17D-004 (3) FINAL INSPECTION SKETCHES FEE _tS�_(� NO, ---L , PROGRESS INSPECTIONS
APPLICATION FOR PERMIT TO DO PLUMBING
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NAME & TYPE 05OUILDING
LOCATION OF BUIL M G�
PLUMBER
PERMIT GRANTED
JC982 19
I
PLUMBING INSPECTOR
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THE COMMONWEALTH OF MASSACHUSETTS
P------------ ---------------------
A LICATION FOR PERMIT TO DO PLUMBING
No. - f ��•� 15-11 19
WORK MUST BE PERFORMED IN COMPLIANCE WITH AL ROVISIONS THE MASSACHUSETTS STATE
PLUMBING CODE AND CHAPTER 142 OF THE GENERAL LAWS.
FIXTURES Sl/
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8TH FLOOR
9TH FLOOR
10TH FLOOR
11TH FLOOR
12TH FLOOR
13TH FLOOR
14TH FLOOR
15TH FLOOR
16TH FLOOR
17TH FLOOR
18TH FLOOR
19TH FLOOR
20TH FLOOR
NAME AVID ADDRESS OF BL?t:)DING NAME CERTIFICATeE�NO.
CORPORATION_
.
PARTNERSHIP
FIRM OR COMPANY 10 MA1N STREET
NEW OR RENOVATION HAYDENVILLE, MA 01039
NAME OF MASTER OR JOURNEYMAN PLUMBER
NAME OF OWNER de� ��� I&�UZ'
ADDRESS OF OWNER S6L ADDRESS
PLANS SUBMITTED? YES TELEPHONE NUMBERS:
NO BUSINESS 17 ER:3 p f�f
ESTIMATED COST OF JOB RESIDENCEC96— '-3��?
1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate
to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be
in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
Signature of Licensed Plumber
7�
Designation and License Number of Plumber
FORM 1240 HOBBS & WARREN, INC., REVISED SEPT. 1973
r
y
Bay State Gas Company
ATTENTION:
Dear Sir:
This letter is to confirm that AF(f9 cubic feet per hour of
natural gas is available for use at
U
The natural gas has a specific gravity of 0.60, heating value of
1000 BTU'S per cubic foot, and the pressure in the street main
is Fri
This information is in compliance with Massachusetts State Fuel
Gas Code, and does not constitute a commitment or contract.
Sincerely,
Theodore J. Dulchinos, r.
Manager - Planning & Engineering
TJD:elf
Springfield Division
PO Box 2025
Springfield
Massachusetts 01101
413 781-9200 !9
j BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
NAME 3 TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
PERMIT GRANTED
DATE 19
GAS INSPECTOR
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
— NnY AM 9 Gt.� Mass. Date /�°�� 19
City, To 4n Permit #
Building Owner ' s
AT: Location ri? �.Sy, p" JAG Name^
Type of Occupancy:
GNewE3 Renovation ❑ Replacement [
"
Plans Submitted Yes ❑ No ❑ `T�
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SUB—BSMT.
BASEMENT
ISTFLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR
6THFLOOR
7TH FLOOR
8TH FLOOR
(Print or Type)
Check One: Certificate
Installing Company Name
[—] Corp.
Address [] Partnership
❑ Firm/Company
Business Telephone Name of Licensed Plumber or Gasfitter
I hereby certify that all of the details and information I have submitted (or entered)in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
TYPE LICENSE: 4" C I
By Plumber
Gasfitter Signature of Li ensed
Title Master Plumber or Gasfitter
City/Town: Journeyman
License Number
APPROVED (OFFICE USE ONLY) PINT SHOP
No.................ff.......
APPLICATION FOR
PERMIT TO DO GAS FITTING
Location
.....................
........... .. ...........
..................
Gas Fitter...... ..........
FEES FOR GAS FITTING PERMITS
New Installation ............................................
Additions to existing piping .............I............
FEB -4 1982 ,
................................................19..........
APPROVED:
................................
Inspector.
PERMIT GRANTED,
Permit filled out by.......................................................
FORM 1243 HOBBS&WARREN. INC.
7HE GOMMONW AL7H OF MA�SSAGHy[USE["f5 �� � �( /
APPLICA N FOR PERMIT TO DO GAS FI 1NG
--- -- --�Z--------19
The undersigned hereby applies for a_permit to perform gas fitting work according to th ollowing s cifications:
Location.15.l..l�....... ........ .. . ..... ..�... .....-.............................,....................Change of occupancy—Yes.............NTo...................
Nameof owner. .. r� .Address........................................................................................
Material of building................................................................................New or old........................Number of families....................Stores.........
What was the building last used for?............................... ..........What is the building to be occupied for?...............................................
NATURE OF PROPOSED GAS FITTING II&DETAIL
Pie
m ,
Floor S1Ze
od-
W J
Basement -
1st
3rd
NOTE—Mark Below by N Whether
New Gas Fitting .................................................... NOIF..........................................................................................................................................
........
Alterationsin Gas Fitting .................................... ....................................................................................................-........................I............................
Replacement of Fixtures ...................................... ..................................
Estimated Cost $...................................... .. ... , .
�s� . .. - -- ........ ... .. .......... ........ ...... .. .. . ........ .. . . .I..N �`%.7�j.........................
...
SIGNATURE OF MASTER GAS FITT ............. ....................................... LICFNSF NO......./.•.. .........
TELEPHONE N�..6r°0...-34.0.:1...✓...........ADDRESS&..,`......./..!.![�W.IY...... ...:..... .
LICENSE EXPIRES...............................................
GAS FITTER MUST RECEIVE PERMIT EFORE COMMENCING WORK
All work hereafter performed must be tested before being used, and the Supervisor must be notified when all connections are in
position and the final test is applied.