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HomeMy WebLinkAboutBLDG-23-001141 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE August 31,2022 PERMIT# BLDG-23-001141 JOBSITE ADDRESS 579 BUCK ISLAND RD OWNER'S NAME TURINO ASSOCIATES LLC G OWNER ADDRESS 2000 COMMONWEALTH AVE AUBURNDALE MA 02466 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 1 FURNACE GENERATOR GRILLE 2 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 hal,e the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my sigrature 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 Ralph Giangregorio LICENSE# 9339 SIGNATURE MP© MGF ❑ JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: RALPH J GIANGREGORIO ADDRESS. 188 Route 28, CITY Dennis Port STATE MA ZIP 02639 TEL FAX —I CELL EMAIL of lce(i3gsplumbing.net S3 LON M3IA3M NVId #111Na3d $:333 ❑ ❑ 111183d 3H1 SV S3A213S N011Y3IlddV SIH1 oN seA S310N NO1103dSNI 1VNId VINO 3Sl 210103dSNI MOJ 39Vd SIH1 S31ON N01103dSNI SVJ HOl0?J PMEI___ L .fi _' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK MA DATE PERMIT # 23 `- 1 I `-t � ti�_ �� t CITY [LJ ? r \yIr_ /�/'� .�... �-�-�'-� �. •nt 7= (7 ,,,,.,,A.hr�`. 1.1..-J Yi e vjmawcrc-a_.sne,�.w f..�-M..,.w'ra. JOBSITE ADDRESSL-; '� (? T ,j OWNER'S NAME Laggiziari Ai1 Lk GOWNER ADDRESS c� TE 5 _1 ct O- oaf FAX _____� TYPE OR OCCUPANCY TYPE COMMERCIAL El EDUCATIONAL 0 RESIDENTIAL El PRINT CLEARLY NEW:L RENOVATION:0 REPLACEMENT: LA PLANS SUBMITTED: YES Li NO 0' APPLIANCES Z FLOORS-► BSM 2 3 4 5 6 7 8 9 1 10 11 42 13 14 BOILER __ moomil _ BOOSTER � �� � .�� z �_ . � �� :. . : _ ._ ._ , _�_: CONVERSION BURNER r_.. - - 1. r.,y_. COOK STOVE ! r� 4 ,_ _ "'➢ r� : f• - . ate: •wssw+oFr... M1r •��-� /A .. '.�•'d! ._ _ '' , -^'=rw• '�. j ��� � f ,.:.�::..x. f �f __-_'fir t =Zr� DIRECT VENT HEATER I l' - ,, .: .., l `' -10:- i .. .' ,._ __, 'I, DRYER - 1 fr i; FIREPLACE , FF MK _._: ..... ,, .,, , ; i „If .. i FRYOLATOR {2e'4-�ry r\ -l�epAel mi.- = - ;,• , F -- ` t E q { `��7i:ilt'9 �.� fi _j .-� 'fix..t. ... �irr� 6}*17�1': FURNACE Keen . ice !s 1 _ GENERATOR tf ,_ r i .�., ,I.,- .. ' _ wz:- -v r GRILLE 1t ! I, I' ,_._.. . •ri . INFRARED HEATERIMI NW I `;...... 4 az _� 33 ° tie ..« a w+•. . :E LABORATORY COCKS '. _ ' t..... ,..� ' . .,a��,. ,� ._ a .. . ', -� ___- . - - MAKEUP AIR UNIT I F �,: M ) :---._--,N. rr,: ,...-.,.... rnrorcn. r r' }7.If + 't-.0.-0, ---•'Zt. . —, OVENIN— i � I� " it POOL HEATER ROOM/ SPACE HEATER _ ,, ROOF TOP UNIT .... ' - --- h _--� _.._.. _10-0,- -------. # ty v_ ri _- ' ' __ 4' ,1 yg r ' �6. irri"^"f:. iii _ „mac .'I..aik ViditEiji TESTi` ` 1 - _LL .:-I , f .0...-,31 _ ' _:4, ,------ UNlTHEATER # } T 3.]`w T� .-i \ _ 1..- - .-� Yvcaw+^ rw UNVENTED ROOM HEATER is t I, � -t- :; - !' OL�._u�.. WATER HEATER _ ' a i R _._. -�.._ .. .,i .. - r .. , " .'`yltiib3.i:r•.M M:.:.ti•..' �.:1'•J',rY " .u61:.'iT_.^^•.1 � va.M�.�fN• �w_ B1Y } 1 OTHER" _ - _ '<a.- •.. ^� �ryr;rr�vl-trsarnrrr. all { _ - i' ! . 1 t ` MICIMMIliiiii . ....._ r� Imo'. .f ' - ___ __._. . ... . INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL, Ch. 142 YES 040 LJ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY 0 BOND Li 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 0 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 ail plumbing work and installations performed under the permit Issued for this application will be in compliance with all P rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. • ,, 1_.----si (40, .;.-Le_z.t..7„,e-,,..4_,L; /4,_ PLUMBER•GASFITTER NAME Rliekia ~` '- ..c)Aii r7k, LICENSE #azi SIGNAT E MP 0 MGF 0 JP ID JGF® LPGI 0 CORPORATION kj#Eiv L i PARTNERSHIP Q# b1 LLC H#i 1 COMPANY NAME:L? •A4 ' .� ti'�.�� i ' ADDRESS ! F / is Li ;> 1 . M._.��+��.�� IiJ Yftii f .�OFO�GWK G6i�iL•�I L .1f1G�•._ -_1:.� ' CITY L 't- o n 1 . STATE I/IA_P ZIP _) .. '' TEL �►�c. ILL...'•a.�•.••.••�..,• - Ja-^q ...] FAX la2D t -b r CELL