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HomeMy WebLinkAboutBLDP&G-23-04488 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK w, CITY YARMOUTH MA DATE 2/13/23 PERMIT# BLDP-23-004488 yy ' JOBSITE ADDRESS 72 DEBS HILL RD UNIT 46A OWNERS NAME HAMILTON DOROTHY J TR �drt:'st`9� D OWNER ADDRESS DOROTHY J HAMILTON TRUST 40 EISENHOWER RD FRAMINGHAM,MA 01701 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL 0 PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES .i FLOORS-4 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/OIUSAND 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 1 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 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 at Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBERS NAME r checkoway LICENS418417 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 C E I USETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK "� 0 TH ORT MA DATE 1.2/8/23 PERMIT# ec.bp-2.3-cv4k4E--- JOBSITEAD S 72 DEBS HILL RD,YPT I✓V OWNER'S NAME[DOT HAMILTON j nING DEPARTMENT ill OWNER ADDRESS 58 EISENHOWER RD,FRAMINGHAM TEL 508-561-2249 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL I I EDUCATIONAL Li RESIDENTIAL !I PRINT CLEARLY NEW: fl RENOVATION: _ REPLACEMENT:L'1 PLANS SUBMITTED: YES ilj NOL FIXTURES Z FLOOR-, BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB �_. CROSS CONNECTION DEVICE T DEDICATED SPECIAL WASTE SYSTEM 1 I I I r „ t. lilt DEDICATED GAS/OIL/SAND SYSTEM Ali _, i 1 DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM j , DISHWASHER _ _.a-�___ _ _ DRINKING FOUNTAIN 'i 1� _ � � FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) ij. I____ _ ,, i1jl, KITCHEN SINK - LAVATORY i 1� _ _ _- ROOF DRAIN SHOWER STALL SERVICE/MOP SINK I 1 L I I , I_ . ... .. .. .. TOILET URINAL i WASHING MACHINE CONNECTION WATER HEATER ALL TYPES 1 y Y i WATER PIPING___._______-_- _ I I 1 _ _ _I OTHER 1 ma T-. L I I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES I 'I 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 J BOND Li 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 Li AGENT Li 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 • best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with •1 •-. ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME[R Peter Checkoway -LICENSE#[13417 ' NATURE — MP I'1 JP El CORPORATION I I#I "PARTNERSHIP'_ I#I LLC L I#I COMPANY NAME Checkoway Enterprises ADDRESS 11 Scargo Hill Rd CITY€Dennis STATE MA ZIP 02638 TEL F508-385-1911 FAX 508-385-6858 CELL 508-735-9993 EMAIL 1 checkent@comcastnet MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY YARMOUTH MA DATE February 13,2023 PERMIT# BLDP-23-004488 JOBSITE ADDRESS 72 DEBS HILL RD UNIT 46A OWNER'S NAME HAMILTON DOROTHY J TR G OWNER ADDRESS DOROTHY J HAMILTON TRUST 40 EISENHOWER RD FRAMINGHAM MA 01701 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL El 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 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT - POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER 1 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 0 OTHER OF INDEMNITY El 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 at Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME r checkoway LICENSE# 13417 SIGNATURE MP© MGF❑JP❑ JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑#I ILLC ❑# COMPANY NAME: ICHECKOWAY ENTERPRISES ADDRESS. 111 scarpo hill rd,11 SCARGO HILL RD CITY 'DENNIS STATE MA ZIP 02638 TEL 5083851911 FAX CELL EMAIL IcheckentOcomcast.net =• E IA 4 Pf USETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 'V 1=> GITY iify.jUTHPORT ' MA DATE 2/8/23 PERMIT# 1 .b7"Z3' ySf JOBSITE ADD ES B 72 DEBS HILL RD,YPT r�} ,f�, � .!�p...__..__. OWNER'S NAME DOT HAMILTON Zn DING DEPARTMENT O0F3ADDRESE 58 EISENHOWER RD FRAMINGHAM 1 TEL 508-561 2249 IFAX' I TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL ,i PRINT CLEARLY NEW:I- RENOVATION: M i REPLACEMENT: 'I PLANS SUBMITTED: YES. NO, I APPLIANCES 1 FLOORS BSM 1 2 3 4 5 1 6 7 8 9 10 11 12 13 14 BOILER i a BOOSTER 1 � � 1 I 1 _i e CONVERSION BURNER -,- I v - I R COOK STOVE DIRECT VENT HEATER '` 1 FIREPLACE r FRYOLATOR ---- < FURNACE - - -- r—GENERATOR GRILLE I - s INFRARED HEATER F - ,.. � ' LABORATORY COCKS MAKEUP AIR UNIT L. ' -_-- OVEN I ._ I �. a ; POOL HEATER , s ROOM/SPACE HEATER I } ROOF TOP UNIT r TEST l f I UNIT HEATER a• UNVENTED ROOM HEATER i 4 : :: -L WATER HEATER 9 � �: 11 . 3 OTHER i INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES i.'-_.'NO !. i I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ; 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 .. ,_' 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 my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pe in vision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME R Peter Checkoway LICENSE# 13417 < SIGNA U MP. MGF LLC # JP _ JGF LPGI : CORPORATIONS j# PARTNERSHIP #m�. _ •, o._ COMPANY NAME: Checkoway Enterprises I ADDRESS 11 Scar o Hill Rd CITY Dennis ' STATE MA I ZIP 02638 TEL 508-385-1911 E FAX 508-385-6858 CELL 508-735-9993 =EMAIL checkentecomcast net