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Home My WebLink AboutBLDP-19-001183 Unit 204 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ilia CITY West Yarmouth MA DATE 8/21/18 PERMIT#/1/49/117-00 00/!CS 5D JOBSITE ADDRESS 345 Camp Street,Unit#204 I OWNER'S NAME Ravenswood-Charles White Management POWNER ADDRESS 330 Commonwealth Ave,Boston,02115 TEL 617-267-1283 IFAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL El PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:Q PLANS SUBMITTED: YES❑ NO0 FIXTURES T FLOOR-. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB I 1 I I I 1 i I CROSS CONNECTION DEVICE _, r r ant I DEDICATED SPECIAL WASTE SYSTEM 1— DEDICATED GAS/OIIJSAND SYSTEM DEDICATED GREASE SYSTEM , i i DEDICATED GRAY WATER SYSTEM I DEDICATED WATER RECYCLE SYSTEM DISHWASHER 1 i I i DRINKING FOUNTAIN i i iI FOOD DISPOSER I ; FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) I iii i KITCHEN SINK LAVATORY ROOF DRAIN SERVIESTALL . 11 1main1 ,STALL 1111111 SERVICE/MOP SINK TOILET URINALI I I WASHING MACHINE CONNECTION i I I I I - I I WATER HEATER ALL TYPESI i WATER PIPING I 1 I OTHER r I _I I i i I I I I t i 1 i i I I I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES❑ NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UABILITY INSURANCE POUCY❑+ OTHER TYPE OF INDEMNITY 0 BOND ❑ 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 application waives this requirement • - CHECK ONE ONLY: OWNER ❑ AGENT 0 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 and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 71404 Rott4i PLUMBER'S NAME Frank W.Roderick LICENSE# 7794 SIGNATURE MPQ JP❑ CORPORATION Q# 1762-C PARTNERSHIP❑# LLC 0# COMPANY NAME Rusty's,Inc. ADDRESS 222 Mid-Tech Drive CITY West Yarmouth STATE MA ZIP 02673 TEL 508-775-1303 FAX 508-771-9310 CELL EMAIL mburke@nistysinc.com 927934tl Ept„ _ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK cm • tw CITY West Yarmouth MA DATE 8/21/18 PERMIT#/.-4,'/I'6"1 al,_ 50 ' JOBSITE ADDRESS 345 Camp Street,Unit#204 OWNER'S NAME Ravenswood-Charles White Management GOWNER ADDRESS 330 Commonwealth Ave,Boston,02115 TEL]617-267-1283 (FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL RESIDENTIAL a PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:a PLANS SUBMITTED: YES❑ NOD APPLIANCES 1 FLOORS-. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER � I I y I � I A I CONVERSION BURNER ! II l I . COOK STOVE — �- DIRECT VENT HEATER i I` I '1 • . u 1 1 DRYER I IN 9 4-8 h—N FIREPLACE — 171 I FRYOLATOR 1—h 1 1 II— 1 k V B FURNACE — 1 1 1—I i 1—i 1 1 J GENERATOR i N i— — 4` GRILLE - b— 1 1 !I N 4 v INFRARED HEATER 1 rl I I 11 1 I 1 I I ♦i1 LABORATORY COCKS 1— d „-- — MAKEUP AIR UNIT I N 1 I 1 1 ,1—` 1 I — 1 OVEN t I 1 I I 1 I k I I POOL HEATER —I ROOM/SPACE HEATER I I I •I —.I ROOF TOP UNITI I N 19 '' TEST 1— I �1 k I UNIT HEATER i I 'I I .1 i UNVENTED ROOM HEATER — 1 I I I 1 I i i 1 WATER HEATER i i I OTHER I I M I w 1 1 .1 I I i— I 11 1 1 rI I ►1 1 'i it ni i I 9 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 LIABILITY INSURANCE POLICY 0 OTHER TYPE INDEMNITY p BOND ❑ 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 application waives this requirement. CHECK ONE ONLY: OWNER ❑ 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 and installations performed under the permit issued for this application will be in compliance allPertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Zaortr2 Roc4ue4 PLUMBER-GASFITTER NAME Frank Roderick LICENSE# 7794 ( SIGNATURE MP I MGF❑ JP❑ JGF❑ LPG(❑ CORPORATION[3# 1762-C PARTNERSHIP❑# LLC❑# COMPANY NAME: Rusty's Inc. ADDRESS 222 Mid-Tech Drive CITY West Yarmouth STATE MA ZIP 02673 TEL 508-775-1303 FAX 508-771-9310 CELL EMAIL mburke@rustysinc.com 927934 444- pc /11j- A-9 11,