The URL can be used to link to this page

Home My WebLink AboutBLDG-21-004305 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE January 30,2021 PERMIT# BLDG-21-004305 JOBSITE ADDRESS 35 OYSTER COVE RD OWNER'S NAME BEELER JOHN H G OWNER ADDRESS BEELER BARBARA M 35 OYSTER COVE RD SOUTH YARMOUTH MA 02664-2320 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES ❑ NO ❑ FIXTURES FLOORS--4 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❑ 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 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK _1_ CITY,'a, e�Z? __ I MA DATE /-2S -gyp J I PERMIT# 0)6 21 -W 30S JOBSITE ADDRESS O j�5 I CZ t1 ` tad• I OWNER'S NAME In C0� A is•r GOWNER ADDRESS : 1 TEL 1FAX I. TYPE OR OCCUPANCY TYPE COMMERCIAL;] EDUCATIONAL PRINT _J RESIDENTIAL CLEARLY NEW:._ RENOVATION: J REPLACEMENT: PLANS SUBMITTED: YES I NQ APPLIANCES 1 FLOORS--• BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER ___J I____J__-1_J-.._I___J I_I—J`__1-1_J__i BOOSTER _ 1 1 1 t_I—J _J _J__J_1 I__J_1 CONVERSION BURNER i_ 1 i _ I_J 1 __I I—J __I_j_1._1 _1 COOK STOVE I I ' -_I I. I_1_J __Li_J__ _-1_J ___I_I DIRECT VENT HEATER —i_ ___1_I I ____J_I I 1 I DRYER • 1�. 1—J_ lam_ ._. 1 i_. 1 1�__I_1 FIREPLACE I 1—J_1____1 1 __-___I t.--_J I i 1—J__I 4. FRYOLATOR ! 1__1 _.J.___,-_ I 1 I 1 _I--1 --_J—J FURNACE ,ft�T't __-1_____1 / 1'._J I _J 1 1 --___I__I 1---' __ _J .._�I__I I GENERATOR ? I i .1 I i i l GRILLE —J _J__J._ __.I 1 l__!___J _J�._! _I ___J._.._.J _ - I.___J • INFRARED HEATER —J__I_J —J 1 _____1._ i --1 --- ; —I _J_1___J_J I LABORATORY COCKS I 1 1 _;--.-t I I_1____1 _._..__I___I_1_ _____I_.-J it MAKEUP AIR UNIT I I_,_,,,..,_1 I_J I .I-.-....J ___J I I ___I —I _.__1 __J OVEN I -.�_._1-,_I I. I ___1___..I I I _.__ ...._.I�-' I---! I POOL HEATER _I I.___J —J _ _I___._._1 I I�.J___1 .—J___ __J 1 ROOM/SPACE HEATER ____1 I I i aI _. 1_ i_! i ! _ I ROOF TOP UNIT _..._...1 I____ I I ' _ 1___ I ` I I ; _ I _rJ 1 TEST ____..._i i `_I _ I i i I i 1 I UNIT HEATER _.r_! 1 _.__ ___. _ ___i l _1 .I.•_.� ___.J 1 _—J UNVENTED ROOM HEATER ,__ -` _,1 1 ___- I _J___J _J 1 I 1__J i --.I WATER HEATER -.----___ ,- .. I I i 1.- I , I,J._____1____ __i_1_J_J OTHER_ 1 1 I _. I_..._ + ?_�I l -_____I �..J—J _I !____.J ._.J 1111 _-I ; i 1.___I l t _I _i i I. I__�_I . t INSURANCE COVERAGE kI have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES I i NO J I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY, ; OTHER TYPE INDEMNITY . BOND 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 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 the, Massachusetts State Plumbing Code and Chapter 142 of the General Laws. C' PLUMBER-GASFITTER NAME -rtiOrik j�S epC/6• CA.4J I LICENSE# �S`,1.Q-1 A D SIGNATURE r �� MP 'MGF'^J JP JGF ! LPGI _J CORPORATION (�°.# 4-O5.7 I PARTNERSHIP_# I LLC J#' I COMPANY NAME: ( YL - _.. TIAI g St✓ .d1 G-+ADDRESS . _ - __.. �� 3v 04c2r,�S,1 n�.�'c�� I CITY Cif. Pr C o"Du I STATE,'S' - ZIP O?.7.2-- TEL - --_ ^- c�-------- 1 _1 FAX ' - 1 CELL EMAIL Jt: . E .0 6- E Di $a _�, -81/3 - �_ -1 • JAN 25 2021 r ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT Ej FEE: $ PERMIT# PLAN REVIEW NOTES • 4kiA t•. 414-14A1C; ,