23C-037 (4) 660 RIVERSIDE DR BP-2019-0934
GIs#: COMMONWEALTH OF MASSACHUSETTS
MW:Block: 23C-037 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:Zoning Permit BUILDING PERMIT
Permit# BP-2019-0934
Proiect# JS-2019-001146
Est. Cost:
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: LORENZO GARDINER 1132385
Lot Size(sq.ft.): 16465.68 Owner: Jeff Marney
Zoning: GI(100)/WP(48)/ Applicant. LORENZO GARDINER
AT- 660 RIVERSIDE DR
Applicant Address: Phone: Insurance:
y t=- rL V —=L n ALc a ( L L we
ItST ISSUED ON:3/4/2019 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONCRETE ALLYWAY, DOORS, FLOORS, IRON
BARS ON WINDOWS, CHAIN LINK GATE, 3 BAY SINK
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: House# Foundation:
Drivcway Final:
Final:—?7-Z0?
z Off ^ Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough�11
Oil: Ina�la*io
27-Z� ,1
Fina : '��; S� o Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of si nature•
FeeTyAe: Date Paid: Amount:
Building 3/4/2019 0:00:00 $100.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck–Building Commissioner
IcJW(_ J 4 �_ 51 -70
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY 1 a21v � ._ MA DATE_ .._. PERMIT#
JOBSITE ADDRESS OWNER'S NAME:I_
POWNER ADDRESS y! r4� CO �� L�Ga �D�,/4C TEL i/I�-,)q 7,0 `1/�S� FAX
TYPE OR OCCUPANCY TYPE COMMERCIALY EDUCATIONAL RESIDENTIAL
PRINT
CLEARLY NEW: RENOVATION _... REPLACEMENT: PLANS SUBMITTED: YES NO,
FIXTURES Z FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB --
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM _ 771
1
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER - —
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY __
ROOF DRAIN
SHOWER STALL
SERVICE/MOP SINK W
TOILET
URINAL `
- _' — Ak fAl PT 0 N
WASHING MACHINE CONNECTION t
WATER HEATER ALL TYPES �IMWF -
WATER PIPING _ --- -
OTHER
�C
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YE' NO
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY I...., 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 Ggperal�d that my signatur eryi plication waives this requirement.
CHECK ONE ONLY: OWNER 13--AGENT
66-NATURE OF OW 61R ENT
I hereby certify th.Wall of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be inc pliance with all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws,
PLUMBER'S NAME I�-� (�' M4/V�'. (?� ''LICENSE# ��`j �' ( (L SIGNATURE
MP _, JP CORPORATION # PARTNERSHIP ILLC `#
COMPANY NAME` � {� LA (7 _ ADDRESS \0\�_ CST-j; ',J
CITY] L`' F�\l�l-`� STATE ZIP TELi
FAX L CELL
qra0 GL' /C'6
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
g
�F CITY ��orevce MA DATE _b(N)V PERMIT# ?�
JOBSITE ADDRESS 6�0 OWNER'S NAME 1- eur RC C:
GOWNERADDRESS t# ,�� ��1 S� ��1�� , �i t TEL FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL
PRINT
CLEARLY NEW RENOVATION REPLACEMENT: PLANS$UBMITZED: YES N0'
APPLIANCES 7 FLOORS— BSM 1 2 3 4 5 6 7 8 9/" 1 13 14
BOILER a
BOOSTER _ 1 .
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER r "
DRYER n. r
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM/SPACE HEATER _
ROOF TOP UNIT
TEST _ PLUR 18
UNIT HEATER HA
UNVENTED ROOM HEATER VPRF OT - OVED
WATER HEATER
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
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 certify that all of the details and information I have submitted or entered regarding this application are true and accurate 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 provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. t
PLUMBER-GASFITTER NAME j i,.in L!A r (0C- LICENSE#3541 SIGNATURE
MP MGF JP xj JGF LPGI CORPORATION # PARTNERSHIP # LLC #
COMPANY NAME: TZM LADDRESS i �1� C-t�(t1STS�rtJ L"inn 2
CITY w�k/,\1tt� STATE " ZIP TEL
FAX CELL EMAIL
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