29-227 (6) BP-2023-0609
160 ACREBROOK DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-227-001 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-2023-0609 PERMISSION IS HEREBY GRANTED TO:
Project# REPAIR 2023 Contractor: License:
Est.Cost: 20400 PRIORITY I RESTORATION 108771
Const.Class: Exp.Date:08/25/2024
LEBLANC. MATTHEW S & ROSALYN D
Use Group: Owner: DEVINCENTIS
Lot Size(sq.ft.)
Zoning: WSP tpplicant: PRIORITY 1 RESTORATION
Applicant Address Phone: Insurance:
75 MARION ST (413)287-1644 WCMA000191401
CHICOPEE, MA 01013
ISSUED ON: 06/01/2023
TO PERFORM THE FOLLOWING WORK:
REPLACE 6 DAMAGES ROOF TRUSSES AND ROOF SHINGLES
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: 6. -01 t'Z3 House # Foundation:
Final: Final•p, Final: Rough Frame: C7 7 �II
a 317-cam .-/- _
Na 2q�. _
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: QPV Insulation: 014 7- a23 ie.I P.
Smoke: 1' Final:6,V 945.23 kliG
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: A
b 5•2 • Pi •
' !
Fees Paid: S132.60
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
C2Mni.?(A) ,7rnJWN-Dn , "14311
160 acF- o `)12-
Commonwealth of Massachusetts Official Use Only
Wiz, —'L4 Z3�flS�rZ
W1! Department of Fire Services Permit No.
I t_Ec?t BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked NV
b
T.-�� [Rev. 11/99] (leave blank)
vAPPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
w c All work to be perfonned in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEAS ; ' NT IN INK OR TYPE ALL INFORMATION) Date: ((// `// 043
i . or Town of: crril c1 0,14 Pi 1 To the Inspector of Wires:
By this application the undersigned gives not' e ofrhis or her intention to perform the electrical work described below.
Location(Street& Number) h 't . ) t/ '
Owner or Tenant 11 A'" r e j 0 ai (. Telephone No. 5 t:. ).0, 774/
Owner's Address S A pi t
•
14 0` Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building ti,,,, 1 t, Utility Authorization No.
Existing Service Amps / Volts Overhead n Undgrd 0 No,of Meter!
•
New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: C ci it, i if//A to M'/i1 ery i ct d /if//TS i ti tii,�t�j
d`lc'"►/ �f i t iic4 e j / 4�� (w 7%t r i i, F S l a+i 6 .The' hi r S(. a l e cT�i Pa J
Completion of the following table'may be waived by the Inspector of Wires.
No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans Tf T
• Transformers KVA
No.of Lighting Outlets • No.of Hot Tubs Generators KVA
No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Batte 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 • Heat Pump Number Tons KW No.of Self-Contained •
Totals: Detection/Alerting Devices
No.of Dishwashers • Space/Area HeatingKW Local ❑ Municipal 0 Other
p Connection
No.of Dryers Heating Appliances I, Security Systems:
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
• Heaters Signs • Ballasts No.of Devices or Equivalent
No.ri dromassa a Bathtubs No.of Motors • Total HP TelecommunicationsoDevices
orWin :
y� g No.of Devices Equivalent
OTHER: • I
• Attach additional detail if desired,or as required by the Inspector of Wires.
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 cove 'ge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE (BOND ❑ OTHER 0 (Specify:) il a t i
(expiration bite)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: (p/ /) 0,3 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: t- {O Cello)14\.� • �(,lei,�"i C LIC.NO.: 3 3/ ) -"A
Licensee: i/q t"1 e.S (,i,t;wtiL 11 k% Signature LIC.NO.: ' 3 y 7y,)-.
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: (413 1:),ii `i 7 7 3
Address: N-ett .-I t,k4 , ]� q J�hu r. 0 ) l ir L'l v� Alt.Tel.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: $ / .9,, 5 I
_-._.-•---.Signature.....__... .__. .. Telenhone No.
bN ,/ Cr "I _f(
SSASSV tic QO8
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MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
1 1
S
_y" C IT1' #2r��>r�l� j MA DATE 0g%4� _ I PERMIT# Pe-20 2-3 'D 3 6 3
co 1 JOBSITE ADDRESS 114.0 4C{el,(Q,K 1r OWNER'S NAMEI Le
. 0 'OWNER ADDRESS L TEL: ct.Z' 7 FAX I-
TYPEbR OCCUPANCY TYPE COMMERCIAL 1 EDUCATIONAL ❑ RESIDENTIAL
PRINT
CLEARLY NEW: RENOVATION: REPLACEMENT: l,/ PLANS SUBMITTED: YES❑ NO[I
FIXTURES 1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB 11111 F I _
CROSS CONNECTION DEVICE 1 _ _
DEDICATED SPECIAL WASTE SYSTEM - 4 1—1...
DEDICATED GAS/OIUSAND SYSTEM
41
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM �_ y
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER 1 i
DRINKING FOUNTAIN — -
FOOD DISPOSER y —1
.� �L
L
FLOOR/AREA DRAIN ���
INTERCEPTOR(INTERIOR) M
,'i�IIIII
KITCHEN SINK
LAVATORY I _
ROOF DRAIN __ P & G4XS ItNkSPE 'TOM -
SHOWER STALL
SERVICE I MOP SINK N DRTr1 A MPTON
TOILET AFPR VED riO1 Ail' 0
URINAL d
WASHING MACHINE CONNECTION -
WATER HEATER ALL TYPES l
WATER PIPING
I I _ .
OTHER Z
-
-• E , 4
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Lt 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 i
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. -&' �P
PLUMBER'S NAME'6 t'. Cl`r LICENSE#�7�5� 1 SIGNATURE
MP / JP] CORPORATION /[ PARTNERSHIP❑# ]LLC❑#I
COMPANY NAME11496 6,M ADDRESS 51 Cloak 1
CITYr4 I9(em e� TSTATE ZIP Ob'� TEL ` 13"vf75-I 04'
V�i
FAX CELL EMAIL 69 ? 11, w 1�,�YJ
%r 22 - y -$
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