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HomeMy WebLinkAboutBLDG-22-007265 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 1 c/ CITY YARMOUTH MA DATE June 16,2022 PERMIT# BLDG-22-007265 JOBSITE ADDRESS 579 BUCK ISLAND RD OWNER'S NAME TURINO ASSOCIATES LLC G OWNER ADDRESS 2000 COMMONWEALTH AVE AUBURNDALE MA 02466 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL Q RESIDENTIAL 0 PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES ❑ NO❑ FIXTURES FLOORS-I 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 1 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 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❑ 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 ❑ JP❑ JGF❑ LPG! 0 CORPORATION❑# PARTNERSHIP 0# LLC ❑# COMPANY NAME: RALPH J GIANGREGORIO ADDRESS. 188 Route 28, CITY (Dennis Port I STATE MA ZIP 02639 TEL FAX CELL EMAIL office(aa3gsplumbing.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 nlA- : VA- K(4 L am MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK r , Il r= CITY 'k j p\ yG.r(YY)j - ! MA DATE (o Li y c)-, I PERMIT# Z—L r 7 Z C'S JOBSITE ADDRESS � TS '2ck.�)OWNER'S NAME IlY\00,y 00a (GZCi GOWNER ADDRESS - - TE 53 -7 H0-CO0 FAX -~ 1 TYPE OR OCCUPANCY TYPE COMMERCIAL IIEI PRINT EDUCATIONAL Q RESIDENTIAL IA CLEARLY NEW:Q RENOVATION: REPLACEMENT:E' PLANS SUBMITTED: YES El NOLr APPLIANCES 1 FLOORS-1 BSM 1 2 3 4 S 6 7 8 9 10 11 12 13 14 BOILER NM MA!.onowiiiikup ....isituig,pik _am me um BOOSTER i MN NM a i i �' .: m! h CONVERSION BURNER MO W Imo!MI- ONE iiili illni.�MIMI_[l 'i ;' COOK STOVE DIRECT VENT HEATER 4 I DRYER I ( _ f. FIREPLACE FRYOat MN WWII"!API _MCA!11.111.1111111111 IATOR r -1111.1 MNi lam, MI i I '. 'MIMI FURNACE i am me um jai MIN'Ali N lin iiim ON MIN GENERATOR N WWN; .MR�� GRILLE A OKI i:��WI II>�.I MR,: INFRARED HEATER 1111111.101111111 Welt 11111UM 1•11411/110111111111111 OM illit 1.11114111111Wil LABORATORY COCKS IIIIIrIIIIIII am ow OM ME11111111.1.1111 IIIIIIII,1 MAKEUP AIR UNIT NI VIR111111111111.11 alring Mit SSW WIPP 1,1OVEN IBWIIIIIIXIIRWR a . RUINPOOL HEATER _ � f _ . ROOF TOP UNIT TRug I ROOM/SPACE HEATER TEST 1 UNIT HEATER , ill, , _UNVENTED ROOM HEATER 1 __ i _ .- WATER HEAT R RR OTHER a r Mali. t ' a tinil 11.111511.1.11=gali=11111 .. -... is 1 MI 1i I7 11111 i . { f'•,..f XII INSURANCE COVERAGE I have a current)lability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES (r NO Q I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY[` 1 OTHER TYPE INDEMNITY 0 BOND Q 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 Q AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that ell 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 comp nce with aZinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME( �, 1 ��R D iQ iLICENSE# 3 SIGNAT E -1--tp MP a MGF 0 JP Q JGF Q LPG'Q CORPORATION®#13qq L G: PARTNERSHIPQ#F LLC Q#1 COMPANY NAME:I 3 GS pz„„ 1,04.. 4 !/GFJ l aI<d-ADDRESS ! k lyrt i = S T• _ _w CITY DtAi.vk54»07 ! STATE1/M19' lap.Oa63i 1TEL aS -.3 - ,5 / ., J FAX S-39'g gifiil CELL ,JEMA1L_OSE IC f P,3 6,5 Pkt,M d.l ti 15_ •_ .R. E IvVE_ Q JUN 14 2022 B U ikP4 By: