HomeMy WebLinkAboutMiscellaneous - 53 WATER STREET 4/30/2018Date . f %..... .. ?
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that . 1� G. �t.�3.f f 1�� ................
has permission to perform...L4..(............................ .
plumbing in the buildings of.r'f".C4.......................
at.. A....C1............. .N-ortrth Andover, Mass.
Fee. 2 s . Ll c. No...3 ?. 1.. ....:. G-!
P$. UMBING INSPECTOR
Check #
5813
MASSACHUSETTS UNIFORM APPLICATION
(Print or Type)
/Nno,O� t tL011lass. Date
s
Building
PERMIT TO DO PLUMBING'
Permit # ^�
Owner's Name U awa U
Type of Occupancy Residential
New ❑ Renovation ❑ Replacement N Plans Submitted: Yes ❑. No ❑
FIXTURES
Installing Company Name Heritage Htg . &Plg . Co. Inc. Check one: Certificate
Address 35 Pleasant Street IX Corporation 714
Stoneham, Ma 02180 C7 Partnership
Business Telephone 781--4.38-1776— i-1 Firm/Co. _
Name of Licensed Plumber Gordon Switzer —
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 coverage by checking the appropriate box.
A liability Insurance policy M 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:
Owner ❑ Agent ❑
1 hereby ce tify that all of the details and information I have submitted for entered) In above 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 provisions of the Massachusetts Stale Plumbing Code and Chapter 142ofthe General Laws.
By Sin re of Licensedumber T
Title
Type of License: Master [g Journeyman ❑
City/Town 1313 2 2
APPROVE) O F'ICE US€OLhI-Y License Number
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Installing Company Name Heritage Htg . &Plg . Co. Inc. Check one: Certificate
Address 35 Pleasant Street IX Corporation 714
Stoneham, Ma 02180 C7 Partnership
Business Telephone 781--4.38-1776— i-1 Firm/Co. _
Name of Licensed Plumber Gordon Switzer —
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 coverage by checking the appropriate box.
A liability Insurance policy M 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:
Owner ❑ Agent ❑
1 hereby ce tify that all of the details and information I have submitted for entered) In above 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 provisions of the Massachusetts Stale Plumbing Code and Chapter 142ofthe General Laws.
By Sin re of Licensedumber T
Title
Type of License: Master [g Journeyman ❑
City/Town 1313 2 2
APPROVE) O F'ICE US€OLhI-Y License Number