17C-191 (8) II WILDER PL BP-2019-1082
GIs M: COMMONWEALTH OF MASSACHUSETTS
MV-.Block: 17C- 191 CITY OF NORTHAMPTON
Lot:-00 1 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv: Bath reno BUILDING PERMIT
Permit a BP-2019-1082
Proiect# JS-2019-001765
Est.Cost-.$11500.00
Fee: $71.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: STEPHEN CAMP 082531
Lot Size(w.ft.): 5096.52 Owner: SIMMONS KATHLEEN E
zoning:URB(100 Applicant: STEPHEN CAMP
AT. 11 WILDER PL
Applicant Address: Phone: Insurance:
46 EAST ST (413) 527-7124 () WC
EASTHAMPTONMA01027 ISSUED 01.4/3/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:BATH RENO
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
�/ �/ .i Footings:
Rough: x Z / Q Rough: : HouseM Foundation:
Driveway Final:
Fina
`K��/5' Qe Rough Frame; O.I(, $ -IQ K Q
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:U�
Final: Smoke: Finan d,e L.2']•Iq XW
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS]tULES AND IONS.
Certificate of9eCBeegeV 7Signature: G
FeeTvpe: Date Paid: Amount
Building 4/3/20190:00:00 $71.50
212 Main Street,Phone(413)587-1240,Fax:(413)597-1272
Louis Hasbrouck—Building Commissioner
obox alt4$ $-10.00
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING
,pWORK
(�
CITU R MA DATE Jam/ I PERMIT#
JOBSITE ADDRESS GU ; o C OWNER'S NAME T Jdlq OS
P OWNER ADDRESS .I/17t TEL'"/ ]FAXO
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL u�yrc
U,roDNTIALI,
PRINT
CLEARLY NEW ,j RENOVATION:(� REPLACEMENT:7 PLANS SUBMITTED: YES N0�
FIXTURES] FLOOR_ BSM 1 1 2 3 4 5 b 7 1 8 1 9 10 11 12 13 14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GASIOIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR INTERIOR
KITCHEN SINN
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE I MOP SINK 41
TOILET n r
URINAL
WASHING MACHINE CONNECTION nip N
WATER HEATER ALL TYPES 91-11-111"A IM-CIN
WATER PIPING
OTHER
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES..,J NO L-j
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LABILITY INSURANCE POLICY L/ 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 Lave,and that my signature on this permit application waives this requirement.
CHECK ONE ONLY: OWNER .. . AGENT
SIGNATURE OF OWNER OR AGENT
I thereby certify Mat all of Me details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge
and Met all plumbing xoA and installations performed!under Me permit issued for this application will be in m M all PeNnent provision of the
Mas"Mussbs Sam Plumbing Code and Chapter 142 of Me General Laws.
PLUMBER'S NAME.?;6Vd6C ��Y _ LICENSE# 'SIGNATURE
MP,._ JP, CORPORATION # PARTNERSHIP # LLC' # —�
COMPANY NAME ryJ S,r('J GF+G `R'ii ADDRESS
CITY ly""47160C STATE 1-/ 1 ZIP I O�1�l _. TEL I -�//� Cd
FAX ��— CELL /.$' -3 1 EMAIL ///$ po�,b- horn CGs7, //fT
/6�
ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
Yee No
THIS APPLICATION SERVES AS THE PERMIT ❑ ❑
FEE: S PERMITp
P N VI W OT
11 WILDER PL EP-2019-0731
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 17C
Lot: 191 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE FIRST FLOOR BATH RENO WITH LAUNDRY
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2019-001765
Eu.Cost: Contractor. License.
Fee: $65.06 MICHAEL LONG Electrician 50407
Owner: SIMMONS KATHLEEN E
Applicant: MICHAEL LONG
AT: 11 WILDER PL
AaalicantAddress Phone Insurance
17 DICKINSON ST (413) 584-7665 C-(413) 587-3174 Liability, MP197313
NORTHAMPTON MA01060-1503 ISSUED ON:4/1620190:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE FIRST FLOOR BATH RENO WITH LAUNDRY
Call In Date: Date Requested Inspection Dete/SignOff: Reimoect?:
TremWUG:
Special Instructions
x
Rough S-- 149 Nj Qr - - -/°/ 2c-
x
Special Instructions:
Final- xe—
SIZE Called In:
Signature:
Fee TypeAmount: DatePaid
Electrical $65.00 4/26/2019 0:00:00 789
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo