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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
NORTHAMPTON Mass. Date //- cZ3 19 87
City, Town Permit #
Building Owner's
AT: Location-4(5- ��, , a22 �-z Name
��.Z ..� Type of Occupancy:_ dwelling
New ❑ Renovation ❑ Replacement ❑
Plans Submitted Yes ❑ No ❑
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x = O O Z W 0 ; O J 0 W Y O a t— O
SUB—BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
6TH FLOOR
GTH FLOOR
TTH FLOOR
STH FLOOR
(Print or Type)
Check One: .Certificate
Installing Company Name Hodges Plumbing
I and Heating ] Corp. 672 ,
Address 12'3 Hawley Street "p0.Aor, ///(p _ [:] Partnership�„�
Northampton, MA 01060 ❑Firm/Company
Business Telephone 586-1150 Name of Licensed Plumber or Gasfitter
Richard W. Hodges
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 Massachusetts State Gas Code and Chapter 142 of the General 1Lws.
TYPE LICENSE:
By Plumber
Gasfitter Signature of Licensed
Title Master Plumber or Gasfitter
r' City/Town: Journeyman
� License Number
APPROVED (OFFICE USE ONLY) r'iaf'
I W/h
Date 8 Dec 1987
Plan No. 37 9
ktichard LHodges
Gas Fitter
Holly Martineau
Owner
Street 45 Acrebrook Drive
Building Old—New.