HomeMy WebLinkAboutBLDP-21-003751 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY YARMOUTH MA DATE 1/6/21 PERMIT# BLDP-21-003751
11,
. JOBSITE ADDRESS 248 CAMP ST UNIT N2 OWNER'S NAME BASILI BRIAN A
P OWNER ADDRESS BASILI SUSAN M 968 MAIN ST YARMOUTH PORT,MA 02675-2125 TEL
TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ RESIDENTIAL El
PRINT
CLEARLY NEW: 0 RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑
FIXTURES .1 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
SERVICE/MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION
WATER HEATER
WATER PIPING 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❑ 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 James Wahtola LICENSE 1B800 SIGNATURE
MP ❑ JP ❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑#
COMPANY NAME WAHTOLA PLUMBING AND ADDRESS 24 Plant St
HEATING
CITY Hyannis STATE Ma ZIP 02601 TEL
FAX CELL 5082945273 EMAIL office@wahtola.com
J �
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
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
_:sells
`-;411t y CITY Yarmouthport I MA DATE 12/29/2020 I PERMIT# etL12 J) �
l
JOBSITE ADDRESS Foxwood II Condo,248 Camp Street,N2 OWNER'S NAME Sue Basili 1
POWNER ADDRESS 968 Main St.Yarmouthport,MA 02675 TEL 508-362-3723 IFAX
TYPE OR OCCUPANCY TYPE COMMERCIAL LI EDUCATIONAL 0 RESIDENTIAL 0
PRINT
CLEARLY NEW:Q RENOVATION:D REPLACEMENT:0 PLANS SUBMITTED: YES 0 NOD
FIXTURES 7 FLOOR-. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB j '1 i-.." I TM,.AY' ,. aCC ,. io ' I1 i IV „.,1
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GASIOIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM I 1 1
DISHWASHER
DRINKING FOUNTAIN i i
FOOD DISPOSER
FLOOR I AREA DRAIN
INTERCEPTOR(INTERIOR) 1 l
KITCHEN SINK
LAVATORY
ROOF DRAIN _. . _- - l -
NM NW NW all NW MN NM NM NNINIS NM MN
SHOWER STALL 1I _. I I
� .ram 1 1v4IJIl
If
iiirmee
WASHING MACHINE CONNECTION ( IIIIIIVIIIIIIIIIIIIIIIIIF11111111i ; •M, .I , ;.
WATER HEATER ALL TYPES
WATER PIPING , _ k
I '11111141111.111111111111111111111111111111111111111111111111 itlIFWINNI i
11111111110111111111111111111111111111111111111111111111111111.1111111.ii not mall
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO Ej
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY Q 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 El AGENT Q
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this application are e 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 c. .11 ce th all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME James Wahtola LICENSE# 16800 I SIGNATURE
MP JP D CORPORATION®# PARTNERSHIP Q# LLC®#
COMPANY NAME Wahtola Plumbing and Heating I ADDRESS 24 Plant road unit 7
CITY Hyannis I STATE MA I ZIP 02601 ! TEL 508-778-6868
FAX 508-862-2129 I CELL 508-294-5273 I EMAIL office@wahtola.com OS/ > I