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HomeMy WebLinkAboutBLDP-21-004460 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ez CITY YARMOUTH MA DATE 2/5/21 PERMIT# BLDP-21-004460 I �f JOBSITE ADDRESS 222 BUCK ISLAND RD UNIT 57 OWNER'S NAME CALABRESE DONALD L TRS P OWNER ADDRESS CALABRESE CHARLOTTE G 222 BUCK ISLAND ROAD UNIT 5-7 WEST TEL YARMOUTH,MA 02673 TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL El PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES NO❑ FIXTURES z 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/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 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❑ 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 El 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 Virgilio Silva LICENSE 3/1395 SIGNATURE MP ❑ JP © CORPORATION D# PARTNERSHIP El# LLC El# COMPANY NAME VIRGILIO SILVA ADDRESS 155 SUDBURY LN CITY HYANNIS STATE MA ZIP 026012462 TEL FAX CELL EMAIL virgiliomga@hotmail.com r. ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES ti Yes No THIS APPLICATION SERVE AS THE PERMIT Ei ❑ FEES; PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK w:,ly CITY Yarmouth MA DATE 01/28/2021 PERMIT# "2 • i /4) JOBSITE ADDRESS 222 Buck Island Rd. �N i} S_'} OWNER'S NAME Greg Letoumeau OWNER ADDRESS 222 Buck Island Rd. l) S: 7 TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL U EDUCATIONAL U RESIDENTIAL PRINT CLEARLY NEW: ® RENOVATION:U REPLACEMENT: PLANS SUBMITTED: YES D NO0 FIXTURES 1 FLOOR GSM 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 _ _ __ _ _.a DEDICATED WATER RECYCLE SYSTEM , DISHWASHER TM. . - � . .. _ DRINKING FOUNTAIN . - � ((� __ FOOD DISPOSER FLOOR/AREA 111111111.1111111111111111111111111111111/111111111111111111111111111111111111111111111111111 INTERCEPTOR(INTERIOR) -I _RIRRRRR�� 'I. _ 111L.. LAVATORY ROOF DRAIN Ii Iiieii - - ``11111 SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION _ WATER HEATER ALL TYPES WATER PIPING OTHER (... _ I 1111111=i11111111111111111111 ! INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL is drt2 7 AYES 61, NO U IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY) OTHER TYPE OF INDEMNITY El BOND U 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 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 . nowledge and that all plumbing work and installations performed under the permit issued for this application will be i i , , .nce with all Pertinent provision the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME I Vrgilio Silva LICENSE# 31395- - • URE MP 0 JP EJ CORPORATION Q# PARTNERSHIP:3# LLC Ei# COMPANY NAME Silva Plumbing&Heating ADDRESS 155 Sudbury Lane CITY Hyannis STATE MA Zip 02601 TEL FAX 1 CELL 774-836-0176 EMAIL virgiliomga@hotmail.com