HomeMy WebLinkAboutBLDP-22-007155 •
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
• CITY YARMOUTH MA DATE 6/10/22 PERMIT# BLDP-22-007155
rh JOBSITE ADDRESS 5&7 JUDAN WAY OWNER'S NAME RASMUSSEN NORMAN W JR
P OWNER ADDRESS RASMUSSEN ERMINIA 759 SPINNAKER CT SECAUCUS,NJ 07094 TEL
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL 0
PRINT
CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES NO❑
FIXTURFS Fl OORS—. RAM 1 2 3 4 5 6 7 8 9 10 11 12 14 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 1 2
ROOF DRAIN
SHOWER STALL 2
SERVICE/MOP SINK
TOILET 1 2
URINAL
WASHING MACHINE CONNECTION 1
WATER HEATER 1
WATER PIPING 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 0 NO❑
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY 0 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.
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 Phillip Durfee LICENSE 18774 SIGNATURE
MP 0 JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑#
COMPANY NAME Durfee Plumbing ADDRESS 12 Bertram AVE STE 5
CITY South Dennis STATE MA ZIP 02660 TEL
FAX CELL 5088018004 EMAIL
ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVE AS THE 0 ❑
FEES$ PERMIT#
PLAN REVIEW NOTES
DiBenedetto, Mark
From: Clarke, Kristin
Sent: Monday, August 22, 2022 8:24 AM
To: DiBenedetto, Mark
Subject: FW: Plumbing Permit - 7 Judan Way
From: Norman Rasmussen <normanras@gmail.com>
Sent: Wednesday, August 17, 2022 1:45 PM
To: Clarke, Kristin <KClarke@yarmouth.ma.us>
Cc: ricardodasilva@bragabros.com; Erminia Rasmussen <erminiaras@gmail.com>
Subject: Plumbing Permit- 7 Judan Way
Attention!: This email originates outside of the organization. Do not open attachments or click links unless you are
sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure.
Otherwise delete this email.
Kristin -
Please note that Phil Durfee will no longer work on our project.
Braga Bros will be in touch with you to pull a new permit to
enable them to finish the plumbing work at 7 Judan Way.
Tks,
Norman
Norman Rasmussen
Cell: +1 201 887 0404
Nil Difficile Volenti
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