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Home My WebLink AboutMiscellaneous - 5 WALKER ROAD 4/30/2018 (4)L 8864 Date.. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ..... ................. ....... has permission to perform ...... plumbing in the buildings of ......Al� ..... at 4�/i / .... NortXhdover, Mass. Fe4e-�,. Lic. No.. . ....... PLUMBING INSPECTOR Check ff 30. CX) CWT ME0 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ' City/Town: %V • !-17 V (, r , MA. Date: a' I i Permit# Building Location: �j l 1 PfOwners Name: Zovpw AeLLf" Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No CWT ME0 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No jI If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ EkINSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the a cene I Law and tha�ignature on this permit application waives this requirement. Check One Only Owner ❑ Agent ET natuer wne s ent I hereby certify that all of the delalls and information I have submitted (or entered) regarding this application are true and accurate to the best of my r.numvuge anu inai an piumomg worK ano installations perrormed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Title ❑ Plumber Signature of Licensed Plumber City/Town ❑ Master /� APPROVED OFFICE USE ONLY []Journeyman License Number: _kgoo DEDICATED z SYSTEMS LU z CAo Y z V1 Uj a Q: z z H Y N Q Ln Q y Q W O W oac 0m v=i it oQc p FW- '^ > Q �^ Y H a X Q LU `� F- ~ J Q WLL Ln 0 Q W O D W z W J z U a LL LU o LA 3 W Q Q IA L- o o >> o O Z LU LU a a a Q Q V1 W Q a Q m ca c c = Y g g � 3 3 3 o a Q Q 3 SUB BSMT. BASEMENT 1sT FLOOR 2HD FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Check One Only Certificate # Installing Company Name: El Corporation I Address:,20 /`lr%T>./✓>aA ,. f�: City/Town: .-I ! rl , /I State: El Partnership rr LL Business Tel: Q ��b 7 Fax: ❑ Firm/Company Name of Licensed Plumber: I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No jI If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ EkINSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the a cene I Law and tha�ignature on this permit application waives this requirement. Check One Only Owner ❑ Agent ET natuer wne s ent I hereby certify that all of the delalls and information I have submitted (or entered) regarding this application are true and accurate to the best of my r.numvuge anu inai an piumomg worK ano installations perrormed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Title ❑ Plumber Signature of Licensed Plumber City/Town ❑ Master /� APPROVED OFFICE USE ONLY []Journeyman License Number: _kgoo Date.... -w 8865 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ....�.......... . . has permission to perform ....t.. plumbing in the buildings of .... .-, ....... ... . at #`� +� . ! _,f� ..... ......... North Andover;,Mass. FA "—s U .... Lic. No... .. P . ...... ,� PLUMBING INSPECTOR Check I! �� • MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: L 6n 1 [IUP r , MA. Date: Permit# Building Location: V\ r Owners Name: lam% V1, �/ Type of Occupancy: Commercials Educational ❑ Industrial ❑ Institutional ❑ Residential W New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No FIXTURES INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No.® If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent gnature of Owner or Owner's Ac I hereby certify that all of the data regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: ell- // 4�z jL Title IBJ Plumber Signature of Licensed Plumber Cit /Town El Master City/Town License Number: ,30��(`� APPROVED OFFICE USE ONLY DEDICATED SYSTEMS � LW z z Z Y O n > Uj In CA Z LA H J 2 Q of W vi LW (9 = p G Z z V1 C Z a N = N a H W Y Z Q o: W Vf Z Q Ln N w O Z M it Q Q . = F W Q R O m N W a ~ a Z C Z {A �A V d X L LUj x J Q 3 3Q J Y x = a3 Qa O ZO Q 3 zv x~H } Uj HF W ° OO OZ pQ < mmuuO U. x ° LA 4A 3 3 3 0 SUB BSMT. BASEMENT 1sT FLOOR 2ND FLOOR 3RD FLOOR 4T" FLOOR 5T" FLOOR 6T" FLOOR 7T" FLOOR 8T" FLOOR Check One Only Certificate # Installing Company Name: (' Address: 1/1��I'M O�CK City/Town:df4 tic � State: ❑ Corporation k1 El Partnership DD // �y Business Tel:%c(� b�� Fax: ❑ Firm/Company Name of Licensed Plumber: / INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No.® If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent gnature of Owner or Owner's Ac I hereby certify that all of the data regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: ell- // 4�z jL Title IBJ Plumber Signature of Licensed Plumber Cit /Town El Master City/Town License Number: ,30��(`� APPROVED OFFICE USE ONLY 4 r .ti MMONWtAL.TH OF�iAA�A u ''MIPLUMBER.: LICENSED AS A JO I . r ISSUES THE ABOVE LICENSE TO: EDWARD F WALSH 137 PLEASANT ST m l i 671,4 . WOBURN. MA 01801—SSI 36900 05/01/12 78k0_6 f I i J - 1 CONTROL. # -G020593 { I11pORTANT inotify our Board at the: If this license is lost o r de Licnsure, 1000 Was St., i DlVislon of Profes i 7th Floor, Boston, MA 02118. our board If your name or address shown is changed, notify your next er mailing s refer to your license number. of correct name or address to insure pro Renewal Application: Alway rovisions of the General taws. This license is subject to the p as amended. It is a personal privilege, andhis li not be on your or assigned to any other person. Keep person or posted as required by law. WARNING THIS DOCUMEN I NAS � EIVHAtdCED SECURITY f EATURES- ,_,.� Mo ACRO" CERTIFICATE OF LIABILITY INSURANCE DATE{MMroDIYWY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. e certificate holderls an ALUTIONAL IMUREA the po cy es Must be endorsed. It bUBKOUATION 1.5 VVAIVEA Subject o the terms and conditions of the policy, certain policies mayrequte an endorsement A statement on this certificate does not confer rights tothe PRODUCER 781-247-7800 PJAMP odman Insurance Agency, Ina 781-444-0090 45 RosemarySt., Bldg. A PHONE IfFNAX E-MAIL e e d h a m, M A 024 9 4-3238 e ffre y G rosse r GENERAL LIABILITY PRODUCER SHAWM� STO INSURER AFFORDING COVERAGE NAIC R INSURED S h aw m ut P ro pe rty Manage m ent Co INSURERA:Holyoke Mutual Insurance Co. 14206 Matt Dy ke ma n INSURER B: S to r Insurance 200 Me r rl m a ck St Haverhill, MA01830 INSURE: C: T rave I e rs In su rance INSURER D INSURER E : 10/14/11 MED EV(Anyoneperson) $ 5,0 WaRRInki NI IMR11=17• THIS S TO CERTIFY THAT THE POLICIESA S E ISSUED TO THE INSURED NAM EFTB O C PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR TYPE OF INSU EFF POLICY EXP Limr I; GENERAL LIABILITY I"POLICY EACHOCCURRENCE $ 1,000'] JJLW$ 100 A X COMMERCIAL GENERAL LIABIUTY CPP907840100 10/14/10 10/14/11 MED EV(Anyoneperson) $ 5,0 CLAIMS -MADE El OCCUR PERSONAL & ADV INJURY a XC GENERAL AGGREGATE $ 2,000, GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMPIOPAGG $ 1,000, PR0. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OIMVED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ (Per accident) HIREDAUTOS $ NON -OM HOCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ $ WORKERS COMPENSATION OFH- 7777.777 B AND EMPLOYERS' LIABILITY YIN ANY OFFICERIMEMBERIXCLUDED? CUTIVE � NIA C0378090 11101/10 11/01/11 PP E.L. EACH ACCIDENT $ 500 E.L. DISEASE - EA EMPLOYEE $ 500 (Mandatoryln NH) If yes, describe under 0 CFidelity, DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 107Addltlonal Remarks Schedule, if more space Is required) Walsh is an employee of Shawmut Properties Management Companies nd cove red under the workers' Comp and GL listed above BLANK— Shawm ut Property Mgmt SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. rese ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Date. TOWN OF NORTH ANDOVER 3: 0 PERMIT FOR PLUMBING SACHUS� ti This certifies that�.!' ..................... has permission to perform .... . ................ :........... plumbing in the buildings of .. ;?? at .....4 ........... North Andover, Mass.. Fee .3. ..... Lic. No. / p.� ..1.. ........ ./ PLUMBING INSPECTOR Check # � S 7995 (Type or prinf NORTH AND Building Locatio AJ 4-1 Lee—, MASSACHUSETTS UNIFORM ,APPLICATION FOR PERMIT TO DO PLUMBING MASSACHUSETTS 041,. - New El Renovation El Type of Occupa C Replacement D S, Plans Submitted yes ❑ Date — / C —U Amount 3 r g - No F1 Instaliing.Company Name f Check one: Certificate Address Q 7 LJ Partner. Business elephone _ 3Y Firm/Co. Name of Licensed Plumb=. -- -11-1-1 ` Insurance Covera re: Indicate the type of ins ce coverage by checic Lability insurance policy Other type of indernrti appropriate box: ri �L•J ty the Bond Insurance Waiver. L the undersigned, have been made aware that the licens three insurance ee of this application does not have any one of the above rgnature Owner Agent I hereby certify that all of the details an information I hav ubmi best of my knowledge and that all plumbin d ' to dons (or i Ve PPtication are true and accurate to the compliance with all pertinent provisions of the Mass nde sued for this application will be in cd PI b' o Co hapter 142 of the General Laws. By: aignaWre 01 Lr nsrn tum Title Type of PI mbing Li nse City/Town G 3G License vumoer ❑ APPROVED rocs usa olvr_.r Journeyman This certifies that Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 10 .............`. ........................ has permission to perform ..... ..... ....................... . plumbing in the buildings of . /Pte'�� -L.. UI-r.`"..(C.-�6 ..... at .%%.! f!! f l..�j......:..... . North Andover, Mass. PLUMBING INSPE TOR Check # �f) % l� 8011 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PUThinmG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building New 13 /Owners Name Date -09 � (� �w Permit F Of Occupancy I(P A L Amount _ I$ Renovation Replacement Plans Submitted yes No . any i Check one: Installing (`oy/ Certificate Co Addressr'7 '/� G a_ 11 A& ❑ Partner. Business e}ephone 17f— rl Firm/Co. Name of Licensed PlumbeIndicate tirr. ` Insurance Coveraee: o type of mheckinsur(hee coverage by cg the appropriate box: Liability insurance policy Ej Other type Of indemrli❑ ty Bond Insurance Waiver I the undersigned have been made aware three insurance that the licensee of this application does not have any one of the above Signature Owner I hereby certify that all of the details and ' ormation I have su best of my knowledge and that all plu ing work and installa ' compliance with all pertinent provisio of the Mas e By. `--"S azure or Lace Title City/Town APPROVED wncs usa oNLy E3Agent FCh ca'�Oaretrueand accurateto the ed or this application willbe in e 42 of the General Laws, Type of Plumbiri� License /036 License vumoer Master ❑ Journeyman Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ..o�� ► �f This certifies that ... ...... has permission to perform .............................. . plumbing in the buildings of .................... at ..) .... .1 f ....... � 1-3........... , North Andover, Mass. rb Fee) ....... Lic. No..�........ - .1 `!,......... . PLUMBING INSPECTOR Check # %/ n MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building New 0 Renovation M i.cuuC r ( fffjwj ry of Occupancy It'S Date —6 Permit # p t. Amount 9 o r, Replacement _t7l' Plans Submitted yes No El F1 Installing Company Name/ /X G,F=� !!�-i-d �`/ ,, &g . Check one: Certificate Corp. Address Partner. ustness elephone -) _ _ 3 Firm/Co. Name of Licensed Plumb Insurance Coverage: Indicate the type of ingurance coverage by checking the appropriate Liability insurance policy �G_.J - ' Other type of indemnitybox:Bond Insurance Waiver. I, the undersigned, have been made aware that the licensee of this applicati three insurance on does not have any one of the above Signature Owner ❑ I hereby certify that all of the details andi, ted tbest of my knowledge and that all plumbicompliance with all pertinent provisions o I ±5ygnc ia�ure of 'Title Type of City l own 16301 APPROVED (OFFICE USE ONLY Licensevin apauon are true and accurate to the ed for this application will be in )ter 142 of the General Laws. Master Journeyman ❑