25A-196 (3) BP-2022-0240
10 SHERMAN AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
25A-I96 CITY OF NORTHAMPTON
Permit: New Build
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2022-0240 PERMISSION IS HEREBY GRANTED TO:
Project# Contractor: License:
Est. Cost: 315000 NU-WAY HOMES INC 013693
Const.Class: Exp.Date:07/20/2023
Use Group: Owner: NU-WAY HOMES INC
Lot Size (sq.ft.)
Zoning: Applicant: NU-WAY HOMES INC
Applicant Address Phone: Insurance:
10 WHITE AVE (413)563-0085
EAST LONGMEADOW, MA 01028
ISSUED ON:03/11/2022
TO PERFORM THE FOLLOWING WORK:
NEW SINGLE FAMILY HOUSE
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: 0,16 3-23-t7 3 Z l/2
Rough:2o.,-20 Rough:lT-..1 ' a'''Z House # Foundation: 0.1C. 3-31-zz v.i?
r QP
y� ,�7/ inal: /Q .,1- Final: Rough Frame: Old. 1-'Z8•7 Z )c,/Q
�� / P►^'
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation: d it g-S-z Z KQ,
// ,
/` ' Z� moke: /6—a _ate Final )I
THIS PERMIT MAY BE VOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: I -
TAr15.-
Fees Paid: $1,093.90
212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272
Office of the Building Commissioner
e
Air . The Commonwealth of Massachusetts �° .,
i Cityof Northampton p r
Certificate of Occupancy
In accordance with 780 CMR, (The Ninth Edition of the Massachusetts Residential Building Code)
this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified.
Identify Name of Building of Space Within, Building Owner, or Permit Holder Certificate No.
Issued to BP-2022-0240
Nu-Way Homes Inc.
Identify property address including street number, name, city or town and county
Located at
10 Sherman Ave. HERS Rating
Northampton, Hampshire, Massachusetts 55
Use Group
Classification(s) Single Family Dwelling Unit
This Certificate of Occupancy is hereby issued by the undersigned to certify.'that the premise, structure or portion thereof as herein specified has been inspected
for general,fire and life safety features. This certificate shall allow for the use as herein described and in cortfbrmance with any and all conditions as identified
below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with
conditions or,tampering with the contents of the certificate is strictly prohibited.
Conditions of Use Single Family Dwelling Unit
All fire protection and life safety systems must be maintained, and all means of egress must be kept clear
Name of Municipal Date of Final Map/Plot:
Building Official Kevin Ross Inspection 11/04/2022
Signature of Municipal Date of
Building Official / Issuance 11/04/2022
25A-196
Horne Energy Rating Certificate Rating Date: 2021-11-02
Final Report Registry ID: 830508004
Ekotrope ID: 6LAXRKw2
HERS® Index Score: Annual Savings Home:
Your home's HERS score is a relative 3 5
0Sherman Ave
performance score.The lower the number, 2 15
Northampton, MA t l060
the more energy efficient the home.To Builder:
learn more,visit www,hersindex.com "relative to an average U.S.home Northampton,
Homes Inc
Your Home's Estimated Energy Use: This home meets or exceeds the
Use (MBtu) Annual Cost criteria of the following:
Heating 57,7 $626 2018 International Energy Conservation Code
Cooling 0.7 $32
Hot Water 2.4 $102
Lights/Appliances 22.2 S850
Service Charges $81
Generation (e.g. Solar) 0.0 $0
Total: 83.0 $1,691
HERS,Index Home Feature Summary: Rating Completed by:
Mar.Piero Home Type: Single family detached
Model: John Handzel Custom Energy Rater: Paul DeliaTorre
isoExisting 10 Community: Northamton RESNET ID: 8776762
Nomcs ""° Conditioned Floor Area: 2,630 ft2 Rating Company: Energy Compliance Services
i7Q Number of Bedrooms 3 27 Hudson Dr.Southwick MA 01077
"° 413-427-2423
R oe .„„ Primary Heating System: Furnace•Propane•95 AFUE
._ 10 Primary Cooling System: Air Conditioner•Electric• 13 SEER Rating Provider: Building Efficiency Resources
en Primary Water Heating: Residential Water Heater•Electric•3<88 Energy Factor PO Box 1/69 Brevard,NC 28712
f:Hj
-"'° House Tightness: 506 CFM50(1.34 ACH50) 800 399-9020 . �:
Ventilation: 71 CFM•?Watts '
,,,, . This Home Duct t eakage to Outside: 11 CFM @ 25Pa(0.42/100 ft2) (: ( °,
wPoi Above Grade Walls: R-21
," Ceiling: Attic,R-50 Pad
r/�l rf� To '"""'�
Zero Energy is Window Type: U-Value:{1,28.SfiGC:0,34 I a Oe+y( , ) e
l Name 0
Foundation Walls: R-13 Paul DellaTorre,Certified Energy Rater
u
+w.ai�tftiir ..rii.-r, Framed Floor: N/A Digitally signed:11/4/22 at 11:24 AM
ill
c of ® Lkotrupe RATER Version:4 ill._;u'4
1" Tie Energy Rating Disclosuree for this borne is availablii from the Approved Rating Provider.
this report does not corrlituh0 arry wart inty or gnarintf r•.
10 Sherman Ave Northam•ton MA
HERS' Index Score: Rating Date: Nov 2,2021
55 HERS Registry ID:830508004
Annual Estimates: Rating Company:
Electric(kWh): 7,060.6 Energy Compliance Services
Propane(Gallons): 578.3 Rating Provider
Budding Efficiency Resources
CO2(Tons): 8? Rating Provider Address:
Approx.Energy Cost: $1,623 PO Box 1769 Brevard,NC
28712
HERS Index Home Feature Summary:
• „,„,�r„„,,r Single family detached,3
bedrooms,2,630 ft'
ISO
,,,a $4* Heating:95 AFUE
HOrlf Sick
Cooling:13 SEER
r8B
Hot Water:3.88 Energy Factor
Reference soe
4ornt Air Leakage:
sa 506 CFM50(1.34 ACHSO;F
Ventilation:71 CFM•9W
ge Duct LTO:
This"me 11 CFM @ 25Pa(0.42/100 ft2)
Above Grade Walls:R-21
Ceiling:Attic,R-50
Zero EnermMorne c
Window:U:0.28•SHGC:0.34
cre«.rr�
fttxr Foundation Walls:R-13
1kotrope RATER-Version:
:
ekotrope 4 0,13024
This a:port doe,not Lf mtit3:rt'.e any Walter,*t Ck'{I ntee
IECC 2018 Performance Compliance
Property Organization Inspection Status
10 Sherman Ave Energy Compliance Servic 2021-11-02
Northampton, MA 01060 Paul DellaTorre Rater ID (RTIN): 8776762
Model: John Handzel Custom RESNET Registered
Community: Northamton Builder (Confirmed)
Nu-Way Homes Inc
0007_John Handzel_10 Sherman
Ave Northampton 211107
HEFk-S0727 000r John
Handzel_12 Sherman
Annual Energy Cost
Design IECC 2018 Performance As Designed
Heating $2.370 $2.114
Cooling $113 $89
Water Heating $108 $108
Mechanical Ventilation $52 $12
SubTotal -Used to determine compliance $2,643 $2,322
Lights &Appliances Mout Ventilation $921 $921
Onsite generation $0 $0
Total $3,564 $3,243
R405.3 Source Energy Exception:The proposed home uses 12.9 MBtu LESS source energy than the re erence home.
Requirements
• R405.3 Performance-based compliance passes by 13 5% The proposed house meets the IECC 2018 Performance - -rice energy bill
requirement by$320 69(12 9 MBtu)
R402 4 1 2 Ar Leakage Testing Aar searing is 1 34 ACH at 5C,Pa.It must not exceed 3.00 A H at 50 Pa
• R402 5 Area-weighted average fenestration SHGC Area-weighted average fenestration SHGC is 0 369 The m•xtrnurn allowed value is
[No Limit)
• R402 5 Area-weiohted average fenestration U-Factor
• R404 1 Lighting Equipment At least 90 0%of fixtures shall be high-efficacy lamps,cutr- fly 100 0%are high-
efficacy
4 R403 6 1 Mechanical Ventilation Efficacy
Mandatory Checklist Mandatory code requirements that are not 2018 IECC Mandatory Checklist must be checked as compl te
checked by Ekotrope must be met
IRC
M1505 4 2, Mecharncal Ventilation Rate
R405 2 Duct Insulation Ati ce.-ts cltsle the thermal envelope must he insulated to ; least R6 0
Design exceeds requirements for IECC 2018 Performance compliance b 13.5%.
As a 3rd pan extension of the code iunsdiction utilizing these reports.I certify that this energy code compliance document has been created in accordan with the requirements of
Chapter 4 of the adopted International Energy Conservation Code based on HAMPSHIRE County.It rating is Projer.t.ed,I certify that the building design de- ribed herein is consistent
with the braiding plans. specifications, and other calculations submitted with the permit application If rating is Confirmed I certify trial the address r- -rented above has been
inspected/tested arid that the mandatory provisions of the IECC nave,been installed to meet or exceed the intent of the IECC or will be verified as such by• other party
Name: Paul DellaTorre Signature:
Organization: Energy Compliance Services Digitally signed: . I
Ekotrope RATER-Version 4.0.1.3024
IECC 2018 Performance compliance results calculated using Ekotrope RATER'S energy and code compliance algorithm
Ekotrope RATER is a RESNET Accredited PIERS Rating Tool Alt results are based on data entered by Ekotrope users.
Ekotrooe disclaims all liability for the information shown on this report
. ' <•':,, 11.1t4 ..'*t 6,11.1"4." .,,* .*. .0“t.', •It4 * ' ',0, 1A1 .#,,*' ' ,1•**#4,4 .. A .4* ,4'.644*,.#'0. A 't tt 4 O.A 1 * 00404 4'f• . ,1%*64'0...1.# Str . ...","
•'$O," •t,' ..' . i,%1 .0,' '.' .' 4. " t .... '., I."t! t't*^''''..
....
•-'
,4- 1 0 Sherman Ave ,.
..,.
.. Northampton, MA 01060
..
Builder: Nu-Way Homes Inc -.....
. .. . .
:,.....„,, Model: John Handzel Custom Communit : Northamton .-
,... ..-
-- :
THIS HOME IS CERTIFIED TO MEET THE 0..
--0 ...
... ...
.0-
,.0
. . . -...‘
..... 2018 INTERNATIONAL ENERGY CONSERVATION CODE .-
....
,.
...,.. . 4::
,0 • 0.
....
Building Features . ....
..,
,--
..•
.-,.... Ceiling Attic, R-50 Duct Supply R-8.0, Return R-8.0
-•-
..-
-- Above Grade Walls R-21 Duct Leakage to Outside 11 CFM @ 25Pa (0.42 / 100 ft2) '
_,
,„..
•-• -
---,, - Foundation Walls R-13 Total Duct Leakage 106 CFM @ 25Pa (Post-Construction) —
:7. .:'•
,-; . Framed Floor N/A Heating Furnace • Propane • 95 AFUE --
:-:
°:" -•.
.. , Slab R-0.0 Perimeter, R-0.0 Under Cooling Air Conditioner • Electric • 13 SEER ..-
-
Infiltration 506 CFM50(1,34 ACH50) Water Heating Residential Water Heater• Electric• 3.88 Energy ••
....
-- Factor
-- -.
•-• Window U-Value: 0.28, SHGC: 0.34
....
....
,..„, As a 3rd party extension of the code junscliclion utilizing these reports. I certify that this energy code compliance document has been created in accordance with the requirements of
... Chapter 4 of the adopted Internalional Energy Conservation Code based on HAMPSHIRE County If rating is Projected,I certify that the building design described herein Is consistent with
....-
the budding plans,specifications,and other calculations submitted with the permit application If rating is Confirmed.I certify that the address referenced above has been inspected/tested ,.. .
4': : and that the mandatory provisions of the IECC have been instated to meet or exceed the intent of the IECC or will be verified as such by another party
)t '
•••• •
...
Name: Paul DellaTorre Signature: If PettaTme --.
.:- .:.
,.I • Organization: Energy Compliance Services Digitally signed: 11/4/22 at 11:24 AM „•-•
,., Ekotrope RATER-Version 4.0.1.3024
2018 fECC compliance results calculated using Ekotrope RATER's energy and code compliance algorithm ..•
Ekotrope RATER is a RESNET Accredited HERS Rating Tool All results are based on data entered by Ekotrope users i••
s::: ) Ekotrope disclaims all liability for the information shown on this report
't*i.:,•;;;;'.' 1'"4*,*tt t:0; t ft t' t!'1.,11: ,0,t0;e*tt Ott'.Ittt"to#'****1';',“44:!*'*1't0,04,':**,tt' ,..'latt *tt'ttt 0,t.e.t tt O.!'Q c'etS;t4.1.:t7t.. t.S. V ''t:44'tt t *‘;'•tt0;t1"'t ':*:t'`:-*
* t",....t;',..,,',..4,..4* - ...it.t...1.,01‘t,...t, t.,...,t,'1..,...ti.syt,t t t'...‘,..-• t%S.s.41,*' t".41.t.t,''t,t,..,0.. ,-, 4,1t. ........,*.t,10,4• * `'.'t Yr.."'
IECC 2018 Label
10 Sherman Ave
Model: John Handzel Custom
Ekotrope RATER-Version: 4.0.1.3024
HERS®Index Score: 55
Ceiling: R-50
Above Grade Walls: R-21
Foundation Walls: R-13
Exposed Floor: N/A
Slab: R-0
Infiltration: 506 CFM50(1.34 ACH50)
Duct Insulation: Supply: R8, Return: R8
Duct Lkg to Outdoors: 11 CFM c@ix 25Pa (0.42 1100
ft2)
U-Value: 0.28. SHGC: 0.34
Door: R-6
Heating:JFurnace• Propane • 95 AFUE
Cooling:Air Conditioner• Electric• 13 SEER
Hot Water: Residential Water Heater• Electric•
3.88 Energy Factor
Average Mechanical Ventilation: 71 CFM
Signature:
2,5-5 T
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
' '-!..;..At = CITY/TOWN /I/D 1 t'` t*Alt /'� A 0,447 - )3/11 L PERMIT# �2 62. 7
.. r— <-Z5" 'MC-o ► ' �{
j .~ JOBSITE ADDRESS /Z SI4 e-.�,4,./ /-1 It9 iev m WNER'S NAME `�W.) 14-C
j p ry OWNER-ADDRESS ER ADDRESS I t7 P k1 k r6- t, La TEL Il 5Z 3•UD$5! FAX
0
TYPE OF 'v OCCUPANC TYPE COMMERCIAL El EDUCATIONAL 0 RESIDENTIAL
PRINT
CLEARLY NEW: RENOVATION:❑ 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 GASIOIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM •
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER I
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR I AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN
LAVATORY
PLJMB NG & GAS INSPECTOR
ROOFDRAIN 3 NORTH AMPTON
ROOF A
SHOWER STALL APPROVED NOT APF HCVED
SERVICE/MOP SINK
TOILET I Z ✓
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
WATER PIPING i / /
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 TH E OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY El BOND 0
OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 o the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
CHECK ONE ONLY: OWNER 0 AGENT ❑
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the detals and information I have submitted or entered regarding this application are true and accurate to the best pi f m kno e
and that all plumbing work and i•stallations performed under the permit issued for this application will be in compliance with all P i e s l e
Massachusetts State Plumbi /•se and Chapter 142 of the General Laws.
PLUMBER'S NAME iA A.__ d N LICENSE# 31.1 s SIGNATURE
MP❑ JP RV CORPORA!ION 0# l PARTNERSHIP❑# LLC�f❑#
COMPANY NAME OSCLJ na 1ii ADDRESS /8 S "'
CITY '/ICY/ 4D( 0) STATE AM ZIP dl(11-59 TEL //3 - 5/77 1 6`I Z.
FAX CELL EMAIL OM4 i
.t9 CarIV
4, pr r (2/ Ri+.17° Si 24
CalS' ,.[.�o�c�' r� V ?. 4JV/
_ w 2 mac/ n• niggly
` 22 / -
Cl_i-/0j1 6,� 1-
_ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
kike
Wili�_ // mil /
S. CITY) /1/01 /1.6,^�' , MA DATE / /1�4 PERMIT#6 I72022-C'5 a'`j
— Joest-E ADDRESS l v S`j e.,e/tt 4,A" A OWNER'S NAME \I MN /4J1/7
OWNER ADDRESS/0 4JAife ;Ps- g Zesty - TEL 9l.S' 3" "; FAX_
TYPE ISt O19CUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL a""'--...'''PRINT -
CLEARLY -- p RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑
APPLIANCES-1 -FLOORS-• BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER
BOOSTER _
CONVERSION BURNER
COOK STOVE /
DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT OVEN PLUMBING & GAS INSPECTOR
POOL HEATER NORTHAMP ION
ROOM/SPACE HEATER APPROVED NOT APPROVED
ROOF TOP UNIT
TEST _ .
UNIT HEATER
UNVENTED ROOM HEATER
WATER HEATER
OTHER
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO ❑
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY Cl BOND El
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 0
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 • • . -•P•e
and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all '• .:• . • •.•of •
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ��
PLUMBER-GASFITTER NAME 60Wv"64- CAS LICENSE#33y3' SIGNATURE
MP El MGF❑ JP�F❑ LPGI❑ CORPORATION❑# PARTNERSHIP❑# LLC 0#
COMPANY NAME C )S S FYi Z/1-: ADDRESS /6 -S--G✓ 1
CITY gh/v J STATE ✓44 ZIP 67 5 L �TEL 97 rr. . ., L/Z
FAX CELL EMAIL oSc- 71"CD^,+v`- 'cv ft
JD ZZr Therz3e/e4:(. 'T
//_yzz c�4
L-rt O 6" f�
I.
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
_.4tffiis-
EL
aw
Tih , CITY NORTHAMPTON MA DATE 10/17/2022 I PERMIT# G .422-'D3 3
JOBSITE ADDRESS 10 SHERMAN AVE NORTHAMPTON,MA 01061 OWNER'S NAME NU-WAY HOMES —111111111
ry
1 cn OWNER ADDRESS 10 WHITE AVE E LONGMEADOW,MA 01028 I TE 413 563-0085 FAX
TYPE Oil '
I PRINT„ OC,UPANCY TYPE COMMERCIAL 0 EDUCATIONAL 0 RESIDENTIAL
CLEARLY NEWNEW103 RENOVATION:0 REPLACEMENT:❑ PLANS SUBMITTED YES 0 NO E
APPLIANCES 1 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER iiiii airni - MI IIIIIII—IMIII
—
BOOS ER 1 111111111M _ iiiii NM—
CONVERSION BURNER Mil iiiil� _���
COOK STOVE MEM _._ __._. _-_-_NEMEM - _ �I F
11101
DIRECT VENT HEATER MN WNW ill11111 .111101 1
DRYER
FIREPLACE N ��� � IN
FURNACELAT NM
FURNACE � I11111.1.11110W'NEM, -1— ----1 WIWIWIIIIM �
GENERATOR M 011111/11M 11111111W1 IIIIIIII NM
GRILLE MN — T W WIIIMIOit
INFRARED HEATER ! ' 1 ]
LABORATORY COCKS iiiii illnii.01111
MOM iiiii
MAKEUP AIR UNIT WIWII ',L�NM
OVEN 1 MOM — 1
POOL HEATER —,�,� ,O��i►�.>tu�.Z�_1.�1f��� iY�
ROOM/SPACE HEATER �l�lf_ ,ta. , ��—,
REST
TOP UNIT - —ni MNI— IaJ� -_ 91kiJl ��i'i
UNIT HEATER 1.1.11111...i;I11111 'W;;1 Wja F 1
UNVENTED ROOM HEATER 11111111111111111111111110111,1111111 T _�',
WATER HEATER iiii Miiiiiinfrin 10.1WWWIWOMI Mr—
OTHER CONNECT TO STUB Mil ) IIMMIMMOMMIWWWIWOMMKUOI
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMI I ICI -- ■�i�I F 1_I
INSURANCE COVERAGE
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 YES Q NO 0
I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY H] OTHER TYPE INDEMNITY iy__ 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 n AGENT 0
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 bqst of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all PertinentOrrovision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME STEPHEN CONSTANTINE I LICENSE#3063 � C SIGNATURE
MP❑ MGF❑ JP❑ JGF❑ LPGI 0 CORPORATION❑# PARTNERSHIP 0#1 LLC 0#
COMPANY NAME:OSTERMAN PROPANE LLC ADDRESS 339 AMHERST RD.
CITY SUNDERLAND STATE MA IZIP 01375 ITEL 413-549-1000
FAX CELL EMAIL
ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ ❑
FEE: $ PERMIT#
PLAN REVIEW NOTES
`/ y-aL .A7.t
35 FG-�2-IJ Sr 00// /
Commonwealth o/Ma99achusett9 Official Use Only
0= t Permit No.eP--20 22 "D S S 7
_mil_ eparimznt o/.ire Jervice9`
/,
Occupancyand Fee Checked &/3 1
-- ' I BOARD OF FIRE PREVENTION REGULATIONS
[Rev. 1/07] (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
PI
LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 1 1 j/Z L.
r" Ci or Town of: r 1412EI fC E To the Inspector of Wires:
By this appli ation the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 35 F1Z!V
Owner or Tenant f E i-or: JELL Ey Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes V No n (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters
New Service Amps / Volts Overhead n Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: -12eA-1 (e r.xIS T,nq f 7(,,,,,, T Co J it
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T
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. Initiating of Detectionand
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 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 this application is true and complete.
FIRM NAME: JME LIC.NO.:A16187
Licensee: James Mailloux Signature LIC.NO.:E33364
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:413-585-1592
Address: 221 Pine St.Suite 160 Florence,MA 01062 Alt.Tel.No.:413-563-4654
*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: $ 475-—
7- 7- a-2- g r,
o a y- as i F�1 QP` '^