29-584 (7) BP-2024-0050
111 WOODS RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-584-001 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-2024-0050 PERMISSION IS HEREBY GRANTED TO:
Project# shower 2024 Contractor: License:
YANKEE HOME IMPROVEMENT
Est.Cost: 18048 INC 066324
Const.Class: Exp.Date:03/28/2025
Use Group: Owner: M TOSSWILL ANDREW R&PATRICIA
Lot Size(sq.ft.)
Zoning: URA Applicant: YANKEE HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
36 JUSTIN DR (413)341-5259 WC 9099267
CHICOPEE, MA 01022
ISSUED ON: 01/18/2024
TO PERFORM THE FOLLOWING WORK:
replace tub with shower
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:2—/ ?. Zy Rough: House# Foundation:
Final: ' v Final: Final: Rough Frame:DC 2. (Li 2'•t '. 'r
Gas: ire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final: Ail 2•Z.Z4 kip?
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
la • # .>2 -
Fees Paid: S123.50
212 Maui Street,Phone(413) i87-1240,Fax:(413)587-.1272
Office of the Bu .i' Commissioner
G/�">`-')-74,7 4D `�
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
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�,G1� z CITY lo(IE+JG� �.._ .. MA DATE 1� Ill.
o ry JOBSITE ADDRESS OWNER'S NAME
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Po OWNER ADDRESS _i_ ,. ., TEL �I/�56 3 z. 1y . FAX ^ 1
TYPE OR OCCUPANCY TYPE COMMERCIAL fl EDUCATIONAL 0 RESIDENTIAL
PRINT
CLEARLY NEW: i RENOVATION: REPLACEMENT:Lij
PLANS SUBMITTED: YES 0 NO<
FIXTURES Z FLOOR—I BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM 1 l
DEDICATED GAS/OIL/SAND SYSTEM � �
DEDICATED GREASE SYSTEM —
DEDICATED GRAY WATER SYSTEM , . 3; 6
DEDICATED WATER RECYCLE SYSTEM ! 1`l' t 'rs ? 7 _ _ F
DISHWASHER 1 1 f.___. _I
DRINKING FOUNTAIN ia I_
FOOD DISPOSER ' ,
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK
1
LAVATORY
ROOF DRAIN i
SHOWER STALL _ i
SERVICE/MOP SINK li t
TOILET �_ :�, �.
URINAL - .., .»Ρ.
WASHING MACHINE CONNECTION ji �_ , _ .t ..,_ _. ;__
WATER HEATER ALL TYPES 1 1 l
WATER PIPING __._. _ .._.__
OTHER = IF —
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES Al NO La
IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY x 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 L1,
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 corn fiance wi ertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME i INMT\!D Pi 13tmc rm - _#LICENSE# ‘'1/44A$0 SIGNATURE
MP z JP 0 CORPORATION i # t Sa PARTNERSHIP #M LLC LJ#L.
COMPANY NAME 'W131LCt: f}OMe-- ADDRESS. 3u Jos T'i 0
CITY[ " `4\ Log Cc 1 STATE,,nix ZIP 1 b 1o1-7,- 1 TEL 1 q 13-3 4,t -S Z Ste/ ...,
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