/Co. i3usiness Telephone d]5-,OP-ZIKj Name of Licensed Plumber �/�%.�^ /1��/'/^Gt ✓� INSURANCE COVERAGE: Chacx 1 have a current liability Insurance policy or Its Substantial equhWent Yes one No ❑ If you have checked y", please Indicate the type coverage by checking the appropriate box A liability Insurance policy AN Other tyP-e of indemnity O 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 Ws permit application waives this requirement. Check one: SignOwner ❑ Agent ❑ Nttr• o Owner a Owners ant ' I hereby csrtIty that all of Sha details and information I have submitted (or enteredl In above application are true and accurate to the best of my knowledge and that as plumbing work and installations performed under the permit Issued for We application wilo�n PwIlnent provisions of the Massachusetts State Plumbing Code and Q%War 142 of tM at un" �ppana with aA Two bigna u• of /per Clty/Town Ucense Number / / 67 Type of Plumbing License: Master fg Ai'f'f:JViD (OFFICE USE ONLY) Journeyman 0 IT° 2$00 Date / . ? /g F... TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING This certifies that ., /5. -�-."'�-..: ". .-� .................. has permission to perform .................... plumbing in the buildings of ..?fel S. P G z ................ at ............... . North Andover, Mass. Fee. Lic. No.../,!. PLUMBING INSPECTOR 01131!96 08:53 25.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File a MASSACtiUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFiTTiNG t (Print or Type) r NORTH ANDOVER Mass Date �`�! 6 t3uilding New Location Renovation I:] �I 36 Permit # 12 946L Owners Replacement Q Pty -110_c Plans Submitted n (Print or Type) / Check one: Certificate lnstailing Company Name �� / Q Corp. Address /1,��� f% Q Partner. Firm/Co. Business Telephone: Name of Licensed Plumber or Cas Fitter_.!%�/� Insurance Coverage. Indica-.e tie tyke o: insurance coverage by checking the aacrooriate box: Liability insurance policy 2! Other tvpe of indemnity Q Bond Q Insurance Waiver: I, the undersiened, have been made aware that the licensee of this appiication does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Q Agent Q I hc:eby ec:tiry that all of the dc(tila and information I have submitted (or entered) in *Lore aOptieation are true and agcy:ate to the best of mY knowledge and that aLL plumbing work and Inuadatiocs ;sz•'o=c d wader-Pcrsait i=zd fo: this appuntioa will be is compliance with all -,crtincnt proriaions of Loa Massachusetts State Cas t:adc and Cvpte 143 u tSe Ccrtc:d Lara. ,. By Title City/Tc ern APPROVED (OFFICE USE ONLY) TYP= LIC SIS Iu.Ttber 1 Gasiitter Signature of Li ensed 1 Master Plumber o Ga fitter journeyman — ���t�7 'License I�itunber oa _ . tat us m f C V tZ F_ ~ as G Z O UA C C C Q ? l ( U 1 Iii m H r wa O y`1 y t- a y G W C V L 7f < G FC- Q w 41 yt Q7 J < �L' _ O Q Na W tZ I.- U us 1ta U1 C O BASEMEXT I I { I + I I ( I I I I { f I I I ! I ( 1 I -IST FLOOR j 2"10 FLOOR I I I E I I ( f I I I I f I I { I I { ! I I 1 I I f 3Ra FLOOR STK FLOOR E f I ( I I 1 E I• I I I I I I I I f I f f { { 5TH FLOOR 6TH FLOOR 77Id FLOOR I I I I f I I I I f ! I I ( I aTHFLaOR ! { I I (Print or Type) / Check one: Certificate lnstailing Company Name �� / Q Corp. Address /1,��� f% Q Partner. Firm/Co. Business Telephone: Name of Licensed Plumber or Cas Fitter_.!%�/� Insurance Coverage. Indica-.e tie tyke o: insurance coverage by checking the aacrooriate box: Liability insurance policy 2! Other tvpe of indemnity Q Bond Q Insurance Waiver: I, the undersiened, have been made aware that the licensee of this appiication does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Q Agent Q I hc:eby ec:tiry that all of the dc(tila and information I have submitted (or entered) in *Lore aOptieation are true and agcy:ate to the best of mY knowledge and that aLL plumbing work and Inuadatiocs ;sz•'o=c d wader-Pcrsait i=zd fo: this appuntioa will be is compliance with all -,crtincnt proriaions of Loa Massachusetts State Cas t:adc and Cvpte 143 u tSe Ccrtc:d Lara. ,. By Title City/Tc ern APPROVED (OFFICE USE ONLY) TYP= LIC SIS Iu.Ttber 1 Gasiitter Signature of Li ensed 1 Master Plumber o Ga fitter journeyman — ���t�7 'License I�itunber a t - 2688 Date. 1/�it.......... HORTIy TOWN OF NORTH ANDOVER pf t,,.ao , bhp 1 -of 5• p� PERMIT FOR GAS INSTALLATION � F CL C? This certifies that . ��� �!?� �: , h .�4 .................... has permission for gas installation ..F. "q r .............. . in the buildings of ....... ... ... I .. U' co' at ......... .... , North Andover, May. Fee.,? Lic. No.././.%?.G ;? GAS INSPECTOR o WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NO . ANDOVER , MA Mass. Date . fig Permit p '� Building Location 34 Owner's Name_J/!lf�/�.5 NO.ANDOVER,MA New ® Renovation ❑ Type of Occupancy. RES L% Replacement ❑ . Plans Submitted: Yes❑ ' No ❑ Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certfilcate >r Address 91 BELMONT STRFFT C3 Corporation NO . ANDOVER , MA . 01845 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142 - Yes 42Yes] No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. A llablllty Insurance policy ZI Other type of Indemnity O Bond ❑ OWNER'S INSURANCE WAIVER: 1 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: Owner❑ Agent ❑ Signature of Avner or Owner's Agent I hereby certify that all of the details and intormalion I have submitted (or entered) In ove applicatlon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this a �Icatipq will b� In cgmp(lance with all p-erdnent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral lawyl BY T e of Ucense: 01'lai.,mber gnatur o c nse um a or Gas fitter Title rittaster Ucense Number M-3440 City%Town ourneyman MF1-K-, /FD (CFFIC0 . N WV1 N V7 U N ¢ N K a -` W W N Q O U © t... - n � .o rt W © u < = W a- C > 0 rt U U W N FO- < v; Q W W U. W = O ~ W o Ut W < W > 2 W U. 7 < G < d < J O U O C WF- > D a F� O SUB—aSMT. BASEMENT 1+ 1 1ST FLOOR 2ND FLOOR I I I 3RD FLOOR 4TH FLOOR I I I STH FLOOR 6TH FLOOR ( I I 7TH FLOOR I I I I I STH FLOOR i Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certfilcate >r Address 91 BELMONT STRFFT C3 Corporation NO . ANDOVER , MA . 01845 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142 - Yes 42Yes] No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. A llablllty Insurance policy ZI Other type of Indemnity O Bond ❑ OWNER'S INSURANCE WAIVER: 1 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: Owner❑ Agent ❑ Signature of Avner or Owner's Agent I hereby certify that all of the details and intormalion I have submitted (or entered) In ove applicatlon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this a �Icatipq will b� In cgmp(lance with all p-erdnent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral lawyl BY T e of Ucense: 01'lai.,mber gnatur o c nse um a or Gas fitter Title rittaster Ucense Number M-3440 City%Town ourneyman MF1-K-, /FD (CFFIC0 . '•.,r,r,ir,.,i�v .,...-v.�-x.. -.. ...,,.r _ .. ..: �- .- •— ,.i:<?R,—..,�r."i^*=_. -T•y.:yync-f'�....;. 1 - h`;�' 2075 Date . l�' C .... F TOWN OF NORTH ANDOVER pF t,.no ,",tip moo? °,. `p PERMIT FOR GAS INSTALLATION 5 �9SSACNUSESS ,r This certifies that .(_."!9. e,1A ................ has permission' for gas installation .. ' ' ► . } ..... ........ in the buildings of ../V/? e� 5,xj.c 1( ... ...... . at .. . ,�tn.r. 1. t . t'.�' i-............ , North Andover, Mass. Fee: o??..... Lic. No. 3 `/Y P .. . ................. . 41/29/96 13:55 25;00 pA,OAS INSPECTOR a WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File