The URL can be used to link to this page

Home My WebLink AboutBLDG-20-002566 �"'' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK Jwj CITY cc-„� l./ Q r:s3• �/� MA DATE ��/ PERMIT#�J '�® b� JOBSITEADDRESS �O a...- Doi a.‘..{-- Ave.. OWNER'S NAME Lo�.,.,.�..w �Qr„�� G OWNER ADDRESS TEL FAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL lk/ CLEARLY NEW:❑ RENOVATION: Ik REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO[J•-- - APPLIANCES J FLOORS--4 BSlul 1 2 3 4 5 6 7 ° 9 10 11 12 BOILER I3 1-4 BOOSTER • CONVERSION BURNER _ COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE I FP,1'CiLATOR !I FURNACE �� GENERATOR _______ GRILLE INFRARED HEATER J LABORATORY COCKS --i MAKEUP AIR UNIT • OVEN I • POOL HEATER - •ROOM SPACE HEATER ____. . R ROOF TOP UNIT Erg► ED TEST ... . . . ... . .. 1, P I? F-r•UNIT HEATER UNVENTED ROOM HEATER $ ` �� WATER HEATER �— OTHER BUILDING J�-PAKinnt T '� By f - INSURANCE I have a current liability insurance policy or its substantial equivalent which hicOhVmeets the requirements of MGL.Ch.142 YES 10 I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW • LIABILITY INSURANCE POLICY 0/ 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 1 Massathusetts General Laws,and that my signature on this permit application waives this requirement. �► CHECK ONE ONLY: OWNER 0 AGENT ID 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 ac rate 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 h all Pertinent provi ' of the \=` Massachusetts State Plumbing Code and Chapter 142 of the General Laws. LE j PLUMBER-GASFITTER NAME 6 (e-...-- . S is t r..--c- LICENSE#Z09 e( .1 SIGNATURE MP❑ MGF 0 JP JGF❑ LPGI ❑ CORPORATION❑it PARTNERSHIP 0 41-- LLC 0# COMPANY NAME ADDRESS 0tc_c,ci,._ Fo_f11 RCI , CITY (/Gr'G✓C v ---- STATE r7A ZIP 0 ?-6 cf- TEL 7754^ Z49--0WO FAX CELL EMAIL ad- �2OUGI3 GAS INSF�.—�rxQr�NQ ES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERivlIT ❑ ❑ • A tF / m FEE: u PERMIT# • PLAN REVIEW NOTES Pt Ei4 '40 ccf l/LQI AQA(14.02A, — 0". tio2, L12, 3. f$4:1)P j i= OD B. ( IL 10 25, ,k,& (� CLCIt„NOW- MA 01775 4400r ''`•�` APPLICATION FOR PERMIT City or Town: Yarmouth Date: 10/31/2019 Permit Number: 102538 In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made by: Address: 165 DIANE AVENUE/South Yarmouth, MA 02664 For permission to: Unvented Gas Heater Installation 527CMR 1.12.8.6 Name of Competent Operator: Berube/Glenn Sherman Cert. No. Date Issued-Rejected 10/31/2019 By (Signature of applicant) Date of Expiration: Fee: $5 0.0 0 $ Paid Due 139 165D01 ' ow— L!/1'11.QflL C/VWi AVIA14,02A, 1 I I .Q, a. A c/ULP, 11�wbJ it ' ti 03.0. &Jr, 1025, Ainiz 9 a d„Uato-, 01175 .*„.• IAA di PERMIT DIG SAFE NUMBER City or Town: Yarmouth Date: 10/31/2019 Start Date: Permit Number(if applicable) 102538 In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted to: Berube/Glenn Sherman For permission to: Unvented Gas Heater Installation 527CMR 1.12.8.6 Restrictions: Strict and complete compliance with all federal,state and local laws, rules, regulations and codes. Notify YFD before and after work is complete. At: 165 DIANE AVENUE/South Yarmouth, MA 02664 Fee Paid $ $50. This permit will expire on Signature of Official Granting Permit L� Title C APT, 1f is II_ lThis permit must be conspicuously posted upon the premises ►`. Page 1 of 2' . Robin Glenney From: Aaron Wyatt(aaronwyattOgreaternewengland.comj Sent: Thursday, November 07„201312:30 PM To: Robin Glenney':'Jennifer Shovlin' OMS FIREPLACE SHOP,INC. Subject: RE: Mass Approval numbers 277 WHITES PATH SOUTH YARMOUTH, MA 02684 Robin, Here's the link to the MA plumbing board site to look them up by product description or by manufacturer. h ttp://license.reg,state.m a.0 s/public/pi_prod ucts/pb_sea rch.a sp? type=G&manufacturer=Empire+Comfort+Systems% 2C+Inc&stype=spec&model=VFSV&prod uct=&description=&prize=50 here's the info and codes below. Empire Vented Decorative Empire Comfort Systems, VFSV16- 4/4/2012 4/3/2016 493004i3 Appliance Inc 4 Empire ______ .._ __. _— Unvented Gas Log Heater Empire Comfort Systems, VFSV16- G3-0413- Inc 4 4/4/2012 4/3/2016 4 90 • Empire Unvented Gas Heater Empire Comfort Systems, YFSV18- G3-0413- Inc 4__ 4/4/2012 4/3/2016 490 Empire vented Decorative Empire Comfort Systems, vFSV18- G3.0413- Appliance Inc 4 4/4/2012 4/3/2016 490 Empire vented Decorative Empire Comfort Systems, VFSV24- G3.0413- Appliance Inc 4 4/4/2012 4/3/2016 490 __ Empire "-- .AUnvented Gas LogHeater Empire Comfort Systems, VFSV24 G33.0413 . Inc4 4/4/2012 4/3/2016 Empire _._. ...__.-.. Unvented Gas Log Heater Incpire Comfort Systems, 4FSV30• 4/4/2012 4/3/2016 49-0413 W— Empire Vented Decorative Empire Comfort Systems, VFSV30• G3-0413- Appliance Inc 4 4/4/2012 4/3l2016 490 From: Robin Glenney [mailto:rob@fwwebb.comj i 1/7/)1113 100.100'd GI0dIHWI 850 83M Md i :71 o/n7_1n_.. ..