HomeMy WebLinkAboutBLDG-19-003196 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
® = CITY Yarmouth MA DATE 11/26/18 PERMIT#f/2Dk/Ir9" //V
JOBSITE ADDRESS 36 Channel Point Road OWNER'S NAME Norm Peters I
GOWNER ADDRESS Go Peter Moulton Construction TEL 508-385-8330 IFAX 1
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL❑ RESIDENTIAL ID
PRINT
CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES❑ NO❑
APPLIANCES 1 FLOORS-. BSM 1 2 3 4 5 6 7 8 9 10 i 11 12 13 14
BOILER isra
BOOSTER 1 I
CONVERSION BURNER _I I I _ I I II I I
RECT VENT HEATER iiIiiIiIiIiRihRI
FIREPLACE
FRYOLATOR 1, i
1
GENERATOR UlIllillu
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
II—
I lit
OVENI
POOL HEATER
ROOM/SPACE HEATER ,aim �nill:
ROOF TOP UNIT
TEST ! 0' mliii'
UNIT HEATER
1111111111
UNVENTED ROOM HEATER SIN OE PA ,TME IT MS
WATER EATERsou
OTHER ��
--- i it I I I I I I
1
1 { i , 1 i
1
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 ❑ 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 with all ertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
er
PLUMBER-GASFITTER NAME Stephen D.Ewing LICENSE# 15281 SIGNATURE
MP 0 MGF❑ JP❑ JGF❑ LPG!❑ CORPORATION Q# 3672 PARTNERSHIP❑# LLC❑#
COMPANY NAME: Edgewater Plumbing&Heating ADDRESS P.O.Box 656
CITY Sagamore I STATE MA ZIP 02561 , TEL 508-317-9680
FAX CELL 508-737-0077 EMAIL steve@edgewaterplumbinginc.com I
C lat)gAio 460 afrk
•
•
4
Pfl
4o 5-n --)-kfre-d-J
. . ._ .,.....,......,.,
. • - ,..
...,
Ir
•• •
.,-1`..
.. . . .
... . . ...... ... ....
,.•.•.•.....,„. .,.._,..,.,.,,,.,._ ,_..:.. ..,•••..,..,..,,....„.•••••••.........••••••:.....•••,•••...... . . . . .
;6.4
,.....2.:/..,.... ,,...`...,:.,...9,..,....'....i.:..,..,•:.. .r:,.. ../..i.iik>;.t ? ''-• ' -..:5'''X''' 5 ...' ffliiii*SI:41.....:j:,....:•:i:I..'::::::......... . ' '',Vi, • .'.. . ••••••'. .
.. . '
. , .
.1,!"-;tit'i;e.6.z.-.44.....4411..11,.,',.•;.:•i',::4--,7i;[,";':"'','''- . '' - -1.- i'''''',.P''''';'-'''''17.:'-7,-:',F:,..:,'.'',"
4:"::'"''''-i':'''f:A5.fi",(,Z.,;,tilr;!:;41"..-.17,'A.:4:044'-'',-1",--'' ''''',:'' '.''''''''..i..::,. .'.]:, .Flii,,,',,,,,',!. .,,,. • . . „ . , „:,,, ,„,,,,.i ., .
...,:"..:
:-';..",'' :.,''."'f:,..'",'"'""if,'"..41.T11,14.?4,..:04::,-, ‘""'... ' • ' • •-:::::"'',:".",.:::::"..:"T,:,...',.:',,-,.
..:
:., : .. "''. ' ,:r,;',,',...,:i.,,',E;;;! ' •
-,..
,.. „ ,....,,,,.... ..... ..„ •. . •
#4'.'•.. . ........:;... . '''''''',;;‘,.....:' t ' .
.... , . ,
... ,..:•-
..
. ..
.-:.- .. • ..
_•:... • .
.....„ .
•0E-• •
•
._... ,
-,.......,--- ----- • -
...,-.
c....;•:.
...i...
46.1110MINOMMINNIONOMMINENissumimik
....::
-.:'..• -
'. --.':i.;---,•::':';.c..70.'.-.&-'72--...- .=-.
. _,..._„.• . . .,...
.- .. .. . :. .• .... . ..
-•:,
. ......: ,...
.....:••.,,,„':-.:•,,
.... ,
,.,..,, -:-....,.....,,
\,..
..,--
....„..
. ' ..'Pft•-...'.•'''.11•Ws-,,,,,,f...s,,..':
...: '
..,::
. ..::. rT!111.1:11riiit'
..'illir..,3`...:','
.:,
-
,.
. .....,
-......_.,.._. _ .... ..,......„.
• . ..
.. . ... . _ .
. . .,
.. . . „:„..... •
. ......
. .......
.....,..,.. ...,,
• ..:.:::::,......,
. - :....!•?.:..........4.....;:•.•
. •..4::::,~4.4.,,,,,i,.1).:.,,,..,,,,,,
.•••.
.•'...;.11,:;- ,,,441:.;'.....,,,,k-,.&!....,-'1--',,,, . ... .-. ,,.:- . .
'.'--;.•':::::::.t4.4F.: 7.-- '...',
. . -.• . --:.'3:flif'eaM-,,I;;;F:',:--- •
.. !•
.. • .., :''.1.;'t".:-.:1;;:.V.4.-."." ^"', '
. ..
.:,•••'.......,Nff.-",.,if.L,.,T. .'",..,,
. .:-.. : •••. ::,.,..•*,g::;,..1.1-.
.:i::;'.....:'. ..'..:........Z...4:4-.'-= .:?..:-.,.
' .
••• --..
. .._,.....,... _
\••••-.......,... -
-.
... „......-.-,.--
'..j::.
4010100110
, -
.. . ..„.......,..,.....,. ... .,........... : . ,.,..,:iii.,...,,,.,...t,....,. ...,.........................::,,...z:. 1,-- ,ii 4.,,,!'
. ''-:•:-,,,,,,,,,,,,,,,,,,,,,,,,,,,,,...,,,..„..,..,...„„„„..,,..„,.„,...,..:.7„, ,„......._. .„,..., _. . .. ,
. . -........„.....„.„...
. ..,...„.....-...... ,
•
.„..... .„..-.:
....
-.-. • . .
'....,.,.-,!. .•.._.•,:.- -•
4,- ....
--....1.: , .. .
45---:
.-.----=---,
_...:
it 7
-='
•
......„i...:.:-
IV
_.
.:.. .
............:..: