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Home My WebLink AboutBLDP-21-006799 • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK a CITY YARMOUTH MA DATE 5/24/21 PERMIT# BLDP-21-006799 I i 2 JOBSITE ADDRESS 52 KENCOMSETT CIR OWNERS NAME ralph lovuolo P OWNER ADDRESS TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:El REPLACEMENT:El 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 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 1 WATER PIPING OTHER 1 OTHER DESCRIPTION: 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 El 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. PLUMBERS NAME Stephen Winslow LICENSE 112298 SIGNATURE MP ❑ JP El CORPORATION ❑# PARTNERSHIP ❑# LLC El# COMPANY NAME STEPHEN A WINSLOW ADDRESS 8 REARDON CIR CITY S YARMOUTH STATE MA ZIP 026641207 TEL FAX CELL EMAIL inspections@efwinslow.com • ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE ESE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE PERMIT ❑ ❑ FEES$ PERMIT H PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK I w • � F .= CITY YARMOUTH MA DATE 5/18/21 PERMIT # aJOBSITE ADDRESS 52 KENCOMSETT CIRCLE, YARMOUTHPOti OWNER'S NAME RALPH LOVUOLO P , OWNER ADDRESS ; SAME TEL 774.994.8525 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL {µ1 EDUCATIONAL U RESIDENTIAL .Tel PRINT CLEARLY NEW: RENOVATION: L REPLACEMENT: PLANS SUBMITTED: YES NO� FIXTURES 1 FLOOR—+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 11 I si 11 CROSS CONNECTION DEVICE I i DEDICATED SPECIAL WASTE SYSTEM _ __ l ,I , (to DEDICATED GAS/OIL/SAND SYSTEM i � IF---1 1 „r--- ,A ' �j ' I ' V) DEDICATED GREASE SYSTEM 11) DEDICATED GRAY WATER SYSTEM ° I l € _ I DEDICATED WATER RECYCLE SYSTEM ,m ::. DISHWASHER � DRINKING FOUNTAIN ,v I FOOD DISPOSER + I s . L•z:‘:-a CO ii ,_ FLOOR /AREA DRAIN _. � � INTERCEPTOR (INTERIOR) I ,, � KITCHEN SINK ........,.. `, ..._. _ _ .W ._. ... LAVATORY ' '' —IF li ,:..,. .4 a. .... ROOF DRAIN .- _ ... SHOWER STALL _.. �. Yimilimi I ` II SERVICE 1 MOP SINK ... ,, - ,. a TOILET s L. X ,, F:---:. ,,, .. . _.,.:= ,:,..,t,s_...,, ._.,,, _ss.s..URINAL ii i C ..„..... . a, WASHING MACHINE CONNECTION 1 i i ` ,_.,,___ '_...:.. ,, .�.:xn- ,:.„,t, x :..r \ iillll '1,:w WATER HEATER ALL TYPES WATER PIPING a- ,3 .� $Y ._ ii _ _. r OTHER 0 �►AQ . 1h�r0A ,_ . r .� 1 _ I1 £E _ 1' le jjI I 1 INSURANCE COVERAGE: I have a current Iiabilit�insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES El NO ' IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY E i 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 r e to the b t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in co lia with II ertine proYisio of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. . :. PLUMBER'S NAME LSTEPHEN WINSLOW LICENSE # 12298 ---- �._..... .__ SIGNATURE MP . JP CORPORATION '#E 3281 C PARTNERSHI P LJ#gy LLC I , # COMPANY NAME E.F. WINSLOW PLUMBING & HEATING l ADDRESS 8 REARDON CIRCLE CITY SOUTH YARMOJTH d STATE , MA ZIF € 02664 TEL 508-394-7778 FAX 508 394 8256 CELL ` NIA 1 EMAIL INSPECTIONS@EFWINSLOW.COM