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HomeMy WebLinkAboutBLDP-23-003670 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK r r CITY YARMOUTH MA DATE 1/5/23 PERMIT# BLDP-23-003670 • aC JOBSITE ADDRESS 183 ROUTE 28 OWNER'S NAME THE COVE AT YM ASSOC LTD P OWNER ADDRESS %VACATION RESORT INTERNATIONAL PO BOX 399 HYANNIS,MA 02601 NTNRG TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES NO❑ FIXTURES 1 FLOORS I BSM 1 2 3 4 S 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 WATER PIPING OTHER 1 OTHER DESCRIPTION:drain piping INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 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 William Heath LICENSEI12021 I SIGNATURE MP ❑i JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME WILLIAM 0 HEATH ADDRESS 265 GREAT WESTERN RD 45 Main Street CITY Sandwich STATE MA ZIP 026452428 TEL FAX CELL EMAIL billsboat330@gmail.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 ? ti (4 G0 ,) 3� A,' MASSACHUSETTg UNIFORM APPLICATION FOR A PERMIT TO PERFORM!":„.-----'.."5 ---'' RM PLUMBING R E 4 _sal'.. ' lay WORK ,; _ MA DATE 9 z�zz PERMIT# D C 3 0 2022 •:'ITE ADDRESS ! ?,3094r',4 six.i.r OWNER'S BUILDING DDARTM 4., I N:RADDRESS By. is. s-aL.. ?t,(4 :FAX FT, " • - • PANCY TYPE COMMERCIAL:r EDUCATIONAL PRINT RESIDENTIAL[] CLEARLY NEW:C RENOVATION:L REPLACEMENT:% ? 2•,'s r,,., PLANS SUBMITTED: YES( i N0 FIXTURES 1 FLOOR--' BSM 1 ©© BATHTUB 4 5 s 7 8 9 10 13 14 L.CROSS CONNECTION DEVICE I_ """"MM _ _ r—" �� DEDICATED SPECIAL WASTE SYSTEM i_ �i � ` .-. :: �m im DEDICATED GAS/OIUSAND SYSTEM Mi111 1.0 aWWI j l �r DEDICATED GREASE SYSTEM iII �M DEDICATED GRAY WATER SYSTEM ! r------' - 1r ( ; DEDICATED WATER RECYCLE SYSTEM ; 11 �� . r DISHWASHER W---- MMI�i;� DRINKING FOUNTAIN iWiM� ! r--' ITIUMI FOOD DISPOSER �- MIIM��MIMfMMl ;�l FLOOR I AREADRAIN ' ' om MII � INTERCEPTOR(INTERIOR) � ; i . I — -- KITCHEN SINK .. I IM— +M'M LAVATORY i, ; ROOF DRAINTW �—`�, II tus SHOWER STALL - SERVICE 1 MOP SINK - ` ' _ 1: TOILET i - IIIWj 'M,1 URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES .S t ni WATER PIPING �'! i 1W �r ! .� OTHER Lr4�l J 9& 1,� WI_ . I _ I ^�_ :I � ! �€ 11 ��� .mow a I ^_ 1 ;�i �iMii ,M eWomatimmonwe - iNsuNCE COVERAGE: —Owlll i—ice `I—il-1i — I have a current liability Insurance policy or its substantial vaallennt which meets the requirements of MGL Ch.142 142. YES 12— NO [I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY j OTHER TYPE OF INDEMNITY t 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 CHECK ONE ONLY: OWNER 1 1 AGENT Li I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the hest 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 Lk?'u.0-r1 1,14ixl. lik 'LICENSE#1 I ZdLI ? SIGNATURE MP Fr JP --�� CORPORATION[, #j PARTNERSHIP LC Di I f COMPANY NAME th-I# SeAu r Lc. G;..17 ,1_,--- I ADDRESS I.Yr: '! -' J. y'..wT- CITY I Si,�w� � j -_� ._...__. .. �- i �- STATE 1 rh a— I ZIP I DZ 5—f. TEL Svc -»,� / oyS FAX`... I CELL)77 Y Y e7 1 EMAIL 1 r 6 4-r 3 3 0 e •411,/. Cy..? - ,(7-a