Loading...
HomeMy WebLinkAboutBLDP&G-22-007488 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK U4. CITY YARMOUTH MA DATE 6/29/22 PERMIT# BLDP-22-007488 JOBSITE ADDRESS 36 BOB-0-LINK LN OWNER'S NAME AHEARN LORNA J P OWNER ADDRESS 36 BOB-O-LINK LN WEST YARMOUTH,MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL m PRINT CLEARLY NEW: 0 RENOVATION:0 REPLACEMENT:m PLANS SUBMITTED: YES NO❑ FIXTURFS • 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 0 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❑ 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'S NAME Ralph Giangregorio LICENSE 9839 SIGNATURE MP © JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME RALPH J GIANGREGORIO ADDRESS 188 Route 28 CITY Dennis Port STATE MA 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 ❑ FEES$ PERMIT# PLAN REVIEW NOTES r / 4P p6 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY 63(' E- \lo.c ock MA DATE Lo(39 I a D' PERMIT# JOBSITE ADDRESS Q O-( L4\. OWNER'S NAME I—C.h'(\O. Ahem OWNER ADDRESS SCu'Nk TEL 5 -3-)5--(00r6. FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL 0 RESIDENTIAL07 PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:Er PLANS SUBMITTED: YES❑ NO FIXTURES 1 FLOOR-' 8SM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM • DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE I MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES l WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Er NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POUCY OTHER TYPE OF INDEMNITY 0 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. 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 to the best of my knowledge and that all plumbing work and installations performed under the permit issued for This application will be in Nance with aN Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ✓J%/ PLUMBER'S NAME go kr1 'a �� `1 e'• LICENSE# l 13q :8 GNA E MPE1 JP❑ CORPORATION El# Iv C.. PARTNERSHIP❑# LLC❑# COMPANY NAME 41, -2$ Pilo:.•,. iYY� �- N ADDRESS /V'Sc JV ,L- c1i CITY DOOM S Partv STATE f t- ZIP (�)P 3"I TEL FAX 60 1 (64.{S-I CELL EMAIL (jT 14, 3 Ct i,►►-kloI✓tq •rlQf MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK e, CITY YARMOUTH MA DATE June 29,2022 PERMIT# BLDP-22-007488 JOBSITE ADDRESS 36 BOB-O-LINK LN OWNER'S NAME AHEARN LORNA J G OWNER ADDRESS 36 BOB-O-LINK LN WEST YARMOUTH MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:© PLANS SUBMITTED: YES 0 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 i 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 ❑ 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 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© MGF 0 JP 0 JGF❑ LPG! 0 CORPORATION❑# PARTNERSHIP 0# LLC 0# COMPANY NAME: RALPH J GIANGREGORIO ADDRESS. 1188 Route 28, CITY Dennis Port STATE [MA ZIP 02639 TEL FAX CELL EMAIL officea3gsplumbing.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 /V1 '. VF MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK r m" CITY 11a)C5k y0.r111c\AA\ I MA DATEI (01 lam I PERMIT# - 1`1 $ JOBSITE ADDRESS OWNER'S NAME 1,Orncv Ah4rxrn GOWNER ADDRESS I Caxv _ ._._.•- TEL c?-•715--(c_c61FAx== TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL Li RESIDENTIAL Er PRINT CLEARLY NEW:(J RENOVATION:Li REPLACEMENT: PLANS SUBMITTED: YES[J NOE APPLIANCES 1 FLOORS-I 8SM 1 2 3 4 5 8 7 8 9 10 11 12 13 14 BOILER _ _ ..,...K I BOOSTER NE INN all IIIIII I 11111111 INN" CONVERSION BURNER IIII( ( j 121.111 COOK STOVE DIRECT VENT HEATERRIM 111 1111 DRYER M pm MIN � i FIREPLACE FRYOLATOR 11111111111111111;.. FURNACE -' INNWNNW GENERATOR =RR,' GRILLE RRRISM.R.R INFRARED HEATER , !( iAIM'N'", 'NMI M LAB MAKEUP AIR UNIOCKS I lianill.M1111111UMIR T OVEN (ice;omit sin: • - i so aim ungino low nu POOL HEATER ilia NM INN NM P 0.111111110111.lint f Illllll>l O'OM1r— ROOM/SPACE HEATER • ROOF TOP UNIT TEST i; UNIT HEATER f _ UNVENTED ROOM HEATER i!.MI;iiii !;fii 'iifi 0iiiii 1.1 Gills 01R;ice; lifiiii11111ii WATER HEATER •OTHER �._,: -r - war _ -W /. [A. INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES ErNO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY( 3 OTHER TYPE INDEMNITY ® 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 ® AGENT SIGNATURE OF OWNER OR AGENT 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 comps nce with a lnent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. �o PLUMBER-GASFITTER NAME'Rd/19 A gi yi ti�R a o aQ } ICENSE# 93.3 31 SIGNAT E MP( MGF® JP L] JGF❑ LPG'❑ CORPORATION®#163 L.I. PARTNERSHIP®#I --J LLC COMPANY NAME: GS N�- ,j•- 1rUC4ADDRESS I P-64 ST. ._ I CITY ( L) <ui)J.5.„��z ia . I STATE 1/2/1- f ZBPI. abs ITEL $`- CEIVEDI FAX i-391 b5(.17.CELL EMAIL O f;4"1 e ( -3 441;Zv'w R .Q --•---.•_._�s_. ate_ JUN 2 9 2022 BUILDING DEPARTMENT By-