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24D-118 (5) BP-2020-0213 11 CHURCH ST COMMONWEALTH OF MASSACHUSETTS GIS H CITY OF NORTHAMPTON Map:Block: 24D- 118 Lot: 131000 1 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: PlumbinBUILDING PERMIT g Permit 4 BP-2020-0213 Project# JS-2020-000354 Est.Cost: $17500.00 Fee: $114.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: KARAS HOME IMPROVEMENT 087657 Lot Size(sq. ft.): 7100.28 Owner: HANNAH RACHEL&: PAMELA BOCKOL 7_onine11RB(100)/ Ap_plicant• KARAS HOME IMPROVEMENT A T. 11 C'.-LURCH S T Applicant Address: Phone: Insurance: 10 WOODHAVEN DR (413) 374-8638 WC BELCHERTOWNMA01007 ISSUED ON.812112019 0:00:00 TO PERFORM THE FOLLOWING WORK:ADDING BATH IN EXISTING SPACE POST THIS CARD SO IT 1S VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final:�('�-�-/9� /�Rough Frame: oe b-1-I lze Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: Pe I 4 e(.? THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS %ULES AND RE ULATIONS. UviPc�;rx- Certificate o cSi nature: FeeType: Date Paid: Amount: Building 8/21/2019 0:00:00 $114.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK F CITY; MA DATE 3----- HERMIT#� JOBSITE ADDRESS _ OWNER'S NAME P _ OWNER ADDRESS ' TEL'__ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL. _ EDUCATIONAL , RESIDENTIAL PRINT CLEARLY NEW:^� RENOVATION: ] REPLACEMENT: PLANS SUBMITTED: YES 1\10 FIXTURES Z FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 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 DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) i KITCHEN SINK LAVATORY I ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL all 114 WASHING MACHINE CONNECTION WATER HEATER ALL TYPES VF- WATER FWATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142, NO IF YOU CHECKED YES,PLEASE INDICATE THE 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 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 comp4apce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 42 of the General Laws. PLUMBER'S NAME LICENSE# E= SIGNATURE MP�' JP0 CORPORATION # PARTNERSHIP # w�'LLCE4 COMPANY NAM DDRESS4 f W. CITY �j �� STATE ZIP , �j TEL / FAX CQ[I - EMAIL NO alt ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes NO THIS APPLICATION SERVES AS THE PERKO ❑ ❑ FEE: S PERAIIIT# PLAN REVIEW NOTES 11 CHURCH ST EP-2020-0163 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 24D Lot: 118 ELECTRICAL PERMIT Permit: Electrical Category: ROUGH&FINISH WIRING OF 2ND FLR BATHROOM Permit# Electrical PERMISSION IS HEREB Y GRANTED TO: Project# JS-2020-000354 Est.Cost: Contractor: License: Fee: $65.00 MAREK DYBACKI ELECTRIC Journeyman Electrician 51672 E Owner: HANNAH RACHEL & PAMELA BOCKOL Applicant: MAREK DYBACKI ELECTRIC AT. 11 CHURCH ST Applicant Address Phone Insurance 1468 CENTER STREET (413) 763-3605 () C-(413) 695-4060 LUDLOW MA01056 ISSUED ON:8/23/2019 0:00:00 TO PERFORM THE FOLLOWING WORK: ROUGH & FINISH WIRING OF 2ND FLR BATHROOM Call In Date: Date Requested Inspection Date/SiunOff: Reinspect?: Trench/UG: Special Instructions X ` r Rough n -J 'c X Special Instructions: Final: /V- / - �q SRE Called In: Signature: Fee Type:: Amount: DatePaid Electrical $65.00 8/23/2019 0:00:00 2885 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo