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Home My WebLink AboutBLDP-23-003507 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 12/27/22 PERMIT# BLDP-23-003507 11)r, JOBSITE ADDRESS 9 CADET LN OWNER'S NAME Joe Keremian P OWNER ADDRESS 9 CADET LN WEST YARMOUTH,MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:0 RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES NO❑ FIXTURES 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 1 ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER 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❑ NO 0 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 0 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 Stephen Winslow LICENSE 1,2298 SIGNATURE MP ❑ JP 0 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME STEPHEN A WINSLOW ADDRESS 8 REARDON CIR 8 REARDON CIR CITY S YARMOUTH STATE MA ZIP 02664 TEL 5083947778 FAX CELL EMAIL inspections@efwinslow.com 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 1 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFRM PLUMBING WORK ti ;,,,in►� MA DATE _____�_. L 3 -1 G 7 -" CITY YARMOUTH - =4f- E 12/20/22 PERMIT # JOBSITE ADDRESS 9 CADET LANE j OWNER'S NAME! JOE KdREMIAN OWNER ADDRESS SAME TEL1 617-803- 71 FAX' -7----7, TYPE OR OCCUPANCY TYPE COMMERCIAL I.,._i EDUCATIONAL [ RESIDENTIAL pi PRINT CLEARLY NEW: L._ RENOVATION: s REPLACEMENT: Li-I PLANS SUBMITTED: YES I I NO ' I FIXTURES 1 FLOOR-. BSM 1 2 3 4 5 6 7 8 9 1 10 11 12 13 14 BATHTUB • -� �. _,_ _ ._._._ r. F ...,.,:,,..,y�,...nllxtA.w... �.:.vw.s..-. .ryiJk ., ...:.r ,15,_,_..- ..._..e:aG):....,:. .'..1N.6.........! .64M•..;II .1 M CROSS CONNECTION DEVICE t _:: X � .. .._. DEDICATED SPECIAL WASTE SYSTEM .K 1. .._ _.. ._..it._1C..,,.r r DEDICATED GAS/OIL/SAND SYSTEM x ,`4' t, i y, DEDICATED GREASE SYSTEM _ . ._. ,; t .:.. DEDICATED GRAY WATER SYSTEM I. �' iIINIII DEDICATED WATER RECYCLE SYSTEM q : . ... . s. ��._.:: . ..�_ M� . . _ � .. � � M � ! i' DISHWASHER I DRINKING FOUNTAIN ; il MO FOOD DISPOSER I —117 _ �_: _.,�_. a .d..,,.e.w�. ¢�. :. sd�e �� `:.. .:.s rx R::..[::2t dd V FLOOR /AREA DRAIN INTERCEPTOR (INTERIOR) ...:. �, i Mil.., . .. KITCHEN SINK r',r ...._ «. _...... . LAVATORY 1 , 1 II f -� _� �_ ROOF DRAIN �.. _ _ I ,, • SHOWER STALL ` :x.:.1L....._ _ _ .:_..it,..II�tHIRli.Eh4 bt.g...L1 3,...s.:..t..:.-_ _ ... w... ... ....... .._. ,,. ..1.... € „ �. :. I � i SERVICE / MOP SINK .. _. c. :,,txr. TOILET I'. 1 e URINAL WASHING MACHINE CONNECTION ,, h1.1111 C it , WATER NEATER ALL TYPES t........... illill In IMP NNNIIIIIIIMIIIIIIINIIIIIHIIMIIIINII WATER PIPING - - OTHER f ,. y .�. .- I l I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 0 NO El IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 1 LIABILITY INSURANCE POLICY ' ` OTHER TYPE OF INDEMNITY i BOND Li i 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 I.I 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 it e to the b t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in co II with II ertine proyisio of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME i STEPHEN WINSLOW LICENSE # 12298 SIGNATURE MP! %s JP CORPORATION i# 3281 C IPARTNERSHIPEJ#Lt1LLCL1#! COMPANY NAMELE.F. WINSLOW PLUMBING & HEATING 1 ADDRESS 8 REARDON CIRCLE CITY SOUTH YARMOUTH STATE [_ MA , ZIP '02664 �1 TEL 508394'7778 �^ - FAX 508-394 8256 1 CELL NIA —I EMAIL EINSPEOTIONS@EFWINSLOW.COM