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23B-035 (11) BP-2017-0722 61 LOCUST ST GIS O COMMONWEALTH OF MASSACHUSETTS Map:Block:23B-035 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-2017-0722 Project# JS-2017-000886 Est.Cost: $15000.00 Fee: 2555.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group:— ALL-TEK BUILDERS INC 76435 Lot Size(sq.ft.): 27007.20 Owner: WOHL CARINA Zoning-:NB,100 !URB o / Applicant: ALL-TEK BUILDERS INC AT. 61 LOCUST Sr Applicant Address: Phone: Insurance: 88G INDUSTRY AVE (413) 736-001A WC SPRINGFIELDMA01104 ISSUED ON.114/20170:00:00 TO PERFORM THE FOLLOWING WORK.NON STRUCTUAL INTERIOR DENTAL OFFICE - 5100 SF **INTERIOR ONLY** 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: /-a 7, ) House# Foundation: p in Driveway Final: Final: Z Final: ( ,.�/ `k Rough Frame: Gas: Fire Department Fireplace/Chimney: 1 ✓ Rroiub- Oil_ ri.sala ;uf�: x Final: Smoke: ` / Final: 17 4 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL T ON OF ANY OF ITS RULES AND RE U ATIONS. �� � l 17 F Certificate of Occu ahc 7 ►'3 signature: i FeeType• Date Paid: Amount: Building 1/4/2017 0:00:00 $2555.00 f s 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck--Building Commissioner `s i z ez) 61 LOCUST ST EP-2017-0653 'A L, bW-� lbT COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 23B Lot:035 ELECTRICAL PERMIT Permit: Electrical Category: WIRING FOR DENTAL OFFICE Permit# Electrical PERMISSION IS HEREBY GRANTED TO: Project# JS-2017-000886 Est.Cost: Contractor: License: Fee: $360.00 M B PRECISION ELECTRIC LLC MASTER ELECTRICIAN 13860 A Owner: WOHL CARINA Applicant: M B PRECISION ELECTRIC LLC AT. 61 LOCUST ST Applicant Address Phone Insurance P O BOX 1035 (413) 237-3510 () C- Liability, MPT6311 H BELCHERTOWN MA01007 ISSUED ON:1/26/20170:00:00 TO PERFORM THE FOLLOWING WORK. WIRING FOR DENTAL OFFICE Call In Date: Date Requested Inspection Date/SiEnOff: Reinspect?: Trench/UG: Special-lnstructions X Rough -7 X Special Instructions: Final: - 1- 0 Ce —/ G - 7 12r'h SRE Called In: Signature: Fee Type:: Amount: DatePaid Electrical $360.00 1/26/2017 0:00:00 4393 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo SIN- MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY aVC ��/ t,��i ./..� MA DATE i/�� i 6 PERMIT# 1- C'� a O JOBSITE ADDRESS �06 v S 7' J f. OWNER'S NAME /-5f. R4 iz v R-"' W IPA L POWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL,i , EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION REPLACEMENT: PLANS SUBMITTED: YES NO FIXTURES 7 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 1 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEMOF SUI ANG INAECTIOM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY ROOF DRAIN e SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING _. �OTHER �W i �21t" it Cc' ^1 / INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY V 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 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 iniance wit all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. L PLUMBER'S NAME Daniel J.Bishop LICENSE# 8460 S NATURE / MP JP CORPORATION # 2705 PARTNERSHIP # LLC # COMPANY NAME Aquarius Plumbing&Heating,Inc. ADDRESS PO Box 603 CITY Southampton STATE MA ZIP 01073 TEL 413-527-6771 FAX 413-527-5453 CELL 413-563-3120 EMAIL mkazunas@yahoo.com er -7 AAO --7 ,,vow e 090/ ,715 5 4f ,4,.,..jrZr7-16 A *v a f CITY OF NORTHAMPTON, MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS 125 LOCUST STREET NORTHAMPTON, MA 01060 June 9,2017 Carina Wohl 61 Locust Street Northampton MA, 01060 Backflow Preventer for 61 Locust Street. (RPZ on Vacuum System) PROPOSED CROSS CONNECTION INSTALLATION The City of Northampton Department of Public Works has reviewed your application and plan for the proposed cross connection installations. The information submitted is attached at the end of this notice. In accordance with Chapter 111, Section 160A of Massachusetts General Laws and 310 CMR 22.22 of the Massachusetts Drinking Water Regulations,the City, hereby grants approval for the installation with the following provisions: I. Drinking and domestic water lines, lines for safety showers, and lines for eyewash units must be taken off the upstream side of the backflow preventer for devices installed as in-plant protection. 2. The backflow preventer shall be located so as to permit easy access and provide adequate and convenient space for maintenance, inspection and testing. 3. Tightly closing valves must be installed at each end of the device. 4. The device must be protected from freezing, flooding and mechanical damage. 5. The owner or owner's agent must maintain a spare parts kit and any special tools required for removal and re-assembly of the device. 6. The owner of the device shall be able to shut down water lines after reasonable notice during normal business hours to permit necessary testing and maintenance of the device. If it is not possible to meet this requirement,a by-pass line equipped with an approved type of backflow preventer shall be installed. 7. Any reduced pressure backflow preventer or double check valve assembly and shut-off valves must be installed in horizontal alignment between three and four feet from the floor and a minimum of twelve inches from any wall. 8. If a reduced pressure backflow preventer is to be installed on a hot water line,a device approved for use at the elevated temperature must be used. 9. All water lines shall be color coded according to the State plumbing code,except that water filtration plants,pumping stations,sewage treatment plants and sewage pumping stations shall label all water lines in lieu of color coding. In addition,the City of Northampton Department of Public Works requires that the installation be completed within sixty(60)days after the receipt of this letter. Following installation,you must contact this office to make arrangements for the initial inspection and test. A permit from the Northampton Plumbing Inspector is necessary for the installation of each device. As the owner of this cross connection,you must be aware of the importance of maintaining these device(s). Unprotected cross connections can and have resulted in the loss of water supply and public health damage. You are responsible for compliance with Massachusetts Drinking Water Regulations,310 CMR 22.0. Failure to take any action deemed appropriate by the Department of Environmental Protection or its designee,City of Northampton Department of Public Works or otherwise failure to remain in compliance in the future with the applicable requirements,could subject you to legal action including,but not limited to,criminal prosecution,court-imposed civil penalties or civil administrative penalties. A civil administrative penalty may be assessed by the Department of Environmental Protection for each day you are in noncompliance with the requirement referred to above. If you have any questions regarding this decision, please contact Matt Pelott,City of Northampton Cross Connection Control Coordinator 413-587-1096. Sincerely, Matthew Pelott CC: Plumbing Inspector City of Northampton Department of Public Works Division of Water Supply C V ti 125.Locust Street Northampton,MA 01060 —� -� 3 Backflow Prevention Device Design Data Sheet Application for Installation Owner's name ' Address i-1 d mac'c Sf 5 r Av-6,,u zvd Telephone number 3 - � OW"--- Utul u.S Facility L113 -,S-6 2>/ "' Address Contact person/agentt� _ rn t C©1 Cnw j Telephone number of facility contact person New facility, Existing facility--k,- General description for then of th installation of a bac ow device ;k Device Datay- Manufacturer e �`7 � Model No. ` RPBP or Double Check Valves Hot or cold water unit----C4� LT_ By-pass arrangement Yes or No Exact location of devico r SC'rhtt-tJ 5� t11 ��Z61 v f 0 VuzF- Water usage down stream of device Gate valve Ball valve X Butterfly valve Plans and Spare farts Required t i ns` a for W1 ' be t fon -or h device t A fully labeled,detailed schematic of the potable and non-potable water piping immediately 99mandins the backflow prevention device installation showing: 1. Height above floor of the device 2. Distance from wall of the device 3. Type of chemical(s)used(if any)and the type of equipment upstream,and downstream of the device Please note block:The schematic drawing must be at least 8'/2 by 11 inches with the following information in the comm W title block. Submitted by: 1 Y Plumber's signature. 5 Plumber's license#: Owner/agent signature: Date: All information listed above must be included on schematic drat ine. In additionj a fee of$65.00, made savable to the City of Northampton for each device application must be submitted to the D.P.W.before4nv application will be processed. A permit form the plumbing inspector may be t necessary for the installation of these devices. t R S Approvals or denials of this application will be sent directly to the owner. if you have any questions, please can the Department of Public Works at 413-587-1570. r t Official DPW use oul Approval: Denial: R R t L J 3 r