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13-048 (2) 21 HATFIELD RD BP-2016-0672 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 13 -048 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2016-0672 Project# JS-2016-001145 Est. Cost: $54000.00 Fee: $351.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MATTHEW J DERY 64404 Lot Size(sg. ft.): 87991.20 Owner: SZAWLOWSKI SFIELLEY & D W HOOK LLC Applicant: MATTHEW J DERY AT. 21 HATFIELD RD Applicant Address: Phone: Insurance: 408 HOOSAC RD (413) 369-4447 WC CONWAYMA01341 ISSUED ON.12/1/2015 0:00:00 TO PERFORM THE FOLLOWING WORK.DEMO ROOF FRAMING & ADD 8 WALLS & TRUSS ROOF SYSTEM 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: Ja v House# Foundation: (�0 Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: '��' � G '® L�/�>� Final: �y Smoke• Final: V.�• z' S ' "1 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF RANI' OF ITS IZULES ANDR U TIONS. f Certificate of Occu anc — Signature: FeeType: Date Paid: Amount: I�uildin� 12/I/2015 0:00:00 $351.00 212 Main Street, Phone(413)587-1240, Fax: (41 3))587-1272 Louis Hasbrouck—Building Commissioner 7Z ?/tom' DI/Tt�GU/2.S Gi4V�2►J�'L��L v� �IaS�Vlcs�a Sil�1/�5 NU CDS'i�►c,c7V 5 N14PoPz/4iL- pN 51PIR5 F►20E't The Commonwealth of Massachusetts City of Northampton �a Certi icate o Occupancy In accordance with 780 CMR, Section R110 (The Eighth Edition of the Massachusetts Residential Building Code) this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified. Identify Name of Building of Space Within, Building Owner, or Permit Holder Certificate No. Issued to Matthew J Dery BP-2016-0672 Shelley Szawlowski & D W Hook LLC Identify property address including street number, name, city or town and county Located at 21 Hatfield Rd Northampton, Hampshire, Massachusetts Use Group Classification(s) Single Family Dwelling This Certificate of Occupancy is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or, tampering with the contents of the certificate is strictly prohibited. Conditions of Use Single Family Dwelling All fire protection and life safety systems must be maintaines, and all means of egress must be kept clear Name of Municipal Date of Final Map/Plot: Building Official Kevin Ross Inspection 02/05/2019 Signature of Municipal Date of Building Official ' z Issuance 02/05/2019 13-048 21 HATFIELD RD EP-2016-0551 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 13 Lot:048 ELECTRICAL PERMIT Permit: Electrical Category: ROUGH&FINISH COMPLETE HOUSE WITH 200 AMP UG SERVICE Permit# Electrical PERMISSION IS HEREBY GRANTED TO: Project# JS-2016-001145 Est.Cost: Contractor: License: Fee: $200.00 M & S ELECTRIC Master Al 7278 Owner: SZAWLOWSKI SHELLEY& D W HOOK LLC Applicant: M & S ELECTRIC AT. 21 HATFIELD RD Applicant Address Phone Insurance 119 ELM ST (413) 247-5330 () C-(413) 539-8339 Liability, S1968713 HATFIELD MA01038 ISSUED ON.-111912016 0:00:00 TO PERFORM THE FOLLOWING WORK: ROUGH & FINISH COMPLETE HOUSE WITH 200 AMP UG SERVICE Call In Date: Date Renuested Inspection Date/SiznOff: Reinspect?: Trench/UG: Special Instructions x Rough /O '(9 7- 1 7 �`1 x Special Instructions Final: SRE Called In: 20961032 Signature: Fee Type:'• Amount: DatePaid Electrical $200.00 1/19/2016 0:00:00 2253 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo C&V a q > ��to MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBINGWORK A CITY(fOWN 1 V MA DATE I PERMIT# PP-10 "` 2-6 JOBSITE ADDRESS _ 6)'1 L ( , OWNER'S NAME %taQ44 ..-S2FnW 1 OWNER ADDRESS W TEL 13 " P g lam, �G,c.� 3�9 F TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIALk PRINT CLEARLY NEW:❑ RENOVATION:10 REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES 7 FLOOR BSM 1 2 3 4 5 6 7 8 9 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 a,F DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL PILL MBIN &GA INSP WASHING MACHINE CONNECTION N WATER HEATER ALL TYPES WATER PIPING OTHE INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Ej/NO ❑ IF YOU CHECKED YES,PLEASE INDICATET TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 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 E)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 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 provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME A s1(z5t1.—'t3Nac y., LICENSE# ` . _ SIGNATURE MP[91 JP❑ CORPORATION[:1# PARTNERSHIP❑# LLC J#C2O _-�� COMPANY NAME` Or-,,A�rn�j;,, _,�1 ikcx&�� ADDRESS-10- CITY DDRESSt00CITY HRS}1 'Y��S7 STATE tAAI ZIP n\,Q FAX CELL -a\\-] EMAIL l E1/ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY NORTHAMPTON MA DATE 01/29/2019 JPERMIT# JOBSITE ADDRESS 121 HATFIELD ROAD OWNER'S NAME ISHELLY SAWLOWSKI GOWNER ADDRESS ISHELLYSAWLOWSKI I TE 413-563-7691 IFAX�..� TYPE OR OCCUPANCY TYPE COMMERCIAL D EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW:Lj RENOVATION: REPLACEMENT:Ll PLANS SUBMITTED: YES[j NO E] APPLIANCES Z FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE _._ INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST ..._..__.......::............ ....................._.... .............. _.. . ....._........_ ... UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHE INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY E 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. CHECK ONE ONLY: OWNER ® AGENT 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 best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in com fiance Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASF ITTER NAME JOHN PUZA LICENSE#766 c��--- SIGNATURE MP Ej MGFEI JP® JGF® LPGI Ej CORPORATION®# PARTNERSHIP®# LLC®# COMPANY NAME:j AMERIGAS ADDRESS 216 LOCKHOUSE RD CITY WESTFIELD STATEMA ZIP L01085 �TEL 413-568-8972 FAX 413-572-6946 CELL EMAILI SHERRY.CHAFEE AMERIGAS.COM