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HomeMy WebLinkAboutMiscellaneous - 16 & 18 Chatham Circle SII � �a n x Date,� -. . ." . kOIVTN TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SA HUS This certifies that . . . !r. '. . .4. ref?'". . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . plumbing in the buildings of . . .�?�. �.4 ' ` r� . . . at. . ./. .0-.l.F . . .�/t?.>`h.�. . .t. .o.r.rr.-,North Andover, Mass. Fee. Lic. No../�cl.r�. . �► ,��,�. ,.1... . . . . . . . PLUMBING INSPE6TOR Check # r 4971 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) 99 71 NORTH ANDOVER,MASSACHUSETTS 11 �/ nn II f , �C -re Date �'�d {'o{Building Location 61) jd '11 13 16'�b Own1� NametGnS� permit# �A yYl ('yD 5 5i n¢ Type of Occupancy Amount New Renovation F-1 Replacement El Plans Submitted Yes No FIXTURES Z: w x a �" a W F � r� a x x � d W W W d W A z A A 04 1 E- a C� StRlV >E?t1�IIVT q Ia y MRaR 4MRL at sMRfM 6M �ERE 9M (Print or type) p `I Check one: Certificate Installing Company Name (�lC�� �//-m n f 1/1J�'YI �i n o e �NA>�i X14 El Corp. Hof Address 'I 6 m relJ ✓>�/C O Partner. kka(uj, AAA. 01 r,- Business Telephone 9•S7- 66 j Firm/Co. Name o£Licensed Plumber. 1 fan 7 r Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy u 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 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massach State Plumbing Code and Chapter 142 of the General Laws. By: Signaum or-Licensed k2mfnnber Type of Plumbing License Title .)410 Cit ase i um er Master Journeyman APPROVED(OFFICE USE ONLY Date. .....'......... .... ,,ORTk TOWN OF NORTH ANDOVER O 9 • PERMIT FOR GAS INSTALLATION SACNUSEtt This certifies that . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . .�':. :. `.':. . . . . . . . . . . . in the buildings of . . ... . . . . . . f.G. . . . . . . . . .. .. . . . . . . . . . . . . . . . . . at /J— North Andover, Mass. Fee. . . Lic. NoJ. . . . . .. . . . . . . . . . . . . . . .: .. . . . GAS INSPECTOR Check# 376 MASSACHUSETTS UNIFORM APPLI CATON FORD TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations _(` ijolr14 Permit# 2 C/V 11 `` Amount$ �hGG'F+1fAvv� � �SfhQ Owner's Name �ID Y1NU(rP( COfwlir( CVn54, New�/ Renovation ❑ Replacement ❑ Plans Submitted E - 0 SUB-BASEM ENT ASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR =FF�119 8TH. FLOOR (Print or type) one: Certificate Installing Company NamC`1 I-Mnpr/� b`'hf qfq4I-�4 Corp. Address-1 6 �6me� d� { ❑ Partner. Oly Business Telephone cl E)- 6 Q� � ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. YesEa' No❑ If you have checked 3M,please indicate the type coverage by checking the appropriate box. Liability insurance policy ©/ 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 ❑ 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Cha ter 142 of the General Laws. r-- By: Signature of LicensedIumber Or Gas Fitter Title Plumber U y y 9 City/Town ❑ Gas Fitter License Number ❑i- Master APPROVED(OFFICE USE ONLY) ❑ Journeyman