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HomeMy WebLinkAboutBLDP&G-22-006989 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY [YARMOUTH MA DATE 6/2/22 PERMIT# BLDP-22-006989 JOBSITE ADDRESS 1039A GREAT ISLAND RD OWNER'S NAME YCYB LLC P OWNER ADDRESS MA 01581 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL D PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:© PLANS SUBMITTED: YES 0 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 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 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ OTHER TYPE OF INDEMNITY❑ BOND❑ 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 plurnbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts Slate Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Spencer Hallett LICENSE 16224 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME SPENCER HALLETT ADDRESS 381 Old Falmouth Rd Unit 36 CITY MARSTONS MLS STATE MA ZIP 026481372 TEL FAX CELL EMAIL office@hallettplumbing.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES 5 PERMIT# PLAN REVIEW NOTES ' .\ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK -.; CITY 1_ 4c.-nh -, € MA DATE L j0:- j----1 PERMIT # 7- — `A il JOBSITE ADDRESS 1034q 6recjIslancii. j OWNER'S NAME eyon i POWNER ADDRESS I TELL SO F1' CP - X TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL RESIDENTIAL y..J PRINT CLEARLY NEW: r s RENOVATION: [,I REPLACEMENT: PLANS SUBMITTED: YES u N0b FIXTURES 1 FLOOR- BSM 1 2 1 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 SYSTEM J 1 DISHWASHER I II II1J DRINKING FOUNTAIN ,� 1 IL I FOOD DISPOSER 1l _. _ . Q I FLOOR 1 AREA DRAIN 1 1 U I il �) INTERCEPTOR (INTERIOR) j i j J 1 KITCHEN SINK J i( LAVATORY ( i ROOF DRAIN 1 _ ! U 11 SHOWER STALL J 1 .j I ti SERVICE / MOP SINK �( TOILET I 111 URINAL i I WASHING MACHINE CONNECTION 1 1 . WATER HEATER ALL TYPES 1 1 �{ WATER PIPING 1111111111111 - OTHER =RR ,, ,,_Ztyn.he) - . a J i . _f J f INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES ❑ NO n IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 1. � OTHER TYPE OF INDEMNITY El BOND 11 ._ 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 E AGENT E 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 accura - . ,'r best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance w' . I P;..i•: t ovi 'on of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. /./.4 09P-- PLUMBER'S NAME Lqpencer Hallett I LICENSE # 16224 I IGNATI 'E MP[] JP ❑ CORPORATION ❑# 3834 JPARTNERSHIPLI# LLC❑# _ COMPANY NAME Spencer Hallett Plumbing & Heating ADDRESS 381 Old Falmouth Rd, Unit #36 CITY Marstons Mills J STATE MA ZIP 02648 TEL 508-428-6080 d FAX 508:428-7991 J CELL EMAIL office@hallettplumbing.com _ _ -. ,q731/ �• a t a • - . t • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK li_ CITY YARMOUTH MA DATE IJune02,2022 'PERMIT# BLDP-22-006989 iu JOBSITE ADDRESS 1.139A GREAT ISLAND RD _ OWNER'S NAME YCYB LLC G OWNER ADDRESS MA 01581 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL PRINT CLEARLY NEW: 0 RENOVATION:0 REPLACEMENT:0 PLANS SUBMITTED:YES❑ NO 0 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 ❑ NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LABILITY INSURANCE POLICY❑ OTHER 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-GASFITTER NAME Spencer Hallett LICENSE# 16224 SIGNATURE MP©MGF❑JP❑ JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP ❑# LLC❑# COMPANY NAME: SPENCER HALLETT ADDRESS. 381 Old Falmouth Rd Unit 36, CITY MARSTONS MLS STATE MA ZIP 026481372 TEL FAX I CELL EMAIL offce(a),hallettplumbinq.com S310N M3IA32i NVld #1I11213d $ :33d ❑ ❑ lIVE3d 3E11 SY S3Aa3S NOIlb'011ddd SIHI oN s8A S310N N01103dSNI 1VNld KIND 3Sl 210103dSNI 210d 3OVd SIHI S31ON N01103dSNI SVO HJf102! MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ' i t Ark:, tj*'t CITY Neil/y MA DATE 51c 3I PERMIT # ` JOBSITE ADDRESS 1059 OWNER'S NAME ___3ck,n _ __ M M GOWNER ADDRESS TEL ~ - r-(00 FAX TYPE OR OCCUPANCY TYPE COMMERCIALS EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: _ REPLACEMENT: 21 PLANS SUBMITTED: YES E NOL:1 APPLIANCES -1 FLOORS-* BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER N �. w �.n_ BOOSTER 11111 .-r .. l 1 I 1 1 CONVERSION BURNER MMr S.!!ilalli11.11 COOK STOVE MOW Nil _ 11111 ii DIRECT VENT HEATER M. M-1 Ell 11.1 _ KM 11111111W111.r.ms, DRYER I - ._. . ®ill M MN ME IMITIMIM MN MIN FIREPLACE MMI� __ FRYOLATOR EN 1111B ,a!= FURNACEMIIIMIIIIMIWIMII Ml 10111MMUIIIIIEMIE 111111 GENERATOR ®rgIKI=MEIMI 11111111111101M=111111111111111MMIM _ GRILLE WiM-MmimiNMfMmIIIK INFRARED HEATER -. MIMI MEW — NM IIIN®1_I1111111M LABORATORY COCKS 11111..111 M 111111 I MAKEUP AIR UNIT III MJ — OVEN ��1. � � � � . . i •idi min I� f roritr ! m ; NE UNIT HEATER UNVENTED ROOM HEATER WATER HEATER ® � 11 IMIlm!il OTHER MIN M IMI MM. Mr M NM INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES 1 NO I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY i 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 waives this requirement. CHECK ONE ONLY: OWNER [T ] AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this applicationare true . , a accurate a - - •estof my knowledge and that all plumbing work and installations performed under the permit issued for this application will be it corn. l'i: . .r''ertlnent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. �� , , PLUMBER-GASFITTER NAME Spencer Hallett I LICENSE #II16224 SIGNATURE MP MGF ® JP ® JGF [] LPGI ® CORPORATION 0# 3834 I PARTNERSHIP # LLC 1# COMPANY NAME: Spencer Hallett Plumbing & Heating, Inc. ADDRESS 381 Old Falmouth rd, Suite 36 • I CITY Marstons Mills I STATE MA ZIP 02648 TEL 508-428-6080 FAX 508-428-7991 1 CELL EMAIL office@hallettplumbing:com '�a=J .. ' '.:,r