Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
BLDP-18-04639
k. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK I )1,1,7; CITY YARMOUTH JOBSITE ADDRESS 392 NORTH MAIN ST MA DATE 2/19/18 PERMIT# BLDP-18-004639 OWNER'S NAME LIN-MARCUS PETER P OWNER ADDRESS 28 HALLET HILL RD WESTON, MA 02493-1753 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL m PRINT CLEARLY NEW: 0 RENOVATION: l9 REPLACEMENT:0 PLANS SUBMITTED: YES❑ NO m FIXTURES 1 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 1 CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTE DISHWASHER 1 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN , INTERCEPTOR(INTERIOR) , KITCHEN SINK 1 LAVATORY 1 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER _ 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 m 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. 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 Alex Braga LICENSE#5668 SIGNATURE MP 9 JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ALEX B BRAGA ADDRESS 2 MOUNTWOOD RD CITY MARSTONS MLS STATE MA ZIP 026482111 TEL UW$—$ft7— 1,266 FAX CELL EMAIL Ge{i- ROUGHPIA MIRING INSPECTION NOTES BELOW FOR OFFICE USE ONLY _FINAL INSPECTION NOTES 376 1 r V ,L+/Q THIS APPLICATION SERVE AS THE Yes No I. RIygc10 0 DCDMIT d �lC /V Q d k-D c FEES$ PERMIT S //'n ft- /y/I/)�/J PLAN REVIEW NOTES 14 / riws • Q� •