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HomeMy WebLinkAboutBLDG-21-002927 R MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
C TY YARMOUTH
L MA DATE November 20,202( PERMIT# BLDG-21-002927
JOBSITE ADDRESS 41 IROQUOIS BLVD OWNER'S NAME ABBER JEFFREY A
G OWNER ADDRESS ABBER MAUREEN D 518 FELLSWAY EAST MALDEN MA 02148 TEL
TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ 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
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 1 .
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 0
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 Cameron Natale LICENSE# MA 4600 SIGNATURE
MP❑ MGF © JP❑ JGF 0 LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑#
COMPANY NAME: ( ADDRESS. 200 Audreys Lane,
CITY Marstons Mills STATE MA ZIP 02648 TEL
FAX 5085341272 CELL 7743537354 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
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
WEST YARMOUTH 11/06/2020
ti ti CITY MA DATE PERMIT# 3C162 - o
JOBSITE ADDRESS: 41 I ROQ U O I S BLVD..._.-....... ..._.. .. ... ..� I OWNER'S NAME ABBER
978-9736168
OWNER ADDRESS - �• TEL FAX:
,..4a .IRO U _ .t� c . _z.. ,,.,.,�,.:��.. . �.w .. �
TYPE OR
PRINT OCCUPANCY TYPE COMMERCIAL r.. EDUCATIONAL ; RESIDENTIAL
Tti .
CLEARLY ,
NEW.; RENOVATION: ...;I REPLACEMENT: =.. ` PLANS SUBMITTED: YES ,„: NO „",1
APPLIANCES `l FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER ' k 7`t l ' (}} }j( 7ij k{[ j
'•*t-T-Yrr .....,a,mj• w+rc RA11., .rRslnnas� si"SATF 42 .•eeown." tr!" .t+7R'!!r. P •wnS11111• tii:1p r1Pv.) -.w ,..4.1 I.�.vi..4.. J .w,.tlt± ..12E isntilW
.�. -- .
BOOSTER f 1. i S [(
nEtr-•-r..r• . .•�•"•r'r"` i-":-•"a•+J f' _._ ....... ....,►-"w+"•�....;,.�:N,.."^«;".r.�."r37�*•�"01M7{'"" `'�".,"•rrtr -wr.t...,...
• CONVERSION BURNER .....,..J i i1 I ] (iy ( W I
✓R Xr"7:1; 7.....1 •'"".ry.)a v-l�RM .....__... .) + r•s�w+X�. �I 7,7..y '�i•'�•.,'12f1'� •iV�Ti v4i:• •'"••WILY• .Y._._._
..iM.•. ACT* 1F
COOK STOVE _ ..€ ..,. __. ,-_ i . , . f ... t _ _.... ...
_.o_...r7 i ' .' .r.�crfrr..,t-t w.
DIRECT VENT HEATER • .._..�; �• i ....�•�;.:. -- :"�.'`��'�"�;'•:. '�.- .. _ .. _ .._ .-�-��...
r x
:'7,!�..74• ,r i fpi»rau ir'-- '''.'.,'---...'' ^.'r'4, -.,.Z....-' ` ':," 7'w. .: 2,1n.rwr . ,-Ray aa�.farawt' .__`.� ...,I
DRYER a _ i 1..
'•..•, ((( -. {] �•+•f•- Y ��•y jtlf_:,Yt}^�'Y.df. ._.7..art.7-rn*:nn 7777+� mnr�,.» ;wx.swwi f..w..n .1i,+rr.=. _ 7.7"..• (s
FIREPLACE ' _�1`i 3.1.. trgri7.`"1.»"aka�lm;*E�n�'.•.� 1t''." . ..; •x»`a»rn'P. ?'?"77..4 atxw=•r»R esc,;t +I .au.w. wvww•+w f :,wy±. ' —i,
FRYOLATOR _ i _
f
-t r1,1,7o J• •4^ loft,�M.t i• YEti.1N .....f: YW=41•Ce*1q'0.l7LS •vawi.ureseLtrlrrP.S9P1nr� 4,7„,,4„,PM..f. !-iMaMw.MYrIM..MM,M.MM ... +.�. .w>Af•
FURNACE f�[ S} Ili
q'!TO `EF
LYY.t OYf!- .t't f �N#�M11MMu.[.aww.•w C....y.,r+,� Y1FNl'�••Ar�.»REf1»EtESri�ilf'rYYf'H t {fQ•yeir•w ` +V �4. 7_!.•7.T�+�!.T !'"•M^f1R i
GENERATOR - :, " ^f 1 X '�►+ '.l L 7
•.r . r{ .r r„ :,tfr f .t.(W-Yw •ww.uw .w"wt•`em- Tswo re : .4WNirNifti. XNN•�"}M•f vif MM... H..1 Y -.w!..=71 T^^•YYM•'2O.p u
1: ;
GRILLE -, • • .f .,...�.......:.......-....»� .1..�.n. ,�f ,tr.l",. : ..a.W." , ., . ....N_".-. 'w..r .. .�, --. • r..,,ar..r.r r"
▪ INFRARED HEATER -- _ °� .. >... .,; K ._. I. f4-: -w _..,, e. I I
^-'-74,'•• r7- • fN..• .... u'.f'....."rt r••••••"•- .z,7,...-.Pf•% filar
LABORATORY COCKS tt r___�: f , [[y` `
' .`7µrta w<wL".•..w.w ,..wcw L,.. w..„Y' ...— 4.r ..w..w: n.....--.f.. w.....„ w.....wtt •. •fit ..,.. +•'•+ch--,-,--ac1. -9.ws�.....f sarimotnrl
MAKEUP AIR UNIT ..•! Kt: ...."._... _..,..... ,.w.....r.. w ...$ w-.,:�..I_ ., ..I.<,.-r,fE..,,
OVEN .
3
m. .11:.4r +oxew..•""r^ .....,�..r.,' .L� `•fi:iiir .. ..-.t..-.h ._-- �s'te,n ta!'g'�'"_�n".1• •'TiriMe+fr'aua �'�f.n .
POOL HEATER _ ........... __... . _. .._. . ��;=r..,...., ...w.....� ... ......r....1
t i t i f
ROOM I SPACE HEATER ` •.w. _. ` is s E a {
q I� I
ti.nu .�..• ......_........" ....-...• ..••• ':.. 'err P �+"••=•••...c •
.__j_,. .w.... "•"!,..-...... •:.T„",Tf`,-__..... •- .... ;1,1aor�r ..
ROOF TOP UNIT ' j - __ _ . a_--.-
is r t ...� .-. R ; . .
7 t
j`f'af ...'..`".._`.. .. .'"'"'.`"�. . :7";i '7{' xiil"r 'r""VR aYs.nr.E- .f.+.E-••• 1'�w-»-•. _ r,tr+trt•+.[•�.x,: :`,Ti��.lna�.�a �fr �,r ��r..,fw•_ ,..rw... ..
TEST --- - A-.._._......
.- _ �.
UNIT HEATER ., ...... ..=:..._. .:..�:. „_.,. : away - .... .. .. ..� 'IS n�' r g(t --: ■!
• l.� � t .! � ..w.'.. .i �"�Cf S:3S31� YILwwKt.R ..Mw. "...si
-. r
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__. ... ._ ......•r 1, .w, :^�^7^ .. .rD... ._....,..-.w J,y~• �r...0 +f ti3C1-S2RS.i ii9P7i�2Eii# __K..oYi_ aP= I
UNVENTED ROOM HEATER . I ."Jrr, 1H E
_a �{�'.� �fiR -•e. .-�r:r+.rg; ic.n:at.ral :bra ....r•.•••
k�
WATER HEATER :
'••••••:%77:..17•!°+:744 :' ..: .:._.-:7.f"*."'''j'"`""''''''.-1
OTHER _
2715
it
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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 �i. NO ...,,...i.
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY ,iiJ OTHER TYPE INDEMNITY ;rwI BOND LM
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
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 accurat t of my kno edge
and that all plumbing work and installations performed under the permit issued for this application will be in complian ' all Pero pro i e
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME CAMERON NATALE
LICENSE # GF4600 SIGNATURE
". '� -•,-,ovttxs• xnw r•,.,,zEa•winvn:sv x sr �,evwe.a.."uwaul' .u.nF•a-+v�s,..iss.
MP MGF JP . , JGF LPGI CORPORATION ii# 307 PARTNERSHIP . . # _ LLC ..„`#
COMPANY NAME; ROBIES HEATING & COOLING j ADDRESS: 279 YARMOUTH. RD �.--
F_
CITY HYANNIS I STATE MA ZIP 02601 TEL 508475-30 3'- ` .
.,.__...._._._... nte�,:..,�_ .......�...ara-r'ra..'.a...rnwxa•a�w<,c,•.ya..r.......:....... x-..F�.fP...,....pw«..y.. - ...
_
FAX` 508-534-1272 CELL 508-775-3083 EMAIL MARYa ROBIES,COM
--�— 1`I{
.. ... ... _.___.. ..... _......_.�.._T.._Yw•!:!.a.._e".-f-%. -.-.-rev.e.ytw '^`wf: :!:''f!fT•!.'evern:+nv..::vr.":..wr:T!N.u....r.w+rww•w....t-:'.aw ......nvw.nw�. - =-=�.Y;C�'
5
ulLDI V)
ROUGH GAS INSPECTION NOTES THIS PAGE FQR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ ❑
FEE: $ PERMIT#
PLAN REVIEW NOTES