HomeMy WebLinkAboutMiscellaneous - 62 Saunders Street Ga 5a..,,,oEKs ss
'[SUILD6NG FILE
Date.. ... .. .�Y
pORTM
�'.. •° •14C TOWN OF NORTH ANDOVER a
PERMIT FOR PLUMBINGLOW '
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This certifies that . . �. . . . ..!... .' . . . . . . . . . . . . .
has permission to perform . . . . . . . . . . . . . . . . . . . ,
plumbing in the buildings of . . .`. . . . . . . . . . . . . . . . . . . . . . .
c-C
at . �. . .�!� r ' . . . . ., North Andover, Mass.
Fee.�'��. . . . .Lic. No.fa D l. . . . . ... . � /l . . . . . . . . >
PLUMBING INSPECTOR
Check # 26 ( z
792
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
Building LocationODate Q
t �wnersName�G�'tl permit#
Z
T anAmount
Type of Occu c �t
New Q Renovation's Replacement Plans Submitted Yes
. � No
FIXTURES
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U O W O
W W q
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,ism IIJ"DM
�FLOOR
3MELOM
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(Print or type) Check one:
Installing Company Name 1�(i Certificate
TIr- Corp.
Address -A 0
�-�
Partner.
Business elephone —
Firm/Co.
Name of Licensed Plumb _ / / 6 {'�
Insurance Coverage: Indicate the type of in uAnce coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ Bond
Insurance Waiver- I the undersigned,have been made aware that the licensee
three insurance of this application does not have any one of the above
rgnature Owner ❑
Agent
I hereby certify that all of the details and' rmation I haves tted ( me in a ve appIi o are true and accurate to the
best of my knowledge and that all plumbin and installations erf ed d r P rmit Iss fo is application will be in
compliance with all pertinent provisions of the Massachuset to Pl
Code an C to 1 of the General Laws.
By:
re o s umo
Title
Type of Plumbi g Licens
City/Town
rcense um er Master 1 �► Journeyman
APPROVED(OFFICE USE ONLY