HomeMy WebLinkAboutBLDP-18-004602 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
®I{e eCITY YARMOUTH MA DATE 2/15/18 PERMIT# BLDP-18-004602
!r � JOBSITE ADDRESS 10 MELVA ST OWNER'S NAME OGDEN EDWARD
P OWNER ADDRESS 10 RIDGESIDE RD DANBURY, CT 06811 TEL
TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El
PRINT
CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YESE 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
ROOF DRAIN
SHOWER STALL
SERVICE/MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION
WATER HEATER
WATER PIPING
OTHER 2
OTHER DESCRIPTION: 1. Irrigation back flow
2. Outside rinse station
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES El NO El
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY El OTHER TYPE OF INDEMNITY El 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 Richard Whiteside LICENSE 2i969 SIGNATURE
MP El JP El CORPORATION El# 3969 PARTNERSHIP ❑# LLC ❑#
COMPANY NAME Murphy Services Inc ADDRESS 29 Maple Terrace
CITY South Dennis STATE MA ZIP 02660 TEL
FAX CELL EMAIL
•11
ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVE AS THE OCORIIIT
FEES$ PERMIT#
PLAN REVIEW NOTES
I
Fallon, Rosa
From: Erica Karukas <ekarukas@callmurphys.com>
Sent: Thursday, February 15, 2018 9:42 AM
To: Fallon, Rosa
Subject: 10 Melva Street
Importance: High
Hi Rosa,
I just pulled another plumbing permit online for 10 Melva Street for an outside rinse station and an irrigation back flow
preventer. I did not remember that I already pulled a plumbing permit for an outside rinse station for this property, so is
there any way you can cancel just the outside rinse station from the permit I just pulled? We need to keep the irrigation
back flow on this permit. I know you can't refund me the money but I just want to make sure we don't end up with an
open permit in the end....
Thank you!
Thank you,
Erica Karukas
Accounting Manager
Murphy Services, Inc.
34 Whites Path I South Yarmouth, MA 02664
Direct: 508.760.1660 x. 112 1 Fax: 508.760.1670
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