HomeMy WebLinkAboutG-12-187 (20 Gooseneck Road) • .� SACHUSETT R NG
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t (• City/Town,Yarmouth MA. Date: 09/30/11 Permit# 1r�2 ' (a
"c% t Building Location: 20 Gooseneck Rd M#135P#1 Owners Name: Rice
G Type of Occupancy: Commercial ❑ Educational 0 Industrial 0 Institutional 0 Residential Cit
New: 0 Alteration: 0 Renovation: ❑ Replacement: ❑ Plans Submitted: Yes 0 No❑
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FIXTURES
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> V w z 0 -I i-- P la UJ uj Z O Z J 0 LL Iy., H W I"' F W B 6UILDINGDEPT
U O O tui t7 O 2 J O d C R FW-• 7 m > O �_
-SUB BSMT.
BASEMENT I
`r-FLOOR
2W0 FLOOR----"--
3°FLOOR
4m FLOOR I
I-5m FLOC " i
8m FLOOR
`7m FLOOR
t!2 FLOOR ( I 1
Check One Only Certificate#
Installing Company Name: Hall Plumbing & Heating, Inc.
&Corporation C-2803
Address:447 Old Chatham Road City/Town: South Dennis State: MA
0 Partnership
Business Tel: 508-385-9127 Fax: 508-385-6604
❑ Firm/Company
Name of Licensed Plumber/Gas Fitter:James Pazakis
INSURANCE COVERAGE:
I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL.Ch.142 Yes K No 0
If you have checked Yes,please Indicate the type of coverage by checking the appropriate box below.
A liability insurance policy a, Other type of 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 tht
Massachusetts General Laws,and that my signature on this permit application waives this requirement
Check One Only
Owner ❑ Agent 0
Signature of Owner or Owner's Agent
By checking this box U I hereby certify that all of the details and information I have submitted(or entered -garding this application are true and
accurate to the best of my Knowledge and that all plumbing work and Installations performed u • e •-milt Issued for this application will be In
compliance with all Pertinent provision of the Massachusetts State Plumbing d Cha• 142 of - General Laws.
Trty� ...de of License:
By (IS. umber
Title fiQ 1
❑GasMasterFitter
ensed Plumber/Gas Fitter
City/Town HJourneym• Llcber: PL-15030-M
�.APPRQYEQ(4FEI.CE.U.SEQNLYI LP Instal • a : um