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HomeMy WebLinkAboutBLDP&G-22-004118 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK j-� CITY YARMOUTH MA DATE January 25,2022 PERMIT# BLDP-22-004118 JOBSITE ADDRESS 424 ROUTE 28 OWNER'S NAME TOWN OF YARMOUTH G OWNER ADDRESS 1146 ROUTE 28 SOUTH YARMOUTH MA 02664-4463 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ 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 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 1 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 INDEMNITYE 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 Al Cassano LICENSE# 9015 SIGNATURE MP© MGF ❑ JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: ADDRESS. 8 Fruean Ave, CITY S.Yarmouth STATE MA ZIP 02664 TEL FAX CELL 5087769536 EMAIL SID @,,CAPECODMECHANICAL.COM MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK , Ire; `l I!$ = _ ='^ "Ii CITY YARMOUTH *1 MA DATE;01/17/2022 PERMIT# ZZ JOBSITE ADDRESS'424 Route 28 West Yarmouth MA 02673 OWNER'S NAME I TOWN OF YARMOUTH Y.....4.a.mA.a saa` e..a•�n GI '1 TEL 508 398 2231 FAX' OWNER ADDRESS 1146 Route 28 South Yarmouth, MA 02673 �r TYPE PR NTR OCCUPANCY TYPE COMMERCIAL i,R EDUCATIONAL LA RESIDENTIAL El CLEARLY NEW RENOVATION:; ° REPLACEMENT _'�' PLANS SUBMITTED: YES, ,j NOin APPLIANCES 7 FLOORS—+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER 1 CONVERSION BURNER ' ® t COOK STOVE DIRECT VENT HEATER I MINI DRYER FIREPLACE FRYOLATOR I } r r URNACE--- ----- _� �. t 1 GENERATOR GRILLE 11.11110.1111017 I INFRARED HEATER LABORATORY COCKS ®N �• MAKEUP AIR UNIT _ I , OVEN POOL HEATER , ROOM/SPACE HEATER - 1! ROOF TOP UNIT 1 n: .. fir. TEST �I s' tr C: �:.,: _ 6 i .-, ., ..€ .,.�> -e ....:.,gin UNIT HEATER 1 € I UNVENTED ROOM HEATER WATER HEATER .,�__._._ .. _.. 1 , jugs INIMINSI Mail .__. OTHERa . low INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES [ij NO Li I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW t r' O ICY OTHER TYPE INDEMNITY BOND LIABILITY INSURANCE POLL i 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 U,., 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 a Albert Cassano LICENSE# 9015 SIGNATURE MP ! MGF JP JGF nj LPGILj CORPORATION i #`3016 1 PARTNERSHIPe#, LLC; # COMPANY NAME: Cape Cod Mechanical Systems, Inc ADDRESS 8 Fruean Warr CITY South Yarmouth 1 STATE' MA °ZIP 102664 TEL 1 508 776 9536 FAX j CELL�508-776 9536 1EMAILI tnfor�capecodmechamcal com ti-., , �vM..�. ...�-.. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK u CITY YARMOUTH MA DATE 1/25/22 PERMIT# BLDP-22-004118 �` -° JOBSITE ADDRESS 424 ROUTE 28 OWNER'S NAME TOWN OF YARMOUTH P OWNER ADDRESS 1146 ROUTE 28 SOUTH YARMOUTH,MA 02664-4463 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURFS • FLOORS—I BSM 1 2 3 4 5 6 7 8 9 , 10 11 12 13 14 BATHTUB 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 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 1 WATER PIPING 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 TYPE 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'S NAME Al Cassano LICENSE 9015 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ADDRESS 8 Fruean Ave CITY S.Yarmouth STATE MA ZIP 02664 TEL FAX CELL 5087769536 EMAIL SID@CAPECODMECHANICAL.COM '-1 ,,\ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK P.4_71 ,vir CITY YARMOUTH MA DATE 01/17/2022 PERMIT# z z `/ 1 f JOBSITE ADDRESS [424 Route 28 West Yarmouth, MA 02673 OWNER'S NAME[TOWN OF YARMOUTH OWNER ADDRESS 1146 Route 28, South Yarmouth, MA 02664 TEL[508 398 2231 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL' i„r EDUCATIONAL PRINT � RESIDENTIAL CLEARLY NEW: RENOVATION:, REPLACEMENT: 1 I PLANS SUBMITTED: YES 0 NOS, FIXTURES Ti. FLOOR-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE I € 1-~- illo1 7 DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM i i Jrii 1 ( ,1--- '011.111111111 DEDICATED GREASE SYSTEM l �� t DEDICATED GRAY WATER SYSTEM r _` ;I ,l ' ' _ ;. W I it �"..� (- --i --_ DEDICATED WATER RECYCLE SYSTEM <1 ef'"--"(I r €--'mil -._ . _° h DISHWASHER f ► {-' 1 1imuf i ---` DRINKING FOUNTAIN � x FOOD DISPOSER FLOOR/AREA DRAIN I---- ` r`� INTERCEPTOR(INTERIOR) I l I "`IT =, KITCHEN SINK 1, s- ;�- '1 LAVATORY _l ROOF DRAIN ..~ € 1 .-- , r SHOWER STALL I jr—IL , ; 11 it 1 I.. ` 9i 11 SERVICE/MOP SINK t ,� t $I__._. __-. t I, W:� TOILET URINAL I — I_ 1r_ I. WASHING MACHINE CONNECTION WATER HEATER ALL TYPES I` -1__ '� r, 77,ir, ' f WATER PIPING ,I .. lw _ _`' (m I . tf ,mom ... OTHER I -in t NM Win { _ t INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO ri IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY I OTHER TYPE OF INDEMNITY =` ) BOND €U w. 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 El AGENT t 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 Albert Cassano __ ...� - __... LICENSE# 9015 SIGNATURE MP riLl JP 0 CORPORATION rj#0016 PARTNERSHIPS# I LLC LJ#I COMPANY NAME Cape Cod Mechanical Systems Inc 0 ADDRESS 8 Fruean Way _-..... CITY South Yarmouth STATE MA ZIP 102664 TEL 1508-776-9536 FAX 3 CELL 508-776 9536 EMAIL info@capecodmechanical.com