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Home My WebLink AboutBLDP&G-22-002072 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK :_ CITY YARMOUTH MA DATE 10/12/21 PERMIT# BLDP-22-002072 JOBSITE ADDRESS 48 IR0QU0IS BLVD OWNER'S NAME MARTELL JOAN A(LIFE EST) P OWNER ADDRESS 48 IR0QU0IS BLVD WEST YARM0UTH,MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL RESIDENTIAL ❑ PRINT CLEARLY NEW❑ RENOVATION:❑ REPLACEMENT',❑ PLANS SUBMITTED: YES❑ NO ID FIXTURFS FLOORS—r RSM 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 INSJRANCE POLICY❑ OTHER TYPE OF INDEMNITY❑ BOND 0 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 Richard Whiteside 1 LICENSE 16850 SIGNATURE MP ❑ JP ❑ CORPORATION OH PARTNERSHIP ❑# LLC ❑# COMPANY NAME Murphy Services,Inc. ADDRESS 34 white's Path CITY South Yarmouth STATE MA ZIP 02664 TEL 5087601660 FAX I I CELL EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK L. y CITY YARMOUTH MA DATE October 12, 2021 PERMIT# BLDP-22-002072 T-•_ti. JOBSITE ADDRESS 48 IROQUOIS BLVD OWNER'S NAME MARTELL JOAN A (LIFE EST) G OWNER ADDRESS 48 IROQUOIS BLVD WEST YARMOUTH MA 02673 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL El PRINT CLEARLY NEVV: ❑ RENOVATION:❑ REPLACEMENT: © PLANS SUBMITTED: YES ❑ NO 0 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 irsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES El NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER OF INDEMNITY El BOND ❑ OWNER'S INSURANCE \NAIVER: 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 plurnbing work and installations performed under the perm t 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 Richard Whiteside LICENSE # 15850 SIGNATURE MP 0 MGF ❑ JP ❑ JGF ❑ LPG] ❑ CORPORATION [] # PARTNERSHIP ❑ # Lc ❑ # COMPANY NAME: Elurphy Services. Inc. ADDRESS. 34 white's Path, CITY South Yarmouth STATE MA ZIP 02664 TEL 5087601660 FAX ] CELL EMAIL S310N M31A321 NVId #111A1213d $ 33d ❑ ❑ 11WH3d 3H1 SV SAS NOIJVOIlddV SIH1 oN saA S310N N01133dSNI 1VNId AlN0 3Sfl H0133dSNI H0d 30Vd SIH1 S310N N011aadSNI SVO HOf10H