36-220 (4) 77 WINTERBERRY LN
NI CpMMONWEALTH
ap:Block:Lot: BP-2022-0174
3C-220-001 OF MASSACHUSETTS
Permit: Alts Renovations CITY OF NORTHAMPTON
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2022-0174 PERMISSION ISHEREBYG
Project# KITCHEN RENO RANTED TO:
Est. Cost: 85000 Contractor:
GABRIEL LAPOLLO License:,
Const.Class: 088071
Use Group: Exp.Date: 12/06/2023
Lot Size (sq.ft.) Owner: FERGUSON JEAN &DAVID THOMA
Zoning: WSP
Applicant: GLAPOLLO RENOVATION CONTRA TOR
Applicant Address
Phone:
189 BIRNAM RD
(413)768-7277 Insurance:
NORTHFIELD, MA 01360
ISSUED ON:02/24/2022
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:
Rough2„,.22_, Rough• 3+ -`2-Z House#
Foundation:
�� na
�s��� 3 .a' � Final: Rough Frame:O �. 3- 5.22 :R
Rough: l—
ire Department• • Driveway Final:
Fireplace/Chimney:
Final: Oil:
Insulation:0,,L VtA Pi 1r26'.' .5-26
-77 j
Smoke:
Final:0,j( 8-Iq'ZZ X,R
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL. TION
ANY OF ITS RULES AND REGULATIONS. OF
Signature: r
i A; 411\10,Ak., )‘ • Qat.- I k t i
i I (
Fees Paid: $552.50
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
-77 w I r-n2,t3G�P-1f Lr t
Commonwealth.
// Official Use Only
Commonwealth of Y/lasoachwett6
'' `4 .,
_ `/ c� cc7-7 Permit No. 2-22 17) o
' irk i 2epartmant of,}ime Sartficed
's._1_i= " Occupancy and Fee Checked' 770
<,, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07 (
_,-.;.$ ) leave blank)
J
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL I ORMATION) Date: Q I , —C�
City or Town of: ND NT n To the Inspector of Wires:
By this application the undersigned gives notice of his or er intention o perform the electrical work described below.
Location(Street&Number) I wifyit /-14...
Owner or Teaaat ' Lk..1,f 1( Q Telephone's.
Owner's Address , Me,
Is this permit in conjunction with a building permit? Yes icxNo ❑ (Check Appropriate Box)
Purpose of Building b\jU(?t l 1( Utility Authorization No.
Existing Service Amps I' (")/24-1()Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps 110 /24D Volts Overhead❑ Undgrd[1 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: W L g ---Or f r)/ 11( rEXPEI
r?n.0v . )
Completion of the followingjable may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans T . f T
Tr No.Transformers ICVAVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ -No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners —No,of Detectionn and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump-Number Tons 'KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
p Connection
No.of Dryers Heating Appliances KW Security yyms:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or EquivalentWin
No.Hydromassage Bathtubs No.of Motors Total HP 'TelecommunicationsNo.of Devices or Equivalent
0 I'HL.R:
Attach additional detail if desireg 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 g BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: I OVVer ' L.U,e LIC.NO.:A— 19(...19]
Licensee:J.Qn( ,r) ' �Gf Signature LIC.NO.: --"' , LP
(If applicable e+nte "exempt"in th.1�license number line Bus.Tel.No.• - I
Address: 16 N.YVey I iedt' .S)i'( '+ FrAlf)(%4{-i IIISi �� Olt?3(� Alt.Tel.No.: - 13
*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 aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: SCJ,9J, Gv
829 -st:e• to - Z
tie
aE&O ldd d
4-W/or)3 �o.`—
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY/TOWN N(gm Am oJv MA DATE Ahzlaa PERMIT#PP2b2ecArtri
JOBSITE'ADOIRESS "I1 W.E.Iv T .C2 E.FZ2*Y ‘rakVG- OWNER'S NAME EV:=1)\.) k"ER�l..)5�
OWNER ADDIkESS �� l \r\--Z-R UCC'l�1 ‘^ C TEL 1"'\\3" `(c8 T7 FAX
TYPE OR OCCUPANCYITYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
PRINT
CLEARLY NEW:❑ RENOVATION:'k REPLACEMENT: PLANS SUBMITTED: YES❑ NO❑
FIXTURES 1 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
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 PLUMB NG & GAS INSPECT UN
SERVICE/MOP SINK NORTHAM PTON
TOILET APPROVED NOT APPROVED
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
WATER PIPING
OTHER
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 jYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY �/ OTHER TYPE OF INDEMNITY ❑ BOND LI
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 El 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 . __ -to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in c. . -ertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
l
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PLUMBER'S NAME�OI�'AL.O UOEMEc . tt__p
L LICENSE# ��7 t0,5 , SIGNATURE
MP\ JP El ,1''\\WCORPORATION El# PARTNERSHIP❑# LLCA#COM C1 I60
COMPANY NAMERC NmiistAi & ��fxtTlJb ADDRESS
CITYWI N DEERIF-xE STATE t ZIP 0\- 13 TEL V303.515— 9089
FAX CELL cSCkiY\Q_ EMAIL C 01h ai..
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