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HomeMy WebLinkAboutBLDP-21-003132 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _ ,,�,��� CITY YARMOUTH MA DATE 12/2/20 PERMIT# BLDP 21 003132 }'I JOBSITE ADDRESS 7 WISTERIA RD OWNER'S NAME FERRI PETER TRS P OWNER ADDRESS FERRI MARIANNA 1384 WASHINGTON ST NORWOOD,MA 02062-4021 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW: El RENOVATION:El REPLACEMENT:El 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 1 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 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 El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El OTHER TYPE OF INDEMNITY El 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 Kevin Mcbride LICENSE#1620 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME KEVIN J MCBRIDE ADDRESS 11 COCHESET PATH CITY WEST YARMOUTH STATE MA ZIP 026732559 TEL FAX CELL EMAIL kmcplumb@comcast.net ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE PERMIT ❑ FEES$ PERMITS PLAN REVIEW NOTES 70. oc.) InRP : 06Ia05c2, P,9Ae6-4. : ©.a . a07 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK r_�s P CITY YAQI'YIOLJT )-) ____ MA DATE I (� PERMIT# 6P-2H)L)315 r �. JOBSITE ADDRESS LIIILLaszfirel...M.......1 OWNER'S NAME (.h r.; eO VC_lG r j POWNER ADDRESS 1. , rc ca 171cvxes+e r tY1 TEL 50 I9g4 -r4 C FAX TYPE OR OCCUPANCY TYPE COMMERCIAL Li EDUCATIONAL ® RESIDENTIAL Er PRINT CLEARLY NEW: Li RENOVATION:® REPLACEMENT: PLANS SUBMITTED: YES LI NOLJ FIXTURES 1 FLOOR--; BSM 1 2 3 4 5 6 7 8 9 14 11 12 13 1 14 BATHTUB 1111111111111111 MRl=PI 111111111111111111111111s11111111111111 ! 1( ! CROSS CONNECTION 11111.14111111111111111111M11111111111111111111111111111111111111111111111111111111111111111111111111 DEDICATED SPECIAL WASTE SYSTEM _ J'� �' � _ WW.:,W _DEDICATED GASlOILISAND SYSTEM ����i �! nii..11 � ! � I. ; .� �ii. 1 :: t DEDICATED GREASE SYSTEM :i ___ _ ; _ ( a . PRIM DEDICATED GRAY WATER SYSTEM :( ] 1 �� ' DEDICATED WATER RECYCLE SYSTEM WPM. _J Via ; :! .( L .( DISHWASHER - _ (_ i 4. ( DRINKING FOUNTAIN ; __ i _ _ l' i, .(1 _--_ - __..1 t ; I; I fI FOOD DISPOSER i _ ; � ; �����i �' .lit�j .� mil ,; FLOOR/AREA DRAIN INTERCEPTOR (INTERIOR) _ , II.-__ ;:�^(j -_. . :i- -. . -__ _i( l ( ! i�r.- KITCHEN SINK _._. _ill . ._i_____ __._-�.• AIM_ i _ ...- t .t...._._.. LAVATORY J. i L__ L-_ - 1! -z--- : iMI ' M . ROOF DRAIN r _ . ° _t SHOWER STALL i (, I! I1,I'llrI, L . ; SERVICE/MOP SINK MEM .. I —_ —__ ' , _ ( AFMEM. ) - �! —1 , ., - TOILET i _.( ." -_n , i URINAL i .___ ._ i; r i ,I WASHING MACHINE CONNECTION it ;'Ilia MIR 11111111111111,11111111111111111111111111111 WATER HEATER ALL TYPES '> _ i11111111111111111111 WI WATER PIPING I ,l--..__ f._.. ' - -_ . .,...—i; __ ---- ._... .- - g_. _ 1 - .. ._ _;11MINIIMMEWE OTHER - -- -- _ :111.11, f; 'I ,ir ( 1I (i -11 ilingliiin ViiiMilliiiii 111111111111111 Milli Milk OM MUM OM iM PIM Milt ill111:111111 Milli 1171-11. i- -__,.,,_____. ..,.-.,_ .___. __ r ter- ill1111 Mil Milt ,,: !_ I- -_. '__.- _. 'I., _ �--ii ;I----._ .L�-•-..�Minot liumuntilout INSURANCE COVERAGE: / I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 0 NO {-__,_1 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ER 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 D AGENT -_i 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 ccm. noe wi h all .erti ent= rovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. / f PLUMBER'S NAMEKe..A.):_f•�_.��_�-'.- r��� -o ____� _ .,�„ _LICENSE # i-(v_*X�'?-. — SIGNATURE MP A JP L CORPORATION 0# Wtom,, jPARTNERSHIP Lj# - LLC(i# _ _ COMPANY NAME 14/C. .2.1.C.,.i ADDRESS C..40.,..j)(?-ad CITY a `/c ,-- , ,-��. STATE ' ZIP d L ,3____._ TEL 16.-Q_I").7.77S.:-.._4 _ ..._._i . FAX 6 d "l ct u-ts nt CELL 50� 3tA-37 #( EMAIL �^/' ; PO b lil t, t', • /\4V BUILDING DEt-ARTMENT By —