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Home My WebLink AboutBLDP-23-005271 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY IYARMOUTH MA DATE 3/24/23 PERMIT# BLDP-23-005271 1 JOBSITE ADDRESS 8 TIDE LN OWNER'S NAME KERRY KING P OWNER ADDRESS 19 ELDREDGE LANE COHASSET 02025-0000 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL ❑ PRINT CLEARLY NEW: 0 RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES NO El FIXTURES • FLOORS—. BSM 1 2 , 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE 2 DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTE tf DISHWASHER 1 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN —INTERCEPTOR(INTERIOR) KITCHEN SINK 1 ' LAVATORY 1 ROOF DRAIN • SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER _WATER PIPING OTHER 1 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 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 Richard Whiteside LICENSE 16850 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME MURPHY'S SERVICES,LLC ADDRESS 34 White's Path CITY (South Yarmouth STATE IMA ZIP 026641212 TEL FAX I I CELL I EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES Project Job MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _t_ CITY , Yarmouth _ _ MA DATE 3/23/2023 PERM 7/ JOBSITE ADDRESS 18 Tide Lane OWNER'S NAME King OWNER ADDRESS I 51 Fords Crossing, Norwell, MA 02061 TEL 617-529-3751 1 FAX I TYPE OR OCCUPANCY TYPE COMMERCIAL _I EDUCATIONAL ni RESIDENTIAL Li PRINT CLEARLY NEW: L I RENOVATION: REPLACEMENT: . _ PLANS SUBMITTED: YES 1 NO FIXTURES Z FLOOR—' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 _z BATHTUB i ii II -- - ' I' - CROSS CONNECTION DEVICE =� 2 __ ��: _ 11111111111111111 £r DEDICATED SPECIAL WASTE SYSTEM ' �_- I - __ -- I— _ _ } DEDICATED GASl01L/SAND SYSTEM ( 11_ II "L[1_I L IT--IF s=ITI DEDICATED GREASE SYSTEM I 11 _MIIIMMillittillIMMMINIIMMaillii._ DEDICATED GRAY WATER SYSTEM -_ 11 _ IT —LiM _ l DEDICATED WATER RECYCLE SYSTEM I _I l; I i1IIII DISHWASHER 1 1 i 3 -- r 1 ►f _ DRINKING FOUNTAIN it I T - IIIII I II FOOD DISPOSER I. I ,; _ FLOOR / AREA DRAIN f` '`Mi _- !� T � IONO111 -7 INTERCEPTOR (INTERIOR) IT MI i —}1 jII ME— ' 11 == KITCHEN SINK €3 1 ';_ II LAVATORY r i If 1 s_ __ ROOF DRAIN _ ( II 'i ii { SHOWER STALL 11 ( 1 IMMO i! I' int =1 __ SERVICE / MOP SINK 1 It I 1 II l �TOILET F6 1 IP-- — , ! SE URINAL 1 .. - Fr €} li , WASHING MACHINE CONNECTION ` li MIMI _ IF {I i 1E 1 WATER HEATER ALL TYPES 3 __ _ IMMBIL1111.11•11i WATER PIPING 3,, —1 = WWI _. I11 II I OTHER I Ice Maker . I `_ 11 _: 11 __. E--i h 11 ;1111all ;r _1111111nM_M.M1 t - __ . -.. _-_ -- i- _ _. _ ,1 -, . i INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES NO T 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. 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 ar= : an, a urate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be i ci • :nc- w' h all Pertinen of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME ' Richard J. Whiteside !LICENSE # 15850 SIGNATURE MP i JP CORPORATION # PARTNERSHIP #i I LLCH l H# 4611 COMPANY NAME Murphy Services Inc ADDRESS 34 Whites Path u CITY 1 South Yarmouth 1 STATE MA j ZIP 02664 TEL 1508-760-1660 •y fr r7,----76 FAX 508-760-1670 CELL EMAIL cshea@callmurphys.com 11 jridlon@callmurphys.com : ` ,R 2 4 2023 r i `..`,-D1Nt-' UUt -mtal4ENT