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Home My WebLink AboutBLDP&G-21-007541 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 6/28/21 PERMIT# BLDP-21-007541 JOBSITE ADDRESS 6 ASTOR WAY OWNER'S NAME AHERN CHARLES L P OWNER ADDRESS 6 ASTOR WAY SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: 0 RENOVATION:D REPLACEMENT:❑ PLANS SUBMITTED: YES NO❑ FIXTURES FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTE DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 1 WATER PIPING 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 TYPE 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'S NAME John Kane LICENSE 12755 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME JOHN KANE ADDRESS 39 MONOMOY RD CITY S YARMOUTH STATE MA ZIP 026641984 TEL FAX CELL EMAIL sjk1725@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE PERMIT ❑ ❑ FEES PERMIT H PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK =n - CITY 5 4V01a01`- MA DATE 6 _a•s' - al PERMIT# 1Y-DO-r-1(-0O7Si( JOBSITE ADDRESS 6 At ' way 6 y OWNER'S NAME VJG v,S h cs 4 he 0 vvv POWNER ADDRESS SG rim, TEL SOS( -as-0 ao 35/FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL[_ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:2 PLANS SUBMITTED: YES ❑ NO Eg FIXTURES 1 FLOOR-+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB - CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM _ DISHWASHER • , DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN .- __, — . .-.____. — INTERCEPTOR(INTERIOR) T KITCHEN SINK _ LAVATORY • , ROOF DRAIN SHOWER STALL - . _ SERVICE/MOP SINK TOILET - URINAL _ WASHING MACHINE CONNECTION _ . WATER HEATER ALL TYPES WATER PIPING _ OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES® NO 0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UABIUTY INSURANCE POUCY ® OTHER TYPE 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 It Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT t�i 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 compli nce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. P LICENSE# 2.a 7 SS^ SIGNATURE LUMBER S NAME MP❑ JP[ . CORPORATION❑# PARTNERSHIP Q# LLC 0# COMPANY NAME 1064- 1c a nc. P 1 b9 ADDRESS 3 61 111110 In 0l n c'-I i2d • CITY S y G r(Yi 0 u tln STATE irn G ZIP 0 2'6'/ TEL FAX CELL SOS '6 &S- S6 Sd EMAIL 3 Kcaroc E_ N 5 e y u ho o.Go M MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 7,3 6 MA DATE June 28, 2021 PERMIT# BLDP-21-007541 ®.!I�+i � CITY YARMOUTH JOBSITE ADDRESS 6 ASTOR WAY OWNER'S NAME AHERN CHARLES L G OWNER ADDRESS 16 ASTOR WAY SOUTH YARMOUTH MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL El PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT: El 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 1 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 El NO El IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER OF INDEMNITY El BOND 0 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 issuec 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 John Kane 1 LICENSE # 22755 SIGNATURE MP ❑ MGF El JP ❑ JGF El LPG! ❑ CORPORATION El # PARTNERSHIP ❑ # LLC ❑ # 1 COMPANY NAME: JOHN KANE ADDRESS. 39 MONOMOY RD, CITY S YARMOUTFi STATE MA ZIP 026641984 TEL FAX —1 CELL EMAIL sjk1725 angmail.com 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 S UNIFOP.M APPLICATION FORA PERMIT TU HEt-truKty► t..if=, ri MIN VVUKt' CITY: S - y ofYY�oV h MA. DATE: ! a '' PERMIT# 5A r w Q_4 --o �- JOBSITE ADDRESS: 6 Ay tdJ UlfuV OWNER'S NAME matSV1et Ain( attn • 1 OWNER ADDRESS: Sa vnt- TEL JOY a d - ava q FAY,: TYPE OR OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL 7 PF -T CLEARLY NEW: RENOVATION: REPLACEMENT: [ PLANS SUBMITTED: YES ❑ NO [? I APPLIANCES-! FLOOR--F ! Bsmt 1 1 1 2 3 1 4 j 51 6 7 8 9 10 11 12 13 j 14 I BOILER ! I I j BOOSTER I I 1 i I CONVERSION BURNER I I I I I COOK STOVE I I DIRECT VENT HEATER DRYER FIREPLACE I I I I I FRYOLATOR I ( I I FURNACE I I I 1 GENERATOR I I I GRILLE I I I I 1 INFRARED HEATER .... LABORATORY COCK ( I I I I i ' F. Ir' -I ! '> j MAKEUP AIR UNIT I I I I I 1 __ i 1 1 OVEN I I i I I1 P 1 l R POOL HEATER I 1 I I I' I I I ROOM / SPACE HEA I E'. I I I I I I:.__ I I i ROOF TOP UNIT I I I ii ['LIN ,)11,1 - L_,.: 1 i-: , 1;:-_ ,,, T, ,, I TEST I I I 1 I .'`,--- ---..}--.-_—_1-__dv-...Li UNIT HEATER I i I I I I I I 1 I I I I UNVENTED ROOM NEATER I I I I I ! I I I I I I WATER HEATER I I I I 1 I 1 I I I 1 1 1 1 I I 1 _ I I i 1 1 I I I I I l I I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of NiGL. Ch. 142 YES I NO D if you have checked YES, please indicate the type of coverage by checking the appropriate box below. LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ❑ BOND D 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 0 AGENT ❑ SIGNATURE OF OWNER OR AGENT 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 'n compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBERIGASFITTER NAME: -Joky. Idanc LICENSE# a1SS' SIGNATURE COMPANY NAME: 7uc Ic Ku AG P I b ADDRESS: 3 ci 016 0 a m o t CITY : 5 7 0 rrA p u 4 V% STATE: iu ZIP: a 2 b b / . FAX: TEL: CELL: 508 - 68 S—Sb S6 EMAIL: j \(a ft F Lt S e. )(oho o , co 141 MASTER ❑ JOURNEYMAN 21. LP INSTALLER El CORPORATION ❑ it PARTNERSHIP 7 ` L L G❑ ' A, .° �S� CL. i t I ; I I 1 I 1 c a a i 0 •u I z a 4 • i I I • I I z I z v I ✓i cn c I Z C u r Cr) r u p , C z 0 i U I J I I I n Li 4 c I— L I I i f E- c 0 z11 p I u a z I rn t7 I 0 g \ . I li