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24C-143 (8) BP-2022-0319 11 ARLINGTON ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-I43-001 CITY OF NORTHAMPTON Penn it: Addition PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT • Penn it # BP-2022-0319 PERMISSIONIS HEREBY GRANTED TO: Project# 2022 ADDITION Contractor: License: Est. Cost: 179000 KEITER CORPORATION 102457 Const.Class: Exp.Date:06/20/2022 Use Group: Owner: KURTZ JUSTIN & JENNIE E. HOWLANI Lot Size (sq.ft.) Zoning: URB Applicant: KEITER CORPORATION Applicant Address Phone: Insurance: 35 MAIN ST, 2ND FLOOR (413)586-8600 MCC20020005382021A FLORENCE, MA 01062 ISSUED ON:04/11/2022 TO PERFORM THE FOLLOWING WORK: CONSTRUCT NEW IN-LAW APARTMENT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing hispector ofgW "` D.P.W. Building Inspector Undergrou�}d Service: QP Meter: Footings: C'1� 1. ', `/ oughP ay ought et House # Foundation: Gas: Final:�� j Final: Rough Frame: DR 9 •� /d I Rough: Fire Department Driveway Final: Fireplace/Chimney: VikkariAL, ^^ + FLoatt2 it To Final: Oil: Insulation S;,,,l"LL ie/3/a2„ � to 10 '7-Zz- IC Smoke:0A 1—S--93 Final: 6.14 1- 10.13 THIS PERMIT MAY BE D V K BY THE CITY OF NORTHAMPTON UPON VIOLA ION OF ANY OF ITS RULES AND REGULATIONS. Signature: r Fees Paid: $1,164.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Buildiue Commissioner it S�rv11\r4 O / /� ° _::> -, ( (7ooclA C) Z ZZ -L -01 t ,IL/V„ v .... V,V " I Commonwealth,o/ a�5achuaella Official Use Only 127- �`:' t c� Permit No. �'e '�o 02-- 3=.!iBI aUeParlmenl o��ire Services a. aQ� V. 1 e i Occupancy and Fee Checked it �_ _� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)' ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK I 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: August 1,2022 City or Town of: Northampton To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described Blow. Location(Street&Number) 11 Arlington Street Owner or Tenant Adam Skiba Telephone No. 4C3..530..9904 Owner's Address • Is this permit in conjunction with a building permit? Yes [Xj No ❑ (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd P No.of Meters New Service Amps i Volts Overhead ❑ Undgrd I 1 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Electrical as part of an addition 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 o No.of Switches No.of Gas Burners No. In Dete and nitiatinnggon 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 Li Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNo fDevices or q u v l y g No.of Devices Equivalent OTHER: ER: 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 ❑x BOND ❑ OTHER ❑ (Specify:) 1 certify,under the pains and penalties of perjury,that the informati, t 's applic 'l is is true and complete. FIRM NAME: JSN Services, Inc. _. LIC.NO: 939458 Licensee: Steve Wilson Signature �Ir -WI. LIC.NO,: 22634A (If applicable,enter "exempt"in the license number line.) us.Tel.No.: 413-583-2227 Address: 193 Holyoke Street Ludlow, MA 01056 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. SS-002597 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 PERMIT FEE: $125.00 Signature Telephone No. 4-Q 1 ,no �� - t. 0 �„ ( 8)(- Lo �3 aj � ti rd ° k+ ldo ,_,,.tV-r -30- pc, I rvo WU-- H56 - 01/-^ AAA& ct I — Aro (rrc O '-' ou}c,\F 91' Cd Jr%" - a SG //t) o0 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING IVORK �t;=;,)EtS CITY/TOWN Northampton MA DATE 07/05/2022 PERMIT#Pf —2.42Z—0262 : a 11 Arlington Street Jennie Howland JOBSITE ADDRESS g OWNER'S NAME p OWNER ADDRESS 11 Arlington Street TEL 413-586-8600 FAX TYPE OR'•.;1 OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL 10 PRINT CLEARLY NEW:❑ RENOVATION: 0 REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ FIXTURES 7 FLOOR-0 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/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM —� DEDICATED WATER RECYCLE SYSTEM DISHWASHER t DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK 1 LAVATORY t ROOF DRAIN SHOWER STALL tPLUMBING SERVICE I MOP SINK N 3RTHAMPT©I4 TOILET t ANPHOVV L U NU I APPROVE© URINAL WASHING MACHINE CONNECTION i WATER HEATER ALL TYPES _.—j11111111111 WATER PIPING s OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES ] NO El 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. R. Scott Cernak II Digitally signed by R.Scott Cernak II Date:2022.07.05 13:43:36-04'00' CHECK ONE ONLY: OWNER 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 bet 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, � tzi ce�2 ez�r. PLUMBER'S NAME Richard Scott Cernak II LICENSE# 15672 SIGNATURE MP[29 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 Vivb /el- c12J,7io 465�° MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 7_.tij �.?aCITY Northampton 07/05/2022 =( MA DATE PERMIT# 202--028 11 Arlington Street Jennie Howland ' JOBSITE ADDRESS g OWNER'S NAME Gi:: OWNER ADDRESS 11 Arlington Street TEL 413-586-8600 FAX TYPE — OCCUPANCY TYPE COMMERCIAL ill EDUCATIONAL ❑ RESIDENTIAL 0 PRINT' CLEARLY NEW:❑ RENOVATION: ❑■ REPLACEMENT: ❑ PLANS SUBMITTED: YES E NO❑ APPLIANCES 1 FLOORS-0 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE - I DIRECT VENT HEATER DRYER FIREPLACE _ _ FRYOLATOR FURNACE GENERATOR 1 GRILLE INFRARED HEATER - LABORATORY COCKS - MAKEUP AIR UNIT OVEN POOL HEATER RPLU VIDING & GAS INSPECTOR ROOM/SPACE HEATER ROOF TOP UNIT - - NORTHAMPTON �I "TEST APPROVED NOT APPHOV-o UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER A'ieve ' g e I i 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 COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ® OTHER TYPE 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. R. Scott Cernak II Digitally signed by R.Scott Cernak' ' II Date:2022.07.05 1353:43 0400 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 bet 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. Rie/,ai ax,I.af PLUMBER-GASFITTER NAME Richard Scott Cernak II LICENSE# 15672 SIGNATURE MP[X MGF❑ JP E JGF❑ LPG' ❑ 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 / //tip ' i ck 27D1 //I�•�v MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ffJJ/ ton 1.1 CITY/TOWN Northam p MA DATE _07/05/2022 PERMIT. e-2,1)22 02 2- 11 Arlington Street Jennie Howland JOBSITE ADDRESS g OWNER'S NAME P OWNER ADDRESS 11 Arlington Street TEL 413-586-8600 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL El EDUCATIONAL ❑ RESIDENTIAL❑■ PRINT CLEARLY NEW:❑ RENOVATION: ■❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO El 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/OIUSAND 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 1 LAVATORY 1 ROOF DRAIN SHOWER STALL 1 PLUMBING & GAS INSPECTOR SERVICE/MOP SINK NORTHAMPTON TOILET 1 APPROvtD NOT A!PROVED URINAL WASHING MACHINE CONNECTION 1 WATER HEATER ALL TYPES 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 D 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. R. Scott Cernak II Digitally signed by R.Scott Cernak II Date:2022.07.05 13:43:36-04'00' CHECK ONE ONLY: OWNER ❑ AGENT El 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. Ru„<i.144,/ ~..d 99 PLUMBER'S NAME Richard Scott Cernak II LICENSE# 15672 SIGNATURE MP l l 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.corn -# -ee— 'v u czA,4 •-