Loading...
HomeMy WebLinkAboutBLDG-21-000413 - - MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE IJuly 29,2020 PERMIT# BLDG-21-000413 JOBSITE ADDRESS 011 CUTTYHUNK LN I OWNER'S NAME PITRUZZELLO SEBASTIAN G OWNER ADDRESS PITRUZZELLO ANGELA 404 BARTHOLOMEW RD MIDDLETOWN CT 06457 TEL I TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL El PRINT CLEARLY NEW: 0 RENOVATION:❑ REPLACEMENT:© PLANS SUBMITTED:YES❑ NO FIXTURES FLOORS-. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE 1 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 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY© OTHER OF INDEMNITY❑ 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. 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 Ralph Giangregodo LICENSE# 9339 SIGNATURE MP©MGF 0 JP❑ JGF❑ LPGI 0 CORPORATION❑# PARTNERSHIP ❑# 1LLC❑# COMPANY NAME: RALPH J GIANGREGORIO ADDRESS. 188 Route 28. CITY Dennis Port STATE MA ZIP 02639 TEL _FAX CELL EMAIL Iofficena,3gsplumbina.net 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 F-I 1I - f J�11 1.C1..- 6 i i13t a a 4 1.17,1270R11.4 AFFLIC;AT! Fib A PERROT TO PERFORM irk Rrame 1111 1=1 _ 7,---46. -2- /-Cod `-/r3 ker GU -50 roo 4h I: MA. DA1L" I, Zi a� a0r JO13Sf"i EADDRES8 Cu -4.1 )L>-- l,.. L(\. l OWNER'S NAME C'�,,r 1 ice, t-+ru - Ito Jr• 1 G- - aliJw ADDRESS: '' 1 :1 . 1r, <4 i 3_ `-I 5)u(FA t: Y. 1 '°R- OGGUI'ANCY iYP GOi►-teRCI`I Q E�1L I.1CAT1Qi'AL 0 . ENEMA-0/ CLEilaLY NEt'V 0 RENO ATION:t i REPLACEiE1IT: - PLANS Stl81b t i ' YID Nail PIXUTRES v FLOOR I aunt ) 1 ` ? I 3 ' 4- S 6 . I T S 9 1 10 11 1 /2 13 14 , BDILC? i I _ -T —I I 1 BOOSTER - I- CdiYvEi":8ION SUMER I - co_!: _ - • I t I 1 1 l f OIMG-1 VENT HATE ] - I - - _ I i,l;Y_a I 1 1 1 i 1 _ I FtrEP;RCE- . I • I I I I I____.__FrivOI OR 1 1 I 1 1 I uptisy CE 1 1 ( I 1 G:;iLj,g I I - I ' 5QRRTotill COCIle 1 1 - I I I i,4i 1@t�IR !ill► I f i I � POOL .--.-. ... Pt I ( I I l : I I l�Ir.A1'i .I I 1 1 I I i ROOM I SPACE HEAi ROOFTOP UNN!l - I 1 I 1 • I i I } • T�.0 I' - 1 1 1 1 I .I I I I ! I l 1 I!An.li �R 1 I —I 1 i, I I I uh!\i .F4ThO ROOM HEATER .1 1 t 1 -- 1 l 1 - I l 1 I 1r1'P1T R HEATER 1 I I I I I- I I i - 1 I I I - ___ 1 1 i I 1 1 1 fr (-I 1 I I I I 1 1 1 1 i i—+] 1 1 IiI1.SLIR RICE COVERAGE I have curs-Err liabil-i'?:frzurancepitty arils subs��I` ai iticitr2a5 ME raffitSWIt of MGL G114 _E rag 0 If you Nave cheetcsa pla2.saindicE -.ihetyos.of coueraueigrcheccM 1.g ppra siaieU,rzb..IoJ L(AEILET tr QIL3U_AIIICE P i 1CIT OTHER TYPE INDEEiilf}D1!T'( U BOND 0 - OMER'S IiBL P.AItiCE!Ufl/R:l am a-are illel tie licsis ao ,1a,- avn 117e icta+sance coveaga req v Chapir 142 of the - Massac 1usVcs`emal Laws..any;that 5i nature Gil Lh s p sh appiiea or:>;:ar this raqoire=an - CEECIC Oi'iE ONLM Ql111ILEI; 0. AMFf 0 SIGNATURE CIF OWr R OR AGENT' . hereby certiy that all of lba details aiid inincraflon I have submittal Watered)mating jilsapplis;aIiar are hue and accurate IN the bast of ray I;n glerlge EI r5 lhei all plumbing'IWt Id loi12110ons performed undi:,the parart Issued fortis applicati 11 I , I J;, ' ';-11 P.01"t/ provielon of the MagnaliuseM Stgo Plumbing Code and Ci apie i 2 al'the General Lai=s. PL41MBGC`10611 i I WI M},��' PA-11Z7 C r-"it/61 60_,Lt1A!1GI '?SE•1 1 SIGNATURE COi+nl'ANV lgAllilE:1:. C" A'c 44r!C`t- - 75-32/C= 1=DRESS:i "rc A'1r? _` ' . :'7'7 r '--1 Cll\r: (s.2i=7fi l/f~r.r2L J-7'7 —.. i r']I f 1/-f jib ZIP: Q f — a PAX: O� J_ - I U �v ...Fc �f' �_ )Cam.:LaJ 7R;%4 1.]�',11..: -D i-+t j CAL 3CI cYn h►;1�,I•((t?^1' ._,_1 '--.- �� J ! C �t�1•'ir`ti10* � i.I.0 t I try��m.._' MASTER Z JQLIFI��I NIAN 0 LP If9STT- L_ C N gt ai 4�;�ii►'iitt-,- IFi�'�.�ill_ L — �j�� 2 8 2020 a f3uti,'D!N0 t�F PART ME NT i 41 J °1� fir' . fi