12C-094 (2) BP-2022-0050
2M p:RMO cI Lot: DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
I2C-094-00I 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-2022-0050 PERMISSION IS HEREBY GRANTED TO:
Project# RENOVATION Contractor: License:
Est. Cost: 410000 Scott KEITER 102457
Const.Class: Exp.Date:06/20/2022
Use Group: Owner: O'NEILL, WILLIAM B& KRISTIN HALLBERG
Lot Size (sq.ft.)
Zoning: WP/WSP Applicant: KEITER CORPORATION
Applicant Address Phone: Insurance:
35 Main St. (413)586-8600 0 MCC200200053820121A
FLORENCE, MA 01062
ISSUED ON:01/18/2022
TO PERFORM THE FOLLO WING WORK:
RENOVATION
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:( eiv0 i Rough (Gl 1512 House # Foundation:
Cam
Z 99"'�� s al: /0 _a a Final: Rough Frame:0., t,- t7.22 16 4?
Rough: ire Departmen Driveway Final: Fireplace/Chimney:
Oil: Insulation: 0.{G ; Z
Final: .a.) t�-r z.,. Z le 49
Smoke: it',PV/0 " Final: 0k 10/gMg
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: $2,665.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
Lle r� 2 -"7, .4.0
c 18-) f20 dal
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
4 = CITY/TOWN Northampton MA DATE 2/21/2022 PERMIT#P/22d2?-o6q
Moiem woo s I c 7x.) Bill O'Neil
JOBSITE ADDRESS 28 Morning Drive OWNER'S NAME
OWNER ADDRESS 28 Morning Drive TEL 413-586-8600 FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
PRINT
CLEARLY NEW: ❑ RENOVATION: ® REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO❑
FIXTURES 7 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 1
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK 2
LAVATORY 1 2
ROOF DRAIN
SHOWER STALL 2
SERVICE I MOP SINK 2 PLUMBING & GAS INSPECTOR
TOILET 1 2 NORTHAMPTON
URINAL APPROVED NOT AP1-ROVtU
WASHING MACHINE CONNECTION 1
WATER HEATER ALL TYPES 1
WATER PIPING 1
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 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. R.ic/iana/r�.Piisr,2,i�S
PLUMBER'S NAME Richard Scott Cernak II LICENSE# 15672 SIGNATURE
MP M JP❑ CORPORATION ®# 4386-PL-C PARTNERSHIP❑# LLC❑#
COMPANY NAME Western Mass Heating Cooling&Plumbing, Inc. ADDRESS 4 South Main Street(Suite K)
CITY Haydenville STATE MA ZIP 01039 TEL 413-268-7777
FAX CELL EMAIL info@westernmassheatingcooling.com
2E-#70 --
-e
Z2 NMo'ie-t J1 SIG s f K
C..on:mai /ea&.of I/taa6actrtooth Official
List Only
i'SU,i c j, ;t Permit No.f!Q�2 0?i2 `l
l • ;fit. ,. .UoParinaan�`of ire Services //�'�_�
=';- :"1=j•f� a Occupancy and Fee Checked ?'?0 D
1 ( ',,,, �� -43OAR?OF FIRE PREVENTION REGULATIONS [Rev. 1I07} (leave blank)
"�-,._. -APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
r. JJ I[work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
{PLEASE.t' TIN INK OR E ALLIlti -'O.I�1vL�iTION Date: 04- 1 Lf-0. -
[.`.-'i_ _City o1 Town of: To the Inspector of Wires:
yxiiis application the undersigns Vs noti e o is or her_ tentio to perfonn the electrical work described below.
y_ Loca€ion(Streei&Number) Vs
Dj f S)r! p ,t1 ���
Owner or Tenant +fin J i• o t I' '. !����I �(� ).C� Telephone No. �,� )- r t�
Owner's Address ,C me,.
Is this permit in conjunction with a building permit? Yes No 3 1 (Check Appropriate Box)
Purpose of Building I) (',{\I n() Utility Authorization No.
Existing Service Amps 170/14()Volts Overhead C Undgrd E No.of Meters
New Service Amps l L.0/24D Volts Overhead E Undgrd E No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: rji'4-"7 e Q) p haw..?
16 • ffy 01l-.1
Completion of the following table may be lvaived by the Inspectorof Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No. f T
Transformers KVAVA
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. `ions No.of Alerting Devices
Tons
Heat Pump Number.Tons ICIV No.of Self-Contained
Totals: - —��_-�� Detection/AlertingDevi
No.of Waste Disposers ces
_
No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other
No.of Dryers Heating Appliances KW rSeco.of ,stems:*
N
No.of Devices or E uivalent
No.of Water KW
No.of No.of Data Wiring:
Heaters Sians Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs Na.of Motors Total HP -TelecommunicationsNceor qui a
No.of Devices 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 g BOND ❑ OTHER 0 (Specify:)
I certify, under the pants and penalties of petjtuy,that the information on this application is trite and complete.
FIRM NAME: .----UU t ¢'` , -) ' i..-_ LIC.NO.:AI 01
Licensee:3DMA-h0rn --itve Signature LIC.NO.: ) (KOlo,
(if applicabl en a exempt"in rlt license number line. '' Bus.Tel.No.:14l �� [I l
Address: j'-ie.) N. e iiPi ,SfreCt T'�tflG! H4�•S, MA 01 D5D Alt.Tel.No.:`it '.55).-`-1))tj7
*Per M.G.L.c. 147,s.57-61,security work requires Departnt 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.
OwnerlAgent l'ajI�Signature TeIepttoneNo. 1'ERTTFEE: $ ,L,'"`
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