HomeMy WebLinkAboutPlumbing Inspection Request 9/3/24 Commonwealth of Massachusetts
f Division of Occupational Licensure
wit.► Board of Registration of Cosmetology and Barbering
� 3.t�111 ; 1000 Washington Street, Suite 710, Boston, MA 02118
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,,° 617-701-8792
Plumbing Inspection Form
INSTRUCTIONS: This form should be completed only if plumbing work has been
done in the shop after purchase. �j
Date: 977 / Z I
This is to certify that I am a Plumbing Inspector for Y0.r ,- cv-1-L ,and that the plumbing
Name of city or town
alterations or installations for:
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Name of Shop Applicant
605-7 2c1,1.4 Z ?
Street Number Street Name
t(art c J-L h /.-
City State
are in accordance with the specifications of the state plumbing code found at 248 CMR,
Name of Plumbing Contractor M i (& Plc Qr,a
License# / 9 4 s'I ?
Exp.Date 'S// /2 v z 4*Address 3-7Frc..,kt;.. 4..4' hi G' , /t2.4
No. Street City/Town
Signed: .' c /S-2 S-c., /in S/' /z o 1 c.
Plumbing Inspector License# Exp. Date
/ SEPo3202
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Revised Dec 2021