HomeMy WebLinkAboutMiscellaneous - 63 HAY MEADOW ROAD 4/30/2018 (2) 7HAEAW ROAD
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" MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT. TO DO GASFITTING $�
(Print or Type)
Mass. Date ��` .� / 19
' o City, Town
- Permit #
Building 0 y ���� NameOwner's
AT: Location � ,/�' � . Name
Type of Occupancy: b O d
New` Renovation ❑ Replacement ElPlafis Submitted Yes ❑ No
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SUB—BSMT.
BASEMENT
1STFLOOR
2ND FLOOR
3RD FLOOR
4THFLOOR
STH FLOOR
6TH FLOOR
7THFLOOR
STH FLOOR
(Print or Type) Check One: Certificate
Installing Company Name Gagnon Plumbing Heating & Gas Inc. rx-1 .Corp. 1524
Address P8860 .0
i artne.ship
Salem 11A 0 970 ❑ Firm/Company
Business Telephone 508-744-4'14.9 game of Li%ensed Plumber or Gasfitter
Tjhomas R. Gagnon
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurance including completed operations coverage.
Signature of Owner/Agent
I have a current liability insurance policy to include completed operations coverage.
By TYPE LICENSE:
Title ❑ Plumber Signature of Licensed
Plumber or Gasfitter ,
City/Town ❑ Gasfitter
APPROVED (OFFICE USE ONLY) ® Master i 0136
❑ Journeyman License Number
FORM 1243 HoeBs b WARREN,INC.1989
COMMONWEALTH OF MASSACHUSETTS
BOARD ' IN PLUMBERS AND GASF T rl'r:RS
IMPORTANT NOTICE,.'. " !
L ( LICENSED S h(1 JR`1h�F=YMN 1''I_UMBER PF.RMITSFOR PLUMBING�NDOAS�►ITTINO
INMTALLATIO S ON STAT OWYND vN(161%
FACILITIES MUST BE FILED AT THE
`kr=: OFFICE OF THE STATS BOARD.
P kx THOMAS R .GAGNON m
BOX 8860
SALEM MA 01971-8860 ,
18597 05/01/98 154984
q
COMMONWEALTH OF MASSACHUSETTS
mv
-IN PLUMBERS AND GA SFTTTERS '
LICENSED AS A MASTER PLUMBER PERMITS FOR PLUMBINOANDOASFITTINO«
'}•' �' ISSUES THIS LICENSE TO INSTALLATIONS ON STATE OWNED OR USED ,ti
q ( FACILITIES MUST BE FILED AT THB
OFFICE OF THE STATE
ni = 'Y,PEI1' THOMAS R GAGNON m
'1 + Ap
.
;�, ' I PO BOX 8860
SALEM MA..'01971-8860
985.E � � 10136 05/01/98 154985
COMMONWEALTH OF MASSACHUSETTS
IMPORTANT NOTICE a�a'�•�..
IN PLUMBERS AND GASFITTERS pERMITSFOR PLUMBING AND GAS FITTING ?s:
INSTALLATIONS ON STATE OWNED OR.USED
REGISTERED AS A PLUMBING CORP
•:
S IS LICENSE TO
ISSUETHUU55
( � FAC16TIES M T BE'FILED AT THE:` •
ss'•1+ ,N I , OFFICE aWHE STATE BOARD.";'
`THOMAS R GAGNON •.�w.� !
'= PO BOX 8860
:SALEM MA 01971-8860
`454986 ;. 1524 05/01/98 154986
F. (aoo�vr�earuuea� a�✓�La sJac�zuaP/tb T
...
` Restricted To: oo '134
2 8
n
DEPARTMENT OF PUBLIC SAFETY
SPRINKLER'-CONTRACTOR LICENSE
1 t I
fi ', - usber:: Expires: 81.thdate:
{' rf '� 08/31/1991 08/31/1951 �'•� '.�;
Restricted To: °00 a�
THONFS R GAGNON a
d DRUNLIN RO g• �+
`•*. .1,.) IPSVICN, NA 01938 I
GAGNON PLUMBING HEATING&GAS FITTING,INC. 1447
v ,Town of North Andover 11/26/96
Licenses and Permits 63 Hay Meadow Rd. 15.00
FLEET 63 Hay Meadow Rd. 508-975-7222 15.00
i
T TO 2375 Date./��y/9�........
_A
�oRTM TOWN OF NORTH ANDOVER l
o S
PERMIT FOR GAS INSTALLATION
s c
SACHUSEt� ^ "
O
This certifies that 62",7. !' ! . . . .t .'� . . . . . . . . . . . . . . .
has permission for gas installation . . .�'A.
in the buildings of . . .�AR� cCCn
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .at !
�NtAcly w
And v r
• • • • • o e , Mass.
Fee.,lJ . . . Lic No./906 . . . . . . . .
AS INSPECTOR
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