31B-189 (8) BP-2023-0005
75 GOTHIC ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31B-189-001 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-2023-0005 PERMISSION IS HEREBY GRANTED TO:
Project# 2022 RENOVATION Contractor: License:
Est. Cost: 100000 ALISHA PHILLIPS 106378
Const.Class: Exp.Date: 02/26/2024
Use Group: Owner: BIRDSALL DIEHL WILLIAM A&J
Lot Size (sq.ft.)
Zoning: URC Applicant: AXIOM LANDSCAPE &HOME IMPROVEMENT LLC
Applicant Address Phone: Insurance:
40 PINE VALLEY RD (413)320-9669 WCC5005020083
FLORENCE, MA 01062
ISSUED ON: 01/05/2023
TO PERFORM THE FOLLOWING WORK:
REMODEL KITCHEN&BATHROOM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service:i f f of I2$ ' Meter: Footings:
Rough:z//Y- Rough:t f 11K Ii'`'� House # Foundation:
f
I
Final: Final: :.)'2J Final: Rough Frame: ��-- y•L1 Z3K t'Z-a
Cell" • :t K4,
Gas: �/j J 5- Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:C"!< S-S 23 i4.2
Smoke: Final: V,k f j-1 1-2.316 k
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: S650.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
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Commonwealth of Massachusetts Official Use Only
'Y ,r — ,� Department of Fire Services Permit No.Gr '�3 D272
. _�l� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 0/D�9
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
�r All work to be performed in accordance with the Massachusetts Eleqtrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:I March 20, 2023
Cr or Town of: Northampton To the Inspector of Wires:
By this appltion the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)75 Gothic St
Owner or Tenant Jeanne Birdsall Telephone No. 320-7219
Owner's Address
Is this permit in conjunction with a building permit? Yes III No❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.�30764f lv C'
Existing Service 200 Amps 120 / 240 Volts Overhead V Undgrd I 1 No.of Meters 2
New Service 320 Amps 120 / Volts Overhead 1V Undgrd ❑ No.of Meters 2
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Bath&kitchen and service change
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 Swimmin Pool Above In- No.of Emergency Lighting
g 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 Ileac 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 Water No.of No.of No.of Devices or Equivalent
Heaters KW Data Wiring:
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: (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 _...4; LIC.NO.:
(If applicable,enter "exempt"in the license number line.) ,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 la . By my signa a below,I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent.
Owner/Agen
Signature Telephone No. I-113 3 2 D I PERMIT FEE $230.00
2 ( f Service$105.00
Renovations$125.00
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
-Aire" CITY/TOWN Northampton _ MA DATE 12-14-2022 PERMIT#Pp 202y—6(-17)-
JOBSITE ADDRESS 75 Gothic Street OWNER'S NAME Axiom Land & Home
p - OWNER ADDRESS 75 Gothic Street TEL FAX
TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL El RESIDENTIAL
PRINT
CLEARLY NEW: El RENOVATION: ® REPLACEMENT: El PLANS SUBMITTED: YES El NO El
FIXTURES 7 FLOOR-' 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 1
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR I AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK 1
LAVATORY 1 PLUMBING & CIAS iN PE.0 1 U1-1
ROOF DRAIN NORTHAFV PTOV
SHOWER STALL 1 !?PPPOVED POT APPROVED
SERVICE/MOP SINK 1
TOILET 1
URINAL
WASHING MACHINE CONNECTION 1
WATER HEATER ALL TYPES
WATER PIPING 1
OTHER
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 El 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. /a 4 z/ lw-sra,li 99
PLUMBER'S NAME Richard Scott Cernak II LICENSE# 15672 SIGNATURE
MP[ JP El CORPORATION ®# 4386-PL-C _ PARTNERSHIP El# LLC El#
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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