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HomeMy WebLinkAboutGas Fitter Permit_BLDG-23-9523 - BLDG-23-9523 18437Associated Building Permit Number -- Type of Work to be Completed installing gas generator Project Cost (Do not include the dollar symbol [$].) 12400 Occupancy Type Residential Work to Start 10/10/2023 New true Renovation -- Replacement -- Type of Fixture Generator If Other, type of Fixture -- Location 1 Quantity 1 Please enter the Total number of fixtures (calculated by adding all of the fixtures entered in the previous section) 1 Gasfitter Name LESTER J WADE Business Name -- License # 4569 License Expiration Date 05/01/2024 License Type Master Gas Fitter Type of Business Corporation Corporation/Partnership/LLC License # 28-2953773 Mailing Address COTUIT, MA, 026352702 Gas Fitter Permit BLDG-23-9523 Applicant Lester Wade 508-477-8887 info@ccipgenerators.com Location 28 EGG HARBOR RD WEST YARMOUTH, MA 2673 Project Info Fixtures Total Fixtures Primary Contractor City COTUIT State MA Zip Code 026352702 Email Address info@ccipgenerators.com Preferred Phone # 5084778887 Alternate Phone # -- I hereby certify that all of the details and information I have submitted regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installation performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. true I have a current liability insurance or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Type of Insurance Liability Policy Are you an employer? Select from the options below. I am an employer with full and/or part time employees. Insurance Company Name Arbella Policy # or Self-Ins License # 4220090553 Expiration Date 11/20/2023 I do hereby certify that under the pains and penalties of perjury that the information above is true and correct true Liability Insurance Type of Insurance Coverage Workers' Compensation Insurance Affidavit Policy and Job Site Information Workers' Compensation Affidavit Signature