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Home My WebLink AboutBLDP&G-23-001900 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK >+ - CITY YARMOUTH MA DATE 10111/22 PERMIT# BLDP-23-001900 JOBSITE ADDRESS 45 GENERAL LAWRENCE RD OWNER'S NAME FAGREY SANDRA M P OWNER ADDRESS 66 MONTVIEW ST WEST ROXBURY,MA 02132-2532 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 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❑ OTHER TYPE OF INDEMNITY Cl 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 1 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 19681 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# 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 El FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PE MIT 0 PERFORM PLUMBING WORK I arham . G1 0. 044 MA DATE M Z/? PERMIT# Z 3 I c . ;:,.,1 T 1) " �� '€:�QITE [MESS /1�WNER'S NAME / / T Bt.-J.-TING ING DE;R F DRESS EL 77 "7 (OOFAX • - • •— - TYPE COMMERCIAL❑ ED CATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT: PLANS SUBMITTED: YES ❑ NOK FIXTURES 1 FLOOR-4 BSM 1 2 3 l 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE r DEDICATED SPECIAL WASTE SYSTEM ' DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM ------ DEDICATED WATER RECYCLE SYSTEM DISHWASHER • DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP S NK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES ' WATER PIPING / 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 TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POUCY ❑ 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 1 Massachusetts General Laws, and that my signature on this permit application waives this requirement. \-__ CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT VI 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 Stale Plumbing ode and Chapter 142 of the neral Laws. / &d / r PLUMBER'S NAME fV1 et Mogo LICEN E# SIGNATURE MP❑ JP 3.1 n` C RPORATI N ❑# PARTNERSHIP❑.# c4 ❑# COMPA Y AME /I C8 1 t ]� ADDRESS 3 / / / CITY � ^ n < /1'� �, ) 41 5 STATE /N/ ZIP a Z o7Ves TEL 77 ( n a /ZZ FAX CELL EMAIL 4,g/-• /''] /7!66 Altt.5 I1•Cds, 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 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK Ft CITY YARMOUTH I MA DATE October 11,2022 PERMIT# BLDP-23-001900 JOBSITE ADDRESS 45 GENERAL LAWRENCE RD OWNER'S NAME FAGREY SANDRA M G OWNER ADDRESS 66 MONTVIEW ST WEST ROKBURY MA 02132-2532 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL RESIDENTIAL El 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 Michael Mcbride LICENSE# 19681 SIGNATURE MP❑ MGF 0 JP❑ JGF❑ LPG' ❑ CORPORATION❑ # PARTNERSHIP 0# LLC ❑# COMPANY NAME: EICHAEL R MCBRIDE ADDRESS. 9 Rustic Drive, CITY West Yarmouth STATE MA ZIP 02673 TEL FAX ]CELL EMAIL stinger.mcbride(a,gmail.com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES _S= 44 SACHUSETTS UNIFORM APPLICATION FORA PER ET T PERFORM GAS FITTING VVORK r ._ r z ITY q tvit D ei/3_ :�,-;.5• HA DATE PERMIT it- .Z 3 r UV JiITE ADDRESS B IL�INf3(�EPA TrrPr�T OWNER'S NAME �{/)"e,r I 'ir . DDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL OMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL[Z. CLEARLY NEW:❑ RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES❑ NO %! APPLIANCES T FLOORS-4 BSM 1 2 3 1 5 R 7 0, BOILER 9 to 11 12 13 �,, BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FP,I'C)LATOR �— FURNACE GENERATOR ______ GRILLE — 1--- INFRARED HEATER — -- LABORATORY COCKS MAKEUP AIR UNIT OVEN I POOL HEATER ROOM I SPACE HEATER 1 1 ROOF TOP UNIT -- r TEST i ' UNIT HEATER UNVENTED ROOM HEATER — - _ WATER HEATER I _ OTHER INSURANCE COVERAGE I have a current liabili 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. .t SIGNATURE OF OWNER OP,AGENTCHECK ONE ONLY: OWNER ❑ 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 4`— 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 J Massachusetts State Plumbing Code an Chapter 142 of the Gener aws. /I ovPLUMBER-GASFITTER TER NAME Al I let. � A/'{ LICLIJSE Jr � ��`` SIGNATURE MP ❑ MGF ❑ JP [ ' JGF ❑fp, CORPORATION ❑itPARTNERSHIP❑it LLC❑ COMPANY AME (k1 13 rf i7� �I ADDRESS 3 4 4, , 74 f CITY e��l z1/ STATE 14a ZIP d Tip d / 7 Q FAY. CELL TEL r� E/ �� EMAIL Al, I�OUG GAS aSPECT S THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes N9 • THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ • FEE: $ PERMIT ft PLAN REVIEW NOTES • • • • • •