36-112 (2) ROOKSDE C1R BP-2022-0901
215 I I5Bo :L COMMONWEALTH OF MASSACHUSETTS
36-I 12-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0901 PERMISSIONISHEREBYGRAN D TO:
Project# BASEMENT BATH Contractor:
Est. Cost: 13132 License.
Const.Class:
Use Group: Exp.Date:
Lot Size (sq.ft.) Owner: L EDWARDS, REBECCA
Zoning: WSP Applicant: L EDWARDS, REBECCA
Applicant Address Phone:
215 BROOKSIDE CIR Insurance:
FLORENCE, MA 01062
ISSUED ON:08/02/2022
TO PERFORM THE FOLLOWING WORK:
ADD BATH TO BASEMENT
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: Rough: House #
Foundation:
Final:/9,y O. Final: (� P a2
� - y� Final: Rough Frame:
Gas: Fire Department -, Driveway Final: Firep
lace/Chimney:
Rough: Oil:
Insulation:
Smoke:
Final:O.K I I-1-zz d e
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL• TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: ;
,) (A). ' •
;'
Fees Paid: $85.00
212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272
Office of the Building Commissioner
op
6:_k. 41/7O 89 Ta,
,l I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY I - .r/orC,)cF_ ._ MA DATE( 8111 a• „.._ PERMIT#Pj-D2 -O2'7
4BSITE ADDRESS i a/5,_ !?vK.3'iae.. Gei- ' OWNER'S NAME! %E.r3�'crq dw -Ps
-OWNER ADDRESS c?4S- 'Q'-oo K 8f'Oe Cie- __I TELl 7Jy-7a25�-s3' !FAX i• „._._,_ .....
TYPE OR OCCUPANCY TYPE COMMERCIAL 77 EDUCATIONAL ,--: RESIDENTIAL
PRINT
CLEARLY NEW: i RENOVATION:,} REPLACEMENT: PLANS SUBMITTED: YES -1 NOT1
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/OIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER r __ _. _._ ,
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY _;; _ ::—_,Y.._:-_ .. _
ROOF DRAIN
-PLUVIBIRG al-GAS-II
SHOWER STALL J M f'f
N-- - -"-_
SERVICE/MOP SINK NOR THA PT q
TOILET ` _. APPR - NrJI *P QV`_b
URINAL •._ _.. _
WASHING MACHINE CONNECTION :_
WATER HEATER ALL TYPES
WATER PIPING
OTHER ! -
a
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 17 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 compliance with all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. , --
PLUMBER'S NAME Mitchell Matusiewicz i LICENSE# •9523 SIGNATURE
MP"'�_ JP LI CORPORATION i' 1#1 2543 iPARTNERSHIPI if i LLC! _WI_
COMPANY NAME; AM/PM Plumbing and Heating,Inc. i ADDRESS;PO Box 527,46 Prospect Street h__ �. __.._��w.__'
CITY'Hatfield STATE j MA : ZIP :01038 ; TEL 1413-247-5502
FAX 413-247-5544y?CELL;GRs fefigr EMAIL 1 a mpmplumbingr�verizon.net__ _� �� _
22-A7- Q/
tea , (3 1 Z24 -
z-' (.:J/. tvr/rc' I V . G IRC
Commonwealth,o/Ir/addacLdettd Official Use Or ly
sue`=
aF WNW�• cc�� Permit No. ip 2D —b 77 (
;� 1 2e artnrent o p�ire Serviced
a Occupancy and Fee Checked AZ/�
rv `, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
ry All work to be performed in accordance with the Massachusetts Electrical Code(MEC), CMR 12.00
(PLEASE PRINT IN INK OR TYP ,ALL INFORMATION) Date: —e)6 a;—
City or Town of: 7U<k o i To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perfop the electrical work described below.
Location(Street&Number) ? IS t�V-pal�Svc12 C. t r O�ey1G4. ,�IdA'
Owner or Tenant et:0� f a,visa9 3 Telephone No.
Owner's Address
Is this permit in conjunction jtli a building permit? Yes 2 No ❑ (Check Appropriate Box)
Purpose of Building V-'e Il4 r,/7 Utility Authorization No.
Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters
New Service Amps - / Volts Overhead❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: \-rj.fl-- ..i h
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑-No.of Emergency Lighting
grnd. grnd. 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 No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Connectionppl
❑ Other
p• Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW -No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications NofDeieor Wiring:
No.of Devices Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of ' ctrical Work: (When required by municipal policy.)
•
Work to Start: --- Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO ERAGE: 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 equivalent. The
undersigned certifies that such o erage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:)
I certify,under the pains and p 'rallies of perjury,that the information on this application is true and complete.
FIRM NAME: O(..U& OC)1 . ,ItC-(1' 1C l a IC.NO.: g.916,
Licensee: O Wa4\ L. 0 J Wtnut Signature LIC.NO.: ��`
(If applicable errt r"exempt"in the license number hie.) Bus.Tel.No.: �L
Address: 'd (A)- Cc)Mtn Ir+-fie" Q Ct)M^^1,1 yf+(-1 ).AU4 dlo,)Ge 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 coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ 6 S
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