17B-023 (6) BELOW FOR OFFICE USE ONLY
FINAL INSPECTION, SKETCHES PROGRESS INSPECTION
FEE4•�,J ,r
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
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NAME 3 TYPE OF BUILDING
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LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
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PERMIT GRANTED
DATE 19 �
GASINSPECTOR
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type) 9
Ae/�
/y0/'r`�CL6riap�/.'h Mass. Date /� -- 19_JJ
_ City, Town Permit #
Building own
e s
AT: Location 7 �i 'e U Name"4Y" 4oV
Type of Occupancy:
New ❑ Renovation Replacement ❑
Plans Submitted Yes ❑ No ❑
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BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
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7TH FLOOR
8TH FLOOR
(Print or Type)
Check One: Certificate
Installing Company Name Richard's Plumbing & Heating Inc,
❑X Corp.
Address 79 Union StreetpRear [] Partnership
_
Easthampton,Ma 01027 ❑ Firm/Company
Business Telephone 413-527-0291 Name of Licensed Plumber or Gasfitter
Richard A Boulanger
I hereby certify that all of the details and information 1 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 an pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
By TYPE LICENSE:
Plumber
Title Gasfitter Signature of Lice sed
City/Town:— Master Plumber mb86r or Gasfitter
Journeyman -7867
APPROVED (OFFICE USE ONLY) License Number
BELOW FOR OFFICE USE ONLY
FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS
FEE °
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
T Ln CI
NAME&TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE
PLUMBING INSPECTOR
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type) "-
Mass. Date 19
City, Town Permit #
Building G�, > , Owner ' s , --
AT: Location7/
Type of occupancy cc .
New ❑ Renovation Replacement ❑
Plans
FIXTURES Submitted: Yes ❑ No ❑
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SUB—BSMT.
BASEMENT /
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
(Print or Type) Richaxd s
Installing Company Name Plg.& Htg. Inc. Check One: Certificate
❑ Corp.
Address 79 Union Street ,Rear ❑ Partnership
Easthampton,Ma 01027 [1 Firm/Company
Business Telephone 413-527-0291 Name of Licensed Plumber
RICHARD A BOULANGER - ---_-- -_-,-
I hereby certify that all of the details and information I have submitted(or en(ered)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 perlinem pro-
visions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. )
BY -- -- - -
Title Si n Licensed lumber
Type of Plumbing License
City/Town: PST -7867 _ t�-t
APPROVED (OFFICE USE ONLY) Number ['t Master [1 journeyman
Y
2892 q 119 5 5
Date .......................................................................19-............
Plumber ... ......... ................ ..................................
Owner ....
........................................... .................................
Address .......4 .............................................
.......................................................................................................
i Date -
Plan No. ,-%/
Gas Fitter_
Owner
Street
Building Old—New.