14-007 (7) 163 KENNEDY RD BP-2021-0807
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 14-007 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: KITCHEN RENO BUILDING PERMIT
Permit# BP-2021-0807
Project JS-2021-001377
Est. Cost: $40000.00
Fee: $250.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: HANS DALHAUS 101628
Lot Size(sq. ft.): 89298.00 Owner: PORT WHITE LISA
Zoning: Applicant: HANS DALHAUS
AT: 163 KENNEDY RD
Applicant Address: Phone: Insurance:
11 CHERRY ST (413) 977-6094
EASTHAM PTO N MA01027 ISSUED ON:1/21/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:KITCHEN RENO
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: 7 Rough: 3 -/U--a House# Foundation:
Driveway Final:
Final: -7 2 3•--Z1 Final:
).'_ Rough Frame:0 rC_ 2q-Z 1 K-12
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:O.1C- 3-26f -II J!l 0.
Final. Smoke: Final: O,k 2ES-ZI Vt2
THIS P-CRIVIIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGU TIONS.
l
Certificate of Osempancy J/( Signature( ' • ' I
FeeType: Date Paid: Amount:
Building 1/21/2021 0:00:00 $250.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
163 KENNEDY RD EP-2021-0695
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 14
Lot: 007 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE KITCHEN RENO
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2021-001377
Est.Cost: Contractor: License:
Fee: $65.00 IAN T DURYEA ELECTRICIAN Journeyman Electrician 13109B
Owner: PORT WHITE LISA
Applicant: IAN T DURYEA ELECTRICIAN
AT: 163 KENNEDY RD
Applicant Address Phone Insurance
120 MORGAN ST (413) 262-0142 C- Liability, MPT9085E
HOLYOKE MA01040-2016 ISSUED ON:2/23/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE KITCHEN RENO
Call In Date: Date Requested Inspection Date/SignOff: Reinspect?:
Trench/UG:
Special Instructions
x
Rough -\ -/b" I QeN
x
Special Instructions:
Final: 7 42
SRE Called In:
Signature:
Fee Type:: Amount: DatePaid
Electrical $65.00 2/23/2021 0:00:00 0772
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo
— ` cif* /VI Li- 4 a-
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
4 . .l c,
77,4 _ CITY:Northam ton MA DATE 2/8/2021 1 PERMIT# f 2.02/—0277
-0 J ITE ADDRESS [163 Kennedy Rd OWNER'S NAMEI Lisa White
1
ER ADDRESS 163 Kennedyr Rd TEL 781 583 8758 FAX L
= YPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL � RESIDENTIAL,, '
o "
CLEARLY. NEW:h,_., RENOVATION:0 REPLACEMENT:Ej PLANS SUBMITTED: YES[J NOD
-
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 _.
I
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER 1
DRINKING FOUNTAIN .
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK 1 �,..
LAVATORY
ROOF DRAIN --l v ----
SHOWER STALL
l')t;nI �a 6, U Its G
F �.,_ -
SERVICE I MOP SINK �` E '� l�
Y,
TOILET . : s UV , j NOT—AP - 1
URINAL <�
WASHING MACHINE CONNECTION u
WATER HEATER ALL TYPES
WATER PIPING . L
OTHER , Ir _ 1 r
1
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 L.' 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 1-2,1 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 combliance wit al Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. L ' ^
J
PLUMBER'S NAME John T.Ge k LICENSE# 16079 IGNATURE
i _
MP , JP CORPORATION J#1 =PARTNERSHIP # 1295560___ LLC
COMPANY NAME John T.Geryk Plumbing&Heating,LLC ADDRESS 89 Oak St
CITY illorence STATE MA ZIP 01062 TEL'413-727-3057
FAX CELL 413-336-3893 EMAIL 'john@johntgerykplumbing.com
7 -Z3-74 g
46-00
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
; -1 CITY ,Qlo thampton MA DATE 2/8/2021 PERMIT#6f 7i�Z�^�Z717
JOBSITE ADDRESS 163 Kennedy Rd OWNER'S NAME Lisa White
OWNER ADDRESS 163 Kennedy Rd TEL 781-583-8758 FAX
E OR: OCC1 FANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL
"INT
C RLY „j RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES - NO
APPLIANCEk41----- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER —
BOOSTER
CONVERSION BURNER
COOK STOVE 1
DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
PLUMBING & GAS #NSI LC,T O
POOL N
POOL HEATER 3
ROOM/SPACE HEATER NORTHAPJIPTON
ROOF TOP UNIT APPROVED NOT APPROVED
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 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 acc rate 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 al rtinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
k
PLUMBER-GASFITTER NAME John T.Geryk LICENSE# 16079 SIG ATURE
MP MGF JP JGF LPG' CORPORATION # PARTNERSHIP # 1295560 LLC #
COMPANY NAME: John T.Geryk Plumbing&Heating,LLC ADDRESS 89 Oak St.
CITY Florence STATE MA ZIP 01062 TEL 413-727-3057
FAX CELL 413-336-3893 'EMAIL john@johntgerykplumbing.com
F7A.-4% -7*
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11/11‘l C•17740 CZ) 4/1,74/2