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HomeMy WebLinkAboutBLDG-22-006277 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ‘44,f CITY YARMOUTH MA DATE May 02,2022 PERMIT# BLDG-22-006277 JOBSITE ADDRESS 388 STATION AVE OWNERS NAME SALING HAROLD J III G OWNER ADDRESS SALING TERRI L 388 STATION AVE SOUTH YARMOUTH MA 02664-1835 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL El 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 1 FIREPLACE FRYOLATOR FURNACE 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 0 NO❑ IF YOU CHECKED YES.PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ OTHER OF INDEMNITY BOND ❑ OWNERS 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 Vincent Marino LICENSE it 15136 SIGNATURE MP©MGF 0 JP 0 JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP 0#F LLC❑# COMPANY NAME: BEST YET INSTALLATIONS INC ADDRESS. 10 Meadow Rd, CITY Spencer STATE MA ZIP 01562 TEL 5088852378 FAX CELL EMAIL permitsnabestyetinstallations.com S310N M3IA321 NV-Id #IIW2i3d $:333 ❑ ❑ lJIN2:13d 3H1 Sd S3A83S NOLLV011ddV SIHI oN saA S310N NOI103dSNI lYNI3 AlN0 3Sfl W103dSNI 2103 39Vd SIH1 S310N NOI103dSNI SVO H9l02i 9'_ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ,..!_ . -y � PERMIT # � � - � Z 77 CITY r c ''0 Q- 'i....r,7. aH ..�..,T�..�..T_._.__..•�.. MA DATE -_ , ao� JOBSITE ADDRESS Yl 3' %5..__.Y.�.. ..��;C�1. � . OWNERS NAME V G OWNER ADDRESS 1 .. TE , .' .YT_, .,.: a _.�...z _ � _ _ l07' a?�' FAX .�._ , r _� TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES 1 _ Nor-4 APPLIANCES Z FLOORS—+ BSM 1 2 3 4 7 8 10 11 12 13 14 , BOILER -.._ - 4. BOOSTER ' }_ I CONVERSION BURNER 1._ �� ,. COOK STOVE 1 IA . a __ DIRECT VENT HEATER DRYER 1111117 g FIREPLACE . . f �v. FRYOLATOR 1 FURNACE _ GENERATOR I GRILLE ,i li -L MI1li ____IM___,._ M-- i INFRARED HEATER f NMI-�- .. __., LABORATORY COCKS ______ MAKEUP AIR UNIT L . : OVEN _ ..�_w_. L l .. POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT a ------- . - ___ ---MIIIIIII. _ Minli. — ,iller TEST 1 ' IliiiiiiiiiniMillinillt, _ _ -__ UNIT HEATER Mit __ __.-- IIIIIIII�` -MIIW __ . _. UNVENTED ROOM HEATER ..._.�. 1 IlillillitillIM7 WATER HEATER 111.1110111M01111 --- � NE L OTHER s I___ _______________ _______ , _________ _____ 1 _ , 17:-.. .! _ 1111111M11.1•1111- NMI L _ _ _ _ ___ . — lailliMM1111111111111M. a INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES [7iNO I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW , 1S-b LIABILITY INSURANCE POLICY 1 OTHER TYPE 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. CHECK ONE ONLY: OWNER bar AGENT 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 alliert.nent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ott/W-(`P4fr6"------- - PLUMBER-GASFITTER NAME \ \\:: A\Ceje GA'{onu ,,iLICENSE # 51 3(0 1 VSIGNATURE MP L MGF J JP C:jj JGF ID LPGI 0 CORPORATION Er#Nts3c PARTNERSHIP[3# _ , ,_. LLC E#= V61- COMPANY NAME:bet - y1S IIG�--1-r . _.nOi ADDRESS 110 _ Ct Uu) . 1 CITY i --... P.v-\c ._�.... , _, _ STATEA ZIP 0 (oc _ . TEL Sea. - ,3 _. .x.,._. .� . FAX 32-135: _5:73,-,, CELL r ._.._.,. . . _._ EMAIL - .M.,t+S fu)F/u^A)U ,b e-i-_ r\s-kcii.1 1 Ct''t-(J_. _.. ..,.._ r., m _