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Home My WebLink AboutBLDP-22-005064 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK y, CITY YARMOUTH MA DATE 3/14/22 PERMIT# BLDP-22-005064 JOBSITE ADDRESS 7 STARBUCK LN OWNER'S NAME MCBRIDE PAUL N III P OWNER ADDRESS 7 STARBUCK LN YARMOUTH PORT,MA 02675-2417 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL 0 PRINT CLEARLY NEW:0 RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES El 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 1 WATER HEATER WATER PIPING OTHER 2 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 0 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 John Bowman LICENSE 25724 SIGNATURE MP 0 JP 0 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME JOHN W BOWMAN ADDRESS 182 South St CITY 'South Yarmouth STATE MA ZIP 026646047 TEL FAX CELL 5085421171 EMAIL john02664@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES \es 'So THIS APPLICATION SERVE AS THE 111 ❑ FEES S PERMIT# PLAN REVIEW NOTES G .>> F SSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK j CITY i. ri PO/Li MA DATE -3//0 '4N- PERMIT# Z `I iZ4OB$IT ADDRESS 3- 57 AR3 Vc-k Lti( OWNERS NAME PA UL- I9c,13I4104_, B iLDir EP, F276WHER DDRESS 3 STa2&e/C.& L,..1. TEL'OB ak377 9. 15— FAX By. TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL , PRINT CLEARLY NEW:❑ RENOVATION: REPLACEMENT:❑ PLANS SUBMITTED: YES ❑ NO❑ FIXTURES T FLOOR 69m 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 SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN _ INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL / SERVICE/MOP SINK TOILET / URINAL _ WASHING MACHINE CONNECTION 1 WATER HEATER ALL TYPES _ WATER PIPING OTHER F_jr e--- a� $r.4-14- 1 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES❑ NO ISt 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 f` Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNERS 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 wi IIII Pent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME �o1.J 80t)M4~.l �� LICENSE# Qs 3 q / / GNATURE MP❑ JVI CORPORATION❑# PARTNERSHIP❑.# LLC❑# COMPANY NAME - 3fo thvi4-0—/ ,j urn I ADDRESS /c l'AQz eCORP_ OSe_t dr- R CITY Vt4cY / Y}O _ STATE fr • ZIP O.a.6 T3 TEL 15-0g ! oZ l/ '1 FAX CELLS J /r'3—/ EMAIL 611,I692.0 4/6 6.,n04'+• C45 fY ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES