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HomeMy WebLinkAboutBLDP-15-005562 y r , L g • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK = 17*r "01 Y` l� Y n Lr\ `mss � CITY MA DATE Ft-irk-Min PERMIT# /JL/IP'/S•A7rrat JOBSITE ADDRESS 47lk VVI I/11/V4pL4 I OWNER'S ,�Iy1E 07+447:61 OWNER ADDRESS Jam_ I TEELL , —k).1(61 (FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL a PRINT r� CLEARLY NEW:❑ RENOVATION:ID REPLACEMENT:112 PLANS SUBMITTED: YES D NOD FIXTURES 1 FLOOR-. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB "I ` CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM 1 DEDICATED GAS/OIUSAND SYSTEM I DEDICATED GREASE SYSTEM �' r _ DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN - FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR(INTERIOR) 111 — KITCHEN SINK LAVATORY ROOF DRAIN — - — - SHOWER STALL ' - SERVICE/MOP SINK TOILET URINAL WA IAIGffACHINFCONNFCTIO,! } - - - -- ,I - -WAETAFTEDD L`! W ERPIPINf3 — OT ER , MAT Ofi /111h ' a BUILDING DEPARTMENT i -ice INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES I] NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND ❑ OWNER'S INSURANCE WAIVER:l 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: r 't? ■ 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 true a•• :• o the best of my knowledge and that all plumbing work and Installations performed under the permit issued for this application will be In comp) ,,,�- Peril >• - •vision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Phillip Durfee LICENSE# 13774 r SIGNATURE MP[3 JP❑ CORPORATION 0# PARTNERSHIP/ '' ILLC[Th 3152 COMPANY NAME Durfee Plumbing&Healing LLC ADDRESS 2A Huntington Ave. CITY South Yarmouth I STATE MA ZIP 02664 TEL 508-0193078 I FAX 508-258-0592 CELL 508-801-8004 EMAIL phil@durfeeplumbing.com;joy©durfeeplumbing.com i7 ` i SJ, MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK a'airs ilikiL � CITY cfOktn "q�' / p�in� I MA DATE��PERMIT# te-oP ir-ed 5Chz ' JOBSITE ADDRESS �yy r Y lr'f�NI.&a {OWNER'S I 01 f avv t I G � M4- rf't OWNER ADDRESS E FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL PRINT ❑ ❑ RESIDENTIAL CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT** PLANS SUBMITTED: YES❑ NOD APPLIANCES 1 FLOORS BSM 1 1 2 3 4 5 8 7 9 9 10 11 12 13 14 BOILER BOOSTER — — CONVERSION BURNER r COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR 41/4.444� A , - GRILLE ,,, ` 1D I INFRARED�IFAT1R ? .fin\' I,Ik _ c MAKEU fRIJNIT „ s / ' OVEN POOL HEATER y ROOM ISPAC' : R !-ll11111111•1•111111; ,,-�� {p 'I �O ROOF TOP UNIT S—� ,M' c95P44"' ISWSIONS TEST ass I /�. 0 5555lt 5 UNIT HEATER r��y y�y �� __as / `' ,,,-/ 'S' *Miat . 111. \ .,r .•iutiliAl7i.t[i illi .�. 0.1. ,�0' S5iseE'f■■[siwiimii 0TE- , •TERL w ' �:nasa t•105555S �� L� • �_ 6 itiAa'11101�1 1/ 1111110.11•111111110111111101111111 nil® 00 OtS1 •11101100mi BU"-"."` 1 INSURANCE COVERAGE I h. eetwrrentllabiIty.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 a OTHER TYPE INDEMNITY ❑ 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 a e best of my knowledge and that all plumbing work and Installations performed under the permit Issued for this application will be in comp � ninent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Phillip Durfee LICENSE# 13774 / % vl 01:,-"-- MP a MGF❑ JP❑ JGF❑ LPG!❑ CORPORATION❑# PARTNE'.t-IP 0# I LLC❑+ # 3152 COMPANY NAME: Durfee Plumbing&Heating LLC ADDRESS 2A Huntington Ave. CITY South Yarmouth STATE MA ZIP 02664 TEL 508-619-3078 FAX 508-258-0592 CELL 508-801-8004 EMAIL phl@durfeeplumbing.com ot if