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Home My WebLink AboutBLDP&G-22-000625 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/4/21 PERMIT# BLDP-22-000625 I I JOBSITE ADDRESS 3 OAK GLEN VILLAGE OWNER'S NAME YOUNG DAVID P OWNER ADDRESS YOUNG SANDRA 18 WESTVIEW DR MANSFIELD,MA 02048 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW:El RENOVATION:El REPLACEMENT:El PLANS SUBMITTED: YES❑ NO El 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 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 El NO El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El OTHER TYPE OF INDEMNITY El BOND El 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. PLUMBER'S NAME Michael Mcbride LICENSE 16681 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME MICHAEL R MCBRIDE ADDRESS 9 Rustic Drive CITY West Yarmouth STATE MA ZIP 02673 TEL r FAX CELL EMAIL stinger.mcbride@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMIT U PLAN REVIEW NOTES • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK n_ -'may—P Q 1 1== �=/.,• CITY ( ( MA DATE `\ /' T' PERMIT# 2 Z (pL >1 _� !•••••i ., p JOBSITE ADDRESS C � Q OWNER'S NAME OWNER ADDRESS L. I.'1 S LA b V TEL 77, -J7 7FAX TYgE R OCCUPANCY TYPE f�21 T COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL 171 X • C _ LY NEW:❑ RENOVATION:❑ REPLACEMENT: ElPLANS SUBMITTED: YES❑ NO❑ FIX1i0 S 1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 J 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM r-- DEDICATED GAS/OIL/SAND SYSTEM — a DEDICATED GREASE SYSTEM . DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM — DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER , FLOOR I AREA DRAIN INTERCEPTOR(INTERIOR) _ KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL ` SERVICE/MOP SINK - I TOILET r URINAL . j 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 Q NO ❑ 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 t' Massachusetts General Laws,and that my signature on this permit application waives this requirement. T CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I�1 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 LICENSE# 176 u 1. SIGNATURE MP❑ JP gi p) 1 CO RATION El# PARTNERSHIP❑.# �}LLC❑# r" ro P • COMPANY N 1 r C� �" _et ADDRESS ��V L �J r f CITY V V ' 4 (Ai OL)(' L STATE ,,,H ZIP 0 2(L' ( J TEL 77 y- 0 6 ?_/ e2 FAX CELL EMAIL i (� 4-'(_• `' ,� ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No �•'L �j27 I Z( c:- THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE August 04,2021 PERMIT# BLDP 22 000625 II_ JOBSITE ADDRESS 3 OAK GLEN VILLAGE OWNER'S NAME YOUNG DAVID G OWNER ADDRESS YOUNG SANDRA 18 WESTVIEW DR MANSFIELD MA 02048 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW: El RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES ❑ NO El 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 i FURNACE GENERATOR GRILLE INFRARED HEATER , LABORATORY COCKS MAKEUP AIR UNIT , OVEN h POOL HEATER ROOM I 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 El BOND El 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 Michael Mcbride LICENSE# 19681 SIGNATURE MP El MGF El JP El JGF El LPG' ❑ CORPORATION El# PARTNERSHIP El# LLC ❑# COMPANY NAME: MICHAEL R MCBRIDE ADDRESS. 9 Rustic Drive, CITY West Yarmouth STATE MA ZIP 02673 TEL FAX CELL EMAIL stinger.mcbride(a,gmail.com S310N M3IAJZI NVld #.IWHl3d $:33d 111%13d 3141 SV S3AH3S N0I1V0IlddV SIHI oN saA S310N NOI103dSNI 1VNId AlN0 3Sfl b0103dSNI 210d 30Vd SIH1 S310N N01103dSNl SVO HOflO I '=pi fAAHE.i ETTS UNIFORM APPLICATION FOR Qt PERM T TO PERFORM GAS FITTING WORErC MA0 11-a ; ..-:,..--7,P • ,,.,6 I tf DATE PERMIT > o I JOBSITE ADDRESS L 9' OWNER'S NAMEI- ( /D_toff Yô 6 y_ CNJ c 1 OWNER ADDRESS s L -' 7) _) ri. FAX 'l a5 j E 0 I �'� P OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL [I]PR W 1 -7L _ p NEW: RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES NO ir co cc S 1 FLOORS-4 BSIvi 1 ? 3 1 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 j LABC)RATORY COCKS I MAKEUP AIR UNIT j ilL: : OVEN POOL HEATER ROOM 1 SPACE HEATER. ROOF TOP UNIT TEST - UNIT HEATER - UNVENTED ROOM HEATER WATER HEATER / 1 I OTHER INSURANCE COVERAGE I have a current liability-insurance policy or its substantial equivalent which meets the requirements of NIGL. Ch. 142 YES NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE CE POLICY K OTHER TYPE INDEMNITY n BOND I 1 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the l Massachusetts General Laws, and that my signature on this permit application waives this requirement. I �P CHECK ONE ONLY: OWNER —1 AGENT [1 ---, 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 i compliance with all Pertinentprovision of - ` Massachusetts State Plumbing Code and hapter *142 of the General Laws. the PLUf�REER-GASFITTER A1 ..L 12._& �.. NAME r t LICENSE # (0( SIGNATURE MP ❑ MGF f7 JP [ . JGF fl LPGI CORPORATION l li PARTNERSHIP El # 0 LLC COMPANY i\l M - �. 1-44- ADDRESSn .7 I ! 1 c Of viiNe CITY U6 Cy c m1 O� STATE ZIP ? 6 TEL 7 2 yvd / eE FAX CELL EMAIL :'1 -------- -------------------------- -------- ------ ROUGH GAS I1 5PE�TIQr�( rJ° EL THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No GI'-Z 1Z?j2 THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES