31B-053 (5) 26 LANG WORTHY RD BP-2016-0869
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31B-053 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT
Permit# BP-2016-0869
Pr2ject# JS-2016-001469
Est,Cost:$106000.00
Fee: $689.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: KENNETH LEBLANC 55471
Lot Size(sq. ft.): 23086.80 Owner: GULLERUD STEVE
Zoning: UR4.(l00l% Annlicant: KENNETH LEBLANC
AT: 26 LANGWORTHY RD
Applicant Address: Phone: Insurance:
P O BOX 307 (413) 250-8234 0 WC
SOUTH HADLEYMA01075 ISSUED ON:3/7/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:REMODEL KITCHEN & CREATE MSTR
BEDROOM/BATH
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: Rough:/ _ / i1 House# Foundation:
Driveway Final:
Final:GS 7//7 Final: •��///
Rough Frame:
- )91/11—
Gas: Fire Department Fireplace/Chimney:
Rough: fi► /a Oil: Insulation: Lf )676" 0 fvf_Aerf
Final: j.,..V."- � Smoke: 11/3711(0
(JOY\ D Final: (3„4w/7 �'
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THIS PERM ( MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REG A ION virzel ►s/ . //
Certificate of Occupancy 7
r' Signature: `/
FeeType: Date Paid: Amount:
Building 3/7/2016 0:00:00 $689.00 .
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
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• , Vi CITY NORTHAMPTON �» ___,�__ _ MA DATE 08/03/2016 PERMIT# ' / 7" 7
JOBSITE ADDRESS 26 LANGWORTHY RD -. �. _. OWNERS NAME BEILI YANG
GOWNER ADDRESS BEILI YANG TEL 408-462-2318 FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL
EDUCATIONAL RESIDENTIAL 1
PRINT
CLEARLY NEW: ' RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO
APPLIANCES 1 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER
BOOSTER BE4V
CONVERSION BURNER t 1
COOK STOVE 1
-
DIRECT VENT HEATER } 'S " + i, `
-
DRYER
I L
FIREPLACEF c,�;,_ t>` '' t
FRYOLATOR Nca!"—',=!.
FURNACE _
GENERATOR _
GRILLE
-
INFRARED HEATER _ -
_
LABORATORY COCKS '%. :. `
MAKEUP AIR UNITaP oRC�VF� N nT APPRnVPD
OVEN d�
POOL HEATER
ROOM I SPACE HEATER _
ROOF TOP UNIT _
TEST j 1
UNIT HEATER
-
UNVENTED ROOM HEATER _
WATER HEATER
OTHER OUTSIDE LINE j
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 in complia with ertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
r
PLUMBER GASFITTER NAME JOHN PUZA LICENSE# 766 1 SIGNATURE
MP MGF JP JGF __,i LPGI .s CORPORATION # PARTNERSHIP # LLC # i
COMPANY NAME: AMERIGAS 'ADDRESS 216 LOCKHOUSE RD
CITY WESTFIELD STATE MA ZIP 01085 TEL 413-568-8972
FAX 413-572-6946 CELL EMAIL SHERRY.CHAFEE@AMERIGAS.COM
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
1 IA r�:z:a,xFl -
r�,Ti_ CITY NORTHAMPTON MA DATE 08/05/2016 PERMIT to l7' S�0
JOBSITE ADDRESS 26 LANGWORTHY RD OWNER'S NAME BEILI YANG
GOWNER ADDRESS BEILI YANG TEL 408-464-2318 FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL
PRINT
CLEARLY NEW: ' RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO
APPLIANCES 1 FLOORS— BSM 1 2 3 4 1 5 6 7 1 8 1 9 10 11 1 12 13 14 1
BOILER
BOOSTER
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
DRYER J
FIREPLACE _
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS PLUMEAG& GAS,1;,i7. CTOri
MAKEUP AIR UNIT saOF1 T `.,1PTfvd
OVEN
POOL HEATER, rs
ROOM/SPACE HEATER1 t �_ d/ G ~—
ROOF TOP UNIT
�
TEST _
UNIT HEATER _ _ _
UNVENTED ROOM HEATER _ _ _
WATER HEATER
OTHER HOOK TANK TO LINE _
t
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES f NO
!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
1 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 comp' rice wi Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME JOHN PUZA LICENSE# 766SIGNATURE
MP MGF JP JGF LPG' / CORPORATION # PARTNERSHIP,w„1# LLC # 1
COMPANY NAME: AMERICAS ADDRESS 216 LOCKHOUSE RD
CITY WESTFIELD STATE MA ZIP 01085 TEL 413-568-8972
FAX 413-572-6946 CELL EMAIL SHERRY.CHAFEE@AMERIGAS.COM
IMPORTANT SAFETY INFORMATION:Emergency Telephone#800-Gas-4You IMPORTANT TERMS&CONDITIONS
! Payments-By sending your check,you are authorizing the Company to use
For your safety, propane has a strong, unpleasant odor added so that information on your check to make a one-time electronic fund transfer from
propane leaks can be detected. You and each person using or handling your account at the financial institution indicated on your check, or to
propane must be able to recognize the smell of propane. Ask for a Propane
Safety Brochure or MSDS to demonstrate the smell of propane. Always take process the payment as a check transaction.This electronic debit will be for
the amount of your check,no additional charge will be added to the amount.
action if you smell any foul odor. Since there is a possibility of odor fade or Funds may be withdrawn from your account as soon as the same day we
other problems with your sense of smell,you should respond immediately to receive your payment and you will not receive your check back from your
even a faint odor of gas. Additionally,it is recommended that you purchase financial institution. If we cannot collect your electronic payment, we will
and install propane gas detector(sJ according to the manufacturers' issue a draft against your account.'if you wish to opt out of the electronic
instructions as a back-up warning device. If there is any possibility that a check conversion,please contact yourlocai Company office.
person will not recognize the odor of propane,you should not use it until a Definitions—
propane gas detector has been installed. Fuel RecoveryFee: This fee, which is assessed for propane deliveries and
,,r, P P
�IFYOUSMELLGAS: service calls, helps to offset the significant expenses incurred by the
• No Flames or Sparks: Put out all smoking materials & other open Company in fueling its fleet of commercial motor vehicles.This fee fluctuates
flames.Do not use lights,appliances,telephones,including cell phones. on a monthly basis as the Company's cost of fuel fluctuates.For updated fuel
Flames or sparks from these can trigger an explosion. recovery fee information, please contact your local Company office on a
• Leave the Area Immediately: Get everyone out of the building or area monthly basis.
where you suspect gas is leaking. HazMat&Safety Compliance Fee:This fee,which is assessed for propane
• Shut-Off the Gas:Turn off the main gas supply valve on the propane deliveries and service calls,•helps to offset a portion of the costs the
tank if.t is safe to do so. Turn the valve to the right to close. Company must incur to comply with federal, state and local government
• Report the Leak:From a neighbor's house or other nearby building away regulations, including, but not limited to, hazardous materials, homeland
from the gas leak, call the Company right away. !f you cannot reach
security, emergency preparedness and workplace safety. It is also used to
The ComoanvS�II911 or ourleCal fi P fund, among other things, vital employee safety training and inspections,
y �_dar*zn—II"" _ cylincer re-qualification, and enviionmen'tarcompliance. THE FEE IS NOT
• Do Not Return to the Area or Building until The Company or the local GOVERNMENT IMPOSED, NOR IS ANY PORTION OF IT PAID TO ANY
officials who have responded determine it is safe to do so. GOVERNMENT AGENCY.
• Get Your System Checked: Before you attempt to use any of your Special Trip Charge: This charge is incurred by Customers who request
propane appliances,The Company or another qualified propane service immediate deliveries or non-emergency service after business hours or on
technician must conduct a leak check. weekends.This charge can vary greatly due to the distance involved and/or
c/-CARBON MONOXIDE: IMPROPERLY VENTED OR DEFECTIVE APPLIANCES the time required to service this request and will be based on local labor
CAN CAUSE POTENTIALLY FATAL CARBON MONOXIDE POISONING. HAVE rates which can be obtained from your local Company office.
YOUR SYSTEM PERIODICALLY INSPECTED BY THE COMPANY OR ANOTHER Service Dispatch Charge:This charge is to cover the costs associated with
QUALIFIED PROPANE SERVICE COMPANY. dispatching a service technician to a Customer's residence or other location
to perform service work on customer-owned equipment and appliances or to
L.RUNNING OUT OF GAS: DO NOT RUN OUT OF GAS, SERIOUS SAFETY
pick-up a Company-owned tank or cylinder. Customers should note that
HAZARDS,INCLUDING FIRE AND EXPLOSION,CAN RESULT. upon arrival at Customer's location, additional charges may be assessed
• If an appliance valve or gas line is left open when the propane supply depending upon the nature of the problem. The Service Dispatch Charge is
runs out, a leak could occur when the system is recharged with collected at the time the service er tank/cylinder pick-up is scheduled.This
propane. charge will not be credited towar service work performed. Please check
• Air and moisture could get inside the propane container resulting in the with your local Company office rets lfhg the availability of appliance repair
possibility of odor fade. service.
• If you run out of gas,your pilot lights will go out and can be extremely Tank Rent is an amount charged to customers who are leasing Company-
dangerous if not handled properly Owned Equipment.
• A LEAK CHECK IS REQUIRED. Returned Check Charge is an amount charged to customers whose check is
• SET-UP REGULAR FORECASTED DELIVERIES. Check the gauge on your returned because of insufficient funds.
tank and if the fuel level drops at or near 20%,call The Company. PAYMENT TERMS AND LATE FEES: For Customers Receiving Invoices:
Customer agrees to pay all fees,rates,and charges within ten days after the
L,tLlGffTlNG PILOT LIGHTS invoice date or on the due date, whichever is later, to the location
It is strongly recommended that a qualified propane service technician light designated by the Company. For Customers Billed-On-The-Road:Customer
any pilot light that has gone out. agrees to pay all fees,rates,and charges within ten days after the delivery or
• A pilot light that repeatedly goes out or is difficult to light may be a service to the location designated by the Company.
signal that there is a problem with the appliance .-r 'u-r .,.,. -nn - - . 'ails r ' ':,les, or charges within 25 days after the
system.-If this OCG6';do net—'f—to—f4,the problem)r
�,y c rn'ay";unless promplted"Tiy law, add—a
qualified propane service technician to evaluate the y � '� 'e daily balance or a fate charge of
1 `� any reserves the right to require
IF YOU LIGHT A PILOT YOURSELF, YOU ARE TAXA._ _,.
STARTING A FIRE OR AN EXPLOSION. MANY SERIOUS INJURIES f .• rR WHF''' ivories or service in advance or to post a
. ... ued by the Company at any time in whole or
PEOPLE ATTEMPT TO LIGHT PILOT LIGHTS. PROCEED WITH GRC-. -AU' n ;nr,hof nce.
and follow the manufacturer's direct` aFee and Fuel Recovery Fee do not apply to
'LOTH ER IMPORTANT SAFETY RU '. LPr�� .s 3 _"l" 1 /Znv�ustomers in CT.
• DO NOT allow unqualified pers nel tc tJy
or system. CALL BE RE YOU DIG! If you are planning to landscape or make
• If any of your appliances have been floodea, _ off the gas
immediately at the tank. DO NOT use the gas system until the wet or improvements to the exterior of your home or business, the Company
flooded appliances have been checked or serviced. reminds you to have the underground lines marked under your State's call
• Keep combustible products, like gasoline, kerosene or cleaners, in a before you dig program. It is important for you to know exactly where your
separate room from propane appliances. Appliance pilot lights could gas lines are located and avoid digging in that area. We care about your
ignite fumes from those combustibles. safety,so contact your local Company office before you start to dig and we
will work with you to locate your propane gas lines.
eicoaa7/ 'g-5
f
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
L. CITY 0 .1 Y', MA DATE 3 ----2-/-/62-�'� PERMIT# 61-1&,.. I1f(2
r JOBSITE ADDRESS 2 6 41-vJ t�u�/ II OWNER'S NAME �0 e' (3 0LG J4
GOWNER ADDRESS_ / TEL o)9/-/,1/ FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
PRINT
CLE_4RLYNEW:0 RENOVATION:EREPLACEMENT:0 PLANS SUBMITTED: YES 0 NO lij
APPLIANCES Z FLOORS-. BSM 1 2 3 4 5 6 7 8 - 1F? '
ti. i r -.13-- 14
BOILER If . �•.+
BOOSTER --. t--
CONVERSION BURNER
COOK STOVE I ��"J r
DIRECT VENT HEATER t f
DRYER
. NOR V'�N•rnsae TIONS
.AMPTO see
FIREPLACE _
FRYOLATOR _ _
FURNACE
GENERATOR
GRILLE
INFRARED HEATER -
LABORATORY COCKS
MAKEUP AIR UNIT PLUA^@ING 8,GAS NS ECTOR
OVEN NST. •MPsnn
POOL HEATER �' " :,s NOT AP ROVED
ROOM/SPACE HEATER _ _ ;�
ROOF TOP UNIT a
TEST I
UNIT HEATER
UNVENTED ROOM HEATER -
WATER HEATER
OTHER
I
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES 0 NO ig
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY [el BOND 0
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 fE
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this application are tru- -nd accurate to the be t of owledge
and that ail plumbing work and
installations performed under the permit�is�s r this application will be in com 2S. ce i thy/ '-rti,ent,:ro n of the
Massachusetts State PlumbingCode and Chapter 142 of the General J aw( /0M7 4 I ' -
PLUMBER-GASFITTER NAME 64,7chdt165:1 LICENSE# `G ATURE
MP�- MGF❑ JP❑ JGF❑ I 0 CORPORATION❑# PARTN -SHIP❑# LLC❑#
COMPANY NAME �C! / a- 1//f ADDRESS /D / 17,,o - C'
l,,;, ? `6 190 CITY l/ Gt),t7.�I-Pi STATE�� ZIP � �b �-/J TEL �� 9
FAX (/ CELL ‘SO-c)gri EMAIL
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
0151.1---:� v. CITY/TOWN 0 //1 MA DATE 3'1/70- PERMIT# Pr- I& -3%
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JOBSITE ADDRESS 4 '' __ //9 i41?fr Z>' ,1d OWNER'S NAME 5-713°"' O 6d/ -vJ
P OWNER ADDRESS �""'` TEL -29/-/a / FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL ❑ RESIDENTIAL, ]
PRINT
CLEARLY NEW:0 RENOVATION:93 REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO
FIXTURES 1 FLOOR BSM 1 2 1 3 4 5 6 7 8 9 12 13 14
BATHTUBCr
CROSS CONNECTION DEVICE f. ' �-�tE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIUSAND SYSTEM 4 — 1 20W
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM iDEP..OF 6 1,R„;��;F,•tena�s
DEDICATED WATER RECYCLE SYSTEM NORTHAMPTON,r✓A 01060
DISHWASHER • / _
DRINKING FOUNTAIN
FOOD DISPOSER _/
FLOOR 1 AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN
LAVATORY SINK
_ 3 f WISTING&G*ShvSrtG I UP
. TON
ROOF DRAIN41,N.:°—.1 % NOT APPROVED
SEOWER /
MOP
SERVICE l MOP SINK
TOILET ./ ?"
URINAL
WASHING MACHINE CONNECTION _ /
WATER HEATER ALL TYPES f .
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 0 NO y
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY 0 OTHER TYPE OF INDEMNITY J] BOND 0
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/ - and accurate to the be t of m knowledge
and that all plumbing work and installations performed under the pe issued for this application will be in c•�•.lance with all Pertine •ro i':on of the
Massachusetts State P • bing Code and Chapr 142 of the G al Laws. / 4. A
PLUMBER'S NAM i ' r L/
/' '/d!/ LICENSE#/6977 '/ ,/�
ATURE
MFl,1:j JP❑ CORPORATION ■# PARTNERSHIP 0# LLC❑#
COMPANY NAME _ / e ' / ADDRESS /5) 1 iv 1p S* C'I
CITY _ • .L Al / ' STATE Al/l ZIP 0 4?'2 TEL SP-to/p2
FAX CELL j 3D d cJ E-J EMAIL
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26 LANGWORTHY RD EP-2016-0642
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 31B
Lot:053 ELECTRICAL PERMIT
Permit: Electrical
Category: REMODEL KITCHEN&CREATE MSTR BEDROOM/BATH
Permits Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2016-001469
Est.Cost: Contractor: License:
Fee: $125.00 DENNIS R BERNASHE ELECTRICIAN MASTER ELECTRICIAN
12799A
Owner: GULLERUD STEVE
Applicant: DENNIS R BERNASHE ELECTRICIAN
AT: 26 LANGWORTHY RD
Applicant Address Phone Insurance
P O BOX 118 (413) 532-4002 C-
SO HADLEY MA01075-0118 ISSUED ON:2/18/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:
REMODEL KITCHEN & CREATE MSTR BEDROOM/BATH
Call In Date: Date Requested Inspection Date/Sim:Off: Reinspect?:
Trench/UG:
Special Instructions
r/
Rough 7 /- ic,
x
Special Instructions: p
Final: '////6 /"Lit
SRE Called In:
Signature:
Fee Type:: Amount: DatePaid
Electrical S125.00 2/18/2016 0:00:00 1631
212 Main Street.Phone(413)587-1244.Fax(413)587-1272-Inspector of Wires -Roger Malo