24A-252 19 PILGRIM DR BP-2016-1020
COMMONWEALTH OF MASSACHUSETT
S
GIs#: CITY OF NORTHAMPTON
ti1ap:Block:24A-252
LoPERSONS CONTRACTING
TO THE GUARANTY FUND (MGL�.142A)
permit• Buildin DO NOT HAVE ACCESST
Cate�or • renovation BUILDING PERMIT
Permit# BP-2016-1020
Project# JS-2016-001722
Est Cost• $91000.00
Fee•_.$592.00 PERMISSION IS HEREBY GRANTED TO:
Contractor: License:
Const. _p . ANDREW O'BRIEN 047357
Us_ Gr°up:
Lot Size(sg 541.52 Owner: LEIGH DOUGLAS
Zoning• L RA(100)! Applicant: ANDREW O'BRIEN
AT: 19 PILGRIM DR Insurance:
Cl ar:tAddress: Phone:413 563-1902 Workers Corn sensation
75 a ton Rd.
HOLYOKEMA01040-1543 ISSUED ON:3/4/2016 0:00:00
TO
PERFORM THE FOLLOWING WORK:REMODEL 2ND FLR BATH, RECONFIGURE 2ND
FLR BEDRMS & ADD 2ND FLR DORMER
POST THIS CARD SO IT IS VISIBLE FROM D.P.W.HE STREET Building inspector
Inspector of Plumbing Inspector of Wiring
Service: Meter:
Underground: Footings:
House# Foundation:
Rough: 61/ �l!o Rough '1�_(
Drivew•a}•Final:
Final: Final:
/27g0//‘ Rough Frani 94)! f ce Q
Fireplace/Chimney:
Gas: Fire Department
/6 G --
Insulationaa,
Rough: Olt'
Final: A/ •—lS -/ 7 ���
Final: Smoke: (/jC �
THIS PERMIT MAY BE REVO ► ; i .tom THE CITY OF NORTHAMPTON UPON VIOLATION/ OF
...ci' 1144 p o•.Vc.0 4-
ANY OF ITS RULES AND R. '�'/ /� ,o
Certificate of Occu•an
�i ` Si._nature:
OFP-
FeeT , e: Date Paid: Amount:
Building 3!4/2016 0:00:00 $592.00
212 Main Street,as Phone
l�Bu) 8ding Commissioner 7-1240,Fax:(413)587-1272
Louis Hasbrouck
I ) 34i
(o 7-
°
/ o
cveA1/4)/3 t--ku: 443
cot /339 qo
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
%M e
CITY kit)4/1c, .,per f, MA. DATE S---Z- LOI6 PERMIT#-(DR., 1G ' Y37
y f l
JCBSITE ADDRESS ICI R lei r- C`r k ti 2 OWNER'S NAME �a,,� Le,
I
OWNER ADDRESS St.,n-,c TEL 1-'al ei -3a2.3b c'3 FAX
TYPE OR OCCUPANCY TYPE: COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL gr."--
PRINT
/PRINT NEW: ❑ RENOVATION:D REPLACEMENT: ❑ FLANS S'JEMIT T ED: YES 0 NO 0
CLEARLY
FIXTURES.. FLOOR— BSMT 2 3 I 4 I 5 16 7 I 8 9 10 11 12 13 14
BATHTUB I I I I I I
DROSS CONNECTION DEVICE I I I I I
DEDICATED SPECIAL WASTE SYS I i I I
DEDICATED GAS(01USAND SYS I
DEDICATED GREASE SYS I I
DEDICATD GRAY WATER SYS I I
DEDICATED WATER RECYCLE SYS I I I I
DRINKING FOUNTAIN I I ( I
DISHWASHER I I I
FOOD DISPOSER I I I I I
FLOOR/AREA DRAIN I I I I I
INTERCEPTOR(INTERIOR) I
F, NIbiNCa&:.,+V iNSNEt�l JR
KITCHEN SINK il+: ..:i,'TON
LAVATORY 2-• - I I A ROVED/ PKOT AP"FOV D
ROOF DR4IN I '�
SHOWER STALL I I I
SERVICE!MOP SINK I I I I I I I
TOILE ) ' I
URINAL I
'/DASHING MACHINE CONNECTION I i` I 1 I i
WATER HEATER ALL TYPES I I
WATER PIPING I 5 _ I • I I
OTHER I , I 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. Yes ErNo❑
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY DLZ OTHER TYPE OF INDEMNITY 0 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 BOX ONLY: OWNER 11 AGENT 0
Signature of Owner or Owner's 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 State Plumbing Code and,CChapter 142 of the General Laws.
DLUMBER NAME (`�OA)k n ( - cx . GL, SIGNATURE /�(y %• ��!
_IC# 5097-4 M?❑ JP CCE- CORPORATION ❑# PARTNERSHIP ❑# L LLC ❑#
DCMPANYNAME L 4� P—.1lc QI^'tb 4- ,c•-r,c� ADDRESS: (1 �Dc� ((c 57 r
c STATE ZIP G1� �c,� �Jo.. ` ~/c>c
CITY iv•S!J -�(� /�A I EMAIL (.9'� � l �L� � (� r
FEL J CELL 9r3 --5-6_Y--b8o7 F.AX
ROUGH PLUMBING INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ 0
— -- ct/— /'4 - FEE: $ PERMIT# —
_____ 4"6 PLAN REVIEW NOTES
4
/4'4; f — J —
19 PILGRIM DR EP-2016-0856
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 24A
Lot:252 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE 2ND FLOOR REMODEL
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2016-002321
Est.Cost: Contractor: License:
Fee: $125.00 ROMEO L BEAULIEU & SONS INC MASTER ELECTRICIAN 3923A
Owner: LEIGH DOUGLAS
Applicant: ROMEO L BEAULIEU & SONS INC
AT: 19 PILGRIM DR
Applicant Address Phone Insurance
PO Box 1386 (413) 538-8741 C- Liability, ZHN0774120
HOLYOKE MA01041-1386 ISSUED ON:5/18/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE 2ND FLOOR REMODEL
Call In Date: Date Requested Inspection Date/Si•nOff: Reins en?:
Trench/UG:
Special Instructions
x r�
Rough r-�,L -/(s cal's
x
Special Instructions:
Final: _
SRE Called In:
Signature:
Fee Type:: Amount: Dateraid
Electrical S125.00 5/18/2016 0:00:00 37663
212 Main Street, Phone(413)587-1244. Fax(413)587-1272- Inspector of Wires -Roger Malo