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Home My WebLink AboutBLDG-21-007474 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 741=1 CITY YARMOUTH‘1/4„. MA DATE June 23,2021 PERMIT# BLDG-21-007474 7,50 JOBSITE ADDRESS 13 WEBSTER RD OWNER'S NAME claudia norton G OWNER ADDRESS 13 WEBSTER RD WEST YARMOUTH MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: 0 RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES 0 NO 0 FIXTURES FLOORS—+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER . COOK STOVE 1 DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR . FURNACE GENERATOR . GRILLE , INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER . ROOF TOP UNIT TEST 1 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 0 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 (Herbert Healis I LICENSE# 120177 I SIGNATURE MP❑ MGF 0 JP© JGF❑ LPGI 0 CORPORATION 0#I I PARTNERSHIP 0# LLC 0# COMPANY NAME: (HERBERT M HEALIS I ADDRESS. 178 STUDLEY RD, CITY (S YARMOUTH I STATE (MA I ZIP 1026642906 I TEL I I FAX I I CELL I 1 EMAIL Ihhealis@yahoo.com I ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT 0 ❑ FEE:$ PERMIT# PLAN REVIEW NOTES _-s- .-- Apr. fi fis -,it 12 / r i—•I1-t \ts„ ir, :- .\.... MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 4,1T .--, -- CITY ryir,-n6---uth--- --- --------------1 MA DATE16/21//271 III PERMIT # $ -, - r JOBSITE ADDRESS[ 13 Webster Rd j OWNER'S NAME [ Norton G ........... r.,.........._________ _ __, OWNER ADDRESS ___.. . ._saine_.,,,.,....,,...,,,,,_,,_____________,_ TE . FAXI I TYPE (llt OCCUPANCY TYPE COMMERCIAL[] EDUCATIONAL [1 RESIDENTIAL bk.I PRINT CLEARLY NEW:tx1 RENOVATION: [1 REPLACEMENT: Li PLANS SUBMITTED: YES r_i Noix,--.1 APPLIANCES Ti FLOORS-, BSM 1 2 3 4 5 6 7 8 1111 11 12 13 14 ., BOILER 1_, ._ . .1k,.,....,,,,„, ....... . .- i!. . ,... .'',..... . I . . 1' _ , _I I F. II I 1 1 1, 11 11 i 4- . , BOOSTER 17. ,r---(1.-----1f.-------1'!------- 1, .... _. r - I F .. ,,--11__. . I! . -1:: ---.11-....7.711-7 1 CONVERSION BURNER - - -.:,._-..t.it _ _, :___ ___-:_ ..._4........,_..........:. ..-t•-•_1:_r ._i i.._ _1:_.-xi_____.....tr_____ ___-______,1_-_____..,i __ ,,. .__..__ _.____ P __ 1 . . i . 11. . 11 i COOK STOVE 11 . i t,_..,._ If: .re_--.....-T-_-_-__Ii; i;:. .:.i_•..._ _ DIRECT VENT HEATER 1 lk, . . ti._. _ Jr: 1(: 1.!` It Ir 11 . _,_ i ii . 1 DRYER r.7. 1J-----11-1— ---1117:111. :..---t:--- if ---ri. --,---4[1..:111----.--11-_-- ._ rif...... If .111 -_ _Jj. ! -1 FIREPLACE 1 ... 11 . . . I I I' ..1: I. I- I. 1 I r ! FRYOLATOR I_ , .U._ ..7.711[7—..11.7.7,14;_- i ....11,L.--__,-,--T f---. . 11... ..----..„1=1. '. ..-. ----.,....,Jr..j...,11,.. .. .1 FURNACE 1.---..---r•-.7:-.11 ..-------11-.. --...--.-- r-----1,---"-„r----11---_--il---------rt----711------1T---117---. .! (-----11-.-.-.. ---1 GENERATOR ! li. , . . _ _ 11,_. . _ k__ , ..J .:_, . . .. ,.. . .. . -. . I . ::.i GRILLE INFRARED HEATER i I! j .. if 11 .-' TIE! _ !1---..- IF -Jr- ii . 11- 1 1- ---11.."- -_-11 1!_-.-- 1 LABORATORY COCKS 1. [:, ,IA: 1 _ , 1 Th MAKEUP AIR UNIT 1 14 11!"-----11--11 li 4. , irr ii - mi ----j--- )1.- 1 FT". --.1r-. --1, OVEN 11 :i1 .117 I -11 -I; --0,- -. 1,17--- li -- 11,. - TT fil 71 I----. fii- - i POOL HEATER 1 ...., . t..1 . .i1,, IC—. -.-r-i- . f . . . . ..c... . I. o._ , . i .... _ 1 -,..:„.. , _.1 . ,. . 1 1: ROOM/ SPACE HEATER ii_. . ...._.T._.......i F. ..•...1r._...-:_:...:L.:,. ..:.._.__.:_Ir.......:.;_:_r_L-.:—t i____:L-........if_.....!_'_..IrIf__:::::— _i- ..:_i,.._ _____ i I ..._:._....1 I„ i ° -'''''-—• 1"- - ' -e..--1 __ —1 '' '.1.:.:.:_:.-_: ':'....'_-__L-_::•--: _7_______' ..._ 1.1.:...:....._":___, ._:..:...f...' "4<'1._...".. .....__::.-_-_- f_ ._-_._. • _....'.-.. _ ROOF TOP UNIT r IC: 711:._--, it _, -.--1 c--_- i: ._ . -1).... .11 ._ _,_ ft.:, . , ir, .. y--. . . .1c ii. .. ii. '. .. II . . . 1, TEST .12, p, . . _ 1._ _.. I . ...._:_ ...:.____.,,,....‘,=_, ....1: ._ ,_. .1,, . ... ,,.. _ ___)„..:,..,:.,:::::„... „_.1._...„.,. ...1! UNIT HEATER I _ ri)! _ 11, , 11:-,-- ---F-- !. i: --L-. 1.F. - -- II--.-- 1[7: _ 1.! , Ir . I.! '1 11 — .1 UNVENTED ROOM HEATER 1--.--- 1"..r--.11- _ UI 1'11--- -I' I: 11--_-: 11-- .1-1 II __ _ II .I! --.}L 7 11 1 ' WATER HEATER .f.. r..;, . 1! ! . r 1 t-.. . :•71--,- I 1 i! 1 ! (, , ----M.-7711--------C----jr-----11-7-117"---1 1.--- 1 1--—11-----1 . _ .. 11 ...: _II_ _ ,,P.. .,..„ ...,..,.!.. 1:: . .. . tf .,. PT .. . ii .. ... ti fi ---ir- i , ..„. Y .---iii,------if -11:1--- --)1- ---i!! ----ft --.! - ii. .- .7117 -111- _ fi_ .. ... 11...,..!,--.11 t--..---;-11---. -1 INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES kil NO I1 I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY kJ! OTHER TYPE INDEMNITY rj BOND 11, 1 . 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 Ej AGENT Li 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 ac rate to the best o knowledge and that all plumbing work and Installations performed under the permit issued for this application will be In co th all P n t Ision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 1 _ rie I __. PLUMBER-GASFITTER NAME [Herb Healis 1 LICENSE #12017 1G .... r______ _______I .. MP Li MGF1—. ._,1 JP kji JGF1 j LPGI[1 CORPORATION El# [ 1 PA ERSHIP ..- #L 1 LLC r-.-pL i - COMPANY NAME:[ USA Mechanical i ADDRESS i 78 Studley l3c1 — ---1 CITY South Yarmouth ] STATE pa j ZIP', 92664....ATEL[508_77 _6 5495 _ FAX CELL __ EMAIL hpaliSgyahOp.corn _ . .. ..____ _____ _______________________,,,,,, 1 _