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Home My WebLink AboutBLDP-17-003258 I► ., 6-to 3cd-ir Nor *20 S , MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK I=.EIU=5 p -alit ;, CITY Yarmouth Port MA DATE 12/6/16 PERMIT# /-'07 093a2s' JOBSITE ADDRESS 14 Strawberry Lane OWNER'S NAME Joan Perera POWNER ADDRESS 13 Birchwood Lane,Lincoln MA 01733 TEL 781-259-8944 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL D PRINT CLEARLY NEW:D RENOVATION:❑ REPLACEMENT:Q PLANS SUBMITTED: YES 0 NOD FIXTURES 2 FLOOR-• BSM 1 2 3 t 4 5 6 7 8 9 10 11 12 13 14 BATHTUB [ FIl, I [ F � I F I CROSS CONNECTION DEVICE it Ir DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM i L I DEDICATED GREASE SYSTEM J i I i1 i DEDICATED GRAY WATER SYSTEM II U DEDICATED WATER RECYCLE SYSTEM lc1 DISHWASHERQ i i -- i DRINKING FOUNTAIN FOOD DISPOSER ✓I ir FLOOR/AREA DRAIN JP 1 I , INKITCHEN SINK (INTERIOR) �. ' KITCHEN SINK 1p, LAVATORY I 1 ROOF DRAIN i J �raw, ��l �I , II SHOWER STALL SERVICE/MOP SINK �I, " TOILETr , i 01 URINAL WASHING MACHINE CONNECTION _ I WATER HEATER ALL TYPES 1 WATER PIPING OTHER r imr r ,r- til I 1, INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABIUTY INSURANCE POLICY❑+ OTHER TYPE OF INDEMNITY ❑ 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 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 t e d accur to to he best of my knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in c, pli with all P inent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBERS NAME Keith J.Famham LICENSE# 11601 SIGNATURE MPU JP CORPORATION Q# 3698C PARTNERSHIP 0# LLC 0# COMPANY NAME South Shore Heating&Cooling,Inc. ADDRESS 57 Whites Path 1 CITY South Yarmouth STATE MA ZIP 02664 TEL 508-398-6901 FAX 508-760-2681 CELL EMAIL Walt ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ _ FEE: $ PERMIT# PLAN REVIEW NOTES r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK _[ mil"iia CITY Yarmouth Port MA DATE 1216116 PERMIT# /31-1V-1 7 043 $ JOBSITE ADDRESS 14 Strawberry Lane OWNER'S NAME Joan Perera GOWNER ADDRESS 13 Birchwod Lane,Lincoln MA 01773 TEL 781-259-8944 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL❑ RESIDENTIAL Q PRINT CLEARLY NEW: RENOVATION:El REPLACEMENT: PLANS SUBMITTED: YES 0 NOD APPLIANCES 1 FLOORS-. BSM 1 2 3 4 5 6 7 El 9 10 11 12 13 14 BOILER 1 �� I L 55_S BOOSTER . �� ,S— _ ,5 CONVERSION BURNER _5S'; � iM_r �S COOK STOVE MO 1.1111 Mat DIRECT VENT HEATER Sinai.MS 111.1 . DRYER SII INS eiraft� FIREPLACE initela[Me _�alni— FRYOLATOR MSS.isrs.■ . SEE STI ■■r FURNACE Sersmai SS ai S GENERATOR E TS[SP 5Sit Sat SUSS GRILLE r =MINE SOB Sense INFRARED HEATER oa. e LABORATORY COCKS I insammat ilias[on 4 MAKEUP AIR UNIT el= CC:Ew _aa IS OVEN SKS liSriff POOL HEATER r =ISElmatirianuin ale ROOM/SPACE HEATER r aS�Ij SS FS ROOF TOP UNIT r ' 5I��.,�' � TEST - �s San r r� i UNIT HEATER I Mia_ '[ Cee__ UNVENTED ROOM HEATER — ��r II I 1S*, WATER HEATER 1 iSSI OTHERa I—Men ISGSSS—S SI 11181'r Sim siSt �I�ff11�I�114�I111 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 Q OTHER TYPE INDEMNITY ❑ 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 ❑ 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 ?curate to the est of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli in t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Keith J.Famham LICENSE# 11601 SIGNATURE MP MGF 0 JP JGF❑ LPGI❑ CORPORATION D# 3698C PARTNERSHIP 0# LLC❑#_ COMPANY NAME: South Shore Heating&Cooling,Inc. ADDRESS 57 Whites Path CITY South Yarmouth STATE MA ZIP 02664 TEL 508-398-6901 FAX 508-760-2681 CELL EMAIL J 1 \ ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES • fi