HomeMy WebLinkAboutMiscellaneous - 51 Phillips Court � � _ . � � -�
i
i
3496 Date.. ea..... i
,NORTH TOWN OF NORTH ANDOVER
pf s�.ao ,e,1'O
FO? y.. n LA
PERMIT FOR GAS INSTALLATION
'h4 S CMUSEtt
This certifies thatr . . . . `Vit- '�'"
/ � �vhas permission foi gas installation :-%`L
in the buildings of . ....7'? `:��. . .
at J :�-�:7�'? :
�`N
orth Andover, Mass.
Fee/15. .. . . . . Lic. No �.7. a' . . . l '.%.c. . �../. . . . . . . .
GAS INSPECTOR,
vvv
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
MASSACHUSETTS UNIFORM APPLICATOR FOR PERMIT TO DOG FITTING
r• 'y �"V_
Type or print) Date
NORTH ANDOVER,, MASSACHUSETTS
Building Locations �Pill Permit#
j �/',�? Amount$ ��
Owner's Name �Q Vl nl,�y 'v(,�
New❑ Renovation ❑ Replacement ❑ Plans Submitted
m Cn
z C z C z
G :1 y d Z �• ,
Z -t m ^^ =C `' n z C cd ` '1
-t w C Z C
SUB-BASEM ENT
-n BA SEM ENT
IS'r. FLOOR
2ND . FLOUR
3RD . FLOOR
JT Ii . FLOG R
sTlt . FLOOR
6T If FLOOR
7T 11 . FLOOR
3T 11 . FLOOR
(Print or type Check one: Certificate Installing Company
Name Df
A n ❑ Corp.
Address VTnlero.—
Firm/Co.Esiness Telephone 1
L tme of Licensed Plumber or Gas Fitter /1
INSURANCE COVERAGE Check on .
I have a current liability Insurance p 'cy or it's substantial equivalent. Yes Nom
If you have checked yes,please in Cate 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:
..'_i Signature of Owner or Owner's Agent Owner Agent ❑
hereby certify that all of the details and informalion I have submitted{or grit red) i 4a ove applica[ion are true and accurate to the '
best of my knowledge and that all plumbing work and installations perform fund r ermit issued for this application will be in Y
Y
compliance with all pertinent provisions of the Massachuse .tate Gas C hapten l' of the General Laws. =
By: ignat ofJ �censed Plumber Or Gas Fitter
Title Plumber
❑City/Town as Fitter License I umoee ` F
Master ,
APPROVED(oFPICE USE ONI.Y) ❑ Journeyman '
Date. i
N° 4497
o'.".� ' TOWN OF NORTH ANDOVER
° p PERMIT FOR PLUMBING
This certifies that : . . . . �. •
has permission to perform -�'r' • • '"`` f
�C
plumbing,in"the buildings -: . . . . • • • • • • • •
at-37 . . . . .��. .. �. . .. .. - IVo h Andover, Mass.
ff .
Fee `` . . .Lic. No.r�c % -? . ./. f !�[� . . . . . . . . . . . . .
. .
��-PLUMBt/G�I SPECTOH
Check #—;�(F(3
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
Date4.417
Building Location 6 e^ J� (�IVtOwners Name Q ✓' Permit#
,( l f� �{,
Type of Occupancy Amount '�1k�1('ll�y' ��
New Renovation ReplacementEl Plans Submitted Yes D No
FIXTURES
Cn C11 z
w x a '" Cna s
d a F,
-. . W H W F.
w W F W d W A a F d Cn
rU Ln a
z
SLIMR]C
HAg1VWM
M HDOR
ZD H M
3M HEM
4TH FLOOR
5TH FLOM
MHOM
7TH FLOOR
SIH FLOOR
n
(Print or type) / � � Check Corp.: Certificate
Installing Company Name
Address = '`ice L P er.
Business Telephone ( — Firm/Co.
Name of Licensed Plumber: V1 1 oni'
Insurance Coverage: Indicate the*e of in ce(coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity El 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 ent )in a ove application are true and accurate to the
best of my knowledge and that all plumbing work and installations erformed Pit Issued -application will be in
compliance with all pertinent provisions of the Massachusetts Stat PI bing ap er 14 of the General Laws.
By: titgnature.ot Licens
Type of Plumbing e
Title I?,,-7q?
City/Town icense um er Master Journeyman ❑
APPROVED(OFFICE USE ONLY