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Home My WebLink AboutBLDP-23-001018 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ( ", CITY [ARMOUTH ] MA DATE 8/25/22 PERMIT# BLDP-23-001018 I � 'g �_;,, JOBSITE ADDRESS 15 FROST AVE OWNER'S NAME Charles Sterling P OWNER ADDRESS TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW: El RENOVATION El REPLACEMENT:El PLANS SUBMITTED: YES El NO El FIXTURFS • 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 DESCRIPTICN: 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 El OTHER TYPE OF INDEMNITY 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 signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT I hereby certify that all of he 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 michael pierce LICENSE 34718 SIGNATURE MP El JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ADDRESS 4 kaycees way CITY west yarmouth STATE f MA I ZIP 02673 TEL FAX CELL EMAIL mapierce774@gmail.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 1 ,1 illii ill ILUIA IA 1 li I) 1111 111 1 ,, , MA DATE 2 fit5 � �...s�saw.e.�. t:s�fuser..jai.��w9..aF.x:-+wa�.a•.ocie.rrm�.��+•>�.zinr`: . �/ / PERMIT# 4 JOBSITE D ESS C' OWNER'S NAMECI4r-) s / .. _ aU NG DEPARTMEN ey. --OWN .ADD ESS TELF :FAX TYPE OR OCCUPANCY TYPE COMMERCIAL _ EDUCATIONAL RESIDENTIAL c..--' PRINT CLEARLY NEW: ., RENOVATION: REPLACEMENT: L. r PLANS SUBMITTED: YES NO 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/01USAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER ? , DRINKING FOUNTAIN { FOOD DISPOSER # FLOOR 1 AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN t SHOWER STALL SERVICE/ MOP SINK TOILET — 'j,.- URINAL __ . WASHING MACHINE CONNECTION WATER HEATER ALL TYPES I WATER PIPING OTHER ' A.w INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES _f. NO 0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY iaV4 OTHER TYPE OF INDEMNITY BOND o664T -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 and a rate to the best of my knowledge and that a!! plumbing work and installations performed under the permit issued for this application will be in compli ' all Peitifrerrt pro n offhe Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME.Michael pierce LICENSE # 34718 AT-ORE MP JP i v i CORPORATION L # PARTNERSHIP #i n LLCM _ # b 1.A._ i„„... z•'.d'1Ya42r`.?G x mow.-, s' ... •.:',,a1,4ga: s .. COMPANY NAME!' Fierce Plumbing_.�,�..A. ...�.�r..�..,,.�..�..,�_�... .� ADDRESS 4 Kaycees Way CITY West Yarmouth ' STATE Zip 02673 {$i TEL ...,...., _......,...-.,y�.u,,...�.: •..,.,..,au•.:.�.,,�„�,...�..--Yam.,_..,,: ,� ........_,.....,.�.....u, , v_.... .. .-...�.,.,....,....,.c..- •,. .N+.e.<•...w,.:a+_„y,�i' '-- .&:Si4w.sT s:.... ..«.e:soy,...i.c.w.c i., .„...pia.,,,,,,.::.ar'1Fi1ti:Fs...,,,,,i .,.•. ,...�,+..,..�......-..., :�..--.t,.�... :,.�-.,,...:n:_.�.- ..-.:,u„�,...�,...-.,..-.0 -...:--„ ,.:,.._,.: -:�.� _,m �: ,,.,.......�t..s.�.,..,..,u,.-:.,•,..-,.st+...•w�..a..,.�..•.w,.�,...,..,.s..,.,.�.�...o...r......ri�w.+.. .«...�.-,u.,,....--a...�«,......�,,,«-�.a....�..�sr FAX CELL 7747223221 - EMAIL Piercepiumbingservlice@gmail.com .%:-...,an`6ssz �le9:in&m+kr,u.•w':,w.:iv - r...^w.-u_,..- um.,«.-... rnr..�.o-.�o.+r.w.r.wrf• t.c.s.i+�c..ra�...i.....o.w,�wci ,...,,-s.:�-..v_......�.-r-:..:.....�>....-„-�:-.�-..-.._....,.,a.....�......G+-.:,, _..:.:.,-._ ._..-.._..y.:.crrr:.mww�rxa.:mxsays,..w..�e.,�.ueac,.::.•aa-..w�c•...r -.- ra.ssdcc+n. - ,.rs�...r:=--s»..:r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH —I MA DATE August 25,2022 PERMIT# BLDP-23-001018 JOBSITE ADDRESS 15 FROST AVE OWNER'S NAME Charles Sterling G OWNER ADDRESS TEL TYPE OR OCCUPANCY TYPE COMMERCIA_ ❑ 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-GASFITTEF NAME michael pierce LICENSE# 34718 SIGNATURE MP❑ MGF ❑ JP[] JGF❑ LPGI ❑ CORPORATION❑# - PARTNERSHIP ❑# LLC ❑# COMPANY NAME: ADDRESS 4 kaycees way CITY west varmouth STATE MA ZIP 02673 TEL FAX 7 CELL EMAIL mapierce774(a�gmail.com S310N M3IA38 NV1d #111N2l3d $:33d ❑ ❑ 1IV Ed 3H1 SV S3A213S N0llvO lddv SIHJ oN se), S310N N01103dSNI 1VNId A1N0 3Sl 210103dSNI 210A 30Vd SIH1 S3lON NOLLO3dSNI SVO HOfOa ,t,i, UgliNti [l N 111111.111111 iiiiiiiiilltill !UR kr LIIiiiii I u lin pill II ., .___ P' �7 ,J �, MA DATE / 5-/ 4 PERMIT # .3 ,L� OWNER'S NAME e ic/P� 5)- ç-ii a r 0/1 Cr LAAN 0 2 %ITE\ADIRESS J5'" "Fro 5� 1.`C-- TEL *6 FAX kji---DE1 _ R 1 'ESS a __ • 1 ' 0 CY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL 1_- CLEARLY NEW: RENOVATION: REPLACEMENT: ✓ PLANS SUBMITTED: YES NO APPLIANCES Z FLO ORS-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 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 , INSURANCE COVERAGE insurance policyor its substantial equivalent which meets the requirements of MGL. Ch. 142 YES v NO I have a current liability I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE E3Y CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND OWNER'S INSURAN CE 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 of the details and information I have submitted or entered regarding this application are true and with accurate. teo the e best proofs on knowledge Ind tha aertfu that all will be in compliance he and that all plumbing work and installations performed under the permit issued for this application Massachusetts State Plumbing Code and Chapter 142 of the General Laws. _ ,-- PLUMBER-GASFITTEF� NAME Michael Pierce LICENSE #34718 N MP MGF J3 JGF LPG' CORPORATION # PARTNERSHIP # LLC # COMPANY NAME: Pien;e Plumbing ADDRESS 4 Kaycees Way CITY West Yarmouth STATE Ma Zip 02673 TEL FAX CELL7747223221 EMAIL pierceplumbingservice@gmail.com