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Home My WebLink AboutMiscellaneous - 88 MABLIN AVENUE 4/30/2018This certifies that .........e+ ...e+ . �!!n m , has permission for gas installation .... . ........ . . . in the buildings of.-P, Z-o�CL ..................................... pp��v at .......4,)5. `?.�.�,� ..X?....... , North Andover, ass. Fee ... Lic. No.1 �5'' � ... GAS INSPECTOR Check # 8359 M00A G TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK fr?fl�.�i OCCUPANCY TYPE COMMERCIAL[]EDUCATIONAL NEW: ❑ RENOVATION: ❑ REPLACEMENT: APPLIANCES Z FLOORS BSM BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER PLANS SUBMITTED: YESQ NOD ' "® w INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES VNO [� I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 1^ OTHER TYPE 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. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER [3 AGENT El I hereby certify that all of the details and information I have submitted or entered regarding this application are a and accurate t e best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in m Iia wit II P ' ant provision of Ae Massachusetts State Plumbing Codg and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME LICENSE # ATURE MP 21MGF [D JP [ JGF Q LPGI ❑ CORPORATION D/# �y—�-� PARTNERSHIP [I# LL 03 C ®# COMPANY NAM . ¢' ��ADDRESS CITY (,� STATE ZIP TEL CELL e i COMMONWEALTH OF MASSACHUSETTS a REGISTER:EES AS A PLUMBING CORP ISSUES THE ABOVE 4_ CENISE TO: c ROBERT A SAMMATARO ROBERT A SAMMATARO P&H, INC �. 8 DUNRAVEN RD z i WINDHAM NH 0308.7-1263 3373 05/01/14 140820 COMMONWEALTH OF MASSACHUSETTS PLUMBERS AND GASFITTERS LICENSED AS A MASTER PLUMByR. `MUES THE ABOVE UGENSIE TO ROBERT A SAMMATARO 8 DUNRAVEN RD WINDHAM NH 03087-1263 9333 05/01/14 170 • N Date .... �A/* TOWN OF NORTH ANDOVER A os ; PERMIT FOR GAS INSTALLATION 9SSqu�Et • . �\ This certifies that`� .... ... has permission for gas installation t- ?�./�� . ..... . in the buildings of! 1.. %- ...%..... . :�::....... . at . ... . ! . . ............. , North Andover, Mass. Fee %V.• A. Lic. No..07K .......................... GAS INSPECTOR Check # 13✓ .S "4758 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 6761 L Permit # !Vs� iyy v r� �R(/y AIJ��VE� ,Mass. Date Building Location_ g g OA&U LJ AVE J' Owner's Name S7E PHEW C H 1 A A NOETN LN -06V C (( '�i / Type of Occupancy R -CS I OC TJTI P L New ❑ Renovation ❑ Repia�e ent'o Plans Submitted: Yes❑ No ❑ Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone .68,7-:1105 Name of Licensed Plumber or Gas Fitter Francis X. Corkery Check one: Certificate # Corporation 1862 ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: I hare a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 1K No ❑ If yotfthave checked Yes, please Indicate the type coverage by checking the appropriate box. 11 A liability Insurance policy D< Other type of Indemnity El 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: Signature of Owner or Owner's AgentOwner❑ Agent El hereby certify that all of the details and information I have submitted (or entered) in abo plication are true and accu%e to the best of my knowledge and that all plumbing work and installations performed under the permit Iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene - s. (j i T of License: •i Plumber Signature of censed Plumber or Gas Title Gasfitter Master License Number Ci lfowngJourneyman TOME O IC S _ ONLY Y • NMItMEN�� . ONE ONES NMI •• ■��/song■ ��■ •• ■��i ■ son Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone .68,7-:1105 Name of Licensed Plumber or Gas Fitter Francis X. Corkery Check one: Certificate # Corporation 1862 ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: I hare a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 1K No ❑ If yotfthave checked Yes, please Indicate the type coverage by checking the appropriate box. 11 A liability Insurance policy D< Other type of Indemnity El 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: Signature of Owner or Owner's AgentOwner❑ Agent El hereby certify that all of the details and information I have submitted (or entered) in abo plication are true and accu%e to the best of my knowledge and that all plumbing work and installations performed under the permit Iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene - s. (j i T of License: •i Plumber Signature of censed Plumber or Gas Title Gasfitter Master License Number Ci lfowngJourneyman TOME O IC S _ ONLY Z - O_ x_• p U W a , N Z N N W 0. n O !L CL n x_• 1- r tL N � s J n 2 O O Q W O W ~ ' U � • a U. o a x x cr a 0 W U. d Z O tL O t- W a w W m u a � CL .� CL a W W Ld w a w x z 0 r Z , N 1`