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Home My WebLink AboutBLDG-21-003767 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ` j16 CITY YARMOUTH11= MA DATE January 07,2021 PERMIT# BLDG 21-003767 JOBSITE ADDRESS 114 STANDISH WAY OWNERS NAME OCEAN RESORTS MARKETING INC G OWNER ADDRESS C/O COLONIAL ACRES RESORT 114 STANDISH WAY WEST YARMOUTH MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL Q 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 1 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 El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER 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-GASFITTER NAME Thomas Coughlan LICENSE# 8529 SIGNATURE MP© MGF ❑ JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: THOMAS J COUGHLAN ADDRESS. 48 HERITAGE DR, CITY WALPOLE STATE MA ZIP 020812240 TEL FAX CELL EMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE:$ PERMIT# PLAN REVIEW NOTES a MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK Vlit-_—=--- s!"- CITY t 1 1-•7 1t. , . . . . I MA DATE /S -1 PERMIT# W`2I-Cb7(' I JOBSITE ADDR SS f eOaTiii , /9G ~eO e *I OWNER'S NAME : �,Fi Slt ��, y�¢6. 1 OWNER AD)Dk S ,� ,� _ ... _ S$ f 7s Q r'�3. FAX �: TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL'LI PRINT CLEARLY NEW: .____I RENOVATION: J REPLACEMENTS PLANS SUBMITTED: YES ._.J NO.X( APPLIANCES Z FLOORS-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER I ' I I I I I I —__I ..._._... _ I _____I._—__I ____I ____IBOOSTER - 1 .. I I I r I I _-_-i1 ____I_ __I ___ 1 — __IJ ____I CONVERSION BURNER I I I f I, I I I ! I I COOK STOVE I I I I J I _______I ___I_, ___ _____ __ _ _ _ ___ � _ I __I DIRECT VENT HEATER I I 1 I __1 _� I I I Imo! ______I _ DRYER . .. s . . . I- I.�. i __ I _ I. II i FIREPLACE - _I. I I _ I 1. . .. I 1 _ 1 I - I I I I FRYOLATOR ------ I - , � ._. .I,-- 1 _ s �� .. ... I . . I � -1 _ —-- -- - - _ _ FURNACE0 II .f. I - I --I I I i __ I J I I GENERATORGRILLE I I . ` �. I i .._ .._._! — —i - i .1 I ..._....__.I _.�.I ._..._. I I ___�, INFRARED HEATER j -_ ___ 1 _- I 1_.- . . _ J _�I -,;-_-....4 ..._ .. - I `� _� _ ____I —_ I I LABORATORY COCKS I } I . _ I I . I AIR UNIT ....__ ; , .. . : I -- . j; �. I _._.I _ I 1 r 1 _ MAKEUPVEN • _..._. 1 I �� .___..- J --- I _--I _.____! I. O _....�...► ..,____I ____._! - I ..... ! _.__ f _____I _ I _....Y_._I _ i ._..,._._i __.__ f __.-.____I i k POOL HEATER _._..I _I .__. I I I _I ' _I ...1 _J . I _ I ROOM / SPACE HEATER l -� ROOF TOP • ._� _- __.. I_ _._ _._ �___. _ -_ �:....:�. I I I UNIT .�._�...' ! I 1 , '° a i , I TEST T ; _._..___ _....._. ._... ,_ � -------1 ` _.�.._+ _ ; • UNIT HEATER _ ; _ i i t . i . _ , UNVENTED ROOM HEATER - _ _ 1 r �_ i -____. __ I I I M� _I , __J WATER HEATER I I. . I 1 -� �-_-- ---�: � �� r�..._. .l - . . __._._.I __..___.. �.._._1 I i OTHER , I I _ , _{ i _ _.�...._ t � � 0 h. __-.. __._, j ...:1.,! ; _ j _._._._._._i ._. 1 __ _..._i -.ram __i_ _ i 1 I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES NeN0 .3 I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY< OTHER TYPE INDEMNITY . BOND 11 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 i AGENT ._J 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 e Massachusetts State Plumbing Code and Chapter 142 of the General Laws. _ _ __.,• ..,r, •• y I •• ,_ j.., ,,,, -,... “,..1M1 M• :A.,I.:-a---...o....-,v. --.7---il PLUMBER-GASFITTER NAME � "i," �' � � LICENSE# Q'I in SIGNATURES MP MGF .21 JP GF J LPG! -1 CORPORATION ' 1# 4?O j~`W 1 PARTNERSHIP I# LLC COMPANY NAME:' � �� .._- l�1G•�',. __ L-I�Q/6 f ADDRESS �a i Sg7- - _2),ei,,it,---- 1 _.._._...__ . CITY tA" -'1.�. + STATE ZIP _ _� - �p r - - 'E --- 1 ' TEL � a C FAX ;=--- ------, — -- -- -- -- -- :- -•- ._ .__._..-- -._._. .. ... G I CELL: EMAIL: J ,�, (4-1_ , ge.- ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT 0 0 FEE:$ PERMIT# PLAN REVIEW NOTES 1