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Home My WebLink AboutBLDG-21-004249 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK l l'�_ts0� a CITY CRMOUTH MA DATE January 29,2021 PERMIT# BLDG-21-004249 JOBSITE ADDRESS 25 MOLLY RD - I OWNER'S NAME DON FUNARI G OWNER ADDRESS 25 MOLLY RD WEST YARMOUTH 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES ❑ NO 0 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 1 GENERATOR 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 insu'ance 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 Virgilio Silva LICENSE# 31395 SIGNATURE MP❑ MGF ❑ JP❑ JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: [VVIRGILIO SILVA ADDRESS. 155 SUDBURY LN, CITY HYANNIS STATE MA ZIP 026012462 TEL FAX ]CELL EMAIL virgiliomgaRhotmail.com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT 0 ❑ FEE:$ PERMIT# PLAN REVIEW NOTES , T^_� .r-- --- -- -- - . * MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK —�"�l= Yarmouth MA DATE PERMIT # iiD '- dl OCITY 01119I2021 JOBSITE ADDRESSI25 Molly Rd. OWNER'S NAME IDon Funari OWNER ADDRESS 125 Molly Rd. TELL__ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL D RESIDENTIAL El PRINT CLEARLY NEW: RENOVATION: Lj REPLACEMENT: v PLANS SUBMITTED: YES 1-7 NOE' APPLIANCES 7 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER L - 1 _ BOOSTERr '11 _ - CONVERSION BURNER _ r -11-- COOK STOVE ....___ _.,,_ _ ,. �. - . - —..o:.- DIRECT VENT HEATER L., y.,,,_ -. ...IL 1 - DRYER --- -IL. .4. H ---. FIREPLACE �L.._-, `i - ---if ..— FRYOLATOR - i FURNACE - - = ' ,= — GENERATOR - .. - GRILLE I L. _ �______ - -�- INFRARED HEATER E LABORATORY COCKS #11t.... . L MAKEUP AIR UNIT [ L.. OVEN - POOL HEATER 1, .� ROOM / SPACE HEATER ,, _ _ — ROOF TOP UNIT ___ TEST a - _ UNIT HEATER .__ UNVENTED ROOM HEATER r - I - WATER HEATER _ OTHER :, - :_. _M _.... __ �... 4 .. 4L L...._ f......_ INSURANCE COVERAGE I have a current liability_insurance policy or its substantial equivalent which meets the requirements of M9Lsch. 142 l ' ,,� Ns` iii I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW OTHER TYPE INDEMNITY BCI 707 I LIABILITY INSURANCE POLICY � � - . , 1 i OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage requiredby Chapter 142 of the__ ; , Massachusetts General Laws, and that my signature on this permit application waives this requirement. 1 By ,_ ' 24 =° CHECK ONE ONLY: OWNER 0 AGENT fl SIGNA-^URE 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 ot_ y 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 CVirgilio Silva I LICENSE # 31395-J SIGNATURE MP MGF JP JGF _ LPG! E CORPORATION iii.i# 1 _ _ PARTNERSHIP # LLC # I COMPANY NAME:jSilva Plumbing & Heating ADDRESS 155 Sudbury Lane CITY 'Hyannis STATE MA�Zip 02601 ITEL FAX CELL 7748360176 EMAIL virgiliomga@hotmail.com