HomeMy WebLinkAboutMiscellaneous - 80 MORNINGSIDE LANE 4/30/20181
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ...
has permission to perform ............
plumbing in the buildings of ................
at. ..".Z�.: ^'' ,-�.^�!a.r!� . -r? L -.. , North Andover, Mass.
Fee _.?,0D ... Lic. No. 3. .. 1�� .�.-......... .
/ PLUMBING.'IN PECTOR
Check #
7274
MASSACHUSETTS UNIFORM PPLICATION FOR PERMIT TO DO PLUMBIP
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
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Building Location /910wners Name �B%�iw' %i/G�,% / ��/9Rl,�dN Permit # 7a 7 y
/� Amount 13� �a
Type of Occupancy Dille j`i-'V: -
New 1:1 Renovation 0 Replacement
FIXTURES
Plans Submitted Yes 11 No El
(Print or type) Check one: Certificate
Installing Company Name '/�Lfdllpflx/ Alk*lgi/J�j ❑ Corp.
Address Sa G �'9GG Sr V Partner.
Business Telephone 7,7x toy S7 -31`a y Firm/Co.
Name of Licensed Plumber: 771alw�l
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy EJ Other type of indemnity D 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 installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Plumbin de and Chapter 142 of the General Laws.
By:rgna ure 31.0censeci YJUMDer
Type of Plumbing License
Title a y ,�r 3 3
City/Town rcense 1,471-M-7 Master ❑ Journeyman rM
APPROVED (OFFICE USE ONLY
Date ...:........ `. ... .
r TOWN OF NORTH ANDOVER
-,t PERMIT FOR GAS INSTALLATION
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This certifies that . !..... rfr" ` .... ?? ......... ........
has permission for gas installation
in the buildings of .. d :.. .
at �� y��� ! 3' �, North Andover, Mass.
Fee. ... Lic. No�� '.......... .
% GAS IN'W6TOR
Check # /7(�— f
58 97
tE
NIASSACMSFM L'NZF'ORNI APPLICATON FOR
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations o rn 6ledy iv � S c ,JL
'TC) 4 jlfurv/ �CA>2 SI o^f Owner's Name
DO GAS FITTING
Date //30,167
NeW13Renovation Replacement Plans Submitted ❑
Permit #
Amount S 2e, 0f�
(Print or type)
Cly* one: Certificate Installing Company
Corp.
Name /9L�o/�A�✓
Address Ea 6
A L
S T
Partner.
Nva -//
MA
Business Telephone
9Sy y
Firm/Co.
Name of Licensed Plumber or Gas Fitter
10«e f.4
IST. FLOOR
!6TH. FLOOR
(Print or type)
Cly* one: Certificate Installing Company
Corp.
Name /9L�o/�A�✓
Address Ea 6
A L
S T
Partner.
Nva -//
MA
Business Telephone
9Sy y
Firm/Co.
Name of Licensed Plumber or Gas Fitter
10«e f.4
INSURAINCE COVERAGE- Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ® NoD .
If you have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy 0 Other type of indemnity 13 Bond 13
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 13 Agent 13
t hereby certify that all of the details and information 1 have submitteu for entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed ander Permit Issued for this application will be in
�,cmpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 42 of the General Laws.
By:
Title
CitylTown
A-PPROVED ,CFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber vZ ve 3.7
Gas Fitter license Number
er
Master
Journeyman
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