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Home My WebLink AboutBLDP-22-000629 #160 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ,I CITY YARMOUTH MA DATE 8/4/21 PERMIT# BLDP-22-000629 mr,I ' � JOBSITE ADDRESS 579 BUCK ISLAND RD 1(.0 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❑ FIXTURFS • 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 0 NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY❑ OTHER TYPE OF INDEMNITY 0 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 Ralph Giangregorio LICENSE 9339 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 ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE ❑ ❑ FEES$ PERMIT# PLAN REVIEW NOTES • ..s MASSACHU SETTSt UNIFORM APPLICeIlLOR A PERMIT TO PERFORM PLUMBING WORK CITY tj4P91- y pi � MA DATE ��?q- I/ PERMIT# Z2- 0-9 JOBSITE ADDRESS Sri 6t 1CJ5/cocC 4t1 b0 OWNERS NAME TOrlk l ss 17 S p OWNER ADDRESS 3 j hl rrra 'a Ci r tote31° - S?> lGo pa FAx TYPE OR OCCUPANCY TYPE COMMERCIAL[ EDUCATIONAL 0 RESIDENTIAL❑ PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:❑ PLANS SUBMITTED: YES 0 NO❑ FIXTURES"I FLOOR asks 1 2 3 4 5 e 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED E, DEDICATE)WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOT:DRAIN • SHOWER STALL 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. YES 1E60 0 IF YOU CHECKED YES,PLEASE INDICATE THE E OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 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. CHECK ONE ONLY: OWNER 0 AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the deists and information I have au or entered regarding this application am true and accurate to the beat of my knowledge and that all plumbing work and insStiattons performed under the permit issued for this appllcalionwAl be In wnh ail Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 4PLUMBER'S NAME ��G Cj','✓l `3 r- LICENSE# at,3q 4 E MPit JP 0 CORPORATION 21#' 'v C PARTNERSHIP 0# I. LLC❑# COMPANY NAME l c Psi j:".104 i -,} 1-iecd- i ADDRESS 1(1S x 11/�A i h c- CITY ,,.in►S ro rt STATE VA. ZIP 0 0,3 G TEL FAX , L l:)4.c'-( CELL EMAIL 0 i