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Home My WebLink AboutBLDP-22-004561 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK pl j CITY YARMOUTH MA DATE 2/16/22 PERMIT# BLDP-22-004561 JOBSITE ADDRESS 3 OAK GLEN VILLAGE OWNER'S NAME YOUNG DAVID P OWNER ADDRESS YOUNG SANDRA 18 WESTVIEW DR MANSFIELD,MA 02048 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURFS FLOORS-0 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 1 DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION 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❑ NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ 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. PLUMBER'S NAME R Peter Checkoway LICENSE 1)3417 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME R PETER CHECKOWAY ADDRESS 11 SCARGO HILL RD CITY DENNIS STATE MA ZIP 026382306 TEL 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 ❑ ❑ FEESS PERMIT# PLAN REVIEW NOTES CC*/19d MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK —.F _m e��? CITY au�f RMOUTHPORT MA DATE 2/10/22 PERMIT # ' 1 " ' S 6 f �YA JOBSITE ADDRESS 3 OAK GLEN OWNER'S NAME DAVID YOUNG P J OWNER ADDRESS 18 WESTVIEW DR, MANSFIELD TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL 0 PRINT CLEARLY NEW: RENOVATION: v REPLACEMENT: L. PLANS SUBMITTED: YES NO FIXTURES Z FLOOR-0 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB , -_._ r----- 1_ r------ ,------„ , CROSS CONNECTION DEVICE - 1 IF _ DEDICATED SPECIAL WASTE SYSTEM L IL y 'L I I __ 1r DEDICATED GAS/OIL/SAND SYSTEM f'_ ,.-1' W _ _ ___ DEDICATED GREASE SYSTEM J i , DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER 71 f :7 .----4 r----17-4- I---- DRINKING FOUNTAIN L F FOOD DISPOSER ! iii-- , -1----.+-_-- — — 1 r FLOOR / AREA DRAIN 3L1 INTERCEPTOR (INTERIOR) 1L 0 f _ 11 li KITCHEN SINK 1�.. _ _. .� 1=-- LAVATORY _ ROOF DRAIN _ SHOWER STALL it - _ it 1! IF . L SERVICE / MOP SINK F -II I • ' .. . . TOILET �� c� I URINAL _ _ , ; WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING ,�- ��L.. r....: OTHER .- i fi E _ _ r _ ----- ` INSURANCE COVERAGE: 1 1 I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES i NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY i 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 ac uratbest of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance i inent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME R Peter Checkoway LICENSE # 13417 IGNATURE MP i JP CORPORATION # PARTNERSHIP #1 LLC j #I I COMPANY NAME LCheckoway Enterprises ADDRESS 11 Scargo Hill Rd .1 61=1111110•••• %.........*••••adriiIIIIIEWIfij CITY[pennis STATE MA ZIP 02638 TEL ' 508-385-1911 J FAX 1 508-385-6858 CELL I 508-73J-9993i EMAIL [121eckent@comcast.net 1