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Home My WebLink AboutBLDG-22-002000 . . MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ems' CITY YARMOUTH J MA DATE October 07,2021 PERMIT# BLDG-22-002000 ti_ JOBSITE ADDRESS 176 UNION ST OWNER'S NAME Rudy ouispe G OWNER ADDRESS 176 UNION ST YARMOUTH PORT MA 02675-1942 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL 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 1 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 OTHER DESCRIPTION: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets'tie 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 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 Joselin Sanchez LICENSE# 31804 SIGNATURE MP❑ MGF ❑ JP 0 JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP 0# LLC ❑# COMPANY NAME: JOSELIN C SANCHEZ ADDRESS. 108 BAYVIEW ST, CITY WEST YARMOUTH STA—E MA ZIP 026738211 TEL FAX ]CELL EMAIL gioyannisanchez524(@,yahoo.com S310N M3IA321 NV ld #111Na3d $:33J ❑ ❑ 111t213d 3H1 SV S3AN3S N011tl3llddv SRL oN saA S31ON NOI103dSNI IVNIA VINO 3Sfl 210103dSNI 210d 3OVd SIHJ SALON NO1103dSNI SVO HOfOa MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY yarmouthport MA DATE 10-7-21 PERMIT # �y JOBSITE ADDRESS 176 union street OWNER'S NAME Rudy Quispe POWNER ADDRESS same as the above TEL[ IFAX TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL n RESIDENTIAL El PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES [ NO FIXTURES 7. FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB Irm , CROSS CONNECTION DEVICEEl DEDICATED SPECIAL WASTE SYSTEM AN .---1 , DEDICATED GAS/OIL/SAND SYSTEM in', _ DEDICATED GREASE SYSTEM _ illffilli DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM W-7mu_'m MEM DISHWASHER MR� MONIMMINIE M�_ minDRINKING FOUNTAIN !_ ® 111111_Ell KillE1111131111111111 FOOD DISPOSER Mil FLOOR /AREA DRAIN -- — illit INTERCEPTOR (INTERIOR) IllaillitMll IIM __111111.1 oniumao _ KITCHEN SINK LAVATORY OEM Irlif111111111.11111511111mg ROOF DRAIN _ ME SHOWER STALL _ iMI: M_IIIIII SERVICE / MOP SINK 11,11.111' 1 M " TOILET ME M 1 `all 111.111111111111 URINAL '_= 1 —1111111.1 WASHING MACHINE CONNECTION �! JI ormial WATER HEATER ALL TYPES lila -- - ----- WATER PIPING 1 OTHER 1 MAIN alli 111.11111111 Mir INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES[J NO E IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW I LIABILITY INSURANCE POLICY v OTHER TYPE OF INDEMNITY BOND Ei 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 j 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'S NAME Joselin C Sanchez LICENSE # 31804 SIGNATURE MPL JP v CORPORATION❑# PARTNERSHIP # 1ucEl# i COMPANY NAME Giovanni plumbing ADDRESS N/A -.....i..5 1RECEI _ CITY West Yarmouth STATE Ma ZIP 02673 TEL 508-360-1389 —.------- .-- ----- Iumbin 657 mail.com FAX J CELL 508-3601389 EMAIL p 9 @g _ OCT D7 2021 Lv" t, h7T�1ENT BU l