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HomeMy WebLinkAboutBLDG-23-002961 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK C: CITY IYARMOUTH MA DATE (November 29,2021 PERMIT# BLDG-23-002961 PI Y JOBSITE ADDRESS 11 HOOVER RD OWNER'S NAME (Peter Moulton G OWNER ADDRESS I TEL' TYPE OR OCCUPANCY TYPE COMMERCIAL -PRINT ❑ RESIDENTIAL ID 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 GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER 1 OTHER DESCRIPTION:replace piping 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 0 OTHER OF INDEMNITY CI 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 (Sean Oleary I LICENSE# 13957 I SIGNATURE MP❑ MGF❑JP 0 JGF❑ LPGI ❑ CORPORATION❑#I I PARTNERSHIP 0#I ILLC ❑#I COMPANY NAME: ISEAN F OLEARY I ADDRESS. 12 FABYAN RD,2 FABYAN RD CITY IPlvmouth I STATE MA ZIP 023602390 j TEL FAX I I CELL EMAIL advantageheataca(�gmail.com 111.1 P>IBASSAcHuSl=TTS UNtFORi1€1 APPLICATION FOR A PERMIT TO PERFORM I GAS FITTING WORK MA DATE r r`" PERMIT# 23 -- 29 c. 9 I� SI E. DRESS r� OWNER'S NAME f �l �6�(c), DEP.R9jFN .ADDRESS ..,.,..;` T TEL Ogs'FAX ?�J Er— PRINT CY TYPE I COMMERCIAL❑ CLEARLY EDUCATIONAL ❑ RESIDENTIAL MEW:❑ RENOVATION: ❑ REPLACEMENT: APPLIANCES PLANS SUBMITTED: YES❑ NO❑ BOILER FLOORS-� 111111ppriallerialaill 60OSTER 13 1h CONVERSIOIV BURNEP, - iliDIRECT VENT HEATER ---11111111a1111111EMI IIIN all =- ' DRYER --==- FIREPLACE FRYOLATOR _- -- GRILLE[11 --_� --=== - INFI;AREI:I HEATER —© _— _—� LABORATORY COCKSMil �-- - =__-- MAKEUP AIR UNIT _�_�_ POOL HEATER ____all In = ____�__-- © �liriliRoar-TaP uNIT _ alinallilialama UN _®®® ® IIIII LiIdVEIVTED ROOM HEATER --===-- WATER HEATER r�—__ 1.1111111111111.1.1111111111111 I have a current fiabl! insINSURANCE COVERAGEurance policy or its substantialRAGE �- I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVEequivalent BY hich meets the requirements of flBGL.Ch.142 YES I� �t0 CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OWNER'S INSURANCE WAIVER: OTHER TYPE INDEMNITY 0 I am aware that the licensee does not have the insurance coverage required BCha ND ❑ Massachusetts General Laws,and that my signature on this permit application waives this re i g 4 ed by Chapter 142of the • `:I requirement. •`-, SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER I—� ` I hereby certify that all of the details and information I have submitted or entered regarding ❑ AGENT 0 and at all plumbingwork performed and installationsapter under the permit issued for this application will be in complian �w(Ih all Pe b Massachusetts State PlumbingCode this application are true and curate to the best" and Chapter 142 of the General Laws. y knowledge PLUMBER_GASFITTER NAME n�► �'�sion of the MP 0 MGFLICENSE# 5 hi, 7s�// 0 JP 0 JGF[�LPGI ❑ CORPORATION � � � SIG -'� URE COMPANY NAME l 0 II CITY ' � % PARTNERSHIP❑�r � ADDRESS 6 CC�. j, STATE _ ZIP q3 /(� FAX CELL 6 I' k�� D �r TEL 66�' , -! (L �a1 . ,. , EMAIL U 4 L ( 6" 4 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ' c/ CITY YARMOUTH MA DATE 9/23/22 PERMIT# BLDP-23-001552 731 h JOBSITE ADDRESS 270 LONG POND DR OWNER'S NAME SPARGO SUSAN L P OWNER ADDRESS 52 TURNPIKE ST SOUTH EASTON,MA 02375 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL m PRINT CLEARLY NEW: 0 RENOVATION:0 REPLACEMENT:© PLANS SUBMITTED: YES NO m FIXTURES 1 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE 1 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 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 1 WATER PIPING QTHER OTHER DESCRIPTION: 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❑ 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. 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 Richard Whiteside LICENSE 1i6850 SIGNATURE MP © JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME Murphy's Services,Inc ADDRESS 34 White's Path CITY South Yarmouth STATE MA ZIP 02664 TEL FAX CELL EMAIL • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK n 57/ CITY 'YARMOUTH MA DATE September 23,202 PERMIT# BLDG-23-001551 it JOBSITE ADDRESS 1270 LONG POND DR OWNER'S NAME SPARGO SUSAN L G OWNER ADDRESS 52 TURNPIKE ST SOUTH EASTON MA 02375 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL PRINT ❑ RESIDENTIAL CLEARLY NEW: 0 RENOVATION:© REPLACEMENT:❑ PLANS SUBMITTED: YES ❑ NO FIXTURES FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER 1 BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/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 © NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY © OTHER OF INDEMNITY 0 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. 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 'Richard Whiteside I LICENSE# 15850 SIGNATURE MP 0 MGF 0 JP❑ JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: 'Murphv's Services,inc ADDRESS. 134 White's Path, CITY 'South Yarmouth I STATE MA ZIP 02664 TEL 15087601660 FAX I CELL I EMAIL ' •