HomeMy WebLinkAboutMiscellaneous - 620 CHICKERING ROAD 4/30/2018 620 CHICKERING ROAD
2101064�31-0000.0
` Date. . . . . . .
I
TOWN OF NORTH ANDOVER
p PERMIT FOR PLUMBING
i o • J
SSACNUS�
This certifies that1?S .,. .;� s. . d l G
. . . . . .. . . . .
has permission to perform . . . . J
plumbing in tfi `buildn s of . . . . . . . . . . . . . .
at . . . . . . . . . . . . . . . . . . . . . North Andover, Mass.
FeeO4� !/.4 Lic. No.1-. . .
PLUMBING INSPECTOR
Check #
6 '1-
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ✓�J
(Print or Type)
v , Mass. Date 'Zcct4 Permit # 1:0
Building Location (r Owner's Namy t.Al I Al/A - `f
Type of Occupancy �t S 17 C iJ ti A(--
New ❑ Renovation ❑ Replacement IHS Plans Submitted: Yes ❑ No ❑
6TURES
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N
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SUB—BSMT.
BASEMENT
IST FLOOR
2ND FLOOR
3RD FLOOR "
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
STH FLOOR
Installing Company Name �2Or�EieT Q • 1jj4frMATAje7 Check one: Certificate
Address 1^0�44 mt4&) ❑ Corporation
/r E14 Ll Fn)} 41 A . ❑ Partnership
Business Telephone -5 q 7 1 9-Arm-/Co.
'Mame of Licensed Plumber 2r,,.3r,�r fhb S,q,vi,vltq req ee-
INSURANCE COVERAGE:
I have a cu ent IJabliityns ra ce icy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes a NoIf you have checked Vis, please Indicate the
type coverage by checking the appropriate box.
A liability insurance policy 1d 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:
Signature of Owner or Owner'sAgent Owner ❑ Agent ❑
1 hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations narformed under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum " e and qapter of the eral Laws.
Title
re of UcensedPlumber
City/Town Type of License: Master Journeymalr E]
`,
0 1 SE ONLYY— License Number3 5
BELOW FOR OFFICE USE ONLY
L• PROGRESS INSPECTIONS
FINAL INSPECTIONS SKETCHES 1
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME i TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE 19
PLUMBING INSPECTOR