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Home My WebLink AboutBLDP-22-000818 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 8/12/21 PERMIT# BLDP-22-000818 rl JOBSITE ADDRESS 48 HEATHER LN OWNERS NAME(Robert Alexander • P OWNER ADDRESS 48 HEATHER LN YARMOUTH PORT,MA 02675-1908 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL El PRINT CLEARLY NEW:0 RENOVATIONS.El 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 1 LAVATORY 1 ROOF DRAIN • SHOWER STALL 1 SERVICE/MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION 1 WATER HEATER 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 El 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 El OWNERS 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. PLUMBERS NAME Zachary Lucas LICENSE 16865 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# Lc ❑# COMPANY NAME MID CAPE MECHANICAL ADDRESS 300 Queeen Anne Rd. CITY Harwich STATE MA ZIP 02645 TEL FAX CELL EMAIL midcapemechanical@gmail.com 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 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 3 _�ti,,,l= = 11— sIg ,..,� CITY Yarmouth I MA DATE 08/11/21 PERMIT # JOBSITE ADDRESS 48 Heather Ln 1 OWNER'S NAME Robert E Alexander POWNER ADDRESS 48 Heather Ln Yarmouth Port, MA 02675 TEL 508-654-8842 FAX[ , , .1 TYPE OR OCCUPANCY TYPE COMMERCIAL 1j EDUCATIONAL 0 RESIDENTIAL El PRINT CLEARLY NEW: U RENOVATION: IA REPLACEMENT: J PLANS SUBMITTED: YES J NOD FIXTURES Z FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB , , CROSS CONNECTION DEVICE a 1 1 11• 1 1 11 DEDICATED SPECIAL WASTE SYSTEM inginillnill.WWWWIIIIIIIIIIIIIWWWW1111, DEDICATED GAS/OIL/SAND SYSTEM inignigniwingwiniinrinimintuntintwim DEDICATED GREASE SYSTEM IIIIIIIIIIIIIIFIIIIIIIIIIFIIIIFIIIIIFWWIIIIIIIIIIIIIIFIIIIIIFIIIIIIIFIIIIIFNICIIIIIF DEDICATED GRAY WATER SYSTEM InllrllnrWIIIIrWIMIFWWWjnllFINIIEWINIRWnir DEDICATED WATER RECYCLE SYSTEM jurw � w � I.i.,i „. immxii ..,_ 0 „,. . ,, _ �n DISHWASHER Rmi ,1 i DRINKING FOUNTAIN FOOD DISPOSER inriniwunnintingwinrintintwaggingintini FLOOR /AREA DRAIN igniunriminguanignigurinionfinningrawnitinwini INTERCEPTOR (INTERIOR) inrinfilili11111111111111111111111111111111111111111111111111W11.11111111111111111111111 KITCHEN SINK WWWIIIIIIIIFINIIIFIIIIIIIIIIIIIIFJIIIIIIFIIIIIIIIIIIFJIIIIIEIIIIIFIIIIFIIIIIIIIIIN LAVATORY imirigninintincintinginiingligifinionignrigitiguni ROOF DRAIN SHOWER STALL imirwriggiwwwinginimunioniing Immo. SERVICE / MOP SINK gurimunigniwinrunrinringwinimerwinmor TOILET lnrinffllnllnIFFMIFINMFIMFIINlrjdlrllnrllnrIIIIIIIIIInlnng URINAL IIIIIFIIIFIIIIIIIIIIIIFIIIIIWIIIIIFIIIIIFIIIIIIIIIIIIIFIIIIFIIIIIIIIIIIIIIIFIIIIIII WASHING MACHINE CONNECTION wintwiniiiirlinigniwiligingsnimig miming WATER HEATER ALL TYPES inignininitiniinunioniuntinininniriniung gm WATER PIPING untiniontuniiintwwwwinfinurwinraiiiint OTHER 1111111111.11111111111111111111111111111WINIFIIIIIMIWIE111111111111111 IIMIIIMIIIIMIIIIMIIIIIIIIIIIINIIIIIIIIIIIIIIIIIIIIEIIIIIIIIIIIIIIFWIIINIIIIIIIIIIIIFIIIIIFIIIIIIIIIIIIIIFIIIIIIIIFIIIIIIFIIIIIIIIIIIIIIIII INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES ri NO 0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El OTHER TYPE 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. CHECK ONE ONLY: OWNER Ej 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 the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in co pliance with all rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME [ Zachary Lucas 1LICENSE # PL16865-M SIGNATURE MP El JP ® CORPORATION®# JPARTNERSHIPLJ#F.JLLcI#[_ J L.....j COMPANY NAME[-Mid Cape Mechanical I ADDRESS 300 Queen Anne Rd Unit#7 CITY Harwich STATE MA I ZIP 02645 I TEL 508-246-9277 FAX 3 CELL ` EMAIL midcapemechanical@gmail.com