06-064 (22) I
' „ City of Northampton
BUILDING INSPECTION LABEL
APPROV E11:1
Inspector .1�; ►/� }'tip L�
Date q'/C -/G J`u� \AL„`,y-
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK f 5
J� C TY 1J 0. 1 Ackp-t-ciA) MA. DATE i hill/l 6 PERMIT#
JOBSITE ADDRESS '1 a C. h.ec '✓i Ur ‘,/P ,E4 1_ OWNER'S NAME !7 f'
OWNER ADDRESS TEL FAX
•
TYPE OR
OCCUPANCY TYPE: COMMERCIAL 0 EDUCATIONAL ❑ RESIDENTIAL •
PRINT
CLEARLY NEW: . RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES ' NO 0
FXTURES Z FLOOR BSMT J 1 1 2 1 3 1 4 1 5 6 1 7 8 1 9 1 10 1 11 12 13 14
BATHTUB 1 1 1
CROSS CONNECTION DEVICE 1 1 1
DEDICATED SPECIAL WASTE SYS 1 1
DEDICATED GAS/OIL/SAND SYS
1 DEDICATED GREASE SYS
DEDICATD GRAY WATER SYS I
DEDICATED WATER RECYCLE SYS , 1 1
DRINKING FOUNTAIN I I I I 1
DISHWASHER / 1 I 1
FOOD DISPOSER 1 I 1 1
FLOOR/AREA DRAIN I ! 1 I
INTERCEPTOR(INTERIOR) I 1
KITCHEN SINK • /
LAVATORY 3 • �Ut'.MG :AS I SPECTOR 1
ROOF DRA.N i iL -,-
SHOWER STALL I ` �� �,yT n^rnevc_, I
SERVICE/MOP SINK 1 1 1 I
TOILET ,S 1 1 " I
URINAL i I I 1
WASHING MACHINE CONNECTION 1 ' I I 1 1
WATER HEATER ALL TYPES 1 / 1
WATER PIPING /
OTHER
1 I
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which,meets the requirements of MGL Ch.142. YeA No 0
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND 0
OWNER'S INSURANCE WAIVER: I err/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 BOX ONLY: OWNER 0 AGENT 0
Signature of Owner or Owner's 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 2 of the G ral Laws.
PLUMBER NAME C al1I#t/IC VJ UIUUAt' SIGNATURE 1
LIC# 0,1)C6 MP* JP 0 CORPORATION 0# PARTNERSHIP ❑4 LLC 0-# 3 61S--
.
COMPANY NAME e,p(ecS '�()lv 'V4 ADDRESS: t"jl QcOStO-rAi S
C'TY 19 1 S7.4TE ZIP ryto3 -1 EMAIL ( 1 ( r)0'l r(O c AJ S/e, re row-if
TEL4(2)- 6A6' FC2 D- CELL FAX
I
1100li6 a6/1,9�m6, ��
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
CITY: ))1' at Jf r l MA. DATE: Yf! /l 6., PERIvIIT# 6,-* /7-q?
JO3SITE ADDRESS: 2I (11 r ST4a j j- (°rr: OWNER'S NAME: 1,�/'e.
GOWNER ADDRESS: TEL: FAX:
TYPE OR OCCUPANCY TYPE: COMMERCIAL❑ EDUCATIONAL ❑ RES
PRINT _�IDENTI.�+L
ICLEARLY NEW:X. RENOVATION:❑ REPLACEMENT:0 PLANS SUBMITTED: YES 'O E
APPLIANCESI FLOOR—, Esmt
1 1 2 1 3 I 4 5 6 7 8 I 9 10 11 12 13 14
BOILER
BOOSTER I I I
CONVERSION BURNER - I ( I I
COOK STOVE
DIRECT VENT HEATER I I I
R I f I I
Ir� I I I l
IRDRYEEP!ACE
FRYOLATOR I I I
I f 1
FURNACE
GENERATORGRILLE
I I I f
INFRARED HEATER f
f I I I I
LABORATORY COCK I I
MAKEUP AIR UNIT I
I I I PLUMING 8,.GAS INI
OVEN ISPFr, 'CR
POOL HEATER. ( '�'--- ' i,-,T N -
ROOM/SPACE HEATER I I 'R.� 1 NOTPPRO ED
iROOF TOP UNIT 1 I I 1
TEST / ( I I 1 I I
UNIT HEATER
UNVENTED ROOM HEATER I I I I
WATER HEATER I
I
i I I
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES4 NO ❑
If you have checked YES,please indicate the type of coverage by checking the appropriate box below.
LIABILITY INSURANCE POLICY)2 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 E
SIGNATURE OF OWNER OR.AGENT
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"jp compliance ''h all Pertinent
provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
7 '-
PLUM3ER'GASFITTE,R NAME: LICENSE#
��v�1,�J.�nc(c��S�t( /Arc S(G RE
COMPANY' INAME:1f /. 5S P1 19,hl ADDRESS: 3 i gioy-C�1if .
CITY: Ontrt t-InI
STATE: M ZIP: C'ID?j S F.AX:
EL: CELL:gf' -both--3F6p1� EMAIL:
MASTEi,C JOURNEYMAN 0 LP INSTALLER 0 CORPORATION 0# PARTNERSHIP 0# L LC&I#112.X.*
ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes No
TI IIS APPLICATION SLRVLS AS THE PERMIT ❑ ❑
FEE: $ PERMIT
./a43// /)t2 rJ vpe-e- ) 40P247.N REVIEW NOTA
72 CHESTNUT AV EXT
BP-2016-1e141
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:06-064 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:New Single Family House BUILDING PERMIT
Permit# BP-2016-1141
Project# JS-2016-001961
Est.Cost:$420000.00
Fee:$1465.30 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Gr p: JEFFREY MORIN 97133
Lot Size(sq. ft.): Owner: IMRE LUDWIG
Zoning: Applicant: JEFFREY MORIN
AT: 72 CHESTNUT AV EXT
Applicant Address: Phone:
29 GRANT AVE Insurance:
NORTHAMPTONMA01060 ISSUED ON:4/5/2016(413)0::00::004-7799 0
TO PERFORM THE FOLLOWING WORK:CONSTRUCT SFH W/ATT GARAGE/DECK
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W.
Building Inspector
Underground: Service: Meter:
Rough: �� j/L Rou h: Footination11`/r-W0/eC
"1 House ouse
Driveway Final: (/� `�,j1 9-
v.o‹7,-5. . ..
Final `9 7 Final: 07f.-- deo
7
PR f" RI/F ame 'c
Gas: Fire Department
Fireplace/Chimney:
Rough: Oil:
�Q Insulation:
Final: %" f,/, Sm e: 6 K 11/o/17 Final: •- our
cid To„ N v;re V s
TIIIS PERMIT MAY BE YOKED BY THE CITY 01' NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND R U TIONS.
Certificate of Occupancy /t
d I Signature: _.
Feel-vile: Date Paid: Amount:
Building 4/5/2016 0:00:00 $1465.30
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner
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• City of Northampton
BUILDING INSPECTION LABEL
APPROVE
Inspector yr, C-
Date_-16- /G 7�u� -
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72 CHESTNUT AV EXT EP-2017-0106
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 06
Lot:064 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRING FOR NE\V HOME
Permit tt Electrical
PERMISSION IS HEREBY GRANTED TO:
Project it JS-2016-001961
Est.Cost: Contractor: License:
Fee: $200.00 JAMES MAILLOUX ELECTRIC Master A16187
Owner: IMRE LUDWIG
Applicant: JAMES MAILLOUX ELECTRIC
AT: 72 CHESTNUT AV EXT
Applicant Address Phone Insurance
55 MAIN ST - 2ND FLR (413) 585-1592 C-(413) 563-4654 Liability, MPTO721Q
FLORENCE MA01062 ISSUED ON:8/9/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:
WIRING FOR NEW HOME
Call In Date: Date Requested Inspection Date/SignOff: Reinspect?:
Trench/UG:
Special Instructions
Y ff
Rough 9—A n/�-�4 'A,d N
x
Special Instructions:
Final: /- 23-/ 1 072.‘1`N
SRE Called In: 22421548 g - 12 - ft Pp
Signature:
Fee Type:: Amount: DatePaid
Electrical 8200.00 8/9/2016 0:00:00 11326
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo