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Home My WebLink AboutBLDP&G-21-001570 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 9/25/20 PERMIT# BLDP-21-001570 h= JOBSITE ADDRESS 10 ELIZABETH LN OWNERS NAME CAPALDI GERALD P P OWNER ADDRESS CAPALDI ANNA M 253 VEGA ROAD MARLBOROUGH,MA 01752 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL PRINT CLEARLY NEW❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES NO❑ 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/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❑ NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY D 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 Plumbing Cade and Chapter 142 of the General Laws. PLUMBERS NAME R Peter Checkoway LICENSE W417 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME R PETER CHECKOWAY ADDRESS 11 SCARGO HILL RD CITY DENNIS STATE MA ZIP 026382306 TEL FAX CELL EMAIL checkent@comcast.net 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 vg' ., CITY Lw YARMOUTH MA DATE 9/18/2020 PERMIT # 1) I J �;, } JOBSITE ADDRESS 10 ELIZABETH LANE, W Y OWNER'S NAME JERRY CAPALDI _ _ POWNER ADDRESS 253 VEGA RD, MARLBORO 01752 TEL 774-307-0674 'FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: i PLANS SUBMITTED: YES NO 1 FIXTURES Z FLOOR-I BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB , CROSS CONNECTION DEVICE 1 DEDICATED SPECIAL WASTE SYSTEM .Y_ r__: _. ._ DEDICATED GAS/OIL/SAND SYSTEM 1 DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM :IP: - ' \ DISHWASHER �� _ -- �. DRINKING FOUNTAIN FOOD DISPOSER FLOOR /AREA DRAIN I INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN _ SHOWER STALL II— _ 1 SERVICE / MOP SINK r :,.;1 TOILET URINAL ' .__, - 4� --' f WASHING MACHINE CONNECTION WATER HEATER ALL TYPES 1 - -- WATER PIPING IL II OTHER 11 ----7.— , — ;ram i i ----11 _, , ,fir . _ 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, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Li OTHER TYPE OF INDEMNITY 0 BOND E 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 SIGNATJRE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or ertered regarding this application are true and accurate to e- est of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance w.th al P ' ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME R Feter Checkoway I LICENSE # 13417 SIATURE MPj JP 1 CORPORATIONS#C PARTNERSHIP .#' LLC #, , - 1 COMPANY NAME Chec:koway Enterprises ADDRESS Lii Scargo Hill Rd CITY Dennis STATE Mq ZIP 02638 TEL 1508-385-1911 FAX !id8-385-68581 CELL[508-735-9993 EMAIL checkent@corncast.net .... .. _'..' � fit•... '}:. +{ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ,1 • ,_. ---_,_( CITY YARMOUTH MA DATE •September 25, 202 PERMIT # BLDP-21-001570 r: � JOBSITE ADDRESS 10 ELIZABETH LN OWNER'S NAME CAPALDI GERALD P G OWNER ADDRESS CAPALDI ANNA M 253 VEGA ROAD MARLBOROUGH MA 01752 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 ❑ 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 R Peter Checkoway LICENSE # 13417 SIGNATURE MP 0 MGF ❑ JP ❑ JGF ❑ LPGI ❑ CORPORATION ❑ # PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME: 'DETER CHECKOWAY ADDRESS. 11 SCARGO HILL RD, CITY DENNIS STATE MA ZIP 026382306 TEL FAX CELL EMAIL checkentAcomcast.net ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NO11S Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE:$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 474 _: • , CITY W YARMOUTH MA DATE 9/18/2020 PERMIT # 3L-Dp"21- 15 JOBSITE ADDRESS 10 ELIZABETH LANE, WY OWNER'S NAME [JERRY CAPALDI CT OWNER ADDRESS ' 253 VEGA RD, MARLBORO 01752 TE 774-307-0674 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES -1 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER _. BOOSTER U CONVERSION BURNER COOK STOVE DIRECT VENT HEATER _ _ DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT ' OVEN POOL HEATER t ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER _ UNVENTED ROOM HEATER WATER HEATER 1 OTHER .— INSURANCE COVERAGE I have a current Iiabili_insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 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 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 �,j AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all o-'the details and information I have submitted or entered regarding this application are true and accurate to,.tfie,best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance wit jp ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME R Peter Checkoway 1 LICENSE # 13417 S NATURE MP ,,�,j MGF JP JGF LPGI CORPORATION PARTNERSHIP LLC L # COMPANY NAME: Checkoway Enterprises ADDRESS 11 Scargo Hill Rd CITY Dennis STATE MA ZIP 02638 TEL 508-385-1911 FAX 508-385-6858 CELL 508-735-9993 EMAIL checkent@ccmcast.net ‘d\O y z