HomeMy WebLinkAboutMiscellaneous - 5 Woodchuck (2) 09793 Date . .. �. �j . . . .
TOWN OF NORTH ANDOVER
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PERMIT FOR PLUMBING
his certifies that . O.K.a.". .CF �. . . . �.I,/
*,s permission to perform . . . . . . . , • . • • . . . • • _ . • .
plumbing in the buildings of. . . . . . N.()i� . . . . . . . • . . . . . . . . . . . .
at . . . . ,� . . . . . . . ,North Andover, Mass.
Fee . . (�. . . . Lic. No. .Ica.�I K mb. . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
Check#
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town: ,V -1- G 1 /f'n , MA. Date: Permit#MV,
Building Location: �� /� �r<' L!� Owners Name: iyL� ,I ��L�y��
Type of Occupancy: Commercial❑ Educational❑ Industrial ❑ Institutional❑ Residential
New: ❑ Alteration:❑ Renovation: ❑ Replacement: Plans Submitted: Yes❑ No❑
FIXTURES
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SUB BSMT.
BASEMENT
1 FLOOR
2 FLOOR
3 KuFLOOR
4 FLOOR
-Em—FLOOR
fi FLOOR
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8 FLOOR
A.' f� � Check One Only Certificate#
Installing Company Name: �"
❑Corporation
Address: 4- C- /"ityrrown:M CV41-el state:
k Zip Code: v fir„t []Partnership
Business Tel: 20C-{'% Fax' ?,5'G fr�dlClj rmlCompanyvo r�
Name of Licensed Plumber.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 942 Yeselm�o❑
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
Signature of Owner or Owner's Agent Owner ❑ Agent ❑
I hereby certify that all of the details and information 1 have submitted for entered)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:
T,1ie (lumber Signature of Lice ed lumber
CitylTown ❑Master
APPROVED(OFFICE USE ONLY
['Journeyman License Number: ) G�
e
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0 MASSACWSETTS!
PLUMBERS AND GASFITTERS,
LICENSED AS A JOURNEYMAN `PLUMBER
ISSUES THE ABOVE LICENSE TO:
iCRAIG B, 'ADAM
" 6 WHITE AVE
METHUEN
'HA 01844 623.4
26318 05/01/143 . 183473 ..:'
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Date .. . . , ,
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TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
~his certifies that o . . . . . . . . . . . . . . . .
� I
'has permission for gas installation . . . . . . . .1 L.4 e :re .. . . . . . . . . .
in the uildings of. . ` 1 !i Iv . . . . . . . . . . . . . . . . . . . . . .
at . . N . . . . . .. . . . . . ,North Andover, Mass.
Fee . .a�.--. . Lic. No. .� !"�?'�. . . . . . . . . . . . . . . . . . . . . .
r GAS INSPECTOR
Check# �� '7
8586
to4l
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
Cityffown•,4 �" 'vel'[ MA. Date:— :2- ,�1 Permitg
Building Location: It/or C C /� 4--,Owners Name:
Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential['
New:❑ Alteration:❑ Renovation:❑ Replacement: Plans Submitted: Yes❑ No❑
FIXTURES
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SUB BSMT.
BASEMENT
1 FLOOR
2 FLOOR
3 FLOOR
4 FLOOR
5 FLOOR
WH FLOOR
7 FLOOR
8 FLOOR
Check One Only Certficate
Installing Company Name: /l /T .
❑Corporation
Address• - r y City/Town: Y/A 1`l6i iP n State: Zi IA.
❑Partnership
Business Tel: -�l � - % o° Fax: 1 [a-F-rm/Company
Name of Licensed Plumb#r/Gas Fitter.
INSURANCE COVERAGE:
I have a current llabil insurance policy or its substantial equivalent which meals the requirements of MGL Ch. 142 Yes Q-No El
y 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 ❑
not have the insurance coverage required by Chapter 942 of the
OWNER'S INSURANCE WAIVER:I am aware that the licensee does
Massachusetts General Laws,and that my signature on this permit application waives this requirement
Check One Only
Owner ❑ Agent ❑
Si nature of Owner or Owner's Agent
By checking this box C);l hereby certify that all of the details and information!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 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.
Tyl.ef License: '
By Plumber
❑Gas Fitter Signature of L' nse Plumber/Gas Fitter
Title ❑Master
9;foumeyman License Number: �1�0
City/Town []LP installer
APPROVED OFFICE USE ONL
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COMMONWEALTH OF MASS.4CHLISETTSp
e e e e i
PLUMBERS AND GASFITTERS.
LICENSED AS A JOURNEYMAN-PLUMBER
1SSUES THE AddVE LICENSE TQ
CRAIG B. DAM
`6 WHITE. AVEco
�4ET.0u N
'MA 01844 6234
i •
26318 ..........05/01/1 �c
18,, ►73 =
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Date,/-7-9.
,,ORT
°f ,q,41
o� TOWN OF NORTH ANDOVER
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• - PERMIT FOR GAS INSTALLATION
• s
'q USEt
This certifies that . . . .t 'l. . . . .t.,.�.�! . . . . . . . . . . . . . . . . . . . .
has permission for gas installation
in the buildings of .'
at . .°U`. . . .. `. . . . . . . . . . . . . . . .. North Andover, Mass.
Fee.3.j .-. . . Lic. No.. 7Ly. . . . .Q .�^-a- -. . . . . .
GASINSPECTOR
Check# )
4634
MASSACHUSETTS UNIFORM APPUCATON FOR P TO DO GAS FfFr.LNG
(Type or print) Date 2-/ 5-047
NORTH ANDOVER,MASSACHUSETTS
Building Locations L)CA Permit# ye� y
Amount$
OnA Owner's Name{
New Renovation ❑ Replacement ❑ Plans Submitted ❑
x
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w ° oa x a
z o w o 0 0 o z H
oa v, N w F W a
w w Z Q w a
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SUB -BASEM ENT
BASEMENT
1ST . FLOOR
2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR
6 T H . F L O O R
7TH . FLOOR
8TH . FLOOR Idi
(Print or type) /� Check one: Certificate Installing Company
Name -/ ❑ Corp.
Address . ' 9 u 203 0, ❑ Partner.
Business Telep one Firm/Co.
Name of Licensed Plumber or Gas Fitter a A-)
INSURANCE COVERAGE Cheone:
I have a current liability Insurance policy or it's substantial equivalent. Yes No❑
If you have checked yes,pi ase indicate the type coverage by checking the appropriate box.
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
Mass. General Laws,and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent 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 Massacbusr,7s StateG s Code Chapter 141111,General Laws.
Signature Licensed Plumber Or as Fitter
By: ® Plumber �S1?68
Title
City/Town ® Gas Fitter License Number
® Master
APPROVED(OFFICE USE ONLY) r/ Journeyman