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Home My WebLink AboutBLDP-23-004037 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK L CITY YARMOUTH MA DATE 1/23/23 PERMIT# BLDP-23-004037 JOBSITE ADDRESS 135 SOUTH SHORE DR UNIT 34 OWNER'S NAME MILLER JOHN L SR P OWNER ADDRESS 8912 SEVEN LOCKS RD BETHESDA,MD 20817-2056 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL PRINT CLEARLY NEW: 0 RENOVATION:0 REPLACEMENT:0 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 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 ❑ 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❑ 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 Joselin Sanchez LICENSE 3t1804 SIGNATURE MP 0 JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME JOSELIN C SANCHEZ ADDRESS 108 BAYVIEW ST 108 BAYVIEW ST CITY WEST YARMOUTH STATE IMA 7 ZIP 026738211 TEL FAX I I CELL I —I EMAIL plumbing657@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ��' CITY south Yarmouth MA DATE 1/17123 PERMIT # 2_ 3 t-/o 32 _,,,L ,�f JOBSITE ADDRESS 135 south shore Dr....Unit 34 OWNER'S NAME John miller J 8912 seven locks Rd, MD OWNER ADDRESS TELF— i FAX C TYPE OR OCCUPANCY TYPE COMMERCIAL E EDUCATIONAL 0 RESIDENTIAL Q PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: , PLANS SUBMITTED: YES [v NO FIXTURES Z FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB ,J4.__ C-—1 CROSS CONNECTION DEVICE ....4 ••....i DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM J f DEDICATED GRAY WATER SYSTEM +____ DEDICATED WATER RECYCLE SYSTEM i DISHWASHER `` DRINKING FOUNTAIN J FOOD DISPOSER FLOOR /AREA DRAIN t i L ., --i INTERCEPTOR (INTERIOR) j KITCHEN SINK 1.___ ' i LAVATORY L—J _ l J. ROOF DRAIN SHOWER STALL j 1 I - SERVICE / MOP SINKf____. -1 TOILET 1 I URINAL WASHING MACHINE CONNECTION Ii WATER HEATER ALL TYPES r. WATER PIPING OTHER . L _ _. �- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES Ei NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY v 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 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 Joselin Sanchez LICENSE # 31804 SIGNATURE MPL JP[ CORPORATIONO# PARTNERSHIP L_;#+ LLC0#I COMPANY NAME Giovanni plumbing ADDRESS N/A CITY West Yarmouth STATE Ma ZIP 02673 TEL 508-360-1389 FAX CELL 508-360-1389 EMAIL plumbing657@gmaiol.com GOLCI