24A-124 (8) BP-2023-0121
5 CALVIN TERR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24A-124-001 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-2023-0121 PERMISSION IS HEREBY GRANTED TO:
Project# ADD BATH 2023 Contractor: License:
Est. Cost: 31000 Alexander Lane 117411
Const.Class: Exp.Date: 05/04/2026
Use Group: Owner: MILLER POLLIN ROBERT N& SIGRID
Lot Size (sq.ft.)
Zoning: URA Applicant: ALEXANDER LANE
Applicant Address Phone: Insurance:
57 Prospect Ave. 9174704122 6562ub-ow34856
NORTHAMPTON, MA 01060
ISSUED ON: 02/13/2023
TO PERFORM THE FOLLOWING WORK:
ADD BATH TO 2ND FLOOR
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: ' , .3 eML House# Foundation:
Final: Final: j-3 I n Final: Rough Framer.i( 3- 3 i-2.3 )'.
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final: L-2- z 3
d �L. L-6,Z5 iCia2
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: 16,t,f\ictic
juk
Fees Paid: $202.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
113 I9c— 70.-kro erZ 171/,
a
5cALVI Al 7 ac-6
_ __ (..,ommonwealtlz o////amacheedettd Official Use Only
G1 Permit No.
2epartm,ent oi5ire Serviced
Occupancy and Fee Checked -19'9. -
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
AILLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRIVY'IN INK OR TYPE ALL INFORMATION) Date: O3-679-a 3
City or Town of: /!/'c Mf1, tc,7 To the Inspector of Wires:
By this application the undersigned gives notice of Ills or her inte tion t perform the electrical work"scribed below
Location(Street& Number) 5 7 12r t'"c! ��/{e ari/tq'.�r, 'ice.1 o/ 6
Owner or Tenant Aj.b t /V d'• 5 ia/f"/1e/- G d// -,4 Telephone No. y/3`�",.9 //�r '
Owner's Address _4-7 Prrsp' d�Aue-Af r fil //'1 �./ aieer
Is this permit in conjunction with a uilding permit' Yes- No ❑ (Check Appropriate Box)
Purpose of Building ��/ ,if �e (lill i Utility Authorization No.
Existing Service Amps / V its Overhead ❑' Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity / •— OPV9
Location and Nature of Proposed Electrical Work: / /Q'a' I./Q 1 h j-p'D 7n
Completion of the following table may be.waived by the Inspector of Wires.
No.of
No. of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Trans T I�'VA
Trformers VA
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 JNo.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
Heat Pump Number Tons____KW No.of Self-Contained
No.of Waste Disposers
Totals: ��- Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Other❑
Connection I
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or E•uivalent
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 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 ❑ OTHER El (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: /Yf f.4oel 1 v,,,,q ,f/t9d,IC LIC.NO.: g.SD y07
Licensee: ,..11jCA47e( Low / Signature !i y G _ LIC.NO.: -SD y07
(If applicable.enter "exempt"in the license number line.) -G ��rs�'�us.Tel.No.• �i'-76GS
Address:f 7 )0ij A-i�,� 7,7 /Y'r7//{Owl`O. z<ze, O/D 6,0 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 agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: S 5
/20.5-(1 3)3S 03 a ` �2<,