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Home My WebLink AboutBLDP-23-003001 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ► ' c� CITY YARMOUTH MA DATE 12/1/22 PERMIT# BLDP-23-003001 JOBSITE ADDRESS 50 OLD MAIN ST OWNERS NAME BEGGS JEFFREY L P OWNER ADDRESS BEGGS ALBERTA M 14 FORTES WAY OSTERVILLE,MA 02655 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL 0 PRINT CLEARLY NEW: 0 RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES El NO❑ FIXTURFS z FLOORS-4 BSM 1 2 3 4 5 6 7 8 9 10 11 19 13 14 BATHTUB CROSS CONNECTION DEVICE 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 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 El 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. PLUMBERS NAME Virgilio Silva LICENSE 3/1395 SIGNATURE MP ❑ JP 0 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME VIRGILIO SILVA ADDRESS 155 SUDBURY LN CITY HYANNIS STATE MA ZIP 026012462 TEL FAX CELL EMAIL virgiliomga@hotmail.com } —le MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ,-.n ;'' CITY Yarmouth MA DATE 12/01/22 F_^x PERMIT# 2�' 3"u' JOBSITE ADDRESS 50 Old Main St OWNER'S NAME Beggs Jeffrey L POWNER ADDRESS BEGGS ALBERTA M 14 FORTES WAY OSTERVILLE MA02655 TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL El RESIDENTIAL 0 PRINT CLEARLY NEW:Ei RENOVATION:® REPLACEMENT:0 PLANS SUBMITTED: YES El NO0 FIXTURES 1 FLOOR BSMR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE _ .,I i r - y I ' I DEDICATED SPECIAL WASTE SYSTEM I DEDICATED GAS/OIL/SAND SYSTEM s I_ DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM I d , , . . _ I { __ 1 DEDICATED WATER RECYCLE SYSTEM 1 DISHWASHER i - I - DRINKING FOUNTAIN _ '1 1 FOOD DISPOSER FLOOR/AREA DRAIN R �`_ INTERCEPTOR(INTERIOR) _ ( { I I KITCHEN SINK LAVATORY _ _ { I - e 'I _ ROOF DRAIN 1 - -- ® 1 I SHOWER STALL SERVICE I MOP SINK 1 1I ,_ I TOILET J ._ f _ _u _ - _ __ URINAL I . . 1 1 I I 1 WASHING MACHINE CONNECTION WATER HEATER ALL TYPES J _ _m I ,I �I I .- ._ I WATER PIPING _ __ _ _ w OTHER [-__ - ___� __ 'I 1 in 1 1 1 1 , i INSURANCE COVERAGE:VERAGE: 1 I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO El 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 U 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 CHECK ONE ONLY: OWNER 0 AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to i• i• t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complian • ' a Pertinent prows in of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. '_ PLUMBER'S NAME VIRGILIO SILVA LICENSE# 31395-J SIGNATURE MP El JP 0 CORPORATION 0# (PARTNERSHIP 0# LLC®# COMPANY NAME Silva Plumbing&Heating INC ADDRESS 155 Sudbury Lane RECEIVE D CITY lyannis STATE MA Zlp 02601 TEL _ m�..._ .�.....� fFC ni 7022 FAX CELL 774-836-0176 EMAIL virgiliomga@hotmail.com r3L111 DING DEPARTMENT By Cgii 1,( 33