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BLDG-19-001954 ••trie MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK I1a; CITY YARMOUTH MA DATE 9/24/18 PERMIT#/iZOfrr?' l /95` JOBSITE ADDRESS 1 SPRUCE STREET OWNER'S NAME SALLY OLIVER GOWNER ADDRESS 50 PRINDIVILLE AVE FRAMINGHAM,MA 01702 TEL 508-760-3442 IFAX TYPE OR OCCUPANCY TYPE COMMERCIAL G3 EDUCATIONAL [] RESIDENTIAL[ PRINT CLEAR NEW.Q RENOVATIOMda—REPLACEM , : O PLANS SUBMITTED: YES NOD APPLIANCES 1 FLOORS-0 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER , •• CONVERSION • : • _ ilLI I I I i COOK STOVE I j • r i. l DRYER FIREPLACE I L. ..i r FURNACEI _,. .- _ I . _ L. I :- t']- • I GRILLE 4, x ' INFRARED HEATER �. e...,. - �..' _ . ' p LABORATORY COCKS - • MAKEUP AIR UNIT L. I1- II 1 'ti 1 OVEN . .« . _ .. _ , POOL HEATER I i ... '1._ , r ; ROOM/SPACE HEATER 1 ,. ROOF TOP UNIT LI V;_... • I •m a l(_,., 1, it I TEST UNIT HEATER ._ . I 1- I' { ...._! L UNVENTED ROOM HEATER I LI" WATER HEATERt F £ OTHER 1_,_ I I`— + al I 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 ©+ 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 C •NE OLY: OWNER © AGENT 0 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and Information I have submitted or entered regarding this applicat. curate to e b of my knowledge and that all plumbing work and installations performed under the permit Issued for this application will • • a t all P inent pro ion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. • PLUMBER-GASFITTER NAME Richard J.Whiteside LICENSE# 15851 IGNATURE MPO MGF❑ JP Q JGF❑ LPG'Q CORPORATION Q# 3969 PARTNERSHIP❑# LLC©# COMPANY NAME: Murphy Services Inc ADDRESS 34 Whites Path CITY South Yarmouth STATE MA ZIP 02664 TEL 508-760-1660 FAX 508-760-1670 CELL EMAIL cshea@callmurphys.com /1 klaube@callmurphys.com au- ROUGII GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ f��jH/�L/ C.G, Q FEE: $ PERMIT# jC�� ��J PLAN REVIEW NOTES 1// v✓r