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Home My WebLink AboutBLDP-19-001068 PMP : (cr. 1'�'1°RRCee. : ,.cs, MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK �L r CITYC..__ - y gi 1 b ll i (-1 _-1 MA DATE FITIT1 PERMIT# P-99-470 AA( JOBSITEADDRESS IF I Monroe L , I OWNER'S NAME !_'ri c, Cwr1nson P OWNER ADDRESS I TELko1)17(s-n 117 f FAX TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL 0 RESIDENTIAL PRINT CLEARLY NEW.© RENOVATION:DI REPLACEMENT:Ir PLANS SUBMITTED: YES 0 NO❑ • FIXTURES 7 FLOOR-' BSM 1 2 3 4 5 6 7 8 9 10 j 11 12 13 14 • BATHTUB T• �t - ; - S CROSS CONNECTION DEVICE �, Sat NM DEDICATED SPECIAL WANTS SYSTEM ��, DEDICATED GASfOIUSAND SYSTEM �,; lalOSIIIMI DEDICATED GREASE DEDICATED GRAY WATER SYSTEM apt ri _ ;, DEDICATED WATER-I-tuna SYS i tNI I; i_ -n k, DISHWASHER I ----iz Ii I ,. � DRINKING FOUNTAIN! ,,, i, I � � FOOD DISPOSER 1 I 'E--; -I■ I r, I IJ al FLOOR/AREA DRAIN I `1/44 1 SN' ' I� INTERCEPTOR(INTERIOR)n} , I , KITCHEN SINK - a OM LAVATORY •-• ■— - ROOF DRAIN i i �■ a--1 1 i i si•a---- r----, SHOWER STALL, r+, 1------1-"II m i r SERVICE/MOP SINK_ , TOILET `, :_ URINAL WASHING MACHINE CONNECTION 111.1, M WATER HEATER ALL TYPES 64 WATER PIPING ' t r �_„_...,�,6__-i OTHER - - r .. ti al, INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES dN0 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 1! • OTHER TYPE OF INDEMNITY Q BOND OWNER'S INSURANCE WAIVER:lam aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement CHECK ONE ONLY: OWNER 0 AGENT • SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work end installations performed under the permit issued for this application will be In co:,,esancu withall Ion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME iS/PU:r ID t+J.7ri Ci 9- 1 LICENSE# I(hot.0 - SIGNATURE MP Ba JP© nJ CORPORATION�f#;SO Ce JPARTNERSHIP®# LLC[# I • COMPANY NAME ia/,A M'R,,• r A} P. TAr,, I ADDRESS I 11 ('J ' f:), -1/ I • CITY W. '/G.rn.ov4A ISTATE 1W ZIP 02 c' f 73 TEL (5 D2 i)-7-7i, 4556 I FAX as "el e-ufiEEJ CELL to))314.37 EMAIL I era ( plumb C 01 e_AS4 0 0 PA • J • • u,11- ku\k) = � � . . , 2 iPti-A.- -s.. .8://„.97://fi. -: 1 • .. . J . - i 1 p74P ,oA/P c e-/ • ._MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK :%.%--5--- '• CRY,Taw —7/AO"( n(J1-1-1-1 MA DATE '„L I PERMIT ft tha/?rod/Oft �(�t JOBSITEADDRESSI # I Monroe., 1,n, 1OWNER'S NAME I Fr/c. Scawcnson 1 LT OWNERADORESS 1 • 140977A-O:I7IFAXS TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL® RESIDENTIAL 1 ' PRINT Cr EARLY NEWQ RENOVA110N:Q REPLACEMENT:2 - PLANS SUBMITTED: YES 0NO0 APPLIANCES 7 FLOORS Bs4 1 2 3 4 S 6 7 ` a 9 10 0 11 I 12 13 14 BOILER - OM'S qU BOOSTER ' I ( _ _ , CONVERSION BURNER JUMPS - COOKSTOVE - ' I .._ DIRECT.VENT HEATER 111111F Melt DRYER r a*."...., � gal.iS '. FIREPLACE 1 r I _---_ - FRYOLATOR I • FURNACE • GENERATOR I - 1 '- t �,l. . : sie 1=1"1111111L GRILLE I 1 r.v , it i _,= car-rtr'fi. ,,v717 ton ; � • L INFRARED HEATER' 0 , I LABORATORYCOCKS• I =;-.Letr ort MAKEUP AIR UNIT I l t t i so � .- , i OVEN' L J7 ; / , /lb w - POOL HEATER . .a -, , - ROOM/SPACE HEATER J ROOF TOP UNIT TEST UNIT HEATER , UNVENFED ROOM HEATER - r - . -WATER -EATER--- - -- 4 _ , - # --I - OTHER 1. t I INSURANCE COVERAGE I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch.142 YES Q�NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UABNTY INSURANCE POUCY I,ELIROTHER TYPE INDEMNITY© BOND Q OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit bpplicatlon waives this requirement • CHECK ONE ONLY: OWNER Q AGENT 0 SIGNATURE OF OWNER OR AGENT • I hereby certify that all of the details end hrfwmatlon I have submitted or entered regarding this application are true and ervaate to s best of my Imowledge and that ell plumbing work end Installations performed underthe permit limed for this applladfon will be In ampfanee ii a prevision of the Massachuselts Stats Plumbing Code and Chapter 142 rtthe General Laws. C -'-5<;fr - PLUMBER-GASnTTER NAME}keV;n 1Y1 C r:tie.. 9 LICENSE - 1168 0 � SIGNATURE Ml' P©MGF© JJGF Qt LPGI0 CORPORATION[l# a 86• C. PARTNERSHIP 0/4 I t1.c D# • COMPANYNAME leonmA rtAe. Plum*Ike} Sncc4ADDRESS 1 II (]ncjr.Gr4 P4A 1 • CITY I.V. Y.nerne)oat • I STATE rThZ1P • . G. 3 TEL! (sot)-t71- 4 566 1 t • FAYe,!o'r)79o-67s61CR4 l` w.i - • • V • .'VAD ._ _ . . - _ :. . . r. ` 1 � `. �..