HomeMy WebLinkAboutBLDP&G-23-003469 • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
yr,_ CITY YARMOUTH MA DATE 12/22/22 PERMIT# BLDP-23-003469
JOBSITE ADDRESS 12 MARGARET JOSEPH RD UNIT 5 OWNER'S NAME GONYEA PETER R
P OWNER ADDRESS GONYEA KATHLEEN R 12 MARGARET JOSEPH RD YARMOUTH PORT,MA TEL
02675-2440
TYPE OR OCCUPANCY TYPE COMMERCIAL RESIDENTIAL 0
PRINT
CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑
FIXTURES 1 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❑
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY❑ OTHER TYPE OF INDEMNITY 0 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 Peter Gonyea LICENSE 16720 SIGNATURE
MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑#
COMPANY NAME PETER R GONYEA ADDRESS 12 MARGARET JOSEPH RD
CITY YARMOUTH PORT STATE MA ZIP 026752440 TEL
FAX CELL EMAIL kath.plum@yahoo.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
•
TION FOR PESM1T TO CC PLUMBING
UNIFORM APPLICAG
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INSURANCE COVERAGE:I ?nve a currant Iiaciity Insurance odic/ or its substantial eaurealent «ntcr meets the reruirernents :f MG,_ ' _
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Yes Ne '
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OWNER'S INSURANCE WANER: I am aware that the licenses does not ?lave the Insurance ccvera.;e m oire-:' s•:
Qlaatet 142 at the Mass General Laws, and that my signature an this permit at:01=tton waives :t'is -ec~tltrer,ert
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t mime r cxnty that ad of the drags mid information I have submitted (ar entered) In above aoofrcztron Ora true ant icc.:rate ca '!"e zest :'
tnevoeCQti And that 3U plumping weft yid PnStaeattGrls performed Under time otemst 133ued tar !MIS wwo1=tlan .'4 ::e n :CTT'G '1f1C! +'('1
?eftimmt arcw arcs of the masssacr'usatts State Mvnrouty Cade and Ctacter t 42 of the General Laws
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APPIPPC'v€i (CF►Z USE CNt_f 1 Licsn•ra Number /-1 -7 6-'
BELOW FOR OFFICE USE ONLY
FINAL INSPECTIONS SKETCIIEa PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME I TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE 19
PLUMBING INSPECTOR
•
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
`ti,::,,rj CITY YARMOUTH MA DATE December 22,202;PERMIT# BLDP-23-003469
JOBSITE ADDRESS 12 MARGARET JOSEPH RD UNIT 5 OWNER'S NAME FGONYEA PETER R 1
G OWNER ADDRESS GONYEA KATHLEEN R 12 MARGARET JOSEPH RD YARMOUTH PORT MA TEL
02675-2440
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL❑
PRINT
CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:Q PLANS SUBMITTED:YES 0 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 0
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY❑ OTHER 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 as 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-GASFITTER NAME 'Peter Gonyea LICENSE# 15720 SIGNATURE
MP 0 MGF 0 JP❑ JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP 0# LLC❑#
COMPANY NAME: 'PETER R GONYEA 'ADDRESS. 112 MARGARET JOSEPH RD, I
CITY YARMOUTH PORT 'STATE MA ZIP 026752440 TEL '
FAX CELL' EMAIL 'kath.plumlla,yahoo.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
MASSACHUSETTS UNIFORM APPUCATION FOR PESM!T TO CO GAS ►� �5
BILL # i 1
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INSURANCE C;VERAGE:
I ?'cave a current ;taco ty ,neuronce policy or is substantial equivalent vouch meets the requirements ct 'AGL C-
Yea No `:
It you have checxed 'Je . tersa inCtate the type coverage by c lecxtng the aooroonate `zax.
A jaciity instuance optic/ Cther type of Indernntty Bone
OWNER'S INSURANCE 'tyAIVEA: I am aware that the licensee does not 'lave the insurance overage -e' irec _•/
;"zaoter 142 of the Mass. General Laws. and that my signature an erns ;ermtt abdication *varies 'Ns •e�trlrer^ert
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,r'' �L�L �� Cwnett�y Agent
4�i ai r or er s A•gerrt�
I hire y partly that all of the detests and information I Mare submitted for Intend' In above aoolicaben are true and accurate 'o 'he Wiest t
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