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Home My WebLink AboutBLDP-22-004457 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK , CITY YARMOUTH MA DATE 2/10/22 PERMIT# BLDP-22-004457 I JOBSITE ADDRESS [225 ROUTE 28 OWNER'S NAME AMS PROPERTIES LLC P OWNER ADDRESS 225 ROUTE 28 WEST YARMOUTH,MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES El NO❑ FIXTURFS • 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/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 4 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 36901 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ADDRESS 37 Calvin Drive CITY Dennis STATE Ma 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 ❑ El FEES$ PERMIT# PLAN REVIEW NOTES • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK '-'-,-!-7,-, r,_ ; CITY fG l me -i . MA DATE 9-- -o(\ PERMIT# 2Z— 'j 61 6-7 JOBSITE ADDRESS ) S P-Fa a W ya Mott-. OWNER'S NAME I2,o cX • POWNER ADDRESS • TEL 5 "8 77 S- S 66 f FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ❑ RESIDENTIAL❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:I ---- PLANS SUBMITTED: YES❑ NO❑ FIXTURES Z FLOOR-, BSM 1 2 3 4 5 6 7 B 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 SYSTEM "__'-_, DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER _ FLOOR/AREA DRAIN _,3 --{ INTERCEPTOR(INTERIOR) KITCHEN SINK —4 LAVATORY ROOF DRAIN SHOWER STALL 8 (.. F. , v E SERVICE/MOP SINK r. 'TOILET '' i RINAL ' -PE-B — WASHING MACHINE CONNECTION _- WATER HEATER ALL TYPES y BU ii-1_iNU u=r-HK MEN WATER PIPING J -- 1 ("\) OTHER r Li . INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Lj NO 0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UABIUTY INSURANCE POLICY kr OTHER TYPE OF INDEMNITY 0 BOND ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Ma/s'a husetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIG TURE OF OWNER OR AGENT 'VI I hereby certify that all of the details and information I have submitted or entered regarding this application 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 ben m liance wit I Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME LICENSE# %` ° I . / SIGNATURE MP❑ JP In'''' CORPORATION❑# PARTNERSHIP Ell ✓ LLC❑# COMPANY NAME 010 C- vr.\D,..- 4 fte4i.tig . ADDRESS CGi L'`"-- C CITY cvl rl . 5 STATE 41 c. ZIP C'�C-2 3 G; TEL FAX CELL _IL- 7_, t( g)G c ," / EMAIL 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 • •