The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 46 BREWSTER STREET 4/30/2018 (2) 46 BREWSTER STREET U-2 2101023.0.0072-0000.0 Date..Z{�3// ....... HOR7M o� TOWN OF NORTH ANDOVER � D ' - PERMIT FOR GAS INSTALLATION s a 9SSACMUSEt This certifies that . . . !?? � !y!tl'h . . . . . . . . . . . . . . . . has permission for gas installation . .1//9 !".!�?j.�Jn in the buildings of . . . .. . . . . . . . . . . .. . . . . .. . .. . . . . at . . . .7.` . r�'f1SQQ`P1` `rTNo h Andover, Mass. Fee. ;.•.tYQ Lic. No.. f.6 .. . . . GAS INSPECTOR Check# to3 8056 9308 Date. z - .�. . pftNORTN,hO TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING1 ��'^�,..o•q''`ty '' ssAcwUS� + This certifies that . . . ein !'?�'�? . . . . . . . . . . . . . . . . . �. . . has permission to perform plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . at. . . : . : ., No h Andover, Mass. Fee.v?Z. SU Lic. No.. �� . �! __ ._ f y PLUMBING I SPT�i EGTOR Check # l�SSS3 _ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _ CITY__ Q�. — ,2 oV 2.Y _J MA DATE PERMIT# JOBSITE ADDRESS OWNER'S NAME` - I OWNERADDRESS �- - TEL,? 127-0 25�FAX! TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL EDUCATIONAL ] RESIDENTIAL LX PRINT CLEARLY NEW:w�' RENOVATION.Lj REPLACEMENT: ' - -� PLANS SUBMITTED: YES L_! N.0 FIXTURES I FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13= 14 BATHTUB CROSS CONNECTION—DEVICE -- --`- DEDICATED SPECIAL WASTE SYSTEM " DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM - DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM - DISHWASHER DRINKING FOUNTAIN — - FOOD DISPOSER _ FLOOR I AREA DRAIN - - INTERCEPTOR(INTERIOR) - KITCHEN SINK LAVATORY - - ROOF DRAIN SHOWER STALL - - -- SERVICE I MOP SINK TOILET URINAL - WASHING MACHINE CONNECTION WATER HEATER ALL TYPES - - WATER PIPING _ OTHER INSURANCE COVERAGE: - I have a current liabilityinsurance policy or its substantlal.equivalent which meets the requirements of MGL Ch_142. YES-X NO s IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY BOND i OWNER'S INSURANCE WAIVER I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement CHECK ONE ONLY: OWNER s_,__11 AGENT °_ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I,have submitted or entered regarding this application are-true and accurate.to the best of my knowledge and that all plumbing work and installations performed under the perrnit issued for this application will be in co_rnpliance wl Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. t PLUMBER'S NAME rQa�r�ck `(`t10 ~ ^~ i �` x�.gsn .�,LICENSE#i�C_S SIGNATURE MP; X JP -- CORPORATION' 'PARTNERSHIP`- # i i LLC # _ i COMPANY NAME ADDRESSI� �� T� -_--- _ i CITY; \h C a`r� - STATE i _,_ �ti---; @�T ZIP; Z cB 6 S TEL FAX' CELL! EMAIL _-- f ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES c Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ A / FEE: $ PERMIT /v # 002 v PLAN REVIEW NOTES MASSACIRUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK - CITY ..__; MA DATEPERMIT# ;'Z"7 \2 1 JOBSITE ADDRESS: rg,vQ _c'._ ___...__ OWNER'S NAME OWNER ADDRESS i- � �� .. --------- ._i TEL PRINT OCCUPANCY TYPE COMMERCIAL E OREDUCATIONAL!, RESIDENTIAL CLEARLYNEW RENOVATION:` REPLACEMENT: PLANS SUBMITTED: YES NO x APPLIANCES Z FLOORS-- tai 1 2 3 4 5 6 7 8 9 10 11 12 s3 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE _ DIRECT VENT HEATER _ ... DRYER - FIREPLACE FRYOLATOR FURNACE - -- GENERATOR - 0111E . ! INFRARED HEAiEFt - LABORATORY COCKS MAKEUP AIR UNIT _ OVEN 410 m POOL HEATER RDOM/SPACE HEATER J. ROOF TOP UNIT TEST UNIT HEATER _ __.- UNVENTED ROOM HEATER WATER HEATER -- -- INSURANCE COVERAGE. I I have a current liabilityinsurance policy or Its substantial equivalent which meets the requirements of MGL.Ch.142 YES 'X:NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW i LIABILITY INSURANCE POLICY 11XJ OTHER TYPE INDEMNITY ' ? BOND OWNER'S INSURANCE WAIVER:I am atirare that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that lily signature on this permit application waives this requirement. { i - CHECK ONE ONLY:---OWNER_:._..:. AGENT _.---- -. -.-- SIGNATURE OF OWNER OR AGENT I hereby certify that ail of the details and informatics I tae submitted or entered regarding this appilcabon are true and accurate to the best of my kroMedge j and that all pfLrnbing cork and histaiiahars performEd tinder the permit issued for this application Will be in comcliance ertinent provis-icn of the Liassachusetts State Plumbing Code and Chapter 142 of the General Laws. �( PLUMBER GASFiTTERNAME r4.c�il r'tCk `( ac 'LICENSE#�6 Z�'-� SIGNATURE - — - _ MP )C MGFJP�_ 71_" JGFLPGI I CORPORATION Xf# Z�S�i� ';PARTNERSHIP F--;# LLC � # I ---- COMPANY NAME: G k.M-- !M 1 nod ADDRESS CITY 1-- C `n� .__.. STATE' ZIP;O_Z4S FAX': !CELLI ;EMAIL', ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: S PERMIT# PLAN REVIEW NOTES Ce L),e4 C/fz o 1--P a 7�