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Home My WebLink AboutBLDP-22-003813 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 1/7/22 PERMIT# BLDP-22-003813 k.---_,Iifi : JOBSITE ADDRESS 51 CURVE HILL RD OWNER'S NAME Manuel Atienza P OWNER ADDRESS 51 CURVE HILL RD SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES❑ NO❑ FIXTURES FLOORS-I 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 1 ROOF DRAIN SHOWER STALL 1 SERVICE/MOP SINK _ _ _ _ TOILET 1 URINAL WASHING MACHINE CONNECTION 1 WATER HEATER WATER PIPING OTHER 3 OTHER DESCRIPTION: pot fill, o.d.shower, utility sink 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 Troy Gilbert LICENSE 1;5573 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME COASTAL MECHANICAL ADDRESS 21 L Fruean Ave CITY WAREHAM STATE MA ZIP 025711324 TEL FAX CELL EMAIL lisa@coastalphc.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ El FEES$ PERMIT# PLAN REVIEW NOTES ,�'� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK �.auu• 4, CITY South Yarmouth ,.....W MA DATE[01/04/2022. PERMIT# 2�", �g�� JOBSITE ADDRESS , 51 urve Hill Road OWNER'S NAME Manuel and Jean Atienza POWNER ADDRESS same TELF FAX TYPE OR OCCUPANCY TYPE COMMERCIALS EDUCATIONAL LI RESIDENTIAL EJ PRINT CLEARLY NEW: [ _J RENOVATION:Li REPLACEMENT:Li PLANS SUBMITTED: YES❑ NO( 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 1i DISHWASHER 1j DRINKING FOUNTAIN i I' FOOD DISPOSER ---In it if— FLOOR/AREA DRAIN _ I.-. INTERCEPTOR(INTERIOR) KITCHEN SINK 1 11111111=I— LAVATORY 7 1 ROOF DRAIN 1_ SHOWER STALL 1 - SERVICE/MOP SINK r I ' TOILET 1. j' .._il___. —1 URINAL WASHING MACHINE CONNECTION 1 WATER HEATER ALL TYPES WATER PIPING ii OTHER pot filler 1 71 1 � . - utility sink 1 �L- outdoor rinse station 1 ¶1 In 41111. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES Q NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 1[1 OTHER TYPE OF INDEMNITY i _ 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 0 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.. /4 7 yd.6i2,477 �— PLUMBER'S NAME Troy Gilbert LICENSE# [13573 SIGNATURE MP Lv I JP❑ CORPORATION❑# IPARTNERSHIPD# 1 LLC Li#[4350 1 COMPANY NAME Coastal Mechanical ADDRESS 21 L Fruean Ave CITY! South Yarmouth I STATE MA I ZIP 02664 1 TEL 15087378747 FAX CELL 5088506955 1 EMAIL lisa@coastalphc.com