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38B-219 (5) 17 FAIRVIEW AVE BP-2020-1134 GIS#: COMMONWEALTH OF MASSACHUSETTS Ma :Block:38B-219 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: KITCHEN RENO BUILDING PERMIT Permit# BP-2020-1134 Proiect# JS-2020-001900 Est.Cost: $30000.00 Fee: $195.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor., License: Use Group: MATTHEW KOZUCH 106644 Lot Size(sq. ft.): 4399.56 Owner: MAZZEI CRISTIANO Zoning: URB(100)/ Applicant. MATTHEW KOZUCH AT. 17 FAIRVIEW AVE Applicant Address: Phone: Insurance: 6 HIGH ST (413) 570-3279-0 FLORENCEMA01062 ISSUED ON.5/21/2020 0:00.00 TO PERFORM THE FOLLOWING WORK:KITCHEN 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: 6- Z-Vc�Rough: House# Foundation: i0 Driveway Final: Final:?Z© 20 Final: l� 7-al-ao �6'►^-S Rough Frame:O:L/- t'- I'Z Zd2c) l'►0 Gas: Fire Department Fireplace/Chimney: Rough: il: Insulation:0- K 1 2-z�;zc; leOp final: v X20 Smoke: Final: 0,/(_ 7- ZZ-ZOZO IC� 6� THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES ANDU NS. art Pc�:TIoti r j�C Certificate of Signature: G FeeType: Date Paid: Amount: BuildinS 5/21/20200:00:00 $195.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner c�, x/21 ')o 11z\ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY Northampton i MA DATE 5/26/2020 PERMIT#1-2020 o y o� JOBSITE ADDRESS 17 Fairview Ave OWNER'S NAME Dave Potter OWNER ADDRESS 17 Fairview Ave TEL 413-658'"8813 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL !"J RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES F 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 I DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER i DRINKING FOUNTAIN FOOD DISPOSER i FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY ROOF DRAIN __:... SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER 3 i 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 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 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 applicationare r and a ur a the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in liance it rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME John T.Geryk w LICENSE# 16079 URE MP'„„ JP® CORPORATION, a# PARTNERSHIP # 12955 000 LL-C j# COMPANY NAMEJohn T.Geryk Plumbing&Heating,LLC ADDRESS' 89 Oak St _. ..__ .__- CITY Florence STATE MA ZIP ;01062 TELr___L413-727-3057 FAX CELL['413-336-389'3 EMAIL john@johntgerykplumbing.com o � . tog-L�. C- ft�13>1 P!"' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY Northampton MA DATE 5/26/2020 PERMIT# L710-7020-69!�j JOBSITE ADDRESS 17 Fairview Ave OWNER'S NAME Dave Potter GOWNER ADDRESS 17 Fairview TEL 413-658-8813 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES-1 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE 1 DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST11 1 UNIT HEATER UNVENTED ROOM HEATER 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 to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comjncit II ertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. , k PLUMBER-GASFITTER NAME John T.Geryk LICENSE# 16079 11 1 S GNATURE MP MGF JP JGF LPGI CORPORATION # PARTNERSHIP # 1295560 LLC # COMPANY NAME: John T.Geryk Plumbing&Heating,LLC ADDRESS 89 Oak St. CITY Florence STATE MA ZIP 01062 TEL 413-727-3057 FAX CELL 413-336-3893 EMAIL john@johntgerykplumbing.com � ^�- � �' � z z 17 FAIRVIEW AVE EP-2020-0847 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 38B Lot:219 ELECTRICAL PERMIT Permit: Electrical Category: KITCHEN RENO Permit# Electrical PERMISSION IS HEREB Y GRANTED TO: Project# JS-2020-001900 Est.Cost: Contractor: License: Fee: $65.00 IAN T DURYEA ELECTRICIAN Journeyman Electrician 13109B Owner: MATT KOZUCH Applicant. IAN T DURYEA ELECTRICIAN AT. 17 FAIRVIEW AVE Applicant Address Phone Insurance 120 MORGAN ST (413) 262-01-42 C- Liability, MPT9085E HOLYOKE MA01040-2016 ISSUED ON:6/5/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.• KITCHEN RENO Call In Date: Date Requested Inspection Date/SignOff: Reinspect?: Trench/UG: Special Instructions x Rough Cu,-40 , a O x Special Instructions: Final: -7-071 - �0 Q.►M SRE Called In: Signature: Fee Type:: Amount: DatePaid Electrical $65.00 6/5/2020 0:00:00 0728 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo