36-401 (4) lauolsslwwo38wpling-Xanolgs HSM01
ZLZI-LS9(E Ib) d 'ObZI-L8S(£Ib)auogd 10a11S ulrw ZIZ
01'66ZI$ 00:00:0 LIOZ/S/b 8wpplq
:lgnosuV :p)rd alr4 :a ,Laa3
:a,ntru ,s =21111H
p}oaJe�;!Yap" Sts1OIZV'I 322 SSI 30 ANV
30 NnnOLLV'IOIA N0d(1 N01dWVH1H0N 30 ALIJ 3HI AH GINOA3H HU AVIV IINRIHd SIHI
Af �-,✓J grrl3 s�J£�J? :axlowg Gam./, 9/ O/Iruld
"1 L/LILL'II/L N V '::uogrinsul
•1!0 ///Q:g8nod
:(auwlg1/aarldaal3
tuawtJ�aTid :srO
1 ®rtJW
.awrld yHnoa
:lrrld :lewd
:IrY1,.1.16MiA1JQ fin{
:uogepun°d pasnotl ��e-'_'n:gbnoN
:s5uL�t�i�9 ;y$nuJl
g003 L,�
gala pr.
lotaadsul lluipong W :aawag pL/R-2
'M'd'(t $nPIMlu Jotaadsul Hwgwnld J0 oYa ul
.L332LLS HH,L IN02I3 3'IHISIA SI .LI OS 0dVp SIH,L ISOd
AEMdVJ WO Z 'dS L9£Z
3S(l0H AIIWVd 310NIS M3 l0f1NISN00-Mal0M 'JA/IM0770i aKL y mo-4Xdd O.L
00"00"0Z'OZ/S/3"N0Q3/1SS/ MWV1NN01dWVH. '10N
pM ZO L OL66-ZSS .£I b) 989 X05 (5—d
:aauaJusut �a..
NOSdOf 113SS(121 -1uvaN V -�U�oz
J'I'7 AVM N0SNHw3 :JaMMO Z9'O£9l #' �a' --S 10-1
L£9£90 NOSdorll3SSf121n-0lpasn
:asuaarq : TSJOJavJJuv� 31su03
'Ol Q7JArVY9 d9",VH SIA701SSIWX.9d 01"66Z[ :aa3
00000961 11SoJ IS9
949100-LL0Z-Sf #1aaold
9L0TLL0Z-d9 #puuad
,LIIT.�T�� Ha DNIQ'IIIlg MOH pwrdal u'SMall , D—IRD
(VZK 0IOW) 0Nf1d AINV8Vf1J 3Hl Ol SS300V 3AVH ION 00 u!pl!ns S 1-ad
SH013VNII.l03 O3N31S103NNI1 HIM OMIWNINOJ SN0S113d loo- :lot
Nold61IV ulf0AI 30 A113 lot,-91: 1a0I rW
S1,L3SIIH3VSSV1V 40 H.L1V3AAN0L1W00 -#SID
9L01-L 60Z-d9 AVM KOSNHw3 99
bs G 4 so 00
r—\ MASSACHUSETTS UNIFORM APPLICATION FORAERMIT TO PERFORM PLUMBING-WORK
CITY H
MA DATE PERMIT# LI
JOBSITE ADDRESS OWNER'S NAME f m /7J n
POWNER ADDRESS TEL /3-bSU-bad. FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
PRINT
CLEARLY NEW: RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES E] NO[-]
zn
FIXTURES 1 FLOOR— BSM 1 2 1 3 1 4 5 6 1 1 8 1 9 10 11 12 13 14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GASIOIL/SAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR I AREA DRAIN
INTERCEPTOR(INTERIOR)_
KITCHEN SINK
LAVATORY
ROOF DRAIN
SHOWERSTALL
SERVICE I MOP SINK -
TOILET
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
WATER PIPING
OTHER
11 MI. M
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 PDL ICY❑ OTHER TYPE OF INDEMNNY ❑ 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 Lars,and that my signature on this pentad application waives this requirement
CHECK ONE ONLY: OWNER ❑ AGENT ❑
SIGNATURE OF OWNER OR AGENT
I hereby ceNfy Vat all of the tletaile am information I have subninell a emere4 regaNiig this atmicatbn are nue am accurate to the best of my knmMedge
am that all plumbing wak am installations perfametl umer the Permit issued far this application will be in compliance with all Pertinent pmNsion of the
Wasachusees State PlumMng CAM am Chapter 142 of Me Genal Lewy. ,
PLUMBER'S NAME I Mark Wendolowski LICENSE# 12394 `�/ 51 URE
MP❑ JP❑ CORPORATION❑# PARTNERSHIP❑# LLC❑# 3675
COMPANY NAME Express Plumbing, HeaBng 8 Solar L ADDRESS 131 Prospect St
CITY Hatfieltl STATE MA ZIP 01038 TEL 413-626-3862
FAX r CELL EMAIL mwendolowski@ inwst.net
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
^ CITY jorjp" p-,,; nJ MA DATE (� /. PERMIT#
}
JOBSITEADDRESS
I :.I'J/o Ei�1CtLQl� (A..�y OWNER'S NAME fltiti+/Ktir/C yiiP�/I�./�M
GTOWNER ADDRESS - TELq/g-,y 5b-6,Uj'FAX r
TYPE OR
PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL _ RESIDENTIAL '
CLEARLY NEW>0 RENOVATION'..... REPLACEMENT: PLANS SUBMITTED: YES NO
APPLIANCES 7 FLOORS— SSM i 1 2 3 1 4 5 b I 7 8 9 1C 11 12 I 13 1 14 i
BOILER _ __..
BOOSTER
CONVERSION BURNER - _-- - -- _- - - - _-
COOK STOVE I
DIRECT VENT HEATER
DRYER
FIREPLACE
-
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT -- � - _ _- - -- - - -- - - _- -
OVEN
POOL HEATER
ROOM I SPACE HEATER
ROOF TOP UNIT .
TEST _. -_ ,�
UNIT HEATER
UNVENTED ROOM HEATER - -.
WATER HEATER - _-- -
.OTHER
INSURANCE COVERAGE
Ihave a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO
1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
UABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND
OWNER'S INSURANCE WAIVER:I am aware that the Ncensee 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.
CHECKONEONLY: OWNER AGENT '.
SIGNATURE OF OWNER OR AGENT
hereby certify that all or the details and information I have submitted or ersanxt regarding this application are true and accurate to the best o my knowledge
andthat
all
Plumbing work and installations,Pertorrtl under the permit suedfor this application will be in complyne-J Pertine vision or the
Massachusetts State Plumbing Cade and Clnpter 142 of the Gereml Laws.
PLUMBER-GASFITTER NAME Mark Wendolowski LICENSE# 12394 SIGNATURE
MP MGT JP JGF -PGI CORPORATION # PARTNERSHIP # LLC #8675
COMPANY NAME.Express Plumbing, Heating&Solar LL(ADDRESS 131 Prospect St
CITY Hatfield ` STATE MA ZIP 01038 TEL 413-626-3862
FAX CELL 413-626-3862 EMAIL.mwendolowski@comr sine[ _
66 EMERSON WAY EP-2017-0921
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 36
Lot:401 ELECTRICAL PERMIT
Nmit: Electrical
Categoge WIRE NEW DWELLING WITH SERVICE
Pcrmit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2017-001845
Est,Coss Contractor: License:
Fee: 5200.00 PAUL R MILLER MASTER ELECTRICIAN 21413
Owner: EMERSON WAY LLC
Applicant. PAUL R MILLER
AT. 66 EMERSON WAY
Applicant Address Phone Insurance
24 ALVORD PLACE (413) 244-2124 () C- Liability, 6805C793578
SOUTH HADLEY MA01075 ISSUED ONa512120170:00:00
TO PERFORM THE FOLLOWING WORK:
WIRE NEW DWELLING WITH SERVICE
Call ILt Date RegugIt dlwpecfion Date/Sig.Q1L R ' a t'
Trench/UG
Special I.rructions —
x }
Rousth
X
sped.]Iastr efleas:
F' 1 /O /2
5'RE Called Im 24010686
Si atvr¢:
Fe Tw .. A ou t• DatePaid
Electrical $200.00 5/2/2017 0:00:00 3023
212 Main Strutt,Phone(413)587-1244,Fox(413)587-1272-hupector of Wires -Roger Malo