HomeMy WebLinkAbout2005 / 2006 Building Transmittal oF- .r TOWN OF YARMOUTH
f Building Department (OFFICE USE ONLY
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Town Hall Recorded By: lc
Yarmouth,MA 02664
(508)398-2231 ext.261 Permit Fee: $0.00
Deposit Rec: $25.00
BUILDING PERMIT Payment Type: Cash ChkNo.: 0
Net Owed: ($25.00)
TRANSMITTAL Application Date: 7/14/2005
Issue Date:
Temp Permit No.: T-06-027 Expiration Date
Applicant Name: Mark Nugent Comments: Map/Lot: 048.97
Applicant Phone: convert garage into playroom with bath
Building Location: 00007 CIRCUIT RD W
Owner's Name: Mark Nugent
Owner's Addres 26 Hunters Glen
Marshfield MA 02050
I
Owner's Telephone: (617) 875-2483 , 4
8 fib 0 n, 2005
REVIEWED BY: HEALTH DEPT.
1. WATER DEPARTMENT: DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
/3. CONSERVATION: DATE: N/A:
4 EALTH DEPARTMENT: DATE: Vidlo(-- N/A:
A. BUILDING DEPARTMENT: DATE: N/A:
6. FIRE DEPARTMENT: DATE: N/A:
PLEASE NOTE
COMMENTS:
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RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE:
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vri lam`'/Q Date Printed: 7/26/2005
r''o'"--r=-. APPLICATION FOR PERMIT TO DO PLUMBING
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. TOWN OF YARMOUTH (OFFICE USE ONLY)
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` ".: ,�-�I Fee: $ 5 3 �'ti I.�r�
.. or PERMIT NO. P- ab_(C;a -
P # g50 )
JJ. Date 20
Building Owner's �Ma.12*- tJ u��_ti l
AT: Location ' ( i i2 C u i '� I•'_ L 1A.A_5`I Name
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Type of Occupancy 1,v 1. 11 1 r
Newt Renovation ❑ Replacement❑
• Plans Submitted Yes❑ No❑
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SUB-BSMT.
BASEMENT
1ST FLOOR I i i I I
2ND FLOOR
3RD FL OR
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(PRINT OR TYPE) ....--,
- �, ` Check One:
Installing Company Name i + D, 'S i. AAAA '�i 1 st j V '. ❑ Corp.
Address 45 3 AN, L' .k`_ Esq ❑ Partnership
W .ict_vt i,- e: v+I, 1 P./\-4'► C'X—6`7 3 P-14rrreCompany
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Business Telephone `7 7 V - ' 310 _ 'b II Name of Licensed Plumber—n7"-) 7 1 C' lig
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INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes lig' No ❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
A liability insurance policyOther type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required by Chapter 142 of
the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check on Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
I hereby certify that aH of the details and information I have submitted Signature o icensed
(or entered) in above application are true and accurate to the best of Plumber
my knowledge and that all plumbing work and installations performed /
under Permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbing Code and ‘ License Number
Chapter 142 of the General Laws. Type: Master❑ Journeyman 4-