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HomeMy WebLinkAboutMiscellaneous - 64 PHILLIPS COMMON 4/30/2018 (4) 4 Pkfz// s 66mmor) i i 1 . Location f, �� / � l C/ Jz //h'I fyl v1�C �` eNo. Date �oRTM TOWN OF NORTH ANDOVER 3?O.�t.a° ,a 14•QL .. a - p Certificate of Occupancy $ 114 6 Building/Frame Permit Fee $ 176A v'u �'SSACMus Foundation Permit Fee $ - 't R,T� r Permit Fee $ Sewe AdRA Fee $ pl3'4 J(�If jute Connection �ee $ NO.Anv�r do �. � eOlL't(?r �g Building Inspector Div. Public Works f Location — 1-),L1/1(!P-S rD��9f�a�� / No. Date NORTH TOWN OF NORTH ANDOVER j 660 1ti G? �....' .• O0 Certificate of Occupancy $ Building/Frame Permit Fee $ c us�� Foundation Permit Fee $ zno, Dp 1 Other Permit Fee $ PAID, 1aeQ ion Fee $ " Jer-Gonnection Fee $ Plo. Andover Collectors ' k,,;` Building Inspector Div. Public Works Location - g�No. L27— tl Date 14 // z, l / NORT1y TOWN OF NORTH ANDOVER O? • 1 e 0. Certificate of Occupancy $ d # Building/FrameP Permit It Fee $ �'�s' °''�t� • ' Foundation Permit Fee $ s�C use Other Permit Fee,, $ P6PY 1 eviction Fee $ 'p- ���� Vat connection Fee $ flT TSOTA�' $ 2-000, 00 Bu'llding Inspector f Div. Public Works v PE$tMIT- NO. � � , APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. P (- hA/ 1 P GE 1 i MAP d40. LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK 'PAGE — ZONE I SUB DIV. LOT NO. I LOCATION - PURPOSE OF BUILDING _ r OWNER'S NAME NO. OF STORIESSIZE -206 6 OWNER'S ADDRESS SEMENT R SLAB ARCHITECT'S NAME Cr SIZE OF FLOOR TIMBERS IST 2ND Q 3RD BUILDER'S NAME �j^, . SPAN �l1 Lill `1a.i A DISTANCE TO NEAREST BUILDING �Q; DIMENSIONS OF SILLS --- DISTANCE FROM STREET �A' POSTS ` 1i \\\CCCJJJ DISTANCE FROM LOT LINES-SIDES 26t REAR ^S/� '" GIRDERS /L� v (2 t AREA OF LOT ?s-o� Cy�'LsLi.J FRONTAGEd`�'�j�o HEIGHT OF FOUNDATION y I h THICKNESS /D IS BUILDING NEW Ue:S r"� L/ SIZE OF FOOTING O/0 x �I X L IS BUILDING ADDITION `j Q MATERIAL OF CHIMNEY IS BUILDING ALTERATION,I j O IS BUILDING ON. OLID R FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE /) IS BUILDING CONNECTED TO TOWN WATER "/1/ C-s BOARD OF APPEALS ACTION, IF ANY fL Yr IS BUILDING CONNECTED TO TOWN SEWER I i 14 IS BUILDING CONNECTED TO NATURAL GAS LINE Q v 3 PROPER INFORMATION INSTRUCTIONS I MUff FOR FOUNDATION ONLY LAND COST 060I SEE BOTH SIDES ISULATED BY PARA. 114.8-S. B. G-EST. BLDG. COST /�Q�� .•. T. BLDG. COST PER SQ. FT. C PAGE 1 FILL OUT SECTIONS 1 - 3 ESJ PAGE 2 FILL OUT SECTIONS 1 - 12 _ DATE Z FEE PAID EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. • ELECTRIC METERS j UST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE F,fLED AND APPROVED BY BUILDING INSPECTOR . DATE FILED BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED T FEE �L� a r O"� ` OWNER TEL.#JO� PLANNING BOARD PERMIT G CONTIR.TFL.04-.S�70 - 19 y' �_ CONTR.LIC.# � BOARD OF SELECTMEN PERMIT FOR FRA LME tom,fri tiff f „ LESS FDA /00 . DATE: %Z�vfEE PAID.ILU DUE FRAME PERMIT$ //68•U` BUILDING I ECTOR C_ ; BUILDING RECORD 1 OCCUPANCY. 12 •,'f SINGLE FAMILY STORIES MULTI. FAMILY OFFICES r THIS SECTION MUST SHOW EXACT.DIMENSIONS OF LOT AND.DISTANCE FROM - •- _ •_ APARTMENTS LOT LINES AND EXACT'DIMENSION'S OF•, 'BUILDINGS. WITH ,PORCHES. GA- RAGES. ETC. SUPERIMPOSED.:THIS REPLACES,;Pi •OT PLAN. CONSTRUCTION L•} 2 FOUNDATION I 8 INTERIOR FINISH CONCRETE d 1. 2 I3_ I CONCRETE BL K. PINE BRICK OR STONE HARDW D —`__ '• _ PIERS PLASTER _ _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ -•�? '/, Yi '/, FIN. ATTIC AREA NO B M T FIRE PLACES HEAD ROOM _ MODERN KITCHEN 77-74 WALLS I '9 FLOORS T CLAPBOARDS _ B 1 2 3 l S DROP SIDING `CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING WARDV✓'D _ Y ASBESTOS SIDING COMMON_ VERT. SIDING ASPH.TILE _���LP i /161 �1A,1m Tani rill STUCCO ON MASONRYt', '. o viol anum E rill J? t STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR cr 1 BRICK ON FRAME'-' � I - CONC. OR bNDER BILK. STONE ON•MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING ti GABLE HIP BATH Q FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) 1 FLAT SHED WATER CLOSET J- ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPE LESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM i STEEL BMS. &COLS. HOT W'T'R OR VAPOR WOOD RAFTERS ](L AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS Q; IL Oei +<tiGY I ?; .s"• •..• .�e� : .r. 2nd ELECTRIC 1st. 13rd I NO HEATING ." FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION lJ�.t'PS ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT DRESS ASSIGNED BY D.P.W.- STREET . �,, U6 124- APPLICANT ;l��apS rnnann� , (� (� PHONE �- DATE OF APPLICATION b l 2 TOWN USE BELOW THIS LINE BOARD DATE APPROVED • IOC TOWN PLANNER DATE REJECTED CONSERVATION COI hiI SION DATE APPROVED CONS - VATION MIN. DATE REJECTED BOARD OF HEALTH z&A'Ay DATE APPROVED HEALTH SANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT AAo SEWER/WATER CONNECTIONS ACl c� FIRE DEPT. --W' V- t RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Jlt�l 171992 , �"j wjC�LEG- EPA_��� /3, 9S0 S F, \ p sa S,UD I i S NEPEBY CE.PT/FY TO Tye T/TLE/,1/SUPD P ANO IL or / L,41v TO 7/�E BAN.r Ts�gT THE 0n'ELG/uG /S COC.4TEG OA/ ' THE TN.4T/T aC6S COAI/F ..elw /N HY/Tf1 A//Dovz.e zowl-G RErsA.PO/NG SETBAC.CS FROM STeEETS f LOT -'-VES 1 FU.�riS�C.P GE.�T/FY T//i4T T•Y/S ON'ELL/N6 /S NOT / L 1744 rE0 /tet/ 7We FL000 11-4014.P0 A PE.4. O,PA/f�jV /cOiP aSyewN e/t/�E � N/Ty P.4NGG so ,v/ /o d GG/P G.. irj 2500 9 OCd s. mov � 8 5 E✓ 6 �lA,pir�Evr(ofoe,o JEFFREY tiN; o,vo s/s/83 OF ✓ F �S , .</ > .P.L.S. GTE �4 OP H d � SURA T///S PLAN FO GE- P//,ePOSES- tipT FO,P Bovvopy AETE.P�li�f/.4Tiory eo�.vo.4.ey/.v.�o.P.yi- /NE.P.P//Y1.9Gt'E.VG�•dEE,P�.I/G SE.Pl�/lES AT/O.V 774,ee,(l FRO�YI EX/ST/.(/C PE'COPpS. (olo f'q.P,(� .ST.PEET °� A.VDOYE�P, �Yl,4SS.4ly//SETTS O/8/O I �,eo.,-, ,9.v/.vsrevmE.vT SvevEy /3,95-0 S.F, • Ex/sT/NG' 0.4 TION 1 1. /,3/ Ma ' 1 �'/EREBY OE.PT/fY TO TyE T/TLE/.c/SU.POK ANO �L O/ TD T.�/6 BAN.f T.S�gT T//E Oa'ELG/.u6 /S LOCATED av TiS/E LOT qS S.SfOIY.V ANO Tf/.4T/T OGEES G'O,l/FOPiYI //(/ . !Y/Tf1 Tf/E TO/yN OF!/,c OW.5716.e 20S' -e le eEIsULAT/O.f/S , / ��QOvE� /J f�SS• �QEGv4.?D/N!s SETBAC.I'S FROM ST'PEETS � LOT 1 FU�s'EP CEPT/FY T/.'wT TiY/S �IrEGG/N6 /SNOT. / /740,4 TFG f/•4Z•440'.4.PE.4. OiPANY/V FO.P OAl I�er44Z MCA JEFFREY tiN oAo`s/�s/83 /6 OF Q �Na s RV�� Tip//,S PLA�t/FO GE P//,PPOSES-it/OT FD.P . BO!/NO.PY.G�ETE.P�Y1/i(/f1T/O�/ ,BOU,vo•4,es��.V,�O.P�ji- �E.P.P/rtl.9C�E'.�iG�.�/EE,P�.t�G SE.PY/L'ES AT/OPV TA.NE.S/ -;ea / EX/ST/.(/C PELO,POS. 6 f'q•P,{� .ST.PEET . - A.t/ODI/E.P, /yl�4SS,4C,f�aSETTS O/8i0 I-U 0 1W a-canul H V A T I L T PLANV41NG F fll�A tA I OR I Tjq A I 6 own ® 0Andover 0 ._ No. RIVEWAY ENTRY PERMIT � b M E W er, Mass.-NTILAME A 99A C PERMIT 30 L 0 BOARD OF HEALTH THIS CERTIFIES THA;W!U./ ..C�M. ......... .....12W W- We.... BUILDING INSPECTOR has permission to eru)"O... uildings n .S... 0Fj0 1Rough to be occupied WS6W.490.* W./Ay...P VdW. .A*w............................4 4b Chimney ... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY Final REGULATED BY PARA 114.8-S. B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONT6ELECTRICAL INSPECTOR 6 6_1"_f2� FEEPAID se ughSTA,6%, EIS CONS U RTrvice PERM FOR MMUBU Final LDI DAM FEE PAIM 0*NG INSPECTGASINSPECTOR p Occu ancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the PrMlftlm_ DUE FRAME PERMIT$'li4 'D 0 FIRE DEPT. Do Not Remove Burner No Lathing to Be Done . Until Inspected and Approved byMtET NO, Smoke Det. Building Inspector PLANK IL RAL CO am _ O << own ® !� '® F. ��.4er. ndover v � �AIIVEVAY ENTRY PERM I '�� 4 L �� A L H EAr�do�er, Mass., BOARD OF HEALTH T UILD 'I M�W O�,C (C�46q PE RMI /!1�� �'�o ..... ...... ... . .....,� THIS CERTIFIES THA .•. .... .. ... .... . . ............ BUILDING INSPECTOR has permission to erW.W . .. Sb ' g � poig( 1 . ....co %'�„^.� � t� `!2. ...... utldtn son .... . . . ........... � Rough L G' �'� ACI . •. •• •AY.. P�� A A,� Chimney fL�0- d" -3 j to be occupied as ..... Fi al lt�' provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUM, CyINS ECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of R 7 i 3 4 Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY Ficial-�-- KWLATED BY PARA 114.8-S. B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. 7 �- 1-1 -7 PER I T EXPIRES IN 6 M O N T6A`T�E � ELECTRICAL INSPECTOR 6-/S-`/Z FEE PAID /�' Rough O ,/� i I INN FSS CONS , ICU( F .01 Service STARTS Service ©/{ PERMIT FOR FRAME/BUILDING Final ` 1 _ DATE:�,;; FEE PAI •.• ••• B WING INSPECT GAS INSPECTOR Occupancy Permit Required to Occupy Building g6h B `.1RM9T /a 6�, O F. a Display in a Conspicuous Place on the Prig oo'; ofl to /,>, DUE FRAME PERMIT$ , . _ a 0 FIRE DEPT. Do Not Remove Burner No Lathing to Be Done . Until Inspected and Approved by NU Smoke Det.R� 17- Building Inspector ��'"� ' s CERTIFICATE OF USE OCCUPANCY Building Permit Number 2 3 8 Date AUGUST 31 , 1 9 9 2 THIS CERTIFIES THAT THE BUILDING LOCATED ON 64 PHILLIPS COMMON ( Lot # 22 ) MAY BE OCCUPIED AS SINGLE FAMILY D W Ell I N G IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. OF NORT y H 02 CERTIFICATE ISSUED TO P h i t t i p�s Common D e v . C o p p. 733 Tunnpi e St. =.1 ADDRESS N o a h Andover . MA • �s r 2i,9SSAC HUSE��� 42 6 Building Inspector Feb. 4. 2007 3:26PM Dan L. Gelinas , P.E.978.465.5160 No-9982 Gelirlas 5trudural �rgwerir>q LLC Phone 978.465.6436 Daniel L.Gelinas,P.E. Fax 978.465.5160 579A North End.Blvd. Salisbury,MA 01952.1738 email dahlgeliaas@adelphia.net February 4,2007 Gerald A.Brown Fax 978.688.9542 Inspector of Buildings,Town of North Andover 400 Osgood Street Phone 9545 North Andover,MA 01845 Copy: Jay Clementi f 978.688.4098 Principal,Production Manager p 5036 153 Maple Street Methuen.MA 01844 SUBJECT: Rhea limon Skolcr 64>Phillips Common,North Andover,MA Dear Mr.Brown: Per the request of General Contractor Jay Clementi,Gelinas Structural Engineering LLC(GSE)went to the above site on 2.2.07. The purpose of this trip was to perform a walk thru and confirm the LVL framing satisfies code. The following are the results of our observations: Executive Summary: All LVL framing observed is per the drawings and satisfies the Massachusetts State Building Code 6h j Edition Chapter 36. This includes the rear gable end wall framing in the cathedral roof area. Please call with any questions. !;s DANIEL S GFLINA' STRUCTURAL ' NO-33"4 T ��9F-tSTEA�� ssorrAL Very Truly Yours, ,..;.. Darnel L. Gc inas,P.E K LVL$a Wag ak sis 2-2-07 job 06147.&t, Feb . 4, 2007 3 :27PM Dan L . Gelinas , P.E .978-465 -5160 No.9982 Gelinas 5brudural �nglneerinq LLC Phone 978.465.6436 Daniel L. Gelinas,P.E. Fax 978.465.5160 579A North End.Blvd. Salisbury,MA 01952-1738 email danlgelinas@adelphia.net February 4,2007 Gerald A. Brown Fax 978.688.9542 Inspector of Buildings,'Town of North Andover 400 Osgood Street Phone 9545 North Andover,MA 01845 Copy: Jay Clementi f 978.688.4098 Principal,Production Manager p 5036 153 Maple Street Methuen, MA 01844 SUBJECT: Rhea Simon Skoler,64 Phillips Common,North Andover,MA Dear Mr.Brown: Per the request of General Contractor Jay Clementi,Gelinas Structural Engineering LLC(GSE)went to the above site on 2.2.07. The purpose of this trip was to perform a walk thru and confirm the LVL framing satisfies code. The following are the results of our observations: Executive Summary: All LVL framing observed is per the drawings and satisfies the Massachusetts State Building Code 68' Edition Chapter 36. This includes the rear gable end wall framing in the cathedral roof area. Please call with any questions. c AN EL L. N 0 .ELINAS STRUCTURAL N N NO-33994 /STEA���a��� SSJO �NC�.•,. Very Truly Yours, PJ.eI. Darnel L. Ge inas,P.E K LVL framing ok site observations 2-2.07 job 06147.doe 6ellna5 5hdural �ngineerinq LLC Phone 978.465.6436 Daniel L. Gelinas, P.E. Fax 978.465.5160 579A North End Blvd. Salisbury, MA 01952-1738 email danlgelinas@adelphia.net February 4, 2007 Gerald A. Brown Fax 978.688.9542 Inspector of Buildings, Town of North Andover 400 Osgood Street Phone 9545 North Andover, MA 01845 Copy: Jay Clementi f 978.688.4098 Principal, Production Manager p 5036 153 Maple Street Methuen, MA 01844 SUBJECT: Rhea Simon oler, 64 Phillips Common,N rth Andover, MA Dear Mr. Brown: Per the request of General Contractor Jay Clementi, Gelinas Structural Engineering LLC (GSE) went to the above site on 2.2.07. The purpose of this trip was to perform a walk thru and confirm the LVL framing satisfies code. The following are the results of our observations: - Executive Summary: All LVL framing observed is per the drawings and satisfies the Massachusetts State Building Code 6h Edition Chapter 36. This includes the rear gable end wall framing in the cathedral roof area. Please call with any questions. DANIEL L. y�N GELINAS STRUCTURAL N0.33994 /STEPE� Very Truly Yours, SS��NAL Fes? Y. Daniel L. Gelinas, P.E K LVL framing ok site observations 2-2-07 job 06147.doe Date ;y .r 40R of •�"o TOWN OF NORTH ANDOVER PERMIT FO S PLUMBING SS US This certifies that 7 ll. . k"V . . . . . . . . . . . . . . . has permission to perform . .�t�., "L�! .7. . . . . . . . . . . . . . . . . . . plumbing in the buildings off•. . .... . . . . . . . . 1 at . . North Andover, Mass. YNR Fee. 'Z. . . .Lic. No. . . :V . a PLUMBING INSP Check # �a 3i X194 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location ��_PY \l p S CCt..,"o Owners Name e t&kp U S 1C@ i t T Permit# Y y Amount ,S'L � v Type of Occupancy . W[u 1 M�� New Renovation Replacement Plans Submitted Yes [:] No FIXTURES 12 a s<l�lasv� I IS')C FIDat � ! M>U ! 4M FO k 5MFUM sMFLOCR 71H>D slHFLUOICR (Print or type) Check one: Certificate Installing Company Name_ \\� �\AK s. 1�1' Corp. Address M® aOs,N,-j Partner. Business Telephone p 1 •"11 d 74 U-5 71 Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate thg type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El Bond ❑ insurance Waiver. I,the un ersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent 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 Massa u State Plumbing Code and Chapter 142 of the General Laws. By: �ignaiare-,= dumber Title Type of Plumbing License ,i j City/Town icense Surnger Master Journeyman ❑ APPROVED(OFFICE USE ONLY /t /. �'�o. . . ... . . pf No°TN ,ti0 TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION �9 u SSAC NUSEt _ This certifies that . . . .A.�.!'. . .' . . . . . . . . .` . . . . . . . . . . . . . . . has permission for gas installation !!!v in the buildings of .�� a►�i� . . . !✓ -'`� . . . . . . . . . . . . . at 46 /. r /. �. . . . .Ci??'r+'^'. . . . ., ort ndov�er, Mass. v s Fee. U Lic. No/e; a'r� . . . �. GA INSPECTOR Check# 0 ti 5 815 A, ZZ MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date I Z" OTJ NORTH ANDOVER,MASSACHUSETTS�p a, 1 Building Locations 1,9 LI �� 1 1 S Cl I VA�U�./ Permit# Amount$ 3 p 1 ,��'&�/� Owner's Name � i S(r New® Renovation Replacement Plans Submitted x W w w z C Q ¢ z z O z a w Q s z o a > w � w � z Q � a a w a � F w H C7 F� z H z �? W C7 p > t: F U J w > a F Q z Q m z o z a o a x O w 3 A C7 OU a > o a F O SUB -BA SEM ENT BASEM ENT IST . FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5 T H . F L O O R 6T H . F L O O R 7TH . FLOOR 8TH . FLOOR (Print or type) ^ Check one: Certificate Installing Company Name rt� i 1�`^�� \Pkb .I N+T �. . Corp. Address `� �H S d� V C�- �-�e'�C�u1 C �'� E] Partner. 9 Business I a ep one a , ��^�\ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 No� If you have checked Les,please'ndicate the type coverage by checking the appropriate box. Liability insurance policy 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's Agent Owner 13 Agent 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 Massact`h sett St to Gas Code and Chapter 142 of the General Laws. f BY: Signature of Licensed Plumber Or Gas Fitter Title Plumber I- \Z�-� City/Town Gas Fitter License Number Master APPROVED(OFFICE USF ONLY) Journeyman