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Home My WebLink AboutBLDP-23-003289 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY YARMOUTH MA DATE 12/13/22 PERMIT# BLDP-23-003289 • tl JOBSITE ADDRESS 166 SEAVIEW AVE UNIT 1 OWNERS NAME LATOURNEAU CRAIG A P OWNER ADDRESS LATOURNEAU COLLEEN R 545 LAMPBLACK RD GREENFIELD,MA 01301 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL ❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES El NO❑ FIXTURES FLOORS RSM 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 El NO El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El 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. SIGNATURE OF OWNER OR AGENT I hereby certify that all of the derails 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 rcheckoway LICENSE 18417 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME CHECKOWAY ENTERPRISES ADDRESS 11 scargo hill rd 11 SCARGO HILL RD CITY DENNIS STATE MA ZIP 02638 TEL 5083851911 FAX CELL EMAIL checkent@comcast.net 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 PLUMBING WORK �� PERMIT # Z3 -- _ CITY [ 5 > jZ. io 1 MA DATE (� ) ? 1j-3— JOBSITE ADDRESS (C416 S�Av ttw f ti/ 4- 1 E OWNER'S NAME![ ►1G ZEI-44..) Nfe v POWNER ADDRESS .SAS ' TELi FAX TYPE OR OCCUPANCY TYPE COMMERCIAL Di EDUCATIONAL f l RESIDENTIAL PRINT CLEARLY NEW: Li RENOVATION: [' REPLACEMENT: PLANS SUBMITTED: YES NO❑ FIXTURES Z FLOOR—► BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB ---,; , -1r---- 1 -- i - i CROSS CONNECTION DEVICE ," DEDICATED SPECIAL WASTE SYSTEM _ ICI _ - -a�� Il ! DEDICATED GAS/OIL/SAND SYSTEM 1 _ }� MEM1 I h � DEDICATED GREASE SYSTEM �� ( — �I. � DEDICATED GRAY WATER SYSTEM �1 _ MIMI HE l� � M - = �.i, _ .Lir 1 -.�.-- I DEDICATED WATER RECYCLE SYSTEM � DISHWASHER -I - _ 1 _ _ IMI DRINKING FOUNTAIN �; _MINI M MMII '_1 i ,L FOOD DISPOSER .r M!_ ! !!�1 FLOOR / AREA DRAIN (— mum _- m� INTERCEPTOR (INTERIOR) MEW- M IMI KITCHEN SINK . _ LAVATORYI la = EEE" ROOF DRAIN n TillJ _ Eril II SHOWER STALL NEM _ ��I( I SERVICE / MOP SINK M, -1 M Mili TOILET i 1111 - NCR mem ':, 'I 11 mm,____ URINAL WASHING MACHINE CONNECTION — 1111111 ;j WATER HEATER ALL TYPES ;� ,_ !II! am ,WATER PIPING - , OTHERL. II.. IimintimiMMiiiiimi j I I 1 I I " - 11 I' d Mill 1 - i I. l I I _ C - � - i I- I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 1 NO s IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Hi OTHER TYPE OF INDEMNITY - I BOND L_ 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 ! Ai 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 be o y knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinen ore ision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ri PLUMBER'S NAME , R Peter Checkoway _ LICENSE # [13417 SIGN y • E c MP[Q JP _ CORPORATION n# PARTNERSHIP; #1 LLCD# COMPANY NAME Checkoway Enterprises ADDRESS 11 Scargo Hill Road CITY Dennis STATE MA ZIP 02638 TEL 508-385-1911 FAX 1 508-385-6858 I CELL 508-735-9993 ' EMAIL checkent@comcast.net