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HomeMy WebLinkAboutBLDP&G-23-000388 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK yfi 3 CITY YARMOUTH MA DATE 7/25/22 PERMIT# BLDP-23-000388 JOBSITE ADDRESS 30 ELLIS CIR OWNERS NAME KUEHN DAVID LAWRENCE P OWNER ADDRESS 30 ELLIS CIR YARMOUTH PORT,MA 02675 TEL J TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATIONS.❑ REPLACEMENT:© PLANS SUBMITTED: YES NO❑ FIXTURFS • FI OORS—. 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 Spencer Hallett LICENSE 16224 SIGNATURE MP ❑ JP ❑ CORPORATION 0# PARTNERSHIP ❑# [ LLC ❑# COMPANY NAME SPENCER HALLETT ADDRESS 381 Old Falmouth Rd Unit 36 CITY MARSTONS MLS STATE MA ZIP 026481372 TEL FAX CELL EMAIL office@hallettplumbing.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ FEES$ PERMIT# PLAN REVIEW NOTES „ .. -- — MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK - - y '''... - It F' .-,4g1 CITY LEST-Cu jeia.- n-LAstet MA DATE PERMIT # L 3 — 03 31 JOBSITE ADDRESS 13Q CI s 6f-cA1c_ OWNER'S NAME! ra,r,;Yn.” POWNER ADDRESS JSc 'Y\Q, TELL5O cot- Lie SAX TYPE OR OCCUPANCY TYPE COMMERCIAL [l EDUCATIONAL ❑ RESIDENTIAL PRINT / CLEARLY NEW: ❑ ID �, RENOVATION: REPLACEMENT: L.� PLANS SUBMITTED: YES ❑ NO[Y FIXTURES Z FLOOR-1. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUBI U II CROSS CONNECTION DEVICE LI LI DEDICATED SPECIAL WASTE SYSTEM I 11 DEDICATED GAS/OIL/SAND SYSTEM 1 (I El DEDICATED GREASE SYSTEM II DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM it DISHWASHER IL I. DRINKING FOUNTAIN ' L E FOOD DISPOSER [I Ii E Ii Ii FLOOR 1 AREA DRAIN y INTERCEPTOR (INTERIOR) II [I U El KITCHEN SINK U U 11 LAVATORY U L! U U ROOF DRAIN LI L U LI SHOWER STALL LL L) U SERVICE / MOP SINK U TOILET U 11- U U U URINAL �[ LJ II 11 WASHING MACHINE CONNECTION / ' ! ii ii Er WATER HEATER ALL TYPES I LI Ii IL WATER PIPING OTHER -1.I Ll 11111111r I U U Ll ll INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES pi NO ri IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY I vi OTHER TYPE OF INDEMNITY Cl BOND L. 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 accura - • ,1"" best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance w' . I P s s " ovi 'on of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. / / i,,:_10r-4 PLUMBER'S NAME Spencer Hallett j LICENSE # 16224 I IGNATI 'E MP[I JP ❑ CORPORATION F1# 3834 IPARTNERSHIPLI#I LLC❑# COMPANY NAME Spencer Hallett Plumbing & Heating T I ADDRESS 381 Old Falmouth Rd, Unit#36 CITY Marstons Mills V �_W _��J STATE MA $ ZIP 02648 I TEL 508-428-6080_ ______I CELL EMAIL office hallett lumbing.com , .-.._,..�..._. _..�...� _-..... ._ _-.�....� -�C f � _ ,... ._r..,-.... FAX 508 428 7991 �.�,..r....@.�„_ _p._....-_..... -.,� ..-....__m_.�.. ,�w.�. .. - MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK Ll1 � CITY YARMOUTH MA DATE July 25,2022 PERMIT# BLDP-23-000388 li ,: z JOBSITE ADDRESS 30 ELLIS CIR OWNER'S NAME KUEHN DAVID LAWRENCE G OWNER ADDRESS 30 ELLIS CIR YARMOUTH PORT MA 02675 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 Spencer Hallett LICENSE# 16224 SIGNATURE MP© MGF ❑ JP❑ JGF❑ LPG! ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: SPENCER HALLETT ADDRESS. 381 Old Falmouth Rd Unit 36, CITY MARSTONS MLS STATE MA ZIP 026481372 TEL FAX CELL EMAIL office anhallettolumbinq.com S310N M3IA3N NVId #1111213d $ 33d ❑ ❑ 11112J3d 3H1 SV S3A2J3S NOI1VOIlddV SIHI oN saA S310N N01103dSNI 1VNIH AINO 3Sfl NO103dSNI 21Od 3OVd SIHl S310N NO1103dSNl SVO HJfOH MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK f ==ail s ``-may f=- CITY v MA DATE 4_ 140 t 3 3 PERMIT # JOBSITE ADDRESS 3c 1.-s 0,j r cl e ' OWNER'S NAME ?rug h 1 GOWNER ADDRESS 5ci. _ TEL J OFAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL Q PRINT CLEARLY NEW: L I RENOVATION: [ 1 REPLACEMENT: I PLANS SUBMITTED: YES LI NO[d APPLIANCES Z FLOORS-+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 I 14 BOILER . _ ....__ 1I _ Jr- ..__.._ BOOSTER II .I l il 1. II CONVERSION BURNER COOK STOVE L._.=.._._I _____IL___ i r - � J I �I 1 DIRECT VENT HEATER II II �[ i , �1 �. DRYER I- II-I I-1I-_ = C_ I ]I FIREPLACE I I II I_ '_ � 1—IT— i1111111111.11111111111111111111111111 FRYOLATOR I r 4 f- U FURNACE GENERATOR _ I -_ GRILLE ___Li___IL— '- lr�I:= --II I! I—_ 1 INFRARED HEATER I ___IL___AL _i. I! I ____ = I LABORATORY COCKS MAKEUP AIR UNIT L____y__-_-I F IF I I I L__ I , IL__ _ OVEN M. I .. .1I ..A .. 1 . .. .J j jI_.. POOL HEATER l 1 11 - 1. il. U l _I ROOM / SPACE HEATER L. l (J 11 .. 1 I J i El I ROOF TOP UNIT L.__ _ I- .-.-II I L.......-.I L__ I_-I I L ,I '_ I TEST -�I I (- I I-. I --i, UNIT HEATER J II E 1 I, U . II 1 F 1. Ili , I UNVENTED ROOM HEATER I ll E I i 1 0 IL J ( I. 1 J II WATER HEATER I: 1 I. U 1. t Ii - ---.. ... 1 . 1.-_ U U I 1L OTHER I .�.. (J � U {1J 011 1 L IJ 1 _ J .J �' jL 1 IL- 1' _IL__ tr 1 1 1 J 1 1 ---1i I L_ __W1 i t I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES v NO , I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY v OTHER TYPE INDEMNITY BOND 1 I 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 i AGENT SIGNATURE OF OWNER OR AGENT — I hereby certify that all of the details and information I have submitted or entered regarding this applicationare true . .• accurate -. - - •estof my knowledge and that all plumbing work and installations performed under the permit issued for this application will be it com• .�•: '4 .i"'ertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r/ rt� PLUMBER-GASFITTER NAME Spencer Hallett LICENSE # 16224 SIGNATURE MP i . MGF JP JGF F1 LPG' ® CORPORATION [# 3834 I PARTNERSHIP ,# 1 LLC [-1# COMPANY NAME: Spencer Hallett Plumbing & Heating, Inc. ADDRESS 381 Old Falmouth rd, Suite 36 CITY Marstons Mills 1 STATE MA ZIP 02648 TEL 1508-428-6080 W FAX 508-428-7991 CELLL EMAIL office@hallettplumbing.com