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Home My WebLink AboutBldp-22-002882 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK / CITY YARMOUTH MA DATE 11/18/21 PERMIT# BLDP-22-002882 I' JOBSITE ADDRESS 52 POWERS LN OWNERS NAME steve cohen P OWNER ADDRESS TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL 0 PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:m PLANS SUBMITTED: YES 0 NO❑ FIXTURES -I FLOORS—. RSM 1 2 3 4 5 . 6 7 8 9 , 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE 1 DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND 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 SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 1 WATER PIPING OTHER OTHER DESCRIPTION: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO 0 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 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. 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 Michael Mcbride LICENSE 1!9681 SIGNATURE MP 0 JP © CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME MICHAEL R MCBRIDE ADDRESS 9 Rustic Drive CITY West Yarmouth STATE MA ZIP 02673 TEL FAX CELL EMAIL stinger.mcbride@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES S PERMIT# PLAN REVIEW NOTES ii (v C mAp: PAgcEt ' gt� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK —,, i NMI v;-=- 'Z,QY __ CITY ��, at.1 _ lri� MA .DATE mV �i� PERMIT# 2 1- ' 1" JOBSITE ADDRESS MINI 1111/ Illfr OWNER'S NAMEr k11 (OA 4j I P .OWNER ADDRESS q r'G 5 7-�-at : C 2 4tL4j -s�O VAX,_____ t TYPE OR OCCUPANCY TYPE COMMERCIAL© EDUCATIONAL D RESIDENTIAL PRINTPLANS SUBMITTED: YES❑ NOJ CLEARLY NEW:ID RENOVATION:❑ REPLACEMENT: 11 FIXTURES 7 FLOOR-0 BSM NM 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB K LW „� p : IIINIIIIMNI CROSS CONNECTION DEVICE ' •_ DEDICATED SPECIAL WASTE SYSTEM Jl . ' 'r p.mo' " DEDICATED GAS/OIUSAND SYSTEM 111111111:111.W111111111110111.14.1101.111.11111.11111101.111 1.1111I ' 1111111 DEDICATED GRAY WATER SYSTEM .115,11.1.1.1.111. :.WM MN� .�; DEDICATED GREASE SYSTEM 0111111.11.11.11/1110.11111.11..1.111111--� s - r � � ice,Mir DEDICATED WATER RECYCLE SYSTEM li�l'�! •'I I1 l�� I Imo'•' DISHWASHER UM XIII 1101.L 1 'II UUU i I l r_�Mil,MU DRINKING FOUNTAIN rmi! ,W' Ill I I 'I ssommom FOOD DISPOSER I 1 ; 1i ,� 11 I il-- lummil FLOOR/AREA DRAIN .1.1.111011111011.11 . ,x[ ,; i'WNW OW INTERCEPTOR INTERIOR 1.11111111111=11111.010111•11.01111,1111111)11W ' l� KITCHEN SINK jr � ,iIi ; LAVATORY I111, INUAMIMM1 WO1TO_rOmi: I "IN' I'Mil ROOF DRAIN `I,;—, 'SIM 111110=11011,11111111111111,1111111111111111,111•1' SHOWER STALL I�i�j��i�MINK��I�II�;� I SERVICE E I MOP SINK I'I, 1.11111 _i __ '' ' URINAL lid ISI Ill ' II WASHING MACHINE CONNECTION WI l ��1� ��II� i WATER HEATER ALL TYPES M'gr4g'Winimillimilistlanisir MI OW 11,11•1111.1111111111111 WATER PIPING I iW01jl ',111111WW ,l 01111.111111,PM;MC OTHER IIIIIIIIIIMIIIIIIIMIILNNIIIIRIINIIILIIIIIIIIIOIIIIIIIUJIMCIIIIIC',NM! IMir_OM'I_Migir'�_! 111.111111101111111011•11 riM'MI Milli.1.miff_min '' at IIIIIIIIIIOIIMIMOIMIIIIIIIIIIIIIIIIIImo' :M1111111,111,111111111 1011111111M:,NE .: 1 INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch.142. YES DT NO ❑. IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY®. OTHER TYPE OF INDEMNITY® 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 ® 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 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 complian wit all Pertin t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. \ L 1 u PLUMBER'S NAME I '1 t - 1 LICENSE# Ifklaora SIGNATURE MP JPVj CORPORATION# a . PARTNERSHIP®#allIM LLC[Di n �� ` L 4—i ' ',i COMPANY NAME i �� f t �C.I� }�7—�-f- I ADDRESS_`� (-rq, !'`� CITY Cf n l d STATE DES ZIP n i�Q()r I TEL.......7.7r -6- (D Z/.2......t. FAX I I Celli 1 EMAIL6 ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT 0 0 FEE: $ PERMIT# PLAN REVIEW NOTES 40, .fi *MO E 4,414 $ OW"