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Home My WebLink AboutBLDP-23-005626 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK Imin ;° CITY YARMOUTH MA DATE 4/10/23 PERMIT# BLDP-23-005626 JOBSITE ADDRESS 26 MISTY LN OWNERS NAME OMALLEY MEGHAN P OWNER ADDRESS GARCIA DEBORAH 70 SOMERS STREET BROOKLYN 11233-0000 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW El RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES I 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 1 LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER WATER PIPING 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 El NO El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ OTHER TYPE OF INDEMNITY El BOND El 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 Joselin Sanchez LICENSE 3t1804 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME JOSELIN C SANCHEZ ADDRESS 108 BAYVIEW ST 108 BAYVIEW ST CITY WEST YARMOUTH STATE MA ZIP 026738211 TEL FAX CELL EMAIL plumbing657@gmail.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 _l a4 CITY 1 - i 4W10k MA DATE 6 C h PER it-- Z3 C'C) Ji 6 JOBSI • ADDRESS �{/5 1 r Z-eti, OWNER'S NAME 74E6; C) H/e:-(E jr OWNER ADDRESS- ,e'rnG c i S -,.,Cc d tie_ TEL FAX P TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL[ PRINT CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: [1 PLANS SUBMITTED: YES(' NO E FIXTURES 1 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 l AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK fi ' LAVATORY . ROOF DRAIN ( R:�-.. E [`, C SHOWER STALL I� SERVICE/MOP SINK TOILET [ a 1 rAlt 10 zui URINAL M J , . j WASHING MACHINE CONNECTION BUILDING DEPA�TMrt - WATER HEATER ALL TYPES By _ t 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❑ NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UABILITY 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 j, 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 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 Perlin provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. —c � �v r ` G 7 �-�/l CC 2PLUMBER'S NA _ 0 4-6, I,, C- _So,,c-.,� LICENSE# 3)�L\ I SIGNATURE MP E JP I CORPORATION❑# PARTNERSHIP❑.# LC❑# COMP Y NAME 7:-af(2^ (/9'✓/ r>> /ii,7.Z7 ADDRESS 7/4 CITY • 1 o 11 (1 c STATE ZIP_ �� TEL � G .3 a �� FAX CELL-5-O3 -3tt-e, ' 3 e EMAIL,fib/f/m G�j r7 iP 5"7? mtfi ( 0- C o l ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES a