Loading...
HomeMy WebLinkAboutG-13-1049 I 'k t . MASSACHUSETTS UNIFORM APPLICATION FORA PERMIT TO PERFORM GAS FITTING WORK $)-. CITY Yarmouth MA DATE 5/30/13 PERMIT# bpi-•i6vQ JOBSITE ADDRESS 327 South Shore Drive(South Yarmouth) M#266/L#118 OWNER'S NAME:Riviera Beach Resort GOWNER ADDRESS SAME TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 129 EDUCATIONAL 0 RESIDENTIAL PRINT CLEARLY NEW: ® RENOVATION:0 REPLACEMENT: 0 PLANS SUBMITTED: YES 0 NO0 APPLIANCES 1 FLOORS BSM 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 —FURW GENERATOR GRILLE INFRARED HE AI ER LABORATORY COCKS TIARECIFATRINIT OVEN POOL HEATER ROOM / SPACE HEATER - ROOF TOP UM!" ItSI deCEP ( 4 . . UNIT HEATER . • �r A 'iv I I -so •y. , 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 © NO 0 I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ® 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 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 •and accurate to the '-st of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance ith all Pertinent prove ion„quie Massachusetts State Plumbing Code and Chapter 142 of the General Laws. at. ' L _ _ PLUMBER-GASFITTER NAME:James Pazakis LICENSE#PL-15030-M ,V S TURE MP ® MGFD JP 0 JGF 0 LPG! 0 CORPORATION ® #2803 PARTNER; IP 0#Cha, LLC 0# COMPANY NAME Hall Plumbing & Heating. Inc, ADDRESS 447 Old Chai Tad 2 n P7 2 fl CITY South Dennis STATE MA ZIP 02660 TEL 508.385.9127c{ , MAY0 2013 u FAX 508-385-6604 CELL EMAIL HallTechnician(a)comcastnet I C) .4 "v.-. it", • :.1_, snow M3IA3II:NV7d A 11Wa3d .I $ :334 0 0 lIWa3d 3W.SV S3Aa3S NOIlVOIIddV 51111 oN seA S3.LON NOLLJ3dSNI 7VNId KLNO 3511 NO.LO3dSNI UUOd 3OVd SACC snow NOLL33dSN •