HomeMy WebLinkAboutBLDG-23-7083 Co l V L C.:Aw.11e.0 AV I- I N A I
PROJEC- I ',
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
i_, CITY Yarmouth � MA DATE 6/15/21 I PERMIT# /3L ; " d 3'" 9oY
JOBSITE ADDRESS 11 Canary Lane _— I OWNER'S NAME Shea _ I
GOWNER ADDRESS 27 Mirage Cove Drive Rancho Mirage,CA 92270 I TEL 917-693-4218 s _ IFAX
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL j RESIDENTIAL 0
PRINT
CLEARLY NEW:D RENOVATION:® REPLACEMENT:El PLANS SUBMITTED: YES® NOE]
APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER 1 1 , AlI ' 1_ , l � LJ
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BOOSTER � I °i , L � .-�-E 1 ' ai
CONVERSION BURNER . � J 11... --..11 ._ III ,, _.� .�_a-., 11 .1 -- .. 1„ i-... .1
COOK STOVE
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DIRECT VENT HEATER
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DRYER 11 ._11. = J,..-F._-. I _ J1. 1L J _ I _J1. 1.....=.=,,...a
FIREPLACE ( -1 _ _I! g 33� 1� .,, 1 n.. ...L. . .,. -.A
FRYOLATOR r i . 1...,.,.]I_--jfaJ ,,,, . t. I LIJ _II _. r . �..
FURNACE 1- 1=1_. 1�.._,,- 1, Ji, .... L. 3. .� i� 1...,,,,, 11----, �_ ,R..�.
GENERATOR 11 � 'a? I_ IL . .., I. _._-_., L, J <_ 11 _._., I,. _.. _. __I1. .o .._I=1 _ ._ 1
GRILLE �1_ 1 .�...�JI1_rl 1 l t ! i..,, 1. . i
INFRARED HEATER EJ1..,,,.._J _ (�_„�_j� , __ 1 ,T A 11 _ _`-
LABORATORY COCKS 11 �� N�.. �� t
1�....._- m L._..., , 1i J__-a....,.,,..1 ;' 11_. . I Ji ..�,� 1�i _.. II
MAKEUP AIR UNIT 1. n �n., a,,` i.._,_,...-.. I1 e' 1F_ i ..,. 3 . .a1I 1_,. _
OVEN t 1 -A i 1,°.....�.,_ I. _e L. J t J �.....,.�..,
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POOL HEATER 41 �i '3 �, I
ROOM/SPACE HEATER mK,�- 1 _.71._ 1 ,.., ? -11.-—11_ 1 1. -.,
ROOF TOP UNIT L ►1,.., zfIs. Il '1. - I r. 1..�: .u.
TEST '1 (r-.: _ 1! r- t !i 1�— I J1....,.- 1
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UNIT HEATER tr _ i -1--:
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UNVENTED ROOM HEATER �� �i1 _ 11L—. ii .j . J�-`�" LT]
WATER HEATER _ tl ; �--li 4 ii
OTHER 7 1 v..
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INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES E, NO 2.:
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY = OTHER TYPE INDEMNITY 1- ; BOND El
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 i_71
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this application ar e nd ac rate to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in m li ce i all Pe . provis n of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME I Richard J.Whiteside j LICENSE# 15850 TURE
MP MGF Cil JP JGF, LPGI L CORPORATION ,#'3969 PARTNERSHIP # LLC #
COMPANY NAME:1 Murphy Services Inc I ADDRESS'34 Whites Path
CITY South Yarmouth 1 STATE MA ZIP 02664 TEL.508 760 1660
FAX 508-760-1670 CELL 1EMAIL cshea@callmurphys.com Il klaube@callmurphys.com