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Home My WebLink AboutBLDP-23-005978 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ( CITY YARMOUTH MA DATE 4/27/23 PERMIT# BLDP-23-005978 JOBSITE ADDRESS 358 ROUTE 6A OWNER'S NAME BOHLIN NEILL H P OWNER ADDRESS BOHLIN JAMIE G 358 ROUTE 6A YARMOUTH PORT 02675-0000 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL. ❑ RESIDENTIAL El PRINT CLEARLY NEW: El RENOVATION:El REPLACEMENT:❑ PLANS SUBMITTED: YES NO El 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 2 _ ROOF DRAIN _ SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER _ WATER PIPING OTHER 1 OTHER DESCRIPTION INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY III OTHER TYPE OF INDEMNITY❑ 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 Flumbing Code and Chapter 142 of the General Laws PLUMBERS NAME Sean Hanrahan LICENSE 15822 SIGNATURE MP ❑ JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME [3EAN N HANRAHAN ADDRESS 34 N Precinct Rd CITY Centerville STATE MA ZIP 026322643 TEL FAX CELL EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMIT PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK il - $V CITY YARMOUTH MA DATE 4/26/2023 PERMIT# LZ)�-- z 3 --c6 `S /2r JDBSITE ADDRESS 3 56 RaLiTC CoA OWNER'S NAME JOAN GILBREATH I OWNER ADDRESS _ _, ..a,�. . .. _ TEL' FAX ( I TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: l REPLACEMENT: PLANS SUBMITTED: YES NO FIXTURES -1 FLOOR-i BSM 1 2 3 4 5 6 7 8 9 10 I 11 12 13 14 BATHTUB ---� ---y�----- r--- ---- - --- r---- ,---�---- -W- ,- CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM _ DEDICATED GREASE SYSTEM I , DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR /AREA DRAIN I INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY 2 ROOF DRAIN _____ SHOWER STALL 1 i SERVICE / MOP SINK TOILET 1 �� a ice--- ' `. URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER STEAM GENERATOR 1 ii . INSURANCE COVERAGE: I have a current liabiliJinsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES ;.'i NO Ej IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY i OTHER TYPE OF INDEMNITY ' BOND Li 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 cf 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 rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Sean Hanrahan LICENSE # 15822 SIGNATURE MP i JP CORPORATION j# PARTNERSHIP,_ ,_# LLC # COMPANY NAME Seen Hanrahan Plumbing and Heating ADDRESS PO BOX 688 I CITY Centerville STATE' MA ZIP 02632 ; TEL 774-238-0286 R E C E_I V - k 6— , FAX 508-775-4615 CELL same EMAIL hanrahanplumbing@gmail.com CO-. [. APR L7tho23J qt)i ''' BUILDING DEPARTMENT By:--- --------- _- _ .