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HomeMy WebLinkAboutMiscellaneous - 61 LYMAN ROAD 4/30/2018 61 LYMAN ROAD 210/021.0-0010-0000.0 • Date.! . ".dG } T N° 4405 HORTq TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUSf Illi f' This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . plumbing inthe buildings of .. . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . , North Andover, Mass. 2 PLUMB�.N)POR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Date... .� �� ................ OF NOwT#j TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SACHUS� This certifies that CK-- :1.. '- ..`. �. ©�...� J OSS .. ........ has permission for gas installation ..V -O:. -.G,.... .� .�. in the buildings of........3 '.r�.�r � -j.cv.............................................................. `` iM. ....... -�............................. North Andover, Mass. at..: ::1.................. r Fee... P. ......... Lic. 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GASINSPECTOR Check# 1'Uv M�-' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY r MA DATE 07/ /2015 PERMIT# JOBSITE ADDRESS L OWNER'S NAME I GOWNER ADDRESS I Same TE 1FAXI TYPE OR OCCUPANCY TYPE COMMERCIAL[] EDUCATIONAL ❑ RESIDENTIAL[j PRINT CLEARLY NEW:® RENOVATION:❑ REPLACEMENT:® PLANS SUBMITTED: YES❑ NO[ APPLIANCES-1 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER C CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHERIX Re lace Gas Meters x and Associated Pi in In 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 CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Ej OTHER TYPE 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: OWNER ❑ AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I 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 Pertin nt pr vision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME I Robert Josey LICENSE# 9185 �IGNAftRE MP 0 MGF® JP® JGF® LPGI❑ CORPORATION[# 3788C PARTN�RSHIP❑# LLC®#� COMPANY NAME: RH White Construction Co ADDRESS 141,Central St CITY I Auburn STATE MA ZIPI 01501 TEL 508 832-3295 FAX 508-926-4347 CELL 508-245-7431 EMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES e QL� /zy/.��� Division of Professional Licensure: License Search Page 1 of 1 The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Mass.Gov Home State Agencies A-Z Topics Home>Division of Professional Licensure> ONLINE SERVICES ...............................................................................................................................................................................................-...................................................... Check a License Check A Professional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change Contact the Agency LICENSEE More... Name: ROBERT A. JOSEY REFERENCES& E DOUGLAS,MA RELATED INFO NEW SEARCH I Disclaimer Regarding **This Licensee has additional Licenses, click here to view them.** Website License Searches Glossary of License Status Codes Licensing Board: PLUMBERS£t GASFITTERS License Type: MASTER PLUMBER More... License Number: 9185 Status: CURRENT Expiration Date: 5/1/2016 Issue Date: Exam Date: School: This web site displays disciplinary actions dating back to 1993. This license has had no disciplinary actions taken during this time. The page above has been generated by the Division of Professional Licensure web server on Wednesday,July 15,2015 at 3:20:42 PM. ©2007-2011 Commonwealth of Massachusetts Site Policies Contact Us http://license.reg.state.ma.us/public/pubLicenseQ.asp?board_code=PL&type_class=_M&li... 7/15/2015 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING 5�1 (Print of Tye1 NORTH ANDOVER, MAGA Date �L7 2aa� BuQding / P k _ LocationOwnee Name ,-t `1 1, �3�N/�l4�o New ®, Renovation ❑ Rept amen( ❑ Plana Submitted: Yes❑ No.'s OIXTURE3 31 I _ • r ri A O } V •;t 0 a O R s a s N s a t ;t ♦' w 0 s s a. ac o 2 a 's w a ! 44 0 � s � es s a O a a a a < a Y O 3 1 i Z jo Id 06 w s H a 16 i a o 1.94a a ° sua—LINT. IST FLOOR 1110 FLOOR 3110 FLOOR 4114 FLOOR IT" FLOOR STH FLOOR 7TH FLOOR A ——4— OTH FLOOR - jt#1 Mack one: Certflicale Installing Company Name ❑Corp. Address ❑Partnership k' ❑Firm/Co. Business Telephone Name of Licensed Plumber-21 AND INSURANCE COVERAGE: checx one I have a current Ilabilty Insurance policy or is substantial equMalenL Yea ❑ No ❑ It you have checked yM. please Indicate the type coverage by checking the appropriate box A Ilabilty insurance policy ❑ Cther type of kidemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not hAYJL the Insurance coverage required by xM6r, r 11 e� it ass. Genaa4s, and that my sigrattxe on Chia permapplication waives this requirement.. APA Check one: Owner (� Agent ❑ r bf Owner a Agent 1 hereby certify that aq of the detsfls and Information I haw submitted for entetedl In&bow appkatlon are true and accurate to the best of my knowledge and that as plumbing work and Installatlons Wormed under the permfl Issued ke this appiieatlon vn7 be in compliance vrith all pertinent provisions of the Massachusetts Slate Plumbing Code and Chapter keg of General By Signatme set Title Ucense Number City/Town Type of Plumbing license: Master ❑ AM OVED(Of"ME USE CNLYI Journeyman