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37-090 (8) 319 ROCKY HILL RD BP-2020-1246 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37-090 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ACCESSORY APARTMEN I BUILDING PERMIT Permit# BP-2020-1246 Project# JS-2019-002015 Est.Cost: Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN YOSHEN 88490 Lot Size(sq. ft.): 628570.80 Owner: THEBERGE STEPHEN Zoning: Applicant: STEPHEN YOSHEN Al: 3 i9 ROCKY HILL r Applicant Address: Phone: Insurance: P 0 BOX 41 (413) 695-7801 O C U M M I N GTO N MA01026 ISSUED ON:6/19/2020 0:00:00 TO PERFORM THE FOLLOWING WORK:NEW ACCESSORY APARTMENT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Ait 2 A a Footings: Rough: i/ ,zD Rough: PPo House# Foundation: Driveway Final: Rum Cove Final: Final: )0-/4' al"-, �itu t� I�'1R"ZOZU ij^�aRough Frame: 7 2—z�--Z! re•al ?�,�... O,I/ l5'4-z F age /4n210-Zl-� ,"�',,&'51 �- :;-I ad. 13'r teur iO.so-7.va� ,e 2 Gas: Fire Department Fireplace/Chimney: Insulation: 0�4 1 1 '2jp��'''," CC ' Rough: Oil: g( pcce: BIZ pAr y r�Jcr w iw.apO�W � Final: Smoke: lit— t?,—/74 / Final: 1"M4Lta, 3-1-21 1<R. -- -040 -�'� 7fil eems, v Pr 5- Z 1 Ili z THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND RE I. IONS. I t Certificate of Occupancy gna situ 2 • ; , FeeTypc: Date Paid: Amount: Building 6/19/2020 0:00:00 $100.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner rg- G r-J'-11r-2 l`7rnJi fyl� ,y�aw4-61 1 S /Z— 0t ,si?v14 6/rns . �, :7 t' //7=3 LEA rc9 /C�i??� �3 7re-�7": g✓I vire- AT `20v(.9K - 10' i-1U1Z IZ.d1,si'1ic- 0.00 i= sTo P?rne ., GV d4cf HOu93/ HOES - utrissr, I.70064 " 5 ON L 2G� t J/iJroW L- �n I-t-00►Z -51-1016 S TO /AL) i LIJ )200YI 0 5 Be 17-►- M 155 i iUc or--) f z1`1 Yl i��r'AC iCt�?5 J LJqJ-d Ui►--36 2 f-115 ►NC., L.41 - CookksZ-1 Oii pe 1 c 1/ �-(ISM► --Jc i3 A#_ - Po5 r c.Ow,- a-1o,- O/J goin i'3cr3Ms 43/15 ►e T 57-n-J2s $Aii-i 00%-i c. To . - JZ1Se125 f 2 G2tti�r�'12 TI-1f3i-)3/6'' I71 -12- 1= The Commonwealth of Massachusetts City of Northampton, of Occup ancy Certificate anc fp y In accordance with 780 CMR, (The Ninth Edition of the Massachusetts Residential Building Code) this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified. Identify Name of Building of Space Within, Building Owner, or Permit Holder Certificate No. Issued to Stephen Theberge BP-2020-1246 Identify property address including street number, name, city or town and county Located at 319 Rocky Hill Road HERS Rating Florence, Hampshire, Massachusetts 36 Use Group Classification(s) Accessory Dwelling Unit This Certificate of Occupancy is hereby issued by the undersigned to ceriifj that the premise,structure or portion thereof as herein specified has been inspected for general,fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or,tampering with the contents of the certificate is strictly prohibited. Conditions of Use Accessory Dwelling Unit All fire protection and life safety systems must be maintained, and all means of egress must be kept clear Name of Municipal Date of Final Map/Plot: Building Official yin Ross Inspection 03/05/2021 Signature of Municipal Date of 37_090 Building Official Issuance 03/09/2021 Home Energy Rating Certificate Rating Date: 2021-02-16 Registry ID: 321559311 griiii Final Report ire Ekotrope ID: YLeV4Yzd HERS° Index Score: Annual Savings Home: 319B Rocky Hill Rd Your home's HERS score is a relative theperformancem oreg ene visit energy oy reef.fiTchi lowerefficient t the home.thenu To mb e r, 2" 8 2 Florence, MA 01062 Builder: www.hersindex.comlearn more, *Relative to an average U.S.home Brien Tal-Baker Your Home's Estimated Energy Use: This home meets or exceeds the criteria of the following: Use[MBtu] Annual Cost Heating 6.2 5405 2018 International Energy Conservation Code Cooling 0.7 $43 2015 International Energy Conservation Code Hot Water 6.6 $145 2009 International Energy Conservation Code Lights/Appliances 11.7 $660 Service Charges $180 Generation (e.g. Solari 0 0 $0 Total: 25.2 $1,432 HERS Index Home Feature Summary: Rating Completed by: Home Type: Single family detached Energy Rater: Mark Bashista iso Model: N/A RESNET ID: 7580975 hosttng tto Community: N/A Hornet 130 Conditioned Floor Area: 957 Rating Company: New England Energy Raters ft2 in 198 Sylvester Rd Florence MA 01062 Numbei of Bedrooms: 1 Reference TM 43-570-5750 Home ..", Primary Heating System: Air Source Heat Pump•Electric• 10.5 HSPF IIII 3,, Primary Cooling System: Air Source Heat Pump•Electric•18.5 SEER Rating Provider: Performance Systems Development 11111 .10 Primary Water Heating: Water Heater•Propane•0.9 Energy Factor 124 Brindley Street,Ithaca NY 14850 607-277-6240 60 House lightness: 340 CFM50(1.03 ACH50) 4111 so Ventilation: 82 CFM•25 Watts 0.--• 36 Duct Leakage to Outside: Untested s -, ao 20 This Henn Above Grade Walls: R-41 io Ceiling: Vaulted Roof R-133 Zero Energy Home 0 Window Type: U-Value:0.17,SHGC:0.25 mark BashIsta,c-_ 1 ' _ , L. -._ u 1Rr 411.7' lets Imam Foundation Walls: R-38 Digitally signed:2/22/21 at 7:59 AM I) ekot rope TheE.kotrope RATER Version:i.22.2614 e Energy Rating Disclosure for this home is available from the Approved Rating Provider. This re)ort does not constitute an warrant or uarantee. 3198 Rock Hill Rd Florence MA HERS*Index Score: Rating Date: Feb 16,2021 36 HERS Registry ID: 7580975 Annual Estimates: Rating Company: Electric(kWh): 4,736.6 New England Energy Raters Rat Provider: Propane(Gallons): 99.1 Performance Systems CO2(Tons): 3.7 Development Approx.Energy Cost: $1,432 124 Briley Street;tticraT, 14850 HERS Index Home Feature Summary: 4111?. Single family fly detached,3 bedrooms. 957 ft' (*Kiln 40 Heating: 10.5 HSPF HOOICS Cooling: 18.5 SEER Hot Water:0.9 Energy Factor Reference ,„„„ rionte Air Leakage: 340 CFM50(1.03 ACH50) an Ventilation:82 CFM•25 W so Duct LTD:Untested 36 Above Grade Walls: R-41 it.gle Ceiling:Vaulted Roof,R-133 Window:U:0.17•SHGe 0.25 Zero Energy NOMA 0 Foundation Walls:R-38 L.,00.01.• Ekotrope RATER-Version. 122_2614 ekotrope rrcx,rt doe,mg constetute nrey W.011041vo,quetrankr RESNET HOME ENERGY RATING Standard Disclosure (s6„. ‘pa..6. 111O11111. For home(s) located at: 31913 Rocky Hill Rd, Florence, MA Check the applicable disciasure(s): 1. The Rater or the Rater's employer is receiving a fee for providing the rating on this home. 1:12. In addition to the rating, the Rater or the Rater s employer has also provided the following consulting services for this home: ri A. Mechanical system design n B. Moisture control or indoor air quality consulting MC. Performance testing and/or commissioning other than required for the rating itself D. Training for sales or construction personnel LIE. Other(specify) 1:13. The Rater or the Rater's employer is: ri A. The seller of this home or their agent fl B. The mortgagor for some portion of the financed payments on this home C. An employee contractor or consultant of the electric and or natural gas utility serving this home .114.The Rater or Ra:er's employer is a supplier or installer of products, which may include: Products Installed in this home by OR is in the business of HVAC systems EiRater E Employer FIRater EIEmployer Thermal insulation systems jiRater Employer Rater riEmployer Air sealing of envelope or duct systems EIRater Employer Rater CIE mployer Energy efficient appliances MRater jEmpiover Rater Employer Construction(builder, developer, construction contractor, etc) eater jEmployer 1:1Rater Employer Other(specify): 1 Rater IDEmployer riRater rrEmployer 75. This home has been verified under the provisions of Chapter 6, Section 603 'Technical Requirements for Sampling° of the Mortgage Industry National Home Energy Rating Standard as set forth by the Residential Energy Services Network (RESNET). Rater Certification #: 7580975 Name: Mark Bashista Signature: Organization: New England Energy Raters Digitally signed: 2/22:21 at 7:59 AM I attest that the above information is true and correct to the best of my knowledge. As a Rater or Rating Provider I abide by the rating quality control provisions of the Mortgage Industry NationalHome Energy Rating Standard as set forth by the Residential Energy Services Network(RESNET), The national rating quality control provisiOns of the rating standard are contained in Chapter One 102.1.4.6 of the standard and are posted at https://standardsresnet.us The Home Energy Rating Standard Disclosure for this home is available from the rating provider. RESNET Form 03001-2 -Amended March 20. 2017 �� Energy Efficient~~—_~ ��. . ._~ ~~..~'. �� ....~..~..~ ' . ' — _. —_'- Property Organization Inspection Status sib 319B Rocky Hill Rd New England Energy Rate 2021-02-18 Florence, MA01062 MarkBaahista Rater UD (RT|N): 7580975 RESNET Registered REM 160O Simple City 31QB Rocky Builder (Confirmed) Hill Rdfinal BhenTa|'Bmker RESNET Confirmed Rating Normalized Modified End-Use Loads (K8Btu / Envelope Loads (h82tuIyear) year) Category 2000 |ECC As Designed Category 2006 |ECC500/6 As Designed 9O96Target Target Heating 320 10.5 Heating 18,1 8�7 Cooling 2,8 5.2 Cooling 1�5 Total 35A 137 Total 19�6 101.5 Building Features Ceiling U: 0.007 VVinUuw Combined SHGC: 0]8 VVal| U: 0i024 Heating : H8PF = 10,5 Framed FloorU: 0\023 Cooling : SEER = 18.5 8labFl: O.O Duct Leakage toOutside: Untested VNndowU: 0170 This home meets the requirements for the residential energy efficiency tax credit under section 1332, Credit for Construction of New Energy Efficient Homes, of the Energy Policy Act of20O5 Builder should verify that the 45LTax Credit is available for the year in which this home was built. T he undersignecl certifier verifies that: (1)The dwelling unit has a projected level of annual heating and cooiing energy consumption that isan least 6Opercent below the annual level cxheating and 000ling energy consumption of a reference dwelling unit in the same climate zone: (2)Building envelope component improvements alone account for a level of annual heafing and cooling energy consumption that is at least 10 percent below the annual level of heating and cooling energy consumption of a reference dwelling unit in the same climate zone�and (3)Heating and cooling ph have been calculated m the manner prescribed in section 2.O3cd this notice. (4)Field inypemdonsof the dvwo||ingunit(or of other dweUingunits under the ENERGY STAR�,for Homes Sampling Protnco| Guidelines) performed by the eligible certifier during and after the completion of construction have confirmed that, all features of the home affecting such heating and cooling energy consumption comply with the design specifications provided to the eligible certifier. "Under penalties cf perjury. |declare that I have examined this certification, including accompanying documents., and to the best of my knowledge and belief, the facts presented in support of this certification are true, correct, and complete." Name: MarkBashiota Signature: Organization: New England Energy Ro0ara Digitally signed: 2t,22/21 at7�59AM Eko«nopm RATER'Version 3.2,2.2614 ^u results are based""data entered»vsuc*uveusers smvape disclaims all//ou»w for the information shown oothis report 319 ROCKY HILL RD EP-2021-0111 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 37 Lot: 090 ELECTRICAL PERMIT Permit: Electrical Category: NEW CONSTRUCTION WITH EXISITNG SERVICE ZPA-SINGLE FAMILY HOUSE Permit# Electrical PERMISSION IS HEREBY GRANTED TO: Project# JS-2020-001585 Est.Cost: Contractor: License: Fee: $125.00 CALEB MACHAK dba MACHAK ELECTRICAL Journeyman Electrician 53005 Owner: THEBERGE RENE & SUSAN Applicant: CALEB MACHAK dba MACHAK ELECTRICAL AT: 319 ROCKY HILL RD Applicant Address Phone Insurance 33 QUEEN CIRCLE C- Liability, 318B003583 SOUTH HADLEY MA01075 ISSUED ON:8/10/2020 0:00:00 TO PERFORM THE FOLLOWING WORK: NEW CONSTRUCTION WITH EXISITNG SERVICE ZPA- SINGLE FAMILY HOUSE Call In Date: Date Requested Inspection Date/SignOff: Reinspect?: Trench/UG: Special Instructions Rough /VO /0 - J - a 1 s -F- I " F t - /V- S' d 0 2%-• x a_I Special Instructions: Final: /Uv — 7� oZ I 42^ ga-a I v SRE Called In: Signature: Fee Type:: Amount: DatePaid Electrical $125.00 8/10/2020 0:00:00 111 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK % ,CI� Jo 4b "=..lif MA DATE //i/D)ZOID PERMIT# 6P-202/-0/(e O • GPOBSITE ADDRESS 3 Lc?13 I _ i/ i-h' I) OWNER'S NAME `f_ ryy") I V(u jo ER ADDRESS TEL LT) 5 g gg TYPIN3R d PRIM- UPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL V CLEARLY J� :./ RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES- t , LOORS—+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER-- BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER _ DRYER FIREPLACE — FRYOLATOR FURNACE GENERATOR _ GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER PLUMBING & G 4S IN SPECTOR ROOF TOP UNIT NORTHAIVM r'l ON TEST lu-PROVED f\OT APPROVE. 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 i ' 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. I _ 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 prov7 iQn of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. > PLUMBER-GASFITTER NAME ALFRED H.GEORGE LICENSE# 3809 ,!�°' IGNAT�IREf MP MGF ' JP JGF LPG! CORPORATION ' # 130C PARTNERSHIP # LLC # COMPANY NAME: GEORGE PROPANE, INC. ADDRESS 3 BERKSHIRE TRAIL WEST,PO BOX 102 CITY GOSHEN STATE MA ZIP 01032-0102 TEL 413-268-8360 FAX 413-268-0206 CELL EMAIL mgeorge@georgepropane.com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES / 7-3 I- 20 IDACS sS-/ze 7157- 6 s6F- H ,a /,sr- /s A27-4✓ ►e2e4 ic.2 - Cssr- 2-2Z-2/ ,c/,,rr, r — 414?-5 A.4474 iha 'Z z -26 -2/ •Z►� a� C 3.-c2I3 5 - MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 1747- O n MA DATE I & -O^ 1 CITY G" ' T" ' ` ��I i.9PERMIT# 1-1 JOBSITE ADDRESS 3 I G � DJ 'H 1 II 1aA , OWNER'S NAME 5\ That.Yo sae_ OWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL ✓ PRINT / CLEARLY NEW:y... RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES 1 FLOORS-, 8SM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER • COOK STOVE ' DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR i; .... . FURNACE GENERATOR GRILLE .. ! U �1 " INFRARED HEATER - LABORATORY COCKS I MAKEUP AIR UNIT 1 , OVEN r AUG_ 1 6 .. 19 POOL HEATER ROOM 1 SPACE HEATER ~� ROOF TOP UNIT Efoctric F'Iumh q s r TEST '0' UfftlNf;.R GAS INSPECTOR _ UNIT HEATER NORTHAIVIPTON UNVENTED ROOM HEATER APPHL V LU Nor APPROVtD ' WATER HEATER OTHER -- - i INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES I.'. 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 prov iqn of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. '7 4/1Ar't PLUMBER-GASFITTER NAME ALFRED H.GEORGE LICENSE# 3809 SI IC;NATURE MP MGF JP JGF LPGI CORPORATION / # 130C PARTNERSHIP # LLC # COMPANY NAME: GEORGE PROPANE,INC. ADDRESS 3 BERKSHIRE TRAIL WEST,PO BOX 102 CITY GOSHEN STATE MA ZIP 01032-0102 TEL 413-268-8360 FAX 413-268-0206 CELL EMAIL mgeorge@georgepropane.com 9/4r/9 004U4 yr -‘4 /is /a) c 77/-63- ,e,Aijc; friG,er- 74,7, �r .2.-2 zit 'r/t C`C- 4225 ov $�, r'.^�jM SACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK _—,, r-----^_-- �rw�Yr�., ._- _'►*�;� CITY-mpton -, MA DATE 8/13/25 PERMIT#�Z021 ^OQS7 fi 't. 7 1> li 3 FJOBSI1f.- Ai DRESS 1319 Rocky Hill Road OWNER'S NAME Stephen Theberge -4.OWNEI DRESS same I TEL f FAX[ W t� '.1•': OR cr\f),OCCUPI.4 Y TYPE COMMERCIAL Ti EDUCATIONAL 0 RESIDENTIAL �C •LY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO FIXfU ES 1 I [ 11,OR-+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BA`.HTLI� I f- 1 JI II- CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM _ DISHWASHER ) r- DRINKING FOUNTAIN _ FOOD DISPOSER FLOOR/AREA DRAIN F-- ',-----1---1- ._... INTERCEPTOR(INTERIOR) ` KITCHEN SINK 1 LAVATORY 1 1 , _ ROOF DRAIN T i 1 SHOWER STALL _ _ _ _ � t SERVICE I MOP SINK 1— PLUMBING & GAS 11��`ttCTOH • TOILET � 1 'NORTHAMPTON URINAL i, . ,-- WASHING — FPF30V NOT AP151�i(�VED MACHINE CONNECTION rt 1 WATER HEATER ALL TYPES _1 WATER PIPING � ---- -- - - ---- - -�. -- OTHER r WINIIIIIIIIIIMm .4............. _• ..s . INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES , NO j j 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 t 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 Pert�t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. -) PLUMBER'S NAME;Kevin S.Purinton _.___,LICENSE# 15295 / NA RE MP '- JP _,I CORPORATION:3#L PARTNERSHIPL]#L LLCEl# 9 COMPANY NAME Arnold C.Purinton Plumbing&Heating ADDRESS 4 Clesson Brook Road I CITY Charlemont I STATE DO J ZIP 1339 TEL 413-625-8194 I FAX 1 CELL 1413-834-7358 1 EMAIL mkitsimple@aol.com I .. -.......... , ( ( ::"'...-..._.. . -2-- /f--. N -7.-9r3 171d War/ i 2 -I Pr . 1. . ..'A \..._... . •,) e".:-) ,I -"W '90"10" #9/t QZ ./4/' 6. i„-. ' . •i ..., . . 1 , . , . . . . ..........._ 1 1 ., 0_ ( kq[✓ r-- r `� z ►.; ,3 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK °' - .1 1-• CITY —0 1 I MA DATE X // AP' d/` c)P/ U tJ PERMIT o z —> ._.._. JOBSITE ADDRESS 1/7 R vd1,.//l/,e I I OWNER'S NAME J/e..c- 7-4 e-&r f i z� v ro PJ OWNER ADDRESS I TEL 'f IJ Eft' f)AI FAXI i on — rf i i T�E0 -R OCCUPANCY TYPE COMMERCIAL[Ti❑ EDUCATIONAL 0 RESIDENTIAL W CLEARLY NEW:f RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES[ ] NO[__I FIXTURES 1 FLOOR 1 lilli1E111111111111 6 � l 10 11 11 BATHTUB �N� ®'UPI CROSS CONNECTION DEVICE WEI milt iiiimip am siimisilme_ DEDICATED SPECIAL WASTE SYSTEM IIIIIIIII Mill✓a 11111111.1111111111111111111111111111 NMI 11111 DEDICATED GAS/01USAND III DEDICATED GREASE SYSTEM i 11!Itt �� I NMDEDICATED GRAY WATER SYSTEMEal •IIMaw.. ill.1111111 Mall DEDICATED WATER RECYCLE SYSTEM DISHWASHER `_Mill I ��'�!!M DRINKING FOUNTAIN11111111./....141111.1111111N. FOOD DISPOSER Mill It ' ill# III FLOOR!AREA DRAIN1111.11111111111.1. f INTERCEPTOR INTERIOR ;_" #11114.111��; KITCHEN SINK �'"IN IIIIIIIIIIIII MMIMI EMI 1111111111111111111111 SHOWERLAVATORY 71 Mili-s.......,, ,i„,,..,,Irair_irflivwri 1Iw!i+li�+y+�ili�11110111111 Mill Mr- lMIR lSERVICE/MOP SINK ap imp igramagamp me Midi Mei . III TOILET =Ira mitait EN am NMI 11111;FT'i."'. '.- RNIIIIIIIIII11111111111P URINAL m,;�M ME,VI 1111111111111101111.11111MNNM WASHING MACHINE CONNECTION lipligigiuptimaitapi gm moo golgillim mom Of WATER HEATER ALL TYPES WATER PIPING NIIIIIIIIIII WI"MEREMOIIIIR ,.."OTHER —. —I� ��I�'m�I.��.rf CIRCLE 1:GAS TRAP LNDRY TRY inill all 111111.1111 um n am 01111111 _i�'!'♦ BACKFLOW PREV/WATER CLOSET i 1 1 HOT WATER TANK I I i —1 i I INSURANCE COVERAGE: r�y{ I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES rJ NO t' IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW L1e.E'L!TY INSURANCE POLICY{_I OTHER TYPE OF INDEMNITY i I BOND 1-1 OWNER'S INSURANCE AIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts Getter aws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ffi AGENT ❑ SIGNA URE 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 Plumbing77- Code and Chapter 142 of the General Laws. PLUMBER'S NAME 13en Br.-,i r0,t LICENSE# 16-1`l 1 4/ SIGNATURE MP[ JP-1 CORPORATION❑#1 JPARTNER—S #r HIP❑ LLC❑# COMPANY NAME ADDRESS 4 i-44- / !)4, CITY 5,.. i If,JA STATE 4t ZIP 0/.97r TEL N'/) F17 9/a)7 FAX CELL EMAIL iU<n bre_„f,ef„ J,'y - ,C,.iy 1 • t 0 1// C1-27'f' Z2- � ` r 2/12/2021 y City of Northampton Mail-Letter of Dismissal at 319 Rocky Hill r` ` _ NamcitY Of Larry Eldridge <leldridge@northamptonma.gov> Letter of Dismissal at 319 Rocky Hill 1 message Steve Theberge <steve.theberge@gmail.com> Thu, Feb 11, 2021 at 2:46 PM To: leldridge@northamptonma.gov, Ben Brennan <benbrennan@live.com> Dear Mr. Eldridge, I hope you are doing well. I'm writing to let you know that I have dismissed Kevin Purinton as the plumber at 319 Rocky Hill Rd in Florence and have hired Ben Brennan to finish the work. Please close out the original permit that Kevin filed. Thanks for your help with this. Feel free to contact me if you have any questions. All the best, Steve Theberge 319 Rocky Hill Rd, Florence MA 01062 steve.theberge@gmail.com cell: 413-658-5788 www.stevetheberge.com https://mail.google.com/mail/u/0?ik=da6517e5f4&view=pt&search=all&permthid=thread-f%3A1691429453457356634&simpl=msg-f%3A16914294534... 1/1