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HomeMy WebLinkAboutMiscellaneous - 68 MILLPOND 4/30/2018 68 MILLPOND 210/095./095.=8-0000 0 6 3 5 i 9 s NORTH TOWN OF NORTH ANDOVER 0 � `p PERMIT FOR GAS INSTALLATION +no•• 4y �9SSACHUSEt This certifies that . . !�. `'` . .�-.� 14`:.�. . .��! .S. . . r/s�� `• has permission for gas installation . . T•T. !t�.:. . . . .�`. . . !. /� F.%. . in the buildings of . .13=-. .5.� . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . ! . f .. . . . . . North Andover, Mass. Fee.�. . . .. . . Lic. No......>'?. . . i.' . . �Y-: !� . . . . . . . . +`J GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer ir. MASS45 Af APP CAT01Y FOR Pi+RNIIT TO DO GAS FITTING or print) PARCEL DateORTH ANDO q Building Locations & ���\� �� Permit 4 3 S^t! 1 Amount S a�"+ Owner's Name New❑ Renovation ❑ Replacement Plans Submitted ❑ 1A Z Z C' z Cn W sl y :sJ. Z W iJ W W �r ^� % ;� W _?. - y W C W Z S U B -B A S E M E N T ff AS-Em EN "r 1 ST. F L O 0 R 2 N D . F L O O R 3RD . FLOOR 4"r 11 FLOOR sT5 FLOOR 6'r 11 . F L O O R 77 It . FLOOR ST 11 . F1, 00 R (Print or type) ❑eck one: CertificateOte LInstalling Company Name ;v Eti4 YCorp. Address Partner. Business Telephone Firm/Co. Name of Licensed Plumber or Gas Fitter 17�>C Vim-J• `—��N��.. INSURANCE COVERAGE Che.. one: I have a current liability Insurance policy or it's substantial equivalent. Yes Nom If you have checked ves,pl a indicate 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 ❑ 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 Mass ac tts State Ga Cod^ar4d Chapt r 142 of the General Laws. By: Signature of LicensA Plumber Or Gas Fitter Title Plumber 33S CitviTuwn Gas Fitter 7cense INumoer [✓taster APPROVED(OFFICE USF(M.Y) ❑ Journeyman r i o MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTiNG (Print or Type) a� N0.ANDOVER,MA , Mass. Date = 19 Permit Building Location 469 MILLPOND Owner's Name /9fI1,41 NO.ANDOVER,MA Type of Occupancy ' RES New ® Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ ' No ❑ rr; .O F LL¢t aC m W ¢ ¢ O = O F- ¢ y 6 = Z 1... tri O C W -V\ F. Ir N Om > C f. Q t W T ¢ W O < rr < < O O W Q- O (yA F y O 2. F" O sue—as MT. BASEMENT ISTFLOOR 2ND FLOOR �) 3RD FLOOR 1-0 ATH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name CALLAHAN AIR CONDITIONING Check one: CertlfTcate � Address 91 RPTIMONT STREET ❑ Corporation NO.ANDOVER,MA. 018450 Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes RJ No ❑ ' If you have checked ve:s, please indicate the type coverage by checking the appropriate box. A liability Insurance policy fI 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 at Owner or Owner's Agent Owner❑ Agent C:] I hereby certify that all of the details and information I have submitted(or entered)in ove applicatlon are true and accurate to the best of my knowledge and that all plumbing work and Instaliatlons performed under the permit sued for this applicat! Mill b In pllance with all pertinent provisions of the Massachusetts Stale Gas Code and Chapter 142 of the neral law BY Type of Ucense: tuber gnalur o c nse um a or Gas titer Title srilter 11 aster License Number M-3440 City/Town .lou,neyman O . ;:W:.ti'3�i-+w',,•.e?-..3A'"�'�t.c+''�`�✓`'7�^q..+�+"-,.--ay.� 4;,,�.;:=:.,,,s�--,•:tia...;''`"1r'�"�'.ti,"r.h.Y/.." ""..��' �_.r�t"1 sTo - Date...+. �. k►• . � 2442 NORTH TOWN OF NORTH ANDOVER A ? ' `p PERMIT FOR GAS INSTALLATION© • i ♦ CCL! �9SSACHUSEt This certifies that has permission for gas installation . . . in the ildings of . . �. tY,IZI 4 V . . . . . . . . . . . . . . . . . . ., North Andover, Mass. Fee. . Lic. o.J' . . . . . . . . . . . . . . . . . . . . . +' .'�. GAS INSPECTOR I, WHITE:Applicant Y`—CAN�AvR�Y:Building Dept. PINK:Treasurer GOLD:-Pile L( MASSACHUSET .;UNIFORM 'APPLICATION FOR .PERMIT TO DO..GASFITTING TS (Print or Type) < /�Ij a� Mass. Date ���.., 19 �� Permit # - Owners Name >✓�» P - -Building 'Location Type of Occupancy ��10 New P-.1, Renovation ❑ Replacement C! Plans'Submitted: Yes ❑ No ❑ rn w CC CO U cc �. Wcc cc O 8 H S t to C7 U� N :W t m z g = } 8 I, z O W .l Q Z Q) _ z � $ o: ir W W W z Q = W W 0 W W W J co W c� ~ z z r. $ � i o 6_ z L M 3 0 g 8 g > o gir- o i sub BSMT. BASEMENT } i' I 1 ST.FLOOR ,. s 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR t i' 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing 'Company Name 4/ 4FI-0 Check one: Certificate # Address corporation . 17 ❑ Partnership Business !Telephone _ ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equiyalent which meets the requirements of MGL Ch. 142. Yes el/ No ❑: If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy. O 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: Owner ❑ Agent ❑ Signature of Owner or Owner's 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 installation performed under the 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. By — Type of License: L:1 Plumber Title Signature of Licensed Plumber or Gas Fitter ¢4.Gasfitter A Master City/Town U Journeyman License Number APPROVED (OFFICE USE ONLY) .... i.•ti:.,�"�yS�..:Gzn.�-c°+-r"';^� ---- -2rac�+- `r" � --.-,:+rr„1;,v.::ad�t.;;- ._'`,�,.-""r+Wtr�-t�. 2105Date. /.� . .. . . :.. ,NORT/y TOWN OF NORTH ANDOVER A PERMIT FOR GAS INSTALLATION 1s9SSNC,MUSESt ' This certifies that //. . . . . . . . a N_ has permission for gas installation . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .), i L/'v c� . . • • . _ . _ • Andover, Mass. Fee. Yt Lic. No. 4/ . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File