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Home My WebLink AboutBLDP-21-000186 • MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK k.* CITY YARMOUTH MA DATE 7/14/20 PERMIT# BLDP-21-000183 JOBSITE ADDRESS 21 GLENWOOD ST OWNER'S NAME STANOS VALERIE G TR P OWNER ADDRESS THE 21 GLENWOOD ST RLTY TRUST 21 GLENWOOD ST WEST YARMOUTH, TEL MA 02673 TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL 0 PRINT CLEARLY NEW.❑ RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES NO 0 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/OIUSAND 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 0 NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 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 plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbng Code and Chapter 142 of the General Laws. PLUMBER'S NAME Phillip Durfee LICENSE 8P152 SIGNATURE MP 0 JP ❑ CORPORATION 0# 3152 PARTNERSHIP ❑# LLC ❑# COMPANY NAME Durfee Plumbing&Heating LLC ADDRESS 51 FLAX STREET CITY DENNIS STATE MA ZIP 026641206 TEL FAX CELL I EMAIL 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 .. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK , '= CITY West Yarmouth MA DATE 2/14/2020 PERMIT #A DP 9-1-L'' /13 JOBSITE ADDRESS 21 Glenwood St OWNER'S NAME Susan Grassetti POWNER ADDRESS 21 Glenwood St TEL 917 921-2813 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: i PLANS SUBMITTED: YES NO FIXTURES Z FLOOR-. BSM 1 2 3 4 11 5 6 7 8 9 10 11 12 13 14 BATHTUBr— r r— ._._ ,.r.. ..... ,. CROSS CONNECTION DEVICE L i (� i�- _ DEDICATED SPECIAL WASTE SYSTEM ,f DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM 1 DEDICATED GRAY WATER SYSTEM �.. DEDICATED WATER RECYCLE SYSTEM _' _ - ----t=,---, ...:_-. ... ._.. — ..-.2_-_.- DISHWASHER 1 7. _ DRINKING FOUNTAIN F`' '' 1 r— .- FOOD DISPOSER J J.- ,� FLOOR / AREA DRAIN [ r—�:, INTERCEPTOR (INTERIOR) I— �._ . KITCHEN SINK „t..a .—_ ___Lii... .--_ LAVATORY [ ________-- _zi- I ROOF DRAIN , _.1 I SHOWER STALL SERVICE I MOP SINK l_i —I1.___., —I . _ i ifr_____...--.1 HTOILET ___ � �J URINAL �_ �, :r-- ..„4...41,....., WASHING MACHINE CONNECTION _ L_ i_._T. , WATER HEATER ALLTYPES 1 i WATER PIPING - -A L-_-__ . OTHER jaimimi. —L. 1r— -4-417-- : iiiii.MAL.111"--1-- r-- 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 v 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 the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in c••• .,...nce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. s PLUMBER'S NAME [Phillip J'Durfee i LICENSE # id-152 SIGNATURE MPE JP ❑ CORPORATION ❑#[ IPARTNERSHIPLJ# ILLC #ft3774 COMPANY NAME Durfee Plumbing & Heating LLC I ADDRESS [12 Bertram Ave # 5 CITY So� Dennis I STATE [Ma ZIP 102660 TEL 508.619.3078 I FAX 508.258.059:2 CELL 508.801 .8004 , EMAIL sales@durfeeplumbing.com a`