HomeMy WebLinkAboutMiscellaneous - 88 MILLPOND 4/30/2018ill
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTiNG
(Print air Type)
NO . ANDOVER , MA , Mass. Date / r c7 __1 9 A4 Permit _-n&o = _
a Building LocationW -MILLPOND Owner's Name /elz* ee %—
NO . ANDOVER , MA Type of Occupancy RES
Im
New ® Renovation ❑ Replacement ❑ . Plans Submitted: Yes❑ ' No ❑
Installing Company Name CALLAHAN AIR CONDITIONING
Address 91 BELMONT STREET
NO.ANDOVER,MA. 01845
Business Telephone
508-689-9233
Check one: Certificate '
C3 Corporation
❑ Partnership
❑ Firm/Co.
Name of L)censed 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 R3 No ❑ '
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy fJ 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:
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 above application are true and accurate to the best of my
knowledge and that all plumbing work and Installations performed under the permit Idsued for this applicatI90 wilT
In pflance with all
pertlnent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral Law
BY T e of License:
tuber gnatur o c nse um a or Gasiiftiter
Till® stiller
Master License Number M-3440
APY Journeyman
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Installing Company Name CALLAHAN AIR CONDITIONING
Address 91 BELMONT STREET
NO.ANDOVER,MA. 01845
Business Telephone
508-689-9233
Check one: Certificate '
C3 Corporation
❑ Partnership
❑ Firm/Co.
Name of L)censed 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 R3 No ❑ '
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy fJ 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:
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 above application are true and accurate to the best of my
knowledge and that all plumbing work and Installations performed under the permit Idsued for this applicatI90 wilT
In pflance with all
pertlnent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral Law
BY T e of License:
tuber gnatur o c nse um a or Gasiiftiter
Till® stiller
Master License Number M-3440
APY Journeyman
0 .
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2080 Date ..:< ,l . �.... .
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TOWN OF NORTH ANDOVER.
PERMIT FOR GAS INSTALLATION Y
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This certifies that g ...............'
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has permission for gas installation ../ I��.. ................
in the buildings of . !�o r.!� �. ?` ............................. Cr
at .... t. 7. f . �........... , North Andover, Mass.
Fee. 2 )`..... Lic. No..?..t( c( p... ..........................
GASINSPECTOR
WHITE: Applicant CANARY: building Dept. PINK: Treasurer GOLD: File
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type) ^^
' IHNc1l d J P (' , Mass. �1 Date N U .19 l q
4 Permit # 0
Building Location_ D b 1(� r'� I�GV�N/ Owner's Name, CD( r
' P S Can CJ
Type of Occu ancy I� 2
A4%`1Z-
New Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ N9-1�
Installing Company Name \ A -g ee T �u �M�° ac" Check one:
Address Li 60 2ooli <�Corporation
e� o c 8 3
❑ Partnership
Business Telephon 2O& -`'6W -S15--S'�< ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter kc, , (V�qJ�oe ,
Certificate
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INSURANCE COVERAGE:
I have a current bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes'a No ❑
If you have checked rimes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy Q 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:
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 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 Massachu'se'tts State Gas Code and Chapter 142 of th eral Laws.
By — ; i taste f License:
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BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
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6TH FLOOR
7TH FLOOR
STH FLOOR
Installing Company Name \ A -g ee T �u �M�° ac" Check one:
Address Li 60 2ooli <�Corporation
e� o c 8 3
❑ Partnership
Business Telephon 2O& -`'6W -S15--S'�< ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter kc, , (V�qJ�oe ,
Certificate
aO sq
INSURANCE COVERAGE:
I have a current bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes'a No ❑
If you have checked rimes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy Q 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:
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 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 Massachu'se'tts State Gas Code and Chapter 142 of th eral Laws.
By — ; i taste f License:
Title _ Jb u be
SignatureOber
Lic sed Plumb � -G Fs fitter
sfitter City/Town — - .. License (oj
APPROVED (OFFICE USF ONLY) urneyman
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T4- 2280 Date
NORTH TOWN OF NORTH ANDOVER
O PERMIT FOR GAS INSTALLATION
� F
a q • ,
3JIC'4 .
This certifies that .. FF....:
has permission for gas installation .. U.l�.�i!/4 c, r........... V
in the buildings of ... 1?1 4 ... .
at .f.. . , . , , ., North Andover, MassS
Fee. ., ' .. Lic. No. .l. U .... ..1,z- -V.,.... ✓
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/ASINSPECTOR
E1
WHITE: Applicant CANARY: Building Dept. NK: Treasurer GOLD: File