HomeMy WebLinkAboutG-14-642 .tC ,. MASSACHUSE IF RM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
=6N1=zl CITY West YarmouthMA DATE 12-26-2013 J PERMIT# ��% o yah
JOBSITE ADDRESS 100 Lewis Road OWNERS NAME Thomas Demaio
GOWNER ADDRESS 14 Pierrepont Road Newton,MA 02462 I TEL 617-719-0984 FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL EI
PRINT
CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:CI PLANS SUBMITTED: YES NOD
APPLIANCES 1 FLOORS-' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER I i,' A .i i, H l ,^ r,
BOOSTER „-. , '— ', I': -- 1- a[ `
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CONVERSION BURNER i n ;
COOK STOVE 4 ' ., tl .„ 1
DIRECT VENT HEATER E 3 -vara
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DRYER
FIREPLACE1 . t
FRYOLATOR ... e m..- ,..__ , , ..,,..,�I
FURNACE tit w.�,,..-.
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GENERATOR i i i I i =,
GRILLE ,i I r, ,I ii , ,
INFRARED HEATER -,
LABORATORY COCKS I „,,5-1 _ - :- .- .'
MAKEUP AIR UNIT II W t @I
A .. S. m.� :�45•r .,.ar' �. X_.... .,. ..�. �,. ._...e .....av .. a e�-M ...�.. .. ..._:
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POOL HEATER
ROOM ISPACE HEATER Ir s.ara n
ROOF TOP UNIT , I
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UNIT HEATER ! 5 i t t li '>I
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MEIRIM` M
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DEC Q 7 2!
I `eta c -_`/"b INSURANCE COVERAGE
BY
I N • r •• vinsda—nanolicy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES D NO ❑
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY ❑+ OTHER TYPE INDEMNITY ❑ BOND Li
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 tr 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 co pli with II Pe nent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME Adam Trayner J LICENSE/4'10;1 NATURE
MP El MGFD JP ID JGF❑ LPGI❑ CORPORATION❑+ # 175 PARTNERSHIP❑#L LLC 0#
COMPANY NAMELCape Cod Gas Heat&AC Inc I ADDRESS 15 Jan Sebastian Dr Unit D3 I
CITY Sandwich STATE MA ZIP I02563 ITEL5085399303
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FAX[ CELL !EMAILinfo@capecodgas.com