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Home My WebLink AboutBLDG-22-003308 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK klly CITY 'YARMOUTH I MA DATE (December 10,2021 PERMIT# BLDG-22-003308 II— JOBSITE ADDRESS 128 PLEASANT ST OWNER'S NAME IONEIL GREGORY I G OWNER ADDRESS 128 PLEASANT ST SOUTH YARMOUTH MA 02664-4551 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL Ili PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED:YES NO El 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 1 GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM I 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 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 r 42 of the General Laws. PLUMBER-GASFITTER NAME LESTER WADE LICENSE# 4569 SIGNATURE MP 0 MGF Q JP 0 JGF❑ LPG(0 CORPORATION❑# PARTNERSHIP ❑# LLC❑# COMPANY NAME: LESTER J WADE ADDRESS. 22 CAPTAIN ISIAHS RD, CITY COTUIT STATE MA ZIP 026352702 TEL FAX CELL EMAIL 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 fWiASSACHUSETrS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK '.`iY' �� CITY 'Ccr wt c U 4--t-j MA DATE 11-- � a--- -1 1 PERMIT rr 2 z - `3 O 3 1T 1- JOBSITE ADDRESS ! I a- $ P Ira C[5a 'i 4' S+. DWIYIER'S NAME ' 6-re e Q 'is.)€- I ' �i.T OWNER ADDRESS I S t a .- c' 0 4 TEL 50 - 3�`�- 5 31 � FAX !• 9� OCCUPANCY TYPE COMMERCIAL n EDUCATIONAL ( I RESIDENTIAL TV- C 'AJ Y NEW: I RENOVATION: Li REPLACEMENT' Li PLANS SUBMITTED: YES ILi NO Q---- APPLIANCES 7. FLOORS-, BStvi 1 j 2 3 41 5 6 I 7 81 9 10 ' 11 12 13 14 BOILER ----s� - 117 . I. ._., _l - 1 IF _ .1 --_•I ,�-,- j, s.-.. �._..,�,� • — =1 lI r I j• 0 I _ BOOSTER ` ]iti 1 -(r`'� 1I ' _r-i' ;a �! ti i, 1 � CONVERSION BURNED r._._._- I ---- _- _ !I - t_ ;f��_.. 1- C i -_ �' �! {t 1, COOK STOVE i. ,►_ 1r .�. .. .I Ili DIRECT VENT HEATER �l .II . 11—awl - ice'1 1iFirL :I_ DRYER �I _._. .. i# l �� t.1 f# i(__1(_`_-t(___. _1 �` q , F--- _- ' �=- ' ---- 4,._.�....�. ......._,.. 1_ '1. FIREPLACE { " __ 1' I r r 1,^..,. -.-.. .�......�._..r.au_�...Ja!L I-�[_/� ....>, 11_ .- `- ' i', II 4 �l {I , +i tt sl r{ _II_ _ . - t 1---- f _ _ __ •ii _. FURNACE I =i._ '_� '+ 7----- .r- I0. _ I._-- _ _- __-'1-- •�:1• _-.� GENERATOR f ✓' _ _ _ Tom. ;ice L..hf __ I, �_ ' .,,�_ ._ .1 : _�__ t— �_._ S _ .._s GRILLEIL. F_i __i� j -'_` j1f1PaFRAREDHTER i�?�1;__ i ;i •�1� I _i._-.,„til_.`. _ i_.__„ '�'j_ _ . , LABORATORY COCKS -'' r. '' '' • j �,j MAKEUP AIR UNIT 1F iI —=$,---�I L..-T �( E-11 . . . '11 1 OVEN i�-1 - ii_ � ;l _ 'I -_._ -1_ w,.�..'.�,...�. 1 — :. _a!_-_____. ROOM / SPACE HEATER 'I - f" �(�-j� ! 3 'il • •; • ROOF TOP UNIT I II. _ -I j ii i— __11 __ ._�... 1 - -•- F' - -; —ri TEST ..,-�...� UNIT HEATER MI .1 .1 +� `, J ...._. tr'�..�_r�_.. lr,�_- -- _✓. -. 1..�.rww.wr.1.-- •l �w.�.^,.... l'7-Nam:.....'.'_..r`.s: . -- .,.'' .s«w a:.•..�..+ _ y UNVENTED ROOM HEATER I ( '' _''I` I ` .�. �a.�__ ' _ �� •1....w.......�� ...._.s_..y:...._. .w... '1_ ._a-. si.r •� -Via.._— ' .v WATER ER HEATER U ii 11 !` 4 ;I ti i► i _ .1 ,I i w=.....;,�..>z�.._._r+..w•e.. ..,._..,. �^r......ra�r.w::.:•4• .ax..t .._.....a�! i. ! .._a...L_w...__-_.�..w. 41_, fl J______....t_:1______L___, I,i .......1___LE:-...4.E.a_ ti.,....,„..i._._ :.i ..,1____41 _ 1. .. r.7._ i li . 1 1; . r . _ -L. ----",i, . 1._ _ _ 11 ._,.,_r::::- _,i, ___A_____. _ _ _ 13�._..+._ • — - ..1... . _ �.. i• i-�T�I __-TI_- ,.J:..._._.-1... •- t _.'ll_.__._( INSURANCE COVERAGE I have a current liabilitv insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 'l2 YES ' II10 fj I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BO;; BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY I _I BOND n OWNER'S INSURANCE WAIVER: I am avrare 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 L_] 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 accurate to the best of my knowledge and that all plumbing work and installations performed under the permit :slued for this application will be in co pliance with all Pe :'nent pxovislon of the Massachusetts State Plumbing Cade_ and Chapter 142 of the General Laws 0, J e.............,... PLUivIBER-GASFITTER NAME I Lec4t.r- (A met& I LICENSE # if% i SIGNATURE MP iviGF JP f JGF - LPGI ❑ CORPORATION Imo# PARTNERSHIP[ ] —1 LLC ❑#I COMPANY NAME:by" e (.cycet .vte_pZ•t,Le4- pL+ ,kepRESS 23 & „Liete on CI • CITY Ma 51,t p e c_ STATE ATE I MA. ZIP �3 a(.' ((j I I EL ( �0,.-:.' 7'7r s 'S.7 r FAX l -1 CELL15eg- ,.l} - JEMAIL t - , ( C-c.: 4". e*le,;;v:-k 4-:; 4 (:.4,, ;„/1