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
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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
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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