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05-010 (7)
� �n/N O� C�IG� �7 -5�� r7D MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY S MA DATE[6jL PERMIT# JOBSITE ADDRESS >� Ll/IC —_ OWNER'S NAME,! LI ,a n G OWNER ADDRESS �0 (✓-lln�p--- �TE FAX_ , TYPE OR OCCUPANCYTYPE COMMERCIAL EDUCATIONAL ] RESIDENTIAI PRINT CLEARLY NEW:jg" RENOVATION: REPLACEMENT PLANS SUBMITTED: YES[!f NO APPLIANCES-1 FLOORS BsM 1 2 4 e to 12 13 14 BOILER .. _� .. _ - BOOSTER CONVERSION BURNER COOKSTOVE DIRECT VENT HEATER _ DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER _ LABORATORY AIRY COCKS M AKEUPAIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER L OTHER 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 I OWNER I U NCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massacht to ILat s,ay nd that my signature on this permit application waves this requirement. CHECK ONE ONLY: OWNER Lld AGENT SIGNATURE OF OWNER OR AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this application are true ane accurate to the best of my knowledge and that all plumbing work and installations Performed under the permit issued for this application Wil be in compliance with all Pertinent Nspro ion of tl`e Massachusetts State Plumbing Cade and Chapter 142 of the General Laws. C) PLUMBE �R- 7t7 NAME (` LICENSE# SIGNATURE MP EERMGF Q JPLJ JGF Q -PGI F-j CORPORATION:]# PARTNERSHIPF-14 LLC D#� COMPANY NAME: 1 ADDRESS it 7-f CITY t' o I STATE�ZIP I TEL �,� `/ 6031 ' FAX CELL EMAIL 4 . / } \ / / k \ : ƒ � w7 \ ® � MCI] § !/ AJ v d ® k - Lij X02 3 S, oc� ILI, MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK a CITY - ___.. ___ —3 MA DATE PERMIT# JOBSITE ADDRESS 8Y2 9 OWNER'SNAME ,'Flim p POWNERADDRESS IS i <4l rwt St. TELFAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIALrJ' PRINT CLEARLY NEW:[j RENOVATION:© REPLACEMENT.❑ PLANS SUBMITTED: YESN077 FIXTURES? FLOOR— BSM 1 1 2 1 3 4 5 6 T F BATHTUB ."I ...... CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOItISAND 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 SHOWER STALL _ SERVICEIMOPSINK l TOILET URINAL — WASHINGMACHINECONNECTION 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 vs 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 MassachusHls G n I Laws,a that my signature on this permit application waives this requirement. CHECKONEONLY: OWNER AGENT ❑ SIGNATURE OFMMERORAGENT I hereby certify that all of the details and information I have submitted or entered regarding(his appliamon are tme and accumte 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 pro ' not the Massachusads State Plumbing Code and Chapter 142 of the General Lawn. —' PLUMBERS NAME (LICENSE# SIGNATURE MPz JP-. CORPORATION# PARTNERSHIP#FLLC[I# COMPANY NAMEK c� ADDRESS( `/(n fK � eL --Ml CITY o,, STATE ZIP __ Q L) �.b CumTEL FAX CELL EMAIL 1 y I O I m 6 U Z Q Z Y o❑ ITNI Z Y❑ tyl m a z 3 m � 2 6 I r I h � a � U O C aauoiss!wwoJ`dwping-.gonolgwH smo-1 ZLZI-L85(E IV):-1'04ZI-LBS(£C6)au04d'iaa11S u!epl Z I Z 0)'06ZIS 00:00:0 LIOZ1118 Sury!!ng :juvomV :pled MVV :a yaag :aunlou !s oue Hoop;o alpylya0 'SN0IZVlm9am (INV SHIM S.LI90 ANV 30 NOI.LV'IOIA NOdM NOIdWVHIHON 30 AID alll A9:GaMOAHH 39 AVAI 11I1RI3d SIELL yfgz�z �:leoll :agowS :uoge Hsu 1!0 / nou :.<auw!yJ/aaeldand luamlue aQand i,✓,/ :suf) -,5/ ,5,1 --'r `awead On02l 51! lk LIJ9f2 / '+ s/•c/ -J :1°mc' „ �. :uo!lepunod gasnog L-( -h •\` NOROl /g8noa :ffi .100,1 l a :aapp alaw waS 2 C�� J up jowadsol 8mpp"g 'M•d•Q 8uu!MIolulaadsul su!gm dJolopadsul lH3H,LS 3H.L WOH3 31EIISIA SI II OS (IHVJ SIHI ISOd --'h^Al3d "Y'*'i �� 13 OSOOLZ INMIMVdV ALIOSS300V HIIM 3ismH M3N-'"OM DNLII0770-4,YHS"O-TUdd 01 00.00.'01IOL'I/8-AO QH713Sl 9ZOLOVWNOlONIWWf1J I08L-969 Q l4 I b XO8 O d Muvmsul :auogd :ssaJppy Juvall y AAV 3A021J £8 -*IV 93HSOA N3Hd3l$�� /OOI van: u!uoZ -- H13avZITt 3av'Is :+au'HO 9L'8 L O1 I7' S -!S lo•I 06489 N3HSOAN3Hd3lS MaDasn :asuaal7 :mlw.puoJ :sse!J IS-3 'O L Q7LNdXJ d>I3XdH SI AIOISSIlYX3d 00'06zl :aad 00'Oobo4Z aso0'1S9 60L000-8LOZ-Sf #—P—OTO—Id L900-9LOZ-d8 knuuad T TTA T a 11 NT7�rTT(1 (T< AIIOSSeJJV M/asnoll 1!we.i a mg maN: o ales ,J i1(jVZl?V3ollJW)) (]Nnzl AAiNN1VLIVno 31Hi 011 S8303V 3AVH ION 00 ulPl!n8 1!-ad SHO10YUNOJ CMMSI03NNn HIM ON11JYd1N00 SNOSg3d 100- ao•1 No.LdNivmmoN 3o A,LIJ 010-50: 1301 SllgSfIHOVSSVW 3O H.L'IV3,,AANOlVW03 :4 SID L900-8 LOZ-d8 aAv anoxO E8 - -- - - -- - - ---- - C1t4 �Z9Sa __ 5,00 --- --- MASSACHUSETTS UNIFORM APPLICATION FOR A PERMITTO PERFORM GAS FITTING WORK vCITY L.RgLQs ^� � MA DATE )a,1aa//7 PERMITyA_��,�/�_ JOBSITE ADDRESS d3 6ro� Aveoute— OWNER'SNAME GOWNER ADDRESS TEL 4/3-53'-30/6 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL iii PRIVY CLEARLY NEW: V RENOVATION: REPLACEMENT: PLANS SUBMITTED. YES NO APPLIANCES? FLOORS BSM 1 2 3 4 6 e T e s 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOKSTOVE DIRECT VENT HEATER DRYER FIREPLACE Det^ 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 Wj ATER HEATER OTHER I re — ry I INSURANCE COVERAGE 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES f/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 742 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 crefoy that all of the details and information I have submitted criartead mgartling Ih s aFP kation e a Vu and accurate to the best of myk. owledge and that 21I plumbing work and Installations performed under the permit issued' f Pts app ,rn AI ben sath all Print p ov,suo the Massachusetts State Plumbing Code and Chapter 142 of the General Lass { PLUMBER GASFITTER NAME ALFRED H. GEORGE UCENo , 3809 ATIRE I MP MGF - JP JGF LPGI CORPORATION , 4 130C PARTNERSHIP LLC li COMPANY NAME. GEORGE PROPANE.INC. ADDRESS 3 BERKSHIRE TRAIL WEST. PO BOX 102 CITY GOSHEN STATE MA ZP 01032-0102 TEL 413-268-8360 FAX 4'3-268-0206 CELL EMAIL mgeorge@georgepropanemv 83 GROVE AVE EP-2018-0184 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 05 IAt:010 ELECTRICAL PERMIT P.it: Electrical Category: NEW SERVICE Permit# Electrical PERMISSIONIS HEREBY GRANTED TO: Project# JS-2018-000109 Est.Cost: Contractor. License: Fee: 860.00 EPIC ELECTRIC INC MASTER ELECTRICIAN 20267 A Owner: SLADE ELIZABETH Applicant: EPIC ELECTRIC INC AT. 83 GROVE AVE Applicant Address Phone Insurance 123 HAWLEY ST (413) 203-1648 C- Liability, MPT3411 L NORTHAMPTON MA01060 ISSUED ON.-9121120170.-00:00 TO PERFORM THE FOLLOWING WORK: NEW SERVICE Call In Date: Date Reauested I ti D t /S' Off` R ' t?: Treneh/UG: Special Instructions X Rough X Special Instructions: Final: SRE Caned In: 24906268 M /D //- / 7 RP', /O- 13 -/7 47-\ Signature' Fee Twe:: Amount: DatePaid Electrical $60.00 9/21/2017 0:00:00 1299 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-lnspector of Wires -Roger Mala 83 GROVE AVE EP-2018-0326 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 05 Ent:010 ELECTRICAL PERMIT Penna: Electrical Category: WIRE NEW HOUSE Permits Electrical PERMISSION IS HEREBY GRANTED TO: Project# JS-2018-000109 Est.Cost: Contractor: License: Fee: $250.00 EPIC ELECTRIC INC MASTER ELECTRICIAN 20267 A Owner: SLADE ELIZABETH Applicant: EPIC ELECTRIC INC AT: 83 GROVE AVE Applicant Address Phone Insurance 123 HAWLEY ST (413) 203-1648 C- Liability, MPT3411 L NORTHAMPTON MA01060 ISSUED ONII/2/20770:00:00 TO PERFORM THE FOLLOWING WORK: WIRE NEW HOUSE C.1I In Date Date Rema.sted Inspection D t /S' Off' R ' t°' Trench/UG: Special lnstruefions x Rough /d - 1/- /-7 x Spial 1pstrpefions: Finan - -/ Y �\ r2 - No I1YY 2w. -1 S_ wtws �I1"CL SRE Caped Ire '/1 I •I -M7 �✓�-C./2-T- s v c� JLJ " Pv ' Signamre: Fee Type- .Amount D t P 'd Electrical $250.00 11/2/2017 0:00:00 1327 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo