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HomeMy WebLinkAboutMiscellaneous - 60 COTUIT STREET 4/30/2018 (2) 60 COTUIT STREET U-1 210/023.0-0065-0000.0 Date . . . . "oRTM .° .� TOWN OF NORTH ANDOVER SMO PERMIT FOR PLUMBING hY f • o� �'I ,SSACMUS� 1 This certifies that . . . .. . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . .f�L.rZ 5 r �.` . . . . . . . . . . . . . . . . . . . at . . . . . . .C A K< .'. . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . �. .Lic. No.. .,, . . . . . . . . . . . . .. �.� .�. . . . . . . PLUMBING INSPECTOR Check # 1011*�� ` MASSACHUSETTS UNTO APP`UCATON FOR PERNIlTTO DO GAS F MNG (Type or print) Date �p NORTH ANDOVER,'MASSA HUSETTS / Building Locations l n l - y ��w~f Permit# b L" Amount$ Owner's Name ��C( New❑ Renovation 0 Replacement Plans Submitted 0 a� a z o d W a 0.U � F SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR STH . FLOOR (Print or type) 1 /�� Q / CW one: Certificate Installing Company Name - it F— l� U Corp. Address �� Part Business Telephone Rin ,�/ Ar y7--j i, Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ©> No� If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 13 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 13 Agent 13 t hereby certify that all of the details and information IMStat ntered)in above ap lictrtion are true and accurate to the best of my knowledge and that all plumbing work and edun r Permit Is ed for this a lication will be in compliance with all pertinent provisions of the'Mass, - de a Chapter 1 osed Plumber Or Gas Fitter By. Plumber Title � City/Town q Gas Fitter License; u' mT ster ��PPROVED OFFICE USE ONLY) Journeyman