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HomeMy WebLinkAboutBldp-19-006231 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK r t CITY YARMOUTH MA DATE 5/3/19 PERMIT# BLDP-19-006231 JOBSITE ADDRESS 488 ROUTE 28 OWNER'S NAME HOLIDAY VAC CONDO ASSOC INC P OWNER ADDRESS P 0 BOX 940 SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL m RESIDENTIAL 0 PRINT CLEARLY NEW: ❑ RENOVATION:© REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO m FIXTURES 1 FLOORS---* BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SY TE DISHWASHER .� DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY 2 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER WATER PIPING OTHER OTHER DESCRIPTION: INSURANCE COVERA'. : I have a current liability insurance policy or its subs antial equivalent which meets the requirem•its of MGL Ch.142. YES m NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE 0 COVERAGE BY CHECKING THE APPROPRIATE BOX BEL• LIABILITY INSURANCE POLICY❑ ; OTHER TYPE OF INDEMNITY❑ BOND • OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142• he 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 Matthew Scioletti LICENSE Z7041 SIGNATURE MP ❑ JP © CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME Scioletti Plumbing and Heating ADDRESS 58 Townhouse Ter CITY Hyannis STATE MA ZIP 02601 TEL FAX CELL 7748100292 EMAIL SC,t cAel\--% P` vp.03„�J �C &, a •1 . z...6 5G\ O `L "+ ?itevN6,e, pG^� ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES • ".,11 Yes No THIS APPLICATION SERVE AS THE 0 0 FEES$ PERMIT# PLAN REVIEW NOTES le- or`..,r Town of Yarmouth Receipt No.: 46390 ate ritl 1146 Route 28 Receipt Date: 05/03/2019 South Yarmouth, MA 02664 508.398.2231 RECEIPT RECORD&PAYER INFORMATION Record ID: BLDP-19-006231 Record Type: Commercial Plumbing Property Address: 488 ROUTE 28,WEST YARMOUTH,MA 02673 Description of Work: Replacement of toilet and sink units 20 and 25 Payer: Scioletti Plumbing and Heating Applicant: Matthew Scioletti Scioletti Plumbing and Heating 58 Townhouse Ter Hyannis,MA 02601 PAYMENT DETAIL Date Payment Method Reference Cashier Comments Amount 05/03/2019 Check PUBLICUSER580 $105.00 641 FEE DETAIL Fee Description Invoice# Quantity Fee Amount Current Paid Plumbing First Fixture 49290 1.00 $60.00 $60.00 Plumbing Each Additional Fixture 49290 3.00 $45.00 $45.00 $105.00 $105.00 o /5 - /0 0 tido = 6[5-o X _ , oO AA_Receipt_Template.rpt Print Date:05/06/2019 Page 1