The URL can be used to link to this page

Home My WebLink AboutBLDP-23-004406 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK s-(T CITY YARMOUTH MA DATE 2/9/23 PERMIT# BLDP-23-004406 JOBSITE ADDRESS 1.71 ARROWHEAD DR OWNERS NAME Thomas Young P OWNER ADDRESS 71 ARROWHEAD DR YARMOUTH PORT,MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL D RESIDENTIAL El PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:0 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 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION 1 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❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ 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 Joseph Halloran LICENSE 10984 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME JOSEPH M HALLORAN ADDRESS 29 Forest Glen Rd CITY Hyannis STATE MA ZIP 026012537 TEL FAX CELL EMAIL sowdawg@comcast.net ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES a it- 1 2-3 CO Yes No THIS APPLICATION SERVE AS THE FEES$ PERMIT# PLAN REVIEW NOTES 7Cz , MAS ACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK rI— `----_- ir, C-r, -) DATE g/ Z 3 PERMIT# L� " �/�Ic��. JffTE RESS 7/ �¢ , r BQ g RQnw�� C ��k'�i/!r OWNER'S NAME 1 `'1C�M/P l C7V/V �f OWNER DRESS TEL FAX au,. 4G uEPAH `'•FY-P PE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL E PRINT CLEARLY NEW: ,/' RENOVATION: REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO❑ , f FIXTURES Z FLOOR-* 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 SYSTEM - DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY / I ROOF DRAIN SHOWER STALL 1 -- SERVICE I MOP SINK TOILET / URINAL . j WASHING MACHINE CONNECTION 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 Er-NO 0 IF YOU CHECKED YES, PLEASE INDICATE THETYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UABIUTY INSURANCE POLICY [� 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 1 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 I hereby certify that all of the details and information I have submitted or entered regarding this application are true and a ate tote s my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in co fiance it all Pe - t ision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. / 4, PLUMBER'S NAME LICENSE#/&t?j�. ' SIGNATURE MP [2 JP❑ CORPORATION❑# PARTNERSHIP❑.# LC❑# COMPANY NAME T.)a5 �' C7 8/1- a2A A, l uAlth1��- ADDRESS 2-9 Fo'cf4°7± 6- CITY Fi/r ,p v/VI 4 STATE Al 4 ZIP 2-6'0/ TEL 5 -73- - s6 -20>? ' FAX CELL EMAIL SeA-L C11.1A-9 cec-r-m, ->- , 4/x.74 ROUGH PLUMBING INSPECTION NOTES FLOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES