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Home My WebLink AboutBLDP-22-003318 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 12/10/21jv PERMIT# BLDP-22-003318 t JOBSITE ADDRESS 4 COLLINGWOOD DR OWNER'S NAME OHARA JAMES F P OWNER ADDRESS OHARA MARIBETH F 4 COLLINGWOOD DR YARMOUTH PORT,MA 02675-1509 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION',E REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES -i FLOORS—. RPM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE 1 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 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❑ BOND❑ OWNER'S INSURANCE WAIVER:I urn 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 R Peter Checkoway LICENSE118417 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME R PETER CHECKOWAY ADDRESS 11 SCARGO HILL RD CITY DENNIS STATE LA ZIP 026382306 TEL FAX CELL EMAIL checkent@comcast.net ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes \o THIS APPLICATION SERVE AS THE 111 El FEES$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 1u�� CITY YARMOUTHPORT MA DATE 12/7/2021 1 PERMIT # .,�' 1 r` r f JOBSITE ADDRESS ' 4 COLLINGWOOD DR, YPT OWNER'S NAME SEAMUS O'HARA POWNER ADDRESS SAME TEL 774-836-0776 FAX 1 TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: / RENOVATION: L,.. REPLACEMENT: PLANS SUBMITTED: YES , NO] i 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 _r DEDICATED GASiOIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM . 1-_ DEDICATED WATER RECYCLE SYSTEM it_ !I DISHWASHER _ DRINKING FOUNTAIN - '___ FOOD DISPOSER _ FLOOR / AREA DRAIN € & — — INTERCEPTOR (INTERIOR) KITCHEN SINK !.- j LAVATORY - -- � A ROOF DRAIN --. ,F '� - SHOWER STALL SERVICE / MOP SINK � - L TOILET - . .. --- -- -- URINAL i 1_ WASHING MACHINE CONNECTION _ WATER HEATER ALL TYPES _ _ WATER PIPING - -y L.� � OTHER L''a'' i .-. ' INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 0 NO LI IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY i 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. 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 and accurate to e best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with a P ictrit provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. / PLUMBER'S NAME I.R Peter Checkoway _- I LICENSE # L13417 SI TURE MP i JP ] CORPORATION®#L _1PARTNERSHIPE# LLCO# r COMPANY NAME Checkoway Enterprises ADDRESS 11 Scargo Hill Rd CITY Dennis STATE I MA I ZIP 026�38 TEL 508-385-1911 I FAX 508v385-6858 CELL 508-735-9993 EMAIL checkent@comcast.net _ . __ J as