HomeMy WebLinkAboutGasfitting Permit 6/22 no # MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
CITY tAl, 1Ar'vd 4 r` MA DATE (.0l i 119 PERMIT#
JOBSITE ADDRESS 'i S 6'1 3--4-t 5 OWNER'S NAME C.�r r• L•zf„A A lv
GOWNER ADDRESS TEL FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL ❑ RESIDENTIAL 0/
PRINT
CLEARLY NEW❑ RENOVATION:QV REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO 0
APPLIANCES 1 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/S PACE H EAT ER
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 Q40 0
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERA E BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY 0 BOND 0
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 0
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 'th all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. {ce`�
PLUMBER-GASFITTER NAME LICENSE#3018 7 SIGNATURE
MP 0 MGF❑ JP Ell JGF❑ LPGI 0 CORPORATION 0# PARTNERSHIP 0# LLC❑#
COMPANY NAME 1 I Ar'iS (7 4+i,\i N3 ADDRESS 61 14v IS A sIC
CITY Ten`7 N STATE •\J- ZIP U' 3 � TEL
FAX CELL ? g 6 1'G 6 I EMAIL
Chris LoPilato
100 Grandview Rd, Suite 310
Braintree, MA 02184
617-592-7872
June 9, 2022
RE: 45 Hasting Ave West Yarmouth
To Whom It May Concern,
I am the home owner of 45 Hasting Ave, West Yarmouth. I am writing to request the transfer of the
plumbing permit from McBride & Sons Plumbing and Heating to D. Llanes Plumbing.
McBride & Sons Plumbing and heating will no longer be working at 45 Hasting Ave, West Yarmouth.
Thank you for your help in this matter.
Sincerely,
Chris LoPilato