HomeMy WebLinkAboutMiscellaneous - 395 BEAR HILL ROAD 4/30/2018N
a
W
�p
�11 5
4,
0
0
91
Date.g-./j ......
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
'�SA
This certifies that ..... ....
has permission to perform ... ...... ..... .......
plumbing in the buildings o ..........
............ North Andover, Mass.
at.
Lie. No. . ............
Fee�
PLUMBING INSPECTOR
08/2/97 14:51 15-00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APP.L1CAT10NFOR.PERM1T'-:T0b
OPLUMBJNG
(Type or Print)
Mass ate:
NORTH ANDOVER D'
Building Location' Permit
5'
`17'Owners Owners Name Z)e-e 14,f t- tt/A.J
f
New Renovation Replacement 0. Plans Submi
tted
x-
FIXT RES lzte
7TH FLOOR
8TH FLOOR
(Print or Type)
0e Check one: Certificate
Installing Company Name Corp.
Address 5-p
:2Z
[9—Firm/Co.
Business Telephone &„2—
Name of Licensed Plumber:
Insurance Coverage:Indicate the type of insurance coverage by checking the
appropriate box:
Bond F71
Liability insurance policy ET -other type of indemnity
Insurance Waiver: 1, the undersigned, have been made aware,,.that the licensee, of T.
this application does not have any one of the above three insuronce coverages...
Signature of owner/agent of property Owner Agent'4.0
I hcfcbY certify that all of die details and information I have submitted (or entered) in above application ate true M.Vdia(c to the best of my
knowledge and that all plumbing work and installations lvccfnfnicd under remit issued for this application will be * 0111pliance with 2(lpertinent pgop,�,!t`
TWons of the Massachusetts State Plumbing Code and Cltaptcc 142 of (lie Gen L
B
Title gnature of ficensed Plumber
City/Town: Type of Plumbing License j
'License Number 19—M ---a star Ej -journeyman s -
APPROVED '(OFFICE USE ONLY)
%
Z
cn
0
Z
1
Z
to
-C
Cr
*
It
a.
cc
-0
s
03
0
=
a)
6-
a
'<
=
lu
be
0)
gL.
V
Z'
CC
0
C2
=.
et
0:
id
),..
=
=
SL
03
Z
cc
a-
cc-
0
U.
tu
U9
I-
Z
Uj
-j
CL
Cr
-1
—
34
a
IC
US
.0
-1
k.
cc
t-
a
;
a
10
zo
bd
0
0
Q
0
z
z
it
Ir
-
0
34
0
W
<
0
-1
0
Ac
I. -
u.
Ic
ini
0
SUB-,BSMT.
BASEMENT
1ST FLOOR
V:
2ND FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
(Print or Type)
0e Check one: Certificate
Installing Company Name Corp.
Address 5-p
:2Z
[9—Firm/Co.
Business Telephone &„2—
Name of Licensed Plumber:
Insurance Coverage:Indicate the type of insurance coverage by checking the
appropriate box:
Bond F71
Liability insurance policy ET -other type of indemnity
Insurance Waiver: 1, the undersigned, have been made aware,,.that the licensee, of T.
this application does not have any one of the above three insuronce coverages...
Signature of owner/agent of property Owner Agent'4.0
I hcfcbY certify that all of die details and information I have submitted (or entered) in above application ate true M.Vdia(c to the best of my
knowledge and that all plumbing work and installations lvccfnfnicd under remit issued for this application will be * 0111pliance with 2(lpertinent pgop,�,!t`
TWons of the Massachusetts State Plumbing Code and Cltaptcc 142 of (lie Gen L
B
Title gnature of ficensed Plumber
City/Town: Type of Plumbing License j
'License Number 19—M ---a star Ej -journeyman s -
APPROVED '(OFFICE USE ONLY)