25A-106 (14) a a j m m �-
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City of Northampton,Massachusetts
APPLICATION FOR PERMIT TO DO GAS FITTING
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The undersigned hereby applies for a permit to perform gas fitting work according to the following specifications:
Location.......... .i���... �Z S �f... .1. Change of occupancy—Yes............No...... .........
<.>.�.....�.Z ...............................................................
Name of owner.....` .. U
.... . .. .... 4"'.................... .........Address..3 5...�.... C .� % .........�5:f. ...........
Material of building.........4 ...............................................................New or old....V3 iW./.,........Number of families......Z........Stores.........
What was the building last used for?..............
•••••••••.•••••••••....................What Is the building to be occupied for?..... (.r. (..J��t).............
NATURE OF PROPOSED GAS FITTING IN DETAIL
M
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Pipe o
Floor
i t`o 4 1 x x^ 0 � W Siz m v C r C 4 °
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Cd C3 C
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La
ascineut
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OTE—Mark Below by Y Whether
'ew Gas Fitting .................i................................ NOTE............................
......................................................................................................................
Iterationsin Gas Fitting .................................. .......................................................................................
...................................................................
eplacement of Fixtuxes ...................................... ...............................
stimated Cost $......71 —
5. ...........;-... . ...... ...... ...................................................................................................................................................
[GNATURE OF MASTER GAs FITTER.. 4�c. rC,c4.:5,�-4 1 CEN ~%-,y
/ ........................
...... ....................LI sc No � .... ......
,LEPHONE No..... .....ADDRE 5...:1`. `1 F.it !r .�.�/`J�%!% r?......� ERPIRES....°5..- .. ...(.
..................
GAS FITTER MUST RECEIVE PERMIT BEFORE COMMENCING WORK
All work hereafter performed must be tested before being used, and the Supervisor must be notified when all connections are in
position and the final test is applied.