29-616 (3) 615 BURTS PIT RD BP-2021-0790
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-616 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: REPAIR BUILDING PERMIT
Permit# BP-2021-0790
Project# JS-2021-001336
Est.Cost: $62955.00
Fee: $409.50 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: BARRON & JACOBS 60475
Lot Size(sq.ft.): 127630.80 Owner: O'BRIEN JEFFREY& SUE C BRIN-O'BRIEN
Zoning: Applicant: BARRON & JACOBS
AT: 615 BURTS PIT RD
Applicant Address: Phone: Insurance:
70 OLD SOUTH ST (413) 586-8998 Workers Compensation
NORTHAMPTQNMA01060 ISSUED ON:1/12/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:repair from tree damage
OP' 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:
Rough: House# Foundation:
Driveway Final:
Final: Final: 3-'a1 'J i
GO m Rough Frame: ;?,/e:. 1-1- 7, _i ye
Gas: Fire Department Fireplace/Chimney:
Rough: Oil:
Insulation: 4
final:( ' Z Smoke:
c,D Final: d IC 8-10-23 V ie 0
THIS PERMIT AY BE R.' �'�� j NORTHAMPTON UPON VIOLATION
ANY OF ITS RULES ANT f OF 1
Certificate of 9ccl. y 6 T i
ature:/ 2 f
Illk
ow FeeType: Date Pah._ -
tommBuilding 1/12/20210:00:00 $409.50
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck-Building Commissioner
CI °"6q 4g y6
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
•
a
47 CITY /L iiv1/1147L MA DATE '124S-P.-` PERMIT#Ga di- GOU�JJ 7
JOBSITE ADDRESS (.7 Lit 1,i Qi�7 12( OWNER'S NAME j�;? ��i 6 C,t,
GOWNER ADDRESS
TEL 6:-)7: `' `1 ( 5 FAX
TPRINYPE OTR OCCUPANCY TYPE COMMERCIAL 1 EDUCATIONAL RESIDENTIAL
CLEARLY NEW: RENOVATION: REPLACEMENT: * PLANS SUBMITTED: YES NO
APPLIANCES 1 FLOORS—. BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER
BOOSTER <2e,
CONVERSION BURNER
COOK STOVE
•
DIRECT VENT HEATER ��
•
DRYER
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN PLUMBING-& GAS 1NbPECTOP
POOL HEATER NOH I HAMP ION
ROOM/SPACE HEATER APPROVES NOT APPROVED
ROOF TOP UNIT
TEST
UNIT HEATER
UNVENTED ROOM HEATER
WATER HEATER
OTHER
62$ 'Pe
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 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 acc e to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in corn nce all Pertine rovision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ti
PLUMBER-GASFITTER NAME Mark Wendolowski LICENSE# 12394,
ATURE
C.
MP MGF JP JGF LPG' CORPORATION # PARTNERSHIP # LLC ' # 3675
COMPANY NAME: Express Plumbing, Heating & Solar Ilc ADDRESS 131 Prospect St
CITY Hatfield STATE MA ZIP 01038 TEL 413-626-3862
FAX CELL EMAIL
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