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36-402 (3) C SG4- /117 Co 4'z36. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ' =` CITY %U r"ice` MA DATE PERMIT# t `-J.' JOBSITE ADDRESS 60 6` 1" 2° ' '--(4 1 OWNER'S NAME I P OWNER ADDRESS L I TELL FAX r TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL ❑ RESIDENTIAL[ PRINT CLEARLY NEW: RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NOL] FIXTURES 1 FLOOR-' 881.1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 11111(111111M111111.1111111'_ .— 1 IM CROSS CONNECTION DEVICE �:M DEDICATED SPECIAL WASTE SYSTEM jams ��_ 1 .i!l.ng No DEDICATED GAS/OIL/SAND SYSTEM = ' —� Ila�i�,��au' DEDICATED GREASE SYSTEM �. I Int �: DEDICATED GRAY WATER SYSTEM mg am. 101111115 MIRPOII, , DEDICATED WATER RECYCLE SYSTEM ffiri lr- 1i .: DISHWASHER I DRINKING FOUNTAIN l 111.2415. E J._: WM FOOD DISPOSER 1111.111rMIIII _ I I ; FLOOR/AREA DRAINag I� I I I t r INTERCEPTOR(INTERIOR) -_ �— I. I KITCHEN SINK MN IS I i I, .. ( _ - i LAVATORY = OK I- ....;-_- . ..,,, - -1- u. i= ROOF DRAIN .__._ . , i SHOWER STALL ' SERVICE/MOP SINK I OMi�J M r• �' TOILET /i�` _ URINAL I ! WASHING MACHINE CONNECTION —] !Mi=I WATER HEATER ALL TYPES ( : I WATER PIPING 1. � An �� OTHER _ __ � ' ' 1 a' j CIRCLE 1:GAS TRAP!LNDRY TRY I i BACKFLOW PREV/WATER CLOSET ' HOT WATER TANK a_ 1, d II 1 I I INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES I'NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY la- 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 0 AGENT 0 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 bemy knowledge and that all plumbing work and Installations performed under the permit Issued for this application will be in corn, ee with all Pertine pr Sion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. x' a.. J PLUMBER'S NAME I c277- (1.14..C14(,_ LICENSE#Ilo&9Z_ SIGNATURE MP❑BJP❑ CORPORATION Di !PARTNERSHIP # • LLC❑#I COMPANY NAME oft(.4.14.‘,._ �cu Ai//.216 ADDRESS] L"-A., 3.5t5- CITY 6tCITY /:-!...7.&2-7-Li g Wiz.. STATE y.44 ZIP 0/o(.177 TEL -//3- CZG- Ea?n FAX I _____J CELL I J EMAIL .SC 3 7 6.) c a`4_, (7.'," _?+l_ ',1,--C 9/2o4 , )tava/1 /7-/C • r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK r " i—r-y � - o4kL CITY �o�T'd'�`�n ' 1 MA DATED/-/Y-20' /6 .PERMIT# COP 2 �7- JOBSITE ADDRESS ._ w-tcr' 'OWNER'S NAME L___ __- 1 GOWNER ADDRESS I I TEM -__- __-- --------- FAX 1 TYPE OR OCCUPANCY TYPE COMMERCIAL[' EDUCATIONAL p RESIDENTIAL 0— PRINT CLEARLY NEW:N 1 RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES Li NO❑ APPLIANCES 1 FLOORS-, BSM ill 25 6 7 t 14 BOILERi - —RE BOOSTER • r i -- - CONVERSION BURNER j ! _ limi ��litCOOK STOVE I i 1 i DIRECT VENT HEATER I I i t e DRYER I I II --- - I, ._1 I lailt FIREPLACE _ _ '- /_ _I1 i= I __I FRYOLATOR - _-- I 1 ' 4 ')t ° t FURNACE GENERATOR — - --- ---- ----_• . _. ._ _, _. . . GRILLE -) I . INFRARED HEATER jIII )� I LABORATORY COCKS I_�1 I _ I r I MAKEUP AIR UNIT 1 --1 -- I 1 - ! ---_I OVEN -1---1 [ ._ .. �.. I4.�.ze of I POOL HEATER ^ ROOM/SPACE HEATER ----1---I I _ —1 �.'nth, r--; ' L ' -y--_. ' - -1 ROOF TOP UNIT I TEST - -- - I -NMI NMI UNIT HEATER ----I -- - 1 I���1 WEE M NM UNVENTED ROOM HEATER I 1 I IC MN—,_.._- WATER HEATER- - _ _ • 1 i ; 1 OTHER - _ 1 I I l -1 - I -1 I .1111111 . .HEATER RANGE I - . I I - ._h 1 _i 1 I -I , TOM_HEATER . --- I-----1� II I Ii GASPIPING -1 INSURANCE COVERAGE r ,� I have a current liability I�nw insurance policy or its substantial equivalent which meets the requirements of MOL.Ch.142 YES ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY[ - OTHER TYPE INDEMNITY [ I 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 1 I AGENT El SIGNATURE OF OWNER OR AGENT t hereby certify that all of the details and information I have submitted or entered regarding this application are true and a;curate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comp' vlth all Pertin provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r PLUMBER-GASFITTER NAME 1_92)77oir�It 1 LICENSE#I/d/ ! SIGNATURE 1,4P I MGF I I JP❑ JGF[] LPGI❑ CORPORATION M-#- PARTNERSHIP❑#I I LLC❑# I COMPANY NAME:Irkf«ex_ rW`"i&-ub ADDRESS &X Z65- - I CITY 6ts IesLvr77? J STATE fv0 ZIP C IC Z7 TEL y'.3 ' 6Z6 • �v?a FAX1_ CELL EMAIL SOrY7't'@ 'Afit M. .i/1_ Cv • 7:50"- • 212-y//6 1 60 EMERSON WAY EP-2017-0055 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 36 Lot:402 ELECTRICAL PERMIT Permit: Electrical Category: WIRE NEW HOUSE WITH 200 AMP UNDERGROUND SERVICE Permit# Electrical PERMISSION IS HEREBY GRANTED TO: Project# JS-2016-002576 Est.Cost: Contractor: License: Fee: $200.00 STEVEN KEYES MASTER ELECTRICIAN 21213A Owner: CIANFLONE RICHARD & GREGORY SCHARFEN Applicant: STEVEN KEYES AT: 60 EMERSON WAY Applicant Address Phone Insurance 38 STATE RD (413) 422-1220 () C-(413) 695-4968 Liability, BDXGXZ SOUTH DEERFIELD MA01373 ISSUED ON:7/20/2016 0:00:00 TO PERFORM THE FOLLOWING WORK: WIRE NEW HOUSE WITH 200 AMP UNDERGROUND SERVICE Call In Date: Date Requested Inspection Date/SignOff: Reinspect?: Trench/UG: Special Instructions g Rough —9-[IL 912)'" /VO N•.ui- -4 (fox vc,ti L7 1:(92,,1 s ! -aa-"& N Special Instructions: Final: / —clf/Y / G SRE Called Signature: Fee Type:: Amount: DatePaid Electrical $200.00 7/20/2016 0:00:00 5124 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo