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Home My WebLink AboutMiscellaneous - 9 ARDMORE COURT 4/30/2018\19: Of (NORTH 1M O F SA US �4 This certifies that .. V,� �. . .../7. � 5 ........................ has permission to perform .. Rlel� ...................... plumbing in the buildings of ...........J.. S . .§............. . at ... pe.c 5.-. ............ . North Andover, Mass. Fee. Lic. No. 1. ? . . t .. .....' ... — .� PLUMBING INSPECTOR Date . 7/�. `* G C ... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING Check # 4%'l 6893 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS 9/ Date Building Location JA AI'4 Q Owners Name 1/V % d J C�c/'►1 �SPermit # � Amount -2.7 Type of Occupancy New Renovation1:1 Repla ement , �»-�' "plans Submitted Yes No (Print or type)2 j Check one: Certificate Installing Company Name (/!'t't / ❑ Corp. Addres � 9 4' ❑ Partner. Business Telephone D - Firm/Co. Name of Licensed Plumber: XF Insurance Coverage: Indicate the t pe of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the un ersigned, 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 perfo ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus tts State e d Chapter 142 of the General Laws. By: Igna oLicensen er Title Type of Plumbing License - 4 City/Town icense umDer,,- Master Journeyman APPROVED (OFFICE USE ONLY ❑ 1' i • . .-�...�--------�---------- --- WeiI IV I I U01.' MMMMMMMMMMMM-M-- -m-- ' ------------------------- W t --t' 5-N.--®---.----.-m------- (Print or type)2 j Check one: Certificate Installing Company Name (/!'t't / ❑ Corp. Addres � 9 4' ❑ Partner. Business Telephone D - Firm/Co. Name of Licensed Plumber: XF Insurance Coverage: Indicate the t pe of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the un ersigned, 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 perfo ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus tts State e d Chapter 142 of the General Laws. By: Igna oLicensen er Title Type of Plumbing License - 4 City/Town icense umDer,,- Master Journeyman APPROVED (OFFICE USE ONLY ❑ zl- liate. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING lo This certifies that ..... .................... has permission to perform ....................... plumb(ing in the buildings of y . � .t'. ( . ................ at.. P7.. /7.e. � A—? .............. North Andover, Mass. '). �� '. Lic. No../ . ...... Fee. . _-n .......... .9p-LUMBING INSPECTOR Check # 67716 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location J� g�� Date .� )wners Nam i� r� Permit # G ??� Amount --173-0__ _ of Occupancy New ❑ Renovation ❑ Replacement Plans Submitted Yes ❑ No ❑ FIXTI TA F.0 'r (Print or type) Installing Company Name Address Check one: Certificate ❑ Corp. ❑ Partner. Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the t pe ins rance c erage y checking the appro ate box: Liability insurance policy M Other type of indemnity 1:1 Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature IOwner ❑ 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%'�— Sign er Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State and Cha 142 of the General Laws. By: re o icense um er ype of Plumbing License Title —ZCity/Town is se um er Master Journemany APPROVED (OFFICE USE ONLY� ❑ Ii Invoice INVotCE NuOVER: �� r 02 P. O. SOX # 2999 SALEM, N Ir 03079 NDOLPH H. WOLF TSL: 603-234-9231 MA -MAST -m? mu-MHER 12299 9 0.00 $0,00 BY 0.00 $0.00 TOTa4L ,CTII COST.' FOU IIEPI. Cl WA, TESL IIT' 5AZER AY /It `40 laa�L HAD TO REPOSITION NEW 1 3/4CXJtla� $�:50 EA. ; WA T REA TEAT, FOR EASE 2.80 3, 40 oFAfAMT. 1314C 9aUI��Ii /4X3-112 BRS NIP $3.75 Carr. THL5 REQ�K��ll'I1V _ . 6.25 3f4 COP TUSH "L"$ 1.25 PER WATER FEEDS, SLK NIP 1.10 1 3/4CSLIP COUPxUO 3/4CST * 3/4X 11-9X314 CFC TQC •rn9-a � v,�7'F�?I�LS COST. ;T. 10 ,DAYS THANK YOU Invoice TOTAL SILLIN6: Date...e....... TOWN -OF NORTH ANDOVER sole PERMIT FOR GAS INSTALLATION This certifies that .... ...................... has pe'rmission for gas installation .... LA—. f-/ ................ in the buildings of ... ...................... at ..... "? North Andover, Mass. Fee.. Lic. No../.1.', 55. .......... GAS INSPECTOR Check 4 5448 MASSACHUSEYTS UNNORNIAPFUCA'PON FORP`ER UTO DO GAS RUING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS SS Building Locations P4 8M Permit # ..5-1y6 k Amount .$ 7 .y �-- / L i') goo,^r j Owner's Name New El Renovation ❑ Replacement 0 Plans Submitted a (Print or type) Name s r Address Name of Licensed Plumber or Gas Fitter C one: Certificate Installing Company Corp. Partner. Firm/Co. / n i INSURANCE COVERAGE• Check on : V I have a current liability Insurance policy or it's substantial equivalent. Yes rM ndicate the type Noo If you have checked yes, plea e coverage by checking the appropriate box. Liability insurance policy 0 Other type of indemnity 0 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 13 Agent El 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 pe�dn rmit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State ter 142 of the General Laws. Swn DVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber / 2 E Gas FittertL case ui� mTer Master Journeyman 71 -S -T. FLOOR (Print or type) Name s r Address Name of Licensed Plumber or Gas Fitter C one: Certificate Installing Company Corp. Partner. Firm/Co. / n i INSURANCE COVERAGE• Check on : V I have a current liability Insurance policy or it's substantial equivalent. Yes rM ndicate the type Noo If you have checked yes, plea e coverage by checking the appropriate box. Liability insurance policy 0 Other type of indemnity 0 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 13 Agent El 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 pe�dn rmit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State ter 142 of the General Laws. Swn DVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber / 2 E Gas FittertL case ui� mTer Master Journeyman