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Date. . . . . .. . ... .. .. . . ... .
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Of ,O oTH 1't'
0_ p TOWN OF NORTH ANDOVER
- PERMIT FOR GAS INSTALLATION'
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'�s9SSACH S MUS
This certifies that .`. . . . . . . . . . . . . . . . . . . . .
has permission for gas install tion . �. ! /. . . . . . . . . . . . . . . . .
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in thheb/u'Un gs-off .!. . . . . . . . . . . . . . . . . . . . . . . . .
at . . .. . .-.. . . . . . . . . . .. North Andover, Mass.
Fee415- . Lic. No. �V
1 / GAS INSPECTOR
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5 ; 58
MASSACHUSETTS UNIFORM APPUCATION FOR PERMIT TO DO GASFIT TING
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Building Location h�
owner:
` Type ofry— RjLt 7L=N�1 ra
Now ❑ Renovation ❑ RWA Plans Submitted: Yesp No❑
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4TH FLOOR
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In"ft company Name ` /n M A T A i2Q Check one: Certlfkate
Address-. 30 &1A t A gn A tj 4.K ❑ Corpotation
M E 7 rH O F tj MA - Q 1 k qi j_ ❑ Partnenthip
Business Telephone
Name of Licensed Plumber or Gas Fitter -f 0 j3E E T A• S A m M 6 1 A r D
INSURANCE COVERAGE:
I have aY urrent 0WAlty bmwance, policy or Its substantialequivalent which meets the r+equiremmft of MGL Ch. 142.
`► es ( No 13
If you have checked'
ygg. pease Irtdkne the type coverage by checking the appropriate baric.
A Iiabillty Insurance policy id Other type of indemnity❑ BOW ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does R&hm the Insurance coverage required by
Chapter 142 of the Mass. General Laws. and that my signature on thts penMt application walm this requirement.
Cheek one:
OwnerO Agent 13Signaturo of or Owner': .
1 hereby am*that d of the details and kdorrnation I have vAw tted for entered)in above application we true and accurate to the best of my
knowledge and that aA plumbing work and kotallationa Wormed under tin for tint applicatkm be m compliance with all
penitent provisions of the Mtassaehusetts State Gas Code and Chapter 142 0l Isaus.
>r By T of License: '�
Tie Plumber n or Gas FMW
n License Number
.lourneyntan .
BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO..
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APPLICATION FOR PERMIT TO 00 OASFITTING
NAME A TYPE OF BUILDING
LOCATION OF_9U)LDINO
PLUMBER OR GASFITTER ..�..r..
LM NO.
PERMIT GRANTED
DATE-10
OASINSPECTOR
<L\ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
_ (Print or Type)NO
Mass. Date /O — O/ 19_f6 Permit #
Building Location 4D Owner's Name WO ,pA,o
Type of Occupancy S IV
New ❑ Renovation ❑ Replacement ® Plans Submitted: Yes[] No ❑
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BASEMENT '
IST FLOOR
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3RD FLOOR
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4TH FLOOR
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STH FLOOR
8TH FLOOR
7TH FLOOR
MORAN PLUMBING & HEATING INC. ;
Insta 290 B T'o R d,o a y Suite # 101
� Check one:' Certificate '#
Addi M e t h u e n M,a. 01844 ,® Corporation
_ ❑ Partnership
Business Telephone 2) -a a ❑ Firm/Co.
Name-of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes R No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy JD 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's Agent Owner❑ Agent ❑
I hereby certify that all of the details and information I have submitted(or entered)in abppve application are true and accurate to the best of 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 Massachusetts State Gas Code and Chapter 142 of the General ws.
BY T e of License:
Plumber Signature of 'cense u ber or Gas atter
Title Gasfitter
Master Ucense Number
neyl z
City/Town Journeyman
APP O IC S_O -L
BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
F
FEE -
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
NAME S TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
R... ....,.-_w PERMIT GRANTED w< ..-,_._ .._.__-__......-. ...._
DATE,x_19
GAS INSPECTOR
of NO oTti �� . $ 31`%,.-jOWN 1OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
Fzi A
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,SSACHUSEt
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This certifies that . . . .` . . . .�7 �.. . .. ?�
has permission for gas installation/. f:.. . . . . . . . . . . .. . .
in the buildings„of . . . . . . . . / r'. . {�` . . . . . . . . . . . . I . . . . . . .
1
at4 . . �. ' .'�.� :" .`. .'. . . . . ... . , North Andover, Mass.
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Fee. . .:f: ? ."'Lic. No.. . .'•'` :! ".. ->.`?`1! , !Yr >s.'.+r'►,t�...
r I; 4 7 GAS INSPECTOR
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