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Home My WebLink AboutBLDP-21-004423 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 2/4/21 PERMIT# BLDP-21-004423 y .. JOBSITE ADDRESS 5201 HEATHERWOOD OWNER'S NAME HOLWAY WILLIAM G P OWNER ADDRESS HOLWAY TINA G 5201 HEATHE RWOOD YARMOUTH PORT,MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑J PRINT CLEARLY NEW: ❑ 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 1 DRINKING FOUNTAIN FOOD DISPOSER 1 FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY 3 ROOF DRAIN SHOWER STALL 2 SERVICE/MOP SINK TOILET 2 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❑ 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 Peter Hassett LICENSE#1682 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME PETER J HASSETT ADDRESS 8 Skipper Lane Hassett Plumbing & Heating Inc. CITY Yarmouth Port STATE LA I ZIP 02675 TEL FAX I I CELL I EMAIL peterjhassett@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES • vc� Yes No THIS APPLICATION SERVE AS THE PERMIT E FEES$ PERMIT# PLAN REVIEW NOTES , MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK . x..„, CITY 1rmouth MA DATE i 1/27/2021 PERMIT #. Jy r/l ' `2 JOBSITE ADDRESS 5201 Heatherwood OWNER'S NAMEIJohn & BettyHerr1 P _ OWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL 7 RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: v PLANS SUBMITTED: YES I I NO ,1 FIXTURES Z FLOOR-+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB E CROSS CONNECTION DEVICE -. ,__ .w DEDICATED SPECIAL WASTE SYSTEM r ! � _ DEDICATED GAS/OIVSAND SYSTEM n 1 '4 11 UM" ._ MT __ - _,. DEDICATED GREASE SYSTEM 3 _ I DEDICATED GRAY WATER SYSTEM c w _ DEDICATED WATER RECYCLE SYSTEM ; `t DISHWASHER = MEW DRINKING FOUNTAIN NEI lilt '1 FOOD DISPOSER WI'_ r - FLOOR /AREA DRAIN . =--' _. INTERCEPTOR (INTERIOR) i KITCHEN SINK � '` _ .; `MINI INS INN In,IIIIIIII LAVATORYLAVATORY IIIIIIOMNIMIIIIBIIIIIIIIIIIIWMIIIIWIIIIIIIMMIIIIIWIIEINWUIPB ROOF DRAIN _ _ __ _--M [ - _ _ ' SHOWER STALL i I SERVICE / MOP SINK i _' TOILET 2 - URINAL . ,. „ __ WASHING MACHINE CONNECTION I __It L _w,_ n WATER HEATER ALL TYPES . . �_ - ,.._ WATER PIPING _ it OTHER t 'fir. _.. ii. ,� ---*fezlideilill101111~4iliii. ,..— WO. __ _INSURANCE COVERAGE: I have a current liability_insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES El NO 11 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 Li 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 co . . lay,:,'" in-- . •r• ision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ` PLUMBER'S NAME Peter J. Hassett LICENSE # 11682 i SIGNATURE MP - JP® CORPORATION # 3506 PARTNERSHIPQ# , LLC Li 1 1 COMPANY NAME r Hassett Plumbing and Heating, Inc. ADDRESS L8 Skipper Lane 0- ` — CITY Yarmouth Port STATE MA ZP . 02r 675 T TEL 5 8-7 7555 FAX [ CELL 508-237-2175 EMAIL peterjhassett@gmail.com BUILDING DEPARTMEN i