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Home My WebLink AboutBLDG-23-002866 ____.- 0 k MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE November 23,202:PERMIT# BLDG-23-002866 JOBSITE ADDRESS 10 CONWAY DR OWNER'S NAME SOUNDVIEW REALTY TRUST G OWNER ADDRESS 1 YANKEE DR SOUTH YARMOUTH MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL El PRINT CLEARLY NEW: El RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED:YES❑ NO El FIXTURES FLOORS—, BSM 1 2 3 4 1 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 OTHER 1 OTHER DESCRIPTION:outdoor frepit INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES El NO El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ OTHER OF INDEMNITY❑ BOND El 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 Virgilio Silva LICENSE# 31395 SIGNATURE MP El MGF El JP El JGF El LPGI ❑ CORPORATION El# PARTNERSHIP ❑# LLC❑# COMPANY NAME: VIRGILIO SILVA ADDRESS. 155 SUDBURY LN, CITY HYANNIS STATE MA ZIP 026012462 TEL FAX CELL EMAIL virgiliomoa(a),hotmail.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 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ,t l ;.Nis LW 2) ir _" m' CITY (Yarmouth MA DATE[1/22/22 IPERMIT # Z. 3 k L: 10 Conwayrive ames Skagerlind JOBSITE ADDRESS Y OWNER'S NAME � 9 GOWNER ADDRESS 10 Conway Drive TELL !FAX I TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NOT] APPLIANCES 7 FLOORS—• BSM 1 2 i 3 4 5 6 7 I 8 9 10 11 12 13 14 BOILER E___� � - 1.4 ; ,. .. _ � . _ __-_._ .___ BOOSTER _s 4... CONVERSION BURNERMil s COOK STOVE AL_ EMI r-- • • DIRECT VENT HEATER 1 DRYER - _ " ___ I ®- FIREPLACE FRYOLATORri FURNACE f GENERATOR --- f i GRILLE ._. �. L..,.�.... I _ _ 1. .r . ; . ; Y J INFRARED HEATER 7- F - f— LABORATORY COCKS ,, 1 MAKEUP AIR UNIT . i � -- Al J OVEN ;I �j gi POOL HEATER ;,. W' ' i� `, _ I ROOM 1 SPACE HEATER __ ,....._ alli I . ROOF TOP UNIT _ i Ii Ili ,w. I'4Ir, TEST NM i MEMINIMAININViiiii UNIT HEATER - I L_ . .� . . ,,, UNVENTED ROOM HEATER ( Bv' ��' WATER HEATER .�.�.R_,.. 11111. i 7011. OTHER outsoor ire pit 0.0 1 . I� 'MIMI MOM MingliMilli1=011.P = ... fiemeft-- MEN — ilNIMIIMIIIIIMIMI !--- INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES v NO U I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY , OTHER TYPE INDEMNITY BOND j 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 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 1 • : : - - : •• nowledge and that all plumbing work and installations performed under the permit issued for this application will be in complia • all Pertinent provision :f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. frlrgtho Silva 1395J PLUMBER-GASFITTER NAMELICENSE # � SIGNATURE MP ® MGF J JP El JGF U LPG! E CORPORATION # r PARTNERSHIP #h _ LLC ' #' COMPANY NAMEAIva Plumbing & Heating ADDRESS 155 Sudbury Lane CITY Hyannis STATE MA izip )2601 ITEL . __ -__ _. . I FAX . I CELLr74-8360176 BEMAILvirgiliomga@hotmail.com