16D-015 (2) 189 NORTH MAN ST BP-2018-0976
GIs 91 COMMONWEALTH OF MASSACHUSETTS
MV.Block: 16D-015 CITY OF NORTHAMPTON
Lot:-(101 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit' Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateeom KITCHEN&BATH RENO BUILDING PERMIT
Permit# BP-2018-0976
Proiect# JS-2018-001763
Es[ Cost$21000.00
Fee-$137.00 PERMISSION IS HEREBY GRANTED TO.
Const Class: Contractor: License:
Use Group: BOURKE BUILDERS 055137
Lot Size(sc.R.): 11412.72 Owner- HUTCHINS KATHLEEN A
Zoning:URB(l00)/ Applicant: BOURKE BUILDERS
Al.- "I69 NORTH ivlAiri J(
ApplicantAddress: Phone: Insurance:
77 LONG HILL RD (413) 548-9214 Workers Compensation
LEVERETTMA01054 ISSUED OM 4/312018 0:00:00
TO PERFORM THE FOLLOWING WORK 1ST FLOOR KITCHEN AND BATH RENO
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: IV House# Foundation:
0. Driveway Final:
Fiaal: o Final . L/
/Olaf/G� Rough Fnme:
Gas: Fire Department Fireplace/Chimuey:
Rough: Oil: Insulation:
Final: G/�� Smoke; Final: loll's q�f
U
THIS PERMITMAYBE REVO BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS
It
AND UtL, TIONS. ,.
Certificate Of Occu a Si nature:
FeeTvpe- Date Pard: Amount:
Building 4/320180:00:00 $137.00
212 Main Street,Phone(413)587.1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
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C9sar9 3110.,*C'
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING W(O�RKp
CITYffOWN - (y MA DATE � PERMIT# Ea-
JOBSITEADDRESS 7 G^ Q,/f /'��� P�OWNER'S NAME e'ff '4'1
POWNER ADDRESS S TEL6a-895- 72yA FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL F-1 EDUCATIONAL ❑ RESIDENTIALJV
PRINT
CLEARLY NEW:❑ RENOVATIOI REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑
FIXTURES 7 FLOOR- BSM 1 2 3 4 5 6 7 B 9 10 17 12 73 14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GASIOIUSAND 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 DRAINfl
SHOWER STALL
SERVICE I MOP SINK
1 TOILET Elect Plu imq 0.e s
URINAL
WASHING MACHINE CONNECTION
WATER-HEATER ALL TYPES rim PPRI
WATER PIPING PIR V
OTHER
INSURANCE COVERAGE:
I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YESM NO ❑
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
U.4BILITY 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 rertlfy that all of the details and information I have submitted or entered regarding MIs application are true and accurate to the best of my knuwledge
and be all plumbing work and installations performed under Me permit issued for this application will be In mpl�h ay Pedi n9e t provision o(the
Massachusetts Stale Plumbing Cade and Chapter 142 of the General Laws. J/�1 r,)•'^'ti. fyl'1_
PLUMBER'SNAME M\lhGel 3. 014"ZOrl LICENSE# 'MI WIGNATURE
MP❑ JP❑ CORPORATION®# PARTNERSHIP❑# LLC❑# q
COMPANYNAME M.S.01MM, 34NC . ADDRESS 4 Srwth Nlpth �trre'C -1-�h1TX.»
CITY L1PNcbMJill� STATEaf ZIP C)lI TEL 41 P68-3aSI
FAX iii 13-2be''t3'+S- CELL EMAIL@ 111 001h 4%C- C.dYY-'
I leo-0I
7D ,�x
MASSACHUSEM UNIFOOjjR..M APPLICATION FORA PERMIT TO PERFORM OAS FnIFING WORK
CITY /V*dr7AA`—Y' JV1 YMA DATE PERMIT# (QIP-1S-V"
//((VV JOBSITEADDRESS /V A" 144
144 P' fW-07 'OWN sNAMEC�j� /!U6
1�$T OWNERADDREGS .�"°' •� 1EL�3"S^fir Q 'FAX
TMOR OCCUPANCYTYPE COMMERCIAL[] EDUCATIONAL [I RESIDENTIA^
PRW
OZA3"Y NEW.[I RENOVATION:❑ REPLACEMENT,!f) PLANSSUBMITTED: YES[] NO[]
APPUANGES7 FLOORS— I BSM 1 2 3 1 / 1 6 1 .a 1 7 1 B 9 10 11 12 19 14
1301LER
BOOSTER
COWERSIONBURNER
COOKSTOVE•
DIREGrVENTHEATER
DRYER
FlRFPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUPAIRUMr
OVEN
POOLHEATER
ROOM/SPACE HEATER
ROOFTOP UNIT
TEST I I n un.M 01060
UNIT HEATER
UNVENTED ROOM HEATER
WATER HEATER UR
OTHER
tR01D
INSURANCE COVERAGE
I have a currentliablli Tnsurmice policy orb substantial equivalentwhieh meetathe requirements arMOL.Ch.442 YES N NO ❑
I IFYOU CHECKEDYES,PLEASE INDICATE THE TYPE OF COVERAGE BYCHECKINGTHE APPROPRIATEBOXBELOW
LIABILDYINSURANCEPOIJCY IN OTHER TYPE INDEMNITY ❑ BOND ❑
OWNER'S INSURANCEWAWER:[am awarathatthe licensee dues nothavethefnsomnca mordgerequired by Chapter 142 ofthe
Massachusetts General Laws,and thatmysltmature on this parinitappllcatton waives this requhement
CHECKONEONLY: OWNER ❑ AGENT ❑
SIGNATURE OF OWNEROR AGENT
I herehY certlfylheta9 ofthedefals end IMamechn I twasubmMed Oren arou IeWMn9llds appladan areNre and a as Aa wthe beslofrW knowledge
andthetell plumbingmrk and b5tellat!Om performed underthepmmalssuedfnrihtsappllmdonwblbeb 0 ypih apP Nn� tprwtsbn�0ie
Massachueebs Stele Plumbing Code and Chapter 142 Mire General Laws.
PWAIBERGASFITIERNAME M:1 yNif l J.MtYlflr�..'TtJ LICENSE#Ma$3'a GNATTIRE
MP❑ MGF❑ JP El JGF❑ IPGI❑ CORPORATION®# 103VC PARTNERSHIP.❑# LLC❑#
COMPANYNAME ADDRESS cl $Wkh MAMn SeFe�t-P.o.aDxa�s
CITY NalkAVAL ills STATE ISA' AP Dio39 TEL -Nr3- 308- -4d51
FAX 1413,1,2L 9315 CELL EMAIL @ f�i�mnnwav�l+TC• COwI
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