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Home My WebLink AboutBLDP-21-005555 #255 .- rj MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK c` CITY YARMOUTH MA DATE 3/25/21 PERMIT# BLDP-21-005555 I I `V JOBSITE ADDRESS 579 BUCK ISLAND RD OWNER'S NAME TURINO ASSOCIATES LLC P OWNER ADDRESS 2000 COMMONWEALTH AVE AUBURNDALE,MA 02466 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL m RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES 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 LAVATORY ROOF DRAIN SHOWER STALL 1 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❑ 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 Ralph Giangregorio LICENSE SB39 SIGNATURE MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME RALPH J GIANGREGORIO ADDRESS 188 Route 28 CITY Dennis Port STATE MA ZIP 02639 TEL • FAX CELL EMAIL office@3gsplumbing.net r—� ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE PERMIT ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES A P t KciEt..-: �, MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK hi fir } . _ CITY �t MA DATE 3-(6-?1 PERMIT at a o SC JOBSITEADDRESS .S1 JC(�.Ssl� ^ OWNER'S NAME ..j r ,r Ar) 0-5.Sod Ode 2 p OWNER ADDRESS .S 79 dud _IsLvdt2 TEL SO -76/06r9O0 PAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL 0 RESIDENTIAL 0 PRINT • CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO 0 FIXTURES FLOOR-4 BM 1 2 3 4 5 8 7 8 9 10 11 ' 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM L DEDICATED GREASE SYSTEM DEDICATED GRAY WATERS STEM 4_ DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL J - SERVICE/MOP SINK TOILET URINAL • WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING - OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YESO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE PE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW UASIUTY INSURANCE POLICY 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 0 AGENT ❑ SIGNATURE OF OWNER OR AGENT i hereby certify that all of details and Information I have submitted or entered evening!hie application are true and accurate to the best of my knowledge and that ail plumbing work and installations performed under the permit issued for this appttc allonvrlfi be In nce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. wry` PLUMBER'S NAME ga,krk ,• „_>u r�. SIGMA R E"}an l -,n , ) LICENSE# of 13c/ MPS JP CJ CORPORATION®# t3 C PARTNERSHIP 0# LLC❑# COMPANY NAME:�[:S PiL,;r, ?t ;}- P,eG... l/t ADDRESS 15c c 1V Ill CITY PAIN S 'o r-'1" STATE/at ZIP C'9.t�,3 TEL FAX, 4 �agLc-1 CELL EMAIL OTVj!?reD 3r6Sph s,4rn/rt.8 ,al�L�