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HomeMy WebLinkAboutBLDG-23-006044 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE May 03,2023 PERMIT# BLDG-23-006044 JOBSITE ADDRESS 21 CAPT WRIGHT RD OWNERS NAME SPRITZA LOUIS J JR G OWNER ADDRESS SPRITZA CATHERINE F 21 CAPTAIN WRIGHT RD SOUTH YARMOUTH MA TEL 02664-2835 TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL El PRINT CLEARLY NEW: m RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED:YES 0 NO El 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 1 FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM!SPACE HEATER ROOF TOP UNIT TEST 1 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 El 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 Craig Bishop LICENSE# 15101 SIGNATURE MP❑MGF❑JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC❑# COMPANY NAME: HIGH EFFICIENCY LLC ADDRESS. 378 Route 130, CITY Sandwich STATE MA ZIP 1025632342 TEL 5088253695 FAX CELL EMAIL salessu000rtW.high-effciencvllc.com 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 RECEIVED _R MAY 012023 . MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM A p M E T VI A 1.7...I. Gin, 't , ,. ,• . ,, MA DATEi ' PERM! : OIr , e9y .C7 > ..t s..�V�I+;uu�r'ror•x ..�..p...yr,y.. 't f„+�.•,.r.-.>.- r�.ca,--'.n,•.•„ram..- OWNER'S NAME ' `t�a-. . JOBSITE ADDRESS - OWNER ADDRESS i ,r,.._,._„r.,,,,,,I ha-51,,,LVFAX TirkiE O CI FT}UCATIONAI:, l RESIDE IM PRINT OCCUPANCY TYPE CO fMER AL;,,o,t L CLEARLYNEW:i t..( RENOVATION: : REPLACEMENT: PLANS SUBMITTED: YES x NO 7. APPLIANCES 1 FLOORS* BSM . 1 MI 3 _4 5 67 8 9 10 19 14 BOILER '_ �' �� aMIWIMM....,��,...�.�.111.MILI `, l BOOSTER . 11_ i` '- ... '?e '!� Wi� I CONVERSION BURNER 1. - ii1I'M `, �1Wft11 Cook STZ5VE 1-~...ii '! .�WA�1 �_ .1 lM DIRECT VENT HEATER FM WE ! � ''j��.� 1, � - iI EWW:. DRYER � E.- ..-� . _ a FIREPLACE E li ---- l. ._..-_,�M .•,...._.,- i I ' 'E FRYOLATOR • 1 r _ _.�I ME�; MIM FURNACE -- I � ��s GENERAToR M 1 W1 -. - W1. GRILLE W�__ '----- - it �M' . i 'I INFRARED HEATER i i I • L 'M M�'�W OMAIMIR LABORATORY COCKS MM. ��O I L--- -.`_��_� MAKEUP AIR UNIT M -� '—' FRA ilEME OVEN -- - -^� - � � PIIIBMIIIIII POOL HEATER I— ; J� ! �. i III 1 QD M I SPACE HEATER IL - 1 ;_ --- i W ROOF TOP UNIT '_i III l M i _._: Mr�,....-,.�� I g I TEST L. IEMIMi ...'li`�1D�r'...,.,.�,.+llrr_r —�; � �,��• , • UNIT HEATER E 1 I �,~_ _ ,, r._.V. ... ..-w 1 .. UNVENTED ROOM HEATER 1 - _: ^ _ Y , ' r. WATER HEATER MC _,...j. ,�,, �i -- ---.___—�----E , OTHER - _ !'ESL_-_..-�a -.-. 1 -..,,w 11.- _.INEE _ ---,. _ li MOM BEMMIW 'L.::::v..:• -= ----- 7CI:CLI Stir"-1Sr• .:;;=:i.-'.Ctf.W+.+......-. .g. -''f.___ • '.' .i �_-• _ .-��.. I_Iww�wlM. _ 'livE III!_/ iNNIMPIRMIVOW _hQr.ry r.......1._n/.:r-.W�`��YP'fGY` v�„�.�,�,�,�,.,.,�.._ S�»af INSURANCE COVERAGE -�, ` I �� n oIic or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES „y NO I have a current liability insurance Y . I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0, OTHER TYPE INDEMNITY I I BOND fil OWNERS 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 wrarvesthis requirement. • CHECK ONE ONLY: OWNER 1 j AGENT H SIGNATURE OF OWNER OR AGENT my n edge - e I hereby certifythat all ofthe details and information I have submitted or entered regarding this application are e and accurate with a 1 to the best pr of ' th and that all plumbing work and installations performed under the permit issued for This application wit ben comp C'el Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Cri----------- ------7 #��S�IQ� SIGNATURE PLUMBED GASFITTER NAME Grai Bistic 1 LICENSE ,- -Twr ... - D I CORPORATION I,j#1. I PARTNERSHIP , #1.,.M._.� il, LLC _0#L 'I MP MGF�.,...... JP L�.rtl JGF i� I`PGl .. ... � ...�,.•.�...,.�.., --- � � �ADDRESS�378 route �3Q COMPANY NAME:kHIr�h_EfCien . . „,_ .�_.,. ._....._........ . . .,,,,,... E - . - . .C•��'\7/ Sandwich STATE Ma > SIP i 02 E3 TELL .�.� .^..z�,..-�.._ ..,.,� �� .�,r..,. ... I • _ .l EMAILl, salessupport@high-efFiciencyllc.com . r , FAX {{ CELL ,u .- u_ - .. ma.uye ur•.....,......rl . . . . . e