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HomeMy WebLinkAboutBLDP-22-006719 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK • CITY YARMOUTH MA DATE 5/20/22 PERMIT# BLDP-22-006719 cn I JOBSITE ADDRESS 21 ARLINGTON ST OWNER'S NAME TUGBOATS P OWNER ADDRESS HYANNIS,MA 02601 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL m RESIDENTIAL ❑ PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:❑ PLANS SUBMITTED: YES El NO❑ FIXTURFS 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 0 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 0 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'S NAME Paul Kelly LICENSE 111689 SIGNATURE MP 0 JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME IPAUL J KELLY ADDRESS 70 SHOREWOOD DR CITY MASHPEE STATE MA ZIP 026492817 TEL FAX CELL I EMAIL paul@kellyph.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE El 0 FEES$ PERMIT# PLAN REVIEW NOTES • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK __1 a� CITY 11•11 f�k'(P O `ki MA DATE f C 7 `— PERMIT# JOBSITE ADDRESS /( 4> f, .1,- I 1'' ! OWNER'S NAME • POWNER ADDRESS _,t- - TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL�� EDUCATIONAL ❑ RESIDENTIAL❑ PRINT CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT:V PLANS SUBMITTED: YES❑ NO❑ FIXTURES T FLOOR-+ 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/OIUSAND SYSTEM DEDICATED GREASE SYSTEM 1 DEDICATED GRAY WATER SYSTEM T 1 DEDICATED WATER RECYCLE SYSTEM DISHWASHER • DRINKING FOUNTAIN _ FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK _ LAVATORY - ROOF DRAIN SHOWER STALL • R E I V F L SERVICE/MOP SINK ---111. _ --._.- ' TOILETI �� I URINAL MAT i 8 L ULL - j WASHING MACHINE CONNECTION WATER HEATER ALL TYPES- / BUILDING DEPA-RTMENT WATER PIPING By OTHER I I i INSURANCE COVERAGE: l I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0- fio ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UABIUTY 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 1 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 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 knowledgf 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. ndf Vim _ PLUMBER'S NAME LICENSE# II a //4S I J' SIGNATURE MP 1S' JP❑ CORPORATION❑# PARTNERSHIP❑.# LLC El# COMPANY NAME 41.l'y f7'F '�1 ADDRESS 7 ° iv; 'c" 1.,-,c.0ti-+ CITY lnc. it � zt STATE fr g/ ZIP 0 2-4, '' 7 TEL ti z'43 S . C' 51 Z FAX A CELL °+- EMAIL — I P� I/y i>11 .. a y'kt 7-GI) CS'c ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT it PLAN REVIEW NOTES 1 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK �' a CITY YARMOUTH MA DATE May 20,2022 PERMIT# BLDP-22-006719 r JOBSITE ADDRESS 21 ARLINGTON ST OWNER'S NAME TUGBOATS G OWNER ADDRESS HYANNIS MA 02601 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL RESIDENTIAL❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED:YES❑ NO 0 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 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 El 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 Paul Kelly LICENSE# 11689 SIGNATURE MP©MGF 0 JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑o LLC❑# COMPANY NAME: PAUL J KELLY ADDRESS. 70 SHOREWOOD DR, CITY MASHPEE STATE MA ZIP 026492817 TEL FAX CELL EMAIL paulAkellvph.com S310N M31A321 NYld #.IW0:l3d $ :33d ❑ ❑ 1I1%13d 3H1 SV S3A213S NOIIV011ddb SIHL oN saA S310N NO1103dSNI IYNId AlNO 3Sf JO.1.03c1SNI dOd 3EWd SIHI S31ON NOI103dSNI St/0 HJf O l MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK / _ rc`k CITY ��q /li�� 1�J MADATE Zi+ c-s "/ 2- PERMIT JOBSITE ADDRESS // g!11 ( 7L-4- 61 OWNER'S NAME OWNER ADDRESS _ TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL PRINT EDUCATIONAL ❑ RESIDENTIAL❑ CLEARLY NEW:❑ RENOVATION: ❑ REPLACEMENT: [ - PLANS SUBMITTED: YES❑ NO ❑ APPLIANCES FLOORS-4 sClu► 1 2 3 4 5 6 o I BOILER 9 ti) t1 12 •l; 1R BOOSTER I CONVERSION BURNER COOK STOVE DIRECT VENT HEATER �__ DRYER i FIREPLACE FP,I'C?LATOR 1 FURNACE _ I GENERATOR GRILLE INFRARED HEATER _____, LABOPJ{TOR`(COC€;S i--_� MAKEUP AIR UNIT11111! • —I OVEN CiENd � E}- POOL HEATER I J I__I ROOM I SPACE HEATER MAII`_.� 8 ,f2 ROOF TOP UNIT r TEST - . . .__ . . . . . . .. • _ BUJ�D I DEI-APTk/1E UNIT HEATER INVENTED ROOM HEATER —_� I WATER HEATER I _ OTHER ! I— 1 INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MU.Ch.142 YES [IRO ❑ 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 1 fMassachusetts General Laws,and that my signature on this permit application waives this requirement. . CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT 71 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 crckmpliance with al Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. -y P v /' Qj PLUMBER-GASFITTER NAME LICENSE#'//fb /4, r' SIGNATURE MP gr MGF❑ JP ❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP❑# LLC❑# COMPANY NAME ILA( I - `Y t' R ADDRESS CITY r�k 4 tt (L., STATE A ZIP 0 2- 7 TEL,4 3K .5. -- vz 2 FAX CELL EMAIL CAS/f k WUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES 'des No THIS APPLICATION SERVES AS THE PERMIT ( I FEE: $ PERMIT PLAN REVIEW NOTES