HomeMy WebLinkAboutMiscellaneous - 9 EMERSON COURT 4/30/2018 (2)m
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3r '` ,''OWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
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This certifies that .................... ......................
has permission for gas installations "................... .
in the bings of ..�� ........ ;� ... . ...........
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at ... ........................ , North Andover, Mass.
Fee,,.'5:1"07 . Lic. No.% ............. .
V GAOINSPECTOR
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5390
MASSACHUSETTS UNIFORM APPI
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Location9 Tit
Q✓`�� � '�` Owners Name nJ�
le-� A._.-1_fI lt, _ i
New 1:1 Renovation 11
of
Replacement j
i
9
ING
(print or type) 11 nn l Check one: Certificate
Installing Company Name W �� 1 �%VVt� ,� Corp.
t Address J—A 9434t S
Partner.
r; usmess lelephone I- e Firm/Co.
Name of Licensed Plumber: D ( l
Insurance Coverage: Indicate the type of insurallice coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ 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
ignature 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 installati per med under Permit Issued for this application will be in
compliance.with all pertinent provisions of the Massachusetts mg o anq-ChapteP44,2 of the General Laws.
Title
APPROVED (OFFICE USE ONLY
Type of Plumbing License
License MUM Master P1
Journeyman ❑
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(print or type) 11 nn l Check one: Certificate
Installing Company Name W �� 1 �%VVt� ,� Corp.
t Address J—A 9434t S
Partner.
r; usmess lelephone I- e Firm/Co.
Name of Licensed Plumber: D ( l
Insurance Coverage: Indicate the type of insurallice coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ 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
ignature 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 installati per med under Permit Issued for this application will be in
compliance.with all pertinent provisions of the Massachusetts mg o anq-ChapteP44,2 of the General Laws.
Title
APPROVED (OFFICE USE ONLY
Type of Plumbing License
License MUM Master P1
Journeyman ❑
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO'PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
q Date _L�.
Building Location �'� 6,^5X,, � '�- Owners Name ��/ (` ; P wtf S Permit #
Type of Occupancy Amount 3P,
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New ri Renovation Replacement Plans Submitted Yes No ❑
(Print or type) Q DIq Check one: Certificate
Installing Company Name ��� 1 �%Vv"� [I Corp.
Address At S
- ri Partner.
- Z D -7D
usmess a ep one - aRZY- Finn/Co.
Name of Licensed Plumber: _" k d D ( ,� k 'N t y
Insurance Coverage: Indicate the type of insura ce coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ 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
ignature 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 installatiA pe ed under Permit Issued for this application will be in
compliance.with all pertinent provisions of the Massachusetts ng o d!Clapter-�2 of the General Laws.
y:
D (OFFICE USE ONLY
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i ense er Master
tM Journeyman ❑
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(Print or type) Q DIq Check one: Certificate
Installing Company Name ��� 1 �%Vv"� [I Corp.
Address At S
- ri Partner.
- Z D -7D
usmess a ep one - aRZY- Finn/Co.
Name of Licensed Plumber: _" k d D ( ,� k 'N t y
Insurance Coverage: Indicate the type of insura ce coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ 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
ignature 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 installatiA pe ed under Permit Issued for this application will be in
compliance.with all pertinent provisions of the Massachusetts ng o d!Clapter-�2 of the General Laws.
y:
D (OFFICE USE ONLY
z�2 -
2=
i ense er Master
tM Journeyman ❑