17C-058 (7) -57
BELOW BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO.
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APPLICATION FOR PERMIT TO DO GASFITTING
NAME& TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
PERMIT GRANTED
DATE 19
GAS INSPECTOR
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
Mass. Date_ � 19
City, Ifown Permit #
Building _ Owner 's
AT: Location /j0a, ��� �. Name 0,,N ryo e l
10 e--, Type of Occupancy: ;��,��,
GNew Renovation ❑ Replacement ❑
Plans Submitted Yes ❑ No ❑
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3RD FLOOR
4TH FLOOR
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6TH FLOOR
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8TH FLOOR
(Print or Type)
Check One: Certificate
Installing Company Name Bay State Gas Ca.- Corp.
2025 Roosevelt Ave.
Address S;41494 1d, Mass. 01101 ❑ Partnership
❑ Firm/Company
Business Telephone Name of Licensed Plumber or Gasfitter
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1 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 Chapter 142 of the General Laws.
By TYPE LICENSE:
Plumber
Title Gasfitter Signature of Licensed
City/Town: Master Plumber or Gasfitter
Journeyman
APPROVED (OFFICE USE ONLY) License Number
BELOW FOR OFFICE USE ONLY
I
FINAL INSPECTIONS SKETCHES $16.00 PROGRESS INSPECTIONS
�. FEE
{ No. 22/87
APPLICATION FOR PERMIT TO DO PLUMBING
Oweaing Unit
NAME&TYPE OF BUILDING (�
Ed NAAJ�Ottl ;Hurlburt "01,1td tJ(�
LOCATION OF BUILDING
190 Chestnut Street
PLUMBER
Malcolm Cichy
PERMIT GRANTED
DATE 14 Jan 'g87
E
George W. . Staples Jr.
PLUMBING INSPECTOR
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
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mass. Date - I 19
City, Town Permit #
Building Owner ' s
AT: Location Igo (f0 5T Nv S i y Name ey�
-
Type of Occupancy:_
New L43 Renovation Replacement
Plans
FIXTURES Submitted: Yes ® No El
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2ND FLOOR
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3RD FLOOR
4TH FLOOR
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6TH FLOOR
7TH FLOOR
8TH FLOOR
(Print or Type)
/ Check One: Certificate
Installing Company Name a� C{cN, �ux6
Corp.
Address (30 LL)-,)A-4 471' ® Partnership
Firm/Company
Business Telephone c G,5 - j-/aic' Name of Licensed Plumber
I hereby certify that all of die 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 pro-
visions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
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By ���.ri r --/
Title Signature of Licensed Plumb
-�/�, Type of Plumbing License
City/Town: �--� 617
APPROVED (OFFICE USE ONLY
License Number Master ❑ Journeyman