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HomeMy WebLinkAboutP-19-5576 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK fiv _i CITY YARMOUTH MA DATE 4/5/19 PERMIT# BLDP-19-005576 -If �� JOBSITE ADDRESS 711 ROUTE 28 OWNER'S NAME PIER 7 CONDOMINIUM TRUST P OWNER ADDRESS C/O R J+RA OSTELLINO TRS 711 ROUTE 28 SOUTH YARMOUTH,MA TEL 02664-5138 TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL ❑ PRINT CLEARLY , NEW: El RENOVATION:© REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES FLOORS-- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 2 2 CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTE DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL _ 2 SERVICE/MOP SINK TOILET 2 URINAL WASHING MACHINE CONNECTIO WATER HEATER WATER PIPING OTHER OTHER DESCRIPTION: INSU NCE COVERAGE: I have a current liability insurance policy or its substantial equivalent ich meets the requirements of MGL Ch.142. YES m NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El OTHER TYPE OF INDEMNITY El BOND❑ OWNERS 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 16668 SIGNATURE MP ❑ JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME BRAGA BROS.INC ADDRESS 110 Breeds Hill rd,Unit#5 CITY Hyannis STATE MA ZIP 02601 TEL 5088274260 FAX CELL 7744870199 EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE FEES$ PERMIT# PLAN REVIEW NOTES Invoice Cloud- Town of Yarmouth Page 1 of 1 @ What are you looking for? Return to previous page Payment cont smat(on Payment Processed Successfully PRINT Trusted.secure e-payments. Please review the transaction results below. Payment Made To: Town of Yarmouth (508)398-2231 Transaction Date/Time: 4/10/2019 12:06:31 PM Payment Message: Invoice Number: ACCELA-1262071 Name: Rosane Figueiredo Address- 110 Breeds Hill Rd,Unit 5 Hyannis MA 02601 Email Address: Payment Method: Mastercard Card Number XXXXXXXXXXXX2931 Payment Type: Permits Transaction Type: Credit Total Amount $285.00 I Privacy Policy I �'a Trt1Stw8Ye Secure Site https://www.invoicecloud.com/portal/(S(ftjtcgpzhgntqu2bwl0j5t2d))/BillerManualPaymen... 4/10/2019