HomeMy WebLinkAboutBLDP-18-005967 LJA BACC dUSE u�S ULAPOW,i A PPLDC£aTIOI4 FOR A PERG OG 17 TO PERLORO PLUMING Y OR1-
` '-_ CITY 444-_, M - _ _ �. MA DATE I_,:,. . 2j7J1PERMIT#/%/)/2 /86?o7
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JOBSITE ADDRESS f_ ( °Ok_ S ' _ OWNER'S NAME; s(tirli-tc __
OWNER ADDRESS t...(` :.r DA� ..L.t�,lE,___..._., �......-. TEL' � at µ 4 FAX i._._.�_._.._3
TYPE OR OCCUPANCY TYPE COMMERCIAL L EDUCATIONAL � RESIDENTIAL .
PRINT
CLEARLY NEW:El RENOVATION:L REPLACEMENT:(`'I PLANS SUBMITTED: YES E. NO(,-:
FIXTURES 1 FLOOR-4 BSM 1 2 3 4 t 5 I 6 7 8 9 10 11 12 13 14
BATHTUB I p r 41 F 1:T F. 1_. . "[- L ?C ,1 ! .i
CROSS CONNECTION DEVICE -
DEDICATED SPECIAL WASTE SYSTEM I _a L -_ r- i ` 'I .__._��1.._; ll --___11.- I i _._. ...
DEDICATED GASIOIIJSAND SYSTEM i^L ` '1.__ 1. 41 __.. z -.' _1 ._. I.. _ _ '.. ...-_I ---*
DEDICATED GREASE SYSTEM �' I, a I I 1 -� I t
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM _..._ .._I D I _ A I. _ I __. IL...__. I [TT. I__ I I
DISHWASHER I. .. __; a rL $I ii. I ' 11. L_ r i _-_ ;i .._`y '
DRINKING FOUNTAIN ,I E I__ f i t 7I _i� � .`.) 1r-3 l I.. _ ._;L
FOOD DISPOSER r I I— N L [ i L :P 'L_ 1(- 4 „.........11—..._ I I 17.7
FLOOR/AREA DRAIN 1 .. .1 I� _„ ... I. ._.t 1 ._ I _ _17-11 ... __._.._. i r _ 1 i..
INTERCEPTOR(INTERIOR) I1 t(�-f,.. UI_._ .1._ ._._) . I_ I._....! ._ . 1, —'`.Sr _ ;!
KITCHEN SINKl. ...... L.-.. _._..
LAVATORY i r..... L.. . ,;I_- ... _ L- [�`� _t
ROOF DRAIN i_ . _._,:(- ! -'(- (-. ..: - C_. . ._ I1 .. ..3r
SHOWER STALL _
SERVICE/MOP SINK 1-1
t I _ l_ -";� ... °I J. '3i , 1�_.`n P-
TOILET a r. ,I. .. ( (-__r.. _- . )i__ _.I,I 1
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URINAL ._..,_'L._._..__.L.._= ��._�_..._�L. . .._. ,. _ ._. � _ .._�L._ �- `
WASHING MACHINE CONNECTION --1! I._ t-._ 4-- ;L. I�- ' i l _ .:I l I I
WATER HEATER ALL TYPES [- .1 r- .t,_ _ 'I _ I r- ._.1 �I- . ._ ,s C- I
WATER PIPING —_. 1,1. .,I,-_. L___.._.-7 I_._ ...1C- _ L.__.._. tom ._. L____�1 n -=-
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OTHER -- __.__.,, ..._ >I II._ _f__. i^�E L L 'r--`'1 _ I ,1 I __,
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INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES I NO j 3
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY Li BOND L.-1
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 II ii AGENT Li
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 accu re best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in compliance all r ' ion of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
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PLUMBER'S NAME[Spencer Hallett _I LICENSE#[1622.4 J, SIGNA RE
MP FT3 JP—I CORPORATION I.._,., # a PARTNERSHIP+-..•.y"#1_ -, LLCI�E:# —11
COMPANY NAME' Spencer Hallett Plumbing and Healing, Inc I ADDRESS 382 Old Falmouth Rd Unit 36 _��� ��.t
CITY Marstons Mills_ ^__ . II STATE I _Ma 1i ZIP 02648 ( TEL[508-428-6080
FAX 508-428-7991 CELL 7 EMAIL [pencerrhallettplumbing.com —____—_ ��.��_._—
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