HomeMy WebLinkAboutMiscellaneous - 447 WAVERLY ROAD 4/30/20180
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This certifies that ... F,
has permission to perform
Date.'-�
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
.................
..............
plumbing in the buildings of .....................
at ... .... Lj—
............ North Andover, Mass.
Fee ... Lic. No.. . ........
PL/UM'BING INSPECTOR
Check # 0)--,Y
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMI
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
/ Date SA—A-3
-
Building Location ti v-es� Owners Name V Permit '# Fo
Amount Xy
Type of Occupancy
New Renovation ® Replacement PlansiS'u`b itte® No
FYXTURES
(Print, or type) Check one: Certificate
Installing Company Name j ( 6--Pe;r'le `'ee G7 El Corp.
Address S L) 6 X 1 y YL�` S�t�� FlPartner.
ai`irm/co. Telephone Firm/Co.
Name of Licensed Plumber: i34.6- J1,f- //
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy [3 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 ab4
three insurance
ignature Owner Agent rl
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to tl
best of my knowledge and that all. plumbing work and in tion erformedder Permit Issued for this application will be in
compliance with all pertinent provisions of the Mass setts S tepmbinggodeh142 of the General Laws.
VED (OFFICE USE ONLY
Type offPlumbing License �.,/
L23 L
icense um er Master 1 Journeyman