The URL can be used to link to this page

Home My WebLink AboutBLDP-22-000623 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/4/21 PERMIT# BLDP-22-000623 t JOBSITE ADDRESS 45 HASTING AVE OWNERS NAME LOPILATO GERARDO H TRS P OWNER ADDRESS LOPILATO LOUISE R TRS 45 HASTING AVE WEST YARMOUTH,MA 02673-2634 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL 0 PRINT CLEARLY NEW: 0 RENOVATION:0 REPLACEMENT:0 PLANS SUBMITTED: YES NO 0 FIXTURES • FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 2 CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTE DISHWASHER 1 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY 2 2 ROOF DRAIN SHOWER STALL 1 1 SERVICE/MOP SINK TOILET 2 1 URINAL WASHING MACHINE CONNECTION 1 WATER HEATER WATER PIPING OTHER 2 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 ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 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 Dan Llanes LICENSE 30787 SIGNATURE MP 0 JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ADDRESS CITY STATE ZIP TEL 7818646057 FAX CELL EMAIL 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 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH ] MA DATE 8/4/21 PERMIT# BLDP-22-000623 JOBSITE ADDRESS 45 HASTING AVE OWNER'S NAME LOPILATO GERARDO H TRS P OWNER ADDRESS LOPILATO LOUISE R TRS 45 HASTING AVE WEST YARMOUTH,MA 02673-2634 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL CI PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURFS • FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 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 1 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY 2 2 ROOF DRAIN SHOWER STALL 1 1 SERVICE/MOP SINK TOILET 2 1 URINAL WASHING MACHINE CONNECTION 1 WATER HEATER WATER PIPING OTHER 2 OTHER DESCRIPTION: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES❑ 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❑ 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 4)681 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME MICHAEL R MCBRIDE ADDRESS 9 Rustic Drive CITY West Yarmouth STATE MA 7 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 ❑ ❑ FEESS PERMIT# PLAN REVIEW NOTES MASSAC USETTS UNIFORM APPLICATION FOR A ER IT TO PERFORM PLUMBING WORK 'e l=u j-=,� CITY r 4' 1 f---C MA DATE Z�r L l 0 PERMIT# LZ- �. Z3 ____ :1i r' L9�! ,._ _ :BC: TE ADDRESS 0S�"j SOWNER'S NAM �/ ,I�� r�Yllicr,iNQ R ADDRESSL'I a�`t} �( S ^r TEL ZFAX �TXP OR PANCY TYPE COMMERCIAL❑ ED ATIONAL ❑ RESIDENTIAL P' U1tlT (U! C • -LY NEW: ❑ RENOVATION:g REPLACEMENT:❑ PLANS SUBMITTED: YES L NO El 1: 1-- ` F1)ti1R,S 7 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 ------Th mTu 2— CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM r DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM ' DEDICATED WATER RECYCLE SYSTEM DISHWASHER 1 • DRINKING FOUNTAIN ' FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK / LAVATORY 2 r ROOF DRAIN SHOWER STALL ; / ' / SERVICE I MOP SINK r TOILET 2 I URINAL . WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER . / ,g/,_2.r 7 _ - INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Q• 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 ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the i Massachusetts General Laws,and that my signature on this permit application waives this requirement. T �� CHECK ONE ONLY: OWNER [7] AGENT ❑ S GNATURE 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. /7 PLUMBER'S NAME LICENSE# \ 1 SIGNATURE MP ElJ�]/? CORPORATION❑# PARTNERSHIP❑.# LLC❑# p COMPANY NAME _(/ /"l YL. ADDRESS 1,� /7( ,4 14(,4-.)(s CITY CP iN'(-2 ��q ( /4 D-/t nSTATE M,' ( ZIP Z TEL / --.-- FAX CELL EMAIL `- 1 .. Qi-71-1 : 4 r-c q;-L -c ``"--1., ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES