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Home My WebLink AboutBLDP-21-001142 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK a rangy;�` CITY YARMOUTH J MA DATE 9/3/20 PERMIT# BLDP-21-001142 JOBSITE ADDRESS 7 WOODSIDE CIR OWNERS NAME SHAYLOR ROSE M TR P OWNER ADDRESS SHAYLOR REAL ESTATE TRUST 7 WOODSIDE CIR YARMOUTH PORT,MA TEL 02675-1800 TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ 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 LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK 1 TOILET URINAL WASHING MACHINE CONNECTION 1 WATER HEATER 1 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❑ NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY 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 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 R Peter Checkoway LICENSE f8417 SIGNATURE MP 0 JP 0 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME R PETER CHECKOWAY ADDRESS 11 SCARGO HILL RD CITY DENNIS STATE MA ZIP 026382306 TEL FAX CELL EMAIL checkenl@comcast.net ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES ,. Yes No THIS APPLICATION SERVE AS THE PERMIT ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES IC MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 4_tit ‘,-.4..... ,.�= CITY LYARMOUTHPORT MA DATE 18/19/2020 PERMIT # D 'Z1� �i `1 ..,,,7 --: - 1-- ______ r____ JOBSITE ADDRESS 7 WOODSIDE CIRCLE, YPT I OWNER'S NAME MEW HATCH i POWNER ADDRESS SAME TEL 978-766-7001 'FAX I I TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL r-P PRINT CLEARLY NEW: i RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES -1 NOTJ FIXTURES Z FLOORS 1.: 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 i �_ I --I - ; „...._.1[ I DEDICATED GREASE SYSTEM i DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER { tl s'<t -u�_� If _ .�, _ - DRINKING FOIE IN .. !' �', FOOD DISPOS 1 z --; FLOOR /AREF41N o I INTERCEPTOf >TERIC '�r ' Ijf i KITCHEN SIN a in LAVATORY c\' i ROOF DRAIN io C? ` _--- - __ SHOWER STALL ' = f _ 1, i SERVICE / M NK �► (` 1 TOILET ce 15 mm _ _ URINAL .--.- ' !I __L, .._ WASHING MACHINE CONNECTION F 1 WATER HEATER ALL TYPES WATER PIPING i ,� L . OTHER I - LW_ Jd C 411111Wo------. I-- 'iCOMBI BOILER/WATER HEATER 1 _ E.-: _ lI I r ,r . 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 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 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 thy: t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all P ' - t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. �� PLUMBER'S NAME R Peter Checkoway _ iLICENSE # 13417 SIG URE MPQ JP® CORPORATION®# JPARTNERSHIP # 1'ILC #1 COMPANY NAME aleckoway Enterprises ADDRESS 11 Scargo Hill Rd CITY Dennis ISTATE MA ZIP 02638 1 TEL 1508-385-1911 FAX 508-385-6858 CELL 508-735-9993 EMAIL checkent@comcast.net • • • .. I �a 3 • • • • J OF- Amy MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ,y N CITY YARMOUTH MA DATE 9/3120 PERMIT# BLDP-21-001142 = � JOBSITE ADDRESS 7 WOODSIDE CIR OWNER'S NAME SHAYLOR ROSE M TR P OWNER ADDRESS SHAYLOR REAL ESTATE TRUST 7 WOODSIDE CIR YARMOUTH PORT,MA TEL 02675-1800 TYPE OR OCCUPANCY TYPE COMMERCIAL RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:0 REPLACEMENT:0 PLANS SUBMITTED: YES NO 0 FIXTURES 1 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 ROOF DRAIN SHOWER STALL SERVICE!MOP SINK 1 TOILET URINAL WASHING MACHINE CONNECTION 1 WATER HEATER 1 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 0 NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY 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 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 R Peter Checkoway LICENSE 18417 SIGNATURE MP 0 JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME R PETER CHECKOWAY ADDRESS 11 SCARGO HILL RD CITY DENNIS STATE MA ZIP 026382306 TEL FAX CELL EMAIL checkent@comcast.net