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Home My WebLink AboutBLDP-21-002464 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK • • '.w,-. er CITY YARMOUTH MA DATE 11/3/20 PERMIT# BLDP-21-002464 rl'sZ JOBSITE ADDRESS 63 FESSENDEN ST OWNER'S NAME LAFFEY JO ANN P OWNER ADDRESS 63 FESSENDEN ST SOUTH YARMOUTH,MA 02664 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL 0 PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:0 PLANS SUBMITTED: YES El NO 0 FIXTURES 1 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 1 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 WATER HEATER WATER PIPING 1 OTHER 1 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❑ 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 James Portanova LICENSE 14999 SIGNATURE MP 0 JP 0 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME JAMES M PORTANOVA ADDRESS 22 NORTH RD CITY DENNIS PORT STATE MA ZIP 02639 TEL —3Lc —yy73 FAX CELL EMAIL jamesportanova@gmail.com 0 ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES I 1 G'/4/ - Yes No THIS APPLICATION SERVE AS THE PERMIT p ❑ 01NA27i us.5' • Acw 1/E^/T FEES$ PERMIT# ' ill /L J PLAN REVIEW NOTES_ Aief c rs �� Lni/ CrS c FJ q 3e 4-11 12/1- 6 V 11//0/2 a r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK —iFire— a CITY_ ,) L U.-1��'A - =_)_i= / MA DATE PERMIT,# �, "1 f2 -(��1�i/(, JOBSITE ADDRESS - 5S 6" e"7 OWNER'S NAME C 2 r i keel 5 14 N n P OWNER ADDRESS ,5-0- '9-ey TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL _ PRINT CLEARLY NEW: ❑ RENOVATION; }—EPLACEMENT: ❑ PLANS SUBMITTED: YES24— 1G❑ FIXTURES 1 FLOOR-4 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 SYSTEM DISHWASHER I ______I DRINKING FOUNTAIN FOOD DISPOSER ' FLOOR I AREA DRAIN INTERCEPTOR(INTERIOR) _ KITCHEN SINK ( 1 P �* PL l LAVATORY ROOF DRAIN SHOWER STALL Ii 3 SERVICE/MOP SINK I TOILET I' fiuil_D'NU U NART\AENT' j URINAL i - — — ,-� . WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING I OTHER 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 TY OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHERTYPEOF INDEMNITY ElBOND ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the i Massachusetts General Laws,and that my signature on this permit application waives this requirement. 1 CHECK ONE ONLY: OWNER [1AGENT SIGNATURE OF OWNER OR AGENT L'‘.I I h reby certify tha',: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 com ' nce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. i ( C' )9 PLUMBER' NAME) l' l 6 f t''' LICENSE# SIGNATURE MP JP❑ CORPORATION El# PARTNERSHIP❑.# LLC❑# COMPANY NAME t 1�1°VIA— IV'ill.t NiADDRESS ✓�U�' _CITY16 t -S STATE 1/{"VA-- ZIP 62-6 ,3cj TEL J ( ):3G"( --4-4 13 FAX CELL EMAL�U►Y'), fU c' 0 01/ l-14^44-I L.-_6d w- ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES