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HomeMy WebLinkAboutBLDF-23--003928 — MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE January 18,2023 PERMIT# BLDG-23-003928 t JOBSITE ADDRESS 6 WARREN RD UNIT 32A OWNER'S NAME XENAKIS GEORGE J G OWNER ADDRESS XENAKIS TONA M 6 WARREN RD YARMOUTH PORT MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL III PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:© PLANS SUBMITTED: YES ❑ NO ❑ FIXTURES FLOORS—> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE 1 GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER OTHER DESCRIPTION: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES El NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER OF 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. 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 Andrew Leighton LICENSE# 16130 SIGNATURE MP El MGF ❑ JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: ANDREW R LEIGHTON ADDRESS. 20 Brewster Rd, CITY W Yarmouth STATE MA ZIP 026735706 TEL FAX CELL EMAIL halloilcompanv(a.amail.com 0/551 __ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK -uli_ CITY Ur_ ',no LI NAIIIIIIIIInnll MA DATE / ///1 23— 39 Z$ PERMIT# JOSSITE ADDRESS _..._. ..? /'I' __._. .�OWNER'SNAME 'p-- — -- -- -.._.11 G OWNER ADDRESS 'i -- i• ' _ TYPE OR - � _ ..._ �ri_I'SbSr 39$_GSLo�F�xf PRINT OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL Li RESIDENTIAL(-- I CLEARLY NEW:0 RENOVATION:Li REPLACEMENT:giY` PLANS SUBMITTED: YES NO( APPLIANCES.1 FLOORS-4 8SM 1 2 3 4 wmair5 6 7 s BOILER 9 i© 11 32 13 14 BOOSTER CONVERSION COOK STOVE BURNER61917—•"1=1- Inallite --21 =1Ell—-I --n r DRYER FIREPLACE •' E_DIRECT VENT HEATER anans ,L7-1----a b an ► -�-� f 1—. - --i _ I:tttt INFRARED HEATER LABORATORY COCKS a-_,KOHMM—Mtliat MAKEUP AIR UNIT WillIMMF11011,MMININIMINgligililltiMillil POOL HEATER nittSiMMIMNISIIIMINCipttIMINOVIIIIIiii*IlMil TESTIIIIII ROOF TOP UNIT i _ ( I _ ..! IJ: I _ UNIT HEATER •_ UNVENTED ROOM HEATER ' - I a= WATER HEATER i. Jr- t f OTHER wa, , , ^p - ...._ — r -- -- 1 t - I _ .. _ ___i _ .= � INSURANCE COVERAGE _� ,.no,. � - I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO Ej I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY — OTHER TYPE INDEMNITY u BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage re uired b Massachusetts General Laws,and that my signature on this permit application waives this requirement. Y Chapter 142 of the SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER ® AGENT Li I hereby certify that all of the details and Information I have submitted or entered regarding this applicati are tru and cura o the st of my knowledge and that all plumbing work and Installations performed under the permit Issued for this application will e in com ianc with Pertin t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER•GASFITTER NAME . dig ems) - ,Utz T/yl LICENSE# i+ ... SIGNATURE MP i. ' MGF Q JP 000RPORATION `JGF Li LPG!U # r %_?y e, i PARTNERSHIP 0# 1.-7-1 LLC _Ej#� COMPANY NAME:� , �,� �t1Pe ADDRESS %��j CITY l So. < , , s _.___..._.._______-_. _._ j STATE ..ik-e_i9IZIP <".' LTi✓ __ TEL L fef: -'. 3 I FAX C�r,�'� � CELL - EMAIL I s. r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK w, e� CITY YARMOUTH MA DATE 1/4/23 PERMIT# BLDP-23-003630 3. ^;. JOBSITE ADDRESS 39 WEBBERS PATH OWNERS NAME WATKIS YACHA A P OWNER ADDRESS 39 WEBBERS PATH WEST YARMOUTH,MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL m PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURFS 1 FLOORS--, BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 1 CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTE DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY 1 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER WATER PIPING OTHER 1 OTHER DESCRIPTION:bar sink INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES❑ 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: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. 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'S NAME Dennis Gagne LICENSE 9804 SIGNATURE MP © JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME DENNIS M GAGNE ADDRESS 31 Cherrywood Ln CITY Marstons Mills STATE MA ZIP 026481761 TEL FAX CELL EMAIL gagnedmg5l@aol.com -'" RECEIVED /77A• P . LJAN 04 2023 1 P C e BUILDING DEPARTMENT _B - IPORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ,"_— CITY R MO ij.�P.� 1 MA .DATE 1 I a-3 0-Z 2 I PERMIT# JOBSITE ADDRESS 13 2 &IRAs 8 P.41 Pa.`I-e.. I OWNER'S NAME cle,\_. 1 U 1c. c i .OWNER ADDRESS TEL[ JFAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL . PRINT CLEARLY NEW:0 RENOVATION:11K REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES 1 FLOOR-0 BSM il 1 J 2 J 3 4 5 6 7 8 J 9 J 10 11 12 13 14 BATHTUB 1 CROSS CONNECTION DEVICE I •d DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM i DEDICATED GREASE SYSTEM f DEDICATED GRAY WATER SYSTEM • DEDICATED WATER RECYCLE SYSTEM ,i' DISHWASHER IMMI R. 1 DRINKING FOUNTAIN FOOD DISPOSER r FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK I LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET s .,. J I; I k URINAL WASHING MACHINE CONNECTION J WATER HEATER ALL TYPES numammuiww,mann, WATER PIPING OTHER (Zia.' 5 t rUl_ i , " IliliRil , INSURANCE COVERAGE : I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES(jam NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 1 OTHER TYPE OF 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 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 ll 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'S NAME Den At.S Y . C l�.A..e'• �'�"�"" N�TU !LICENSE# �n9�LI( � SIG TU MP JP❑ CORPORATION Vaiii alSet IPARTNERSHIP0#IIIIIIIII. LLC❑#J J COMPANY NAME'P l l Po\WIT P-i-A a L I ADDRESS) I.I C&mp -t- CITY Iv- 2 ItYV9 At 'STATE IMII ZIP I 0 06`2 j 1 ( TEL R a��'� FAX 1 I CELL O J EMAIL 1 .�NSQ A 3\G- 1 CZG(• Cei rrk J