23D-174 (3) BP-2023-0008
30 BAKER HILL RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23D-174-001 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-2023-0008 PERMISSION IS HEREBY GRANTED TO:
Project# 2023 RENO Contractor: License:
Est. Cost: 10000 MATTHEW KOZUCH CS-106644
Const.Class: Exp.Date: 09/25/2024
Use Group: Owner: MATTHEW KOZUCH
Lot Size (sq.ft.)
Zoning: URB Applicant: MILL RIVER DESIGN BUILD
Applicant Address Phone: Insurance:
611TGF Sr ( c0CLA, ` `i4133418893 WC2-315-624269-010
FLORENCE, MA 01062
ISSUED ON: 01/05/2023
TO PERFORM THE FOLLOWING WORK:
REMODEL 5'X8' BATHROOM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: X.:-----Rough:i
Service: Meter: Footings:
Rough:///e/Al ,a,QJ .�3 House # Foundation:
Final: L/9yy� Final:9 1_.7.3 Final: Rough Frame: ') J(./Z
�QV�
Gas: g6„ire Departm t i' Driveway Final: Fireplace/Chimney:
Rough: Oil: 1nsulation:0 1-2f -V g-if
Smoke: Final: D.,Z q.Z2.23 K,j
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: '
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-12 72
Office of the Building Commissioner
30 B('V- i--t2, I-?-i 1.1- / j //�� n DD//
Commowealth o`ifiaMach.u.Ietli Official Use Only
►'-*- - ,/ c� c7 Permit No.(` 2023•'-'003e)
= ��1- a[lepartmenl o�}ire�erviceo
I Occupancy and Fee Checked#//O`,
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
a
_APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(LEASE PRINT IN INK OR TYPE ALL INFOR4VIATION) Date: I)x‘ '1-3
City or Town of: r� P re-'<`-\R,,,,A°NN To the Inspector of Wires:
By this application the undersigned gives notice of his o�\her intention to perform the electrical work described below.
Location(Street&Number) , 0 �,,NY--lam W \\
Owner or Tenant I"ii,i 'LA./L h Telephone No.j I3 '341 • $g 9 3
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No n (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Ili Amps 1-1J) / L4 a Volts Overhead V Undgrd❑ No.of Meters
New Service Amps / Volts Overhead n Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: g,,otvi,rcera.i,--. t-{%Nvv TIAD
Completion of the following table may be waived by the Inspector of Wires.
No.
rano KVA
Total
No.of Recessed Luminaires No.ofCeil:Susp.(Paddle)Fans Tf
Trsformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above i—i In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
oNo.of Switches No.of Gas Burners No. Initiating
and
on 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 Heating KW Local❑ Municipal ❑ Other
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 Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: VI I /7 3 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 equivalent. The
undersigned certifies that such cov age is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE [1 BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
R
FIRM NAME: Dv LA l'be-LA1z - 1-1...,�' L- LIC. NO.: ? Zl`'I A
Licensee: (AN D lif.1 A Signature /w /I" LIC. NO.: Z 3 L 1 1 - A
(If applicable,enter "exempt"in the license number line) ` Bus.Tel. No.: `i 13 'ZG 2 ' D 1`,/,Address: l,7� HorC.A "-1 sT MDi14<6 � Q I l4► 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 ❑owner's agent.
Owner/Agent S
Signature Telephone No. PERMIT FEE: $ ' ('' ':*)
L071 ) yN rL - J '
LAP) 14 c.e'Q
C_k_#61L, (Fe)
.. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
-f,_ CITY Northampton MA DATE 1/3/2023 1 PERMIT# PP 202r3 D003
i
JOBSITE ADDRESS 30 Baker Hill Rd 1 OWNER'S NAME Matt Kozuch I
OWNER ADDRESS 30 Baker Hill Rd TEL 413 341 8893 IFAX 1,,,.., ,,
P ��-
J
i RESIDENTIAL L
TYPE OR OCCUPANCY TYPE COMMERCIAL G EDUCATIONAL
PRINT
CLEARLY NEW:Eil RENOVATION:0 REPLACEMENT:Li PLANS SUBMITTED: YES El NO®
FIXTURES Z FLOOR-, BSM 1 2 3 4 5 j 6 J 7 8 9 10 11 12 13 14
BATHTUB .. __ I _ `. . . .' ..
CROSS CONNECTION DEVICE L ..[ ........ ._ ..., „.w.a. ,.w.y ...... ':.__
DEDICATED SPECIAL WASTE SYSTEM i `� ( MI tIN.
[ [,
DEDICATED GAS/OIL/SAND SYSTEM 1 L i L [ [- ;
DEDICATED GREASE SYSTEM _ .: .__h l .... . .
DEDICATED GRAY WATER SYSTEM I, e 1 11 _,_ _ , >t
DEDICATED WATER RECYCLE SYSTEM E. [ __ ? ,, ._�., ,.. : _
DISHWASHER � . ..__�C 11 .._._. [ mg
DRINKING FOUNTAIN ( S Mil l :[-7-__ ,: I,,,..,�; - . •
FOOD DISPOSER I -MB_ I ,, cam Olt i
FLOOR/AREA DRAIN
INTERCEPTOR
KITCHEN SINK (INTERIOR) C ...vv ..._.:: �.. .. .�
........
LAVATORY , �j,. ,
ROOF DRAIN �I . (..... .. . .- 1 MI NM
SHOWER STALL r _._.....____ I MOM...... €
SERVICE/MOP SINK 1„,,,T r- � ,,.,,,• [___ 1_mm 1 _ _ —„ -
TOILET � 1 j____ r 1 i
URINAL i 1 _
WASHING MACHINE CONNECTION - _. �. .. �: W' __ __ _______
WATER HEATER ALL TYPES _ I- i _ 1
WATER PIPING __ pin 1 1
OTHER 1 E E .1
' d z �y i
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES L _" NO I
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
._
LIABILITY INSURANCE POLICYOTHER TYPE OF INDEMNITY I
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 U AGENT L I
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this application are tru d ac o t best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in co pli ce h all a vent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME John T Geryk ,_ LICENSE# 16079 NA TU
MPL JP CORPORATION`0, # IPARTNERSHIPE 1295560 LLCU#�
COMPANY NAME( John T.Geryk Plumbing&Heating LLC ADDRESS 5 Crescent St J
CITY I Northampton . 1 STATE MA ZIP 01060 TEL L413-727-3057
- --- -------FAX J CELL 413-336-3893 £EMAIL 'ohn ohnt eryk lumbin .coin
-fr(C)`1Q-d r-g -/