23B-094 (5) BP-2022-1063
200NORTH ELM ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23B-094-001 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-2022-1063 PERMISSIONISHEREBYGRANTED TO:
Project# 2022 RENO Contractor: License:
Est. Cost: 95000 KAREN LAVERDIERE 055344
Const.Class: Exp.Date:08/29/2024
Use Group: Owner: MCAULEY JAE
Lot Size (sq.ft.)
Zoning: URB Applicant: KAREN LAVERDIERE
Applicant Address Phone: Insurance:
21 FAIRFIELD AVE (413)268-2080 6s62ub5n25195321
HAYDENVILLE, MA 01039
ISSUED ON: 09/06/2022
TO PERFORM THE FOLLO WING WORK:
REPAIR WATER DAMAGE, ADD 2 SKYLIGHTS, CHANGE OUT/MOVE 2 WINDOWS, INSULATE, SHEETROCK & TRIM,
RE-SIDE
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(j.-i/2Z Rough: 1 1 'J� House# Foundation:
Final: Final: 3 -;2-=2 Final: Rough Frame: r"? > �
-2 -22- 3 Wr%
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:6,1Z li-2 Z2- i�V
a3
Smoke: Final: 0 tZ .3)/ _
7
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: Q
,C1 . W 'I ! , '
Fees Paid: $617.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
/EQ(_) NJ um./1 twit! '=D l aa// q����j/
Commonwealth o//Y/aedachceeetti Official Use Only
, l_ ►t c� cc77 Permit No. tP-20 2Z— d?9g
• __mil_- Tepartment o/.}ire �ervice6
='° _ Occupancy and Fee Checked -7 )j
. BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07
�^�.— (leave blank)
c-)
-" APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPPALL INFORMATIpN) Date: l 0- 3 I — 2 Z
City or Town of: o r arerrEti To the Inspector of Wires:
By this application the undersigned gives notice of 5s or her intention to perform the electrical work described below.
�r
Location(Street&NuA`ber) ZO Q �Uh
Owner or Tenant JCV... MG600V I c s Telephone No.9l3' Q314' S1$
Owner's Address S/4-it k
Is this permit in conjunct" with a building permit? Yes eh No ❑ (Check Appropriate Box)
Purpose of Building ► ,c•••.t a 6•nA Utility Authorization No.
Existing Service AA Amps 17.0 / 2'to Volts Overhead IKI. Undgrd❑ No.of Meters G
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location a Nature pf Pçoosedp Electrical Work: f� ���e ����{�dn
'�-CO 1 4 ►h i s 1�c St /c a /. t
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
of
No.of Switches No.of Gas Burners No. Initiatinnggon Dete and
In 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 HeatingKW Local❑ Municipal ❑ Other
p Connectiony
„d
No.of Dryers Heating Appliances KW Securityms:*
f Devi ms or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
RNo. Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
C,
Estimated Value of Electrical Work: I ?S k_ (When required by municipal policy.)
(I
Work to Start: 10 -29"2L. 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
e-- Sd the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
0 undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
Qr, T i i CHECK ONE: INSURANCE ti.- BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: /v 4k t1 i'k I Signature LIC.NO.: 2z Z t6 3
(If applicable,et)er "exe t"in the licensenber line. �� Bus.Tel.No.: I,"77 4'Od4(
Address: . C) ) Ls 4% 1.J t.1,45 . C e C �t 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)❑ owner ❑ owner's ent.
Owner/Agent _ay
Signature Telephone No. PERMIT FEE: $ k_.'S
No - I I- I - 2� J of)ul \
-cl" GCS dw-1
ca3 I I eP�
7 k 4 3i (1 74 0(&,C.`-v
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
= i _7, CITY A/0 r 1- Y1 cam,,V►1 r •1 MA DATE 30-- (2o2.PERMIT#/Y-Z4 2-2-0 33 S
JOBSITE ADDRESS d,00 , o �11 g l rii 5 T'- OWNER'S NAME /'YJ C al(y
p OWNER ADDRESS 5 4 pfC TEL FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL
PRINT
CLEARLY NEW: RENOVATION: ) ...- REPLACEMENT: PLANS SUBMITTED: YES NO
FIXTURES'! FLOOR-, I gau 1 I 2 1 1 1 4 6 1 6 1 7 8 9 1 1��11 I 12 I 13 I 14
BATHTUB '
CROSS CONNECTION DEVICE - •. .
DEDICATED SPECIAL WASTE SYSTEMM
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM ,
DEDICATED GRAY WATER SYSTEM ,
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER 1 _ ,
DRINKING FOUNTAIN
FOOD DISPOSER _ ,
FLOOR I AREA DRAIN
INTERCEPTOR(INTERIOR) - ,
KITCHEN SINK
I
LAVATORY I
ROOF DRAIN --
SHOWER STALL / " I . - o I nr,� uA� I ikiS P 1 )R
SERVICE/MOP SINK NUJ ti I M A11 v t P 1 CA
TOILET / C "Trr
URINAL .71r
WASHING MACHINE CONNECTION 1 1
WATER HEATER AU.TYPES
WATER PIING
OTHER _
INSURANCE COVERAGE:
I have a grant JbiB „insufa ice policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO
F YOU CHECKED YES,PLEASE INDICATE TIE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
UPOUTY INSURANCE PGLICY d OTHER TYPE OF INDEMNITY BOND
OWNER'S INSURANCE WINNER: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 and accurate to the of my knowledge
and that as plumbing wok and Installations performed under the permit Issued for this application will be in cs with pll P the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME David Fredenburgh LICENSE# 11406 SIGNATURE •
MP -• JP CORPORATION v #2344 PARTNERSHIP # LLC;__.4
COMPANY NAME 0 F Pknnbing&Mechanical Contractors,Inc ADDRESS P.O.Box 1086 9 Stadler Street _.,_,. , 1-- . I
•.__._____ .
CITY Beichertown STATE MA • ZIP 01007 TEL 413-3236116 . ,,:^._ /
FAX 413-323.7532 CELL EMAIL dipkjmbingbelthertown@yahoo.com . .
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