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Home My WebLink AboutBLDG-21-007419 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE June 21,2021 PERMIT# BLDG-21-007419 JOBSITE ADDRESS 39 CENTER ST OWNER'S NAME BOSKEY HILLARD M G OWNER ADDRESS BOSKEY MARGARET M 39 CENTER ST YARMOUTH PORT MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL 0 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 1 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❑ 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-GASFITTE R NAME 'LESTER WADE _LICENSE# 4569 SIGNATURE MP❑ MGF Q JP❑ JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP ❑# Lc ❑# COMPANY NAME: LESTER J WADE ADDRESS. 22 CAPTAIN ISIAHS RD, CITY COTUIT STATE MA ZIP 026352702 TEL FAX —1 CELL EMAIL I 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 ft.iASSi',CHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK �>~, -' ;;., ( -} -}- MA DATE q AF PERMIT m ��L. 1 t -vo r ,`�� CITY i jet._ ��1 �� ~t � C � +' JOBSITE ADDRESS r7, 71 Ce 14-e i, 51 - DOER'S NAiviE I -i l 1 30 5k c ty 1,1 OWNER ADDRESS 1 stcL. 6-(0oV2. TEL c ) q- 96e-t,34,, 4., FAX TYPE OR �- OCCUPANCY TYPE COMMERCIAL J EDUCATIONAL IT RESIDENTIAL cLEARLy NEW: �j RENOVATION: I I REPLACEIv1'.NT' PLANS SUBMITTED: YES El NO APPLIANCES -]. FLOORS- 1 BSM 1 12 3 1 4 5 6 I 7 f 8 1 9 1 10 J 11 ( 12� 13 14 BOILER L..—----.=----,1 F! l; r %! r i �� , is _.__ i r I` i y _ .t, -----� BOOSTER ] f 'i�- �' _ iil r_— _ _ �l_ ' CONVERSION BURNER 1i .� i __ ; ( _ i __ __ ; t= r, —A--- —.----�,.—-----;:.-. 1.------I ---t,----: ti—.—.—._` ' _ ., -c.v COOKSTOVE i 1 +1 ,, •11 IL_ ',_ .1`_._. Imo-fi-____ _' __t1 ' DIRECT VENT HEr.T EP Ii .� _.� ! -W---! ----`-----��kt- =Wit_-�� ._ , DRYER �l _ II = = t. a _ _�[ 1: -._._ _ � _1«t --,;--_.'� "ice ,,= e g FIREPLACE ti I - " --- '! -" -- - :I J) ii __ _ . FRYOLA.TOR �i :{ »__-�_ _-- _ --a n---'= T �-- �I ---�.al _ • I _ LT � l �� i FURNACE „I. �) - :i .. ..___ --___ ,�-.--=�--j` _ '' _: ,-.. _-�j -...., GENERATOR OR �..��;_-�,=--- •�� ' ';; ` �'� _��--.._ r, -- ��- ... !�..._.- t+-- - '} �� --- � L �'f ....—._i�•11 a 11 �iI 'i • is 9 GRILLE ILA �� i� ;,_ ,I INFRARED HEATER Ii �I � `, .,; _ : ). ^� �C ►1_.__z 7 _.. . _ ii . ....,._{ LABORATORY COCKS i ti : _ I - -- C I MAKEUP AIR UNIT 11.7- 11 - I; {` =--ir- ..._. j. II _ J i ii - I;I POOL HEATER ' --L 11 �' -,__. — J. r --- .— 1 ' ROOM / SPACE HEATER I! _�__ 1 '11!.�. _._iI 1.______� ---'✓i- - . .! '� 1 J1 �' P- ROOF TOP UNIT I 1 -__ � � . � �I .-_ � ._I�_ ,�..__..._.,,..1.�. .-I.. It s TEST y ' 'I —�'' it I{ .._._.-__:�..� .._:;j. �.._- UNIT HEATER I ( I :a w t�. i iI Ir ii... �i:..�..... :,I . UNVEN T ED ROOM HEATER I i • i .. `I _ n:. 4_ iL ':1-.. --•in ti��_ - .: __,t?:r1:::1+s •'.-"'� WATER HEATER _ -;l _._ . '' `' .. f:i .1-,ii .i.,..._.__-;-- ..J._._._�: ._, OTHER HER �L� ;; _.._IL_ _.__ ,t {—��I- l...__.1.:. _. ..� 11 -— -+-r- . : -- --- ti d 1_ -—.—, r + IL it - ._.. ..i_.TIC irl. ', ��t_ [l 'u r.. . �� I INSURANCE COVERAGE I h ave a cun-ent l• liability insurance policy or its substantial equivalent which meets the requirements of IMAGL. Ch. 142 YES 1`10 , I IF YOU CHECKED YES, PLEASE INDICATE_ THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE Sty,': BEL0'AU LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY I II BOND I 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 1 &GNATUE OF OWNER OR AGENT 1 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 I;nowiedge and that all plumbing work and ins:allatiors performed under the permi: issued for this application will be in co , plianze with all P c• anent provision of the Massachusetts State Plumbing C.ae and Chapter .142 of the General Laws 4,:ey/ i.,„-ee 1 LICENSE #� 4549 Cl SlGNA I URE PLUMBED-GASFI'TTER NAME LLce4cr' it;a-et G- MP [ [ IviGF 12' JP Eji JGF fl LPG' [ CORPORATION riT( ! PARTNERSHIP I 1,-Li{ ; LLC r-7- `f- PRESS I 23 +��",,,txtc on R_.i • COMPANY NF�iviE:I(�� Lt � �,1c��2�'t�l:.��r. p CITY I 11M 5l,t e C... j STATE 1 MA I ZIP I Oa(,. i(i I1ELi5s ' 7 F 1 ___1 -ELL{503-15T " JEMAILI tf ei, C.c: i p 1e.,,,e_rrr-• M 1-'a , Cz. ►'11 ` t