04-003 (8) 521 AUDUBON RD BP-2019-1008
GIs#: COMMONWEALTH OF MASSACHUSETTS
MV.-Block: 04-003 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categ,ory: Bath reno BUILDING PERMIT
Permit 4 BP-2019-1008
Project# JS-2019-001661
Est. Cost: $21150,00
Eeek 137.00 PERMISSION IS HEREB Y GRANTED TO:
Qojist._Class, Contractor: License:
Use:Group: DANIEL HATHAWAY 081793
Lot Size(ssq. ft.): 718740.00 Owner: ANSALDO ROBERTI,& KELLY J
Zoning: RR(100)/WSP(54)/WP(15)/ Applicant: DANIEL HATHAWAY
AT. 5241 A 1.1 Q US 0 'In"D
Applicant Address: Phone: Insurance:
2 OLD GOSHEN RD X413)695-2937 0
WILLIAMSBURGMA01096 ISSUED ON.311912019 0:00:00
TO PERFORM THE FOLLOWING WORK.-RENO BATHROOM
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: Roug1j; A/,1% 0 t flousp# Foundation:
04 g q I I j �,ARf "'Iveway HUM:
Final: Final., Rough FrAme-,(J,J(-
Gas. FireEemD rt'mut Fireplace/CIii maty:
� a
Rough; Oil: Insulations
Final: Sg Filial; (5),X —7-IZ-)q t12
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND RE IONS.
C=,
Certificate of 0 Signature:
FeeTXpe: Date Paid: Am 4, -at:
Building 3/19/:019 0:00;00 $137.00
212 Main Street, Phone(413)5$7-1240,Fax: (413)587-1272
Louis Ilasbi-oock-—Building Coin in ission,-i-
Lit- `-r U rC/414'/ C) `1
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY Leeds I MA DATE 4/2/2019 PERMIT# PP– 1 fn �)Sl
JOBSITE ADDRESS 1521 Audubon Rd OWNER'S NAMEJ Rob Ansaldo
POWNER ADDRESS I I TELI IFAXF–
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
PRINT
CLEARLY NEW: ❑ RENOVATION:Q REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NOQ
FIXTURES 1 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 NORI
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY 1
ROOF DRAIN
SHOWER STALL 1
SERVICE/MOP SINK
TOILET 1
URINAL
WASHING MACHINE CONNECTION
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!J 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 of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in complia ce with all Pe nt oreviMon of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. G'
PLUMBER'S NAME I Christopher T Salva LICENSE# 15800 SIGNATURE
MP[AJP❑ CORPORATION F–] �
# PARTN I,P/❑�#F— LLCD#
COMPANY NAME I CTS Plumbing&Heating Co. Inc. ADDRESS 1200 Old Belchertown Rd
CITY Ware STATE MA ZIP 1 01082 TEL 413-230-9705
FAXI I CELLI I EMAIL
Y/5-A
521 AUDUBON RD EP-2019-0685
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 04
Lot: 003 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE RENO BATHROOM
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2019-001661
Est.Cost: Contractor: License:
Fee: $65.00 DAVID P FOSTER JR Journeyman 37855E
Owner: ANSALDO ROBERT L & KELLY J
Applicant. DAVID P FOSTER JR
AT. 521 AUDUBON RD
Applicant Address Phone Insurance
24 STAGE ROAD (413) 296-0219 C-(413) 695-6168
WILLIAMSBURG MA01096-9304 ISSUED ON:4/9/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE RENO BATHROOM
Call In Date: Date Requested Inspection Date/SignOff: Reinspect?:
Trench/UG:
Special Instructions
X
Rough
x
Special Instructions:
Final: f' 9" /I Q6
SRE Called In:
Signature:
Fee Type:: Amount: DatePaid
Electrical $65.00 4/9/2019 0:00:00 1310
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo