12C-085 (7) 12 RICK DR BP-2022-1293
Map:Block:Lot: COMMONWEALTH OF MASSACHUSETTS
12C-085-001 • 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-2022-1293 PERMISSION IS HEREBY GRANTED TO:
Project# RENOVATION Contractor: License:
Est. Cost: 30000 WILLIAM SYMANSKI CSFA060290
Const.Class: • Exp.Date: 04/16/2023
Use Group: Owner: THOMAS WICKLES
Lot Size (sq.ft.)
Zoning: RI/W'SP Applicant: WILLIAM SYMANSKI
Applicant Address Phone: Insurance:
233 STRAITS RD (413)247-9939 SOLE PROPRIETOR
WEST HATFIELD, MA 01066
ISSUED ON: 10/18/2022
TO PERFORM THE FOLLOWING WORK:
INTERIOR 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 J/vpe Z Rough:/1 7Q�� House# Foundation:
Final: , 4 . Y Final:
' 'Z�✓23 Final: T 2 l Rough Frame:
Gas: 'Ja Fire De *. nt Driveway Final: Fireplace/Chimney:
Rough: Oil:
Insulation:
Smoke: Final:FA+Lel'" 2-1'1'1•13 i6R --)
0,14 ' -2-1-23 i6,L
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
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Fees Paid: $195.00
212 \lain Street.Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
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__L MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
''�''= ;, CITY/TOWN V l..! CE MA DATE '0/(931 a� PERMIT#}�,�'0GZ'U/o
JOBS TE ADDRESS 1�. 1" I �91-► 3� OWNER'S NAME in U- 04:- S
•p OWN R ADDRESS 1C7'\ . S0 J\ j — 35S'64'�'c
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL
PRINT IN.)
CLEARLY NEW:❑ RENOVATION REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑
FIXTURES 1 fLOOR—I 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
ROOF DRAIN
SHOWER STALL
SERVICE MOP SINK PLUfr/►BINa & GAS INSPECTOR
TOILET .NO#-T.HAIVI-PTN
URINAL -A 'LOVE D NOT APPROVED
WASHING MACHINE CONNECTION fj
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 NO ❑
IF YOU CHECKED YES,PLEASE INDICATE THE PE 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 an. ,. -to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in c•' ertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME ROKIa,I.D U 3EV E? \/ LICENSE# \.O \OS ,—.if" SIGNATURE
MP JP❑ '' ..\\CORPORATION Li# PARTNERSHIP❑# LLCA#00155(11‘0
COMPANY NAMERCIJ� MV}, & tAsfr(TML,' -ADDRESS
CITY60011A DEEKF-iELI) STATEMQ ZIP 0� 1 TEL 4 -515- 9089
FAX CELL (SU`MQ._ EMAIL � Y O
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
CITY 52\V MA DATE coj&Ll j13 PERMIT#C?2O22, 0goy
JOBSI;TE DDRESS � RAC 1Vv� OWNER'S NAME I Oon
1i
G i OWNER ADDRESS v E 1�tJ� C^ t- '1 ItL vi\ "35S-(Qtx{I FAX
TYPE OR PRINT o OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL El RESIDENTIAL(A,
ry
CLEARLY KNEW:❑ RENOVATION: REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑
APPLIANCES Z 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 PLUMBING & GAS INSPF TOR
OVEN NOR—HAMPTO
POOL HEATER APPROVED NOT APPR, VFD
ROOM I SPACE HEATER ;?
ROOF TOP UNIT
TEST
UNIT HEATER
UNVENTED ROOM HEATER
WATER HEATER
70THC
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 16,. 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.
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 co iartt ith all Pertinent pr on of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws_
PLUMBER-GASFITTER NAME LICENSE# ,(pgt) SIGNATURE
MP$i MGF❑ JP❑ JGF❑ LPGI ❑ CORPORATION ❑# PARTNERSHIP❑# nn L.LC'I#
COMPANY NAME C 146 UrnbC- I caMkib t —ADDRESSa WQ--G&Nehr ' tc p
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CITY (� STATE'm1rt- ZIP a�� 1� � 1
FAX CELL C EMAIL`_.k.k. �Iym 1A _�12fl. Q R�tA____1 COM
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Commonwealth of Massachusetts Official Use Only
,, Permit No. 2-0 2 Z— b g i 0
Department of Fire Services
f J 2-2-0
-i .,.. )' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
AR work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEA PRINT Ill INK OR TYPE ALL INFORMATION) Date: 11 l 3/ ?O 2.
City or TOwn of: NdrAhrten }at\ To the Inspector of Wires:
By this application the undersigned gives noticeof his or her intention to perform the electrical work described below.
Location (Street &Number) 1 2. c.. i.LVj 6 r
Owner or Tenant 1-0 YY\ y V ‘s c \.Q\ S Telephone No(ja;ASS--b I
Owner's Address Id P 1-2o.S ow,.1- \/I-C W Or .. ptorEmail
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building 5-eve Cen• '\y (Awe.l\in cl Utility Authorization No.
Existing Service Amps / Volts •/Overhead ❑ Undgrd ❑ No.of Meters
A
New Service Amps / Volts Overhead ❑ Undgrd II No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Kt.v_C h t n I R A- h R / b.ed 10 0 m
(elkOvc en I' of CV/I't-CS
Completion of the followinktable may be waived by the In vector of Wires.
No.of Recessed Luminaires 'Z No.of Ceil.-Susp. (Paddle) Fans T a s Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires 5 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.o Innf Dete and S
initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
Heat Pump Number Tons___ KW No.of Self-Contained
No.of Waste Disposers
t Totals: Detection/Alerting Devices
No.of Dishwashers I Space/Area Heating KW Loral ❑Municipal Connection ❑ Other
No.of Dryers I Heating Appliances KW SecurityNo. Systems:*
f 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.
(Wh
en Value of tectrical Wort`►r !/00O required by municipal policy.)
Work to Start: L2 Inspections to be requested in accordance with MEC Rule 10,and upon completion.INSURANCE COVERAGE:
Unless waived bS, , 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 Kei 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:HAP.E tic tit I LLC. LIC.NO.:ZZ q Z7—A
Licensee: Mn4hetr n pluvicur Signature --74- LIC. NO.:16995- $
(If applicable, enter"exempt" in the license number line.) Bus.Tel.No.: Y _2 • `_
Address: Z$ Mgr. S. E fu ►n m#+ 151627 Email.:U pt1 a etz tiP gets}1.Ca is,
*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 lay:. By my signature below,I hereby waive this requirement. I am the(check one)Downer Downer's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ 125,0U
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