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Home My WebLink AboutBLDP-23-005319 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _,�, .7 CITY YARMOUTH MA DATE 3/28/23 PERMIT# BLDP-23-005319 '# JOBSITE ADDRESS 41 PEREGRINE LN OWNER'S NAME LANDRY PAUL P OWNER ADDRESS LANDRY LINDA M 693 PAGE STREET STOUGHTON,MA 02072 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES El NO❑ 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 1 ROOF DRAIN _SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION _ WATER HEATER `WATER PIPING 1 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❑ NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El 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 Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Joshua Weigel LICENSE 1B424 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC El# COMPANY NAME JOSHUA P WEIGEL ADDRESS 2 GRANITE RD CITY MIDDLEBORO STATE MA ZIP 023462950 TEL FAX CELL EMAIL theweigell6@yahoo.com R� T 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 \--- — R _E__C:._ F_ ly F. D --- TIA-12-- __ ___ toAR 8 2 MASS CHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK • . ciA.4. CIT s7 • L- 9t 60.11Yi MA DATE 1b • L., PERMIT# Z 5 -�~` JOBSITE ADDRESS Li I f e v- t 4J h A OWNER'S NAME PA 1 1..,V41%.) 0(Li . P OWNER ADDRESS ti 1 9 ':C.t ( *) 1, TEL . O<e) 0 ect Lii4FAx h L. TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL D RESIDENTIAL ►1 PRINT CLEARLY NEW: ►:I RENOVATION: 0 REPLACEMENT: 0 PLANS SUBMITTED: YES ❑ NO El FIXTURES-1 FLOOR-' BSM 1 2 3 4 5 6 7 8 9 • 10 11 12 13 14 BATHTUB I I 'iiiii L--) ,I • ---- -- i CROSS CONNECTION DEVICE ... 1.0ii DEDICATED SPECIAL WASTE SYSTEM 1111111 r. I_ DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM ! _ Mid'- DEDICATED GRAY WATER SYSTEM I __ ,I —I _ _ '[ L__.__ - DEDICATED WATER RECYCLE SYSTEM L . [ -- � —_-.. -_-. -- i__ __IIIIIIIIIMMIIIII DISHWASHER l___:.�- ImoI - ._.' - DRINKING FOUNTAIN FOOD DISPOSER i . _I . J._ ..-I. _. - . -- - -._ i __ FLOOR/AREA DRAIN . .iLL_ _....- -_--- __... -_ _ _ _ _ _ ..-_ _ INTERCEPTOR(INTERIOR) 'MO [ --__- _ KITCHEN SINK LAVATORY ` l , . ROOF DRAIN _IM - _ .. -. SHOWER STALL __ _LPL _ . _ 1MMIMM_ SERVICE/MOP SINK 111.1.1.1111111 _ I� TOILET ----ice[ : I - URINAL 11111111111111111111111111 WASHING MACHINE CONNECTION INEMOINI .- i WATER HEATER ALL TYPES NIMPIMININL . _ M'111 _ WATER P N I i - - ■ _I OTHER �� I .. I — MI 111.111.1.1 =WM,111111==61111111 AllillIMINENIMMEIr III.L------ � •111111L1 _ - - --_ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YESP3 NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0. OTHER TYPE OF INDEMNITY ❑ BOND 0 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 know( and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all nest ion of th Massachusetts State Plumbing Code and Chapter 142 of the General Laws. I PLUMBER'S NAME L\ t u a in�t( i4U ----- ---.--r) LICENSE# I Jam•4-1(rV` SI AT E MP[is JP❑ CORPORATION❑# PARTNERSHIP❑# LLC O COMPANY NAME 3 e ADDRESS Z ut iT Pk t \`t 6 1 CITY ID\�cc-O STATE I.\ Z P C)1 c3 TEL Z 39 3 -27 Y S rt FAX 7 CELL EMAIL ARIeTE.17vAD eA- r 4(.Q_ 3 t-R n • co i i -,_. ... . 4 1 .... .....- ,_.._...,.. , , ,..! .3 V , . . , >MOW DMIEIMUJ9 MA015139 OT TIMS239 A ACR 1,91 TADlicHIA ri1101114U aTTIEUH A88iii''.4.-494-4A-t-'-7-1 _ . - . ' It TAM,' ,_ .. _ • 'ii..... 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