25A-143 (11) J8 > s AP-2023-0137
aap:BlockSLot: Cv1VIivIONWEALTf OF MASSACHUSETTS
25A-143-001 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-2023-0137 ' PERMISSION IS HEREBY GRANTED TO:
Project# BASEMENT RENO 2023 Contractor: License: t
Est. Cost: .29500 BURI BELISARIO 100030
Const.Class: Exp.Date: 10/23/2023
Use Group: Owner: Marta P Martinez
•
Lot Size (sq.ft.) •
Zoning: URB Applicant: BURIS GENERATION HI&GC
Applicant Address Phone: Insurance: . ,
31 EXETER ST (413)222-2914 , •
EASTHAMPTON, MA 01027 •r
ISSUED ON: 02/14/2023 r47, :. 4, . '
TO PERFORM THE FOLLOWING WORK:
BASEMENT RENO 1i` {
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POST THIS CARD SO IT IS VISIBLE FROM THE STREET ._:` r : "`
Inspector of P mbing. Inspector of Wiring D.P.W. :1141ding;Inspector :',.`• ,. " N
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Underground: Service: Meter: •Footin s� .
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Rough:, 5'23 Rough ' House# Foundation: ?+�,
Final: /0_y Final: 7'/3 .�j Final: Rough FraWe / ya,• (.-C 2 N''ki'? ;"
Gas: ''�' Fire Departie1" Driveway Final: - Fireplace/Chinni: •
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Rough: Oil: Insulation �� c)
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Smoke: Final: 6 4. 10 , s �•,
THIS PERMIT MAX BE REVOKED BY THE CITY OF NORTHAMPTON UPON ViOlikilOPI OIK
ANY OF ITS RULES AND REGULATIONS. 1 .� `.,T• .'
Signature: / , + " ; ,�,
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Fees Paid: $192.00 '
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C.,om.monweaIh oI///amachuoetld Official Use Only
• 1� I_} =� l Permit No. pZ 23 " Oct��
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!_ 2epariment o) are ervicea
14 4 Occupancy and Fee Checked ij5Y�-
:' . BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
FPLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -74
f • City or Town of: �j/v/A ••.,0-1-oh To the Inspector
of Wires:
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By this application the undersigned gives no- ce�of his or her intention to perform the electrical work described below.
Location(Street&Number) /g % f S/.
Owner or Tenant jt417, i di-At,di—Atne 7 Telephone No. 9/3.2.Z7-.79i
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Owner's Address SC�rnr�
Is this permit in conjunction with a building permit? Yes Non (Check Appropriate Box)
Purpose of Building VtAjty.Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead n Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: LL,Ii' h44/pl,Yn GZs.0/-�evoird 1,4,.4IL_I'
i ri pA.Se+men v7
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf T
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
gmd. 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 Heat 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 Devices or Equivalent
No.of Water Kam, No.of No.of Data Wiring:
Heaters 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:Z5VO. — (When required by municipal policy.)
Work to Start: S y/o13 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE VERAGE: 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 covers in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: kiln IG:lY1Gl'jrevx Signature % 11e73e.y LIC.NO.:_r/ 4 '..
(If applicable,enter"exempt"in the licenset't'1e,li e.) Bus.Tel.No.:
Address:/77 Wes/ S f K �f Q -99r"it • S Cj 0641.1t.Tel.No.: 'we -4.17v
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Saf "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)0 owner ❑owner's agent.
Owner/Agent PERMIT FEE: $ z c
Signature Telephone No. l
7,l 1�3 ,r--i^.vy 1 2
- ""� MASSACHUSETTS UNIFORM APPLICATION F A PE MIT TO PERFORM WORK
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�,,c ` CITY >VVn� l7Tit/,� 1 J) MA DATE C/�/ p.'}y� PERMIT�j,#� Z)013 V vg'%
`2��=` JOB SITE ADDRESS/ 1 /, OWNERS NAME i91?7 1 rl ip"/ e �C �---
GOWNER ADDRESS Tel/email
OCCUPANCY TYPE COMMERCIAL Tel
I I RESIDENTIAL Ai
T4E OR ` ,�
PRINT NEW I I RENOVATION I REPLACEMENT XI PLANS SUBMITTED YES El NO
CLEARLY ��CC
APPLIANCES Z FLOORS— BSM 1 2 3 4 5 6 7 8 _ 9 10 11 12 13 14
BOILER i
BOOSTER
CONVERSION BURNER _
COOK STOVE
DIRECT VENT HEATER - _
DRYER
FIREPLACE
FRYOLATOR
T FURNACE
GENERATOR
GRILLE
INFRARED HEATER _
LABORATORY COCKS _ _
MAKEUP AIR UNIT
OVEN p 1 MB(NG & GAS INSPL C!OP
POOL HEATER NOB T- imIPTGN,
ROOM/SPACE HEATER " D- NOT APPROVED
ROOF TOP UNIT
TEST
- M'''.
UNIT HEATER
UNVENTED ROOM HEATER _
WATER HEATER
_OTHER
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
M h .t.t._Cv.._ral I d t_t_y-'---t.,
�a4o acs ucuc,a,Cana,oily i.11At Illy Jiyi mturrc vai this N@iii5ii application VYdIV@S this re qiilfeiTi8rll.
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 ue d rate to the st f kn edge
and that all plumbing work and installations performed under the permit issued for this application will be in c f all Pertine)t v. on the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws, i
PLUMBER-GASFITTER NAME Phillip G. Hurteau LICENSE# 10963 SIGN URE
MP® MGF❑ JP❑ JGF❑ LPGI❑ CORPORATION®# 2974 PARTNERSHIP❑# LLC❑#
COMPANY NAME Phillips Plumbing& Heating, Inc. ADDRESS 15 Arthur Street
CIS, Easthampton STATE MA ZIP 01027 TEL 413-527-0340
FAX 413 527 2406 CELL 413-626-9725 EMAIL pphl5arthur@gmail.com
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MASSACHUSETTS UNIFORM APPLICATION F R A ERMIT TO PERFORM WORK
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3 37 03 PERMIT#j�I9-ZQL3—0192---
7 _'1i / CITY (tWll- �� � MA DATE
m3e
� • f� , OWNERS NAME
JOB SITE ADDRESS ( )6477..
N
OWNER ADDRESS TEL FAX
P
TYPI OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL P1 RESIDENTIAL;42
PRINT
CLEARLY NEW ❑ RENOVATION REPLACEMENT PLANS SUBMITTED YES ❑ NO ❑
FIXTURES Z FLOOR-4 BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB
r
CROSS CONNECTION DEVICE _ _ _ _ _
DEDICATED SPECIAL WASTE SYSTEM _
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM _ .
DEDICATED GRAY WATER SYSTEM _ _ _ _
DEDICATED WATER RECYCLE SYSTEM _ _ _ _
DISHWASHER _ _ _ ,
DRINKING FOUNTAIN _ _
FOOD DISPOSER _ _ _
FLOOR I AREA DRAIN .
INTERCEPTOR(INTERIOR) _ _ _
KITCHEN SINK _
LAVATORY 1 . ,
ROOF DRAIN _
SHOWER STALL I
- -PLUMBIAI46 & GAS INSPECTOR
SERVICE I MOP SINK - _ ping n tn PION TOILET _ _ _ _ APPRPVED 1\OLAPPROVED
URINAL _ _ _/�� _ _
WASHING MACHINE CONNECTION - _ _ _
WATER HEATER ALL TYPES t
WATER PIPING I _ _ _
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 ar- tr d accurate he b st of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in with all i of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ��A
PLUMvMBER'S NAME Phillip Hurteau LICENSE# 10963 I SI TU
MP El JP❑ CORPORATION®# 2974 — PARTNERSHIP 0# LLC❑#
COMPANY NAME Phillip's Plumbing & Heating, Inc. ADDRESS 15 Arthur Street
cmi Easthampton STATE MA ZIP 01027 TEL 413-527-0340
FAX 413-527-2406 CELL 413-626-9725 EMAIL pph15arthur@gmail.com
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