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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
Northampton Mass. Date /0-15 19 T'�
City, Town
y Permit #
Building Owner 'rs
AT: Location 070'1 nu" Name C e axalk-
Type of Occupancy: d_ welling
New ❑ Renovation ❑ ReplacementEl
Plans Sabmitted Yes ❑ No ❑
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SUB—BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
6TH FLOOR
8TH FLOOR
TTH FLOOR
8TH FLOOR
(Print or Type)
Cht3ck One: Certificate
installing Company Name Hodges Plumbing
Corp.
and Heating ® 11 t
Address 60 No. Maple Street ❑ Partnership +
Florence , MA 01060 ❑Firm/Company
Business Telephone 586-1150 Name of Licensed Plumber or Gasfitter
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 laws.
TYPE LICENSE-
By Plumber
Gasfitter Signature of Licensed
Title Master Plumber or Gasfitter
City/Town: Journeyman 7743
License Number
APPROVED (OFFICE USE ONLY) p llif sk P
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(�,rint or Type)
' NORTHAMPTON Mass. Date To 15— _. 19-v7
City, Town Permit
Building Owner's
AT, Location,-2 &j-,)/ �Q j,,,,z. Name
Type of Occupancy; - dweller
New ❑ Renovation ❑ Replacement
Plans
FIXTURES Submitted: Yes ❑ No ❑
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SUB—BSMT.
BASEMENT
18T FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
6TH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
(Print or. Type)
Installing Company Name Hodges Plumbing Check One� � ' Cextifi�ate
Address_ 123, Hawley' Street ❑ Partnership_.,...
Northampto'nt MA 01060
.- ❑ Firm/Company
Business Telephone 586-1150 Name of - Licensed Plumber
Richard W. Hodes
r
I htrtby i cwtify that all of the details and information t have submitted(or entered)In alMtve application are true and accurate to she best at tar
knowledge and that all plumbing work and installations petlormed under Permit issued for this application will be in compliance with ad Ptttint§i P10-
visions of the Massachusetts State Plumbing Code and Cliapter 142 of the Cenetal Laws.
1
8y ignature of Licensed Plumber
Title Type of Plumbing License
7743 ,
city/Town: License Number ® Master ❑ Journeyman
APPROVED (OFFICE USE ONLY) r�1at it
I h/w/h„ 5.Od'
87 461
Date ...............2�...Q�.........................................19.............,
Richard Hodges
Plumber.................................................................................
Eugene Kostek
Owner .....................................................................I..............
Address 22 Brierwood Drive
................................................................................
Replacement
. .......................................................................................................