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24D-213 (off 4iCr V'e--t s r' BP-2021-2116 65 WARNER ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-213-001 CITY OF NORTHAMPTON Permit: New Build PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-2116 PERMISSION IS HEREBY GRANTE I TO: Project# NEW HOUSE Contractor: License: Est. Cost: 325000 JOHN HANDZEL 013693 Const.Class: Exp.Date:07/20/2023 Use Group: Owner: NU-WAY HOMES INC Lot Size (sq.ft.) Zoning: Applicant: JOHN HANDZEL Applicant Address Phone: Insurance: 10 White Ave. 4135630085 EAST LONGMEADOW, MA 01028 ISSUED ON:10/28/2021 TO PERFORM THE FOLLO WING WORK: NEW HOUSE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector -i 7 .-z2 Underground: `Service: Meter: Footings: Rough- Z9- Z 2 Rough: 3 '4 c-2'3 House # Foundation: 4444weieay Final: 'inal:oy Final: Rough Frame: t=K ��°a �z ‘-07-2Z � ` - P-y_ a- Gas: Fire Depar im it 2P'`� Fireplace/Chimney: Rough: Oil: Insulation: 0 it -1`,- Z2 IV R Final:6,-Z4P—Z.. Smoke:491Z.,,,e [ - "7- Final: O.IL. (o-zq• iz i 'Q THIS PERMIT MAY BE RE\ OKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: i r ''' (Pi v , Fees Paid: $1,175.40 212 Main Street. Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 77 ,// t"W ,trio per ? 1 • The Commonwealth of Massachusetts City of Northampton Certificate of Occupancy a n c p 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 Nu-Way Homes Inc. BP 2021-2116 Identify property address including street number, name, city or town and county Located at 65 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 he 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 06/29/2022 Signature of Municipal Date of 23D-213 Building Official Issuance 06/29/2022 Home Energy Rating Certificate Rating Date: 2021-11-07 Final Report Registry ID: 331662974 Ekotrope ID: ILKP4akd HERS® Index Score: Annual Savings Home: 55 Your home's HERS score is a relative 65 Warner St performance score.The lower the number, the more energy efficient the home.To Builder: learn more,visit www.hersindex.com $ 2„25O Relative* to an average U.S.home NNorthamton, MA 01 062_ u-Way Homes Inc Your Home's Estimated Energy Use: This home meets or exceeds the criteria of the following: Use[MEltu] Annual Cost Heating 61.3 $666 2018 International Energy Conservation Code Cooling 0.6 $25 Hot Water 2.5 $107 Lights/Appliances 23.9 $920 Service Charges $81 Generation (e.g.Solar) 0.0 $0 Total: 88.3 $1,798 HERS Index Homo Feature Summary: Rating Completed by: 411hp, Mere 200,11V Home Type: Single family detached Model: John Handzel Custom Energy Rater: Paul DellaTorm RESNE I ID: 8,1/6762 Community: Northamton Existing • Ito Homes ,40 Conditioned Floor Area: 2,717 le Rating Company: Energy Compliance Services , ,zo Number of Bedrooms: 4 27 Hudson Dr.Southwick MA 01077 Referenc i- i ; Ito Primary Heating System: Furnace•Propane•96 AFUE 413-427-2423 e 3,00 Home w Primary Cooling System: Air Conditioner•Electric•14 SEER Rating Provider: Building Efficiency Resources Primary Water Heating: Residential Water Heater•Electric•3.85 Energy Factor PO Box 1769 Brevard,NC 28712 in House Tightness: 869 CFM50(2.19 ACH50) m 800-399-9620 60 filk Ventilation: 68 CFM•9 Watts Duct Leakage to Outside: 24 CFM @ 25Pa(0.88/100 fti) NI 40 Mistletoe Above Grade Walls: R-21 30 .. Ceiling: Attic,R-49 20 Window Type: U-Vaiue:0.28,SHGC:0.34 Pad Delfa,MI le to Zeta Energy Foundation Walls: R-13 Home cl Paul DellaTorre,Certified Energy Rater Framed Floor: N/A "Mk, i„•••1.itvDigitally signed:6/27/22 at 4:45 PM v24,1,0%, ib ekotrope Ekotrope RATER Version:4.0.1.2938 The fnergy Rating Disclost ire for this home is available from the Approved Rating Provider. This report does not constitute any warranty or guarantee. Home Energy Rating Certificate Rating Date: 2021-11-07 Final Report Registry ID: 331662974 Ekotrope ID: ILKP4akd HERS. Index Score: Annual Savings Home: Your home's HERS score is a relative 65 Warner St performance score.The lower the number, 5 Northamton MA 01062 the more energy efficient the home.To2 Builder. learn more, visit www.hersindex.com 329 *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 54,4 S591 2018 International Energy Conservation Code Cooling 0.6 $28 Hot Water 2.5 S 107 Lights/Appliances 23,8 S912 Service Charges $81 Generation re.g. Solar) 0.0 50 Total: 81.2 $1,719 HERS Index Home Feature Summary: Rating Completed by: 46, r..r.I Home Type: Single family detached Model: John Handzel Custom Energy Rater: Paul DeilaTorre Iv rMsr,t; ,•o Community: Northamton RESNET ID: 8776762 N001es no Conditioned Floor Area: 2,717 ft2 Rating Company: Energy Compliance Services Number of Bedrooms: 4 27 Hudson Dr.Southwick MA 01077 r, ,,p '""""" :'D Primary Heating System: Furnace•Propane•96 AFUE 413-427-1423 Hor0t' ""'100 Primary Cooling System: Air Conditioner•Electric•14 SEER 90 Rating Provider: Building Efficiency Resources Primary Water Heating: Residential Water Heater•Electric•3,85 Energy Factor PO Box 1769 Brevard,NC 28712 ro House Tightness: 869 CFM50(2.19 ACH50) 800-399-9620 -sow Ventilation: 68 CFM••9 Watts ,u Duct Leakage to Outside: 24 CFM @ 25Pa(0.88/100 ft2) —`a0 This Ham Above Grade Walls: R-21 . p° Ceiling: Attic,R-49° Window Type: U-Value:0.28,SHGC:0.34 [alit -/� 1 of fa rol v zero Energy c Foundation Walls: R-13 Framed Floor: N/A Paul DellaTorre,Certified Energy Rater �' � WI bogy Digitally signed:6/27/22 at 4:45 PM 0 E'kotr0 p Ekotrope RATER-Version:4.0.1.2938 The Energy Rating Disclosure for this home is available from the Approved Rating Provider. Energy savings calculated without modifications to the energy model.(As Modeled) This report does not constitute any warranty or guarantee. 65 Warner 't Northamton MA HERS*Index Store: Rating Date: Nov 7,2021 55 HERS Registry ID: 331662974 Annual Estimat-s: Rating Company: Electric(kWh): 7,554.8 Energy Compliance Services Rating Provider Propane(Gallon ): 6094 Building Efficiency Resources CO2(Tons): 8.7 Rating Provider Address: Box 1769 Breva 28712 HERS Index Home Feature Summary: Single family detached,4 --1 bedrooms,2,717 ft2 I a* Heating:96 AFUE Fxtsttng j 140 Hrtt#5 t 1 110 Cooling: 14 SEER .........:LC Hot Water:3.85 Energy Factor loci Air Leakage: 869 CFM50(2.19 ACH50) in Iv Ventilation:68 CFM•9 W _ Duct LTO: Tho Noma 24 CFM @ 25Pa(0.88 i 100 ft2) Above Grade Walls:R-21 II Ceiling:Attic.R-49 Home,,4,9 Enew o Window:U:0.28•SHGC:0.34 '4111P° ""bwitt Foundation Walls:R-13 Ekotrope RATER-Version: iir ekotrope 433.1.2938 rots report does not constrtute arty warranty ot guorentre. IECC 201 : Performance Compliance Property Organization Inspection Status 65 Warner St Energy Compliance Servic 2021-11-07 Northamton, MA11062 Paul DellaTorre Rater ID (RTIN): 8776762 Model: John Haniizel Custom RESNET Registered Community: Nort amton Builder (Confirmed) Nu-Way Homes Inc 0009_John Hand•el65 Warner St Northampton 211107 HERS_0727_000•_John Handzel65 War er Annual Energy Cost Design IECC 2018 Performance As Designed Heating $2,364 $2264 Cooling $100 $69 Water Heating $118 $118 Mechanical Venti ation $60 $12 SubTotal - Used to determine compliance $2,643 $2,462 Lights &Applian -s wlout Ventilation S993 $993 Onsite generatio SO SO Total $3.635 $3,455 R405.3 Sour e Energy Exception: The proposed home uses 9.06 MBtu LESS source energy than the reference home. Requirements O 406 3 Performance-based compliance passes by 9 4% • R402 4'I 2 An Leakage Testing Air sealing is 2 19 ACH at 50 Pa It must not exceed 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 • R403 6 1 Mechanical Ventilation Efficacy • Mandatory Checklist requirementsMandatcheckedor4c=tropiiust thatmet are not (6) IRC,f,1150" 4 3 Mechanical Ventilation Rate • R405.2 Duct Insulation Desig exceeds requirements for IECC 2018 Performance compliance by 9.4%. As a 3rd party extensio of the code junsdiction utilong these reports.I certify that this energy code compliance document has been created in accordance with the requirements of Chapter 4 of the adopte,International Energy Conservation Code based on HAMPSHIRE County If rating is Projected,I certify that the building design described herein is consistent with 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 th- 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 N.me: Paul DellaTorre Signature: Pat<(OeflaMi Organize ion: Energy Compliance Services Digitally signed: 6127/22 at 4:45 PM Ekotrope RATER- Version 4.0.1.2938 IECC 2018 Performance compliance results calculated using Ekotrope RATER's energy and code compliance algorithm Ekotrope RATER is a RESNET Accredited HERS Rating Tool.All results are based on data entered by Ekotrope users Ekotrope disclaims all liability for the information shown on this report ` •*s a!#+t'.1'�4 s'a• � s ,4'..'r+'i'+'st..•t •+#'+'•'t.`.•'r 1 s'i.•• •0 1'A'i,£.+ tV*.'i, •#•'#"#'i,•.;*.`•`3. •3 �' it+•#'R e'i'i.•.i'4+"s'+..i• • ,.,,,V e :,�+"+'#'#. . t', • }/'less##+ .s*s•••• #•+i, 1.#34•+ •e*a.e++#+s•,t1•11•i#a#•.i*s.sa+••i{ 4.4..•s••l+a,+#,t+ is',id .t•#t♦ .•+m •i..,41,• ti tis• • •+ise1f.3et •3s.•'+tt*'s•'ei •' •3 ._ ' • a it t• ... .465WarniSt .,..... . :.: � •-. Northamton, MA 01062 ,�- •.a" Builder: Nu-Way Homes Inc Model: John Handzel Custom Community: Northamton ... .µ-:'), THIS HOME IS CERTIFIED TO MEET THE ‹ ,` „ „. 2018 INTERNATIONAL ENERGY CONSERVATION CODE =.• :� Building Features . Ceiling Attic, R-49 Duct Supply R-8.0, Return R-8.0 . . : 1 Above Grade Walls R-21 Duct Leakage to Outside 24 CFM @ 25Pa (0.88/ 100 ft2) =' Foundation Walls R-13 Total Duct Leakage 129 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• 14 SEER Infiltration 869 CFM50(219 ACH50) Water Heating Residential Water Heater• Electric• 3.85 Energy • ,•. Factor Window U-Value: 0.28. SHGC: 0.34 . As a 3rd party extension of the code jurlsdiction utilizing these reports.I certify that this energy code compliance document has been created in accordance with the requirements of :;,: Chapter 4 of the adopted International Energy Conservation Code based on HAMPSHIRE County.if rating is Proiected,I certify that the building design described herein is consistent with •.� �` me building plans.specifications,and other calculations submitted Aith Me permit application If rating is Confirmed.I certify that the address referenced above has been inspecteditested r'. ,' and that the mandatory provisrcms of the iECC have been instated to meet or exceed Me intent oh the IECC or will be verified as such by another party 4r° .w .y y7 ' -;�„; �M. Name: Paul DellaTorre Signature: Art( diiT.; ff • e'-e Organization: Energy Compliance Services Digitally signed: 6t27/22 at 4:45 Pt `»' a. Ekotrope RATER-Version 4.0.1.2938 . 2018 IECC comptance results calculated using Ekotrope RATER's energy and code compliance algorithm. Ekotrope RATER is a RESNET Accredited HERS Rating Tool Alt results are based on data entered by Ekotrope users. Elotrope.disclaims all liability for the information shown on this report 4 ' :• a,. s. es re. + ri . ,... , • s . i 4e # . t #1,r+ . ti ti t , tt * 'i••• 'ii 4e r i • • l•• s•.1 * a. #. t• rt e• �+3 I •e ti .$ats•+••L't•t •. jl •t#••e.'t a+ +• a tee+# t tt•�k, r • + .tels'•i r t•t • ' 't•tt•s t +.s.6itt'#s'e t!• s• e .$ s• #' s•#°••s•.i•l.t••` • yi• N•,. t•e •• •• ••• 4•••4, 4e••4' � .4••is a •, . stss•!•••ss•s3, a is•i+:'#.1''t•,••' .i••I'`,.'isss•e a#+e t•.„,#i t+•• n•I#t ,+ . .s NECC 2018 Label 65 Warner St Model: John Handzel Custom Ekotrope RATER-Version:4.0.1.2938 HERS®Index Score: 55 Ceiling:,R-49 Above Grade Walls: R-21 Foundation Walls: R-13 Exposed Floor: N/A Slab: R-0 Infiltration: 869 CFM50(2.19 ACH50) Duct Insulation: Supply: R8, Return: R8 Duct Lkg to Outdoors: 24 CFM a@ 25Pa (0.88/ 100 ft2) Window & i oor Specs U-Value: 0.28, SHGC: 0.34 Door: R-6 Heating: Furnace• Propane• 96 AFUE Cooling:Air Conditioner• Electric• 14 SEER Hot Water: Residential Water Heater• Electric • 3.85 Energy Factor Averaoe Mechanical Ventilation: 68 CFM Bulkier or Design Professional Signature: to6wI-- , e- sl Itxpp��// II��//yyi� II Official Use Only Conuxoes�veaLtla o�fi'(a�a,rhaaeftt3 I" *:ii, 'i Permit No. Et'''-- 2-2-0' 3 ", j .epartmenl of.ere ..�sruicee 1 '_1 Occupancy and Fee Checked />'� " t BOARD OF FIRE PREVENTION REGULATIONS ev. 1/077 1 V (leave blank) ! MP APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ORK All work to he performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.Of) (PLEASE PRINT IN INK OR TYPE ALL INFORM4TION) Date: e `s, '2 2 / City or Town of: /Vd r-'4 c np i,1 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 6 3S l`Ili..ffa e - .S#ree.i- Owner or Tenant Jt;1)r i Han n 2e./! Telephone No. AV) S s Oi t' Owner's Address /0 i.ill)i Ave. 6.4-.54- l-�'•� rate{vt-r.:'t f in A L..'10 2 y" Is this permit in conjunction with a building permit? Yes 1 No E (Check Appropriate Box) Purpose of Building 4 C t:.O L.01.__`ft'r'tAC.t c:*'t Utility Authorization No. 3o,S ;,2 SY. / Existing Service Amps / Volts Overhead ❑ Undgrd E No.of Meter New Service 204-, Amps t 24) / 2`'tO Volts Overhead Er. Undgrd 0 No.of Meter j Number of Feeders and Ampacity i Z Location and Nature of Proposed Electrical Work: 71/eA L.Ort S*t••'td{G-tic.� 0 /I r/'t!r j t Completion of the followin fable may be waived by the Inspector of Wires., No.of otal No.of Recessed Luminaires No.of Ceil Susp.(Paddle)Fans Transformers 'I : KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency-Lighting No.of Luminaires Swimming Pool grad. � grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and initiating Devices No.of Ranges No.of Air Cond. Total g Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices p al No.of Dishwashers Space/Area Heating KW Local 0 MConnecunicition [J Other No.of Dryers Heating Appliances KW -Tecurity Systems:* r Y Na of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent a Bathtubs No.of Motors Total HP 'Telecommunications No fDevi Wiring: No.Hydromassage Na of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of!fires. Estimated Value of EI tric l Work: (When required by municipal policy.) Work to Start: .. ,�2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial eqttivalent. The undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing ounce CHECK ONE: INSURANCE [BOND 0 OTHER 0 (Specify:) I certir,under the pains and penalties of perjury,that the information on this application is true and comp! e. FIRM NAME: ra11cy e/ .c• -c,C1"ch.-t LLe LIC.NO.: Licensee: ;Octd 1 S I a'' f3,/e} Signature veezi -9< LIC.NO.:' , -=J'/ 7 -13 /Ifapplicable,enter "exempt"in the license number line i Bus.Tel.No.:013)3 7 -394i 7 Address: y 3 Tck: h fi , yt,, /01/ t'17 9 0/O'S• Alt.Tel.No.:_ *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance cove ge normally required by law. By my signature below,J hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ .2 C. C. - a - a- Qo vb , `'� S_ / 7- 2.), SOILJ,L OirilL c 141, 26 bat L t1r Ll L, at-(- a a- r i`Nti 1 P'\Th - . MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _1, ,51 CITY/TOWN pr a . ft4 MA DATE 3/irj2 L PERMIT# 7P2,.0 22.- 0/0 7 JO11 SITE ADDRESS 65 LJa..LN�2 S." OWNER'S NAME J4L j ,itet rno PN OWNEf#ADDRESS /v �✓ `�- A- chi Cory TEL 4l3'SZ 3' oo5f FAX TYPE ORF- OCtOPIiNCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL®/ PRINT CLEARLY NEW:lie RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ IllalRES 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) PLUM INC GAS INSPECTOR LAVATORY KITCHEN SINK r NORT AMPTON ROOF DRAIN / / APPR VED ItO i APPFOVED ROOF SHOWER STALL / / SERVICE/MOP SINK TOILET / / 2 URINAL WASHING MACHINE CONNECTION / WATER HEATER ALL TYPES 1 WATER PIPING / /_ j uIfltr INSURANCE COVERAGE: I !-• -r!ts- L • -.' ----- -L! \' ---4- ' _-- --• _l "! Al A•.! r1 have a current li'h'+:t.!„--=-�r-r-x n+.::; "-- -- I'- --- IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY i 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 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 wiedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with fir^^• ,.c PLUMBER'S NAME GN✓r/L ''S" LICENSE# 33 e(3S GN URE MP❑ JP rie . CORPORATION❑# PARTNERSHIP❑# ) LLC❑# rsAUL1RtV killRf.0 Sh1..1S /4104- ffllr-iicce (9) CITY C��u� ✓1 // �' STATE 414 ZIP a//Jt) TEL 9/? - ' ? ' Wth __ FAX CELL EMAIL �+�ea"!^'� "AI I'd ,'14 22 27 Z ck4/D / -4gg MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK kr, !6 1=i= CITY G lv z" MA DATE JAZZ-- PERMIT#(-)(-ZD, Z-62 o \ 0 6 S Gt-�''''- -- SI OWNER'S NAME T i n t✓v e JOBSIT&ADDRESS j . G1V OWNER;ADDRESS /ol14j A/5 g (.6 ( TEL yl3'S7. /657 FAX TYPE titOCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL ❑ RESIDENTIAL ILIK PRINT CLEARLY NEW:RENOVATION:El REPLACEMENT:El PLANS SUBMITTED: YES El NO❑ APPLIANCES Z FLOORS-4 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 j ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER I 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 L� NO El I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERA BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY El 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 El 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 kno edge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pe . t • e Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME DN/ '1- OS k^) LICENSE# 334 35 SIGNATURE MP El MGF❑ JP` JGF El LPGI❑ CORPORATION El# PARTNERSHIP El# LLC❑# &d COMPANY NAME C $ Pla.+M-J/i ADDRESS /8.-Sio-ee/ CITY efAr kr ✓� STATE �� ZIP dl�g !'TEL 4i/3-777h r6 11FAX CELL EMAIL cA/c.D e -6 q/�,a,��..GaAl y"-,y"se `co 2v!JT3'24. 1 2 2 -- 2/ - C k ° /001,0 I A(/J . . MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK K awfi�r 3j avl_' � CITY FLORENCE I MA DATE 06/14/2022 PERMIT#6e-2022"02 f c JOBSITE ADDRESS 65 WARNER ST OWNER'S NAME NU-WAY HOMES 1 I ,! OWNER ADDRESS 10 WHITE AVENUE,EAST LONGMEADOW,MA I TEL(413)563-0085 IFAX , . I —TYPE TT-�� C Qiii U�O •ANCYTYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL cc,,,-'CLEARI 1 N :as RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ ',APPLIANCES 1 I,FL•ORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER 1 1 1 r BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR ikllll'iiIillhi GRILLE INFRARED HEATER LABORATORY COCKS I Y MAKEUP AIR UNIT OVEN 1 LU a IN'; & c 5 1 j bP: T POOL HEATER 1 'UH i A O I' ` ROOM/SPACE HEATER PP' •V I i OT . PP` O F.r' IIE::T:ERIORLINEII NITIR 1r II OOM HEATERER _•._ !I �1ineO EXISTING INTERIOR LINE 1 INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 YES ❑NO Li I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. C PLUMBER-GASFITTER NAME Stephen Constantine I LICENSE# 3063 Ix SIGNATURE MP 0 MGF❑ JP❑ JGF❑ LPGI❑ CORPORATION❑#I I PARTNERSHIP:It.. LLC Q#I _ I COMPANY NAME:Osterman Propane LLC ADDRESS 339 Amherst Road I CITY Sunderland STATE MA ZIP 01375 TEL 413 5491000 _ I FAX 413 549 9360 CELL EMAIL _m. n„ 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