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HomeMy WebLinkAboutMiscellaneous - 8 MORTON STREET 4/30/2018N n Date.54�.. <��•° -.'�o TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING This certifies thatr/t has permission to perform ..% t .�� !• , t' .. p ..k ........ t . plumbing in the buildings of ... vaj. S. f AN .................. at .......-,,.... S .1........... , North Andover, Mass. Fee .%--W . Lic. No.1 �)O ... PLUMBING INSPECTOR Check # r% U 8704 7395 Date..... 1 1 V- oto ,e�'ryO TOWN OF NORTH ANDOVER ` PERMIT FOR GAS INSTALLATION • :. SSACHUSE This certifies that has permission for gas installation .. i in the buildings f . Y { 3, r � , , , , , . at ...,�..<........ , North Andover. Fe.,4..S () . Lic. No. Check #� t / �') (' . 'GASINSPECTOR FIXTI IRFS MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:-M, AJYb00E--f), MA. Date: 0 Permit# Building Location: Owners Name: 110t,51 Aj.E Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential [�-- DEDICATED New: ❑ Alteration: ❑ Renovation: ❑ Replacement: [�' Plans Submitted: Yes ❑ No ❑ FIXTI IRFS INSURANCE COVERAGE: I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes Er -No q If you have checked Y, es, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 1 6......L. _._ _.. --, -, •••, •• •�. a•• ..� .��� .,�.a--� a. -u -munnaatte on i nave suomIa for enterea) regarding this application are true and accurate to the best of my Know",and that alt pfumbiM work and installations oerfarm-d r►ndor Ow- ru—rmif kel-c.r f- fhi. c,a :.. ,.,,.....4 ---Aim -11 •.......... w• .­ •.-aaam.nuavua orate rwmomg voce ano Gnapter )4Z or the General Laws. By Type of License: Title Blolumber Si t f Licensed Plumber Cit®'Master APPROVPROV ED (OFFICE USE ONLY) ❑JOumeyman L-iCenSe Number: ��j. DEDICATED z SYSTEMS W z u • > Z a W zUj N Z F- Y } H a V N a W Q a Z 3 N = m 1/1 Z W H LU Z W VI it Z N O Z a !• X h W Uj Uj a a W = o a z' 3 U c j > p 30 a UJ Z Z _ LU a H _ 0 LU ua, U vagi O Z iW- I-- v� Q 0. a 3 SUB BSMT. BASEMENT 1' FLOOR ° FLOOR 3RO FLOOR ,C FLOOR FLOOR 6r" FLOOR 77` FLOGR r FLOOR InstatfFn -Coma Name: G g Company �../� t I AC�-j- %�- �� Check One Only Certificate # N [corporation � T (� Address:91 �� �L j`7GN� S% C' Auto( / State: ! , , ❑ Partnership Business Tel J?T �p�f�-3 Fax: ElFirm/Company Name of Licensed Plumber:f INSURANCE COVERAGE: I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes Er -No q If you have checked Y, es, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 1 6......L. _._ _.. --, -, •••, •• •�. a•• ..� .��� .,�.a--� a. -u -munnaatte on i nave suomIa for enterea) regarding this application are true and accurate to the best of my Know",and that alt pfumbiM work and installations oerfarm-d r►ndor Ow- ru—rmif kel-c.r f- fhi. c,a :.. ,.,,.....4 ---Aim -11 •.......... w• .­ •.-aaam.nuavua orate rwmomg voce ano Gnapter )4Z or the General Laws. By Type of License: Title Blolumber Si t f Licensed Plumber Cit®'Master APPROVPROV ED (OFFICE USE ONLY) ❑JOumeyman L-iCenSe Number: ��j. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING 1 A-IJI)WET) ,.Mass. Date 20 /0 Permit# 3'2�1 Building Location Owner's Name Vdi / 3z 16,6- live TA42 ST Type of Occupancy Rr7. "�/'p New ❑ Renovation f1 Renlncement rat' Plane giihmiff-A- V.. rn C� lnstaHmg Company Name Address 41 %airs! i Business Telephone Name of Licensed Plumber or Gasfitter COVERAGE: Check one: p -Corporation ❑ Partnership ❑ Firm/Co. No ❑ Certificate ")-?L70 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL h. 142 Yes -fl— No ❑ you have checked yes> please indicate the type of coverage by checking the appropriate box. liability insurance policy J:2Other type of indemnity ❑ Bond ❑ VNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required Chapter 142 of the TVIGL, and that my signature on this permit application waives this requirement. of Owner or Owner's Owner 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 po ed under the permit issued for this application will be in compliance with all pertinent provisions of the s hus tts State Gas Code and Chapter 142 of the General Laws. By Typeof Uccle:, Title B—Plumber E3Master Signa ;/, o tensed Plumber/Gasfitter City/Town ❑ Gasfitter ❑ Joumeyman License umber APPROVED OFFICE USE ONLY) • 01• SUB-BASENMNT were ��������■��������� 61 glen* 42 1 DIVA 12 lnstaHmg Company Name Address 41 %airs! i Business Telephone Name of Licensed Plumber or Gasfitter COVERAGE: Check one: p -Corporation ❑ Partnership ❑ Firm/Co. No ❑ Certificate ")-?L70 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL h. 142 Yes -fl— No ❑ you have checked yes> please indicate the type of coverage by checking the appropriate box. liability insurance policy J:2Other type of indemnity ❑ Bond ❑ VNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required Chapter 142 of the TVIGL, and that my signature on this permit application waives this requirement. of Owner or Owner's Owner 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 po ed under the permit issued for this application will be in compliance with all pertinent provisions of the s hus tts State Gas Code and Chapter 142 of the General Laws. By Typeof Uccle:, Title B—Plumber E3Master Signa ;/, o tensed Plumber/Gasfitter City/Town ❑ Gasfitter ❑ Joumeyman License umber APPROVED OFFICE USE ONLY)