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Home My WebLink AboutBLDG-19-004806 t. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK r CITYltPPOOMIf)2 MA DATE /2 J / •I PERMIT* /�06/9-aG & JOBSITE ADDRESS . L(I�b�IQ/ % & CAA) OWNER'S NAME • e�tte vs > GOWNER ADDRESS TEL-)IA_ TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW: ❑ RENOVATION:I2C REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO 0 APPLIANCES 1 FLOORS-4 9SM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 ' BOILER BOOSTER CONVERSION BURNER _ COOK STOVE - DIRECT VENT HEATER 11 DRYER j - FIREPLACE FRYOLATOR — _ T FURNACE _ GENERATOR R GRILLE INFRARED HEATER /iW, sr- LABORATORY COCKS — 4 2210 MAKEUP AIR UNIT �- OVEN ,��, RT SU POOL HEATER ; r ROOM I SPACE HEATER _ . j i t - . ROOF TOP UNIT 1 I TEST ' 1 i . UNIT HEATER l ( I I INVENTED ROOM HEATER I 'WATER HEATER i• 1 OTHER — f _ ' INSURANCE COVERAGE I have a current liability insurance policy or its substantial equtvalettt which meets the requirements of MGL Ch.142 YE,NO 0 I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 01 LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ❑ BOND 0 OWNER'S INSURANCE WAIVER:I ae1 aware that the licensee doss not have the insurance coverage required by Chapter 142 of the I Massachusetts General Laws,and that my signature on this permit application yraives this requirement, CHECK ONE ONLY: OWNER 0 AGENT ❑ SIGNATURE OF OWNER OR AGENT I herel h 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 end installations performed under the permit issued for this application will be In compile with all Pertinent provision of the Massachusetts State Plumbing Code end and Chapter 142 of the General Laws. it , �, k -- 'LUMBER-GASFITTER NAME tNi L646,R LICENSE# //,o // M� !�`�-r 'SIGNATURE IP 0 MGF❑ JP 0 JGF 0 LPG! CORPORATION 0# PARTNERSHIP❑# LLC 0# OMPANY NAME t--71.S re--I&-) U'c2(D104 tom^ ADDRESS U'� • lAak 1707 Ty ) ; ) L.. /U i___S STATE ZIP 0,4 e TEL ,s- Si 740 2 ? > x 7 4 P I1.3 3 CELL &J 1 / 7 7 7' EMAIL,/Lao Fa'R f Ud1k: & z-)4VpoKI, co/i /0 4 j, Application for Extension Type: Gas Board Meeting Date: 10/1/2008 Manufacturer. Flue Sentinel, Inc. Product Name Model Action Approval Coda:Expiration Data/Tabling Reason Commonwealth of Massachusetts .w^ =�� Division of Professional Licensure -M-. _,7,11._ .. Board of Examiners of Plumbers and Gasfitters '�` v 4th Floor 239 Causeway Street, Boston, MA 02114 Flue Sentinel, Inc. October 3, 2008 51147 Simone Industrial Dr. Shelby Twp. MI,48316 USA You are hereby advised that on 10/1/2008 the Board took action pursuant to your application(s)for extended Product-approval for product(s) as indicated on the attached list. Approvals The approval number(s) displayed have been granted. Please be advised, the product shall be installed in compliance with CMR 248, the Massachusetts Fuel Gas and Plumbing Code. Your extended Product-approval is in effect for three years beginning 10/1/2008. At the expiration of the extended three year Product-approval it will be necessary for the manufacturer to petition this Board for an additional three year extended Product-approval. You are further advised that the preceding Product-approvals are not to be construed as an endorsement of these products nor is this letter to be used or reproduced as advertisement of the products. Tablings If an extended Product-approval was Tabled for'insufficient receipt of(a specified)fee', forward the balance of the fee due, directly to the Board Office at the addrtess shown above. Additionally, If this is the only reason for the Tabling decision, you will not be required to appear before the Board again. If an extended Product-approval was Tabled due to the absence of a manufacturers representative-'Failure to Appear' as required, call the Board Office at(617) 727-9952 to re- schedule an appearance before the Board. Failure to reschedule within six months of the date of this correspondence will result in the application fee being forfeited and:the closing of your file. Note: extended Product-approvals may not require a manufacturers representative to be present at the Board meeting. Please call the Board Office for verification. If you have any questions regarding the extended Product-approval decision reached by the Board, please call the Board Office at (617) 727-9952 or email the Board at Cynthia.E.Johnson state.ma.us. c.a•rim 3,a 'et, Very truly yours, For the Board 1,•'*:7= ,ffl4'lael we Director Boa • of State Examiners f Plumbers and Gas Fitters htto://www.mass.aov/doi/boards/ol/ Notre.ofeoasdacaon•875 Application for Extension Type: Gas Board Meeting Date: 10/1/2008 Manufacturer. Flue Sentinel, Inc. Product Name Mode! Action Approval Coder Expiration Date/Tabling Reason Flue Sentinel FOE-10 10/1/2011 03-1008-144 Approved Flue Sentinel FSE-11 10/1/2011 G3-1008-144 Approved Flue Sentinel FSE-12 10/1/2011 G3-1008-144 Approved Flue Sentinel FSE-13 10/1/2011 G3-1008-144 Approved Page 1 of 3 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Mass.Gov Hama State Agencies State Online Services Home Division of Professional Licensure>Board of Registration of Plumbers and Gas Fitters> SEARCH Approved Plumbing Products Online System Office of Consumer Affairs Search By the Diyisip3 fPrpfg eonal licenStire Table. ONLINE PLUMBING PRODUCTS SYSTEM: SEARCH RESULTS ONLINE SERVICES Search Criteria There are 23 records)in our database Type:Gas fitting your search criteria. Please note that Check a License Manufacturer:Flue Sentinel if your product is not displayed in the Locate a Licensed Product: search results,you can refine your search Professional Model: criteria. Online Address Change Description: Displaying page 1., of l t search results New Search pages Contact the Agency Requested products per page: 50 More. PRODUCT, APPROVAL DESCRIPTION, MANUFACTURER MODEL APPROVED EXPIRES CODE APPROVAL CONDITION FSE-10 Trade Flue Sentinel Flue Sentinel, Name:Flue electronic Damper 10 Inch Inc Sentinel 9/112004 10/1/2011 G3-1008-144 Trade Model:FSE 10 FSE-11 Trade Flue Sentinel Name:Flue Flue Sentinel, Electronic Damper 11Inch Inc Sentinel 9/1/2004 10/1/2011 G3-1008-144 Trade Model:FSE- 11 F5E-12 Trade Flue Sentinel Name:Flue Rue Sentinel, Electronic Damper 12 Inch Inc Sentinel 9/1/2004 10/1/2011 G3.1008.144 Trade Model:FSE- 12 FSE-13 Trade Flue Sentinel Name:Flue Flue Sentinel, Electronic Damper 13 Inch Inc Sentinel 9/1/2004 10/1/2011 G3-1008-144 Trade Model:FSE- 13 FSE-14 Trade Flue Sentinel Name:Flue Flue Sentinel, Electronic Damper 14 Inch Inc Sentinel 9/1/2004 10/1/2011 G3-1008-144 Trade Model:FSE- 14 FSE-16 Flue Sentinel Trade Electronic Damper For Gas flue Sentinel, Name:Flue Log Fireplaces•16- Inc Sentinel 10/5/2005 1/6/2013 G3.0110-266 Electronic Ignition Trade Model:FSE- 16 FSE-18 Flue Sentinel Trade Electronic Damper For Gas Flue Sentinel' Name:Flue Log Fireplaces•18' Sentinel 10/5/2005 1/6/2013 G3-0110-266 IncElectronic Ignition Trade Model:FSE- 18 4/1/2010 Page 3 of 3 PRODUCT, APPROVAL DESCRIPTION, MANUFACTURER MODEL APPROVED EXPIRES CODE • APPROVAL CONDITION Trade Model:FSM - 18 FSM-20 Trade Flue Sentinel Name:Flue Millivolt Damper 20 inch Flue Sentinel, Sentinel 3/2/2005 4/1/2012 G3.0409-439 Trade Model:FSM -20 FSM-20 Flue Sentinel Trade Electronic Damper For Gas Flue Sentinel, Name:Flue Log Fireplaces•20" Sentinel 10/5/2005 1/6/2013 G3-0110-266 Millivolt Inc' Trade Model:FSM- 20 FSM-22 Flue Sentinel Trade Electronic Damper For Gas Flue Sentinel, Name:Flue Log Fireplaces-22' Sentinel 10/512005 1/6/2013 G3.0110-266 Millivolt inc' Trade Model:FSM. 22 FSM-24 Flue Sentinel Trade Electronic Damper For Gas flue Sentinel, Name:Flue Log Fireplaces•24 Sentinel 10/5/2005 1/6 2013 G3 0110-266 Millivolt Inc- Trade Model:FSM- 24 Rost Pipe I Previous Page{Next Page I Last Page 02007 Commonwealth of Massachusetts Site Polices Contact Us Site Map 4/1/2010