HomeMy WebLinkAboutMiscellaneous - 7 COURT STREET 4/30/2018 (2) 7 COURT STREET
210/058.0-0026-0000.0
Date.r . ./. L
f NORTH O TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
SSACMUS�
This certifies thatr. . . . . . . . . . . . . . . . . . . . . . . .
has permission to perform . . . f
plumbing in the buildings of . . . .l. . . ! . . . . . . . . . . . . . . . . . . . . .
at. . . 7. . . r -. . .� . . r. '`. . . . . . . . . . . . . .. North Andover, Mass.
F
Fee. Lie. No.. . �: . . '. ... . . . . . . . . . . . . . . .4. . . . `. . . . . .
PU}MBING INSPECTOR
Check # I `�
T- r^ r
o ; uJ
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS ! Date
Building Location 7 (,ay Permit#
elri, r Amounti-
Owner
New 0 Renovation E Replacement Plans Submitted Yes No
FIXTURES
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rEn '�
Bir
BE lFOCR
3�IJt FIDCIt /
4M HDM
Sffl HDM
6M HDM
7M)PJM
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(Print ortype)
d Check oneCertificate
Installing Comp y NameEl Corp.
Address —Tq MA KA 1:1 Partner.
A"
usmess Telephone Q Firm/Co.
Name of Licensed Plumber: {,u ev-
InsuranceInsurance Coverage: Indicate e t f insurance coverage by checking the appropriate box:
Liability insurance policy 0 Other type of indemnity ❑ Bond
Insurance Waiver: I,the undersigned,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 installati@ns performedand r Permit Issued for this application will be in
compliance with all pertinent provisions of the Massa c s is S to Plu g�d C ter of the General Laws.
By igna ure 01 LIcenseaum er
ype of 1pm g License
Title
City/Town cense um er I Master ❑ Journeyman
APPROVED(OFFICE USE ONLY