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Commonwealth of Massachusetts Division of Occupational Licensure Board of State Board of Examiners of Plumbers and Gas Fitters 1 Federal Street Boston Massachusetts 02110-2012 VARIANCE FROM STATE PLUMBING CODE PRE-INSTALLATION $86.00 application fee payable to Commonwealth of Massachusetts DO NOT USE THIS APPLICATION IF PLUMBING WORK HAS BEEN COMPLETED PLEASE PRINT CLEARLY (Section1) APPLICANT INFORMATION: Applicant Name: Firm Name (if applicable): Title or Position with.

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How to fill out the PRE-INSTALLATION online

Filling out the PRE-INSTALLATION form is an essential step in obtaining a variance from the state plumbing code in Massachusetts. This guide provides clear instructions on how to complete each section of the form efficiently and accurately.

Follow the steps to successfully complete your PRE-INSTALLATION form.

  1. Click 'Get Form' button to obtain the form and open it in the editor for completion.
  2. In Section 1, enter your applicant information. Provide your name, firm name (if applicable), title or position with the firm, and today's date. Next, indicate the type of work you are requesting a variance for, either 'New Construction' or 'Renovation.' Fill in your street address, cell phone number, city or town, work phone number, state, zip code, and email address.
  3. Initial all required items listed in Section 1. Ensure that you have documented that the local Board of Health has been petitioned regarding your variance request, if applicable. Also, confirm that you have included all necessary supporting documentation and a non-refundable check for $86.00, unless the property is owned, used, or leased by the State of Massachusetts.
  4. Provide the necessary details regarding the unusual or extraordinary circumstance or hardship in Section 5. This explanation should justify why the variance is needed.
  5. In Section 2, if the property owner is different from the applicant, fill in the owner's information, including their name, firm name (if applicable), address, cell phone and work phone numbers, city or town, state, zip code, and email.
  6. In Section 3, provide the location details of the variance. Include the name of the proposed or current occupier, as well as the street address, city or town, and zip code.
  7. In Section 4, list any relevant plumbing inspector details and any plumbing code sections pertinent to your variance request.
  8. In Section 5, clearly detail the established hardship that justifies the variance request.
  9. Review the certification statement and check the box to indicate your agreement, ensuring that all information provided is accurate. Sign and date the application.
  10. Once you have completed the form, save your changes, and you may choose to download, print, or share the form as needed.

Complete your PRE-INSTALLATION form online today to successfully submit your variance request.

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