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Home My WebLink AboutBLDP-23-000536 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/2/22 PERMIT# BLDP-23-000536 JOBSITE ADDRESS 9 KATES PATH VILLAGE OWNER'S NAME SCOTT MELVIN H P OWNER ADDRESS 9 KATES PATH VILLAGE YARMOUTH PORT,MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL❑ PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:0 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 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY 2 ROOF DRAIN SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION 1 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 0 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'3#395 SIGNATURE MP 0 JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME VIRGILIO SILVA ADDRESS 155 SUDBURY LN CITY HYANNIS STATE MA ZIP 026012462 TEL FAX CELL EMAIL virgiliomga@hotmail.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 _ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY Yarmouth MA DATE 08/02/22 PERMIT # 2-3- c-' `r 3 4 JOBSITE ADDRESS 9 Kate's Path OWNER'S NAME Melvin Scott POWNER ADDRESS 9 Kate's Path TELFAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: Ej REPLACEMENT: PLANS SUBMITTED: YES [ NO FIXTURES Z FLOOR—* BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB [_ jr- CROSS CONNECTION DEVICE .-ir •1r_ DEDICATED SPECIAL WASTE SYSTEM :.�... DEDICATED GAS/OIL/SAND SYSTEM ,:LL . .,,._i[, _ _ ..T.. __ , DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM i — IA , . i�t DEDICATED WATER RECYCLE SYSTEM � _ DISHWASHER ; DRINKING FOUNTAIN L. . IIIIIIIIINWIIIMIWOMMNMIMNMIPWIIIIIII FOOD DISPOSER7 r a .- isgst-,FLOOR / AREA DRAIN �.ev INTERCEPTOR (INTERIOR) R _ , , MIIIIMINEELIM ain KITCHEN SINK �E'■�s LAVATORY 'i 2 01111111 MIME millipromomirtrillaiml _Il :I14 i 1 ROOF DRAIN MIME'Mil — mot; t U SHOWER STALL ,;, . --'.- '1� -' ' ,� -j1. SERVICE I MOP SINK 1 f 1 .� all 1 TOILET 1 mum mil im innenj 1 URINAL .. . . �I� - :r t IMO :•-_-___. WASHING MACHINE CONNECTION !�I � it !elli WATER HEATER ALL T"PES { _ 11111111.11.1MOIMMEMINUIMIMMINIMINIII� WATER PIPING « ' lail OTHER [ , _ , Minallaill=1.111111111111 :1111 N IMMINMEMIllin INSURANCE COVERAGE: I have a current Iiabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES v NO 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 SIGNA-URE 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 myknowledge and that all plumbing wo-k and installations performed under the permit issued for this application will be in complia ertinent provision f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Virgilio Silva LICENSE # 1313954 j SIGNATURE MP JP CORPORATION # PARTNERSHIPO# - LLCL,,,i# _ i COMPANY NAME iSilva Plumbing & Heating t ADDRESS 1155 Sudbury Lane CITYrlyannis JSTATE MA Zip 102601 TEL , FAX J CELL 7483fi0176—( EMAIL virgiliomga@hotmail.com C.V..A+- cf