The URL can be used to link to this page

Home My WebLink AboutBLDP-23-005911 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK iit _ CITY YARMOUTH MA DATE 4/25/23 PERMIT# BLDP-23-005911 z : JOBSITE ADDRESS 55 MARINERS LN OWNER'S NAME KENNEDY JAMES W P OWNER ADDRESS KENNEDY MARGARET 32 HILLCREST ST WEST ROXBURY,MA 02132 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑v 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 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 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. PLUMBER'S NAME r checkoway LICENSE 13417 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME CHECKOWAY ENTERPRISES ADDRESS 11 scargo hill rd 11 SCARGO HILL RD CITY DENNIS STATE MA ZIP 02638 TEL 5083851911 FAX CELL EMAIL checkent@comcast.net 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 ii_W- CITY MA DATE cli,Mfai3 PERM45°r-Z �l JOBSITE ADDRESS 55' 01/1a,iNE(LS L6 . ! wir OWNER'S NAME S k4r97e POWNER ADDRESS TEL NA(i.,Wz,a.3 TEL 6I7 - 77) fLf 3 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ri EDUCATIONAL Li RESIDENTIAL2Ig PRINT CLEARLY NEW: FL J RENOVATION: 1 _I REPLACEMENT: rgi PLANS SUBMITTED: YES ❑ NOISP FIXTURES -1 FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM r 1 _ I� _ — DEDICATED GAS/OIL/SAND SYSTEM mI II I . I I l to ll l i I DEDICATED GREASE SYSTEM 1, .„ ,' rMIMI 1� I l DEDICATED GRAY WATER SYSTEM �� i �m '� mi DEDICATED WATER RECYCLE SYSTEM �I iI�t _ 1111111 1111111 DISHWASHER MAIM 1 RN ______ 1.11_11111M11.1111111111111111 DRINKING FOUNTAIN = 11 —1j— i! _ Int =MIK FOOD DISPOSER 1111111111 M1111 M j II�� FLOOR / AREA DRAIN1111i I' ---'molow INTERCEPTOR (INTERIOR) MINIIIIMIIIIIIIMINE IIMMI:---1 l'1=111111,111111 KITCHEN SINK TI _ OM I, illiniimam EIMMIll`— LAVATORY Illaillit w_i_i l I _____I t ROOF DRAIN l�' SHOWER STALL I 1 I _ i= l' SWIM g SERVICE / MOP SINK RIM I! I TOILET MI ON MN URINAL FMI Il� N Ent WASHING MACHINE CONNECTION �I it �I: 1 1ii1 i 1 WATER HEATER ALL TYPES I ��F�� __ __ _! _ ii WATER PIPING �t I # [-' '�(� ' I OTHER �'IN1 , CI I liM h 11 E ----- - milma I ----- - - ICI'I I' I IIIMMInis INSURANCE COVERAGE: I have a current liability insurance 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 a 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 Li AGENT n 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 • - •est of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance wit. al '-- nent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME R Peter Checkoway LICENSE # 13417 PIGNATURE MP-_ JP❑ CORPORATION 1 # PARTNERSHIP[ # LLC[1# j COMPANY NAME I Checkoway Enterprises ADDRESS 11 Scargo Hill Road CITY[Denrs STATE MA I ZIP ( 02638 TEL 508-385-1911 FAX 508-385-6858 CELL 508-735-9993 EMAIL checkent@comcast.net I .