HomeMy WebLinkAboutPlumbing Inspection Form 4/30/25 Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Registration of Cosmetology and Barbering
(off.—
�_;�'.E- 1 Federal Street, Suite 0600, Boston, MA 02110
https://www.mass.gov/ores/board-of-registration-of-cosmetology-and-barbering
617-727-9940
Plumbing Inspection Form
INSTRUCTIONS: This form should be completed only if plumbing work has been
done in the salon after purchase.
Date: G//3c! / 2
This is to certify that I am a Plumbing Inspector for (fcL-v h,cA,• 4-� ,and that the plumbing
Name of city or town
alterations or installations for:
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ame of Salon Applicant
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Street Number Street Name
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City State
are in accordance with the specifications of the state plumbing code found at 248 CMR,
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Name of Plumbing Contractor ii I v ->\ C z-I 'v
License# 3 2 Q. _
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Exp.Date 0 6, Of , •Q (
Address ,2��J C ff f'(tk-i 'Ql//J i
No. Street City/Town
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Signed:
Plumbing Inspector License# Exp. Date