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Home My WebLink AboutBLDP-22-002422 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 10/27/21 PERMIT# BLDP-22-002422 JOBSITE ADDRESS 89 ACRES AVE OWNER'S NAME Jason Cassidy P OWNER ADDRESS 89 ACRES AVE WEST YARMOUTH,MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTIIRFS FLOORS-' 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/OIUSAND 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 1 OTHER DESCRIPTION:outdoor shower 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 Stephen Winslow LICENSE T2298 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME STEPHEN A WINSLOW ADDRESS 8 REARDON CIR CITY S YARMOUTH STATE MA ZIP 026641207 TEL FAX CELL EMAIL inspections@efwinslow.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE El ❑ FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _ilret�e ' —�- _ CITY YARMOUTH MA DATE 10/18/21 PERMIT # t Z Z Z- m��- . ,_ ..,,,Y ,, ---_,,x-,...i.-- JOBSITE ADDRESS = 89 ACRES AVE, WEST YARMOUTH i OWNER'S NAMEJASON CASSIDY OWNER ADDRESS 150 HUNTINGTON AVE, #SL-11, BOSTON TELL 7816862948 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL [ 1 EDUCATIONAL 0 RESIDENTIAL PRINT CLEARLY NEW: .,,; RENOVATION: 0 REPLACEMENT: PLANS SUBMITTED: YES L , NOD FIXTURES Z FLOOR-* BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 I� _ 1------ _ r ,� :... BATHTUB :� :� �t ..: CROSS CONNECTION DEVICE ; DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEMIIMIIMMIIIIWIIIIIIMIIIFONIJIIIINIIIIIIIIIIIIIIINIIISINIFMIIIIIIIIIIIIIIIIIIVIIII _, DEDICATED GREASE SYSTEM MIIIIINIIMIIIEIIIIIIIINIIIINUINIIIIIIIMIIIIINNIIIIBIIIINIIIMIIIOIIIIIIINIII ' --' DEDICATED GRAY WATER SYSTEM111111W111111.111111•111111111111NEFONNIIIIIIIIIMEMINI DEDICATED WATER RECYCLE SYSTEM DISHWASHER I I I 1 I 111111 FOOD DISPOSER FLOOR /AREA DRAIN 1111111.1111aillit 11111111111111111.1111111011M111•11.11111SION r INTERCEPTOR (INTERIOR) imulillillillimannsiallirminier—rmainHaini ,inHiminlimillillirmirsimmeinli -- KITCHEN SINK +. ..7 " ' '4 • n ,_ , _ SERVICE / MOP SINK MIIMMIIIIIr '111111111/111111 - 1111111111MINIMMINISINtilill TOILET allin. alle„...,.illair__ ,..111111H__ ,M1111r.„_11111.11. MI, . !WI, ,_ allir f. i OTHER1111110.111ammilallannan URINALWASHING MACHINE CONNECTION '' 1 MI wATER plet,N, ___ _ __ _iiim, inumiaiiins, immailos. siiHimoingilliline, no _ I IIIIIIIINIIIIIIIIIIIINIIIIIMIIIIIIIIMIIIIIIIIIIMIIIIIIIIIIIINIIIIIIRNIIIINIIIIIINIIIIIIIIII 1... g - .v1 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES Ej NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY i 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. CHECK ONE ONLY: OWNER 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 r e to the b t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in co Ii with ll ertine proYisio of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. - '',.4. ,.sue a PLUMBER'S NAME I STEPHEN WINSLOW LICENSE # 12298 i SIGNATURE MP= JP CORPORATION � # 3-51C !PARTNERSHIP( # iLLC liti COMPANY NAME! E.F. WINSLOW PLUMBING & HEATING ADDRESS 8 REARDON CIRCLE CITY SOUTH YARMOUTH JSTATE fljK 1 ZIP 02664 TEL i 508-394-7778 FAX 1 508 394-8256 CELL kk1 N/A EMAIL ' INSPECTIONS@EFWINSLOW.COM `A - `A` mm