15B-050 (3) y, " C.A-JCA..._ 3/O0 3 WI 06
illiASSACHUSETTSUNIFORM APPLICATION FOR A PERM!T TO PERFORM GAS FTTTUgG WORK
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CITY: Lc e S NIA. DA; I'2 -1(a -(G, oERMIT4Ga9-0—tet
JOBSITEADDP,ESS: 0(10 C I,. ES A-e.rF,..f pWNE.RSNAIvME:PAt MC1A: k
GOWNERADDRESS TEL: FAX:
TYPE
OCCUPANCY PF: COMMERC/AL 0 EDUCATIONAL ❑ RESIDENTIAL'
CLEARLY NEW REEENOVATION:0 REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO --
APPLIANCES: FLOOR- Asmt 1 2 3 1 4 1 5 1 6 7 8 9 1 10 ' 11 1 12 1 13 14
BOILER MINI - ( S
BOOSTER 1 MI ' ":n
CONVERSION BURNER _ I
COOK STOVE____
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DIRECT VENT HEATER I 1 '' !"
DRYER _ 1 j - - 1-21316 , :
FIREPLACE _� r 1 I
I FRYOLATOR I i l - - I
FURNACE f R _; s"f ,I'�.... m
r'GRI DGENERATOHEArcA —" ? �..._ JI
INFRE
LABORATORY COCK I l
MAKEUP AIR UNIT 1
OVEN I - I
POOL HEATER.
ROOM/SPACE HEATER
ROOF TOP UNIT I I
JEST
UNIT HEATER ` I I
UNVENTED ROOM HEATER b ( Z I (
' WATER HEATErI I ( I I
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INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO 0
if you have checked YES please indicate the type of coverage b 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 _
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. �,...�""�
PLUMBERIGASFITTER NAME:2d-arA UAIA:--S _LICENSE 4'ZSI I1�r SIGNATURE
NY V,COMPANAME: .C 9
. ' t-t . ADDRESS:fZ EQ raYP-u--i3} .Sc.,f-c. .)
CITY: IV O r4"1'v"r'14z,V STATE:II' ZIP: /7 I7Ca C) FAX:
TEL: 320 -71.517— CEL: ..._.._...._EMAIL:JCc4 rLQ&41-t.:.2 tZ1 j4s'o-J to
/ASTER 0 JOURNEYMA LP INSTALLER 0 CORPORATION 0# PARTNERSHIP(]_ LLC❑4
ROUGI. GAS INSPECT ON NO ES TIUS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes Na
THIS APPLICATION SERVES AS TI HE PERMIT ❑ ❑
FEE: S PERMIT P
__� PLAN REVIEW NOTES _
l MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WO K
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v = ; CITY 1105 J ( JMA/�D�ATE/�..� if 1 PERMIT V4!�G�/,,,'X1,/1 Sr2' y-
(f``�� J0851TE ADDRESS C Qj ✓S j-C.tC/. ea: OWNERS NAME
1 it P �} jL2ti S
'.T OWNER ADDRESS 1J TEL y1) "'-.5-Y VT 2A- FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL./
PRINT
CLEARLY NEW:/ RENOVATION: REPLACEMENT: PLANS SUBMITTED- YES NO
APPLIANCES 1 FLOORS— Illa 2 _ I 3 ma 5 6 T 8 9
10 13 14 I
BOILER
BOOSTER 1.111111
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
DRYER
FIREPLACE ra
FRYOLATOR 11111EMIE=1st
/EMI
FURNACE arilail
GENERATOR 111-1.01
GRILLE I 011 In
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT 'gay ;' '
OVE
MOM
POOL HEATER
ROOM/SPACE HEATER
ROOF TOP UNIT weamistimmillof
11 UNIT —
I UNVT HEATER
TEDR
WATER EDROOM HEATER ,.4.40.31.4
..�
WATER HEATER
OTHER TE—I/: 11: it
-
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES i 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.
._. G____ OF
— _._ .......____.
CHECK ONE ONLY. OWNER AGENT
SIGNATURE OF ON{NEft OR AGENT _
_..
to hereby aeM1lthat all the It and ton , havesubmitted entered &a n thispbare true nd .e the hest of my t e
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e
and that all plumbing work and in, daronspepomn under tGelerm L issuedfor t4application will bec panfe Rel Pertinent
ert npntp Is of the
Massachusetts State Plumbing Code arid Chapter 142 of the General Laws
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PLUidBERGASFITTER NAME ALFRED H.GEORGE LICENSE 3609 t DIDDATDREG
MP MGF JP JGF LPGI CORPORATION / a 130C PARTNERSHIP t LLC
COMPANY NAME: GEORGE PROPANE.INC. ADDRESS 3 BERKSHIRE TRAIL WEST PO BOX 102
•
CITY GOSHEN STATE MA ZIP 010320102 TEL 413-268-8360
FAX d13.268-0206 CELL EMAIL rngeorgeggeargepropane.Wrn
1
I
ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
I „Yes No
THIS APPLICATION SERVES AS THE PERMIT- ❑ El
_.. FEE: $---_._ PERMIT#
-- PLAN REVIEW NOTES
/g/a�mraw .,ox. Tia f .err -
306 CHESTERFIELD RD BP-2017-0288
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 15B-050 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cat eg Dry:New Single Family House BUILDING PERMIT
Permit# BP-2017-0288
Project# JS-2017-000485
Est.Cost:$195000.00
Fee:$1505.00 PERMISSION IS HEREBY GRANTED TO:
Const,Class: Contractor: License:
Use Group: ED JAZAB 050099
Lot Siaef scL ft.): Owner: Patrick Melnik
Zoning:RR Applicant: ED JAZAB
AT: 306 CHESTERFIELD RD
Applicant Address: Phone: Insurance:
9 SHEPHERDS HOLLOW (413) 222-4910()
LEEDSMA01053 ISSUED ON:1013/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2000 SQ FT SINGLE FAMILY
HOUSE
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: House# Foundation:
Driveway Final:
Final: Final:5c-Q -11
c5 l? / z -(2e--, Rough Frame:
1— 11--/I 12,1
Gas:/.2/,‘ Fire Department Fireplace/Chimney:
tc/7sR i ('77'-
Rough: Oil: nsulatian:Y--077.-/ OX
Final; L5 /7 Smoke: ha110 / Final: �`� S
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REG IO► S.
Certificate of Occupancy If! Signature: A,.,„ /4/w
FeeType: Date Paid: Amount:
Building 10/3/20160:00:00 $1505.00
212 Main Street,Phone(413)537-1240, Fax:(413)587-1272
1 4111 I' hrptu'-IC—Ruilt4in7 C,otzunICC iOnir
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
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:s'"-‘ ,It CITY L �1/4
, MA DATE -1 l.' -/{, PERMIT#_ 'tr LA q
4 OWNER'S NAME
JGBSiTE ADDRESS ��Co �‹S�-�_l�'� 7i4_ }" h-<- 17\ i
POWNER ADDRESS [ TEL FAX t
TYPE OR OCCUPANCY TYPE COMMERCIAL Li EDUCATIONAL Li RESIDENTIiii
PRINT
CLEARLY NEWT RENOVATION:0 REPLACEMENT:;i PLANSSUB1viiTTED: YES 0 NOl
FIXTURES 7 FLOOR 1 BSM 1 2 3 4 r 5 ' 5 7 8 9 10 ' 11 12 13 14
BATHTUB I ,M
CROSS CONNECTION DEVICE � '_ - M
DEDICATED SPECIAL WASTE SYSTEM -' ~l
DEDICATED GAS/OIL/SAND SYSTEM r- .- -'min _ moms
DEDICATED GREASE SYSTEM - 1' __ —� t;
DEDICATED GRAY WATER SYSTEM - I ! _ r
' DEDICATED WATER RECYCLE SYSTEM ?
-
DISHWASHER
DRINKING FOUNTAIN --- --- - --`--
FOOD DISPOSER _-� 7 `1•1111113111111111111111111111111111Mit-:
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR) --=11.1111------- 'L{
KITCHEN SINK WOLIIIIIMT ma
LAVATORY IIIII INIBMINIMMINITINENumlilliliMilliilali an
ROOF DRAIN MIi` 1 L M.
SHOWER STALL - UNM
SERVICE i MOP SINK IM
UTIMIIMMITIMM
TOILET . O,
IIIIIn
M
URINALIM-1.111111.111.1111=1.111.11.111n1111111111. _ .
WASHING MACHINE CONNECTION «_ ; ` cca t, _ _
.11•101
WATER HEATER ALL TYPES ara.ri,s -'' it
WATER PIPING ! ... M Mt MN
OTHER ! 1 - 111111cMINIUMMINIM aill Ma
IIIIIIMIIIIIIIIMINIIIIIMMENtailliffillin milinitm umnom
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INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YESO 0IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW =_``��
LIABILITY INSURANCE POLICY AfI OTHER TYPE OF INDEMNITY 1 1 BOND i_-j
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 [i
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 al!Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. I �
•�a--'
PLUMBER'S NAME r , sato L_/` I t ,LICENSE# ,-Z,r5/14 {� SIGNATURE
tv1P[1 J CORPORATION C]# !PARTNERSHIP' 1#1.- I LLC # 1
COMPANY NAME( Ll Id, ('i , l ADDRESS (p g 13 r›virz) L! S-j- S ,-[-c_ ~S'
CITY A)., }'t"L��� STATE[ " "' J ZIP r Q IO L, 0 TEL 5/i3 3 z 0 - vy2,
FAX CELL, EMAIL 1 t r ,. ......,12-,),44(,--N 312' )r.¢/- a 4 [ c� /`-c
ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT L] ❑
FEE: $ _ PERMIT#
PLAN REVIEW NOTES
J( !
u1CYC._
306 CHESTERFIELD RD EP-2017-0327
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 15B
Lot;050 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE NEW HOME
Permit# Electrical
PERMISSION IS HEREBY GLINTED TO:
Project rt JS-2017-000485
Est.Cost: Contractor: License:
Fee; $200.00 JAMES MAILLOUX ELECTRIC Master A16187
Owner: Patrick Melnik
Applicant: JAMES MAILLOUX ELECTRIC
AT: 306 CHESTERFIELD RD
Applicant Address Phone Insurance
55 MAIN ST -2ND FLR (413) 585-1592 C-(413) 563-4654 Liability, MPT0721Q
FLORENCE MA01062 ISSUED ON:10/11/20.16 0:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE NEW HOME
Can In Date: Dare Requested(�_ Inspection Date/SionOff: Reinspect?:
Trench/EC: teb_72-�� AL° - \
Special Instructions .�
Rough 1- /3 - /—J cZq
r .
x
"Aerial Instructions:
Final: y - q- i7 RA--"N
SRF.Called /0 -
n p
In: T22846143CP22579538 /0-Iv —
Signature:
Fee Type:: Amount: DatePaid
Electrical 5200.00 10/11/2016 0:00:00 11395
212 Main Street,Phone(413) 587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo
The Commonwealth of Massachusetts
111 City of Northampton !I!
Certificate of Occupancy
In accordance with 780 CMR, (The 8th Edition of the Massachusetts State Building Code)
this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified.
Identify Name of Building of Space Within Certificate No.
Issued to
ED JAZAB Permit#
BP-2017-0288
Identify property address including street number, name, city or town and county
Located at
306 Chesterfield Road
Leeds, MA 01053
Use Group
Classification(s) Single Family Residential R3
This Certificate of Occupancy is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for
general fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified below. It
shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or,
tampering with the contents of the certificate is strictly prohibited.
Conditions of Use
Name of Municipal Date of Final Map/Plot
Building Official Kyle J. ott Inspection Date: 15B-050
/// 05/18/2017
Buildings of Municipal Date of Man
Building Official 6 Issuance Date t'
05/18/2017 Lot