39A-033 (3) IL Comaanmaalth,f Mmmar aanw Official Use Only
" ' m i • ' c� c7 �s Permit No. P; 11—S08"
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▪ !BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) 571.0
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
CU I= I All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
�
I (PereASEI PRINT IN INK OR TYPE ALL INFORMATION) Date: i - ;xN- /q
I r i1y or Town of: ,<1; f/, ,/, 4,, To the Inspector of Wires:
By this ap &alien the undersigned gives nebte of his or her intention to perform the electrical work described below.
==,-it,eeation (Street&Number) ,/,/ la,„, Sf:
—.--6wecror Tenant 52, A, f/a,�:),.,e 6+rs,f1 - 20,4 i o,,„/ Telephone No 'P2 t-et <>n.?
Owner's Address
Is this permit in conjunction with a buildingpermit? Yes ❑ No (Check Appropriate Box)
Purpose of Building
/
p l�[mLn�' l{ /i%C � Utility Authorization No.
Existing Service Amps I Volts Overhead ❑ Uodgrd❑ No.of Meters
New Service Amps 1 Volts Overhead❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: / 1„y , 1,, /171 LA1 / t.(CS- .6 y h,r-taS
i r '
Completion of the following table my be wafted by the Inspector of Wires
No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of TotalNo.
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Agraaved. ❑ gran-d. B❑ ;ant*.
0
tery,mUnitsergeocg Lighting
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. TotalNo.of Alerting Devices
To
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: — Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Leal❑ Muninpal ❑ (Rhee
_ Cgnn4Mlign
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of No.of No.of ices or Equivalent
KVV Data Wiring:
Heaters Signs Ballasts Na of Devices or Equivalent
No.of uni
No.Hydromassage Bathtubs Na of Motors Total DDD" refDevieoss or Wiring
Ncatir Equivalent
OTHER:
Attach additional detail if desired. or as required by the Inspector of Wires.
Estimated Value of Electrical Work: /Or r2re' (When required by municipal policy.)
Work to Start: .4..;..9-/-1) htspeetions to be requested in accordance with DEC Rule IQ and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. the
undersigned certifies that such coves ge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE a BOND ❑ OTHER 0 (Specify:)
I certify,under the ains and ppe skies ofperjwy,that She information on
LIC.NO.:
this application is true and complete,
FIRM NAME: " /e i,- ! . ef.- f :e ,. <' /s4.,n+,--am
Licensee: Pa +i' �. , c-cc ,,7,•- Signature / /� CLIC.NO.: rS`j-ssvy
(If Address:
enter Cxt.mpt"in l�liense numberpne) .A7 .,.�Bus,TeL Na �R ..X42I AF//
Address: , 2 ,? .An- c �„ o-=_c_ --'`.---:l i^/,r.A .-_ AR TeL No..
*Per M.G.L.c. 147.s. 57-61,security work requires Department of Public Safety"S"License: Lie.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner n owner's agent.
nerSiggnaaturregeat Telephone No. PERMIT FEE:$_51ti r,-.,
i
115 CONZ ST EP-2017-0808
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 39A
Lot:033 ELECTRICAL PERMIT
Permit Electrical
Category: LIGHTING RETROFIT WITH 495 FIXTURES
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2017-001826
Est.Cost: Contractor: License:
Fee: $570.00 DANNY CROPANESE MASTER ELECTRICIAN 100005
Owner: GAZETTE REALTY LLC
Applicant: DANNY CROPANESE
AT: 115 CONZ ST
Applicant Address Phone Insurance
17 BOUTIN ST (413) 250-0611 0 C- Liability, MPT0416D
CHICOPEE MA01020 ISSUED ON:3/24/20I 7 0:00:00
TO PERFORM THE FOLLOWING WORK:
LIGHTING RETROFIT WITH 495 FIXTURES
Call In Date: Date Requested Inspection Date/SignOff: Reinspect?:
Trench/EC:
Special Instructions
x
Rough
x
Special Instructions:
Final:
SRE Called In:
Siunature:
Fee Type:: Amount: DatePaid
Electrical $570.00 3/24/2017 0:00:00 1098
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo