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Home My WebLink AboutBLDG-22-003307 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE IDecember 10,2021 PERMIT# BLDG-22-003307 JOBSITE ADDRESS 32 OAK GLEN VILLAGE OWNER'S NAME Judith Garcia G OWNER ADDRESS 32 OAK GLEN VILLAGE YARMOUTH PORT MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT❑ PLANS SUBMITTED:YES 0 NO 0 FIXTURES FLOORS—s 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 El 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 LESTER WADE LICENSE# 4569 SIGNATURE MP❑MGF❑JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC❑# COMPANY NAME: LESTER J WADE ADDRESS, 22 CAPTAIN ISIAHS RD, CITY COTUIT STATE MA ZIP 026352702 TEL FAX CELL EMAIL S31ON M3IA321 NV1d #IIWi`13d $ :33d ❑ ❑ 1IW213d 3H1 SV S3M3S NOILVOIlddd SIHI oN saA S310N NO1103dSNI 1VNIH A1NO 3Sl 2i0103dSNI 6Od 9OVd SIHI S310N N01103dSNI St/0 HJflal MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK v4 +• CITY j 'j rMeu-+'f� PC, ri- MA DATE tI— a-q-- I 1 PERMIT # 'Z-� �3a 7 JOBSITE ADDRESS 3 - Qo_k, (}IL--, OWNER'S NAME jc.c I i'f. Cry r-fi`‘A ',:,..._T; OWNER ADDRESS Sta- c -toaV TEL$V5-- Li,6. -- tl gS FAX , P ' OR PRINT OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL EDUCATIONAL 1 j • C•if E"51..RLY NEW:rE RENOVATION: El REPLACEMENT. fl PLANS SUBivi{TIED: YES ❑ NO2 APPLIANCES 1 FLOORS- BStvt 1 I 2 3 4 1 5 1 6 ( 7 8 1 5 1 10 11 I 12 13 14 BOILER ?•------;, _T________1 ._, -;_ {_ i `_.,._ BOOSTER CR f i, ., y ��','' -----}CONVERSION BURNER, rr ,, -F ,l ,- �1 1(` 171 -`,; n� i. i COOK STOVE Jl _ 0..�_ ---- --1. , _ - - �: _-- ,____:s Y;;�..�..... �.�.,. a I .4 1' l_ li ....._.. ii ' . ._._, DIRECT VENT HEATER if 1�- I ,� II_ ! ?� _ _ _..��..`,i...._�n.'(�. DRYER j _ iFI----t7�. - Vt .. .. 1 4. FIREPLACE - --:, " =- t, ,—J1frI,._ ._. v . ._.. ,.;,,......._„._.......„,.1 FRYOLATOR l _ F_.,_ ._ ,,•-- .' _i'___ .; Ti- ' _ -J • 2 j- GRILLE [r :j ► ;i +`I , 1 :=wIl1!- t ',, �` ;! ''r INFRARED HEATER If--- �F ; i,1 :1-1 II Ii y 1 i! 'J r_ : • LABORATORY COCKS ' ii 'i �---- {t f: -y~-I' —1 MAKEUP AIR UNIT Ifs. 1I lI it 0 .; _?) 4 If . r ii ,� .__ ' OVEN r -1fl _ —u= __' —'1��. !-( . Iw � J __' - POOL HEATER 11 ii_ 1 ',.� iI ' Il -`_ -; _ .1_. ROOM / SPACE HEATER I �� ° w f' lw I _ _ _ =i ROOF TOP UNIT I �I I _. i� - --i _j1`i__;� - ..__... _ �� , TEST �' - ri r---- r i 4S .,,, ---==,- ,• - 3 ......:..,Ji .,.:,a-_i:.::,,.. •..'1.. -,..._,Jt '''- - t .. .,• { '1 I UNIT HEATER f� I `! _� ,_j1 —�; 11-11 =1,.. i____ . -..- _ .,..�.._; ( UNVENTED ROOM HEATER ER t _, , ry1�- ,_ y ?�W 'i 1' .) ._ ,�_tom— � 1•---. -----r. �.-�� L ; -_=r-_r--;'_ _�; r•::, ..-WATER t ER HEATER �� ., __ri ► ' i -- ii OTHER �E n- jL.�w...____ � � �_... i i-•• •• h -..t_:.:� L___.__. _._., I .�� ..' = _ '4 _.-..=j �❑., -- — +�. ...�.._.a. t �,._s' — 1• `� 11 { i t f i 4 ,, L_ . _..._-II-_ s• r �' __._- �., �' L i'- s+- cam=,•. IWSUR.ANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES 10 j I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BO,': BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY !II 1 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 t___I AGENT Li SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details ar4 information I have submitted or entered retarding this application are true and accurate to the best of my knowledge and that all plumbing work and installatiors performed under the permit issued for this application will be in co pliance with all Pe tinent pfouislon of the Massachusetts State Plumbing Cocie and Chapter •142 of the General Laws J' J iddi --- _ 'PLUMBER-GASFfl ER NAME I fir- Lt.;a_ - j LICENSE 4 45t40 rl SIGNATURE MP ❑ iviGF (2/( JP ❑j JGF fl LPG' E CORPORATION 1_14 PARTNERSHIP❑# LLC #[1 COMPANY NAMEIIAf . cc(/' .1..)z• .a f p f�p'P`ESS Q 3 &oo 4c rl1 I• CITY Mit.S1:/‘ pe STATE ! MA JP oat: Y 5 ., TEL ( 5' 0.5='y77-- sT i- '�7 r FAX ( I CELL[5jrt,? - .57) - JEMAIL th-P ( , C,� i am'' i� P �e*.te i-3 c