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Home My WebLink AboutBLDP-22-000855 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/16/21 PERMIT# BLDP-22-000855 �b1 JOBSITE ADDRESS 36 KATES PATH VILLAGE OWNERS NAME audrey saftlas P OWNER ADDRESS TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES NO❑ FIXTURFS • FLOORS—a 8SM 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 3 ROOF DRAIN SHOWER STALL 1 SERVICE/MOP SINK TOILET 2 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 El NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El OTHER TYPE OF INDEMNITY❑ BOND❑ OWNERS 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 Virgilio Silva LICENSE 31395 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME VIRGILIO SILVA ADDRESS 155 SUDBURY LN CITY !HYANNIS STATE MA ZIP 026012462 TEL FAX CELL I EMAIL Ivirgiliomga@hotmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEESS PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK r CITY Yarmouth MA DATE 08/12/21 PERMIT # 22 - c'Y ' '' 36 Kates Path Saftlas JOBSITE ADDRESS OWNER'S NAME Andrey POWNER ADDRESS 36 Kates Path TEL _� ,FAX 111111111111 TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL El PRINT CLEARLY NEW: RENOVATION: [.....; REPLACEMENT: € PLANS SUBMITTED: YES ® NO iii FIXTURES Z FLOOR-► BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB r- '14 _ r---7---_-r. CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM -, - DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM L r DEDICATED WATER RECYCLE SYSTEM K DISHWASHER 1 - -) " 1---- _ , DRINKING FOUNTAIN LI ,:-.:_at _ r=._ FOOD DISPOSER =[ , FLOOR / AREA DRAIN E _ ____ INTERCEPTOR (INTERIOR) 1 :�_-__._�,_ _ I, i ;, ,.a.. ..._..._ KITCHEN SINK 1 - , f LAVATORY ROOF DRAIN SHOWER STALL l—_ 1 1 — __ .. ANIIIIi. SERVICE / MOP SINK f 11 TOILET _ URINAL NM NM WASHING MACHINE CONNECTION 1 _ WATER HEATER ALL TYPES ,� u 7 WATER PIPING - ;i OTHER - IM .,. ....._ = Al.fiffilk, *iilibta `400,31 lalit.lni as-.... L .- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 4, ? NO Ii 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 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 w• en p • • n of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME 1jirgilio Silva LICENSE # P1395-J ! - - E -- MP JP CORPORATION 0#� PARTNERSHIPI # j LLCj # COMPANY NAME Silva Plumbing & Heating ADDRESS 155 Sudbury lane RECEIVED ( CITY Hyannis I STATE MA I ZIP p2601 TEL FAX CELL 7748360176 EMAIL virgiliomga@hotmail.com BUILDING DEPARTMENT By —