The URL can be used to link to this page

Home My WebLink AboutBLDP-23-001635 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 9/27/22 PERMIT# BLDP-23-001635 .„JI ' JOBSITE ADDRESS 67 MERCHANT AVE OWNER'S NAME BRENNAN ELAINE C P OWNER ADDRESS HAMMOND CHRISTINE L 67 MERCHANT AVE YARMOUTH PORT,MA 02675-2238 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL m PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO 0 FIXTURFS FLOORS—. RSM 1 2 3 4 5 6 7 8 9 10 11 - 12 13 14 BATHTUB CROSS CONNECTION DEVICE 1 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 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 Andrew Leighton LICENSE 1,6130 SIGNATURE MP ❑ JP ❑ CORPORATION 0# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ANDREW R LEIGHTON ADDRESS 120 Brewster Rd CITY W Yarmouth STATE MA ZIP 026735706 TEL FAX CELL EMAIL Ihalloilcompany@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 : ! MASSACH3SETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORIg CITYYofertoci41-\____ MA DATE 707 3 - PERMIT T JOBSITE ADDRESS - Co7 e,citct,v /4ue__ : OWNER'S NAME; E/e i a thn 0.6 p OWNER ADDRESS . D c is 'e TEL S( Y cl — 05(FAX TYPE OR ' OCCUPANCY TYPE COMMERC' ; EDUCATIONAL.IONAi_ 7 RESIDENTIAL PRINT — REPLACEMENT: PLANS SUai j : YES �( CLEARLY NEW: � RENOVATION:.GN: _.,: `� ;-_-' ' � � � 7 g C 'u ''� ii i i2 i� FIXTURES ' F OOR 38 � i . BATHTUB __._. ___ . - _ --- = . . . . R S CONNECTION DEVICE _ _: .- -- C DEDICATED SPECIAL WASTE= SYSTEM i - - DEDICATED GASIOIUSAND SYSTEM T- _ __ _ _ -' -< DEDICATED E' GREASES SYSTEM __ - ._ . - " DEDICATE GRAY WA SYSTEM - _-_--_.__ _ — -- --- -. :- - � _ DEDICATED WATER RECYCLE-E SYSTEM. --- . ._ ---. - i - . - -----. - DISHWASHER _ - _ - -- ��-_- 1 . _ - { DRINKING FOUNTAIN -_- -° --- - -- FOC DISPOSER ---.. .. - .. - - _ FLOOR!AREA DRAIN __ - _. . . _gilit Wow mow INTERCEPTOR tGEPTOR (INTERIOR) -- _ _ HEN - -— : ::: 4 _� KITCHEN SINK � ------- - - . ,��_ --.: ROOF DRAIN t----_ WER STALE. i _ . SHO t MCP SINK R _` . SERVICE - 10 ��-simiwgiglOiii..iwiligui _WI _ TOILET URINAL 5- --. . .__ WASHING MACHINE CONNECTION i_ .-..�� - ��■fs��% i� . ' WATER NEATER .-TYPES _ice : — . WAT,..R PIPING -- __. ...� = _ _ OTHER °�-t -'r ___-__--_- --__ '>�' __ - iriiitimor r • --- 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 E BOX BELOW OTHER i Y J BOND 7 .� ! LIABILITY INSURANCE POLICY . TYPEF INDEMNITY 0 OWNER'S INSURANCE WAIVER I am aware that the licensee does not have the insurance coverage required by Chapter IA2 of the Massachusetts General ors,and that my signature on this permit application waives this CHECK ONE ONLY: 0 ER f AO SIGNATURE OF OWNER OR AGENT itted ar� :�ardn��alp `sue to mY l hereby certify that all &tie details and information I have�m p and the all plumbing work and installations performed uncle-ti• permit issued for thus application will in withMassaw'-use State PluTrting Code and Chapter 142 or the General Laws_ 7 PLUMBER'S NAME ANDREW LEIGHTON _ ' = GNATURE LICENSE Y 6130- A r;= CORPORATION o„= 3734G !PARTNERSHIP`.-�. # _ F LLc #1— _— NIP ,iP • ___n__ COMPANY NAME HALL OIL COMPANY INC. j ADDRESS 1435 RT 134 -,------------'--,.- CITY 1 SOUTH DENNIS STATE f n. um I TEL 508-398-38311 Pax . cfR_14d:3US8 i CELL 1 EMA lailromw on?