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Home My WebLink AboutBLDG-22-002509 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ks," - CITY YARMOUTH MA DATE November 02,202'PERMIT# BLDG-22-002509 tl JOBSITE ADDRESS 25 WEST WOODS VILLAGE OWNER'S NAME SUMMERFIELD MARTIN A G OWNER ADDRESS 441 ROUTE 6A YARMOUTH PORT MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ID PRINT CLEARLY NEW: 0 RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED:YES❑ NO 0 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 UNIT HEATER _ UNVENTED ROOM HEATER WATER HEATER 1 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 0 NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 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 1 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 Ronald Hague LICENSE# 7636 SIGNATURE MP©MGF 0 JP 0 JGF 0 LPG! ❑ CORPORATION❑# PARTNERSHIP ❑# LLC❑# COMPANY NAME: RONALD J HAGUE ADDRESS, 62 NEW BOSTON RD, CITY 'DENNIS I STATE MA ZIP 026381901 j TEL FAX CELL EMAIL ronhague(Wcomcast.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 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK it `s6 ir .,rl=_: , �+ C�TYI i .0 r.t, c3� MA DATE 1,,,1!___Vak., 1 PERMlT# Z I', .�.....-.A..�"._ -- Cc2-' 7V I'iSilt�iaTici - _.. av••�-••� i J l DRESSL A?-u,,,.� :\w. • � `� ' - OWNER'S NAME L 1 ctr 1 0 �,�.nw� r� v Z NOV �� 1 OWNER ADDRESS TELq...) 6. 0 -_.. ..._ - -- ... .. - _` _ �._.._..,..�._..--,-MftL4 Z..e-c.e.�.c-(;+may--.O.•i:'a1G:.•c-.+-�.e�,...+ew.mYRA3-.Slti.eirat-.e. � .xx:f�'� aNLe.S.�Q.G.� V F"�i •.......�.....� .r-..-y b�, �- FAX IN DEPARTMENT pitisT— - ('CI PAN YTYP� COMMERCIAL;; EDUCATIONAL 7-1 RESIDENTIAL CLEARLY NEW: RENOVATION: [ ` REPLACEMENT: �::. PLANS SUBMITTED: YES NO APPLIANCES -1 FLOORS-' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER , •..., -. j-�,:��_. - ._�.�... N. ��.• . .,_:... .� .-.e. ._�=w�.z.<,:, ,:.-� �r...;1.��. �u ..1.,.:. )„,,,,,,,,„,„,,,,a BOOSTER 1' # 11I_� 1 CONVERSION BURNER - �._; - _ ,` g y . 1r:�':AS.'t F -J�'•"..3 .,L- '�r:ga �;.i2::�• a ....+,i vr.a] ._2. ..:.: 3rP-lE:.ti+::,t{:2.:•=.LT�'F�.� :l'a'YeR.11 .xu':aYG� ,)g- �A��•'Te�e'+�1 COOK STOVE 3 �j ; G.at.a�,rxa. �•.,ecyasai.-:::sc•Il,.w..r..,:o:-.t tt�' 's.�trrauil.' ,. ... o. .,utv i,t:�+�.r-a-.'rya -«crcau�::ma w:'ua�-:a.,S�:.ucx:.'�r gx:. .�'•-:yrtsuu'.r.�j -' r'''', .r•'�' DIRECT VENT HEATER r— �- :' ----- '' _ — "` T � �.__ Lr-b:vta•s r j-::.a.a•J.•ova Laras'..turd yl.-K.i:t�.u-.•r L, , ,,r,.r...-�a.,,.t-ar»;,rc T.^r.z1.-Kr ra.,r i anr..c.•...u.n.s.F 4.'c urea'. r:.z::; ..."tt• fl •tre)a•�xa•.x:"r Z'..�.•jeklie rl • 1.&Ur.�aa»-, DRYER - r._. 33 �_ 3 y __._$. :2a.,,,,,!•- 4.7.2.6^i Llr.--..r...'.• •rl2[.V.YO1e(J L.,.,..,,,aS:rAIci."2,-- ,...7�"•t. twti- 4 a:J.4t-,:1. -virx:..1,44 '''..fr +;u;W)�wt..t.gww4:,,'N•tr,x,,.:rrA L- r..xur Lr1z-;t-'ia 'FIREPLACE ,Iy __ .4sus..trzt., -rx 9:r»c, :uFa.,-x'..rt .rv.•it •:.F.s.,A j.:ris•..�=tr-o-tr_+, :cs+ruac.-a»a :r>c.s c:I.�'.a...t1 crc.:rt ,a^c.f.sc..S'u.A:warm^s-rx a.ua,�•. • -'.r a::EG-•s fFce...,.a1..aaw�.. FRYOLATOR r-- ��. - -r� II �_ *I-- t L.„.........., ,„,.....dW ii:r,s r-!--iiTV ..,_T.GGA'z 3:r<.-`3«-:rJ'.••5:-rbsi:tr-ai?NM�t6.{s iti.a•S:kai,,¢r•rn\Itn. S,w,,,,,.:J ,,,,„,a.a:3 H+:")qe,,.1.s.i.•lit[ ,,,,,•:.r L..,,,, -;.mac ,,ELL"^,,,,M.R 3:,.=Y_iF:�JLY•-"- i`• - i)+zC.s•x':y4tS tL'rrt:icwFI fi I .a' A'%Sy' 6L 1 . �+"�'.1� GENERATORM _ , t ��. � Eh M-.atr.v � -.gar:soya-•i .. ..,...:a�rmtn+ �..c^rn;-=+suit -.ais'- .a:.cx j-nx.:m4:.rr 1,..�'.es,.-ax..•-,:.� r:m.r.�,•.•.i.-:..:;.:.av-V�2:".a'.- �z.:e ro 7'..a.... :acaw...n'i•%LYi.sfi'1S'trsanrt•.�y a>.- • GRILLE } :,,-. ',.K:..Qa�..,.ti z1.2.,A,«1LTi" , Crv:.ay.-tw•s-.. ea,�_'r n• u•-ua+•.:'ra• 'i 3 m':m '�sna.y uv.- •x-••'w. S:'aaaxaws-aa- o..r�..xnu.. �s.ex...e+... is:su'am.r,+.rr.{ sy vl 'rsw�. mrai¢r.sn:+e+h�.vr:..'ao+,.dr.: INFRARED HEATEF; ,� '`�4. ° � - # 1 _ ' � LABORATORYCOCKS ;"�.: r.�� ,,>:.r.� ..r ''VEAx�[W•t., '.:s,.rt,,..,rVadd > . : �i W� 44,1. s.f,J_ ;..,.,�..�t . .-•, ,.�...,,_.. -in., ._ -...a. .,.4 . �ar aja".�. o. a. L a_mt...4 MAKEUP AIR UNIT a_ - f------� 1, �,_ . __- t �_____ _..__.._._ ._V `� __ n. -.[sire- Qaa- r4.�rr:,:a[t':A ytrr:,-+:sru,- ax:,:.r.;atFO L..x:; ._r.at:_,• ` ar�a-ac (.sca< n•_s. fav•c,n.mow•-.:, s,sr_:tiv,.;xa. i r.Hvom 1....r.:er w L.-� - .,_us::wa:tz Vic.=.�-a.� .1„►.A'_em OVEN _ F;. •C �:. -t.-'Lx _v.e i }, rt:-.4 , .8 ja;'s-. �¢•-vl!.V:s: �: 21..,t'„e�f. xr�s'r.:=4 -A•u-.zssaa:i .aaar ... ii 'Lx�..e•1 t• ._-,L t.u;r,,,..F st1 .*, • Sfi.' POOLHEATER .: •� n s . . a,_,,O';'ar--. s:�--.e.ns._ : • t. •-SJ'm�-,,ra.�, tr-.,n,som-- : [ r. far ._.: ROOM / SPACE HEATER .,,r `I _ �� .� r I.' t 3 ; l�i I l �j_..Ca,.'Weaw y I_ -..^� .i,,,:-x•:.a;a' '!a'-.-asnsk:'[-t u'F;tauc�?_i I.xreeati:r I.r..:•_�anu-`1.r:r.s<uuo-rr.' Y't `F `c'limmsxa .r•n -,sr..x�. ' ,ayw,."�: ' _ I`:'f.�-r. _ - 'rx' ROOF TOP UNIT `V�� r�I Mom' --;` , — - 'i TEST1. J •"drie_k.WfaZ. 1-,A.T.cF-:r;•n fl..vf.n•O1P6,4: 7,,,,A :Yit7.,:.J.:tr,.'F�- S.•:'w Y„..p.-. ` "4'•'..V-,•C L...,.. �i.....V. 1 ._...i7�o 6•.),,,-:_.:�i'T+ ts__0tv1c..• ..i. .=_POi_I5X};L00. 0 .21.1 i `�••p JY7. •• w._i•.. v. •'.�`.w:_h i._.,... ,.+.P Y} Lr UNIT HEATER 1.„....;.,-.' . :--4~•i,.s rk,,, ;,,my.,,.-:'� '..n..0 .._ it }�� s i.4,�.rir. .....1 4,4 ~ _- �;�. uti: F_:.[ r.-,•.�-/),4# I --_ • .fr t rrrz rr*xr-,��,r.a:;..a>�_ra .�cr'YJCi':L�� • - - - UNVENTED ROOM HEATER 1 f A .r l Ii------ WATER HEATER __ . . �: _ :, M1 =dam , = = T . _,_ �, ______ ;lei ct•.- -k� aria ax.c=•�F ^s.-v .„,-„ ar.. n-VY--rrxa a.._a.. aa;a^rs.xa. .r:Koa5:sa.- 4 z4.5pm- .- rx:.; b S"..: tnrsc- ..,i::a a414.zsos ,r• _ x-cx OTHER ' � - gr`—`�Ft--- l;� r----" -- 1y f Ii < r .._.._._._._.-,-_..1. .,a-4,ltcutr.a-,...,,s I l*WM.-4m.F 4.=['.:rrct...'i,tsa..••-,c a :,r...v rt.-:,4 locs.:Cmiw[;:rar^r- �.u:.nca.r-,t-x' �rsw.+n�:�.�st�-s � ,,".•.s .r•,a-,a..;f�^w," -.r icr•rra,.trli :�rx•nws r.` �cr ,..3• .. ._ r. i. __._,..,1 tiiiI}3ir5&i&•lae,dirld6m..T� i 1- k - ,- - - - - — 4. a� < ,� —. . v. 1 .+ 1 �µk r�; t Ln bt>S2AF.QLtISPYL✓rY:aiN¢.."•."e•"aS91,:.Yr.]LQ6Y.�S�d15:isA:s'Gvt4:%t'GA'..tiriAYf:IIirliY.'0�r4-Fi:9-:.N1.62. —4.-- 4,a•% 11.."c:.••,), i Si;-IF=ri'{rl• 4-.: _:'-:Z"'' -Y•..,•••..4 L.••••r:.Z�Mk l✓-.•• ••,{...,,,,,,'.T`.A F'.3s 41,,,CJA.41,-1.1%:rr•M4 j sa:.iVS}'1•CG,.-.•S.:1i,�.11;"',,%a....<ti"h.-.... -..r.,,:,:.�-rj INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES g NO i I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ;' OTHER TYPE INDEMNITY :, w ..41t.i,fili 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 El 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 co fiance with II P rti nt provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws, PLUMBER-GASFITTE R NAME ,4.A.A..rA...0 � r (, .rAA �� w�r a � LICENSE # ] GlIg. IGNATURE r j--, r z ►� mi 5 R MP I- MGF JP , JGF LPGI t CORPORATION rd # �� PARTNERSHIP} # ,�_ w, ,..�•_ LLC # i_�a COMPANY NAME: .C.(1 j/d �y .6 ADDRESS 1-6,21_ / '' //7Jj/\/�f ..F.R a� An...i Aa". !1 �.xr.... .: 6i'itill.Jn... erY•JLYf:]LLY-m .i1:4T -�•9(ytitrirKrdbK CITYt _.�.._ _. STATE '.: iZIP; f �. __ ATELIQ �. �-- a r•w- -•-••.ac,ur ri:csx-�ata.,14.7 n;).,'•-,,,> ty,.-r......1,-. 1csxa:•Nr.,,,,v H74 ._ltrt,�s i"�'•. T FAX I 1 CELL,( '3 7ggtMAIL LIQ:gliCe.,Z, t/s �.1.'' ,1. 1.z....... r„sv.co,.-K-..,.