29-175 (7) 175 BROOKSIDE C1R BP-2022-0705
Map:Block:Lot: COMMONWEALTH OF MASSACHUSETTS
29-175-001 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
Permit # BP-2022-0705 PERMISSION IS HEREBY GRANTED TO:
Project# BASEMENT RENO Contractor:
Est. Cost: 100000 License:
ALISHA PHILLIPS 106378
Const.Class: Exp. Date:02/26/2024
Use Group: Owner: HANLEY CHRISTOPHER J
Lot Size (sq.ft.) •
Zoning: WSP Applicant: AXIOM LANDSCAPE & HOME IMPR VEMENT LLC
Applicant Address Phone:
Insurance:
40 PINE VALLEY RD
(413)320-9669 WCC-500-5020083
FLORENCE, MA 01062
ISSUED ON:06/14/2022
TO PERFORM THE FOLLO lW 7NG WORK:
BASEMENT RENO
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W.
•7 Z F„� Building Inspector
Underground: Service: Meter: a- , _
Footings: (,)1� I(J/ ' �j
Rough/� 2 - 2 Rough: /4 'c, ; House# Foundation:
Final:G.,..,....5,,2� Final:a /. ,2 Final: Rough Frame:
v,e /2. S -2_2 ie,o.
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil:
Insulation: 0,16, 1,2-1 Z2 u,Q
Smoke: Final:rants- L,3- 1�t2
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THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL• TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: 1;
},
1;61
Fees Paid: 5650.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
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__ -- --A ( MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
JITY/TOW Northampton MA DATE 06/16/2022 PERMIT#PP-ZO 2,2- 023(
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`"JOBSITE,9 DRESS 175 Brookside Drive OWNER'S NAME Axiom Land & Home
c\,OWN '4 DRESS 175 Brookside Drive TEL 413-320-9669 FAX
I'
OR fOCCU D-AN Y TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
•LEARLY NEW: ] RENOVATION: ® REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO❑
FI tI RE8 FLOOR-4 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
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
LAVATORY 1
ROOF DRAIN PLUMBING & GAS'iNSPECTIUR
SHOWER STALL 1 NORTHAMPTON
SERVICE/MOP SINK 1 . APPROVED NOT APPROVED
TOILET 1
fr
URINAL .�
WASHING MACHINE CONNECTION 1
WATER HEATER ALL TYPES
WATER PIPING
OTHER
Ir
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES El 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 e/ m/a /
PLUMBER'S NAME Richard Scott Cernak II LICENSE# 15672 SIGNATURE
MP 11 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
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175- 1 o�Sibe cr '&
-� Commonwealth of Massachusetts Official Use Only
Ft=-fit Department of Fire Services Permit No. ��—202Z.�09 7 —
-1`l— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ILO/O7�'3
[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
(PLEASE`1RINT IN INK OR TYPE ALL INFORMATION) Date: November 8, 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 below.
Location(Street&Number) 175 Brookside Cir.
Owner or Tenant Christopher Hanley Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes V No❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service 100 Amps 120 / 240 Volts Overhead 1V Undgrd n No.of Meters 120
New Service Amps / Volts Overhead ri Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Basement remodel
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 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: l
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 li-
censee 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:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Willy Danylieko, Inc LIC. NO.:A 20896
Licensee: Stephen Rogalski Signature ,y� � ✓ LIC. NO.:
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:413-586-0191
Address:35 Meadow Street, Hadley MA 01035 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)El owner ❑owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE $125.00
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