42-067 (3) 17 GLENDALE RD BP-2017-0906
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:42-067 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: REPAIR BUILDING PERMIT
Permit# BP-2017-0906
Project# JS-2017-001539
Est. Cost: $17000.00
Fee: $110.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JOHN W COTTON 085406
Lot Size(sq.ft.): 17728.92 Owner: COTTON JOHN E
Zoning: Applicant: J0HN W COTTON
AT. 17 GLENDALE RD
Applicant Address: Phone: Insurance:
5 WEST ST (413) 247-9608
HATFIELDMA01038 ISSUED ON:1/31/20170:00:00
TO PERFORM THE FOLLOWING WORK.-NEW FLOOR, SUPPORT BEAM - PLUMBING &
ELECTRIC REPAIR
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: 3 b 17 Rough: 3 � -J House# Foundation:
Driveway Final:
Final:,/�/7 Final:y'—� 9�. /17
0 y Rough Fr me:
3-ac,1-7 OK,
Gas: Fire Department Fireplace/Chimney:
Rough: ,f6 /,7 Oil: Insulation:
Final: Smoke: Final: �� / Z2 /'
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc Si nature:
FeeType: Date Paid: Amount:
Building 1/31/2017 0:00:00 $110.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY / C rTl6t��7 / MA. DATE_ 1 PER,MIT#
JOBSITE ADDRESS l lJ eVl- F "`' OWNER'S NAME `J O A �� �
OWNER ADDRESS TEL FAX
TYPE OR OCCUPANCY TYPE: COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL®�
— --PRINK ---- -- --- -- -
CLEARLY ��R� -� TfiED):� NO
FIXTURES 1 FLOOR- BSMT 1 2 3 4 5 6 7
BATHTUB
CROSS CONNECTION DEVICE j
DEDICATED SPECIAL WASTE SYS
DEDICATED GAS/OIL/SAND SYS
DEDICATED GREASE SYS
DEDICATD GRAY WATER SYS I i�
DEDICATED WATER RECYCLE SYS
DRINKING FOUNTAIN
DISHWASHER ` MAR 1 3 2DR
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR) El:ct l Pl;:mbing 8 C�< Inspectors
KITCHEN SINK -
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE/MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
WATER PIPING
OTHER C*
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which,meets the requirements of MGL Ch,142. Yes Lt No❑
IF YOU CHECKED YES, PLEASE INDICATE T TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY [ OTHER TYPE OF 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 BOX ONLY: OWNER ❑ AGENT ❑
Signature of Owner or Owner's Agent
I hereby certify that all of the details and information 1 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 issue for this application will be in
compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of t eneral Laws.
PLUMBER NAME
� -, ��� a SIGNATURE
' Q,-
LIC# �� J MP 2"'JP❑ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑#
--- ADDRESS: Co
`� U�x 6 r
COMPANY NAME .� `
CITYSTATE 1411 ZIP 01032 EMAIL
TEL CELL L �'(9 2(cr FAX
31�e,;,,O' v
-71 �, �,
C)Uch a:1 Iv/0-6,
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
A .. ;. �,. J , 7CITY bI�CfWJll�C�
JOBSITE ADDRESS _. OWNER'S NAME . J
OWNER ADDRESS TEt,
FAX ;
w.
TYPE OR OCCUPANCY TYPE COMMERCIAL __a EDUCATIONAL RESIDENTIAL '
PRINT1
CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES' ' NO
APPLIANCES Z FLOORS, BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER
BOOSTER
CONVERSION BURNER
COOK STOVE j
DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM/SPACE HEATER
ROOF TOP UNIT
TEST
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 NO
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY I--- 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 complianc ith a 7nent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER GASFITTER NAME �phvL Vlt LICENSE#,[14IGNATURE
MP` / MGF_ JP F-1 JGF LPGI CORPORATION-:]# PARTNERSHIP; #` LLC #
COMPANY NAME:L, 'ADDRESSA _..._. ....
CITY � � STATE ZIP U l OT-L=TEL
FAX CELL REMAIL ��
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
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CITY �(��E; MA DATE �"//7 'PERMIT# Co f?-
JOBSITE ADDRESS / 7
OWNERS NAME
GOWNER ADDRESS TEL yI )'"�� �'r 7 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 5 6 7 8 9 10 11 12 13 14
BOILER
BOOSTER
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
DRYER ±I
FIREPLACE 1,
FRYOLATOR Put— 1 2011
FURNACE
GENERATOR I
GRILLE
i
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM/SPACE HEATER
ROOF TOP UNIT NG& AS IN PEC OR
TEST
UNIT HEATER %C J PROVED
UNVENTED ROOM HEATER
WATER HEATER lt
OTHER =QX� �IGE U l
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 compliance with all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws ;
PLUMBER-GASFITTER NAME ALFRED H GEORGE LICENSE 4 3800 � S I i JATURE�� �
i
MP MGF JP JGF LPGI CORPORATION # 130C PARTNERSHIP # L-LC 4
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COMPANY NAME. GEORGE PROPANE. INC. ADDRESS 3 BERKSHIRE TRAIL WEST, PO BOX 102
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CITY GOSHEN STATE MA ZIP 01032-0102 TEL 413-268-8360
FAX 413-268-0206 CELL EMAIL mgeorge@georgepropane com
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17 GLENDALE RD EP-2017-0803
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 42
Lot:067 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE RENOVATIONS AND REPAIRS TO KITCHEN&BATHROOM
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2017-001539
Est.Cost: Contractor: License:
Fee: $125.00 JAMES GROWHOSKI Journeyman 39792
owner. COTTON JOHN E
Applicant: JAMES GROWHOSKI
AT. 17 GLENDALE RD
Applicant Address Phone Insurance
120 HENDRICK ST (413) 527-6499 () C-(413) 626-9773 Liability, SCP36045053
Easthmapton MA01027 ISSUED ON.3123120170:00:00
TO PERFORM THE FOLL OWING WORK
WIRE RENOVATIONS AND REPAIRS TO KITCHEN & BATHROOM
Call In Date: Date Requested Inspection Date/SignOffi. Reinspect?:
Trench/UG:
Special Instructions
x -
Rouizh C) -
x
Special Instructions:
Final: Ab - 7 - 7 C/- (Z
SRE Called ln�-
Signature:
Fee Type:: Amount: DatePaid
Electrical $125.00 3/23/2017 0:00:00 6594
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo