HomeMy WebLinkAboutBLDP-15-000218 MASSACHUSETTS UNIFORM AP• • ' • • • • ' • • • • • r • I r : ' r r • • '
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TY Yarmouth MA DATE 7122114 PERMIT # APP-/r—P
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JOBSITE 7 Yew Lane (West Yarmouth) M#76 I P# 55 OWNER'S NAME Dalpe
OWNER ADDRESS SAME TEL FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL 0 RESIDENTIAL
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CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: ® o PLANS SUBMITTED: YES 0 NO
FIXTURES FLOOR BSM I 2 3 4 5 6 7 8 9 10 11 12 13 14
@ANT S--. ✓
CROSS'CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
-OLUICA I ED GAS/OILJSAND SYSTEM
DEDICATED-GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
r FOOD DISPOSER V
FLOORIAREADRATN �C �`
•TINTERCEPTOR (IN(ERIOR) R
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LAVATOR
ROOF DRAIN OflP NT
SHOWER STALL
SERVICE I MOP SINK 13' __ l `
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1TOILET t/
' UR-MAL
WASHING MACHINE CONNECTION -
' WATER HEATER ALL TYPES_._
WATERPIPINU �• '���
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INS RANGE(.UVERACaE:
I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES ❑ NOD
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY 9 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 here Rertify that all of the details and information I have submitted or entered regarding this application are true and accura : • etest f my knowledge and
that all plumbing work and installations performed under the permit issued for this application will be in complian h a ertinent provi n of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBERS NAME James Pazakis LICENSE#PL-15030-M4 SIG A I UNE
MP ® JP ❑ CORPORATION ®#C-2803 PARTNERSHIP n# LLC ❑#
COMPANY NAME Hall Plumbing&Heating,Inc, -••RESS:447 Old Chatham Road
CITY:South Dennis STATE:MA ZIP:02660 TEL:508-385-9127
FM:508-385-6604 CELL EMAIL Halltechnician@comcast.net
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ROUGH PLUMBING INSPECTION NOTE BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
V-114 Yes No
THIS APPLICATION SERVES AS THE PERMIT 0 0
FEE: S PERMIT#
PLAN REVIEW NOTES
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