30B-051 (5) • BP-202 .2289
189 RIVERSIDE DR COMMONWEALTH OF : ASSAC USET S
30B-051-001 . CITY.OF NORTHAMPTON •
Permit: Addition 1.; C,
PERSONS CON1 R At ZINC Wall i'll UNI:LEEGISTLRED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
-.� ; 'R !
Permit # H P-2021--2289 PERMISSION'S HEREBY GRANTED D TO:
Project# 2 SI OR? AI?DI TION Con raet r: License.
Est. Cost:
333400 DOUGLAS THAYER 107699
Const.Class: - Exp. ftity:04/07/2022 .
Use Group: Owner: "SMITH JASON S
Lot Size (sq.fs.)
Zoning: URN , Applicant: DOUGLAS THAYER
Applicant Address Phonel instiranul
P O BOX 60322 (413)530--4785 * 6H>_B 9F7960c -
FLORi NCE MA 01062
ISSUED ON: 12/17/22021
TO PERFORM THE FOLLOWING WORK:
2 STORY ADDITION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing • Inspector of Wiring - I.P.W. Building Inspector
IV8e75 0,4 Lt-2.i-7.7-14/
Underground: Service: Meter: Footings:OKI :"/ J9?. 1I
Rough: x ougli: fr«q "i, a House# Foundation: C.)iZ I/ �11-
Final: I Final: . Rough Frame:�'�_� `�`K O
3---./7.- 3 7slek- .,--- r,._ ,Final: .�,� �.14 S- 2_,; 22 VA.
Gas re Department f�44AFireplace/Chimney:
x-,, .r`, l tion �� d'tL '"l'iS 2-`2-k l!
Rough: Oil: f i�` Insufaprl Oati►PtcT e- O X 4442
Final: Smoke: Final: b.a. 3-2b-23 v. i
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
•
Fees Paid: $2,I67.00_
a
, ' 212 Main Street, Phone(4 i 3) 587-1240,Fax:(4I 3)587-1272
Office of the Building Commissioner
I ' c1. IVG1'�IuI= .1�
'a�` L-omnwn.weatth of ///a3.achu3ett$
_"_e_ Apartment of iire.eruices Permit No.�P 7�' ' OZ7 2
9 Occupancy and Fee Checked 4A-33
-�-�— 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 EC) 5272CMR 12.00
N �V'�
'LEAS NT IN INK OR TYPE ALL INFORMATION) Date: Y �/
or Town of: To the Inspec r of Wires:
By this appl ation the undersigned gives
ives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 1 O I (RiVe✓SJp(./ Pr
Owner or Tenant IQSpsA t i ik Telephone No.
Owner's Address IV) FiVtiSi Q t✓v
Is this permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Box)
Purpose of Building 1R0504"e Utility Authorization No.
Existing Service 1Q0 Amps 94 / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity ll r
Location and Nature of Proposed Electrical Work: L i Gh f,n 5 d'Ndt R?rep IBC K S
Mt + a,A Ct S 2Prk c ve A--
Completion of the followin_ table may be waived by the Inspector of Wires.
No.
rano KVA
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 0 Tf
Trsformers KVA
No.of Luminaire Outlets S No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
2 grnd. grnd. Battery Units
No.of Receptacle Outlets 5 o No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches a O No.of Gas Burners — No.on Initiating on Dete and
Devices
No.of Ranges I No.of Air Cond. Tonsl —
No.of Alerting Devices
No.of Waste Disposers 1 Heat Pump Number Tons KW 1 No.of Self-Contained
Totals: Detection/Alerting Devices 1
No.of Dishwashers I Space/Area Heating KW 'Local❑ Municipal ❑ Other
Connection
No.of Dryers I Heating Appliances KW mintySystems:* _ T
No.of Devices or Equivalent
No.of Water Kam, No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent ,
No. Hydromassage Bathtubs — No.of Motors Total HP Telecommunicaions Wiring:
No.of Devicet s or Equivalent
OTHER:
,,L I Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of E I�J1J(i(i (When required by municipal policy.)
Work to Start: 0/ ectri I Work:
/0 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides pr of 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 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: DGlvt `'Ot fyl) D./loC-L A VDU 1 LIC.NO.:
Von v YQ&nhh Signature VittGG�- LIC. NO.: 107 j 2-8
(If applicable,enter "exempt"Oahe license number live.) / Bus.Tel. No.:
Address: 2 0 ' I S r� W 771f rneZ-00 Alt.Tel.No.: 3 1 r- 0 C-0 G
*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. : t e below,I hereby waive this requirement. I am the(check one)❑owner owner's agent.
Owner/Agent �� ' PERMIT FEE: $ 0.0
Signature 1 Telephone No. ( t 1 S V f 2,6-
y7t5
I � N
MASSACHUSETTS UNIFORM APIIICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY/TOWN V. ��( �' i J MA DATE 3 AC-
- �'2- PERMIT#PP-20Z2"o/,6,
JOBSITE ADDRESS I `J �sVOti d Q( `f OWNER'S NAME f61N 6,
POWNER ADDRESS - uSori Sm t �h TEL FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL I1
PRINT
;CLEARLY NEW: ❑ RENOVATION: k REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO❑
FIXTURES Z FLOOR-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB ( I_
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER I '
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK 14.
LAVATORY fl '
ROOF DRAIN
SHOWER STALL PLUME ING & GAS INSPECTOR
SERVICE/MOP SINK NORTHAMPTON
TOILET I APPROVED' NOT APPROVED
URINAL � 1 i�],�-�
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
WATER PIPING _
OTHER
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES p 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
Massachus tts 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 alllrtinent pr vision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 7
PLUMBER'S NAME �'I f4V 4C L 4-� ' I LICENSE#i 1 b f ( SIGN URE
MP WI JP❑ CORPORATION ❑# PARTNERSHIP❑# Lc ❑#
COMPANY NAME Optic L p ' i ADDRESS 2 I G A-5'
CITY Cfr$7h47)TY\1 STATE ZIP 01 0 TEL
TEL
FAX CELL chi - 531; - 73 5 7 EMAIL
1'"k E2-L/--
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