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23D-212 (4) 6 6,19.(2.(4v4 .S7 6 WARNER ST BP-2021-1002 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D-212 CITY OF NORTHAMPTON Lot: -4 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2021-1002 • Project# JS-2021-001716 Est.Cost: $315000.00 Fee:$1269.20 PERMISSION IS HEREBY GRANTED TO: Contractor: License: Const_Class_Use Group: NU-WAY HOMES INC 013693 Lot Size(sq.ft.): Owner: NU-WAY HOMES INC Zoning: Applicant: NU-WAY HOMES INC AT: 6 WARNER ST Insurance: Applicant Address: Phone: (413) 563-0085 Liability 10 WHITE AVE EAST LONGMEADOWMA01028 ISSUED ON:3/30/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:NEW SINGLE FAMILY HOUSE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Building Inspector Inspector of Plumbing Inspector of Wiring D.P.W. Service: Meter: Underground: Footings: Rough: Rough:?-g(t, ,9- House# Foundation: � Driveway Final: Final: z-3 --� : ,`Final 6. GLT ( - F1 J J L Rough Frame: (:, IL 7. Z 7 -Z I y►e (\S O r 7o Ws — Fire Department i �r G 6) 17O Fireplace/Chimney: Gas: 7( 0)ii,( ;y Insulation: a/� 9 Rough: Oil: Final: /0.. "-3 / 0 l'- Z J Smoke: , / s-,94 Final: ),!L l Z-9-Zt J/ 1� '5 ". 7 ''KC‘--- ------- THIS PERMir MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND RE L ONS. . `, ' y . TAIT Certificate of Occupancy / /' Signature: 1 yyy���JJJ FeeType: Date Paid: Amount: Building 3/30/2021 0:00:00 $1269.20 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck-Building Commissioner The Commonwealth of Massachusetts !tl f , C 1 , City of Northampton of Occup ancy Certificate anc fp y In accordance with 780 CMR, (The Ninth 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 BP-2021-1002 Nu-Way Homes Inc. Identify property address including street number, name, city or town and county Located at 6 Warner Street HERS Rating Florence, Hampshire, Massachusetts 55 Use Group Classification(s) Single Family Dwelling Unit 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 Unit All fire protection and life safety systems must be maintained, and all means of egress must be kept clear Name of Municipal Date of Final Map/Plot: Building Official Kevin Ross Inspection 12/09/2021 Signature of Municipal Date of 23D-212 Building Official ! / Issuance 01/14/2022 Home Energy Rating Certificate Rating Date: 2022-01-11 Registry ID: 248912356 Final Report Ekotrope ID: jL9p1wr2 HERS® Index Score: Annual Savings Home: 6 Warner St 5 Your home's HERS score is a relative performance score.The lower the number, 4 i Builder: 3 0 the more energy efficient the home.To learn more,visit www.hersindex.com Ay an average U.S.home Northamton, MA 01062 *Relative to Nu-Way Homes Inc Your Home's Estimated Energy Use: This home meets or exceeds the Use UVIBtu) Annual Cost criteria of the following: Heating 58,4 $2,090 2018 International Energy Conservation Code Cooling 0.8 $35 Hot Water 9.7 5344 Lights/Appliances 23.7 5998 Service Charges $153 Generation (e.g.Solar) 0.0 SO Total: 92.7 $3,620 HERS Index Home Feature Summary: Rating Completed by: ...i..., Home Type: Single family detached Energy Rater: Paul Della Torre iv, Model: John Handzel Custom RESNET ID: 8776762 Fronil 140 Community: Nor thamton *30 Conditioned Floor Area: 2,818 ft2 Rating Company: Energy Compliance Services 00 Number of Bedrooms: 3 27 Hudson Dr.Southwick MA 01077 110 Refe,ente 413-427-2423 , ..,, Home aw Primary Heating System: Furnace•Propane•96 AFUE 91, Rating Provider: Building Efficiency Resources Primary Cooling System: Air Conditioner•Electric•13 SEER so RN Primary Water Heating: Residential Water Heater•Propane•0.93 Energy Factor PO Box 1769 Brevard,NC 28712 ni 800-399-9620 au House Tightness: 1150 CFM50(2.94 ACH50) I ,411/11 SO Ventilation: 62 CFM•8 Watts 40 This Nom , P.r.. Duct Leakage to Outside: 19(FM @ 25Pa(0.67/100 ft2) .,, 30 ao Above Grade Walls: R-23 J4J Ceiling: Attic,R-49 i)(24,(1 Defrartwor, 71,,,,,Erten Home 0 Window Type: U-Value:0.28,SHGC:0.34 Paul DellaTorre,Certified Energy Rater law lawny Foundation Walls: R-13 Digitally signed:1/12/22 at 3:17 PM crsolutilff Ekotrope RATER Version:4.01,2810 ekotroe The Energy Rating Disclosure for this home is available from the Approved Rating Provider. This .•rt does not constitute an warran or.uarantee. Home Energy Rating Certificate Rating Date: 2022-01-11 Registry ID: 248912356 Final Report Ekotrope ID: jL9p1wr2 HERS® Index Score: Annual Savings Home: 6 Warner St Your performanc home'se HERSscore.scoreThe is lower a relthativee num be r, 5 the more energy efficient the home.To 4„3 7 Northamton, MA 01062 Builder: learn more, visit www.hersindex.com 6 *Relative to an average U.S.home Nu-Way Homes Inc Your Home's Estimated Energy Use: This home meets or exceeds the Use[MBtu] Annual Cost criteria of the following: Heating 51.6 51,845 2018 International Energy Conservation Code Cooling 0.9 $41 Hot Water 9.7 $344 Lights/Appliances 23.6 5992 Service Charges $153 Generation (e.g. Solar) 0.0 $0 Total: 85.8 $3,374 HERS Index Home Feature Summary: Rating Completed by: ,rdb. ..1.[x•.p Home Type: Single family detached no Model: John Handzel Custom Energy Rater: Paul DellaTorre Existing DO Community: Northamton RE51'°4ET ID: 8776762 Homes 2 y, Conditioned Floor Area: 2,818 ft2 Rating Company: Energy Compliance Services 1D 27 Hudson Dr.Southwick MA 01077 ,,,, Number of Bedrooms: 3 413 417 2423 R`r home ® ioo Primary Heating System: Furnace•Propane•96 AFUE Primary Cooling System: Air Conditioner•Electric•13 SEER Rating Provider: Building Efficiency Resources Primary Water Heating: Residential Water Heater•Propane•0.93 Energy Factor PO Box 1769 Brevard.NC 28712 House Tightness: 1150 CFM50(2.94 ACH50) $00 399 4620 �• \. Ventilation: 62 CFM•8 Watts .111 Ih rinn e Il. Duct Leakage to Outside: 19 CFM a 25Pa(0.67 1100 ft') r ),, Above Grade Walls: R-23 r /� T „, Zoo Energy :, Ceiling: Attic,R-49 /}A« %�( ►✓ri ri1 I(v) 4e Nome ° Window Type: U-Value:0.28,SHGC:0.34 f aul D'LLTc'rre.r=ertiiierJ Energy hater mm„Ksx[, Foundation Wails: R-13 Digitally signed: 1/12/22 at 3:17 PM S, e kotro a Ekotrope RATER Versionn:4.0.1.2810 The Energy Rating Disclosure for this home is available from the Approved Rating Provider. This •a•rt does not constitute an warran or a uarantee. 6 Warner St Northamton MA HERS*Index Score: Rating Date: Jan 11,2022 55 HERS Registry ID:248912356 Annual Estimates: Rating Company: Electric(kWh): 6,909,8 Energy Compliance Services Propane(Gallons): 683.7 Rating Provider (Tons): 8 7 Building Efficiency Resources CO2ro Rating Provider Address: Approx.Energy Cost 53.374 PO Box 1769 Brevard,t12 HERS index Home Feature Summary: Noy boy Single family detached, iw bedrooms.2,818 fr hoeing ," Heating:96 AFUE ficoneS 1!D szo Cooling: 13 SEER Hot Water.0.93 Energy Factor Referenceitt0 Home Air Leakage: NO 1150 CFM50(2.94 AC'H50) Ventilation:62 CFM•8W Duct LTD: T HOfl* 19 CFM 25Pa(0.67/100 ft2) tat Above Grade Walls:R-23 20 Ceiling:Attic,R-49 Zoo bowl Nan* o Window:U:0.28•SHGC:0.34 W— ""1"""`' Foundation Walls:R-13 EkotropeRATER Version ekotrope 4.0.1.2810 Tt*S rerxat does not constitute anyvontunty of[puunntee. IECC 2018 Performance Compliance Property Organization Inspection Status 6 Warner St Energy Compliance Servic 2022-01-11 Northamton, MA 01062 Paul DellaTorre Rater ID (RTIN): 8776762 Model: John Handzel Custom RESNET Registered Community: Northamton Builder (Confirmed) Nu-Way Homes Inc 0143_John Handzel_LOT-4_6 Warner St_Northampton_220111 Annual Energy Cost Design IECC 2018 Performance As Designed Heating $2,070 $2,028 Cooling $135 $100 Water Heating $631 S631 Mechanical Ventilation S54 $10 SubTotal - Used to determine compliance $2,889 $2.769 Lights &Appliances wiout Ventilation $989 $989 Onsite generation $0 SO Total $3,878 $3.757 R405.3 Source Energy Exception:The proposed home uses 7,08 ME3tu LESS source energy than the reference home. Requirements 405 3 Performance-based compliance passes by 7.2°./i/ -Q. R402 4 1.2 Air Leakage Testing Air sealing is 2.94 ACH at 50 Pa It must not exceed 3.00 ACH at 50 Pa R402.5 Area-weighted average fenestration SHGC QR402.5 Area-weighted average fenestration U-Factor Q R404.1 Lighting Equipment Efficiency • R403 6 1 Mechanical Ventilation Efficacy • Mandatory cheddist Mandatory code requirements that are not checked by Elcotrope must be met • IRC M1505 4 3 Mechanical Ventilation Rate R405 2 Duct Insulation Design exceeds requirements for IECC 2018 Performance compliance by 7.2%. As a 3rC party extension of Inc code Jurisdiction utilizing these reports I certify that this energy code compliance document has been created in accordance with the requirements at Chapter 4 of the adopted International Energy Conservation Code based on HAMPSHIRE County It rating is Projected I certify that the building design described herein is consistent with the building plans, specifications, arid other calculations submitted with the permit application It rating is Confirmed, / certify that the address referenced above has been inspected/tested anc that the manutory provisions of the IECC have been installed to meet or exceed me intent of Inc IECC or will be verified as such by anotner party Name: Paul DellaTorre Signature: Pat< etia e Organization: Energy Compliance Services Digitally signed: 1112122 at 3:17 PM Ekotrope RATER-Version 4.0.1.2810 IECC 2018 Performance compliance results calculated using Ekotrope RATER'S energy and code compliance algorithm. Ekotrope RATER is a RESNET Accrediteo HERS Rating Tool.All results are based on data entered by Ekotrope users Ekotrope disclaims all liability for the information shown on this report IECC 2018 Building UA Compliance Property Organization Inspection Status 6 Warner St Energy Compliance Servic 2022-01-11 Northamton, MA 0106 Paul DellaTorre Rater ID (RTIN): 8776762 Model: John Handzel Custom RESNET Registered Community: Northamton Builder (Confirmed) Nu-Way Homes Inc 0143_John Handzel_LOT-4_6 Warner St Northampton 220111 Building UA Elements IECC Reference As Designed Ceilings 25.4 20.7 Above-Grade Walls 127.1 118.1 Windows, Doors and Skylights 92.8 82.7 Slab Floor: 22.1 22.1 Framed Floors 0.0 0.0 Foundation Walls 56.6 63.6 Rim Joists 13.3 10.3 Overall UA(Design must be equal or lower): 337.3 317.5 Requirements fZ) 402 1 5 Total UA alternative compliance passes by 5 9%. 402.3 2 • R402 4 1 2 Air Leakage Testing Art sealing is 2 94 ACH at 50 Pa.It must not eiiceed 3 00 ACH at 50 Pa • R402 5 Area-weighted average fenestration SHGC R402.5 Area-weighted average fenestration.U-Factor • R404 1 Lighting Equipment Efficiency 0 R403 6 1 Mechanical Ventilation Efficacy Mandatory code requirements that are not O Mandatory Checklist checked by Ekotrope must be met • iRC M1505 4 3 Mechanical Ventilation Rate • R403 3 4 Duct Leakage 14 R403 5 3 Hot water pipe insulation Hot water pipes at least 314 in diameter must be insulated to R-3 at minimum Design exceeds requirements for IECC 2018 Prescriptive compliance by 5.9%. Name: Paul DellaTorre Signature: Pad Ortia Th Organization: Energy Compliance Services Digitally signed: 1112122 at 3:17 PM Ekotrope RATER-Version 4.0.1.2810 IECC 201e Prescriptive compliance results calculated using Ekotrope RATER's energy and code compliance algorithm Ekotrope RATER is a RESNEI Accredited HERS Rating Tool All results are based on data entered by Ekotrope users Ekotrope disclaims all tabiity for the information shown cart this report `4 A '4#A#i## $41 8#444*1AY. $$ ^#•6 4*e*#'0 8*!8#44#• •4r****,e scl..*4**t. . x11$4•446$44#4#•44'4• ..' .x#d !#tie84***84 y4'6' .4 44**B4'tts68/8f#4'gip,. <11*_•***$lie*064 .#^ 6. e'" tit.#*•. ' 4*4.".-4*+ - 44#.tt,t** 6. *4#.66o##4, $.* ,4,6,St.#*4 . 44#,4t,#,4 *, 44#,tt,#4#4 44. #4##°,r € ° a n ;. n 66. c x- -.y� a '+4✓ , ; •. 6 Warner St .--i. ,...:. ,. .:_,, , -_ Northamton, MA 01062 , Builder: Nu-Way Homes Inc Model: John Handzel Custom Communi : Northamton THIS HOME IS CERTIFIED TO MEET THE -:= :41 2018 INTERNATIONAL ENERGY CONSERVATION CODE . : .' Building Features .: Ceiling Attic, R-49 Duct Supply R-8.0, Return R-8.0 4•.` .* .- Above Grade Walls R-23 Duct Leakage to Outside 19 CFM © 25Pa (0.67/ 100 ft2) �.. Foundation Walls R-13 Total Duct Leakage 94 CFM @ 25Pa (Post-Construction) ' ^-. =` Framed Floor N/A Heating Furnace • Propane •• 96 AFUE '- " Slab R-0.0 Perimeter, R-0.0 Under Cooling Air Conditioner• Electric• 13 SEER y +> ti: ss -4 Infiltration 1150 CFM50 (2.94 ACH50) Water Heating Residential Water Heater • Propane • 0.93 Energy .,. .• Factor S. Window U-Value: 0.28, SHGC: 0.34 43. #� .; ,- As a 3rd party extension of the code jurisdiction utilizing these reports, I certify that this energy code compliance document has been created in accordance with the requirements of r . :. . Chapter 4 of the adopted International Energy Conservation Code based on HAMPSHRE County.If rating is Projected,I certify that the building design described herein is consistent with ... t the building plans,specifications,and other calculations submitted With the permit application if rating is Confirmed.I certify that the address referenced above has been inspected/tested ,-. .._ and that the mandatory provisions of the IECC have been installed to meet or exceed the intent of the IECC or will be verified as such by another party t ,::x Name: Paul DellaTorre Signature: (ltrt L�rft�� <� - -:'. 4`s Organization: Energy Compliance Services Digitally signed: 1112/22 at ;3:17 PM • • _ Ekotrope RATER-Version 4.0.1.2810 2018 IECC compliance results calculated using Ekotrope RATER's energy and code compliance algorithm Ekotrope RATER is a RESNET Accredited HERS Rating Tool Al results are based on data entered by Ekotrope users . 4. :-� ) Ekotrope disclaims all liability for the information shown on this report. if�':-# • ## 4• #* _ 44 t4 4# �. to S4 #4 . 44 :, 4s „ i# .# t4 . . # , 4 . -* 4f#* 4•:4* #4##°I#•$44* 4 •"# *4'.. i4 '4.44 4�t* 4#4#•t� ##; • 44#'tt'4#4 �� 44# # Ft *#4 tA� 4 # /#•# 4 '4 •#►t°#6 ' • o, .4 R4444*, • 4#• . M • :44484!*#**##44#.*4. 6/ .4*#*#4i #44i4Y44. . I6 .4 *#44 4#f##t* V .# 44a4 # 4 * 4, . ,# 44*4 # ##4# #. by •# 4•4.4#b ##44• • *I • ##44 .4#* 4#*4 i 44•4. 4,•44 44## #♦44 #44S# *i w . , i IECC 2018 Label 6 Warner St Model: John Handzel Custom Ekotrope RATER- Version: 4.0.1.2810 HERS® Index Score: 55 Ceiling: R-49 Above Grade Walls: R-23 Foundation Walls: R-13 Exposed Floor: NIA Slab: R-0 Infiltration: 1150 CFM50 (2.94 ACH50) Duct Insulation: Supply: R8. Return: R8 Duct Lkg to Outdoors: 19 CFM @ 25Pa (0.67/ 100 ft2) Window & Door Specs ain'k U-Value: 0.28, SHGC: 0.34 Door: R-6 Heating: Furnace• Propane• 96 AFUE Cooling:Air Conditioner• Electric • 13 SEER Hot Water: Residential Water Heater Propane• 0.93 Energy Factor Average Mechanical Ventilation: 62 CFM Builder or Design Professional Sig-z. • CIC4ZLILI 43 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK / V V'"6`►� MA DATE 1� 1(2 / PERMIT#/f 9 ZO"ZZ"0031 CITI'�T�N1�N � / �- �' JOE- L ADDRESS 6 �.21�'ts✓�— //-- 1 OWNER'S NAME bWv ,1691/4/7Gt--, '-� N 0 Ig,R ADDRESS /J t AVe TEL9/f'S 3-dl) FAX , PE OR OC NCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL _ u u C&EAR :-NEVI RENOVATION: ❑ REPLACEMENT: ElPLANS SUBMITTED: YES❑ NO❑ FIXTURES 1 HLOOR-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB J 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) KITCHEN SINK / LAVATORY / / 3 ROOF DRAIN PLUMBING & GAS INSPECTOR SHOWER STALL / / VORI HAirPTON SERVICE/MOP SINK APPROVED NOT APPROVED TOILET / / 2 Y;��' �' URINAL WASHING MACHINE CONNECTION I WATER HEATER ALL TYPES / 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 NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY V 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 y kno ge and that all plumbing work and installations performed under the permit issued for this application will be in compliance • the Massachusetts State Plumbingin Code and Chapter 142 of the General Laws. bi PLUMBER'S NAME �i✓41e-1 D-A'^I LICENSE#7-`13S SIGNATURE MP❑ JP 2. CORPORATION❑# PARTNERSHIP❑# LLC❑# COMPANY NAME �i w�'"' ii ADDRESS /e CITY R/ate STATE/414 ZIP TEL TEL 9/? G Vq '4"4g7' /J FAX CELL EMAIL 65 2it.0 5 ►�u,�.�� C - ' ,9.‘--7 0' - �2 C(4)*2 N (10 __ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK An if , l,nnt , (cooky,),-}��-,6fCoto2P21-0y ---U =4 !CITY Me--14,—FP ✓ MA DATE Z1 �f PERMIT#6?-202 .-0021 '' I / =T ["R SITE ADDRESS t/ �at2N S� OWNER'S NAME�6✓ et,'"vt--e-/ °` Cr cI NER ADDRESS /a 4/Xi •74" - 6:— Q TEL 4/.i-57r-evt5-- FAX De TY0 OR �$E UPANCY TYPE COMMERCIAL❑ DUCATIONAL ❑ RESIDENTIAL Er----------- gr, PRfNT c t CLEARLYpit : [ENOVATION:ElREPLACEMENT:El PLANS SUBMITTED: YES❑ NO El0 N APPLTANL'1=Si: ) LOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Bark— BOOSTER CONVERSION BURNER _ COOK STOVE / DIRECT VENT HEATER DRYER FIREPLACE J FRYOLATOR FURNACE / GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT 'LUMBINC & CAS fNSf:CTOR OVEN klORTHAIvIPTON POOL HEATER ROOM/SPACE HEATER APPROVED NOT APPROVED ROOF TOP UNIT ' TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER / OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Er14100 0 I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAG Y CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY [ OTHER TYPE INDEMNITY 0 BOND 0 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 0 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 .- best of m kno. -:+e and that all plumbing work and installations performed under the permit issued for this application will be in compliance w' • . -_ . - . Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ___.1111"-- PLUMBER-GASFITTER NAME a r,,evc,,L 6( N LICENSE#3391 S SIGNATURE MP 0 MGF❑ JP JGF❑ LPGI❑ CORTORATION 0# PARTNERSHIP❑# LLC❑# COMPANY NAME °XS AI S 7 / - l+-, ADDRESS /04 -- CITY fiet.,�J-4,t- STATE MA ZIP 4/d?) $ TEL f/,3" 7i7?-e y 74 , FAX CELL EMAIL 0 5J---te......01-Ae457z-C_Ju4.11 C v M /Z .3 _.. GI2 �100323 $9.S '.� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK L. _ al Iffl !_ II ye CITY iNortl)ampton I MA DATE 09/14/21 PERMIT#6'P-2- 2-)"0.5 S 7-- 1 cam' i JOBSITE ADDRESS 6 Warner Street,Florence OWNER'S NAME Nu-Way homes 1 GOWNER ADDRESS 10 WHITE AVENUE,East Longmeadow 01028 TEL(413)563-0085 IFAX TYPE OR OCCUPAN Y TYPE COMMERCIAL 0 EDUCATIONAL © RESIDENTIAL 0 PRINT CLEARLY NEW:El I RENOVATION:❑ REPLACEMENT:El PLANS SUBMITTED: YES El NO El APPLIANCES 1. FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER 1 I- I BOOSTER j CONVERSION BURNER sin .i --_I_ _ i _-- - i �_ _ I , COOK STOVE DIRECT VENT HEATER lilt DRYER FIREPLACE i ' 1 i I FRYOLATOR 1 FURNACE 1, I 1 I I GENERATOR GRILLE I I INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT I OVEN I 1 [ ( ( _ _ POOL HEATER ROOM/SPACE HEATER � U ' & G;�' '', v • ROOF TOP UNIT .uai.aaMN E TEST UNIT HEATER I .'. UNVENTED ROOM HEATER I I OP lr WATER HEATER OTHER lUG Line I i � I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES ❑NO ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY 0 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. CP1::2--- PLUMBER-GASFITTER NAME Stephen Constantine I LICENSE# 3063 1 SIGNATURE MP❑ MGF❑ JP© JGF❑ LPG!0 CORPORATION®# PARTNERSHIP❑# LLC❑# COMPANY NAME:Osterman Propane LLC I ADDRESS 339 Amherst Road I CITY Sunderland I STATE MA ZIP 01375 TEL 413 549 1000 FAX 413 549 9360 CELL •EMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES — Z/ 9 T` r7 ..