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Home My WebLink AboutBLDP-23-002510 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 11/7/22 PERMIT# BLDP-23-002510 JOBSITE ADDRESS 69 FREEBOARD LN OWNER'S NAME EICHMANN PETER P OWNER ADDRESS EICHMANN JANE 34 RAYMOND ST ROCKVILLE CENTRE,NY 11570 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL 0 PRINT CLEARLY NEW:m RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YESD NO❑ FIXTURFS 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 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❑ NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ 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. 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 Andrew Leighton LICENSE 16130 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME ANDREW R LEIGHTON ADDRESS 20 Brewster Rd CITY W Yarmouth STATE MA ZIP 026735706 TEL FAX I 1 CELL EMAIL halloilcompany@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE El ❑ nrnaarr FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WOR vN ', e I( CITY YchArc)o 542__ • MA DATE k)/c9 4 ic?‘,2:PERMIT JOBSITE ADDRESS 7---&-5 e.,e.boarce Jn OWN NA ME: ' e • 4 pIOWNERADDSESS " TYPE OR OCCUPANCY TYPE COMME-RCA----- EDUCATIONAL 7 RESIDENT PRINT CLEARLY NEW64 RENOVATION. - PsEPLACEIVIEN7::-----, PLANS SUBM7rED: YES T7 FIXTURES'I FLOOR— BEV '`. 23 i 4• 15 fi 718j9 1C111 12 br.3, BATHTUB F-_, CMMMTigfit_allir I SIIIIMI — CROSS CONNECTION DEVICE U. 11-1.11111111111111111111111114-1.01.011/1 DEDICATED SPECIAL WASTE SYSTEM , , _111111111111111111/111.1111W11. MI_WIEW111.11_ ., , DEDICATED GAS/OIL/SAND SYSTEM _ 1 W: _ IIM _W-SIVIOnaWitilitilltalerallr____F._, DEDICATED GREASE SYSTEM ------7" -MI - - - 110411=011115 ' - - DEDICATED GRAY WATER SYSTEM .7iiiisiumit • • 1 f --IL- - DEDICATED WATER RECYCLE SYSTEM = " - NM : DISHWASHER F _Imanoripmersirommer ____ T2_:._ DRINKING FOUNTAIN " 1111•11111•11111- 11111111. _ 1 ___ FOOD DISPOSER L-= MININIWIIMINIMMNI1111111111111111.11111111. FLOOR/AREA DRAIN I , 11111111FM1=111111111,11111111111111011111 ______ ......._.. _ _ . _ INTERCEPTOR(INTERIOR) i::: iMMilliiiialralliiiiilliMAIMIIIIIIIIII-11.114.111 _,,• ,, KITCHEN SINK L. 11110-1-111.771Miumemiamigmaimoitiorammuk LAVATORY C: .. ___1111111110111113111101-11-111111:---."Ft. ROOF DRAIN n-- 11101.111111.111111$1111.111.1111.11/1111.1.NOiliiiiiiii_ . .•__,.. SHOWER STALL :,----- 11.1M-0111FaumpappraiiiintiontWWWICri SERVICE/MOP SINK i _11111111111."111..---- IMF Miii11.1111.11, *110111111,11111111111111,1, TOILET __amaniamoutuum _ .--. ---_.murmumairiiima -1111 -, URINAL _ __ • • _ . __.___ __......._ •.. ._. _ ___ .. _ n 11=r1011111111111'. 11111111111111apt_W. WASHING MACHINE CONNECTION WIA YAMI'l-li cri-1 li-liaa -- —r t II:II.I1I1.iillm.pilnMailml.i Uam'' MM. ugalITNgaIy' mofIM lMiIuigt_ WATERPIPING - MOi - OTHER — . - . 1 10l . . : d.- ,,_. -- -111amport.1111111111111111101011INIIIIIIIIIV: INSURANCE COVERAGE: I have a current liatglitv insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES • •IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING-THE APPROPRIATE BOX BELOW •• LTv INSUSA.NCE POLICY rTi OTHER-YPE OF INDEMNITY - BOND 773 , OWNER'S INSURANCE WAIVER:I am aware that the licenses 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: ER p)AG SIGNATURE OF OWNER OR AGENT •T anI herebytr certify that all of the details, and informationhastellations performed urv.L.,_stitfiemit4roar enteztegartfing this appfi true a= to y',te --- my this a with P ision Massathisetts Stra Plum-ming Code arm ChapMr 142 of the Genera',Laws. -•licali°r1, in , PLUMBER'S NAME I ANDREW LEIGHTON - I L.ICENSE#116130-M : , CNATURE MP'i 2 jl: 1- coRPC.),RATION.,1'It 37340 'I;PARTNERSHI p 774 i L'..,s no COMPANY NAME HALL.OIL COMPANY INC. i ADDRESS: 435 RT 134 CITY I SOUTH DENNIS .-STATE MA i ZIP0266G I 7E-- 508-398-3.831 - , PAX I grIA-1_94-3{368 i CELL EMAIL I halloilcompanyOgmalcom ti.-c S