11A-004 (9) B 2022-0494
17 EVERGREEN RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
11A-004-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2022-0494 PERMISSION IS HEREBY GRANT I TO:
Project# 2022 GARAGE Contractor: License:
Est. Cost: 4600
Const.Class: Exp.Date:
Use Group: Owner: SCHUMANN HOBBS DAVID B& LY N
Lot Size (sq.ft.)
Zoning: URA Applicant:
Applicant Address Phone: Insurance:
ISSUED ON:05/05/2022
TO PERFORM THE FOLLOWING WORK:
DRYWALL GARAGE
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:
Final: Final: 7- Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final: 014 v-7/4 . �J
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIO TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
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i�l►�ji.I. A . UA1 !L
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Fees Paid: $65.00
212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272
Office of the Building Commissioner
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-� Commonwealth,o� a��ac�z«�elts Official Use Only
z „ i� _`' „ c c/�� p��77 Permit No. { 2022 Z!��
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ro .1Jefrarlrnerrl of J`ira�eruice;f
y; i f Occupancy and Fee Checked 9 5
1,,, :as,. OARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
-APPL4 ATION FOR PERMIT TO PERFORM ELECTRICAL WORK
to All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527
CMR 12.00
i
= = (PEASE P', IN INK OR TY E ALL INFORMA ION) Date: �' l 1 •�5
r Town of: � To the Inspector of Wires:
y • ion the undersigned gives notice of his her ntcntion to perform the electrical work described below.
•..mmmista et& Numbe C tk
Owner or Tenant Telephone No.V\V)-czy`)' )
Owner's Address —C aM'A.Q \c`-),
Is this permit in conjunction with a building permit? Vesl 1 No n (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Xmps / Volts Overheadri l ndud No.of Melers
—,
New Service Amps / Volts Overhead l ndb„rd_ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: \1 j� - `c \T` c is - . ,Q
Completion of the following table may be waned by I Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- No.of Emergency Lig ttng
No.of Luminaires Swimming Pool grnd. ;4rn(1. _ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. i f Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of AlertingDevic
Tons
No.of��'astc Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting De 'ces
No.of Dishwashers Space/Area Heating KW Loclipj
Municipal Other Other I
Connection f
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or E 1 uivalent
No.of Water No.of No.of
KW
Heaters Data Wiring:
Signs Ballasts No.of Devices or E!uivalent
No.Hydromassage Bathtubs No.of)Motors Total HP Telecommunications iring:
No.of Devices or E s uivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND OTHER Specify:)
I certify,under the pains and ties o p ,,that the nation on this application is true and complete.
FIRM NAME: rlt.P1 �' \QC�C \ ��`�'' _ LIC.NO,: \'- \ �
Licensee: n t �� Signature i��, LIC.NO,: V ) \
(If applicable,enter"e empt.t the license number hue.) n Bus.Tel.No.: _
�1
Address: � 1 C1 &V .,\ x•Q r1/� -1- V\( Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am are that the Licensee does not have the liabilitrance age normally
required by la ry signature ow, ereby waive this requirement. I am the(check one owner c owner's agent.
Owner/ nt p T `1C).
Signatu Telephone No. V) PERMIT FEE $
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