HomeMy WebLinkAboutBLDP-17-05312 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
— '"--- CITY Yarmouth__ MA DATE 04/06/17 PERMIT#b-017-00,012
JOBSITE ADDRESS 37 Neptune Lane, S.Yarm(Riverview Resort) OWNER'S NAME Topneck Design LLC
POWNER ADDRESS 137 Neptune Lane, S.Yarmouth TEL 508-723-2624 ,FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL[J EDUCATIONAL ❑ RESIDENTIAL
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CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT: i PLANS SUBMITTED: YES fI NoI i_1
FIXTURES 1 FLOOR—+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB ( f_ J
CROSS CONNECTION DEVICE I 1 I
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/01L/SAND SYSTEM —
DEDICATED DEDICATED GREASE SYSTEM 15 "IIIMIIIIII 11117P1111111111111 rilli
DEDICATED GRAY WATER SYSTEM IIMI IIIIIIIMMIIII, 1.1!IMI1, 11W1
DEDICATED WATER RECYCLE SYSTEM I II II Ir--11 II 1.1 I I I II ii li--!I i
DISHWASHER I 1
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN ,I, iPplimmig‘11,1111!!1!
INTERCEPTOR(INTERIOR)
KITCHEN SINK 1 1 I
LAVATORY a
ROOF DRAIN I _
SHOWER STALL rT— '111!
SERVICE/MOP SINK
TOILET d
. I m
URINAL
WASHING MACHINE CONNECTION I-
WATER HEATER ALL TYPES - i - {
I
WATER PIPING u
OTHER r ^�
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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
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY I i I OTHER TYPE OF INDEMNITY H BOND 1 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 ❑ 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 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 Pertin t provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME Kevin J.Sullivan LICENSE# 13041 SI ATURE ------
MP I] JP CORPORATION❑# 2433 !PARTNERSHIP LLC #
COMPANY NAME Ready Rooter,Inc. ADDRESS P.O. Bcx 371
CITY East Sandwich 'STATE MA ZIP 02563 TEL 508-888-6055
FAX 508-888-0242 CELL EMAIL kjs@readyrooter.com