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HomeMy WebLinkAboutBLDP&G-23-005810 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH J MA DATE 4/19/23 PERMIT# BLDP-23-005810 k `°°I� JOBSITE ADDRESS 8 CAPT BESSE RD OWNER'S NAME MORRIS RAYMOND V(LIFE EST) P OWNER ADDRESS 8 CAPT BESSE RD SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIA._ El RESIDENTIAL El PRINT CLEARLY NEW: El RENOVATION:❑ 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 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El OTHER TYPE OF NDEMNITY El BOND El 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 signatu-e 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 enterec 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 Richard McGrath LICENSE 13282 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ARS BOSTON ADDRESS 300 Manley St. CITY West Bridgewater STATE MA ZIP 023790001 TEL 5085889025 FAX CELL EMAIL 8577permits@ars.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMITS PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK Y o= CITY Yarmouth MA DATE 312812023 -a__1 PERMIT # '- TM. JOBSITE ADDRESS ,8 Ca.tain Besse Rd I OWNER'S NAME Geoff Morris OWNER ADDRESS 8 Castain Besse Rd TEL 508-737-0821 FAXI _ _ P TYPE OR OCCUPANCY TYPE COMMERCIAL E7 EDUCATIONAL RESIDENTIAL E PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: v PLANS SUBMITTED: YES Li NOQ FIXTURES Z FLOOR—+ BSM 1 2 4 5 6 7 8 9 10 11 12 13 14 BATHTUB _. CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM ' _ u - F, CIF DEDICATED GAS/OIL/SAND SYSTEM .®I IT ] . DEDICATED GREASE SYSTEM r- I li DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM �y ^1I , .. DISHWASHERP. _ .r . � j DRINKING FOUNTAIN [ FOOD DISPOSER FLOOR 1 AREA DRAIN 72. . y' _ _. INTERCEPTOR (INTERIOR) _. KITCHEN SINK _ _ LAVATORY lA ROOF DRAIN SHOWER STALL 1 SERVICE I MOP SINK Ett,._i. TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL 'TYPES 1i WATER PIPING I ; OTHER a _ ,. 'I ii . �...__. L_�. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES v NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY v 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. CHECK ONE ONLY: OWNER AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are rue 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 cornpli. nce with - ' rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ------ PLUMBER'S NAME [Richard McGrath LICENSE # Ij3282 µ _ 1 /6SIGNATURE MP v ' JP ii CORPORATION rvi# 4542-PLC JPARTNERSHIPEI# LLCEI#I COMPANY NAME ARS BOSTON i ADDRESS 300 MANLEY STREET CITY'WEST BRIDGEWATER I STATE MA I ZIP 02379 I TEL 508-588-9025 . FAX 1508-583-7806 CELL 508-631-0515 j EMAIL [8577Pet@ars.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 1 w .. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK b CITY YARMOUTH MA DATE April 19,2023 PERMIT# BLDP-23-005810 � o JOBSITE ADDRESS 8 CAPT BESSE RD OWNER'S NAME MORRIS RAYMOND V(LIFE EST) G OWNER ADDRESS 8 CAPT BESSE RD SOUTH YARMOUTH MA 02664 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/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 ❑ 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 Richard McGrath LICENSE# 13282 SIGNATURE MP© MGF ❑ JP❑ JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: ARS BOSTON ADDRESS. 300 Manley St., CITY West Bridgewater STATE MA ZIP 023790001 TEL 5085889025 FAX CELL EMAIL 8577permits@.ars.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 UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ''• ,- CITY Yarmouth MA DATE 3/28/2023_ PERMIT # Cita JOBSITE ADDRESS 8 Captain Besse Rd OWNER'S NAME Geoff Morris GOWNER ADDRESS 8 Cpatain Besse Rd TEL 508-737-0821 1FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: v PLANS SUBMITTED: YES NO APPLIANCES Z 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 / SPACE HEATER r ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER 1 OTHER I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES NO I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE 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. CHECK ONE ONLY: OWNER AGENT 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 it ac . ate o the be t of my knowledge and that all plumbing work and installations performed under the permi: issued for this application will be in compli. - ith a i' - inent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Richard McGrath LICENSE # 13282 , SIGNATURE MP v MGF JP JGF LPGI CORPORATION # 14542-PLC PARTNERSHIP # LLC # COMPANY NAME: ARS/Heating & A/C Services ADDRESS 300 Manley St CITY W. Bridgewater j STATE [ MA ZIP 02379 'TEL 508-588-9025 FAX 508-583-7806 CELL 508-631-0515 EMAIL 8577permits@ars.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 t