HomeMy WebLinkAboutMiscellaneous - 68 UNION STREET 4/30/2018Date
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HORTM
0 TOWN OF NORTH ZANDOF El
PERMIT FOR GAS INATION
This certifies thatJrOIR,-./.t.,�."..........................
has permission for gas installation ... V. /................... .
in the buildings of ............................
at .. .....
... �. k..................... North Andover, Mass.
Fee..2.? .... Lic. No..?.:" ... .....
GAS INSPECTOR
Check # U 9 6
5961
A
MASSACHUSETTS iJNHDRMAPPLICATONFOR PERAWTO DO GAS FTrnNG
(Type or print) Date 71,2 d 7
NORTH ANDOVER, MASSACHUSETTS
Building Locations f�8 �����% SF Permit#
Amount $
J-0 i] 10TH %`% �f9/✓ Owner's Name
New❑ Renovation ElL1® Plans Submitted ❑
(Print or type) Check one: Certificate Installing Company
Name -A(,Lale#4ti t &u f3Aj❑Corp.
Address O/3 O x S 7 2 ❑ Partner.
1-.4CVt -PAv C nit �- o r 9 '-/ Z
Business Telephone c, g 5--91 S"4 ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter -,tv g4 �/��o ✓�/�
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑
1 ' d' t the t e --vera a by checking the appropriate box.
If you have checked Les, Pease toica a yp g ❑
Liability insurance policy IS 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 mtormation i nave suormueu kui c„«Mu) in auvvc appi�auvi. "l— .............. — ...
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.
y:
itle
VED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber Z '1/ 43
❑ Gas FittertcL� e— Number
❑ Master
❑ Journeyman
2ND. FLOOR
MW
ITH. FLOOR
(Print or type) Check one: Certificate Installing Company
Name -A(,Lale#4ti t &u f3Aj❑Corp.
Address O/3 O x S 7 2 ❑ Partner.
1-.4CVt -PAv C nit �- o r 9 '-/ Z
Business Telephone c, g 5--91 S"4 ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter -,tv g4 �/��o ✓�/�
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑
1 ' d' t the t e --vera a by checking the appropriate box.
If you have checked Les, Pease toica a yp g ❑
Liability insurance policy IS 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 mtormation i nave suormueu kui c„«Mu) in auvvc appi�auvi. "l— .............. — ...
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.
y:
itle
VED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber Z '1/ 43
❑ Gas FittertcL� e— Number
❑ Master
❑ Journeyman
Date. .a as .. �?�/. .
TOWN OF NORTH ANDOVER
D
PERMIT FOR GAS INSTALLATION
This certifies that
'Aas, permission for gas installation...
'.in the buildings of ..
..................
l R. North Andover, Mass.
Fee. � L� Lic. No.... ,- • :.... .
...... ( /
`GAS INSPEG70F./J
Check # 119
vv
4 6 8 i
MASSACHUSETTS UNIFORMAPPUCATONFOR
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
TO DO GAS Fi' FMG
Date �� J U
Building Locations �' A
/ V `/ VU _ Q /%,-,A/^s- Own 's Name
New Renovation ❑ Replacement Plans Submitted
_ Permit #�Od/
Amount $� 5
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1ST.
FLOOR
2ND.
FLOOR
3RD.
FLOOR
4TH.
FLOOR
5TH.
FLOOR
6TH.
FLOOR
7TH.
FLOOR
STH.
FLOOR
I
(Print or type) )/ j S Check one: Certificate Installing Company
Name. G�J s'y1 /"l �/i�2/�/ �� f'�c f/ e� C ❑ Corp.
` A,< NF S 7� �D / si��� l�/� O /� 3 S— ❑ Partner.
Address
Business Telephone - Q 7 ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑
If you have checked Les, please indicate the type coverage by checking the appropriate box. ❑
Liability insurance policy ED Other type of indemnity 13 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 intormatton 1 nave sunmtttea kor emerea) in aouve appncamm aic uuc anu aUL.uiaic w u,c
best of my knowledge and that all plumbing work and installations�rfortned under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachus�State G doe and er I j2V the General Laws. )
Y
APPROVED (OFFICE USE ONLY)
Signature of Licensed Plu�'in'ber Or Gas Fitter
Plumber �Sfl�t %�? V 7 /(��
Gas Fitter icense Number
Master
Journeyman
t jek
OIe BeraCon
" I\ S.V A A N C E
COMMON POLICY
nFCLARATIONA
Many:QNfBSACWi IesuRA E COMPANY ce:MASSAcimms
Transaction Type
Issue Date Effective Date' Rex Number
Policy Number
File Number
#EW BUSINESS
11106/2003 11/20/20031', lJ5ZUP
PAC QB IU01566
8563175 1
NAKED INSURED and MAILING ADDRESS:
RICHARD BOWMAN
6 HORNE ST
BRADFORD, MA 01835-8024
d/b/a BOWMAN PLUMBING SERVICES
AGENCY NAME AND ADDRESS:
2028852
MACDONALD & PANGIONE INSURANCE
104 MAIM STREET
NO ANDOVER, MA 01845
Business: Plumbing - Light Commercial - not Industrial
Form Of Ownership-. Individual
Policy Period: From: 11/20/2003 to 11/20/2004 at 12:01 AM Standard Time at the mailing address stated above.
SPECIAL INFORMATION
In return for the payment of all premiums, taxes, sucharges, recoupmens and fees, and subject to all of the terms of this
policy, we agree with you to provide the insurance stated in this policy.
One Beacon COMMERCIAL GENERAL LIABILITY COVERAGE PART
I N S U R A N C E
DECLARATIONS
rnpanr. ON13EACON INSURANCE COMPANY : MASSACHUSETTS
' Transaction Type Issue Date Effective Date Rex Number Policy Number File Number
NEW BUSINESS 11/06/2003111/20/20031 IJ5ZUP PAC QB lUO1566 8563175 1
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t .... ... .. C'C4" -!i'--:+--0+•ii \ � .. /M?'i.;4�i}:�i}4i�::v-.v-..v+-: �.1'ti::i�: ii�$�?:.....�. n._.y}
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STANDARD COVERAGES
Each Occurrence:
51, 000, 000
Damage to Premises Rented to You (any one premises):
$300,000
Personal and Advertising Injury (any one person or organization):
511000,000
• Medical Expenses (any one person):
$5,000
General Aggregate (except Products and Completed Operations):
52,000,000
Commercial - not PRODUCTS 5.288 5349
Industrial