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Home My WebLink AboutBLDP-22-000621 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/4/21 PERMIT# BLDP-22-000621 JOBSITE ADDRESS 106 CAPT YORK RD OWNER'S NAME CARVER ROBERT J P OWNER ADDRESS CARVER PAUL J 39 DUDLEY ST MARLBOROUGH,MA 01752-1816 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL El PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ 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 1 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 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 Virgilio Silva LICENSE 3t1395 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# Lc ❑# COMPANY NAME VIRGILIO SILVA ADDRESS 155 SUDBURY LN CITY HYANNIS STATE MA ZIP 026012462 TEL FAX CELL EMAIL virgiliomga@hotmail.com ROUGII PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES S PERMIT R PLAN REVIEW NOTES IN, SSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK �tl__ CI fa outh MA DATE b7/27/21 PERMIT # ? - - (.- LI ..i 1-. NJOBIT ADDRESS 106 Captain York Rd. OWNER'S NAME[ c ,NOWNER; DDRESS 106 Captain York Rd. TEL FAX i TY OR ---)OC(DP INCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL El •CL ',- ' T RENOVATION: 0 REPLACEMENT: PLANS SUBMITTED: YES [ NO FIXTURES 7 FLOOR-+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB `�. CROSS CONNECTION DEVICE - ___ L-- - '----g ) ; - DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM _ DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM r 1 1 DISHWASHER 1 __ DRINKING FOUNTAIN FOOD DISPOSER ..... FLOOR / AREA DRAIN INTERCEPTOR (INTERIOR) _ _ KITCHEN SINK 1 LAVATORYr.+.w.► j ii . v .urrrr.r..e „ __. , . ... ROOF DRAIN SHOWER STALL L. ..._ �..... ! -. .. t . . SERVICE I MOP SINK TOILET - - 1 . . -� -1_ URINAL ' 4_ I tr. T WASHING MACHINE CONNECTIONy- � ! WATER HEATER ALL TYPES iiii 11111111111011t lilt' WATER PIPING [. _ MIN _,_ . 11_� ' � , HE ....r OTR � I . fr __A-- ... — - _or= _if -s r-- r- y - _. ,.._. _ ..-._. 1_. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES NO Lj 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 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 and accurat 10 the begot my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complianc ' all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. .— __-______- _ PLUMBER'S NAME Eirgilio Silva LICENSE # 31395-J r^� ATURE MP JP 71 CORPORATION # PARTNERSHIP # LLC # COMPANY NAME Silva Plumbing and Heating ADDRESS 155 Sudbury lane i CITY Hyannis STATE MA I ZIP 02601 TEL 7?Li - 55N,- 0 l i lt/ i FAX CELL 7748360176 EMAIL vir� giliomga@hotmail.com