30A-046 (11) 37 LEXINGTON AVE BP-2018-0049
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block: 30A-046 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv:•ADDITION BUILDING PERMIT
Permit# BP-2018-0049
Project# JS-2018-000089
Est. Cost: $26600.00
Fee: $172.90 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RONALD LAMAGDELEINE 101704
Lot Size(sq.fr.): 15812.28 Owner: SOUTHERLAND MICHAEL&DEBRA HERTZ
Zoning: URBL300 / Applicant: RONALD LAMAGDELEINE
A1: 3/ LEXiNG i ON HVE
Applicant Address: Phone: Insurance:
112 LAUREL HILL RD (413) 527-8169
WESTHAMPTONMA01027 ISSUED ON:7/24/2017 0:00:00
TO PERFORM THE FOLLOWING WORK.-ADD 14X12 ADDITION TO EXISTING HOUSE AT
FRONT LEFT SIDE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: _
Footings:
Rough: Rough:.,Ja, •/-, House# Foundation:
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P Driveway Final:
Final: Final: aC _ I
I Rough Framer R/IS /0
Gas:/2 --17
/7 Fire Department Fireplace/Chimney:
R.Cu.bh: 6/ L'�!: Insuintion:
Final: Smoke: Final: �/ — �`7
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND ATIONSk�nature: ;
Certificate of Occu anc J ' � � � `' ��
FeeTyne: Date Paid: Amount:
Building 7/24/2017 0:00:00 $172.90
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO ERFORM GAS FITTING WORK
Fi CITY 1 ' � MA DATE PERMIT# ro �
JOBSITE ADDRESSI U OWNER'S NAME
GOWNER ADDRESS �
TYPE OR OCCUPANCY TYPE COMMERCIAL" EDUCATIONAL ._ RESIDENTIAL
PRINT
CLEARLY NEW: RENOVATION:;,,- REPLACEMENT: PLANS SUBMITTED: YES NOF
APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1301LER
1300STER
CONVERSION BURNER -� -
COOK STOVE -
DIRECT VENT HEATER
—r - --
DRYER --- , -T +— -1-
FIREPLACE
FRYOLATOR _
FURNACE
-7- �-_� - �- -----� -- - i
GENERATOR
GRILLE --
INFRARED HEATER -
I
LABORATORY COCKS _
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM I SPACE HEATER --
ROOF TOP UNIT.-- — Y
TEST - -
--
UNIT HEATER -
UNVENTED ROOM HEATER
3
WATER HEATER �-
OTHER ; _...;;.:
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-
_ -
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 YES _ NO
El
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE 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.
SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER 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 best nf mul knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in com ce with all pti t isi o
Massachusetts State Plumbing Code and Chapter 142 of the Geer Laws f
PLUMBER GASFITTER NAME C LICENSE#i� Ct SIGNATURE
MP,l MGF JP�� JGF LPGI CORPORATION # PARTNERSHIP n� #I LLC Lj#aN "
COMPANY NAME: CL ADDRESS S�
CITY STATE ZIP bC� STEL -
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37 LEXINGTON AVE EP-2018-0151
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 30A
Lot: 046 ELECTRICAL PERMIT
Permit: Electrical
Category: ADD 14X12 ADDITION TO EXISTING HOUSE AT FRONT LEFT SIDE
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2018-000089
Est.Cost: Contractor: License:
Fee: $65.00 JAMES MAILLOUX ELECTRIC Master Al 6187
Owner: SOUTHERLAND MICHAEL & DEBRA HERTZ
Applicant. JAMES MAILLOUX ELECTRIC
AT. 37 LEXINGTON AVE
Applicant Address Phone Insurance
55 MAIN ST- 2ND FLR (413) 585-1592 C-(413) 563-4654 Liability, MPT0721 Q
FLORENCE MA01062 ISSUED ON.•9/11/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:
ADD 14X12 ADDITION TO EXISTING HOUSE AT FRONT LEFT SIDE
Call In Date: Date Requested Inspection Date/SianOff: Reinspect?:
Trench/UG:
Special Instructions
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Special Instructions:
Final: % D--/y-/ 7 k '`-
SRE Called In•
Signature:
Fee Type:: Amount: DatePaid
Electrical $65.00 9/11/2017 0:00:00 11746
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo