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HomeMy WebLinkAboutMiscellaneous - 5 Woodchuck (2) 09793 Date . .. �. �j . . . . TOWN OF NORTH ANDOVER w�. 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# f 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 z m o . i W ' z . U QW U) d W Z }Q- Z t>: tN z Q Q W Z D W a. w N ~ W ¢ Y rn n- X .1 W D Q F- Z tY Z v) z V a ti r Q tt! X Q W d C W E J r ZIX IX jr a Y Z = O 0 F '� 2 Z a u. � a. Ne o = W W W Q Q m 0 m t— > > 0 0 0 z Z m i— t•- _ ¢ m m o o i Y U n H � 0 SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 KuFLOOR 4 FLOOR -Em—FLOOR fi FLOOR T FLOOR 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 �� M --� � � �,.� � a `a MON--"- 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 ..:' •<z - i r ,4 J Date .. . . , , . 4i 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 CO W W X = z ¢~¢ 00 m = O ,�,� t3 co p w X z F -Z to z W O F- O w m o aa"` a r w° x > Z N O 9 W O a U. R CO U W W LL'tu � = W f. � _ 1- � W tL Z 9 W > O Z O ul Z Z W d 1". v 111 o o LL a C) z = g O a � I- M > > o 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 1-e Io�Zg��� ,I� ear c6i� w4 ► e I13 kvUO C-L V` J 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 = ..�a- _ I j { J 1 1 i ' Date,/-7-9. ,,ORT °f ,q,41 o� TOWN OF NORTH ANDOVER F 9 • - 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 c C-1 U z N a 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 w t7 > w z � w a w z o zG g . a o x W w o z x o o w .. o w N x o 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