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Home My WebLink AboutBLDP&G-20-004245 - MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK -'r_� CITY •L (4 riv/IDI 1,or'I 9 MA DATE !!.: PERMIT# /' v a f ,1 JOBSITE ADDRESS ( ' pf -c a ai-c L OWNER'S NAME C,IAL{ri Silt/AA-,, j/l j1i'0+J#. 1 P OWNER ADDRESS X- VC 41vf itit got,-PL v' 1441EL�;�O.,-16k -� 1IFAXII TYPE OR OCCUPANCY TYPE COMMERCIAL[i EDUCATIONAL ® RESIDENTIAL lEr PRINT CLEARLY NEW.® RENOVATION:® REPLACEMENT:2---- PLANS SUBMITTED: YES® NO' FIXTURES 1 FLOORS 2 3 6 7 8 9 10 I � 14 BATHTUB NMW MI „,�... .I WWW wimp.: . CROSS CONNECTION DEVICE IMiI�j�[�- 1 '; OMIM. '' DEDICATED SPECIAL WASTE SYSTEM WNM INN I♦�W I 1 I IJ1 I'WI DEDICATED GAS/OIL/SAND SYSTEM On - I I ' Iw1 J DEDICATED GREASE SYSTEM M MI IM,M� I! M I M� WAIN: DEDICATED GRAY WATER SYSTEM II'Filli ��WW __ DEDICATED WATER RECYCLE SYSTEM •T 1 . pis Noir.I I l - . -_ DISHWASHER '—[— - MI •—:� `��... DRINKING FOUNTAIN 1 FOOD DISPOSERRIL _ liminlim _ n. FLOOR;AREA DRAIN Ili NM INIF—IWIIMIN IN=MN NMI.MIMilj. INTERCEPTOR(INTERIOR) M = ; ■IMI�� jiIW KITCHEN SINK I__, ,, �,'OW� _1 ; LAVATORY ��1 _ NN ROOF DRAIN ,[mML-nomm imam g.I I!II .,,,, ..nff,.: SHOWER STALL a , SERVICE I MOP SINK URINAL —',I' —i I_OM . . M.17.11. WASHING MACHINE CONNECTION OM I _ _, ',ME, 'E;[_ ; 'i WATER HEATER ALL TYPES OM Mill rirlIWWWW IMOI 1IIM11110 1_:- WATER PIPING M!MI t l l ... I. i( II N)'II OTHER _.1.I _ I�_,_.. W�! �I�1 I I SW 1111111.1111 wwiw M ,_,.I gi W WW 1I !- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Li NO D IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW I LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND I-1 OWNER'S INSURANCE WAIVER:lam 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 13 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 t t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance ith all P i t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME R PETER CHECKOWAY LICENSE# 13417 i(f3TC�DFRTURE MP 0 JP® CORPORATION L# 4008 PARTNERSHIPLJ# LLC®# I COMPANY NAME BOURQUE HEATING&COOLING CO ADDRESS 1199 PITCHERS WAY 1 CITY HYANNIS STATE MA I ZIP 02631 TEL 508-790-2887 1 FAX 508-771-9696 I CELL 508-735-9993 'EMAIL info@bourgeheatingandcooling.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK �r 0-5� a ��{.�, ar `:I•- CITY �J ' iD(i' 7 .._ 1 MA DATE PERMIT 009' y5 JOBSIT ADDRESS I T 1910-e (.i 1 OWNER'S NAME eitirkI a,044 '1. GOWNER ADDRESS � 0C t ' it 1[i Jthii44/i f, !• / D 1 TEL m�;�,'�, ,a FAX1 TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL (D RESIDENTIAL IV PRINT CLEARLY NEW:D RENOVATION:® REPLACEMENT: PLANS SUBMITTED: YES LI NO," APPLIANCES Z FLOORS—. BSM 1 ' 2 3 4 5 6 7 8 9 10 11 12 ' 13 14 BOILER i__ I _. _�I_ _�__I__.'. ___ .4 4. U _ ,,, _. `_._ . Ii A ,Wit . . t BOOSTER L4=% F .� . ` CONVERSION BURNER I_____! I 11 ( ;. -I-- ._...--- -. ,i 1„ ._.�,..... COOK STOVE �� ,� NM • ;oamour __ DIRECT VENT HEATER 11111nlit__._ ` ___.... t t • iM'j1 : DRYER L.._...._ �. �._ . � �� FIREPLACE NM I 1 �� T MIN M'—, .__ FRYOLATOR 1. II 11 I, i ! a ---Ift � ._ .___ FURNACE �� .. _.1--.__,.(i _�__P.�__ __ _ ._._ � _._._.. �.___._�� -._- ..� i 1 ) . GENERATOR I� it ' GRILLE I I 1 II II i..___IL.___P_--__I' ' f INFRARED HEATER )---L__-_J.;____1J Ji L_ c_�')_1l 1, LABORATORY COCKS immosim It—, 'i: -� .. �; 1, ... `•- MAKEUP AIR UNIT ow mom IIItr='IIt I�iIitlIIIMILs,INIIII; , OVEN L_. U_ U.. U. Lk-- POOL HEATER L_-._e._._ i ._._o .. _, it .. .. ROOM/SPACE HEATER _ � �I k_ L_ ,I ?: ROOF TOP UNIT ? . _ �; TEST L. L__.EI _ t. A I u f Ei _._3'- I UNIT HEATER . Ls u U 1 - ! 11 I'. -... i i U___.ii UNVENTED ROOM HEATER _ WATER HEATER Its ' MINN :1•' OTHER i Millt' INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES 0 NO El I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 'ijj OTHER TYPE INDEMNITY BOND Q 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 1 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 t. = •= t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complian•- with all '- ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. - PLUMBER-GASFITTER NAME R.PETER CHECKOWAY I LICENSE#I 13417 r NATURE MP Ii MGF Li JP LI JGF❑ LPG!0 CORPORATION L# 4008 PARTNERSHIP LJ# I LLC❑# COMPANY NAME: B_OURQUE HEATING&COOLING CO I ADDRESS 1199 PITCHERS WAY CITY l HYANNIS I STATE MA ZIP'02601 ITEL[508-790-2887 1 FAX 508-771-9696 - 1 CELL 508-735-9993 EMAIL info@bourqueheatingandcooling.com _ 1 L'e6L ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 1