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HomeMy WebLinkAboutBLDP-23-002199 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK rr/ CITY YARMOUTH MA DATE 10/24/22 PERMIT# BLDP-23-002199 I' JOBSITE ADDRESS 579 BUCK ISLAND RD OWNER'S NAME TURINO ASSOCIATES LLC P OWNER ADDRESS 2000 COMMONWEALTH AVE AUBURNDALE,MA 02466 TEL TYPE OR OCCUPANCY TYPE • COMMERCIAL m RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:© PLANS SUBMITTED: YES El NO❑ FIXTURES z 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 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 WATER PIPING OTHER 24 OTHER DESCRIPTION:faucet replacement 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 0 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. 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 David lannuzzi LICENSE 10775 SIGNATURE MP © JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ALLCLEAR PLUMBING CO INC ADDRESS po# 1070 CITY Burlington STATE MA ZIP 01803 TEL 6176235533 FAX 6176233782 CELL 6177197265 EMAIL dave@elgeplumbing.com <~`. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 1 �. E E .e , CITY- W-Yarm ithI MA DATE 10/20/22 I PERMIT# i r OCT 2C19 2DDI&ES. 579 Buck Island Rd I OWNER'S NAME Maplewood At Mayflower Wf ER API ES' Same TEL 617 719 7265 FAX'617 623 3782 ' Btb L-D !dam:.L .72 - I A LNT ; 9' _ - '" """ • ' COMMERCIAL Fi EDUCATIONAL ❑ RESIDENTIAL❑ PRINT CLEARLY NEW:r_-I RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES Ej Nor;1 FIXTURES 1 FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB ! M _ i CROSS CONNECTION DEVICE w ` ` DEDICATED SPECIAL WASTE SYSTEM in, I;DEDICATED GAS/OIL/SAND SYSTEM i " I DEDICATED GREASE SYSTEM M. � � I DEDICATED GRAY WATER SYSTEM 1 s DEDICATED WATER RECYCLE SYSTEM M�` ;I DISHWASHER mDRINKING FOUNTAIN E FOOD DISPOSER ; FLOOR I AREA DRAIN _' F f INTERCEPTOR(INTERIOR) MI WWW.I.MLIMM..=MIMS," : KITCHEN SINK 1111111111111111111 IIIIIIIIII MIN MIN MN MN NMI IINNI NMI MINI IIIIIII AM— LAVATORY I I NM NMI NM,�Min MM I ROOF DRAIN M .� SHOWER STALL I ��� "' SERVICE I MOP SINK Eniimmilinumnom € TOILET _ URINAL {I_ �f I WASHING MACHINE CONNECTION ] ;, i i 1 WATER HEATER ALL TYPES WATER PIPING ~ MWWW 1 OTHER Faucets imm m'o ,, 1 �___ m 11,MPRIMIMIMRARWM.ral. M., -- --- l'.-- _j INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES El NO ri IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 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 11 AGENT L,.A 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 David lannuzzi J LICENSE# 10775 SIGNATURE MPii .I' JP 1, CORPORATION1-I#13405 'PARTNERSHIP❑# LLC❑#' COMPANY NAME Allclear Plumbing Co inc ADDRESS 1 po#1070 CITY; Burlington _ __ STATE Ma ZIP 01803 TEL 617 719 7265 I FAX 617 623 3782 1 CELL 617 719 7265 EMAIL dave@elgeplumbing.com