38B-002 (38) BP-2022-0286
142A WEST ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
3813-002-001 CITY OF NORTHAMPTON
• Permit: Alts Renovations
Repair 6;
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Penn it # BP-2022-0286 PERMISSION IS HEREBY GRANTED TO:
Project# 2022 RENO #142A Contractor: License:
Est. Cost: 110000 DAVID .JAGODZINSKI CS106068
Const.Class: Exp. Date: 11/12/2023
Use Group: Owner: SAFE JOURNEYS LTC
Lot Size (sq.ft.)
Zoning: URC Applicant: A & s BUILDING AND REMODELING INC
Applicant Address Phone: Insurance:
123 DEPOT RD (413)230-9160
N HATFIELD, MA 01066
ISSUED ON:03/24/2022
TO PERFORM THE FOLLOWING WORK:
DEMO ALL FINISHES &UPDATE PLUMBING/ELECTRICAL. &NEW FINISHES•
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.N.W. Building Inspector
Underground: Service: Meter: footings:,
Rough: ' _- L Rough: 7✓e House # Foundation:
Gas: Final: -/ _ 3_ Final: Rough Frame: r,.5)4, "7/}3 ` D_
Rough: ` �Z?--2 Fire Department Driveway Final: Fireplace/Chimney:Oil: YR, c / ,
Final: Insulation: `�
P 1 .0' 9/a9/aa �`�. to MI
Smoke: Final.:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES ANI) REGULATIONS.
Signature:
Fees Paid: $715.00
212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272
Office of the Building Commissioner
I 'i44 rt uti a t nn
Commonwealth o/MaMaciLiells Official Use Only it--- ---tie__----=fl, cc77 Permit No.0/� 2-2-'-0S �7
= ThepartmentZ <
m o/,.lire Servicea
1(-�' :%I Occupancy and Fee Checked 2ev
' , e j BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
- ' c" APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
-' All work to be performed in accordance with the Massachusetts Electrical Co`jMEC),527 CMR 12.00
?`PLEASE P NT IN INK OR TYPE ALL INFORMATION) Date: C - 6 -2 2
City or Town of: kinr i�,.a if,a%Ai 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) Lit, '\ W e c1 S? 6,1 ;} 4,432>B--D 02—a o i J
Owner or Tenant S 61 c-L ).-4.,t) 4-41K L 1, Telephone No. —1)3^ `[2 3
Owner's Address 7t
4
Is this permit in conjunctiofj with klrilding permit? Yes E No ❑ (Check Appropriate Box)
Purpose of Building V--'r5 + ..t1'f y k Utility Authorization No.
Existing Service 10 6 Amps qJ / Z I k Volts Overhead pzi. Undgrd❑ No.of Meters
New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Prop sed Electrical Work: 4 As T [1 Sv) P4-oz I re
,� . vt �;�a J at•J L 3
k 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
Pool Above In- No.of Emergency Lighting
No.of Luminaires Swimming grnd. ❑ grnd. ❑ Batte 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 ❑
Connection Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsofDevices
orWiring:q al
No.of Devices Equivalent
OTHER:
l Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value f Electrical Work: \L.&00 I< (When required by municipal policy.)
Work to Start: it 'b `Z li 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: LIC.NO.:
Licensee: v ak S h l k. Signature ."6---------
LIC.NO.: 2 z (4 63iii'
(If applicable,en "exe t to he license tei ber line.)n - r I( Bus.Tel.No.:L{13'. 11i1'coo.I�(
Address: )c� .7 i e% �1 " Jm C� I t2 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 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) ❑owner ❑owner's agent.
Owner/Agent Signature Telephone No. PERMIT FEE: $ `2,J
v 1 bfl i ee -bC-6
.t iy o,v ..‹.a -Le -6
.1 ---IMA SACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
_�an�— 4 D
;—"1:r_; -< CITY ,--7 nr Or.\ MA DATE C//F/,2c /1- I PERMIT#IPI-Zo2 ---Q?'7
Cif&AVE
L.;: N JOB Imo' DDRESS / 2 A kJ SST 51— OWNER'S NAME 50_1-e_ `5ccs,f\e,d S' t_1_C I
cn
ry OWNER DDRESS MDS CC (o 0) TEL(. Goo" 1 TEL W 13--; 3 O- 9 I Log IFAX
o �,
TY! E OFki. ' OC , CY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL EIV
Pr T __
rTIT
CLEARLY RENOVATION:rzi REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO('
FIXTURE TT—'
I{LOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB I 1 1 I
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM I ; 1 1 1 1
DEDICATED GAS/OIL/SAND SYSTEM I 1 i 1 1 I
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM I ; I
DEDICATED WATER RECYCLE SYSTEM f I I I i
•
DISHWASHER
DRINKING FOUNTAIN 11111111
11111
ROOF DRAIN 11111111111
SHOWER STALL If
_
SERVICE/MOP SINK _
TOILET2,0AI
URINAL WASHING MACHINE CONNECTION I I ( ( ( A 7.-
rr CD
WATER HEATER ALL TYPES illil
WATER PIPING
OTHER I, , .w I
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES ID NO
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
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 Plumbing Code and Chapter 142 of the General Laws.
(Air
PLUMBER'S NAME Ryan Grady Wagner I LICENSE# PL34553 J�"` SIGNATURE
MP❑ JP: CORPORATION PARTNERSHIP®# LLC®#
COMPANY NAME Ryan Grady Wagner ADDRESS 16 E Prospect St
CITY Erving STATE Ma I ZIP 01344 I TEL 413-768-9488
FAX CELL 413-387-8257 EMAIL szilinski24@gmail.com
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