24D-292 (8) cLeci- ./w.5- s Lis-
a MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
'; .; CITY /Jar 7'htn'yJkr MA DATE a`14Jj1?e PERMITS OP—t' 12 3
JOBSITE ADDRESS 63 14A(Au14 y sf- OWNER'S NAME \ I t(- Cale')
GOWNER ADDRESS J TEL 6Vf- 7c9 t/ FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONALPRT
RESIDENTIAL '_
CLEARLY ,----NEW: RENOVATION: REPLACEMENT: ✓ PLANS SUBMITTED: YES NO
APPLIANCES 1 FLOORS I &iM r 2 3 4 5 e 1 8 s 10 111 12 13 14
BOILER
BOOSTER
CONVERSION BURNER - _
COOK STOVE r _,
DIRECT VENT HEATER
DRYER
FIREPLACE orEt
FRYOLATOR / 'G'
FURNACE
GENERATOR ....
GRILLE —......- 171111.—TO—Ter- ---7—
INFRARED HEATER
LABORATORY COCKS "!
MAKEUP AIR UNIT i _ Ma
OVEN jI L FEB i 5 2017 i1LJ
POOL HEATER
ROOM ISPACE HEATEMIMI
R
ROOF TOP UNI _ -.
C 'LLE
TEST j ....-
UNIT HEATER
UNVENTED ROOM HEATER
WATER HEATER
OTHER
W cVle _,...
INSURANCE tJ
I have a current liability insurance policy or its substantial equivalent w �/ • NO
If YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHE
LIABILITY INSURANCE POLICY ,- 0 II
OWNER'SINSURANCEGen ra WAIVER:I am aware
ythat
the lion this permit
not dr. he
Massachusetts General Laws,and that my signature on this permft.app
SIGNATURE OF OWNER OR AGENT �,.1
1zll AGENT
I hereby certify that all of the details and information I have submitted or enter `my knowledge
and Mat all plumbing work and installations pd under the permit Issued Sion of the
Massachusetts State Plumbing Code and Chapterapter 142 pt the General Laws.
PLUMBER-GASFITTER NAME Ronald Hodges LICENSE 9452 2--0` _ SK;NA RE
MP + MGF JP JGF LPGI CORPORATION r S 472616345 PARTNERSHIP if LC M
COMPANY NAME: Hodge City Plumbing,Inc. ADDRESS 60 North Maple Street
CITY Florence STATE MA ZIP 01062 TEL 413-586-1150
FAX 413-585.5747 CELL 413-575-9030 EMAIL Scott@hodgecity.net
ROUGH GAS INSPECTION NOTES THIS PAGE POR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PER
FEE: $ _ __._._. PERMIT p,.,_______._._____
PLAN REVIEW NOTES 2M7 ilaGrif<veG i
.007 / `y/4L(J
pectr-CAT/At/
. / r/G L L 4
,re AC or
June 29, 2017
Jill Cohen
63 Hawley St
Northampton, MA 01060
Dear Madam,
Following Gas work performed by Hodge City Plumbing at this location, the Plumbing&Gas Inspector
performed an inspection on February 14, 2017. At that time there was no Carbon Monoxide protection
on the 2nd floor,and is was expressed that a detector would need to be installed. This office left a
voicemail message explaining that the Inspector would need to go back out and confirm this had been
done. We did not hear back from you,so we sent a letter dated 5/18/17. We still have not heard from
you, so are sending you this Certified Mail. You need to call our office as soon as possible to schedule an
inspection. The Plumbing&Gas Inspector needs to be able to confirm you have a working Carbon
Monoxide detector or he will be contacting Columbia Gas and your service may be interrupted. Thank
you.
Northampton Building Department
Office of Inspections
(413)5874271
mcahill@northamptomna.gov
a \1 - act a.
SENDER:COMPLETE THIS SECTION CONtti.ETk MS SECT ION ON DELIVERY
■ Complete items 1.2,and S. // 7 �( i
le Print your name and address on the reverse i 7' (.&ik i/�-d � .
so that we can return the card to you. p r. C.Date0 ofiiJs ee
■ Attach this card to the back of the mailpiece,
or on the front if space permits. ���
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ANNA 0 Signature Confirmation
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• PS Porto 3811,April 2015 Psta 7530-02.000-9053 Domestic Return Receipt
UNITED STATES s I II II (4/. Fi ‘Glass Mail
a M1 T I ge&Fees Paid
USPS
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• Sender: Please print your name, address, and ZIP4®,in t�ls box
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