17D-026 (8) 77 STRAW AVE BP-2018-0832
GIs#' COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17D-026 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Pernik, Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Catesorv:Bath veno BUILDING PERMIT
Permit# BP-2018-0832
Project# JS-2018-001538
Est Cost S6100.00
Fee $65.00 PERMISSION IS HEREBY GRANTED TO.
Const Class: Contractor: License:
Use croup: Homeowner as Contractor
Lot Sirc(sp ft.Y 16335.00 Owner: NAYAK ANAND P&POLLY FIVEASH
Zoninz URB(100)i App ficant: NAYAK ANAND P & POLLY FIVEASH
AT. 77 STRAW AVE
Applicant Address: Phone: Insurance:
77 STRAW AVE
FLORENCEMA01062 ISSUED ON:2/75/2078 0:00:00
TO PERFORM THE FOLLOWING WORK.REMODEL BATHROOM, REPLACE EXISTING
FIXTURES, ADD TILE
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: z/L7 /➢ Rough:-1-� -A/ House# Foundation:
// Driveway Final:
Final:/ /n Final: p
Rough Frame: G�-FO
Rough: Oil: Insulation: �f
Final: Smoke: Final: 6,4- _S/1L/)
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occuoanc //dlGtA�l- Signaturew tihi
FeeTvpe: Date Paid: Amount:
Building 2/1520180:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck-Building Commissioner
/2� "ftT SN
MASSACHUSETTS UNIFORM APPLICATION FORA PERMIT TO PERFORM PLUMBING WORK
CITY P-01mit MA. DATE
PERMIT#_{ 17-2
JOBSITE ADDRESS ? SI'f!0.`✓ Av(, OtNNER'S NAME b9ac�
POWNER ADDRESS 7 Sihnw ry ye TEL
FAX
TYPE OR OCCUPANCYTYPE: COMMERCIAL E] EDUCATIONAL ,-,
PRINT ❑ RESIDENTIAL its/
CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT: PLANS SUBMITTED: YES❑ NO ❑
FIXTURES 7 FLOOR- BSMT 1 2 3 4 5 6 7
BATHTUB B 9 10 17 12 13 14
CROSS CONNECTION DEVICE 1
DEDICATED SPECIAL WASTE SYS
DEDICATED GASJOIUSAND SYS
DEDICATED GREASE SYS
DEDICATE)GRAY WATER SYS
DEDICATED WATER RECYCLE SYS
DRINKING FOUNTAIN xa Ns
DISHWASHER
FOOD DISPOSER
FLOOR IAREA DRAIN
INTERCEPTOR(INTERIOR
KITCHEN SINK -
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE I MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
WATER PIPING
OTHER
I have a current liability insurance all INSURANCE COVERAGE: ,../
—1 p cy -lits substantial a uivalent which,meets the requirements of MGL Ch.142. Yes NI No❑
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY Q OTHER TYPE OF INDEMNITY ❑ BOND
OWNERS INSURANCE WAIVER:1 am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws,and that mysignature on this permit application waives this requirement.
Si nature of Owner or Omer's Aqent CHECK ONE BOX ONLY: OWNER ❑ AGENT ❑
I hereby certify that all Of the details and information I have submitted(or entered) regarding this application ala true and accurate to the
best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in
compliance with all Pertinent provi ''-n fire Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER NAME uXtl V7 CG/-/
SIGNATURE
LIC# '32-7( b MP EI JP L4 CORPORATION ❑# PARTNERSHIP ❑# LLC ❑#
COMoANYNA/IME_ /U� 2ADDRESS- 12-q L"';
L"'I /$!/1
CY_E STATE ZIP UlpO7EMAILt C47J/11 5 a✓GA
TEL CELL
Tu
nM
FAX
-7
....ter. ,�
it -7000
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
low
CITY .Npl4'kC5 tM Pfin fl MA DATE,d _r2, . PERI
JOBSITEADDRESS 'I.__ :77 S_}raw _�V� OWNERSNAME�keWn� - ,Nq"a _]
POWNER ADDRESS '_, TELII-617 qS3 I$64 �FAX� LL
TYPE OR OCCUPANCY TYPE COMMERCIAL. EDUCATIONAL RESIDENTIALI`y
PRINT
CLEARLY NEW RENOVATION V REPLACEMENT'. PLANS SUBMITTED YES I ; NOS
FIXTURES 1 FLOOR- BSM 12 3 4 5 6 1 8 9 10 11 12 17 14
BATHTUB
I
CROSS CONNECTION DEVICE - '''i " '"' - "- Fill
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GASIOIUSAND SYSTEM
DEDICATEDGREASESYSTEM - -
---
DEDICATEDGRAYWATERSYSTEM --I--
DEDICATED WATER RECYCLE SYSTEM i - ,' -`L _ - , -J_ _
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER I '
FLOOR(AREA DRAIN - -" - '-- it
INTERCEPTOR INTERIOR) "" "
KITCHEN SINK -
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE I MOP SINK r +'"- r -__- r p% - ,�
TOILET " -- - -
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES - i, --
WATER PIPING___.._. 'I
OTHER ... __-
_...
� I
I 11 II lr tr— '
INSURANCECOVERAGE:
I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO -
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY A/' OTHER TYPE OF INDEMNITY F 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 Lawn,and that my signature on this permit application waives this requirement.
_ CHECK ONE ONLY: OWNER i7 AGENT
SIGNATURE OF OWNER OR AGENT
I hereby candy that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge
am that all plumbing work and installations performed under the permit issued for this application will be in compliance wetith/all Pertinent provision of the
Massachusetts State of the
PLUMBER'S NAME''PI�Cjn IQ_1lumbing e and Cehapter 142 S� �eral La LICENSE# �'j3� SIG TURE
MPLV JPYN1' Deptex lz!f CORPORATION` L#I
COMPANY NAME I�aY`Si lumbi A 9-i- Heat �n9 ;'ADDRESSC) 99._I_
CITYI yIJt0.M�.�V4�C4 _ STATE ZIP .. p IDOf TEL 41
FAX '._ __.i,CELL�tF -6 ,-36EMAIL
lIZ711
kiUl`v:+'ia:Mi! GaiS ±f k)Y1,Sttt:'I.T.Sq
h0`��ee:9fitfiLiN
C.�Vf3rt+d9A Tt7t# 03ziO3t'1'�A
77 STRAW AVE EP-2018-0672
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 17D
Lot-026 ELECTRICAL PERMIT
Perrnit Electrical
Category: WIRE BATHROOM REMODEL
Permitil Electrical
PERMISSION IS HEREBY GRANTED TO:
Prcjea# JS-2018-001538
Esc Cost: Contractor: License:
Fee: $65.00 DAVID P FOSTER JR Journeyman 37855E
Owner. NAYAK ANAND P & POLLY FIVEASH
Applicant: DAVID P FOSTER JR
AT: 77 STRAW AVE
Applicant Address Phone Insurance
24 STAGE ROAD (413) 296-0219 C-(413) 695-6168 Liability, 08SBANX4594
WILLIAMSBURG MA01096-9304 ISSUED O,V.2/28/20180:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE BATHROOM REMODEL
Call Io Date: Date Requested Inspection Date/SienOff: Reinspect?:
Trench/DG:
Special Instructions
X
Roueh
x
Special lnstrucdons:
Final: 3' T/$ Wyn
SRE Called In:
Sienature:
Fee Tspe:: Amount: DatePaid
Electrical $65.00 2/28/2018 0:00:00 1267
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-lospector of Wires -Roger Malo