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HomeMy WebLinkAboutBLDP&G-22-006279 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK �, CITY YARMOUTH MA DATE 5/2/22 UlPERMIT# BLDP-22-006279 JOBSITE ADDRESS 14 CARTER RD J OWNER'S NAME BECKER PAUL V TRS P OWNER ADDRESS BECKER MARY C 341 LAKESHORE DR MARSTONS MILLS,MA 02648 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL 0 RESIDENTIAL III PRINT CLEARLY NEW: 0 RENOVATION:0 REPLACEMENT:m 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/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 0 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 Mark Moran LICENSE 20786 SIGNATURE MP 0 JP © CORPORATION ❑# PARTNERSHIP 0# LLC ❑# COMPANY NAME MARK R MORAN ADDRESS 16 BRAMBLE BUSH DR CITY FORESTDALE STATE MA ZIP 026441017 TEL FAX CELL EMAIL moranpandh@gmail.com ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVE AS THE rtmnsmer FEES$ PERMIT# PLAN REVIEW NOTES . . MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 1:11 -cra71 CITY YARMOUTH I MA DATE 4/19/22 PERMIT# 22- VZ-1 "1 JOBSITE ADDRESS '14 CARTER RD OWNER'S NAME PAUL BECKER 1 POWNER ADDRESS 14 CARTER RD 1 TEL 508-280-4594 `:,FAX TYPE OR OCCUPANCY TYPE COMMERCIAL j EDUCATIONAL ! RESIDENTIAL PRINT CLEARLY NEW: 1 RENOVATION: ; REPLACEMENT: !,_! PLANS SUBMITTED: YES I NO,+j FIXTURES 1 FLOOR-, BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB �__. �____ . . _... 1 ' - IMMINIUMINII CROSS CONNECTION DEVICE allNialiONINUMMin OM DEDICATED SPECIAL WASTE SYSTEM r-- " r I--- ' DEDICATED GAS/OIUSAND SYSTEM ! r- DEDICATED GREASE SYSTEM ` DEDICATED GRAY WATER SYSTEM i M DEDICATED WATER RECYCLE SYSTEM f r- 1 DISHWASHER mum FOUNTAIN r 1 _ FOOD DISPOSER 1 FLOOR/AREA DRAIN -- -- - - INTERCEPTOR INTERIOR r KITCHEN SINK ` -__.- _ ___ � _..._____ _ - ___..- OM_ LAVATORY ROOF DRAIN --� .. ..- . _ . - -- 111111 MIN MIIIIIIIIIIII all SHOWER STALL I ' ' -' M ( 11.111.11110111M11.1.111_ _MI SERVICE/MOP SINK MI TOILET � _ .- _ _ _ _ MINO IIII URINAL ION ___- __ --__ -. T_ ___- _-__ _ _ M WASHING MACHINE CONNECTION r O-11111M WATER HEATER ALL TYPES MN WATER PIPING r _.._..._ .. .__ analiMMISMIME OM OTHER - --- - . ' t IIINIMMIIIIMMOMMINIMMUIIMMINIMINEMMINI I 1- 1111111IIMMIIMINWINIMMIN INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO j IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY.I L 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. 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 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 compli. ,e with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME MARK MORAN LICENSE# 20786 IG R MP JP v; CORPORATION 1# (PARTNERSHIP # LLC `# j COMPANY NAME MORAN PLUMBING&HEATING 1 ADDRESS 16 BRAMBLEBUSH DRIVE CITY FORESTDALE !STATE MA I ZIP 02644 TEL 508-648-2934 FAX I CELL 508-648-2934 ;EMAIL MORANPANDHca GMAIL.COM i ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK `al c, CITY YARMOUTH MA DATE May 02,2022 PERMIT# BLDP-22-006279 - ll JOBSITE ADDRESS 14 CARTER RD OWNER'S NAME BECKER PAUL V TRS G OWNER ADDRESS BECKER MARY C 341 LAKESHORE DR MARSTONS MILLS MA 02648 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL III PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:© PLANS SUBMITTED: YES ❑ NO 0 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 OVEN _ 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❑ 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-GASFITTER NAME Mark Moran LICENSE# 20786 SIGNATURE MP❑ MGF ❑ JP© JGF❑ LPGI ❑ CORPORATION❑# PARTNERSHIP ❑# Lc ❑# COMPANY NAME: MARK R MORAN ADDRESS. 16 BRAMBLE BUSH DR, CITY FORESTDALE STATE MA ZIP 026441017 TEL FAX CELL EMAIL moranpandh(a gmail.com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE:$ PERMIT# PLAN REVIEW NOTES MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK pis st j=yL CITY YARMOUTH MA DATE 4/19/22 PERMIT# ZT ( 1 JOBSITE ADDRESS 14 CARTER RD OWNER'S NAME PAUL BECKER GOWNER ADDRESS 14 CARTER RD TEL 508-280-4594 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES 1 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 OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER t OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES ' NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE 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. 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 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-GASFITTER NAME MARK MORAN LICENSE# 20786 SIGNATURE MP MGF JP JGF LPG' CORPORATION # PARTNERSHIP # LLC # COMPANY NAME: MORAN PLUMBING&HEATING ADDRESS 16 BRAMBLEBUSH DRIVE CITY FORESTDALE STATE MA ZIP 02644 TEL 508-648-2934 FAX CELL 508-648-2934 EMAIL MORANPANDH@GMAIL.COM ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ 0 FEE: $ PERMIT# PLAN REVIEW NOTES