Loading...
HomeMy WebLinkAboutBLDP&G-22-001764 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK „, CITY YARMOUTH MA DATE 9/28/21 PERMIT# BLDP-22-001764 JOBSITE ADDRESS 17 HOPE RD OWNER'S NAME MICARI PETER P OWNER ADDRESS C/0 LESHCHINER DMITRY 32 WALNUT ST BELMONT,MA 02478 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:D REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURFS FLOORS--- RSM 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 TOILET URINAL WASHING MACHINE CONNECTION 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 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 Michael Mcbride LICENSE 149681 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME [1ICHAEL R MCBRIDE ADDRESS 9 Rustic Drive CITY West Yarmouth STATE MA ZIP 02673 TEL FAX 7 CELL EMAIL stinger.mcbride@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Ye No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES /nne .' P.qgc6c : MASSACHUSETTS UNIFORM APPLICATION FOR A PER IT TO PERFORM PLUMBING WORK W.-11=" CITY `"1 # MA DATE ` ! . ? y Z/ 1 PERMIT# 1. ow JOBSITE ADDRESS17.4zeve r� _ OWNER'S NAM` > t,� _. � rtik ' _ � ,�� `FAX OWNER ADDRESS I 1 0 YetrI^�-^z- iA1 TEL L, _ r Its. P � 0 TYPE OR OCCUPANCY TYPE COMMERCIAL ED EDUCATIONAL 0 $�R'ESI TIA g! 2.6)? , PRINT PLANS SUBMITTED: YES ® NO CLEARLY NEW: 0 RENOVATION: © REPLACEMENT: v FIXTURES 1 FLOOR-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB I _I L..r G. .. =I Lv,.. ,11 1 I_1 i,_.,-...,..1 L„„__-- . ...�..�-., _JtQ_ :' CROSS CONNECTION DEVICE I t • _- -1 = . S ..�.- 1- -,_- ,- ,i--.___L---.�_ L ____I La. _1 DEDICATED SPECIAL WASTE SYSTEM I J L. I i _. - t. 11_ t.uA• i_ - J - Pim DEDICATED GAS/OIUSAND SYSTEM 1 .v.. [ JLJ __L1 _-1�.4L J.D - II -- - d -_ _,. A L .-.__ DEDICATED GREASE SYSTEM L . ij ..-..__,IJ Lr__I,t.- ._i= 1...._ .,IL,_....,1I�,. ., °.1..___: _,i - : - DEDICATED GRAY WATER SYSTEM �w." 1I_�- , n_-1 . -.1.-� 1= - - .j _4L_--_-�/ �-.-r .� -. -�-: DEDICATED WATER RECYCLE SYSTEM L. Jr _.�fl,� �- �-� i •r-i :-�' ,- L_- . --� im DISHWASHER i LF__ 1 .,'-,1L�.-�i1 , - -___ »_ - - DRINKING FOUNTA _ _- y- - ��^ FOOD DISPOSER ILL .-�_ JL _Ji ___ �I a ,-1 _ •1 . ._ t 4 , FLOOR 1 AREA DRAIN • -I _ _ ' -_ .1! __1_,, __J :1_ l� - -® L t JI___ :L INTERCEPTOR (INTERIOR) [____, _ -4,1..__1[� 7_i � �i_,. ss�� _ I KITCHEN SINK I d��....o-1,1 ,11-_�. � ;____L .. C _..�t: r-�..I;.--�,..y. � r ti - J LAVATORY ''1._ ,.7 __ - ROOF DRAIN .._.__.-._11 1.L Lw11____... _ _II 4 i ..II ,....I ti $�_..., SHOWER STALL !i ,g! F �? h ...I JL f! ;I 1( _ �..-�2� .. .. __�- .a-+• w..�,o.- _....,.. �-tJs--•"• - --•a+-�� �-j i��- �� n.P•.e.�c+L w-.a3 .�7.��—r.:] SERVICE / MOP SINK t_—JEDLy l� _ i1 �, .1�I�-�_1�-.--.�.- - �- _ ���t J�.,w. ! J s - TOILET • ai ern,( ... ', L rt 11 ,_1! _ L_.-11. SI 1i . i ...: URINAL L_�I. .. ,I I - -+-1 I- I ..._ i L - ..._I L:„.....J L_J=L..� . _ WASHING MACHINE CONNECTION ,.._._ b'_i ____� -- �__J - I ._ 1 -ti-_��V ti1-{ ,__ J WATER HEATER ALL TYPES '_ - � c..._A`L�._ -a'' ll II..._. ___11 ,j, - I v,. ,. - „i WATER PIPING - L.,� ,....s_ .L__IL L �� ' -� --_..,,1 ...J OTHER {___- 1L..�,..._.�L L. ... 1��.._-. 41.-�- 11 JI�- - ._ -- I��_-_.1��..j_�..� -- .s ��. } I 2; r-- , 1. _ 11. - - _.Jl = _- - --- _. _ ___ ..a__ _- __ - - INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES JO NO Li IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY [j BOND E - 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 Ei 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 L \\*\,N,VOILas_i*.z._ LICENSE # _ - .._.__w SIGNATURE • MPLJ JP © CORPORATION # • 'PARTNERSHIPU#L_ _-. LLC,3# _____I COMPANY NAME L _ JADDRESS - CITY ___ .—_ _ -- - - [ STATE = ZIP - - -- i TEL __,-- __..---_._.____._._. J y FAX 1 CELL 1 EMAIL ik ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT 0 0 FEE: $ PERMIT# PLAN REVIEW NOTES • •+uh tor A,� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK :` �— CITY YARMOUTH MA DATE September 28, 202 PERMIT# BLDP-22-001764 i_ i.,. JOBSITE ADDRESS 17 HOPE RD OWNER'S NAME MICARI PETER G OWNER ADDRESS CIO LESHCHINER DMITR" 32 WALNUT ST BELMONT MA 02478 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: 0 RENOVATION:❑ REPLACEMENT: 0 PLANS SUBMITTED: YES ❑ NO ❑ FIXTURES FLOORS —> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER 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 0 NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER OF INDEMNITY 0 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-GASFITTER NAME Michael Mcbride LICENSE # 19681 SIGNATURE MP ❑ MGF 0 JP ❑ JGF ❑ LPG! ❑ CORPORATION 0 # PARTNERSHIP 0 # LLC ❑ # COMPANY NAME: F1ICHAEL R MCBRIDE ADDRESS. 9 Rustic Drive, CITY West Yarmouth STATE MA ZIP 02673 TEL FAX ] CELL EMAIL stinger.mcbride a(�.gmail.com S310N M3IA38 NVId #1M3d $:33A ❑ ❑ 1101213d 3H1 SV S3AH9S NOI1VOIlddV SIHI oN saA S31ON N01133dSNI 1VNId A1NO 3Sfl 210133dSNI 210d 3OVd SIHl S310N N01133dSNI SVO HOflO1 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 1 IQ 1M- .�N, 5d . g P M 0 c.) 7 2 7 z o ,�;t�,� CITY MA DATE PERMIT JOBSITE ADDRESS /7 #9.pe ad OWNERS NAME `kL-)-7 �I' GOWNER ADDRESS TEL`5/Q • "FAX • TYPE �` OCCUPANCY TYPE COMMERCIAL El EDUCATIONAL El RESIDENTIAL PRINCLEARLY NEW:❑ RENOVATION: ❑ REPLACEMENT: 0 PLANS SUBMITTED: YES❑ Np ] APPLIANCES 1 FLOORS-- BSIMI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE —� DIRECT VENT HEATER DRYER l — , FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE ' INFRARED HEATER LABORATORY COCKS • MAKEUP AIR UNIT ______I OVEN POOL HEATER L-- ROOM/SPACE HEATER ROOF TOP UNIT TEST ... . .. . ._. . . _ . . . _ ...._. .._.... .. . UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER 1 I _ 1 INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch,142 YESYI NO ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY„Xl OTHER TYPE 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 waive::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 compliance with all rtinent provision of the i Massachusetts State Plumbing Code and Chapter 142 of the General Laws. �J� �Z PLUMBER-GASFITfER NAME LICENSE tt r I SIGNATURE MP ❑ MGF❑ JP❑ JGF ❑ LPG( ❑ � � �i � CORPORATION❑4 ro, PARTNERSHIP El4r LLC ElCOMPANY NAME JuCB 1\ I(PO �l`"J6 ADDRESS L Or CITY VIJ- '1 ( /V`0 l/ STATE- ZIP 0 2 t, 7 3 TEL 97l 3 /a //2.R FAX CELL EMAIL J i tT ei' ,—cJ r - ,.)+`'4-E.L '(G& ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES Q • ti N ,