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Home My WebLink AboutBLDP&G-23-000893 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK u_ CITY YARMOUTH MA DATE 8/18/22 PERMIT# BLDP-23-000893 JOBSITE ADDRESS 16 FAST BROOK RD OWNER'S NAME RAGUCCI PATRICIA A P OWNER ADDRESS C/O PATRICIA SPERANDIO 9 CLORINDA RD WILMINGTON,MA 01887-2301 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL El RESIDENTIAL❑ PRINT CLEARLY NEW:El RENOVATION:El REPLACEMENT:El PLANS SUBMITTED: YES❑ NO El 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 El NO El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El OTHER TYPE OF INDEMNITY El BOND El 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 Michael Mcbride LICENSE'f9681 SIGNATURE MP El JP El CORPORATION ❑# r J PARTNERSHIP ❑# LLC ❑# COMPANY NAME MICHAEL R MCBRIDE ADDRESS 9 Rustic Drive CITY West Yarmouth STATE MA ZIP 02673 TEL FAX CELL EMAIL stinger.mcbride@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ 0 FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK == a" CITY , / MA DATE fQ �,c. PERMIT# Z 3 G j:j JOBSITE ADDRESS i. _(.e..4 OWNERS NAME 0:W POWNER ADDRESS 7 Co /+�' 6/,/ .a) TEL FAX TYPE OR OCCUPANCY TYPE L C6f�IMERCIAL❑1G DUCATIONAL ❑ RESIDENTIAL E PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT: PLANS SUBMITTED: YES ❑ Nit] FIXTURES-1 FLOOR—+ 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 �_13 t� V ��, DRINKING FOUNTAIN -- ' _ —'" 1 FOOD DISPOSER E AUG 1 d 11111 ' FLOOR 1 AREA DRAIN INTERCEPTOR(INTERIOR) ` C3UyEPfT KITCHEN SINK e+ - LAVATORY ROOF DRAIN , SHOWER STALL , SERVICE/MOP SINK TOILET URINAL . WASHING MACHINE CONNECTION WATER HEATER ALL TYPES / WATER PIPING OTHER 1 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES al NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q( 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 i, Massachusetts General Laws, and that my signature on this permit application waives this requirement. -.7.:- CHECK ONE ONLY: OWNER El AGENT 1] SIGNATURE OF OWNER OR AGENT L:L.I 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. c� PLUMBER'S NAME 1 IC/ 10� t LICENSE# I1 �� ' v� SIGNATURE MP❑ JP 2 CO ORATIO ❑# PARTNERSHIP Ell LC❑# P r J COMPANY NAME t �" f'( r, �C- ADDRESS 7I F___Ti LC f I) ` CITY 4 ll 4 l c STATE (A--- ZIP C CIO / TEL 71 l no / Z ? FAX CELL EMAIL k v iN\ c I(j CC)40 (CNN, ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT it PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK [m!.( (4 CITY YARMOUTH MA DATE August 18, 2022 PERMIT# BLDP-23-000893 g ;: JOBSITE ADDRESS 16 FAST BROOK RD OWNER'S NAME RAGUCCI PATRICIA A G OWNER ADDRESS C/0 PATRICIA SPERANDIO 9 CLORINDA RD WILMINGTON MA 01887-2301 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ 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 /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, PEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY 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 Michael Mcbride LICENSE # 19681 SIGNATURE MP ❑ MGF ❑ JP E] JGF ❑ LPG' ❑ CORPORATION ❑ # PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME: MICHAEL R MCBRIDE ADDRESS. 9 Rustic Drive, CITY West Yarmouth STATE MA ZIP 02673 TEL FAX ] CELL EMAIL stinqer.mobrideqmail.com S310N M3IMN NVId #11W 13d $:333 ❑ ❑ 111,11213d 3H1 SV S3A213S N011VOIlddV SI41 oN saA S310N N01103dSNI 1VNI3 A1N0 3Sfl 2J0103dSN1 NOd 30Vd SIH1 S310N N01103dSNI SV0 HJfON „: NWT UNIFORM APPLICATION FOR A RT TO PERFORM GAS FITTING WORK ::,�:.. '' her', DATE 2_ PERMIT JOBSITE ADDRESS 8 - k"2,,3 OWNER'S NAME G OWINER, ADDRESS TE�Z -• 5� � ^y FA•, TYPE OR uCCJPAhCY TYPE FE �A L // ( 1� �D, UCAI IC �AL ❑ RESIDENTIAL SIUENTIAL [�PRINTCLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: k PLANS SUBMITTED: YES APPLIANCES f FLOORS-4 SSM 1 _7 BOILER 1 5 6 7 o 9 10 II 12 I; 1 4 BOOSTER CONVERSION BURNER COOK STOVEDIRECT 'PENT HEATER ' _______i DRYER FIREPLACE FRYOLATOR �� V. E D FURNACE I 0 4 0 .�. 21 - . _______, GENERATOR. r-, ,GRILLE0G 1�8 2°2 INFRARED HEATER i_____1____ LABORATORY COCKS �Ui�C�NG UEPAR MEN , MAKEUP AIR UNIT OVEN POOL HEATER ( i1 ROOM ! SPACE HEATER ROOF TOP UNIT TEST _— UNIT HEATER _. _. UNVENTED ROOM HEATER WATER HEATER C OTHER INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of IUIGL.q Ch. 1 42 YES (� NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ❑ BOND 1 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage re uir Mas:�Esrhus.etts General Laws, and that mysignature on this pernit application waives this requirement. e� by Chapter 1 2 of the 1 SIGNATURE OF OWNERORAGENTCHECK ONE ONLY: OWNER ❑ AGENT ❑ kii;• I hereby certify that all of the details and information I have submitted or entered re `� and that all plumbing work and installations e, girding this application are true and accurate to the best of my knowledge performed under the permit issued for this application will be in compliance with all Pertinent rovisi i Massachusetts State Plumbing Code and Chapter 142 of the General Laws. /� P on of the J PLUMBER-GASF€T�f EF, NAME ckkj3 f-1 4 -�- - 1( (LICENSE # SIGNATURE MR ❑ MGF ❑ JP 1 JGF ❑ LPGI ❑ CORPORAT101�! f # ,. ❑ PARTNERSHIP ❑ ��`O� LLC ❑ #� COMPANY NAME p �' ADDRESS — tal , CITY STATE &Ik____ ZIP4144i_ TEL C` • FAX CELL EMAIL al IlG ROI1GII G INSFEc I IOPd NOTES E,S THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES •