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Home My WebLink AboutBLDP-21-006796 #147 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK • r CITY YARMOUTH MA DATE 5/24/21 PERMIT# BLDP-21-006796 e, a i= .fir JOBSITE ADDRESS 579 BUCK ISLAND RD OWNERS 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:0 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 El 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 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 S639 SIGNATURE MP ❑ JP 0 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# I COMPANY NAME IRALPH J GIANGREGORIO ADDRESS 188 Route 28 CITY Dennis Port STATE MA ZIP 02639 TEL I FAX CELL I EMAIL office@3gsplumbing.net •c ' 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• � 1nT in` r ► MASSACHUSETTSr UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK K �_ LDp-2r- ovb'1gG -_- (- CITY jL/�S`r�]'t/� .t� MA DATE .S= r� � PERMIT# d JOBS1TE ADDRESS 57' 6)T j4, sIct fliNNER'S NAME lU✓inl'1 kockkc pOWNER ADDRESS .C7 q ,(L.a,5(Cvi(', I/d TEL, 740 0-900 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL 0 RESIDENTIAL 0 PRINT CLEARLY NEW:0 RENOVATION:0 REPLACEMENT:❑ PLANS SUBMITTED: YES 0 NO❑ FIXTURES 1 FLOOR-4 83M 1 2 3 4 5 8 7 8 9 10 11 ` 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM • DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM f , DEDICATED WATER RECYCLE SYSTEM J DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN _ INTERCEPTOR(INTERIOR) F - KITCHEN SINK LAVATORY ROOF DRAIN • SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current jlablity Insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES tj NO 0 IF YOU CHECKED YES,PLEASE INDICATE 115VPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND 0 OWNER'S INSURANCE WAIVER:tam 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 0 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 beet of my knowledge and that all plumbing work and Installations performed under the permit Issued for this appttcallonwbf be In with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 piths General Laws. '` PLUMBER'S NAME .k(k�'�";u) `1 �'- LICENSE# 33Q - � E z w MPII JP 0 CORPORATION I# o C_ PARTNERSHIP❑# LLC❑# .. COMPANY NAME-.7a c Pit ;rib _, s,ric + 14Q.c.: 1t ADDRESS ) Fx i cfi t CITY ��'�n►S Pod f STATE*1 I�cc ifr ZIP }c ra.3 Cl TEL FAX,=0 1-1 fO 4.c-1 CELL EMAIL 0 i C.P 3r �r<33v,(nj r ,6112•1-