10D-046 (15) BP-2022-0209
MAIN ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
10D-046-001 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
Pernt it # BP-2022-0209 PERMISSION IS HEREBY GRANTED TO:
Project# WATER DAMAGE Contractor: License:
Est. Cost: 237500 JAMES "I ROM PKE (171734
Const.Class: Exp. Date:02/28/2024
Use Group: Owner: NORTHAMPTON GOLF INC
Lot Size (sq_ft.)
Zoning: URA/WP Applicant: SINGLE SOURCE SERVICES
'Spplicant Address Phone: Insurance:
290 TAY'LOR ST (4131427-5320 422(105 2 63 906
GRANBY, MA 01033
ISSUED Old': 03/04/2022
TO PERFORM THE FOLLOWING WORK:
water damage repairs
POST THIS CARD SO IT 1S VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: Footings:
Rough: Rough: House # Foundation:
Gas: Final: iS blow Final: Rough Frame:15.—FT—v CF,�t 0.e 4-6 al
�.�`! � •� p�-� (P4D 5HpP 6 K 4-1-27•22 Kai2
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation:
Smoke: Final: OK V2Ja
'hli-ifIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OP.
ANY OF ITS RULES AND REGULATIONS.
Signature: I ' Q �,
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Fees Paid: $1,663.00
212 Main Street, Phone013) 587-1240,Iax:(413)587-1272
Office of the Li ild g Coin mis;ioner
INC-L. 1�5 /vl/-t!IV 5l [.�G'✓-' 00//
_ Commonwealth o/MamacI u setts Official Use Only
-* _'t Permit No.e-ZO2 L 0 I Z4
• = �;_ r1 eCJepartment of_fire Jervicee
,.- -—7-7 '7 Occupancy and Fee Checked
`�-` BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1 07 y ?���
aj (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
;LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: C, ,C\ , , ""
City or Town of: * \ To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)\. Y\�C\ tQ —
Owner or Tenant Telephone No.�j q' V.0 l�
Owner's Address .
Is this permit in conjunction with a building permit? Yes X1 No n (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: 'VS .\) p, Q( 14,t QV�`\'
Completion of the following table may be waived by the 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
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 Detection 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 Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KWNo.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
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 penalties of perjury,that the information on this application is true and complete.
FIRM NAME: 4'OK' A _ LIC.NO.: \---1\A-2,{\--
Licensee: _ ignatur ,,/"7'I LIC.NO.: \--) ka-3tA-
(If applicable, enter "exempt" the license number line.) Bus.Tel.No.:
Address: 1t�Cl s--IS � _ ve,- b\ 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 aw re that the Licensee does not have the liability insurance coverage normally
required by la y signature below, ereby waive this requirement. I am the(check one)❑ owner 'Downer's agent.
Owner/A
Signature Telephone No.� l�— `O1 3� PERMIT FEE: $ gO,
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