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Home My WebLink AboutP-15-5750 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK suhla CITY South Yarmouth / MA\''ATE 05/20/15 PERMIT# g✓�P "SPO JOBSITE ADDRESS 36 Captain Ryder Rd. n OWNERS NAME Lidiane Roncelli POWNER ADDRESS 36 Captain Ryder Rd. TEL TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL S Io`EDU'•TIONAL ❑ RESIDENTIAL© PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:✓❑ PLANS SUBMITTED: YES NOD FIXTURES 1 FLOOR-. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB I 1 —IA i i t I t L L t L1 CROSS CONNECTION DEVICE - it t C L t L L L L I L kit DEDICATED SPECIAL WASTE SYSTEM J t U I _1. q iL , t 1 f 1 L 1 1 DEDICATED GAS/OIUSAND SYSTEM t, (1 t t t L. t II it L t III DEDICATED GREASE SYSTEM L it L t t L L it L t L L 1 DEDICATED GRAY WATER SYSTEM it I t I it it I 1., it I t it it I DEDICATED WATER RECYCLE SYSTEM L t t 1_ L t_ L L t L t L t t DISHWASHER L _ L •L t t L t L L A t t . . . t DRINKING FOUNTAIN L it t t t. 4 L L t t 1 L L L FOOD DISPOSER .. ... 11 1 it I . it I t t, t V t lit FLOOR/AREADRAIN t L U L .t L. .1 1. t t L t LI INTERCEPTOR(INTERIOR) L t -t t t 1 __ -t t -1 t I t t L KITCHEN SINK I t -t t 1 1 L 1 1_ L t L t I LAVATORY L 1 L __L_ t t t t t - i t t L t ROOF DRAIN — I. - 1_ 1 ! I L L t L I 1 Lit SHOWER STALL L t I I ,L_ 9W !L t p 1 L t_-- t -t SERVICE/MOPSINK ' . 1 _ L t t L ._t -t t L t t. 1 II TOILET _ t t _ _L 1 . .t .1. ti t t 1 L L L L URINAL _ J. t L t _ „L L L it I I it t I L WASHING MACHINE CONNECTION L L L L --t _ L t L L L t L t t WATER HEATER ALL TYPES 1 LI L L ,_ L L t t _t L t L t WATER PIPING t _ 1 t t t I 1 I it it it it OTHER I_ ILL L .. L t t t L t t t t t , ... _ i 1 t I t t d.. L L t L I t_ 1 .- IL t I I t L L t t tilt 41 t I tt 1 t t L t t t t t 1 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 TYPE OF INDEMNITY 0 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 CHECK ONE ONLY: OWNER 0 AGENT 0 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 a.' --. . e o I - - • •.i knowledge and that all plumbing work and installations performed under the permit issued for this application will be in •- .'lance with all Pertin •_..,,,.io of the _. Massachusetts State Plumbing Code and Chapter 142 of the General Laws. - Allir PLUMBER'S NAME Virgilio Silva LICENSE# 313954 / -: tl, IRE MPO JP✓❑ CORPORATION❑M IPARTNERSHIP❑#IJ LLC❑# COMPANY NAME Silva Plumbing&Heating ADDRESS 155 Sudbury Lane CITY Hyannis STATE MA ZIP 02601T F. �r ' F C wic://c_ FAX CELL 774-836-0176 EMAIL virgiliomga@hotmail.com MAY 20 211.J L BUILDING DcF'A.T.. ,. /)/y . . • . • . . . . . .• - . . _ . - . . . . . _ • . • .. • . . (Lr. 1171 .471n. • . • . . . . . . . . k0 S <;eiVi/ N, . . •••t . _ . . .IfA. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK °41= CITY South Yarmouth MA DATE 05/20/15 PERMIT# /Y-4,-/6- OO 5760 JOBSITE ADDRESS 36 Captain Ryder Rd. OWNERS NAME Lidiane Roncelli • GOWNER ADDRESS 36 Captain Ryder Rd. TEL FAX . TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL❑ RESIDENTIAL✓❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑✓ PLANS SUBMITTED: YES❑ NO✓❑ APPLIANCES 1 FLOORS-+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER _ j L 1. 1 L L L 1 L 1 I 1 L 1 BOOSTER 1 1 1 1 I\ 1, I t 1 -1, - 1 ,1 1 1 CONVERSION BURNER , L.. 1 1 1 L L 1_ 1 1 1.. L_. L 1 A _ COOK STOVE 1 1 1.. t 1 1 . .. L 1 1 1 1 1 DIRECT VENT HEATER , _ILL 1 1- 1J 1 L 1 L_ 1 DRYER . �L 1 L 1 1 . L _ 1 I 1 I- L L 1 L 1, .1 FIREPLACE L .L _1 1, L -1 __ I c 1 1 1 I. 1 FRYOLATOR J L L _L 1 L ' .1- - L 1 1 1_ 1 1 1 . FURNACE _ 1 t,._ 1 1_ 1 1. . 1 _ 1. L t I 1 L 1 i GENERATOR -. 1 I I. -j._ 1 L. 1 ._ ._,1 _ _ .1 L 1 . . 11 I GRILLE _ .1 ---t- .1_ 1_ .1 . .1 1,- L 1 1 -1 1 1 .1 INFRARED HEATER 1 _ 1 1 1 L. 1 1. 1 _ 1 A L I . L L 1.- LABORATORY COCKS __, _1„ 1 _1 1. 1 ..L 1 1 _ . L 1 . 1 1 1 MAKEUP AIR UNIT 1 1 . 1 1 L 1 1, .1, 1 1 L 1 . 1 1 OVEN _ I .1 L 1 La. _ -L 1- 1 1 1 I. 1 POOL HEATER - 1. 1_ 1 .1 L_ 1_ 1 LI. 1 .e 1 L 1 L ROOM I SPACE HEATER _ 1 1 1 1 1 .1 1 _L 1 1_ L 1 1 I ROOF TOP UNIT 1 1y. 1 4 L _1 .1. 1 1 -1 1 _ 1_ 1 1 TEST 1 1 1 1 L 1 ..1 1 I I 1 1 I UNIT HEATER 9,_ - 1 I L 1- L L< 1. 1. L. 1 _ 1 1 - .L UNVENTED ROOM HEATER 1_ _ -L 1 I 1. L 1 1 -I L 1 L .L 1 WATER HEATER 1 1 L 1_ 1 -1 L L L 1 I L L 1 OTHER] _ 1 1 . _1 L 1 till I1 1 I 1 . L L L _I -.1 R. 4 1 1- 1 ., I 1 1 I. 1 .1. 1. I 1 1 1 . 1- 1 1 1 I 1 1 I) 9 I L 1 I I. I I I_ I I 9 I 1 INSURANCE COVERAGE I have a current Jiability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q✓ NO Q IIP YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE 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 CHECK ONE ONLY: OWNER D AGENT 0 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 accurat. • y , owtedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance , • vivisi.- if the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. . \ PLUMBER-GASFITTER NAME Virgilio Silva LICENSE#31395-J r_ .TURE MP❑ MGF❑ JP0 JGFQ LPGIQ CORPORATION❑# PARTNERSHIPD# I LLC 0# COMPANY NAME:Silva Plumbing&Heating ADDRESS 155 Sudbury Lane CITY Hyannis ' STATE MA ZIP 02601 1 I FAX CELL 774-836-0176 EMAIL virgiliomga@hotmail.com E I err 0 0 2015 F3UIL6INGOEPAR7MENT /� BY L ..1, . . _ . . ... . . r - . ... . .. . . . _ . . , .. . . , ._ • . . . .. , _ .... . . . - . . . .. _ . . . . . . . . . ... .. . . .. . . _ . - .. _ . :, ... . . . .. . , - , . .. . . . - . . . . . . . . . , . . - • . ... ... . . . . . . . . . .. . .. . .. • . _ . . . . , . . ..,, . . . , . -, .. .-- • . . . , . . - .. . .. - _ . ., - . . .. ._ . • . . . . ..: . - . . _ , . . . . . . • . , . • - , . . . : . . , . : . . . . . . . . • . . . . _. . . . , . . . . . . . . . , .. -... . - -, . . . . . . , - , • . . , . . .. . . , . . _ . • _. . - . . . . - - . . . - . . . . . .. . . „,. . . • . • . . . . .. . . . . r . . t - _ . - . • . . „ . . . . . . . - . . . . . . . . . . . . ., . . .. . . , . . . .• . . . . ... . . _ . . . N , . .. . ... . . , . , . . . . . . . . .. . . . . . , . . . . - , . . ' .- ' - . . . •... . . . . . . . .. , . . . . . . - . . . , . .