17C-081 (5) 41 HIGH ST
BP-2018-0105
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma :Block: 17C-081 CITY OF NORTHAMPTON
Permit:
Lot: PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:KITCHEN RENO BUILDING PERMIT
Permit# BP-2018-0105
Project# JS-2018-000177
Est.Cost: $82800.00
Fee: $538.00 PERMISSION IS HEREBY GRANTED TO:
Const.QAsLSL Contractor:
n License:
Use Groi
THOMAS DADMUN 107919
Lot Size(sq ft.): 17903 16 Owner: CAMMY JUSTIN D&RACHEL RUBINSTEIN
Zoning: URB(100)/ Applicant: THOMAS DADMUN
AT. 41 HIGH ST
Applicant Address• Phone:
60 SCHOOL ST Insurance:
HATFIELDMA01038 413 387-7381
ISSUED ON.7/31/2017 0:00:00
TOPERFORM THE FOLLOWING WORK.-KITCHEN REMODEL INCLUDING NEWWINDOW
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D,P,Wy
Building Inspector
Underground: Service: Meter:
Rough: Rough: -r- Footings:
1-7 House# Foundation:
np� Driveway Final:
Final: Final: : `1 `
Rough Frame:
Gas: Fire Department
Fireplace/Chimney:
Rough: Oil:
Insulation: U 1,—, -//Z/17
Final: Smoke:
Final: //IL/I�- G?
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occi anc •
Si nature• 0-f,�.t,o � �i��-vG�
FeeTvpe: Date Paid: Amount
Building 7/31/2017 0:00:00 $538.00
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 MA MA DATE _j PERMIT# �.
JOBSITE ADDRESS �% �' lT OWNER'S NAME µ
POWNER ADDRESS L// f TEL[ FAX;
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL
PRINT
CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES N0
FIXTURES Z FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY - - -- -- —�
ROOF DRAIN
SHOWER STALL - — -
SERVICE/MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION T
WATER HEATER ALL TYPES
WATER PIPING
OTHER '
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES4 NO
IF YOU CHECKED YES,PLEASE INDICATE THE 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 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. �J
PLUMBER'S NAME � a,tLICENSE# �3�'/ SIGNATURE
MP:� JP; CORPORATION#[:::: "PARTNERSHIPEJ#L- LLC #�
COMPANY NAME= ADDRESS 13 3 l,-) t'2
CITY Li e S T STATEn,, ZIP D/D�S TEL[ Cv�9G
FAX — �/5(,o=CELL y 7 EMAIL S Imo,G— �J�i,, y .�S�-11 T.'-, G�v.y• ) ; C v ,-.
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41 HIGH ST EP-2018-0136
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 17C
Lot:081 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE KITCHEN RENO
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2018-000177
Est.Cost: Contractor: License:
Fee: $65.00 JAMES W ELKINS Journeyman 39185E
Owner: CAMMY JUSTIN D & RACHEL RUBINSTEIN
Applicant. JAMES W ELKINS
AT.- 41 HIGH ST
Applicant Address Phone Insurance
2 WILLIAMS ST (413) 210-1379 C-(413) 534-2436 Liability,
8008030003716
HOLYOKE MA01040 ISSUED ON:8/3-7/2017 0:00:00
TO PERFORM THE FOLLOWING WORK.
WIRE KITCHEN RENO
Call In Date: Date Requested Inspection Date/Si¢nOff• Reinspect?:
Trench/UG:
Special Instructions
X
Roush -S 7 ✓W
X
Special Instructions:
Final:
SRE Called In•
Signature:
Fee Type:: Amount: DatePaid
Electrical $65.00 8/31/2017 0:00:00 1431
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo