HomeMy WebLinkAboutMiscellaneous - 450 BOSTON STREET 4/30/2018 (2) 450 BOSTON STREET
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o'<"•oRT" TOWN OF NORTH ANDOVER
10 , p PERMIT FOR PLUMBING
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,SSACMUS�
This certifies that . . . . . . . . . . . . . • • • • . • • • •
has permission to perform . . . " /:1. . .�-!,-L
plumbing in the buildings of . . . . . . . . . . . . . . . . . . . .
at . . . . . . . . . , . ., North Andover, Mass.
Fee. Lic. No..` 7) Y? . � . : . . . . . . .
/PLUMBING INSP
Check #
5620
3 �G
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT°TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
�Q Date
Building Location �� ;r�lJ � �� Owners Nameo'-Ao zJ . �� � Permit# J-6 L o
Amount 94
Type of Occupancy
New Renovation E]-- Replacement F-1 Plans Submitted Yes O No
FIXTURES
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SIBEEME
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(Print or type) J//J� Check;one: Certificate
Installing Company Name W `4 ����P� Corp.
Address ��� Partner.
Business Telephone Firm/Co.
Name of Licensed Plumber: Q� `r( .
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 0 Other type of indemnity E] 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 submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the M sStat P bing C d C ter 142 of the General Laws.
BY STgna o rcens um r
Type of Plumbing License
Title .
4�
City/Town rcense um r Master umeyman Fl-
APPROVED(OFFICE USE ONLY