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Home My WebLink AboutBLDG-21-003134 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ,i' CITY IYARMOUTH MA DATE December 02,202( PERMIT# BLDG-21-003134 JOBSITE ADDRESS 7 WISTERIA RD OWNERS NAME FERRI PETER TRS G OWNER ADDRESS FERRI MARIANNA 1384 WASHINGTON ST NORWOOD MA 02062-4021 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES ❑ NO ❑ FIXTURES FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER 1 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 I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER _UNVENTED ROOM HEATER _ WATER HEATER OTHER OTHER DESCRIPTION: INSURANCE COVERAGE: I have a current liability insurance 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 Kevin Mcbride LICENSE# 11620 SIGNATURE MP❑ MGF ❑ JP❑ JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: KEVIN J MCBRIDE ADDRESS. 11 COCHESET PATH, CITY WEST YARMOUTH STATE MA ZIP 026732559 TEL FAX CELL EMAIL kmcplumb(a)comcast.net ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTIONtNOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE:$ PERMIT# PLAN REVIEW NOTES 60,00 fPio5 0 Ce r3a9 . 0 -7 MASSACHUSE r1 S UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING VVORK CRY ligyvn ofy 1 MA DATE? R PERMIT# i JOBS1TE ADDRESS^7 11): �- �.�„� ___ OWNER'S NAMEI ,} j1r' c OWNSZ ADDRESS f' S roc 1�nr c o ��)( • M14 Tq 'y rF ) 4qF AX TYPE OR PRINT OCCUPANCY TYPE COIvMERCIAL= EDUCATIONAL [I RESIDENTIAL NEW:Li RENOVATION:0 REPLACEMENT: Z. PLANS SUBMITTED: YES[ NO Li APPLIANCES 7. FLOORS-} BSM c 2 1 3 4 5 6 7 e 9 10 11 12 13 1 14 BOILER - ' - _ f r 11 BOOS1 _ _ _ ` _ CONVERSION BURNER milmtwismomminurimilWANCIWAIN COOK STOVE '11 _ _ 1 r DIRECT.VENT HEATER DRYER .111.111=1 ;i Wialitt v_ i FIREPLACE - g FURNACE WEWIIMPIERINEintimirippiL • GENERATOR GRILLE ; T ; .} �f a— , INFRARED HEA • LABORATORY COCKS •' — �� . � MAKEUP AIR UNIT __ - _M_- �_-��. _ - — — '-- =-�-•--- -jam-�;. - -_ -� �- - *. _ •^S� ai POOL HEATER 1111r+►�W',�j��r , „f 4��•4�yy��;�r�t{(�.�i4•44 4111111 ROOM 1 SPACE HEATER ROOF TOP UNIT • TEST � UNIT HEA t}i UNVENTED ROOM HEATER _ HEA - B• ii i 1 t - ; _ : , I OTHER - :' - :_ • ' '' tea ' ~ INSURANCE COVERAGE - I have a current liability insurance policy or its substantial equivalent which rneets the requirements of MGL Ch. 142 YES 4. _, NO 0 I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Lit OTHER TYPE INDEMNITY J - 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 0 AGENT L 4 SIGNATURE OF OWNER OR AGENT _ I hereby certify that all of the details and Information I have submitted or entered regarding this applicbon are true and accurate tope best of my knowledge and that all plumbing work and installa cans performed under the permit issued for this application will be in compliance u _n r3ocryftprovisicin of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. - �� tilre. PLUMBER-GASH i I E1•t NAME Ike,v f C-B: LICENSE j I(, O: - - - SIGNATURE MP ` MGF D JP D JGF t ( tic4 LPG)Li CORPORATION�#La FS�,� G� PARTNERSHIP �� . COMPANY NAME ,can_ c-8r; 4- lc, ADDRESS • Cam' . ‘lr_►rrnrao` - STATE M ZIP, O 67 114 /56 7`7 =4 554 _ i F t 7�0-G-r85 i cat.15ck I,4.- .;7 EIAULI f1� G J u nc' 6 c=.[ er ryas . ()ft 4 • I BU;LLj„vim �rH MENT 6 - By ---