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Home My WebLink AboutBLDP&G-23-000664 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/9/22 PERMIT# BLDP-23-000664 JOBSITE ADDRESS 834 ROUTE 28 OWNERS NAME HYNES JOHN J JR TR P OWNER ADDRESS THE 834 MAIN ST RLTY TRUST 822 ROUTE 28 SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES NO❑ FIXTURES 1 FLOORS—, RPM 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 El 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 Michael Mcbride LICENSE 9.9681 SIGNATURE MP ❑ JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME MICHAEL R MCBRIDE ADDRESS 9 Rustic Drive CITY West Yarmouth STATE MA ZIP 02673 TEL FAX I I CELL EMAIL Istinger.mcbride@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 r SAChUSETTS UNIFORM APPLICATION FOR A PE MIT TO PERFORM PLUMBING WORK ViTO — CIN 'e /Qrio/" MA DATE 15- �_s_:-.3: _.44 ___ __,r____ _ � PERMIT# ,{.I 5 L'}r SITE AC DRESS �� 7 OWNER'S NAME r BuiL PG—DE 'IWERIAD�RESS t,/ FAG- -- f)ô ',1�-� �-° �2 �� 7 7 / TEL �p / FAX FAX ` TYPE OR OCCUPANCY TYPE COMMERCIAL Oa EDUCATIONAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT: 14 PLANS SUBMITTED: YES ❑ NO[i FIXTURES 1 FLOOR—+ HSM 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 SYSTEM DISHWASHER DRINKING FOUNTAIN . FOOD DISPOSER , FLOOR/AREA DRAIN . INTERCEPTOR(INTERIOR) ' KITCHEN SINK LAVATORY - ROOF DRAIN t SHOWER STALL SERVICE/MOP SINK TOILET URINAL . i WASHING MACHINE CONNECTION - - i WATER HEATER ALL TYPES ` WATER PIPING OTHER INSURANCE COVERAGE: — I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES X 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 Jt Massachusetts General Laws, and that my signature on this permit application waives this requirement. T CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT k.: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 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. / �' t�L �t� PLUMBER'S NAME LICENSE# 1 (''0� . ��Q !.S1GNA1'CJRE MP❑ JP E COF ORATION # PARTNERSHIP/❑.# p f 0/P LLC El# COMPANY NAME Ni V ))C t \ ` 4 ADDRESS 7 f'-- c t/..,//, ` ' te,,,tz'� CITY vp—iL, 1) ✓\ 5 STATE (,, /, ci f ZIP 0 Z lS�6 I TEL 77 y ie 7/zFAX CELL EMAIL ''i-ii14 cj"—`M ciaPi 4 0 7-44,I{,i ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 1 &)O r MASSACHUSETTS UNIFORM APPLICATION FOR PE ET TO PERFORM P GAS FITTING WORK `. __ ,N CITY' ilsk- 40. 4 MA DATE C� 7iZ ": PER1v1IT # A O 5 ,UoSI E ADDRESS6A ,/, , f 4 (Sr- 774 0k 1 4ER',. NAME : UILDI DEPART rA DRESS J J l ? / 'FAx PRINT AI\CY TYPE COMMERCIAL I►'i EDUCATIONAL ❑ RESIDENTIAL 7 CLEARLY NEW: [ RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES ❑ NOrke APPLIANCES 4 FLOORS—+ BSyI BOILER 1 2 5 6 9 1i1 II 12 I3 14 BOOSTER CONVERSION BURNER COOK STOVE , L DIRECT VENT HEATER DRYER r FIREPLACE + FRYOLATOR i FURNACE GENERATOR GRILLE _� INFRARED HEATER I I LABORATORY COCKS MAKEUP AIR UNIT I I OVEN POOL HEATER i ROOM / SPACE HEATER ROOF TOP UNIT -- TEST _ . . F_ . .•_ . _ . . . . . ._ UNIT HEATER _. _. . .. UNVENTED ROOM HEATER WATER HEATER 1 I I OTHER INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY C OTHER TYPE INDEMNITY ❑ BOND El • OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance covers I�e reclr�irec! by Cl�apfier 1�� of tl�e I Massachusetts General Laws, and that my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR, AGENT CHECK ONE ONLY: OWNER ❑ AGENT ❑ -1� I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the bey and that all plumbing work and installations performed under the permit issued for this application will be in complianc ' h I Pertinent rot visio knowledge my Massachusetts State Plumbing Code and Chapt r 142 the Gen ral Laws. P on of the `L PLUMBER-GASFITTER NAME (\40 r i LICENSE # Ira SIGNATURE MP ❑ MGF El JP NI JGF ❑ LPGI ❑ CORPORATION ❑ # PARTNERSHIP ❑ # pr p LLC CC)IVIPAI� ' NAME ) ri- � / i r 1 ADDRESS3 7 1)k0// CITY 4 iflI 5 STATE ZIP TEL FAX CELL EMAIL G r 'S CM1 t1l' 0 r41 L k (re\AN. 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 1