06-064 (34) -
GIS#: COMMONWEALTH OF MASSACHUSETTS 7
MCITY OF
Lor.t: -000000 ck:06-064 NORTHAMPTON
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit' Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Carts ry New Siel Family01H
Pouse
BUILDING PERMIT
ermit#6417
project# EZ-6050
Est Cost' 63428 00
Fee:$130170 PERMISSION IS HEREBY GRANTED TO:
Const Class: Contractor:
use GroueSOVEREIGN BUILDERS INC060176
Lot SI ft 1 Owner: SAMOLE WICZ SCOTT "' GLEASON A[LEEN
zoning: ADDjuant: SOVEREIGN BUILDERS INC
AT.• 11 BEAVER BROOK LOOP
ADoticantAddress•
135 50135 SO TU�ON RD Phone: Insurance:
Compensation 413 527-8001 Workers
WESTHAMPTONMA01027 ISSUED ON-62 8/201 7 0:00:00
TO PERFORM THE FOLLOWING WORK.•NEW SINGLE FAMILY HOUSE WITH GARAGE
POST THI5 CARD SO IT IS VISIBLE FROM THE STREET
Inspector of plumbing Inspector of Wiring D.P.W.
Building Inspector
Underground: Service:
Meter:
Rough: �Jj,/� Rough , 1- 1'7 House It Footings:
/ Driveway Final. Foundation:
Final: Final: )-S'-/e ^
NO �� Rough Frame: �f�„ /
Gas: —Fir,De rtnmt
Fireplace/Chimney:
Rough: 0,1: � /�
LA Insulation: NJSPEGrL4 9(t5t0.7
Sm_ke:
n
Final: //a�• P49-7-I (AW1pkN
61)41
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate ofOccu anc 6*" 1 vza"'rz
Si nature
Fee1WDe: Date Paid Amount
Building 62820170:00:00
$1301.70
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck-Building Commissioner
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wT INSuL.A1fll JS I S6A46/� W64L
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fLtASE R06 0,62� RAI-C-rz Co "7A C-T
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
^
CITY fJT't N MOaa MA DATE -ir- z"'� PERMIT#
JOBSITEADORESS OWNER'S NAME_
POWNER ADDRESS TEL FAX
TYPE OR ( OCCUPANCYTYPE COMMERCIAL El EDUCATIONAL ❑ RESIDENTIALIP—
PRINT
CLEARLY NEW:[Ef' RENOVATIONS.❑ REPLACEMENT. ❑ PLANS SUBMITTED: YES❑ NO❑
I
FIXTURES I FLOOR— BSM 1 2 3 4 5 6 T 6 9 10 11 12 13 14 1
BATHTUB 1 -
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM _
DEDICATED GAS'OIUSAND SYSTEM I —
--
DEDICATEDGREASESYSTEM rt j
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
_
DISHWASHER
DRINKING FOUNTAIN
Ef—
cOODDISIFOSERR I I I
FLOOR;AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY
ROOF DRAIN _
SHOWER STALL /
SERVICE!MOP SINK
_TOILET
URINAL IN
Uiri G8 ASIN PECIDR
WASHING MACHINE CONNECTION / - T N
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. YES R' NO ❑
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE OFINDEM i ❑ BOND ❑ j
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
and
tretailt cehdy pin all of the details and it sprmaarr have under tra"Pted or esuerd f r this app this application are tore are accurate to qp hest of my kiwvJodge
Ma shat all plu State work arA iCropa nd pertwme0 fthe mener l L issued for this application will CC in co ce wrth�all P ILnent provision of tM1e
Massachusetts State Phumhfng Code airtl Chapter 142 of tM1e General Lawn _� ^"� �hen
PLUMBER'SNAME ��"c �'V�'�'F� LICENSE Ifo`C- SIGNATURE
SII MP®' JP❑ CORPORATION❑# PARTNERSHIP❑# LLC❑#
COMPANY NAME �bti�'��oto+.-�r.�C �T-�"� ADDRESS �' ei'x 365
I
CITY_f�LS�rd wYy�z., —i oioz-7
STATE ZIP Ti GAG C�Za
I
FAX _ CELL EMAIL
9�� ,�
ra°
r;�.x �'
ClyL&& /us/ J&Y o�
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 77
CITY MA DATE 76 toil PERMITg
JOBSITEADDRESS] a ,- OWNER'S NAME
GOWNER ADDRESSTE FAXD
TYYPPINT E OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL E] RESIOENTIALQ—PR
!!
CLEARLY NEW:O— RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES El NO❑
APPLIANCES 7 FLOORS BSat 1 2 3 4 5 6 x 6 9fil2L 13 14
BOILER
BOOSTER
CONVERSION BURNER COOKSTOVE DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATORFURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORYCOCKS Ir I
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM I SPACE HEATER
ROOF TOP UNIT
TEST
UNITHEATER
UNVENTED ROOM HEATER
WATERHEATE
OTHER
HEATER RANGE
VENTED ROOM HEATER
GAS PIPING
INSURANCE COVERAGE rr-��..cc
I have a current l�lnsumnce policy or Its substantial equivalent which meets the requirements of MGL.Ch.142 YES L9n0❑
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY❑ BOND Ll
OWNER'S INSURANCE WAIVER:lam aware that the licensee don not have the insurance coverage required by Chapter 142 of the
Massachusetts General Lawn,and that my signature on this permit application waives this requirement.
CHECK ONE ONLY: OWNER AGENT El
SIGNATURE OF OWNER OR AGENT
I hereby ceNfy that all of the dsteas aM lydminaon l have submitted or entered suasion,rats applicetlon are ime arld sixteens to the beat of rM kasla im,
and that all Plumbing v arcl hutelaapro perkinled under the parma Issued for Ws appliicatton will he In cornpll wilhaf P.vfiv odea !i
Massachusetts State Plumbing Code and Chapter 142 of the General laws.
PLUMBER-GASFITTER NAME p��
CD - Cir LICENSER76fr�`? SIGNATURE
MPS MGF❑ JP JGF❑ LPGI❑ CORPORATION Bb PARTNERSHIP❑# LLC❑S�
COMPANY NAME: dl11LL ico ADDRESS a
CITY STATE aMZIP p16 z7 TEL '//3 z(_ En Z-
FAX CELLFEMAIL
i
11 BEAVER BROOK LOOP EP-2018-0008
�19 COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 06
Lot:064 ELECTRICAL PERMIT
Permit: Electrical
Category: WIRE NEW HOUSE TO CODE WITH 200 AMP UNDERGROUND SERVICE
Perm¢# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2017-002350
Est.Cost: Contractor: License:
Fee: $200.00 STEVEN KEYES MASTER ELECTRICIAN 21213A
Owner: SAMOLEW ICZ SCOTT & GLEASON AILEEN
Applicant: STEVEN KEYES
AT: 11 BEAVER BROOK LOOP
Applicant Address Phone Insurance
13 STATE RD (413) 422-1220 () C-(413) 695-4968 Liability, R1216217A
SOUTH DEERFIELD MA01373 ISSUED ON:7/7/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE NEW HOUSE TO CODE WITH 200 AMP UNDERGROUND SERVICE
Call In Date: Date Requested Inspection DateisienOff: Reinspect?,
TreucldUG: 7- 7- / 7 lP h
Special Instructions
x
Rin
x
Special instructions:
Final: NO ` I-T- /� vz. �j � E4 NL� /-/8 -/f 2 -.
1,
SRECalledln: �' �(J o y � ! -�-/g- �7 9pr—
Sicnature:
Fee Twe:: Amount: DatePaid
Electrical $200.00 7/7/2017 0:00:00 5962
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo