HomeMy WebLinkAboutG-07-218MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
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Mass. Date 0120—?1_24
City, Town Permit #a- 07 -a 1Y
Building Owner's
AT: Location Q/a /tG��f�/'l/�'G�/� Name
Type of Occupancy: OSS
New ❑ Renovation ❑ Replacement ❑
Plans Submitted Yes ❑ No ❑
(Print or Type)
Check One: Certificate
Installing Company Name. F. WIN LOW R%voi0irr+NS,4q-jV Corp. 04-2$46193
Address S 'E A-2Da/J � 1C(P-C- O partnership
1f}- 02.66 q ❑ Firm/Company
Business TelephonE(500394-777g Name of Licensed Plumber or Gasfitter
E . F • W IAJS Lo W
I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the st of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in com Ilance with ertinent
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: 9 Master Plumber or Gsfitter
APPROVED (OFFICE USE ONLY) Journeyman Licen e�Num er�00
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(Print or Type)
Check One: Certificate
Installing Company Name. F. WIN LOW R%voi0irr+NS,4q-jV Corp. 04-2$46193
Address S 'E A-2Da/J � 1C(P-C- O partnership
1f}- 02.66 q ❑ Firm/Company
Business TelephonE(500394-777g Name of Licensed Plumber or Gasfitter
E . F • W IAJS Lo W
I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the st of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in com Ilance with ertinent
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: 9 Master Plumber or Gsfitter
APPROVED (OFFICE USE ONLY) Journeyman Licen e�Num er�00
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