BLDG-19-002258 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
" ` CITY e.4470'61 7Ot--71/7 � MMS, DATE 43/07 PERMIT
JOBSITE ADDRESS 3.2 62/m Sa- )/J', OWNER'S NAME PA/euer%fie d/nrar2
OWNER ADDRESS TEL-y 24//-enn FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL 0 RESIDENTIAL r'
PRINT
CLEARLY NEW: /
Lt7 RENOVATION: 0 REPLACEMENT:0 PLANS SUBMITTED: YES 0 NO❑
APPLIANCES 1 FLOORS-. BSN 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER
BOOSTER
CONVERSION BURNER,
COOK STOVE
DIRECT VENT HEATER
DRYER _
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER _
LABORATORY COCKS .
MAKEUP AIR UNIT
OVEN
POOL HEATER •
a 70
ROOM I SPACE HEATER I d r ,: i f
ROOF TOP UNIT a211
TEST /. . . . ..
UNIT HEATER —
UNVENTED ROOM HEATER / • IL. `C
WATER HEATER
OTHER
INSURANCE COVERAGE
I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL.Ch,142 YES 2110 0
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE—/ BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY LAS 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 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 and installations performed under the permit Issued for this application will be In compliance with all Pertinent/ provision of the
Li) Massachusetts State Plumbing Code and Chapter 142 of the General Laws. -
PLUMBER-GASFITTERNAME (parre LOOS LICENSE fl23/76 SIGNATURE
INP ❑ MGF❑ JP
0 JGF[3- LPG!0 CORPORATION 0 fs PARTNERSHIP 0 it LLC❑it
COMPANY NAME��D , nog t1/4-7-024/3;7.--,447,7 yADDRESS 7o A'r e y ch•
CITY /Pion'S/c27 - ' A STATE/W4, ZIP 0244-/S- / �1 TEL 509- x/./20"CJG/ Z_
FAX CELL EMAIL] eCbc PHI pa 3d) pahco •can
D� A Wil./
ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes No
61%
Cj, THIS APPLICATIONSERVES AS THE PERMIT 0 0 th /�
zf�` l Y�/d,��, FEE: S PERMIT tI ` l MAA /�
PLAN REVIEW NOTES
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PERMIT
DIG SAFE NUMBER
City or Town: Yarmouth
Date: 10/15/2018
Start Date:
1
Permit Number(if applicable) 102395
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to: DC Cook Plumbing and Heating
For permission to: Unvented Gas Heater Installation 527CMR 1.12.8.6
Restrictions: Strict and complete compliance with all federal,state and local laws, rules, regulations and codes.
Notify YFD before and after work Is complete.
At: 32 GLEASON AVENUE/South Yarmouth, MA 02664
Fee Paid$ $50.00 This permit will expire on
Signature of Official Granting Permit Title 0-A 97-4 ) 4 do el
This permit must be conspicuously posted upon the premises
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I i VENT-FREE GAS
„ peaprwz--, eat ,,,42/7)44t ,I , DUAL FUEL HEATER
Warming Your Home. Warming Your Heart. MODEL #VFS2-PH2ODT/VFS2-L2ODT
t
rVFS2-PH3ODT/VFS2-L3ODT
1A WARNING:
This appliance is Patent Pending Dual
equipped for(Natural Fuel Technology
and Propane) gas. — 'lull u
Field conversion is �o �° ARA)
` . not permitted other O w ..r>%' ,
than between natural • � 0
'! ,y�
I3 IRS it
'' r �_ Dual Fuel
or propane gases. f-jjZt..;
iii, \
ANSI Z21.112-2013 Vii;
A CAUTION - FOR YOUR SAFETY
)'` A WARNING: IF THE INFORMATION IN THIS MANUAL IS NOT FOLLOWED
',"7", EXACTLY,A FIRE OR EXPLOSION MAY RESULT CAUSING PROPERTY
c °"> DAMAGE, PERSONAL INJURY OR LOSS OF LIFE.
t`'':
t`:
-Do not store or use gasoline or other flammable vapors and liquids in vicinity of this
or any other appliance.
' , WHAT TO DO IF YOU SMELL GAS
t; • Do not try to light any appliance.
• Do not touch any electrical switch; do not use any phone in your building.
• Immediately call your gas supplier from a neighbor's phone. Follow the gas supplier's
instructions.
. • If you cannot reach your gas supplier, call the fire department.
- Installation and service must be performed by a qualified installer, service agency or
3 4, the gas supplier.
iiThis is an unvented gas-fired heater. It uses air (oxygen) from the room in which it is
installed. Provisions for adequate combustion and ventilation air must be provided.
Refer to Air For Combustion and Ventilation section on page 8-10 of this manual.
INSTALLER: Leave this manual with the appliance.
CONSUMER: Retain this manual for future reference.
This appliance may be installed in an aftermarket, permanently located manufactured
(mobile) home, where not prohibited by local codes. This appliance is only for use with
propane or natural gas. This appliance is equipped with a simple means to switch between
propane and natural gas. Field conversion by any other means including the use of a kit is
not permitted.
cx7 Questions, problems, missing parts? Before returning to your retailer, call our customer
IC- u service department at 1-877-447-4768, 8:30 a.m. —4:30 p.m., CST, Monday—Friday or
kt
email us at customerservice@ghpgroupinc.com. IMVFSG2L -2017-03-13
;`F 1
1
T
h.
1 REPLACEMENT PARTS LIST
For replacement parts, call our Technical Service Department at 1-877-447-4768, 8:30 a.m. —4:30 p.m.,
I CST, Monday—Friday. a
1-5 z \�
1-4 1
a
1-1 oa , • Q9443 �`�) \'
I
1-2 1-3 -a
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•
ITEM PART NUMBER
No. DESCRIPTION onVFS2-L20DT VFS2-L3ODT
VFS2-PH2ODT VFS2-PH3ODT
1 Log Set(complete) 1 700-51018 700-M1018
1-1 Log 1 1 700-S1018-01 700-M1018-01
1-2 Log 2 - 1 700-51018-02 700-M1018-02
1 -3 Log 3 1 700-S1018-03 700-M1018-03
1 -4 Log 4 1 700-51018-04 790-M1018-04
1-5 Log 5 1 700-81018-05 700-M1018-05
2 ODS Pilot-NG 1 GZ20-30B GZ20-30B
3 ODS Pilot-LP 1 GZ20-29B GZ20.29B
4 Selector Knob 1 GZ20-17 GZ20-17
i; 5.1 Regulator,(NG)5"WC 1 CR-130(20k) CR-130(30k)
s' 5.2 Regulator,(LP)10"WC 1 GR-130A(20k) GR-130A(30k)
6 Ignitor Module 1 GZ20-32a GZ20.32a
7 Control Valve,EuroSIT 630 1 0630560 0630560
r.
ACCESSORIES
NOTICE:All accessories may not be available for all heater models.
BLOWER KIT - PBAR-2427 For all models. Provides better heat distribution. Makes heater
more efficient.
I(D
27
3 2 GLJ.4. _
') �
Ivy
VENT-FREE GAS
�� -� „eat DUAL FUEL HEATER
Warming Your Home. Warming Your Hearr.
(A-0-DEL #VFS2-PH2ODT/VFS2-L20D9
z.� VFS2-PH3ODT/VFS2-L30DT
A WARNING:
This appliance is Patent Pending Dual
equipped for(Natural S/ _� Fuel Technology
and Propane)gas. �'�- -�- ;(Uj a(A)Field conversion ism not permitted other i r
than between natural : ; -7.4
o , Dual Fuel
or propane gases. r„.1I)-
US
ANSI Z21.112-2013
A CAUTION - FOR YOUR SAFETY
AWARNING: IF THE INFORMATION IN THIS MANUAL IS NOT FOLLOWED
EXACTLY,A FIRE OR EXPLOSION MAY RESULT CAUSING PROPERTY
DAMAGE, PERSONAL INJURY OR LOSS OF LIFE.
-Do not store or use gasoline or other flammable vapors and liquids in vicinity of this
or any other appliance.
WHAT TO DO IF YOU SMELL GAS
• Do not try to light any appliance.
• Do not touch any electrical switch; do not use any phone in your building.
• Immediately call your gas supplier from a neighbor's phone. Follow the gas supplier's
instructions.
• If you cannot reach your gas supplier, call the fire department.
- Installation and service must be performed by a qualified installer, service agency or
the gas supplier.
This is an unvented gas-fired heater. It uses air(oxygen)from the room in which it is
installed. Provisions for adequate combustion and ventilation air must be provided.
Refer to Air For Combustion and Ventilation section on page 8-10 of this manual.
INSTALLER: Leave this manual with the appliance.
CONSUMER: Retain this manual for future reference.
This appliance may be installed in an aftermarket, permanently located manufactured
(mobile) home, where not prohibited by local codes. This appliance is only for use with
propane or natural gas.This appliance is equipped with a simple means to switch between
propane and natural gas. Field conversion by any other means including the use of a kit is
not permitted.
cx-s Questions, problems, missing parts? Before returning to your retailer, call our customer
NA service department at 1-877-447-4768, 8:30 a.m.-4:30 p.m., CST, Monday-Friday or
email us at customerservice@ghpgroupinc.com. IMVFSG2L -2017-03-13
1
•
10/162018 Accepted Plumbing Products Online System by Massachusetts Board of Registration of Plumbers and Gas Fitters
+ dim
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