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Home My WebLink AboutBLDP-21-006286 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 4/30/21 PERMIT# BLDP-21-006286 ism i 11- JOBSITE ADDRESS 308 OLD MAIN ST OWNER'S NAME 308 OLD MAIN STREET LLC P OWNER ADDRESS C/O MICHAEL LUMIA 310 OLD MAIN ST SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES 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 ROOF DRAIN SHOWER STALL 1 SERVICE/MOP SINK TOILET 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 D OTHER TYPE OF INDEMNITY El BOND El 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 Troy Gilbert LICENSE ff3573 SIGNATURE MP ❑ JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME COASTAL MECHANICAL ADDRESS 21 L Fruean Ave CITY WAREHAM STATE MA ZIP 025711324 TEL FAX CELL I EMAIL lisa@coastalphc.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Ycs No THIS APPLICATION SERVE AS THE PERMIT ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 1/4 Witrimr" CITY South Yarmouth MA DATE L04/29/2021 PERMIT # l3 JOBSITE ADDRESS 308 Old Main Street j OWNER'S NAME JCW Enterprises ._, _ POWNER ADDRESS same _______ l TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL .J RESIDENTIAL 7 PRINT CLEARLY NEW: RENOVATION: i REPLACEMENT: PLANS SUBMITTED: YES NO11 FIXTURES -1 FLOOR--* BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE __r___ L. 1 = ._,,w...F. IL . Lit NOME DEDICATED SPECIAL WASTE SYSTEM I. [-- ___ C._. DEDICATED GAS/OIL/SAND SYSTEM - .I NIN111 DEDICATED GREASE SYSTEM In- NIMMI101.1.1111111111--1111111.11 DEDICATED GRAY WATER SYSTEM 11111� DEDICATED WATER RECYCLE SYSTEM --IMO1� _IIJI M i DISHWASHER f _, '_ i J DRINKING FOUNTAIN I FOOD DISPOSER h '1-- 11111011111 IIIIIIIIIIIIMIIINIIIMMIIIMUIIIIIIINIIIIIIIIIIIII FLOOR 1 AREA DRAIN --I I A _Ji o _INTERCEPTOR (INTERIOR) I KITCHEN SINK ! .. ' NEIJIM1110111 LAVATORY IINUMI111111 MEMOIIIIIIIIIIIII _ROOF DRAIN SHOWER STALL 1 MI . , SERVICE / MOP SINK ti i I.` TOILET I URINAL 1 WASHING MACHINE CONNECTION I WATER HEATER ALL TYPES 1111111111111111 __ WATER PIPING I _____{ OTHER mg _ i____ - — , ----t E i ‘mom imiiiii loon -' i .».- M -411101.1111.1W11 I. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES J NO [— IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY i OTHER TYPE OF INDEMNITY I 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. _ CHECK ONE ONLY: OWNER AGENT 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. //Le., qdeef,t-- PLUMBER'S NAME Troy Gilbert _ LICENSE # J3573 IGNATURE MP i JP CORPORATION # 1PARTNERSHIP # l LLC I#L 4350 COMPANY NAME Coastal Mechanical i ADDRESS 21L Fruean Ave CITY South Yarmouth STATE rilrA-1 ZIP ; 02664 TEL 508-767-8747 FAX CELL 508-850-6955 EMAIL [IIsa@coastalphc corn