23B-008 (18) 267 LOCUST ST- 1C BP-2019-0529
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23B-008 CITY OF NORTHAMPTON
Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category: Bath reno BUILDING PERMIT
Permit# BP-2019-0529
Project# JS-2019-000854
Est.Cost: $28700.00
Fee: $200.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Ilse Group: CORY DOUBLEDAY 112033
Lot Size(sq. ft.): Owner: CHRISTINA HIBBARD
Zoning: SI(100)/ Applicant. CORY DOUBLEDAY
AT. 267 LOC_ UST ST - 1 C
Applicant Address: _V'g& 4" Phone: Insurance:
�kX RD f 413 665-7402 WC
SOUTH DEERFIELDMA013731SSUED 01V.-101311 f018 0:00:00
TO PERFORM THE FOLLOWING WORK.-RENO BATH, REPLACE LIGHTS IN KITCHEN
AND DINING, REPLACE FLOOR THROUGHOUT CONDO
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:/z 3 �� Rough: House# Foundation:
Driveway Final:
Final: �b� Final:
Rough Frame:
Gas: Fire Dmartment Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND R GULATIONS.
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Certificate of Occupancy �� Si nature:
FeeType: Date Paid: Amount:
Building 10/31/2018 0:00:00 $200.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
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CITYffOWN Ftov44vG .............__ MA DATE PERMIT#
JOBSITE ADDRESS OWNER'S NAMECg—t, �'AJA qilz�� rzr4
POWNER ADDRESS TEL FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
PRINT
CLEARLY NEw:F1 RENOVATION:F1 REPLACEMENT: PLANS SUBMITTED: YES F] NO F1
FIXTURES I FLOOR— 8SM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
fps rp
FLOOR/AREA DRAIN C k1 I
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE/MOP SINK
F—TOILET ram lun.MA 1060
URINAL
WASHING MACHINE CONNECTION PA 6
I
Nfil P T%0 N
WATER HEATER ALL TYPES A-J
WATER PIPING 3VED
OTHER
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142, YES(�O n
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY 9--"- OTHER TYPE OF INDEMNITY 0 BOND C-1
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 0 AGENT F-1
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 the best UT kwiedge
and that all plumbing work and installations performed under the permit issued for this application will be Hance with all fI rti nt f the
Massachusetts State Plumbing Code and Qiapter 142 of the General Laws.
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PLUMBER'S NAME, ttl-e LICENSE# SIGNATURE V,
MID Be', JP❑ CORPORATION R A_ PARTNERSHIP❑9 LLC[]#
COMPANY NAME P um f ki*-h 44.11:ADDRESS Is
CITY STATE I'll 4 zip bt '35"5 TEL
FAX CELL 91�-413 EMAIL
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