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30A-024 (12) 7- .c / o7.v't r a r�ymrryl_ 9/6/6 ✓6/9 n C. ,LJ 1 j77/7".,11c/Sr �Lr 29e),01) rnirn3 S,t7 t/ 'Y7C 'w rife 46::eirtr or` /4 / 7 /)n-, /Y z) /3 iota npr 20,t,.,9 0/2J 2 CSS / dYtZCs ) '/ Are omen vk) ON 72r r 131 Prospect St Hatfield,MA 413-626-3862 MWcndalowskl@u comcastnet Express Plumbing Heating and Solar Services LW September 16,2016 City ofNorthampton Building Department Attn:Larry Eldridge-Plumbing and Gas Inspector 212 Main St Northampton,MA 01061 413-587-1243 To whom it may concern, Express Plumbing,Heating&Solar Service is requesting a partial inspection on work complete and that the plumbing permit%r Debra Truskinoff of 42 Lexington Ave.Florence,MA be terminated immediately. Respectfully, Mark Wendolowski-President Express Plumbing,Heating and Solar Services LLC S • h tl (j v � / cto 70 �e — 61,0iMASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 'al; CITY/TOWN Norl 4W1/l/OlJ MA DATE g7t7((6 --�PERMIT# PD 1 7��--y7c) co JOBSITE ADDRESS Lid. Phe tt eiStnJ Ave OWNER'S NAMEJ)'bf1 T �L is Kr r)ei ff pl OWNER ADDRESS TEL FAX � j I CTYPE OR OCCUPANCY TYPE COMMERCIAL I7 EDUCATIONAL ❑ RESIDENTIALILI PF�17 CLEARLY NEW:0 RENOVATION:$ REPLACEMENT:0 PLANS SUBMITTED: YES❑ NO 0 FIXTURES 1 FLOOR— 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 SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY 14. a ROOF DRAIN PLUMBING& GAS INSPECTOR SHOWER STALL NO ON SERVICE/MOP SINK 0 1tPf`f1pVED TOILET / URINAL f WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING / OTHER INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch.142. YES* NO 0 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICYS 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 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 hue and accurate to the best of my knowledge and that all plumbing Pork and installations performed under the permitissuedfor this application will with all provisJ ion of the Massachusetts State Plumbing Code mpeof the General Laws. PLUMBER'S NAME(/ fNIZhdlf6'U,/L LICENSE# P397 7 SIGNATURE MP r JP 0 CORPORATION❑// # PARTNERSHIP❑# LLQ # 3 t COMPANY NAMEFXp✓P44j P/i1Mbj 5 ADDRESS /3 ( P(aye c J'' St- CITY tAll—tit/ STATEAtZIPff([1- TEL(0?-44.26' 3Sca FAX CELL EMAIL `/i((iLfvn(fn((j ra54,(` (O.110-[ST i6 /6 ar6t9 6, n -q yv Se- /1/4.1t S/e7 e, z /w !War seeyric 4'- 721r A../0-Zi f G. / � � r''9 /tern 3i9,904-x-72.T . <stave- /30n.1) a2 reer2nce- Css j frt?73 ` - /1/? n-en QV av nr ' d r