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Home My WebLink AboutBLDP-21-002358 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 10/29/20 PERMIT# BLDP-21-002358 1e3' � JOBSITE ADDRESS 55 MICHELLES PATH OWNERS NAME KAREN&JOHN MATRANGO P OWNER ADDRESS 9 SOUTH HAWES RUN WEST YARMOUTH 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL 0 PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES El NO FIXTURES FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 _BATHTUB 1 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 FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY 2 1 ROOF DRAIN SHOWER STALL 1 1 SERVICE/MOP SINK TOILET 2 1 URINAL WASHING MACHINE CONNECTION 1 WATER HEATER WATER PIPING 1 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❑ OWNERS 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. PLUMBERS NAME Andrew Marrese LICENSE#1187 SIGNATURE MP 0 JP ❑ CORPORATION ❑# I I PARTNERSHIP ❑# LLC ❑# COMPANY NAME IANDREW F MARRESE I AC DRESS PO BOX 5069 CITY INORWELL I STATE IMA ZIP 020615069 TEL FAX I CELL I EMAIL Igail.afmplumbing@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES T Yes No (] /d ig 207ti G15 THIS APPLICATION SERVE AS THE PERMIT ❑ FEES$ PERMITS PLAN REVIEW NOTES ,en r " a -i • �- 3oo �> 'e 1 ' lJ1,8a2. dock K t i' tef ' /g if ,;. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK il .1 CITY W. . /9Rmp4,._.,t .,,W,., MA DATE l0 c2� o-. PERMIT # /& ,Y ' c9 1 , '-k ' - a,13.-6-Y. �;-5 JOBSITE ADDRESS L,,,55,r. //� / ch',_` ,-- s ---3 .. _........_ .,,_, it-71 OWNER'S NAME.. AA/ 14 05iw k _/V al/A/ OWNER ADDRESS I TELL FAX : ',Je D COMMERCIAL J EDUCATIONAL .. RESIDENTIAL ? ` 1 TYPE OR OCCUPANCY TYPE .�,.,�,,,. ,, �.� � � /111-416 PRINT CLEARLY NEW: RENOVATION: i 14.1 REPLACEMENT: PLANS SUBMITTED: YES NO FIXTURES I1 FLOOR-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB t --�---� r. ----_- �. ' ' CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM _ Y_ i f_ DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM 1 's DISHWASHER -7-- , - ____, , ----. DRINKING FOUNTAIN __ � FOOD DISPOSER FLOOR /AREA DRAIN _ ;. , l _.. INTERCEPTOR (INTERIOR) �_ _� KITCHEN SINK , ---_.._. , �. _ -_ — -a LAVATORY ___, ROOF DRAIN _ a, _ SHOWER STALL _._., _ I. j -- _ -_. . SERVICE / MOP SINK y_._, TOILET w, a I _ -f URINAL - WASHING MACHINE CONNECTION z I` �. I _ _ I WATER HEATER ALL TYPES .:..........::. WATER PIPING J . t f OTHER _ s Ifl�ip9...A'dt.+8i3feO .?,„..S4kttM . I . INSURANCE COVERAGE: f I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES v`'` NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW /LIABILITY INSURANCE POLICY iY"+ OTHER TYPE OF INDEMNITY BOND L. 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 altered 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 rQ LICENSE # /1/ e9 el SIGNATURE MP , ----JP CORPORATION"✓ , PARTNERSHIP #. . LLC ..., # -v.s...-..:a..:.. .....wtaa.'•....Vv.vr......• :....,.n:ter..-r:..s.r.r+:w«n.>a._.+.:.n.e+w.....-aauv..nw.-:w.:a...a».:.w.....a.n:E 3 COMPANY NAME � ..... ... ADDRESS D' se + 4.rf_,.: ;_ . :.s:.. .„ . .CITY IL STATE ZIP ' � ® TEL - , . ---, - -----, FAX 4,1"j ?ta/vfreg /27'cJlf x ' Q,,,Apgi ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT 0 0 FEE:$ PERMIT# PLAN REVIEW NOTES