HomeMy WebLinkAboutGas Fitter Permit_BLDG-23-9662 - BLDG-23-9662 24495Associated Building Permit Number
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Type of Work to be Completed
REPLACEMENT GAS DRYER
Project Cost (Do not include the dollar symbol [$].)
1001.00
Occupancy Type
Residential
Work to Start
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New
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Renovation
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Replacement
true
Type of Fixture
Dryer
If Other, type of Fixture
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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
STEPHEN A WINSLOW
Business Name
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License #
12298
License Expiration Date
05/01/2024
License Type
Master Plumber
Type of Business
Corporation
Corporation/Partnership/LLC License #
3281
Mailing Address
S YARMOUTH, MA, 026641207
Gas Fitter Permit
BLDG-23-9662
Applicant
STEPHEN WINSLOW 508-394-7778 plumbing.inspections@efwinslow.com
Location
16 ELDRIDGE RD
SOUTH YARMOUTH, MA 2664
Project Info
Fixtures
Total Fixtures
Primary Contractor
City
S YARMOUTH
State
MA
Zip Code
026641207
Email Address
plumbing.inspections@efwinslow.com
Preferred Phone #
5083947778
Alternate Phone #
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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
ARROW MUTUAL
Policy # or Self-Ins License #
2019A
Expiration Date
01/01/2024
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