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32a-169 (4) MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY V MA DATE 3/.).4111 PERMIT# L10-1 �� L JOBSITE ADDRESS 3l, �AM- W j 3--1 OWNER'S NAME rt( GOWNERADDRESS I% RktA5 96ACj( (Zo)(awgV 1 013`1( TEL 413-361- kiI �FAxI Sov%k, TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL( PRTNT CLEARLY NEW. RENOVATION: REPLACEMENT:X PLANS SUBMITTED: YES NO APPLIANCES-1 FLOORS 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 - ROOM I SPACE HEATER ROOF TOP UNIT TEST A 1 SP CT Q R UNIT HEATER WUH111A PTO UNVENTED ROOM HEATER JkPPF OV OT 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 NO 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 i pli ce wit all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME-T--I,/ '� ��, a�,ey LICENSE#73A 31 SIGNATUR MP MGF JP X JGF LPGI CORPORATION # PARTNERSHIP # LLC # COMPANY NAME`,,.,,,{�i�, y n.ty �`Umh�n�. ADDRESS'73 4 Lt t) pK/ V CITY 1V ��J $r��ri� --T STATE )\ ZIP O)3 S 1J TEL 4) 13 T3 q va,4,) FAX CELL T�EMAIL 74 --L) -qj„� �)G -y,�,o U i C a H't 3ZA - I�� MASSACHUSETTS UNIFO APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY '. .a��. > -tan --- ` MA DATE PERMIT# .(bP— JOBSITE ADDRESS 3L ��ty unI OWNER'S NAME �s �y5 Cc GOWNERADDRESS 1ytD `Qf�45Q _(ZDj(a,,.y 1D,3L{( TELLi 3(,j-�j 72` FAX �, TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES N06{ APPLIANCES-1 FLOORS— 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 .t ROOM ISPACE HEATER ROOF TOP UNIT TEST NORTH &ff�'TON UNIT HEATER UNVENTED ROOM HEATER PROVED WATER HEATER OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch,142 YESJCC NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY Lj 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 c rpliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAMEj->,, � LICENSE#3 03 SIGNATURE MP MGF JP':; JGF LPGI CORPORATION # PARTNERSHIP # LLC # COMPANY NAME: ADDRESS W����y �lv,�b;n ADDRESS 3 4 6�1�� u,l L �� CITY �3k�J St,�Ar,_, STATE 'M-A ZIP TEL I 4'3U 641 FAX CELL EMAILwh,kl}j,)(�4 Cot . y �, yr 03VGRTIAT04 mss.; >,► ; �, UX PZ14- 'f LO (ice o'ke Cic -_ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK y� CITY N ct.�1��m�aan MA DATE3l�'ap0 /9 PERMIT# 1 JOBSITE ADDRESS[31, 54 U v�l� 3 OWNER'S NAME GOWNER ADDRESS °(O Xee85tar dye Qct t(vAvc-yjCj3't` TELit3-361- ti�1z FAX s . TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NON), APPLIANCES Z FLOORS— BSM 1 2 3 4 5 8 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 ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATERPP OVE.. OTHER — 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 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 b co n all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAM15_0_„ '� ") 4Ay LICENSE#jrZo3 SIGNATURE MP MGF JPS JGF LPGI CORPORATION # ` PARTNERSHIP # LLC # COMPANY NAME..( ,,,�,..�, �,.) ' 'P1�M to*A, ADDRESS 3 y lj CITY )Jk J `-j NNA \, STATE /Vl�, ZIP 6t355 TEL FAX CELL EMAI L'L) ".,o � D �h�pa , C D1'n" v MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK - CITY MA DATE 3 I;?.;� PERMIT# (9j )iR ti V JOBSITE ADDRESS 3 OWNER'S NAME 1-15 GOWNER ADDRESS zqo Vx,,J5 KA Cov<7 O�3`t I . `TELA(/3 -3(oq-�{Q72 FAX So.• TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONALRESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT:x PLANS SUBMITTED: YES N0>S APPLIANCES 7 FLOORS— 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 GRILLEir INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER RO JED OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES lo( NO 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. PLUMBER GASFITTER NAME`D�-v, LICENSE#7�o-jr � SIGNATURE MP MGF JPS- JGF LPGI CORPORATION # PARTNERSHIP # LLC ,,,,# f COMPANY NAME:rDL�1,%.z1„ _1t1 ���,,� � ADDRESS 3 y C 0 CITY �.�,1 STATE MZIP TEL FAXJ CELL;. --- — EMAIL'JJ�.�Z.�.Yrliy cv- oAk - MA SACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY T-�1. hn��l l r� MA DATE 3) Z2 a/ ) '1 PERMIT# JOBSITE ADDRESS 3 U �wwuly Sa V�,�� OWNER'S NAMEC� GOWNER ADDRESS NC) l�c�(A�l.syr�t3�t l TEL�((3—36�-.EI�?2 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ( EDUCATIONALRESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO�( APPLIANCES 7 FLOORS— 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 r� LABORATORY COCKS _-- -- -- MAKEUP AIR UNIT OVEN _ POOL HEATER _ r ROOM/SPACE HEATER _ 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 V NO 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 corn ianGewith all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME'L_)..v'�N ,��,av�,i� LICENSE# 7k6-7?'_ SIGNATURE MP MGF JP JGF LPG] CORPORATION # PARTNERSHIP # LLC # COMPANY NAMEr►��+ J���.{y �J.�,� n ADDRESS! y ��a�y V )L , CITY STATE M ZIP 4 t ?SS=TEL 'Q f3 �) a FAX . a CELL EMAIL q 0 Uj?_ OIL, /5c'� I V�_ . I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK Ca C CITY !N �� i MA DATE_3 '�a.l j 'PERMIT# _ ,. JOBSITEADDRESS4 L!'!S U ,o OWNER'S NAME OWNER ADDRESS TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL,�,,) PRINT CLEARLY NEW: RENOVATION: REPLACEMENT:' PLANS SUBMITTED: YES Noel( APPLIANCES Z FLOORS-- 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 I FIREPLACE v FRYOLATOR FURNACE ;: ^, 5 -:_ GENERATOR i GRILLE INFRARED HEATER LABORATORY COCKS - - �•I�_ MAKEUP AIR UNIT OVEN POOL HEATER 1e ; ROOM I SPACE HEATER I ROOF TOP UNIT f 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 J)C NO 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 4. 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 co liance all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME-!: 1; „�,��,a I LICENSE# 3k09. 1GNATURE MP MGF_j JP- >� JGF LPGs .w CORPORATION # PARTNERSHIPS ffi,LLC i, # COMPANY NAMEF�-,IW � ,Y,�1 A ADDRESS CITY STATE'M 'ZIP`tj 155 TEL 4 Ci"� d 1.1. FAXI— I CELL:' EMAIL"D��-.,'^��+ City of Northampton Massachusetts - DEPAR224ENT OF BUILDING INSPECTIONS - y. 212 Main Street • Municipal Building t: b Northampton, MA 01060 January 28, 2020 James Cabral 240 Reeds Bridge Road Conway, MA 01341 Mr. Cabral, We are reaching out to you regarding the property at 36 Hawley Street. In June last year it was determined that a fee of$540 would be paid for unpermitted gas work that had been performed in the 6 units there. On June 20th those fees were paid by credit card in the office. Unfortunately, for unknown reasons,the transaction did not go through. Plumbing and Gas Inspector, Larry Eldridge, called and spoke to you on July 8 and informed you of this. It was determined that you would wait for you next credit card statement and either show us proof that the transaction did actually go through, or resend us the payment. That didn't end up happening. If you could please send us the payment via check or money order, or come into the office to pay by either debit or credit card. The permits for that location remain in an open status and will continue to do so while the fees remain outstanding. If you have any questions, please contact the office. Thank you. Meghan Cahill Inspection Services 413-587-1271 r RE El w�. VSD FEB 8 2020 DFpT OF gU1L L _ NORT1-1A,4 D1ON 1NSAEC77pNS ,IA 01060 UC l I'U