The URL can be used to link to this page

Home My WebLink AboutBLDP-23-005317 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 3/28/23 PERMIT# BLDP-23-005317 JOBSITE ADDRESS 717 WILLOW ST OWNERS NAME PEARSON DAVID T P OWNER ADDRESS PEARSON THERESA M 3440 AUSTIN CT ALEXANDRIA,VA 22310 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:0 RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES NO 0 FIXTURES z 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 1 LAVATORY _ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER 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❑ 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 Code and Chapter 142 of the General Laws. PLUMBERS NAME Kevin Abbey LICENSE 12357 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑ COMPANY NAME ABBEY PLUMBING&HEATING ADDRESS 596 Queen Anne Road CITY (Harwich STATE MA ZIP 02645 TEL FAX 5084308462 —I CELL 5083670437 EMAIL abbeyplumbing@comcast.net 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 frfAr.-- -1' '_;;,ka 4• - _ j MA DATE r3,„).7,a3 i PERMIT# MAR 2 8C E D'ESS 7i17 W,1La,,,, r OWNER'S NAME P£A�SG n � eU ING DEOARNER N D• SS ___. TELL IFAX Y • - .- PE COMMERCIAL❑ EDUCATIONAL 0 • RESIDENTIAL 1 PRINT CLEARLY NEW:E RENOVATION: REPLACEMENT:r j PLANS SUBMITTED: YES Q NOLJ FIXTURES 7. FLOOR-, BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB [j -)I _: a� - _.....Y.-l=iC._. -ir- ir--- --__L_tom CROSS CONNECTION DEVICE -- 4) _I---1r— '1___. :L-.-_._kt__._.�L.__.__ _.-,______I_,..__ I DEDICATED SPECIAL WASTE SYSTEM �_,' Jr- ^}[� _,L M 1I_ -"-', 1r - - DEDICATED GAS/OIL/SAND SYSTEM [ 1 1 j�.. 1 t__- _-- '� -1-'.._ j(--' DEDICATED GREASE SYSTEM L —jII (- I.q I -`- DEDICATED GRAY WATER SYSTEM I '__ - II_Ji _ - DEDICATED WATER RECYCLE SYSTEM ; (L _ i -" _ "ir-- it DR Jr:- DISHWASHER J_ - I1� •�' , i � - - • -----1-- - DRINKING FOUNTAIN _ 1 FOOD DISPOSER U. ---Ir- 1 FLOOR/AREA DRAIN � " INTERCEPTOR(INTERIOR) =. r j ')__ ._ 1 KITCHEN SINK _ LAVATORY I �. G is I ROOF DRAIN I L L._..�_ C -._ - !. SHOWER STALL ri__ __ I-- 1 1_ .__ i'1- �L_ _ L�JL_ . a is SERVICE/MOP SINKI TOILET -11r- 1-=-1---4 URINAL i ,i { _ I _.jL .-__l[...-- - ^ WASHING MACHINE CONNECTION _,,tl - — -� ► WATER HEATER ALL TYPES L.-__T_ ;1 _ j' __i! . ! -_ _._1 ..____r_1L WATER PIPING - --7 -- -:--I' -_ '- ' .__ E--_ _ i..--_ OTHER IE -_ L - it -77-- Ir- ! r- ---- ----- ---- -------- ______ Ir- INSURANCE COVERA E: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 12/NO [Ti IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Er OTHER TYPE OF INDEMNITY 0 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 r AGENT 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 corn ' e with.ali P provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. . PLUMBER'S NAME Yti A1-% A eatkci I LICENSE# Ia35 7 SIGNATURE MP1" JP❑ CORPORATION0# PARTNERSHIP#I 1LLCD# COMPANY NAME rhfatZse e Ft ADDRESS S?6 a nj RC/ , CITY TIC GF} STATE i'hM ZIP TEL TEL SOe,-3G7, 6ti37 FAX CELL EMAIL /%6RFY94.v i3ihc...QCDMCAr3T•/VC 1 R1r; „'7i5.Fr,- r j : i RI_... ., ._,,;..,ter 1s j,.... .'f'4r `4 j EST 8 RA"1