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HomeMy WebLinkAboutBLDP-22-007056 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK e, CITY YARMOUTH MA DATE 6/6/22 PERMIT# BLDP-22-007056 ' >� JOBSITE ADDRESS 302 ROUTE 6A OWNER'S NAME OCONNELL JOHN T .D' OWNER ADDRESS OCONNELL KAREN J 302 HALLET ST YARMOUTH PORT,MA 02675 TEL I TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL El PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES El NO❑ FIXTURES • 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 1 ROOF DRAIN SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER 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❑ 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❑ 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. PLUMBERS NAME IJoselin Sanchez I LICENS43F1804 I SIGNATURE MP JP CORPORATION Oft I PARTNERSHIP 0# I I LLC ❑# ( I ❑ © COMPANY NAME IJOSELIN C SANCHEZ I ADDRESS 1108 BAYVIEW ST 108 BAYVIEW ST STATE IMA I ZIP 1026738211 I TEL I CITY (WEST YARMOUTH FAX I I CELL 1 I EMAIL Iplumbing657@gmail.com #. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK rr ' rmouth MA DATE I06I03I2022 'PERMIT# __asl _t4 CITY Ya P JOBSITE ADDRESS 302 cranberry Hwy OWNER'S NAMEIMichael Dwyer I POWNER ADDRESS'same as the above I TELI„ 340 4.3 87 'FAX l I TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL El RESIDENTIAL El PRINT PLANS SUBMITTED: YES 0 NO❑ CLEARLY NEW:D RENOVATION:❑ REPLACEMENT: FIXTURES 1 FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM111111. �,�' DEDICATED GASIOIUSAND SYSTEM �, ______�'INN NEI�,UN� 11111111'�''�'MIN MIMI DEDICATED GREASE SYSTEM ® INNN MIN NMIDEDICATED GRAY WATER SYSTEM MIN NUNDEDICATED WATER RECYCLE SYSTEM ®°'INN''—®I INN 11111111MN''I'I'MIMI NE'MI , DISHWASHER DRINKING FOUNTAIN1111111111111111111111111111111111 FOOD DISPOSER FLOOR I AREA DRAIN 111111 I'SIN MIMI'INN NMI NMI:N MINN IIIIN ENO MIN NIN MN INTERCEPTOR INTERIOR) Nil''NM_INN INN MN'INN 'INN MN INIII NM'NU1111111 Mt KITCHEN SINK inliMNM Mill___ ___ 11111111 MIMI 1111111111 1111111111NMIMMIN 1.11111' ROOF DRA 11111®MINI____ - — N N ��N� N 'O®. ROOF DRAIN MN SHOWER STALL NM Ka OM NM INN Ma NM i MM.MI Mini EMS NM Mir SERVICE/MOP SINK NM NMI,1111111 INN ONO'®r1111111'NISINN MIN INN MN'''MIMI'UN TOILET M 1 NM 1111111Inil INN MIN INN ENNIIIIMINI MIN MN 11111111 URINAL NNEI MINI I'I INN'IIIIII INN N INN INN,MIN'MINI NMI WASHING MACHINE CONNECTION IIIIII NON MN NMI''INN INN I' 'MN NMI NMI ' WATER HEATER ALL TYPES INN®®NOM NMI INN IIIIII INN MN®OnNMI INN N1111111 WATER PIPING OTHER current liability insurance policyor its substantial COVERAGE: I have a ubstantial equivalent which meets the requirements of MGL C .1 2. I : MI al/ Fra IF YOU CHECKED YFAILEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOWBU i D NG DE PAR 1 M E N T LIABILITY INSURANCE POLICY El OTHER TYPE OF INDEMNITY El BOND 0 ey.-- OWNER'S DANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the MassachusettSGeneral Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT SIGNATURE OF OWNER OR AGENT . true and accurate the best of my tcnowledge I hereby certify that ab of the details and information t have �permit ew or entered regarding this application ,'- ncd with all to pro l ion of the and that all p g work and performed it issued for this application will be Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 4?j f , (, ofhG PLUMBER'S NAME IJoselin C Sanchez (LICENSE#131804 I SIG ATURE ® MP JP CORPORATION0#' 'PARTNERSHIP 0#1 1[lc D I#1 ADDRESS( NIA COMPANY NAME Giovanni plumbing&heating ' CITY West Yarmouth STATE Ma ZIP 02673 TEL 150 1389 8-360- FAX CELL 508-360-1389 EMAIL plumbing657@gmail.com '% e "s93