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HomeMy WebLinkAboutMiscellaneous - 45 BEECHWOOD DRIVE 4/30/2018 (4) rleec- nWC) eCt— Date? /.U. . . . NoarM 3j�.<� •�.;.��ooL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING R • o� •+ i SA US r This certifies that . . is. � ' . . . . .`'�• • • • • • • • • • • • • • • • • • • . has permission to perform . . .f S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . at . . L. — . . . . . . . . . . . . .. North Andover, Mass. Fee . . . . .Lic. No..'7r-.<. r. . . . . . . . . C . . . . . . . . . . . v PLUMBING INSPECTOR Check # �Q r 7664 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS =� � Date i- r Building Location W o ners Name r� U Permit# Amount �a Type of Occupancy.- New Renovation Replacement Plans Submitted Yes No El FIX URES z � z FCn H a ow a x ° z z U w Q Cn a C7 d -< P4 P4 w O p d w w Z z a a 3 Ax x ax w w x Cn d z ° w H o a a A a w A a SLDB%E MSEMENr ' ern HmR 21M it" 4M HDM 5M HADCR 6M 110M - 7M HAOM six HAOCR (Print or type) Check e: Certificate Installing Company Name Corp. Address Partner. Business Te ep oneEl Firm/Co. Name of Licensed Plumber: �' —a C4 Insurance Coverage: Indicate the type of insurance coverage by checki g the appropriate box: Liability insurance policy la 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 Agent I hereby certify that all of the details and information I have m ted(or entered)in ab appli plon are true and accurate to the best of my knowledge and that all plumbing work and' stallati s ormed der e ' Is for this application will be in compliance with all pertinent provisions of the Mas "chuset t e lum ' a C ler 142 of the General Laws. BY Sign, I-icenseamer Type of Plumbing License Title �O �s City/TownI end eri r Master Journeyman ❑ APPROVED(OFFICE USE ONLY TOWN OF NORTH ANDOVER vdv�QAovk 6t►J©F��EoL���, SYSTEM PUMPING RECORD - 42002 DATE: J /zn SYSTEM OWNER & ADDRESS SYSTEM LOCATION �O .example: left front of house) DATE OF PUMPING: QUANTITY PUMPED Z 6'`oe--)GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES A NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: