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Home My WebLink AboutBLDP&G-21-005793 T- MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY':Yarmouth I MA DATE 4/5/2021 =;PERMIT# 6 e JM\:\\?\\yT\}TN\\:\\\\\\\",,,""","��M\T\�T\:)?.,�,\M\,,,,,V,,,,,,\\U\\\\\\\\U\ ,,»,,,,,,•.•.,v.•.•.,,�„vvv.,,,�,»>,�,�. JOBSITE ADDRESS :481 Buck Island Rd Unit 14-A OWNER'S NAMEMarie Suefert POWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ,..: EDUCATIONAL :::..: RESIDENTIAL ,^.: PRINT CLEARLY NEW:€::,; RENOVATION:;,,:.:: REPLACEMENT: «.:.: PLANS SUBMITTED: YES i NO FIXTURES Z FLOOR—. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB `• :_ CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM — �Yiii:`.Yu.•.,.. ,ti, e t t -,,ttt, tu..-„ •� .._. ... t c ,r _ DEDICATED GAS/OIL/SAND SYSTEM €:! ::. s r s r r tt DEDICATED GREASE SYSTEM t DEDICATED GRAY WATER SYSTEM "t :f r -._ .-. It - .:.i,t •t �r•ro:.:.`-r Y U .. .. t ,DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN .. `: f L a .:::.<i,,. ,.. ......:Y..!,.:•I. :,).^.7. .u.: FOOD DISPOSER LI d FLOOR/AREA DRAIN :: y......... INTERCEPTOR(INTERIOR) -::.:�:.�:::n...I......I.L,::I::..IfI:.M:I,f:.1111::1!•-:::1,,....II....1.1.,i 1,::.:P::::::::::.................,. .1. :::.,::::iit"3I 14d,.....,.. :::::-:::_:'::.�::�::::::"::':... ...-` KITCHEN SINK ...........` ......... <: ............ LAVATORY "' ....:::::h.1, ,t t•�trt,.r.:a .:,1 '"i{, t.::::::::...:::::::::::r,......... ......t.,.:nr.:::¢.....,y..........t............,..........................=::...._-...:..:;I ROOF DRAIN - SHOWER STALL ..... ».,.. », , . . SERVICE/MOP SINK ;€ = x \t tl, tt. (t. III „ t! ! 2! A! .I! ,L ii* _ 1 „ U, ,II tt! 11 `F - TOILET L URINAL • WASHING MACHINE CONNECTION t: {' ,,::::::::::1 )� ' '22 1 I i...ti li p:;:Iii I :4`:fi ii :7 i, i[ U. ii ! .t ..... i . .... 7.,,, : WATER HEATER ALL TYPES 1 I y WATER PIPING OTHER . ...... . ......, »» :'.li,::::II[: Y-:_:1:1:C;! -`...:1. l: :.a: . ..::::;::::..: :.:........�., ::::.,.:.,:1.: ::. :::::. -i t... -_.-... ..-. •r:..ct.c..,ct. - i..,r -4....�,....t.... ...ut - - _.. .. .. `' n. INSURANCE COVERAGE: - I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES:!..:,;:3 NO s,.,>': 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. 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 complia with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME:':Jason Drew ;:LICENSE#:j,30715 • SIGNATURE MP€:.,.. JP.,..,..J CORPORATION:': : # PARTNERSHIP # LLC # COMPANY NAME Drew's Plumbing =ADDRESS 6 AAassiz St I .........: : :::::. ......::..CITY Brewster : STATE MA ZIP 02631 TEL 508-360-1400 i FAX CELL il EMAIL drews�lumbincaeYahoo:com: ..:..�,....:........ I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 11' c� CITY YARMOUTH MA DATE April 07,2021 PERMIT# BLDP-21-005793 JOBSITE ADDRESS 481 BUCK ISLAND RD UNIT 14AA OWNERS NAME HARDAWAY EILEEN G G OWNER ADDRESS 180 FOREST AVE NEWTON MA 02456 TEL TYPE OR OCCUPANCY TYPE COMMERCIAL❑ RESIDENTIAL PRINT CLEARLY NEW: ❑ RENOVATION:❑ REPLACEMENT:El 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/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 Q NO❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY © OTHER 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-GASFITTER NAME Jason Drew LICENSE# 30715 SIGNATURE MP 0 MGF 0 JP© JGF❑ LPG' ❑ CORPORATION❑# PARTNERSHIP ❑# Lc ❑# COMPANY NAME: JASON R DREW ADDRESS. 6 AGASSIZ ST, CITY BREWSTER STATE MA ZIP 026312626 TEL FAX CELL EMAIL drewsplumbingcapet yahoo.com Y 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 rPt faEFy CITY Yarmouth MA DATE 4.5.2021 PERMIT# 4L D( -1-(--c�o'S JOBSITE ADDRESS 481 Buck Island Rd Unit 14-A OWNER'S NAME Marie Suefert GOWNER ADDRESS TEL .FAX TYPE OR OCCUPANCY TYPE COMMERCIAL::....:: EDUCATIONAL RESIDENTIAL PRINT • CLEARLY NEW: '. RENOVATION::...J. REPLACEMENT::. PLANS SUBMITTED: YES ,._ NO APPLIANCES 1 FLOORS—• BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 114 BOILER BOOSTER CONVERSION BURNER -- COOK STOVE • - DIRECT VENT HEATER DRYER I FIREPLACE • FRYOLATOR :::..... FURNACE i GENERATOR • GRILLE INFRARED HEATER .. — ` LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT ` TEST UNIT HEATER a UNVENTED ROOM HEATER .$ — WATER HEATER 1 .. OTHER ff t INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES j ^ NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY :.....4...i 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 compli ce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Jason Drew LICENSE# -30715„ ` SIGNATURE MP MGF .. ..< JP JGF :.I LPGI .....:: CORPORATION.•,,, # PARTNERSHIP . #. LLC # COMPANY NAME:Drew's plumbing ADDRESS 6 Nassiz st CITY Brewster I. STATE MA I ZIP'02631 ;TEL 508-360-1400 FAX CELL EMAIL;drewsplumbin9ca a iahoo.com .