31A-147 (12) BP-2022-0312
161ORlilS AVI COMMON ZAALTH OF MASSACHUSETTS
Map:Mock:l,►t: .�
31 1-147-001 iTY OF NORTHAMPTON
Permit. Alt, ROM cattIlls
Repit it
1,1 R'(►\ti ( <)\IR \t'I!No \A1111 I'\Ri(iis:'IFRI it t ONIIt \('FORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit , R 1'-2022-(1312 PERMISSIONIS HEREBY GRANTED TO:
2022 RLNO LIVING RI)M1 &
Project s. LAUNDR\ Contractor: License:
IIA\I)1-NVILLi W(ft)I)WORklN(i &
Fst.Cost:
27430 UFSI(.IN INC' I I( 208
Coast.Class: E p.i ate:(14 13 21)25
Use (irYutp: Owner: (ill.lilR"I RItRI R.JERIMY & Fiti1II.Y
I of Sive (cgl.ft.)
main.- I RR I ppliearu: II A\"1)l-N\'i t I.I': Wr tt)D\ i)R KING & DESIGN INC
,nplicant Address Phone: Insurance:
35('ONL S 1 141 i)f,h0-7-40' WMZ-800-$110742 3.2(2 IA
NORTIIAMPTON. \i A 1110+,t)
ISM'ED ON:04/04/2022
TO PERFORM THE FOLLOiIING WORK:
1 I\1Nti R(N►\l RI IRI SII s\i) \l(►VC I Al NT)RY TI 2ND FLOOR
POST TIiIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
I;nderground: Sers ice: Meter: Footings:
Rough: Rough:-. 02V �a house 4 Foundation:
�i
(;as - j Final: Final: Rough Frame: v 46.3.22 )(ai�
Rough: Fire Department Min en a3, Final: Fireplace/Chimney:
Final: Oil: insulation:
Smoke - — Final: OIL 0.25-ZZ KQ
THIS PERMIT MAY BE REVOKED BY THE CiTY OF NORTHAMIPTON UPON VIOLATION OF
ANY OF ITS RULES AND RE(:U LATlONS.
Signature: ( , i q I
_ . ..
I
5I A
4,-)�..al Sinai
Fees Paid: $182.00
A°f- .
EP--2O22-o(FSo
212 Main Street. PIa'nc(413►587-1240.Fa\.141;);87-12"2
Office ice<it ttte 1.3uihtiue ('ommi'.xn.ner
e,-4 ,. -44/ 4, ) •-°--"
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
MA DATEs. l�{ as PERMIT#PP'1.0 22—0 -
�,��� CITY/TOWN �
JOBSITE ADDRESS Cfi �bvkz,12_S �v� OWNER'S NAME V-eKtV . Art
OWNER ADDRESS TELc‘VA-^$11 OloW FAX
TYPR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL v❑/
PRINT
CLEARLY NEW: RENOVATION:d REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑
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/OIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM-
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK PL.
LAVATORY
ROOF DRAIN N
SHOWER STALL NOT APPROVED
SERVICE/MOP SINK _ `��
TOILET
URINAL
WASHING MACHINE CONNECTION I
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 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 ❑ 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 coil i s nce wit all Perti ent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME L )c)36 V LICENSE# '3 9 GNATURE
MP j JP 0 CORPORATION❑# PARTNERSHIP❑# LLC Cif#O4 �1.0'aco'r,
COMPANY NAME P�Cxw - �tA�o 1.Y\V‘CC!(1tY1rri'�c�ADDRESS 1 '�.(1..St 'ItY1CLavl S
CITY 005i.q ,, STATE\XY\ ZIP Q\Oc6 a TEL -Wb V- ' to°B
N1-1--\c6 C)1 . CELL EMAIL YZ Ski-) p Nip.V1 Vf1( .E CAr
7. 21 -Z L