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Home My WebLink AboutBLDP&G-22-002788 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK i_ CITY YARMOUTH MA DATE 11/15/21 PERMIT# BLDP-22-002788 1 JOBSITE ADDRESS 29 NORMA AVE OWNER'S NAME MCCARTNEY PAULA M p OWNER ADDRESS CASH THERESA 29 NORMA AVE SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES NO❑ FIXTURFS 1 FLOORS-. RSM 1 2 3 4 S 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❑ 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 as Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Michael Maille LICENSE 111355 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME MICHAEL J MAILLE ADDRESS 48 Shore Dr CITY Dracut STATE MA ZIP 018262030 TEL FAX CELL EMAIL rachel.whittick@homeserveusa.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ FEES$ PERMIT# PLAN REVIEW NOTES 4r - •t ACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 4 str"� A. "i" 4, CITY South .rmouth I MA DATE 11/8/2021 I PERMIT # 1:1 - 2-i 3 6 �f 2J BSITEDD'ESS 29 Norma Ave ' OWNER'S NAME Theresa Cash I N 6 Et�►bb'1 SS 1 TE L 508-694-6379 I FAX E OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: Li REPLACEMENT: [7 PLANS SUBMITTED: YES ❑ N00 FIXTURES 1 FLOOR-. BSM 1 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB -m- =Inn um ME CROSS CONNECTION DEVICE I` DEDICATED SPECIAL WASTE SYSTEM 11110MI ''I� MI Illan DEDICATED GAS/OIL/SAND SYSTEM 1 M. DEDICATED GREASE SYSTEM 111.111111111111 11111011111, 1 DEDICATED GRAY WATER SYSTEM N IIIMW -1WM Imo. DEDICATED WATER RECYCLE SYSTEM Mil_ _IM. III , DISHWASHER =4MM �_ 1 �1�'DRINKING FOUNTAIN M 111.1111111111101•01•011111,1 NW M nial FOOD DISPOSER IIIIIIIIiiiiiiiiii �1 I_ Il __ I I FLOOR / AREA DRAIN I i i_ i_ INTERCEPTOR (INTERIOR) 1KITCHEN SINK LAVATORY 1aWI �� —__I ROOF DRAIN ` - _- I SHOWER STALL SERVICE / MOP SINK 111.1111.1111111111 IMO 011.11I1111.I I Mill O TOILET 111011111111111111111 ME MEI Mill 1111111 1■ ► Ill.11111111111 MINI URINAL 1 11 .111111111111111.1111 II. WASHING MACHINE CONNECTIONf I WATER HEATER ALL TYPES infinimum inimmorpoiiiiiii lilt 111111111111111111111111111111111111 WATER PIPING 1.111111111111111111111111 OTHER IIMM1111111111111111.111111.1.1111111111111111111111. ilk animmii ANIIIIIIIMAintelli Am Mum iiiiMalliimaiiiiii INSURANCE COVERAGE: I have a current liability.insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 0 NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Fl 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 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. ice, u lr-L— N. L PLUMBER'S NAME Michael Maille 7 LICENSE # 11355 I SIGNATURE MP v JP„...1 CORPORATION,, #L -I PARTNERSHIP'714 I LLC Q# 3609 i COMPANY NAME HomeServe USA Energy Services NE LLC I ADDRESS 5 Constitution Way J CITY Woburn I STATE MA i ZIP 101801 1 TEL 781-359-2606 I FAX 1 1 CELL EMAIL [ cheI.whithck@homeserveusa.com i 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 1 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH —1 MA DATE November 15, 202' PERMIT # BLDP-22-002788 JOBSITE ADDRESS 29 NORMA AVE OWNER'S NAME MCCARTNEY PAULA M G OWNER ADDRESS CASH THERESA 29 NORMA AVE SOUTH YARMOUTH MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL Ej PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ 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 ! 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 ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER 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 pe-mit 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 Michael Maille LICENSE # 11355 SIGNATURE MP El MGF ❑ JP ❑ JGF ❑ LPG! ❑ CORPORATION ❑ # PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME: MICHAEL J MAILLE ADDRESS. 48 Shore Dr, CITY Dracut STATE MA ZIP 018262030 TEL FAX I CELL EMAIL rachel.whittick(a,homeserveusa.com S31ON M3IA321 NVid #1IW213d $:33d ❑ ❑ 111412l3d 3H1 SV S3A213S NOI1VOIlddV SIH1 oN seA S310N NOI1O3dSNI 1VNIJ AINO 3Sf1 Z10103dSNl 210d 30Vd SIH1 S310N NO1103dSNI SVO HJl021 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK .‘\_, , CITY [outh Yarmouth I MA DATE 11/8/2021 ` PERMIT # ? 1- - 7---)7---) 5' i JOBSITE ADDRESS 29 Norma Ave I OWNER'S NAME 'Theresa CCash I GOWNER ADDRESS TEL 508-694-6379 I FAX' TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: L___i REPLACEMENT: v PLANS SUBMITTED: YES ,J NOD APPLIANCES Z FLOORS— BSM 3 4 5 6 7 8 9 10 11 12 13 14 BOILER ME �I. 111111111.111 BOOSTER1; I ini zimmennowigis CONVERSION BURNER 1111111I ,, COOK STOVE . H elanrelM111111111 DIRECT VENT HEATER DRYER FIREPLACE mill _ I I nn -FRYOLATOR "--11111111 FURNACE 11111,1111-110. iiii MOM 0111111111111111111111.1•1111111111111111111W GENERATOR 1111111I_ 1_1W 1 1 .1_ 111111 GRILLE 11111.111I _ L INFRARED HEATER 11M11111111111111111111111111111•111111111 _W111111111111111WW1 LABORATORY COCKS MAKEUP AIR UNIT OVEN WIWI IINKMBE, - IMIlli === 1 POOL HEATER Ii MUM ROOM / SPACE HEATER . II .m., j ROOF TOP UNIT M Ii . TEST I �I� n.! MO MU UNIT HEATER MOM MI MN MI I UNVENTED ROOM HEATER . I i WATER HEATER I OTHER I illig 11.1111111111.11=11111111.1111WWWW1111111111111/11.1141.1 1 _ _ _ ICI 111111111111Minit i - �I�tl OW 1.1111 MI MEI 111111 I' I' INSURANCE COVERAGE I have a current liabiliyinsurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES Q NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY v 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 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 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. 1�1 l - t� 1. --- L PLUMBER-GASFITTER NAME [Michael Maille I LICENSE 41355 I SIGNATURE MP v MGF ,JP ] JGF❑ LPGID CORPORATION ❑#L i PARTNERSHIP❑#[ LLC Q# 3609 I COMPANY NAME: HomeServe USA Energy Services NE LLC 1 ADDRESS HomeServe USA Eney Services NE LLC I CITY Woburn ,J STATE MA I ZIPL01801 ITEL 781-359-2606 FAX CELL JEMAIL[ cheI whttick@homeserveusa com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES