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Home My WebLink AboutBLDP-22-001888 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 10/4/21 PERMIT# BLDP-22-001888 JOBSITE ADDRESS 385 WEIR RD OWNERS NAME Eileen Powers P OWNER ADDRESS 385 WEIR RD YARMOUTH PORT,MA 02675 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL ❑ PRINT CLEARLY NEW:0 RENOVATIONS,0 REPLACEMENTS.❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURFS FLOORS-+ RPM 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 El OTHER TYPE OF INDEMNITY El BONE❑ 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 at plumbing work and Installations performed under the permit issued for this application will be in compliance with an Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws, PLUMBER'S NAME Stephen Winslow LICENSEI12298 SIGNATURE MP El JP El CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME STEPHEN A WINSLOW ADDRESS 8 REARDON CIR CITY S YARMOUTH STATE MA ZIP 026641207 TEL FAX CELL EMAIL inspections@efwinslow.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE El El FEES$ PERMIT# PLAN REVIEW NOTES . , MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK =elmf —'- CITYYARMOUTH M DAT 9 PERMIT # 2Z v/VI �� - A E 9/30/21 JOBSITE ADDRESS M385 WEIR ROAD OWNER'S NAME EILEEN POWERS OWNER ADDRESS SAME TELL 5086485002 FAX Li_ TYPE OR OCCUPANCY TYPE COMMERCIAL ri EDUCATIONAL EJ RESIDENTIAL i[ PRINT x F CLEARLY NEW: RENOVATION REPLACEMENT: W PLANS SUBMITTED: YES NOC\---- : FIXTURES 7 FLOOR-0 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 A ' ' 3) DEDICATED SPECIAL WASTE SYSTEM L • 1 ii CROSS CONNECTION DEVICE : 1 :' ,r v) DEDICATED GAS/OIL/SAND SYSTEM , : I DEDICATED GREASE SYSTEM : DEDICATED GRAY WATER SYSTEM ' ----11 , inn 11 11 DEDICATED WATER RECYCLE SYSTEM i--- . ma. 1— —1 - — ,'--— DiSH%yASFIER , t - DRINKING FOUNTAINr FOOD DISPOSER ' �_ y.. .. 3 . _.. ap .. FLOOR I AREA DRAIN " I INTERCEPTOR (INTERIOR) .-. .._... . — P KITCHEN SINK , r LAVATORY L ) ROOF DRAIN i _... �- SHOWER STALL ,. Iw . 1 SERVICE / MOP SINK .= t, ..- -.�.w TOILET -� — URINAL -1 h y WASHING MACHINE CONNECTION r $ I WATER HEATER ALL TYPES 1 WATER PIPING a OTHER .:: .._ t. It 1 ` i 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 i OTHER TYPE OF INDEMNITY I I. BOND 1_ 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. _w CHECK ONE ONLY: OWNER 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 r e to the b t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in corn lia with II ertine pro' isio of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME STEPHEN WINSLOW LICENSE # 1 I 2298 SIGNATURE MP JP CORPORATION 1# 3281C PARTNERSHIPS, ,#L I LLC # COMPANY NAME E.F. WINSLOW PLUMBING & HEATING , ADDRESS 8 REARDON CIRCLE CITY I SOUTH YARMOU_T STATE Ern MA ZIP 02664 TELE L508-394-7778 FAX 508-394-8256 CELL N/A 1 EMAIL INSPECTIONS@EFWINSLOW.COM