32C-221 (10) 97 IIAwLI:Y s.I_ BP-2022-1370
Mah:I3(ock:Lot: COMMONWEALTH OF MASSACHUSETTS
32 2L1 001 CITY OF NORTHAMPTON
Permit: Acc Structure
PERSONS CONIRAC'TING WITH UNREUIS(ER[I) CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
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1 D1N PERMIT
Penn it BP-2022-137I) PERMISSION IS HEREBY GRANTED TO:
Project# ACC STRUCTURE
Est. Cost: 32752 Contractor: Licence:
Cons!_Class:
Exp.Date:
Use Group: HAMPSHIRE EDUCATIONAL COLLABORATIVE
Lot Sipe (sy.ft.) thwa�c: INC
'Zoning: 01 HAMPSHIRE EDUCATIONAL COLLABORATIVE
Applicant: INC
Applicant Address
Insu
97 HAWI_EY ST e:
ranee:
NORTH.AM P'IT)N, MA 01060
ISSUED ON: 10/25/2022
TO PERFORM THE FOLLOWING WORK:
4X26 ACCESSORY STRUCTURE TO RE USED AS OM('E. .SPACI:
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D,p
Building Inspector
Underground: Service:
Meter: Footings:
Rough: Rough:
House# Foundation:
Final: Final:
Final: Rough Frame:
Gas: Fire Depart►aient
Drives a} Final: Fireplace/Chimney:
Rough: Oil:
Insulation:
Smoke:
Final: vK 4/ �-' ?,3
lifts PERMIT MAY BE '�RED OKEU BY THE CITY OF NORTHA 1IPTON UPON VIOLATION OF
ANY OF ITS RULES ANI) REGULATIONS.
Signature:
` 'I V
Fees Paid: S73.00
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212 Main Street. Phone(413)5R7-1 240 _1
272
Office of the Building Commissioner
(-/7 iA) Y 51
Commonwealth o////adeachueett6 Official Use Only
P._-, � ey c� Permit No. C P 2d v — 090-8
�I .Department of Jire.ervice3
l_� . ' Occupancy and Fee Checked*/0-Y3y
'''' <07 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(MEC),527 CMR 12.00
(EASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /0/28'/Q,
City or Town of: Mori-L-tpfolJ 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) ?? gigue S+,
Owner or Tenant Collabor4tiv2 Zr eduGari*NA! Services Telephone No. ql3-581.-S7a7
Owner's Address c,.tP
Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box)
Purpose of Building Sked Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead n Undgrd n No.of Meters
Number of Feeders and Ampacity (I) Feeder ® ,Of}
Location and Nature of Proposed Electrical Work: Yrbvije. . 0A i'eeoter fr Modular $i ,J ?Ape!.
All irJ+era) W i rrNq e{oNe o� f'e.cfory
O (/ 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.o f AlertingDevices
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 KWNo.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.
Estimated Value of Electrical Work: 37 500,00 (When required by municipal policy.)
Work to Start: 10 /90,9. 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 , . BOND El OTHER El (Specify:)
I certify, under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: TMol-h� �do(N;..k; i LIC.NO.: -2>Yu 4 j
Licensee: � u+M 'g'o1'lA Ejer4l`ie J Servi4ignature / LIC.NO.:
(If applicable enter ` xembt"in the license number line.) /- Bus.Tel.No.:111 -SP7-.2'i00
Address: o�$" Vle4.sa, f 9.1 EaSlke.MPfoM, /h4. of Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of'ublic 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 agent.
Owner/Agent I PERMIT FEE: $
Signature Telephone No. l y S
j \_ 1-
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