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Home My WebLink AboutBLDG-19-002786 M L6�i MUYAW Raid aaQczc et yaR 0 111;51 A war_____=- 19TaiblifivAl hi.„(„2„, o"- , o .61. (8 1025, ua , ,u ., 911A 01775 ' ft..4.41b PERMIT DIG SAFE NUMBER City or Town: Yarmouth Date: 10/02/2018 Start Date: Permit Number(if applicable) 102338 In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted to: Glenn Sherman/New England Plumbing For permission to: Unvented Gas Heater Installation 527CMR 1.12.8.6 Restrictions: Strict and complete compliance with all federal,state and local laws, rules, regulations and codes. Notify YFD before and after work is complete. At: 2 CUTTER LANE/West Yarmouth, MA 02673 Fee Paid $ $50. 00 This permit will expire on Signature of Official Granting Permit Title C A T bl j C This permit must be conspicuously posted upon the premises - `-' IVIASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY 4J e> ✓A-L- MA DATE /0 /K PERMIT# -ea JOBSITE ADDRESS 2- �JT'@.r'' L.�111 OWNERS NAME nt'', Cc-SS; OWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL©""----- PRINT CLEARLY NEW:❑ RENOVATION: REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO APPLIANCES FLOORS--I BSM 1 ? 3 1 5 6 7 3 9 10 11 12 13 14 BOILER —� BOOSTER —� CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE ' _ _ I FRYOLATOR FURNACE GENERATOR GRILLE _ INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN T i POOL HEATER 'c ROOM;SPACE HEATER ROOF TOP UNIT TEST ... / UNIT HEATER UNVENTED ROOM HEATER __ WATER HEATER OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES L 1lOO ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE Y 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 and accurate to the best of my mowledge `— and that all plumbing work and installations performed under the permit issued for this application will be in compliance all Pertinent provis' of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME 6 � 5� LICENSE#Zc'7 J SI 'NATURE ► tr�,,.+Gw MP ❑ MGF❑ JP JGF❑ LPGI ❑ CORPORATION❑#F PARTNERSHIP❑## LLC❑# COMPANYNAME ADDRESS ec) ,...5 CITY g r(e/ c, L STATE /} ZIP o Z6 Y•SS" TEL 7,$1- GoP-c.w ' FAX CELL EMAIL ,a r il z I 0 PI I OD 1 iO4 Gzq i I I I I ]'' II— �1 w0 1I < IzIa � >- w _ _. .. . . Q0,4 F- Q. < ti1.. 1 LU I I- I IIz 0 i 1 i c cr1 1 C, i 6 g 1 . I I