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HomeMy WebLinkAboutBLDP&G-22-003302 • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK IltLri;01CITY YARMOUTH MA DATE 12/10/21 PERMIT# BLDP-22-003302 JOBSITE ADDRESS 105 BEACON ST OWNERS NAME Joanne Sintiris P OWNER ADDRESS 105 BEACON ST SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL El PRINT CLEARLY NEW:El RENOVATION:El REPLACEMENT:El PLANS SUBMITTED: YES❑ NO❑ FIXTIIRFS FLOORS—r RSM 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 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 1 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 Chris Poire LICENSE 38901 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ADDRESS 37 Calvin Drive CITY 'Dennis I STATE IMa ZIP 02638 TEL FAX CELL '7748366461 EMAIL mcplumber@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 • M 5-SACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY o-t`k_ >4.yc„Lik MA DATE 01 3 /2/ PERMIT# 0 9 ZaitITE ADDRESS l0 3 /3 c''co' OWNERS NAME Y,,.,,,,p 5,-74 %r BU c, DEP CRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL. PRINT CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT:� PLANS SUBMITTED: YES ❑ NO❑ FIXTURES 7. FLOOR—, BSM 1 2 3 4 5 6 7 8 9 1D 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 WATER HEATER ALL TYPES " WATER PIPING OTHER 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 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 m signs ure on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT Er SIGNATURE OF R OR AGENT ❑ ICI I hereby certify that all of the details and information 1 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 'vent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. f 9 PLUMBER'S NAME LICENSE# c/t SIGNATURE MP❑ JP E CORPORATION❑# PARTNERSHIP❑.# LLC❑# COMPANY NAME ! ���*` IT ''11 ADDRESS 3 / CITY Dc_'v.r 5 STATE ZIP ✓, 3 �� TEL 7 7 ct Q 5 W 5,q FAX CELL EMAIL I 1 of , J/n€'/ ' 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 S MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK e CITY YARMOUTH MA DATE December 10,2021 PERMIT# BLDP-22-003302 JOBSITE ADDRESS 105 BEACON ST OWNER'S NAME Joanne Sintiris G OWNER ADDRESS 105 BEACON ST SOUTH YARMOUTH MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL ❑ 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 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE _ GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER 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 ❑ OTHER OF INDEMNITY❑ BOND 0 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-GASFITTER NAME Chris Poire LICENSE# 33901 SIGNATURE MP❑ MGF 0 JP❑ JGF❑ LPG! ❑ CORPORATION❑ # PARTNERSHIP ❑# LLC 0# COMPANY NAME: ADDRESS. 37 Calvin Drive, CITY Dennis STATE Ma ZIP 02638 TEL FAX CELL 7748366461 EMAIL mcplumbernagmail.com S310N M31ARI NYld # LIW2i3d $ :33A ❑ ❑ 11Wa3d 3H1 SV S3/A2f3S NOLLVDllddV SRL oN seA S310N NO11O3dSNI 1VN13 AlNO 3Sf1 210103dSNI HOd 30Vd SIHJ S31ON NO1103dSNI Svo HOf102:1 . _ v SACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ii Win' A—__ ., 1A CITY ) � Y�ac...4.,,t L. MA DATE 0- -3"' 2/ PERMIT tt fE'yu,ITE 4D RESS I U 8e,,tc;1 Sr OWNER'S NAME .Jo c4tt- S•'-%t it,f BUI':i-:• . DEP&A/REpKIDD ,ESS TEL L.'7 3,Z(} "+L FAX 1 YYi; 4. R PRIN T OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL❑ ----- CLEARLY NEW:❑ RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES❑ NO 0 APPLIANCES - FLOORS—+ BSM 1 2 3 4 5 6 7 U 9 10 11 12 13 1! BOILER BOOSTER CONVERSION BURNER • COOK STOVE DIRECT VENT HEATER DRYER L_ FIREPLACE ' FRYOLATOR I —, FURNACE GENERATOR GRILLE f_� INFRARED HEATER LABORATORY COCKS - MAKEUP AIR UNIT OVEN , POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER -- - OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES INO 0 I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massi usetts General Laws,and that my signature on this permit application waives this requirement. i. CHECK ONE ONLY: OWNER 0 AGENT Er SIGNATU . F OWNER OR AGENT ''I-• 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 plia e with all Pe ' nt provision of the Massachusetts State Plumbing Code and Chapter.142 of the General Laws. `1 PLUMBER-GASFITTER NAME LICENSE# pi 33 Yv l SIGNATURE MP ❑ MGF❑ JP L`.) JGF❑ LPGI ❑ CORPORATION ❑It PARTNERSHIP❑# LLC❑#: COMPANY NAME P0,r-c- i40—..6,:,5 3 ti—J`' ADDRESS 3 1 C1.,,h J,-- CITY de'r'rr,• 5 STATE 114•t ZIP G a. 3 " TEL FAX CELL 7 7 Li e 3 C 6,'Id/ EMAIL YH G A,rli b-e - 5 01.4./i cool ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT n ❑ FEE: $ PERMIT # PLAN REVIEW NOTES