23C-047 (3) 10d, StA-
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT O PERFOCM, GAS fit (ENG WORK
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10 RANCE COVERAGE
I haves nurrenfi liahilif fisurar[re policy or its substantial equivalent which meets the requirements of NOT.M142 YES Fx] NO D
I IFYOU CHECKED YES,PLEASE INDICATE [HE TYPE OF COVERAGE BY CHECKINGTHE APPROPRIATE BOX BELOW
LIABILITY INSURANCE PO,LIGY x OTHERTYPEINDEMNITY D BOND D {
OWNER'S INSURANCE WAIVER:[am awamfhat the ltcenseedoes not have th�absurance coverage required by Chapter 142 of the 11
kiessachruetLs General laws,and road on t{Ss perrnitapplicatiion waives this rzquiaemmrt.
CHECKONEONLY: OWNER EI AGENT D
SIGNATURE OF OWNEROR AGENT
Ihceeb Royythat all ofthedei Isandinformaflonl have suiminwd or entered regaaMg tltlsapplicafton apeirue apd a[iaoreteto the hoptofmyknpwiedge
and Peat all plumbing Muk wad MalllaF.MperfwNmed und,ae,perot Issued for tis epptimbon W9 be fn Bance II P'Rtn tprmbarus of She
M.sachaaeRs State Plumbing Code and Chapter 142 of ma Soneni Laws.
PLUMBER-GASFITTER NAME nYicYviGt J'.Moaan,.042. LICENSE#M x=}'J_ ON ..
MPD MGFD JPEI, JGFD I.PGID CORPORATIONN# 10190 PART NERSHIP 0# LMC EI4
COMPANYNAMEM.a. ttlOrLt�rY_, Sr�C. ._,ADDRESS 4 $W f.h MAvnn-_S't'Ce6 7LR 30fwM
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32 WILLOW ST EP-2017-0235
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 23C
Lot:047 ELECTRICAL PERMIT
Permit Electrical
Category: SERVICE UPGRADE RENO/ADDITION
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2017-000192
Est Cost: Contractor: License:
Fee: $185.00 MARNEY ELECTRICAL SERVICES Master 17123A
Owner: BARKER JODY P & ERICA SCHARRER
Applicant: MARNEY ELECTRICAL SERVICES
AT.- 32 WILLOW ST
AnplicantAddrerr Phone Insurance
175 MAIN ST (413) 584-0737 C-(413) 535-8905 Liability, BKS55761053
LEEDS MA01053 ISSUED ON:9/13/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:
SERVICE UPGRADE RENO/ADDITION
Call 1. Date: Date Requested Inspection Date/SignOff: Reinspect?:
Trench/UG:
Special Instructions
x
Rough j,4/
x
Stec ecial Instructions: p�
Final: !�G 1 /"✓/fr
SIZE Called In: 21548255
Signature:
Fee Tvye:: Amount: DatePaid
Electrical 5185.00 9/13/2016 0:00:00 7414
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo