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Home My WebLink AboutBLDP&G-21-006797 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK to CITY YARMOUTH 1 MA DATE 5/24/21 PERMIT# BLDP-21-006797 JOBSITE ADDRESS 40 WILFIN RD OWNER'S NAME COUTURES MANAGEMENT CORP P OWNER ADDRESS L PLEASANT ST SOUTHAMPTON,MA 01073-9557 INC TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL El 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 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTE DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 1 WATER PIPING 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 TYPE OF INDEMNITY❑ BOND E 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 fcr this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Ralph Giangregorio LICENSE 91339 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME RALPH J GIANGREGORIO ADDRESS 188 Route 28 CITY Dennis Port STATE MA -I ZIP 02639 TEL FAX CELL EMAIL office@3gsplumbing.net ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE PERMIT ❑❑ FEES$ PERMIT# PLAN REVIEW NOTES 7-)Li pIRcEi.,: MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK • -4t 1 CITY 5 ,•c•--,&-'(. . MA DATE S(7-c'; 1 PERMIT# JOBSITE ADDRESS L() 62/I „ }1 OWNER'S NAME TOL�, (at.) t Y OWNER ADDRESS y 1 cxZ' `.- X( Yt 'l TEL yl 3 G;2((Lai FAx TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY _ NEW:❑ RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES❑ NO❑ FIXTURES 1 FLOOR-4 ! eSM 1 2 3 4 S 8 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASJOIUSAND SYSTEM • DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY - ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET 1 URINAL , WASHING MACHII,E CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER 111 INSURANCE GE: I have a current liability Insurance policy or its substantial equiva en which mee s the requirements of MGL Ch.142. YES IbO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY II'SURANCE POLICY (3 OTHER TYPE 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 CHECK ONE ONLY: OWNER CI AGENT ❑ 1 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 ray hnowiedge and that all plumbing work and installations performed under the permit Issued for this appiicalionwill be in o pliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. /�f PLUMBER'S NAME 1 cJ pk ( '` ✓( LICENSE# a '&3C-7 SI GNAyd RE MP;YL JP❑ CORPORATION 21# 'L r U C PARTNERSHIP 0# LLC❑# COMPANY NAME c P( ;�- Peed,1.tick ADDRESS I DS IV�n r 1„ CITY ��1�,;Vn,S �l�;r cJ STATE�,riI11'&t ZIP ('(3-/r;3 I TEL FAX ,4: =1 {i)6-t i CELL " —� r- J if�,Q7 a`\, EMAILL5 -)l-rt)1�rn/ c,r , w21-- MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK `R F CITY YARMOUTH MA DATE May 24, 2021 PERMIT # BLDP-21-006797 ra S r. JOEISITE ADDRESS LWILFIN RD OWNER'S NAME COUTURES MANAGEMENT CORP INC G OWNER ADDRESS 42 PLEASANT ST SOUTHAMPTON MA 01073-9557 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL 0 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 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 /SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER 1 OTHER t OTHER DESCRIPTION. INSURANCE COVERAGE: I have a current IiabilitNi insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 0 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 ❑ 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 -4 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 Giangregorio LICENSE # ,9339 SIGNATURE MP Q MGF ❑ JP [] JGF ❑ LPGI 0 CORPORATION ❑ # PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME: RALPH J GIANGREGORIO ADDRESS. 188 Route 28, CITY Dennis Port STATE MA ZIP 02639 TEL FAX 7 CELL EMAIL office(@,:3gsplumbing.net ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ El FEE$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ' 41=y CITY f ` x, ,� j MA DATE -= 1-, � PERMIT# 'l3L ()-1� -ou 1, `�"? • N r JOBSITE ADDRESS - G - � _ _._._.. ._._......... C� .. �� _1..,..xJ OWNER'S NAME GOWNER ADDRESS Lijc. -► � TEILaaigal FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL a PRINT CLEARLY NEW:0 RENOVATION:El REPLACEMENT: El PLANS SUBMITTED: YES NOD APPLIANCES l FLOORS-, BSM Km 2 3 4 5 6 7 8 9 10 1 11 12 - 13 14 BOILER ►M� � ,� - BOOSTER WIIIrONNIMMall~ _ I_ 1M - CONVERSION I3URNER -1111M Y � � � - M �I 4 COOK STOVE MUM r � - - - - _ __- I DIRECT VENT HEATER _ _ ., ..,. .:_, .,. � �� _ .•_..-._.: .__�T.�•:,. N . __ .._. .. ..._ _ � ., � . _ DRYER FIREPLACE !, .- J1 �_ 11 _ - _ . __ ' r FRYOLATOR mrstor : t I , 1 - w FURNACE I i _r L . . .I' �.JJ 1 ____._'�.._. _ - GENERATOR _ GRILLE ;CMS, ..11 1MIN ,� ---- INFRA - - - - - �r .��.__ ._;. . - -- RED HEATER ( �. 1. LABORATORY COCKS --- - - -- -- _ -�-- - MAKEUP AIR UNIT OVEN tialit� POOL HEATER _ 1• ROOM 1 SPACE HEATER ! , m -- , ROOF TOP UNIT j llaT.....,:��t' .i �. .�� JC !E ..._. TEST11.11M.100. - -- - - - - - ,� _ .�.- ---..�-_ _ '1 UNIT HEATER rl i _ Mr' , r T IWI - - UNVENTED ROOM HEATER timmirounimeintwayi WATER HEATER * ' _ .. ._ OTHER M .. : - . i ....._...__.._. ..._. . l'.R+ _ ��- .arc.. _ -._... 1'• 1• � ..- .. F ,f'p'ii:{J:pµ".+..•.Lt...a .U?L%:71sJb'1C.4ii:lt.:laSM1lJ.1.I3i•4e.V+.a--.... _ . .t+. w�l. l -� .....+- -. _. . .�M ♦++ - - .. . _ .." -- . INSURANCE COVERAGE I have a current fl bility Insurance policy or its substantial equivalent which meets the requirements of MGL, Ch. 142 YES 0116 LI I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERA BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 5 OTHER TYPE INDEMNITY D BOND LI 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 Li AGENT U 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 ati plumbing work and Installations performed under the permit issued for this application will be In compliance with ail Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. � l v^ PLUMBER-GASFITTER NAME . LICENSE # . ' SIGNU� �-►f t�� MP 74 MGF El JP Q JGF❑ LPG{D CORPORATION #new PARTNERSHIP Li# LLC COMPANY NAME: (' es i ADDRESS jv, CITYLikaolt -� t; .,.... .Y STATE J{[/J/�(�� ; ztP 26�I TEL � � /y,� 9:4 (/� y'>.».,v..y,•rw •.�.arn-..-..:� /•ts>�s..�...t�.-+.i� �..K�.L�.-.�v..�,..� � —'--=-"_+� i.�:. k'G»Ai:rm� FAX[19.13. CELL JEMAIL' ` _ to w...•v.•.r:� ' ` ,�-,. ..-.. .. _'.'_ _ .N�"._._,_.m.....V 'LsaC.Y?W.. _