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Home My WebLink AboutBLDP&G-20-000909 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK iii s—./ — •'lam-i CITY Yarmouth MA DATE 8/5/19 PERMIT#/14,-,19 02'!OQ JOBSITE ADDRESS 6 Marlin Way OWNER'S NAME Davenport Realty POWNER ADDRESS 20 North Main St. TEL 508-367-0116 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL Q RESIDENTIAL 0 PRINT CLEARLY NEW:J RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES❑ NOU FIXTURES-1 FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB L i I 1 I I 1 j I CROSS CONNECTION DEVICE ii ' DEDICATED SPECIAL WASTE SYSTEM MIM `- M MMi um.. DEDICATED GAS/OIL/SAND SYSTEM 1 li 1 i i DEDICATED GREASE SYSTEM i DEDICATED WATER RECYCLE SYSTEM �III_I DEDICATED GRAY WATER SYSTEM DISHWASHER , 1 , r1711ffrill. F UNTAIN ___,� DRINKING 0 FOOD DISPOSER ii- • INTERCEPTOR(INTERIOR) Ii ®®� FLOOR/AREA DRAIN ®V KITCHEN SINK II IM LAVATORY � II _®-�M NM _ R•• DRAIN � SHOWER STALL mg MEM.WW1 OW 1---- INN -mill Mit IIIM� �1 I�1� TOILET � �� iI WASHING r.: MACHINEWATER CONNECTION IQ emot:, ,,,____, ,�I'MI . , , . , r _ WATER PIPING .... „ OTHERan, I I' „, I gi_ ,Iii, I II�� I-IC I. ,_ - INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES J NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY Q BOND Q 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 Li AGENT El 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 a ccur to a st of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli with Pe t r is' n of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Keith J. Farnham I LICENSE#111601 I GN TURE MPEl JP® CORPORATIONQ#1.1698C_ IPARTNERSHIP[1# 1 LLCI_ I# COMPANY NAME South Shore Heating&Cooling, ADDRESS 57 Whites Path CITY South Yarmouth STATE MA ZIP 02664 TEL 508 398 6901 FAX 508-760:22j CELL EMAIL info@southshoreheatingcooling.com • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 111 CITY [Yarmouth MA DATE''8/5/19 j PERMIT# �1-/I)-a0'�X�40( JOBSITE ADDRESS 6 Marlin Way OWNER'S NAME Davenport Realty GOWNER ADDRESS 20 North Main St 1 TEL 508-367-0116 FAX I TYPE OR OCCUPANCY TYPE COMMERCIAL _ EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW:!, i RENOVATION:® REPLACEMENT: PLANS SUBMITTED: YES❑ NOD APPLIANCES-1 FLOORS-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER I I I--- I BOOSTER 2 �W. _ CONVERSION BURNER111111111111111 COOK STOVE r i I DIRECT VENT HEATER ram DRYER 1! 1 _ II � �. ,r I FIREPLACE — l�_ MI FRYOLATOR � GENERATOR t , FURNACE I am GRILLE 01111111•1i -:_ PIN INFRARED HEATER _ LABORATORY COCKS 7 . 1 MAKEUP AIR UNIT ; 17 11 ' —— - OVEN I i 1 1i POOL HEATER I. !' �[— ROOM/SPACE HEATER J 1 7 ; --IC ROOF TOP UNIT L 'r "--- —I_ �r — s TEST L. 1 r �� UNIT HEATER1 _ �I UNVENTED ROOM HEATER r 1 WATER HEATER 1 OTHER 1 l l it it -. - L Fl.A. i�.o. I.-- — l INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES 0 NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ''j OTHER TYPE INDEMNITY I i BOND 1--1 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 an accur e t t e knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compr e wit I P rt e provisio of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. t PLUMBER-GASFITTER NAME_Keith J. Farnham LICENSE# 11601 1 SIGNATURE MP 0 MGF_J JP❑ JGF L LPGI i I CORPORATION❑# 3698C I PARTNERSHIP I LLC❑# COMPANY NAME: South Shore Heating&Cooling, . ADDRESS 57 White's Path , CITY South Yarmouth __1 „ STATE! MA I ZIP r02664 TEL 508-398-6901 FAX 508-760-2681 CELL EMAIL _