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HomeMy WebLinkAboutBLDP&G-22-006754 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 5/23/22 PERMIT# BLDP-22-006754 11 JOBSITE ADDRESS 19 FRANCES HELEN RD OWNERS NAME NARDINI ALBERT P JR P OWNER ADDRESS NARDINI LYNNE E 19 FRANCES HELEN RD YARMOUTH PORT,MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:0 PLANS SUBMITTED: YES 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 0 NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE OF INDEMNITY❑ BONE❑ 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 Francois Paravisini LICENSE 16211 SIGNATURE MP ❑ JP 0 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME FRANCOIS PARAVISINI ADDRESS PO Box 2585 CITY Orleans STATE MA ZIP 026536585 TEL FAX CELL EMAIL bayside@thecapecodplumbers.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE El El FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPUCATION FOR A PERMIT TO PERFORM PLUMBING'INUKK p., OL{TN MA DATE quiz-2-_ . " CITYi1'OWN y-A PERMIT# JOBSITE ADDRESS i GI 111CtS I V% c2OCk6-1 OWNERS NAME IN A RDI is pVVVIVE AUU!'WC. i G 7 7q-911./-i le 2- FAY. TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL PRINT • CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:Et PLANS SUBMITTED: YES❑ NO[i FIXTUTAEB Z FLOOR-' I BSM 1 2 3 4 6 8 7 8 9 40 11 14 13 1+ BAT TUB __ • vim SPECIAL lwTyw��w{�r�r wrpy � ,:, ,. TED S ECUV.� � AITE S`S EM -. DEDICATED GAWOII!$AND SYSf'EM DEDICATED MEAN-SYSTEM DEDICATED GRAY-WATER SYSTEM DEDICATED WATER RECYCIE SYSTEM I: : :_i_- DRINKINN FOUNTAIN F.00�AREA! t ,_ 3 1 INTIPIMPTOR(INTERIOR) 9 , 14.11 i�SINK LAVA fIDOF DRAIN ORME I MOP SINK 411p1BNG MACHINE CONNECTION I WATER WATER ALLTYPES , I WATER PIPING OTHER l C -I— _I 1 I I (1, ft; TUT ETTG. --:-: I have a ounerd lidakissirdta policy or le substantial equivalent which mute the rsgvbemante of MGI.Ch.142. YES CO NO 0 P YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 03 OTHER TYPE OP INDEMNITY E3 BOND CI OiIlYNER'S INSURANCE WAIVERR I am aware that the Meneee Atha banana=cowls required by Chapter 142 of the Naleashosetts General Laws,and that my signature on Ns permit application Uthte requirensni, CHECK ONE ONLY: OWNER CI AGENT a �I • _=OR I harsby certify trat� � • ,• , 9 *ipihmJthsd or entered r ei d tills applfoatlon are true and agate to the b etowledpe and that aft pksnbblp work and Insq � to tctderihs prink tetwsd 1br spplIc.tIon will be In Hance with Ion of the Massachusetts State Plumbing Code and Cheater 142 cf It s General taws, PLUMBER'S NAME. LICENSE# 15211 SIGNATURE IP 0 JP 0 CORPORATI ON j§# 205872589 PARTNERSHIP❑# LLC®# COMPANY NAME Reyslds Plumbing & Heating _ ADDRESS P.O. Box 2585 CITY Orleans • STATE. MA ZIP 0?859 TEL -2554555 FAX 774-818.4249 CELL 774-216-9484 EMAIL SaysIdeeTheCaDeCadPlumberS.COm 1 • a-.a ar.+Ya++u:ae,.newa,a...s.. IK Fel. `� t - .+s. -TM"..:♦ .m.Yf l'r t\ 1 1W r{ p ",(,gq,�yT{ 1 :` ..+aAC,�+.t. w.....M.:n-rs•m r-r_, -w�-s.'/n9o�a t-s..... - _ r 'y', l ...—..�a. .:... .aa-. < 'i , s�F'e-^I<3: 'do-.+ ..,_, f tt°",.. 1 o� f. 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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE May 23,2022 PERMIT# BLDP-22-006754 ki, CT '� JOBSITE ADDRESS 19 FRANCES HELEN RD OWNERS NAME NARDINI ALBERT P JR G OWNER ADDRESS NARDINI LYNNE E 19 FRANCES HELEN RD YARMOUTH PORT MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: 0 RENOVATION:0 REPLACEMENT:© 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 1 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❑ 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 Francois Paravisini LICENSE# 15211 SIGNATURE MP© MGF ❑ JP❑ JGF 0 LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME: FRANCOIS PARAVISINI ADDRESS. PO Box 2585, CITY Orleans STATE MA ZIP 026536585 TEL I FAX CELL EMAIL baysidena.thecapecodplumbers.com S310N M3IA321 NVld #llWb3d $:33d 1I141213d 3H1 S`d S3A213S NOIlVOIlddV SIHl oN seA S310N NOI103dSNI 1VNId NINO 3Sfl b0.1.03cISNI 2iO3 3OVd SIHl S310N N01103dSNI SV9 HOflO J I4- NI 1,_,' MAIMORimarsis I to worrrorsier rer-realwrat worm r bro.rs 11-1.11.••••• •.1.• •••••• "••• •••^ ---- -.I CITY yA RNA otit-r-t4 Wi DATE 4 col 2 2_ PERMIT* JOBSITE ADDRESS 1 CI EY-a-vv,is kelvn Rocka OMR 8 NAME NI AQ_DIti GOWNFR MIMEO! ' TEL-7741-Cfqq-/&1/2 FA MS OR PRINT OCCUPANCY TYPE COMMERCIAL 0 swarm. D RESIDENTIAL DV CLEARLY NBN:0 RENOVATION:0 REPLACEMENT. PLANS SUBACTITD: YES 0 NO 0 FLOORS-+ 1-BHA 1 I , 2 -,_ 2 4 , 5 , 0 1 A 0 a 10 1112 1111 1 14 :•Ai:::‘- BOOMER 1 I AL ••,a,F,-,.. • BURNER 1 t 1 f I 1 J. I 1 I 1 filySoRCE I • ' . Me*lb 1 1 -' I. ' a"i‘" "I=ToRyiliAlica . _ MAKE"'AR uNrr .- .,.. 4 1 ,,, • . i - .. HEAT -ER . . mow iur uni 1 ZIEMER .. . I+1;'.. V 1 -•st. HEATER 1 , OTHER " I natilliiii I I I I I I . I INMS Mild bialemiuraml poll,/albsobsidal mplaimtildob maim requirommis of MEL Ch.142 1191 00 NOD I P YOU CHEWY'S,PUPAE INDICATE THE TYPE OF MIRAGE SY MONNE THI NIPROPRIAMOX ALCM Lusurnmsumtitapourr 0 0114ER TYPE MINIM 0 IIOND 1:1 OVINIMI MUNI=Millie 1 am mare Vat the Masa the bmammeamnpmardad by Glop&lad the mielia wirionu—'ilailIPUI'." ad tut re.;:s.....-‘ure en fhb,........ . aka gib mildilmia. CHECK ONE OM.Y: OWNER 0 mart 0 1 tufty as dialnialtaaNi submitted pr sin Arming iffe ma end Muria to tit bilt MN inovied. indmangettesplisuggrok aid ookilreonemi c=d2tritivhe ping trued for fils application wil vilh all Peanut PLIMBER-C3A8RTTER NME LICENSE*15211 SIGATURE • MP D Kr 10 JP 0 MCI LPN 1:3 CORPORATION gl 0205872589 PARTNERSHIP 04 LLC 0# COMPANY NAME janalanati1takailthX1-.--- ADDRESS P.O.Box 2585 aTy OrISSUIll STATE MA ' zip 02658 TEL 501341654565 , FAX .MA14249 OE.L 774-21 64404 EMAIL BaysicjaertliglapeCadPlumbersmorn ("'°-P `8/00 -7fr 206,e _ ._ ... ,-, .......-.z. ,--....--.14.I.OF.-.A.4..'......•4:-...--,- , ,..-190%.-•• •-,47, - .1,..r srAtIttflr '4,74'i., ..„ ,,i`r jr. , „ :-..-:„.......,...,-........„,..Q ,6.71$43-: ,..„,,,c,...„,,, 14.11?i . -241-..1, 1 1 •,"-,••,..... -,,,4 - ',,,-...-7„....,, ,f...MN Pr77'4,.' .•,.. ' '• "; -1i-3"--i c- '-)• ' ' '; f.‘,7.11.(.,:P" 111. 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