BLDG-19-000906 mkt-7m /(
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
311s CITY ;SOUTH YARMOUTH 1 MA DATE r 8/13/18 —I PERMIT#,.4t/)&/f''O0O&
JOBSITE ADDRESS!30 GENERAL LAWRENCE ROAD I OWNER'S NAME I HILL 1
GOWNER ADDRESS '30 GENERAL LAWRENCE ROAD I TEL 508-619-7770 FAX!
TYPE NOR
OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL'a
CLEARLY NEW:,J RENOVATION:J REPLACEMENT:J PLANS SUBMITTED: YES!_] NOa
APPLIANCES 1 FLOORS-. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER ' " , II
BOOSTER I --,E -- �1' ' " - � ''�I .55,55,57:.
CONVERSION BURNER I " �'i� n H S
COOK STOVE T ffi'
DIRECT VENT HEATER ' — I T
DRYER � t' � �
FIREPLACE _ — '
—. �'�;.--- T — - -- - - .�
FRYOLATOR �' �''� ��
FURNACE �I � '�,
GENERATOR 1 s^ �"^ _P� _�_.,4
GRILLEI , ._.e...! _._ _._ _I ..� ..� . __.-.. ,"_
-.--- - ,�-_,_ - _-..Y'- __
INFRARED HEATER _ �_ _ _ ' �.
LABORATORY COCKS , ;I — 7 t:- s,
-- �.'m.T -. - --rn- -n._s / A
MAKEUP AIR UNIT I- °' r ' f I + I
----r-.''I— _.....-..!' , .......-'"7"'' T"....e.,r _-._r% _-_-r...
OVEN I ' ri r i I , I, i
,— ----�._ . _.- .. —
POOL HEATER 'S I
ROOM ISPACE HEATER I s
ROOF TOP UNIT i
• TEST 1
.-.-T- ---- -S-,P-v.. -.�-�. —.-r "-r .S" ,. -,-_ -
UNIT HEATER I I. I'�—H I ,i ,' I
..�.. _T . ____._ --....._. _--__ _...— -_.�. .-..... . r...-, ... ......7.-..,
UNVENTED ROOM HEATER I—' 5'!� _ ,,'�„ �' 11 , I
WATER HEATER -
OTHER ! _ _
jIi - ! -" - I -- II ",, „ - ,, -- , t
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q NO IJ
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY J OTHER TYPE INDEMNITY 0 BOND 0
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 �,f AGENT I,_,I
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 th best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be i m liana with al Pe in t provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. C/ ' y^�
PLUMBER-GASFITTER NAME i ADAM TRAYNER LICENSE#,3880 NATURE
MP IJ MGF la JP J JGF J LPGI J CORPORATIONJ#1173 1 PARTNERSHIP'# LLC O#7----1
COMPANY NAME:'ROBIES HEATING&COOLING ADDRESS!279 YARMOUTH RD
CITY !HYANNIS I STATE MA I ZIP 02601 TEL'508-775-3083 f
FAX'508-534-1272 ]CELL'508-775-3083 EMAIL!MARY@ROBIES.COM ---------
----
-_- _--`____ ___I
ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
pet 6g D� Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ El ` y/Aj //1
PERMIT#
in_ ���, /L FEE: $ PLAN REVIEW NOTES OMMIT
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