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Home My WebLink AboutBLDP-22-000666 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/5/21 PERMIT# BLDP-22-000666 JOBSITE ADDRESS 12 SATURN LN OWNER'S NAME Leanne Phillips P OWNER ADDRESS 12 SATURN LN SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATIONS,❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO 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 1 ROOF DRAIN SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER WATER PIPING 1 OTHER 1 OTHER DESCRIPTION:ejector pump 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 El BOND❑ 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 Eugene Volosevich LICENSE 26144 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME EUGENE VOLOSEVICH ADDRESS 486 Forest Rd CITY West Yarmouth STATE MA ZIP 026732843 TEL FAX CELL EMAIL VOLLOGG@MSN.COM ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No — THIS APPLICATION SERVE AS THE I=1 El FEES$ PERMIT# PLAN REVIEW NOTES • - mAP : Porii2 e 6 e a MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ==�f =; CITY Y_14 ER- iti L� :-37'.A- 1 MA - DATE 1 PERMIT# • -A 9,1. JOBSITE ADDRESS t g2,_ sSac( Le.4/,! sy OWNER'S NAME d:kf// (1, i /b _ r _ i 1 ,_ POWNER ADDRESS ._.. s -r tA/zfr✓ L -/1/�,./ g TELj ( - 1732 7 1FAX I TYPE OR OCCUPANCY TYPE COMMERCIAL ,_J EDUCATIONAL Li RESIDENTIAL PRINT CLEARLY NEW: Li/ RENOVATION: J REPLACEMENT: Li PLANS SUBM11 I ED: YES Li NO LA FIXTURES 7. FLOOR-* BSM 3 4 6 7 8 9 10 11 12 13 14 BATHTUB _1 . •10111* - CROSS CONNECTION DEVICE ; , _WWI.. _ _ _ i _ '!__ ,, - DEDICATED SPECIAL WASTE SYSTEM •i,, - : -.. _!a - _.___. t L=-J ._____ Mr-A DEDICATED GAS/OIUSAND SYSTEM tm�� ; ___ . m a - —' -_ I DEDICATED GREASE SYSTEM __ . _ a ,I.. !_i' _ - .-.I -- ! .+ DEDICATED GRAY WATER SYSTEM T _-5 _ _ pyl _- __ 1 _ t -___- DEDICATED WATER RECYCLE SYSTEM _ ', _ — 1 S - _ Mi �r '' !_ '' '~�' 1 j - --- --DISHWASf-HER -----------------.. . .-_-� - 1 -11 --- -:_ _--- -- MN jig., ____. . liiiiii DRINKING FOUNTAIN -.__ '1 --_ 'JL_ 1--7L J Aim (� _ _ FOOD DISPOSER _ `if .__ , -- t, , _ -;1 .L_ - , _ . _ FLOOR I AREA DRAIN _ 'E__ 'I. _ -_i _ __ i _-- ---- _it _ _ _ .,J111111111111111 . INTERCEPTOR(INTERIOR) - __ nit LL_I _JINIII .-. -. .- - 1 1 - . - - ' _WI -. KITCHEN SINK ' --- 1_____1 ',.v -- ' _ _ ,-' LAVATORY .y- 1' ,_-1s - 21-- ... 4. _ i_ . I I� L? i - , -1(m4 . ROOF DRAIN _ - ;��_ II - 1 f. ._s4 . _ ' I 1 - -: _._1 . .1111.1 SHOWER STALL . I _ 'J' s' J11 _ L L r _ J L 91 _. ' - / . SERVICE/MOP SINK -- L__.. L-L -J —I t_,- h F _I n_.__1 _ _____- = - - � l_.J TOILET _ .__--- • i ; �.._. ' ;_...� 'I .. I -- =L_ ---` - . �,r. ��-_: _ . URINAL ;�_.___ L_ J I-. ,..� 1 F -_ i_.._._.�. L A _�, . '- ---- '� ,=1 ,. _,. WASHING MACHINE CONNECTION IL_ '1 ,, __ i_=--IL . I! - '' �'L. , WATER HEATER ALL TYPES i _Mai I_ - - I: _ 'F __ _i_1 WATER PIPING .1.11MMINKLIMEMMIIIIMMINIMillIMIEWIIIIMINIS OTHER _ lSIMIILJM- JM is MIWITA.111.11MPOOMVAMantLM.1.. ...MIMIMEMIIIIII.1.11_ -7.i MI _1 Mj 11111111M1M INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES L NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UAB LITY INSURANCE POLICY OTHER TYPE OF INDEMNITY LI BOND OWNER' I SU NC, • IVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massac G era t and that my signature on this permit application waives this requirement. if "1 , - CHECK ONE ONLY: OWNER AGENT =; _ - SIGNATU` OWNER OR AGENT I he, by ce ' that all of the details and information I have submitted or entered regarding this application are true and accurate to the be knowledge and that all plumbing work and installations performed under the permit issued for this application will be in co nce with ail Pert - �sion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. . �—__.- t PLUMBER'S NAME ' ' ____ s&V/ -9 j LICENSE# )--"7/ 2`7/ SIGNATURE - MPD JP 21, CORPORATION .., #L PARTNERSHIP Li#, om _ 1 L LC P# __!1 COMPANY NAME //)kb f JADDRESSk' - f- /2 -j, pc _ i CITY I, A �v4 7'______A STATE , _i ZIP _ es 4 7__ - TEL ? . FAX . -._JCELL(/7c4MAIL V<,/ID c - : ;Ut s /tL �-�Gs-► ____F�.r_.- $J0521 1 B ILD..._______ MilJ =h�1 By. t • 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 • • • • • • • • • • • • • • • • • • • • • • •