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HomeMy WebLinkAboutMiscellaneous - 81 CHRISTIAN WAY 4/30/2018 (2)N j Op e A n 0 = i � b N �. � � W O z O � 1 O O .j MORT1y w 10 9 SACMUSE� Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ........... ........ . .0. . . . . . . . . . has permission to perform. .'.�.. .••••••••••••••••••• .y plumbing in the buildings of .......... • .. at .... /......... `... North Andover, Mass. -. ........ . Fee k .. "... Lic. No..........-. . , ......... . ` PLUMBIIJNSPECTOR Check #— J � J MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) .CPQ .MA Date 2q_O Z- Receipt# Permit#� Building Map:_ New ❑ Renovation .C1 No�d Installing Company Name v ©� Checkone: Certificate Address ��- Corporation EstimateValueofWork: ❑ Partnership BusinessTelephone — 3 — ❑ Firm / Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No 0 If you have checked rimes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of Indemnity 0 Bond 0 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. Checkone: Owner Agent❑ Signature of Owner or Ownees Agent f 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 the 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. By Type of License: Plumber Signature of Licensed Plumber or Gas Fitter Title ase Master Mastterr License Number City / Town Journeyman APPROVED (OFFICE USE ONLY) Revised 05117/00 �oo�omnnm�nnoon Installing Company Name v ©� Checkone: Certificate Address ��- Corporation EstimateValueofWork: ❑ Partnership BusinessTelephone — 3 — ❑ Firm / Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No 0 If you have checked rimes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of Indemnity 0 Bond 0 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. Checkone: Owner Agent❑ Signature of Owner or Ownees Agent f 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 the 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. By Type of License: Plumber Signature of Licensed Plumber or Gas Fitter Title ase Master Mastterr License Number City / Town Journeyman APPROVED (OFFICE USE ONLY) Revised 05117/00 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) I 22a-q�Z ,/1/Cl�DL,lO �' Mass. City, Town Building AT: Location New] Renovation 0 Date e� Permit b �� oZ _ C G<' /S7/ Owner's Name �,��t/lr_ Type of Occupancy: Replacement 0 FIXTURES Plans Submitted Yes❑ NoOf Installing Company Name—,"�%Ly�� Check One: Certificate Corp. -ritcl O Partnership O Firm/Company Business Telephone— Ori r ;',3/ —02 PYY ' Name of Licensed Plumber or Gasfitter JC -0 /r�C1r�40 I hereby certify that all of the detail 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 of the Massachusetts State Gas Code and Chapter 142 of the General Laws. in compliance with all pertinent provisions I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner/Agent I have Wcurrent ' bi ity ' sur nce policy to include completed operations coverage. 3,S`— Signature of Licensed Plumber or Gasfitter 11 Master ❑Journeyman Gasfitter License Number • • • 0 NEON ON NNNNNNNN MENEENNNNE • • ' NNN■NNNNNNNNNNNNNNNN tai7rr"r - Installing Company Name—,"�%Ly�� Check One: Certificate Corp. -ritcl O Partnership O Firm/Company Business Telephone— Ori r ;',3/ —02 PYY ' Name of Licensed Plumber or Gasfitter JC -0 /r�C1r�40 I hereby certify that all of the detail 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 of the Massachusetts State Gas Code and Chapter 142 of the General Laws. in compliance with all pertinent provisions I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner/Agent I have Wcurrent ' bi ity ' sur nce policy to include completed operations coverage. 3,S`— Signature of Licensed Plumber or Gasfitter 11 Master ❑Journeyman Gasfitter License Number Date..................... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ........................................... has permission for gas installation ............................ in the buildings of .......................................... at .................................... North Andover, Mass. Fee......... Lic. No........... WHITE: Applicant CANARY: Building Dept .......................... GAS INSPECTOR PINK: Treasurer GOLD: File a P.P.6 UT fnmanbjealtb of Alrjjgacbussetto DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENut. BOSTON 19,0 APPLICATIONI. FOR PERMIT I°•tet To: HEAD CF FIRE D�EPARTMENT City or Town In accordance with t�e provisions of Cha ter /V" L. as provided in Sec. 9 application is hereby Lade By Name • IF 11 name of•'persomtirmrer corporation Address (street or P.O. see) for permission to State clearly� ) 1 7-�,v !city or T*W8) b —_ f 1 � r� r' � max- i r � • purpose for i which permit # is requested At /7✓1 r9 r if- a , n Name of competent operator_ f'c.L� Ir lr�A, Cert. No. - (If applicable) t HOLDEN BOTTLED GAS INC i Dat® issued—rejected 6-8 1990 By 91 LYNNFiEW StREl T _ .. Date of ex iratio� 6- 8 91 1 p`EJ Mft NA 01U0 P 19 fee $0• Paid—Due .3 9 OC- eee�aeoeeeoeeeeeeeeeaeeeeeeeee.ee.eee.eee.9seee.•.eea• e•.fees* .•a........a••e•••e•••a•.eeeee�eeeeeeeeoeoe Neeeeeoieeeeo• op of AWS acbugett�DEPARTMENT OF PU9LIC SAFETY --DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENuE. BosTON _N_. Andover June 8 1990 wpm, E R M (City or Townt !Ogle! !T In accordance with the provisions ofChapter148• G. L. as provided in __ Section 9 this permit is granted to Name Holden Bottled Gas (Full name of person, firm or corporation granted p.rmlt) tostore 2 100 gallon tanks of LP gas for pool heater State clearly purpose for which permit Is granted Restrictions: must be renewed annually at 81 Christian Way (Puglia! !Ww location If str.et and no, Of desuibe in such maru+•r u to pro l Fee Paid $_2 _ This permit will expire 6-8 19 91 N location! �.. ' .. Isignature of NNaal ranlins Oo►nwtl Fire Chief rntiet