HomeMy WebLinkAboutP-14-209 MASSACHUSt IIS UNII-URM ANNLICA7 ION FOR A PhRM1I TO PERFORM PLUMBINGWORK
t ,W CITY Yarmouth MA DATE 0920113 PERMIT # f ''3' Z�
a JOBSITE 14 Cedar Street(South Yarmouth) M#34/P#180 OWNERS NAME Ayoub
P OWNER ADDRESS SAME a Irv"fiftvP TEL 774-212-0871 FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL 0 RESIDENTIAL x❑
PRINT
CLEARLY NEW: 0 RENOVATION: 0 REPLACEMENT: a , PLANS SUBMITTED: YES 0 NO❑
FIXTURES-+ FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 . 14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEMi
DEDICATED GAS101USAND SYSTEM _ I
DEDICATED GREASE SYSTEM dV rn PO ion( I
DEDICATED GRAY WATER SYSTEM / I
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER u__._T /"
DRINKING FOUNTAIN — (� p 1L
FOOD DISPOSER C LS 9 U W onl coon, f
FLOOR/AREA DRAIN
INTERCEPTOR (INTERIOR) A Z .e- 2 £:13
KITCHEFTSINK
LAVATORY G Jll_Usi "tic:r
ROOF DRAIN ice a.2--
SHOWER STALL
SERVICE I MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION RCCEPa D '-1/P7/-9
WATER HEATER ALL TYPES
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 1
0 NOD
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW ' " - -
LIABILITY INSURANCE POLICY Q 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 0 AGENT 0
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and infornafon[have submitted or entered regarding this application are • _��, -•• : 7" - o my n. -.ge a .
that all plumbing work and installations performed under the permit issued for this application will be In com r rtlnent p.• ion of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. -
PLUMBERS NAME James Pazakis LICENSE#PL-1 t I .I M RE
MP in JP 0 CORPORATION ]#C-2803 • 1 - HIP I, LLC❑#
COMPANY NAME:Hall Plumbing&Heating,Inc. ADDRESS:447 Old Chatham Road
CITY:South Dennis STATE:MA ZIP:02660 TEL 508-385.9127
FAX 508-385-6604 CELL . EMAIL Halltechnician@comcastnet
•
BING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ ❑
FEE: $ PERMIT i
PLAN REVIEW NOTES
t