16B-025 (3) 1111110011101
BP-2021-0399
109 FERN ST
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 16B-025 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-2021-0399
Project# JS-2021-000666
Est.Cost:$20000.00
Fee: $140.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 5009.40 Owner: PREISSLER DONALD W
Zoning: URB(100)/ Applicant: PREISSLER DONALD W
AT: 109 FERN ST
Applicant Address: Ph one: Insurance:
109 FERN ST
FLORENCEMA01062 ISSUED ON:10/6/2020 0:00:00
TO PERFORM THE FOLLOWING WORK:KITCH RENO, REMOVE CHIMNEY
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: /0-.0 ,z) House# Foundation:
() Driveway Final:
Final _Zn`-0/ Final:
f, Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: 3. 2 2_—Z/ Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
4 .
Certificate of Occupancy signatur `
FeeType: Date Paid: Amount:
Building 10/6/2020 0:00:00 $140.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
109 FERN ST EP-2021-0342
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Map: 16B
Lot: 025 ELECTRICAL PERMIT
Permit: Electrical
Category: DEMO&WIRE KITCHEN RENO
Permit# Electrical
PERMISSION IS HEREBY GRANTED TO:
Project# JS-2021-000666
Est.Cost: Contractor: License:
Fee: $65.00 LARRY LAFOUNTAIN Journeyman E32397
Owner: PREISSLER DONALD W
Applicant: LARRY LAFOUNTAIN
AT: 109 FERN ST Lill p11
Applicant Address Phone cL Insurance
40 RESERVATION RD (413) 540-6928 () C-(413) 575-9491 Liability, M003623P
HOLYOKE MA01040 ISSUED ON:10/19/2020 0:00:00
TO PERFORM THE FOLLOWING WORK:
DEMO & WIRE KITCHEN RENO
Call In Date: Date Requested Inspection Date/SignOff: Reinspect?:
Trench/UG:
Special Instructions
x
Rough /O " ) f)
x
Special Instructions:
Final: --2 / 0,11-N
SRE Called In:
Signature:
Fee Type:: Amount: DatePaid
Electrical $65.00 10/19/2020 0:00:00 135
212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo
.Tr-If 1-u yam,
...., c-?:�UI_ASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
CITY O CA\A(rlIVN9V1J MA DATE 31 a 1209( PERMIT#61)-Zv 2l D2-q0
JOBSI DRESS /09 /'Pr2tl1 S 1 OWNER'S NAME I t e W2\5S1Q62
al OWN R-ADDRESS /CDI F vU') ST TELj-9n`460 1kOc) FAX
Pa OCC
NT OR`-" UP 11
Pa NT TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL ET
�
CLF RLY _NE 1' RENOVATION: ❑ REPLACEMENT: ® PLANS SUBMITTED: YES❑ NO El
N - �
AlftANCES S� 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 PLUMBING & GAS INSPECTOR
ROOM/SPACE HEATER NORTHAMPTON
ROOF TOP UNIT APPROVED NOT APPROVED
TEST
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 a d 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 compli ce with all Pe inent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. //�
PLUMBER-GASFITTER NAME C�exJd�L�ZZe`e LICENSE#/670f5- t/l SIGNp E
MP X MGF❑ JP❑ JGF❑ LPG! ❑ CORPORATION ❑# PARTNERSHIP❑# LLC124s#
COMPANY NAME—tx�-22PPJ Vcv-SAC ADDRESS C^�� aai
CITY Ec STATE ` ZIP 0\02-1 TEL Lik3'53-1-"J-ki
FAX • CELL 1-`l13`2`L4'3\2`Q EMAIL ?jvzzeeS\ c�E-1 co *,lYtax tJe*
1
7NSI)!-:CTION NOTFS 3:()!Z INSPECTOR. USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT El
FEE: $ PERMIT#
PLAN REVIEW NOTES
3-z2 - Z i fr;4,-A-C
sal.\ .----- -
-�`" �O'2Sc�4kr...y\c�`6 MA DATE 3/-512c, , 1 PERMIT#l'e'Z0ZI-
J� JOB Ili ADDRESS IOC( NIc-t S� OWNER'S NAME 14C.k�-Q 1 iQ\S )\
POWfiiR'ADDRESS 1U(3k "V:<-4.4‘) '5-\ TEL 1-(1h'WO--1V:6 FAX_
TYPE OR'r, OCC6 NCY TYPE COMMERCIAL❑ EDUCATIONAL E RESIDENTIAL II
PRINT
CLEARLY ' NEWcq RENOVATION: El REPLACEMENT:173 PLANS SUBMITTED: YES❑ NO
FXTtRES 1 .00R-' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
ITHTUB-
OSS CONNECTIONfl VICE - 1 _
DEDICATED-SPECIAL WASTE SYSTEM
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM -
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER _
DRINKING FOUNTAIN _
__FOOD DISPOSER -
~FLOCK/AREA DRAIN _ .L
INTERCEPTOR(INTERIOR)
KITCHEN SINK _ _
LAVATORY _
_ROOF DRAIN
SHOWER STALL T T
SERVICE/MOP SINK _ PLUMBIND & GAS 1NSt'tCfOi-i-
' 1 1 ' N(I-i I t-(Anrll�I ON
TOILET - -
URINAL API-ROVEU NOT APPR6VED
- _ _
WASHING MACHINE CONNECTION _ _ �%
WATER HEATER ALL TYPES _
TWATER PIPING
_OTHER I __ ��
r---
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 El OTHER TYPE OF INDEMNITY ❑ BOND 0
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 som.lianceall Pertinent provision of the
Massachusetts State Plumbing
pCode
�and Chapter 142 of the General Laws.
PLUMBER'S NAME Ge A2s-= ►3J22e� LICENSE# 15701 70.1 SIG RE
AP. JP E CORPORATION[l# PARTNERSHIP❑# LLC❑# Ill DO/I-
COMPANY NAMEJ2?fie S \ ,-I� C ADDRESS—PO O c9 a I _
CITY TU -) STATE C:�__ ZIP 0\0 a-7 TEL ' `113-5 1-3'/ia
FAX CELL 1-913"a4(0-3(a 7C EMAIL oz2ee 5 l & 0C(AY 1Cc ,roe 4
ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ 0
FEE: $ PERMIT#
PLAN REVIEW NOTES •
f
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