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Home My WebLink AboutBLDG-19-1024 S. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK tei ` "FiE c: CITY Yarmouth MA DATE I8116118 PERMIT# nae`/e1100.2 JOBSITE ADDRESS)2 Kencomett Circle J OWNER'S NAME Albert Mercade I GOWNER ADDRESS I Po Box 571 Lancaster,MA 01523 TEL 978-870-0734 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL❑+ PRINT CLEARLY NEW U RENOVATION:❑ REPLACEMENT:L PLANS SUBMITTED: YES NOQ APPLIANCES 1 FLOORS–. BSM 1 2 3 4 5 6 7 6 9 10 11 12 13 14 BOILER IIMINIIIMMIIIIIIIIIIIIIIIIIIIIIIIIIIIII.IIIN BOOSTER111111111111111111111111111111111111111111111111111111111/111111111111111111111111 CONVERSION BURNER 111111111111 INNIIIIIIIININIIIIIIIIIIIiii 111111111111111111111M COOK STOVE 1111111111111111111/11111111111111111111111111111111111111111 '1111111111111111 DIRECT VENT HEATER IMIIMIIMMIIMN..IIINI------ ---IIIII— DRYER /11.1i11111111.1111 M®IIIII IIIII Ina. FIREPLACES NININIMININNIIIIIIIIIIIIIIIIIIIIIIIIIIIMIN FRYOLATOR 11.11.1.5IIM MENNE IMMIRMIIIIIIIIIIIIIIIII FURNACE NININININIIIIIIIIIIIIIIIIIIIIIIMMINIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII GENERATOR MM -- GRILLE 'IMINIII 11111/111INN ' MIIMM111111111111111111111 INFRARED HEATER NMI 1111111111111111111111111111111111111111111111111NNIMM11111.111111111 LABORATORY COCKS �N _IIIIIIIIIII_ � 1111111111111111111111111111111 MAKEUPAIRUNIT �� ®INIIIIIIII1i 1.111111 OVEN 111.111111111111 MIME 11111111111111111111111111111111 POOL HEATER 11111111111111111111111111111111111111111111111111INNINIIIIIIIIIIIIIIIIIIIIII ROOM I SPACE HEATER IIIIIIIIIIIIIIIINIIIIIIIIIIIIIIMININIMININIMININIIIIMINIIIIIIIII— ROOF TOP UNIT ,'1111111 NIMIIIIIIIIIIIIIIIIIIII®IIIII I=IIIIIIIIIIIII TESTNINIMINININININIMINIIIIIIMM1111011111111111111_ UNIT HEATER =MUM MINIM NIIIII IIII UNVENTED ROOM HEATER IIIIIIIIIMMII ®NM III Mani WATER HEATER MI N. 111111111111IN OTHER — — ®1111111111 ® — — NM SSW I NM 1111111111111111111111 INIIIIIIIIIIIII 1111111111101111 FIMINIMI .—a— �NINSI __ 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 D OTHER TYPE INDEMNITY ❑ 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. • EC 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 appli ' ra est of my knowledge and that all plumbing work and installations performed under the permit Issued for this application will !i T e .11 - S'-' - - - -- Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Asp PLUMBER-GASFITTER NAME William B.Holmes I LICENSE#[4592-M J SIGNATURE MPD MGF❑+ JP❑ JGF❑ LPG!❑ CORPORATION❑# 043585106 PARTNERSHIP L.S#L J LLC❑#I COMPANY NAME: RCA Electrical Contractors Inc. ADDRESS[381 Old Falmouth Road,Unit 13 • CITY Marstons Mills STATE MA ZIP 02648 TEL 508-428-0449 FAX CELL JEMAIL ellen c�rcaelectdc.com____ ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT 0 0 (n/ `` /// FEE: $ PERMIT# y I le� 7al r /67 PLAN REVIEW NOTES e/A.