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09-003 (6) 420 KENNEDY RD BP-2021-0604 GIS#: COMMONWEALTH OF MASSACHUSETTS'' Map:Block: 09-003 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2021-0604 Project# JS-2021-001003 Est.Cost: $545000.00 Fee: S1686.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: GOUGEON BUILDERS 075029 Lot Size(sq. ft.): 1539802.44 Owner: SALZ NORBERT Zoning: RR(100)/WSP(100)/ Applicant: GOUGEON BUILDERS AT: 420 KENNEDY RD Applicant Address: Phone: Insurance: 1261 HAWLEY RD (413) 625-9337 WC ASH FI ELDMA01330 ISSUED ON:11/17/2020 0:00:00 TO PERFORM THE FOLLOWING WORK:NEW SINGLE FAMILY HOUSE -. ("ter POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Vr44 . J•e. y•Z-2 i tl•Q Underground: Service: Meter: IIJJ Footings:6,e I Z-7'ZOZO 1l� Rough S , /. , Rough: "�� -c� �,\Mouse# Foundation: �4. i �� Driveway Final: Ok 12�10 K e Final: Final: 74-94 •a! Rough Frame:t) /. Ll- I 21 k R ( er+^, 6120%,.1 o,K 6 Lam.zi Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: 2 i L/,Q Final: Smoke: © -- 7-3c-�/ FinaLAaraa� r7•� 7 3D Zl k• THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. r .>2 I , Certificate of Occupancy Signature: I FeeType: Date Paid: Amount: Building 1 1/1 7/2020 0:00:00 $1686.00 212 Main Street, Phone(413)587-1240. Fax: (413)587-1272 Louis Hasbrouck--Building Commissioner eq-cx.FLo Q evi cif 0-vv FYtcp_ p Ra�—c 417.-3 1 0 S ei 2A I'' C Pw5-r-rz iO Nc-Lb5 To fs� C'OhlPcxrLD TLC cWece 12► e-YL I-1L 1Gri T5 ..Inaatrt,rtuStITS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PL—UM11311Pi1G W4K (LP '4''.". ;,1= CITY/TOWN L �L , MA DATE 5 ,2A-- I R:,2 j PERMIT# , -+2021--bW(t, JOBSITE ADDRESS SAX) kfI)k.)E�i t:4 _ OWNER'S NAMES Like 4 P OWNER ADDRESS TEL FAX. TYPE OR OCCUPAN Y TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL 0/1 PRINT CLEARLY NEW: RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: ES❑ NO❑ FIXTURES 1 FLOOR-' BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB 1 ii CROSS CONNECTION DEVICE I j ` DEDICATED SPECIAL WASTE SYSTEM 1 i DEDICATED GASIOIUSAND SYSTEM HI` DEDICATED GREASE SYSTEM _DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM ' DISHWASHER I f 1 DRINKING FOUNTAIN _.___ ___ i f ;.----r' FOOD DISPOSER l FLOOR 1 AREA DRAIN INTERCEPTOR(INTERIOR) i-- , KITCHEN SINK C j, LAVATORY 1 , r ROOF DRAIN , SHOWER STALL ~I SERVICE IMOP SINK PLt�MBIQJG & GAS INSPECTOR TOILET fa , NO RTHAMPTDN URINAL APPRO'ED NO APIIROV ED WASHING MACHINE CONNECTION j _WATER HEATER ALL TYPES ' WATER PIPING I ' OTHER t l l l - INSURANCE COVERAGE: policyor its substantial equivalent which meets the requirements of MGL Ch.142. YE 0 ❑ I have a current liability insurance q IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Ai OTHER TYPE OF INDEMNITY 0 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 ac rate to the best oo my knowledge and that all plumbing work and installations performed under the permit issued for this application will be• pliance wi all Pertinent p ro.rision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 1 J , ,. � / (7 PLUMBER'S NAME �Yml�1�'��i ` (�ivK ka LICENSE# -C 1 b 591 -,'IGNATURE r1 MP❑ JP❑ __--CORPORATION _ PARTNERSHIP Elf# « ( LLC[]# COMPANY NAME 0 YaLCS(i✓l VL-l.tilbU tJ� iV( ADDRESS VS--- r71 r , � '' .-5 � STATELA.r ZIP_ ► :5 7 3 TEL. 3 1CJ� ij� CITY i:7�� h,��-�L�_t�T?. 1 FAX CELL EMAIL Uyi-'4 ate/ 6 .f-z/ W" /t f6. ay. 604127/ c 24,11-6 s co/t roy-re- fog' 004(juptiorr ca.& "A-6 acra,.,,ems f}-wA i 3 11-w.4-s 0-02, 420 KENNEDY RD EP-2021-0600 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Map: 09 Lot:003 ELECTRICAL PERMIT Permit: Electrical Category: NEW 200 AMP UNDERGROUND SERVICE&WIRE NEW SINGLE FAMILY HOUSE&GARAGE Permit# Electrical PERMISSION IS HEREBY GRANTED TO: Project# JS-2021-001003 Est.Cost: Contractor: License: Fee: $200.00 POISSANT ELECTRIC MASTER ELECTRICIAN 20303A Owner: SALZ NORBERT Applicant: POISSANT ELECTRIC AT: 420 KENNEDY RD Applicant Address Phone Insurance PO BOX 113 (413) 628-3320 C-(413) 325-1607 Liability, 76 SBW IS3611 W HATE LY MA01093 ISSUED ON:1/15/2021 0:00:00 TO PERFORM THE FOLLOWING WORK: NEW 200 AMP UNDERGROUND SERVICE & WIRE NEW SINGLE FAMILY HOUSE & GARAGE Call In Date: Date Requested Inspection Date/SignOff: Reinspect?: Trench/UG: Special Instructions Rough 3 - I ' — G a 2a -— C e'a i a l R lY4 r 3 -2.1 2^• Special Instructions: Final: 7 c 'c?1 6 ' SRE Called In: 3030-2906 _ 1 7- ( P�' Signature: Fee Type:: Amount: DatePaid Electrical $200.00 1/15/2021 0:00:00 6638 212 Main Street,Phone(413)587-1244,Fax(413)587-1272-Inspector of Wires -Roger Malo