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HomeMy WebLinkAboutMiscellaneous - 76 MILLPOND 4/30/2018N° 4283 Date '../: �2e�. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .............. has permission to perform -a ................. . plumbing in the buildings of. 1.1. ..................... at . !�� ''�? ... ......... , North Andover, Mass, Fee':.Z3....... Li c. .�%�............ . PLUr INSPECTOR L� WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) 1i n � A rJ ice, r�2_ , Mass. Date c, 7 Zp_L6M Permit # Building Location M1 Owner's /\j A of dl� a t � -Type of New ❑ Renovation ❑ Replacement 2-11 FIXTURES )L_ -r ,^J % A tK (t, -f 0AD 1) E ,v TI r -Z L_ Submitted: Yes ❑ No ❑ Ir,ling Company Name P1013EleT /� • _'jP rm,4. TA -0 Check one: Certificate Address co AC H mt4 n) / , ❑Corporation N r'_ A J* YO A v i T VL/ ❑ Partnership Business Telephone Z - i9-7 1 ❑-fi—rrn/Co. Name of Licensed Plumber ':Zf; r3 r ga_ T fr' S4 / M1,4 re -4/0C,1 INSURANCE COVERAGE: I have ayes enE'fiability insoura ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checkedrtes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ld' 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 ❑ I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations pefformed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g Itode and;!pte?l of the eral Laws. Title re of Ucensed Plu—m-ber Type of Ucense: Master % Journeyman ❑ CitylTown _ APPFSONED OFFICE FFIC U E ONL Ucense Number Y3 3S NEW Ir,ling Company Name P1013EleT /� • _'jP rm,4. TA -0 Check one: Certificate Address co AC H mt4 n) / , ❑Corporation N r'_ A J* YO A v i T VL/ ❑ Partnership Business Telephone Z - i9-7 1 ❑-fi—rrn/Co. Name of Licensed Plumber ':Zf; r3 r ga_ T fr' S4 / M1,4 re -4/0C,1 INSURANCE COVERAGE: I have ayes enE'fiability insoura ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checkedrtes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ld' 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 ❑ I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations pefformed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g Itode and;!pte?l of the eral Laws. Title re of Ucensed Plu—m-ber Type of Ucense: Master % Journeyman ❑ CitylTown _ APPFSONED OFFICE FFIC U E ONL Ucense Number Y3 3S FE N V m O f- 0 A s O z O O C r O_ z 0 z O m m r• MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) UV G 2 U', NO . ANDOVER , MA , Mass. Date_ggV—d3 = 19 �� Permit # 2033 Building Location ;7L MILLPOND Owner's Name '447,W;/— NO . ANDOVER , MA Type of Occupancy L RES New ® Renovation ❑ Replacement ❑ • Plans Submitted: Yes❑ ' No ❑ Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certificate !r Address 91 BE •MONT STREET I3 Corporation NO . ANDOVER, MA . 01845 ❑ Partnership Business Telephone 5 0 8— 6 8 9— 9 2 3 3 ❑ 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 42Yes Q No O ' If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy ZI Other type of indemnity O Bond O 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 4bove application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this appifcatJ will b In p(lance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral Law 8Y Type of Ucense: Plumber gnatur o c nse um a or Gas titer Title Gasriller Master License Number M-3440 City/Town Journeyman APPnMr-.0 O N H S W N N W U U3 W tz W N N Q lC O O U rn N i - S 7f L1 JQ } ��16 } _ L• .0 F" w d m N H y W OE - of LL N U4 U 4_ W = t.. {rr Q W W ... p W J 2 .: S W cc W W Q C O SiJ > W W Fy t— (U -41 S '� H � < W} W _ x w O= F- s< N -K ~ O O O til W °' O O ��rr1,� = O c7 � O' 3 D O J U ¢ > o a F- 0 O SUB—BSMT. BASEMENT , I ISTFLOOR 2ND FLOOR 3RD FLOOR _ ! 141I I 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certificate !r Address 91 BE •MONT STREET I3 Corporation NO . ANDOVER, MA . 01845 ❑ Partnership Business Telephone 5 0 8— 6 8 9— 9 2 3 3 ❑ 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 42Yes Q No O ' If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy ZI Other type of indemnity O Bond O 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 4bove application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this appifcatJ will b In p(lance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral Law 8Y Type of Ucense: Plumber gnatur o c nse um a or Gas titer Title Gasriller Master License Number M-3440 City/Town Journeyman APPnMr-.0 O i ''��° 2033 Date. 6...... X f NORTH , TOWN OF NORTH ANDOVER: - Q" tiO ti t p n O PERMIT FOR GAS INSTALLATION p 4S$ACNUSEt This certifies that . C `%g. ..... . .. . has permission for gas installation ..,���/�/� . �........... s in the buildings of ..14q f�m,. ....................... at ..%.../fit rx, .......... ,North Andover, Mass. Fee. r} 3.! Lic. No y.Y..U.... ` .. , . . i AS iNSPECTO WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File