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HomeMy WebLinkAboutG-14-775 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK I '°41� �" 7 CITY Yarmouth MA DATE 2/11/14 PERMIT# — 7 7 {V 1 JOBSITE ADDRESS 2 Reid Ave OWNER'S NAME Addington 1 1 GOWNER ADDRESS Addington TELI508-778-5124 !FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL 0 RESIDENTIAL Q PRINT CLEARLY NEW:❑ RENOVATION:D REPLACEMENT:Q PLANS SUBMITTED: YES© NOD APPLIANCES 2 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER InsistalatatiscatistISOMMIXIMUNKIMMIllin: BOOSTER NO1111111101111111111111.0111101111111111011.1MMISMIIIIIIIS CONVERSION BURNERi , COOK STOVE - ; ., DIRECT VENT HEATER _.. . ' DRYERlifimiitliniemialail._ ISM Ili— FIREPLACE FRYOLATOR iraillitillitillesiiMallitilliUMINSIMISIIMM FURNACE '1 S St11NIC1 GENERATOR 1 1I�1 MI11 1 I III GRILLE INFRARED HEATER 1 5555111 555 ,, M1 1I LABORATORY COCKS Mallail11l MAKEUP AIR UNIT I I111I _ OVENOmiiiiiii0.0111- 111.10111110111111.11141111111 POOL HEATER imillatissUivillimillallitilliarnitillitrialillitilitiliti ROOM/SPACE HEATER ROOF TOP UNIT illiiiiiiiMISSITHISSINWISMSNOrnaliii TEST 1ay1�11�y�S1111SS5fi� 11111 UNIT HEATER IS_YIIAIr11;�_ MIS7Illrlri_i lairar 11111e 1111111.111111M111110011.11:011.01011011111118.11111taillii IMO [5L?s'' Z�1AI � �i I1 infill' ' - .'' '111timill111l1111011111i1101111CI1111I1f11I1011111101111 111C111111_111_Ii1111t MN■ 1�0timu �>tcaIMM 111111 1 L� in1111EI1111111111111111 111111G11w1111111 BUILDIN 4�ft1'Sll� INSURANCE COVERAGE I ave atur -r . . .olicy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q NO D I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY []+ OTHER TYPE INDEMNITY Q 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 ❑ 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 Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. .. _. _ .. PLUMBER GASFITTER NAME James Papasodero I LICENSE# M3782 if SI k: -- MP❑ MGFQ JPD JGFQ LPGIQ CORPORATION 0# C171 PART•ERSHIPD# LLC D# COMPANY NAME: ARS/Heating&NC Services I ADDRESS 300 Manley Street CITY West Bridgewater .I STATE MA ZIP 02379 TEL 508-588-9025 FAX 508-588-1059 CELL EMAIL J FI'I