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Home My WebLink AboutBLDP-21-005104 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK r.:g®= CITY YARMOUTH MA DATE 3/9/21 PERMIT# BLDP-21-005104 JOBSITE ADDRESS 57 BEACH RD OWNER'S NAME varrick warburton OWNER ADDRESS 57 BEACH RD WEST YARMOUTH,MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW: El RENOVATION ❑ REPLACEMENT:❑ 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 1 LAVATORY 2 ROOF DRAIN SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION 1 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 El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El 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 Michael Mcbride LICENSE 119681 SIGNATURE MP El JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME MICHAEL R MCBRIDE ADDRESS 9 Rustic Drive CITY West Yarmouth STATE MA ZIP 02673 TEL FAX CELL EMAIL stinger.mcbride@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE PERMIT ❑ ❑ FEESS PERMIT# PLAN REVIEW NOTES Lti ( 00 c. . . MAP .' PAIQC6( à MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK =Tiin�='� 14 MA DATE '3iz-/ IPERMIT# DP- Z t `��c S_i G �,::- -� CITY .� � . g i�0 U _ ' "-• ` Mot 1 JOBSITE ADDRESS . ` �C ,4? OWNER'S NAME (/qrri ck LAA�O U ,' :) )1 TEL O - 7g‘ k IFAxi______i pOWNER ADDRESS . _ TYPE OR OCCUPANCY TYPE COMMERCIAL ID EDUCATIONAL 0 RESIDENTIAL LI ' PRINT PLANS SUBMITTED: YES �`� NOD CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: FIXTURES 1 FLOOR-' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 1 . 1 E l_ ..I I ,__I i. , 1......_ 4�._ .�.- �.... �. r _,- -_._ _ __ I�,_.� - CROSS CONNECTION DEVICE _ ., 'L_I `M; - 1 - �f___ •_�•_ '_ - I-- .� I i - - - 1_ .___ DEDICATED SPECIAL WASTE SYSTEM 1 , i_� i___ it__ -�� ._ .._�►.--.- �i--,--_r -11 t_ r= (__-_ DEDICATED GAS/OIL/SAND SYSTEM _.' .. DEDICATED GREASE SYSTEM Ta �_ �-�-1; -L - 1 - i__- .I L_` ,,.t.-�r�,z ,��.-ten .._s L i. DEDICATED GRAY WATER SYSTEM i.J ___._2 . _ ._.1,- . -- - 1 -µ 8 -fi WATER RECYCLE SYSTEM t _ : 1 "i , : �I .. •'' �,m DEDICATED I �; pout um DISHWASHER --- - - __ ... ,.�--,y.- -_..�:�_ .��.._o ..L� ' -� DRINKING FOUNTAIN !-� _- .- <<_ __- !....�_ - ME AL_J j a�-.,i „Q-�. �, j _,:',�..� I FOOD DISPOSER I �(! -. _._, ____,.1.-----, . -. - __A 1-, JL 1 .. FLOOR /AREADRAIN 1 :, - INTERCEPTOR (INTERIOR) _ } - KITCHEN SINK - - _ . - - li � � �� LAVATORY - �- ROOF DRAIN1 '[ j r= SHOWER STALL :._. _ .9 .�_�� _�L.. t�-�l ��! ,-�._�.�... l.� I�.. �L.., � SERVICE / MOP SINK 1t.-r_i_.- i„. „11 - ;� -.�.�'4�� .�!._.___T` L`� `.�. TOILET 3 ... - '' ' . ..: 1 WASHING MACHINE CONNECTION I. . ! J�:.. _ _ - 1_- ' _ __. _H'i _.i1 _______I ., . - II_ IMPEL, 1 WATER HEATER ALL TYPES ! . ii.,�;,.�,,; La,__.d.'l. - --=a._ ..L. .1I.—Ii i 1 • 1 'L.- --: - _. 1 ;; 11-..._. s .� . __1 L_ _. i L. _1 ___ i.�....�..1 itIi 1 .I.�___J ,i WATER PIPING (mow _ l( II 1 iser. ii OTHER _ - r---- i ,4 1� I�r_ �,� y _ - � - - , 1` . -- - ?1 .. ...i i 1- --4 I ( + r_a ll 111 �..I I 1_1 .. r INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES D NO ❑ . IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POUC OTHER TYPE OF INDEMNITY 9 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 Plumbin Code and hapter 142 of the General Laws. \ -Call.,. ( ti PLUMBER'S NAME • 1 LICENSE # SIGNATURE MP❑ JP Et CORPORATIONLJ# . L ?PARTNERSHIP`#, _ __,.-,. LLC0# • i COMPANY NAME i\k( i:) t' ç pf--4- I ADDRESS 6/ 0s/} T-1(,, if) 1 Id i� ISTATEVAVdZIP . TEL O ? re-2......CIY l J ??% FAX CELL 1 1 EMAIL _ f .y-. Cr r or`i - �t.d.t L''S C 4 ✓1/N i L.__ � 1 ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE:S PERMIT# PLAN REVIEW NOTES fr a .:z '1 s • X.yJy•