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----,,? ----------- . 5 1
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1:10
e
30 -year architectural 2 x 4 rafters 16" on it
shingles over 1/2" CDX` ce nter with collar
plywoo roof sheeting
�. -; ti es 4' on center
' 1,0 .'.‘ ' 1 i
f
l oilp
exclusive detailing, ,4 1
ainted eaves � �� � "
and woo corners �
z !:= ' ' ; ''''- ' / d ouble 2 x 4 top wall
plate i,62 x 4 wall studs
t,xr 16 „ , \ : ' '
i , ... t , double 2 x 6 ,, = on center „,,„„ 41,,,
header over doors g ```
F
pressure treated floor
5/8” DuraTem T1 -11 fastened with "s
�" . syste 4 x 4 rails, joists 12"
galvanized nails, exterior ac lic
g ry on center, 5 / 8 " plyw
latex paint - or 1/2" CDX with vinyl
HOMETOWN INVOICE
S TRUCTURE S . • .
A 627 Southampton Road Order Date 9 / '' iii H Westfield, MA 01085 -1329 Estimated Completion Date 'I wee k5
(413)562-7171
Bill To . .�r , G t Jel'n Iv- 0 iic i I Notes v ?€ c-,C, I ft to i'1 t +
Address 3 7 /4,,j C ...
r I ``�
1- CvItC NA ` L L 1 !1-f li l ' r -1- eo S\/ ft' 0 .; I .
Phone # - 1 1 ? 3 .a c -, 9I'7 Cell Phone #
E -mail Address '
U In -stock Display Shed t DuraTemp T1 - 11 U ❑ Vinyl
4 To Be Custom Built Body Color /AI pfv- . ■ ; LI Body Color
)1 Delivered Fully Assembled Trim Color !n, re Corner Color
U Modular Door Color Door Color
❑ Built On site SOFFIT CHOICE (For New England Style Only) SOFFIT CHOICE (For New England Style Only)
dd . .� �, Solid T1 -11 U Body Color Perforated Vinyl ❑ White ❑ Brown
Size r '" Exposed Rafter Tails U Body Color Beaded Vinyl U White Only
U New England Series Aluminum Strip Vent U White U Brown
A Keystone Series . ' Base Price $ L i 3 CO F
Style Key s t,, t.e (t• Trc; 5 e
Code 77 — 5 Door Adjustment $ 15 0
Shingles Windows Window Adjustment $ I 5 0
❑ Dual Black ❑ 18" x 36" L:1 Ramp W 6' x 4' 5' x 4' L3 54" x 4' ❑ $ i1 / C
LI Earthtone Cedar ' )1 24" x 36"
�.
U Dual Gray ❑ 36" x 36"
U Dual Brown ❑ 36" x 40" Loft ❑ 4' x 8' ❑ 4' x 10' ❑ 6' x 12' ❑ $ I, 5 t
L Weatherwood
. ❑ Harvard Slate Window Boxes ❑ Wood ❑ 18" Color $
U Charcoal Gray ❑ Vinyl ❑ 24"
❑ U ❑ 36" -
Drip Edge: U W ❑ B Grids: ❑ W U B Shutters Li Wood Color $
Single Door Double Door ❑ Vinyl
Width 3 ' Width
Type T_ Type $
Transom Transom $
Grids: U W U B Grids: LI W ❑ B $
Hinges: U Std. ❑ Strap Hinges: U Std. U Strap
❑ Site Preparation - pad size x (subject to site evaluation) $ 7 6 `z n I`
❑ Overwidth Road Permit Fee $ - `f C ., t
lading Illustration Subtotal $ -5 ' O
1 1„ - 1)Q; I �� Sales Tax $ 9 c; . 0 &
�o � 1 OP- TOTAL $ 5 g "I ,O6
Trailer Truck
s — — Deposit $ 0 (' . ;,
�7 :II 06 . r- ---,, ,-; ,. .,
\ . , ,.. \-----., Balance $ ., - _ 1 - -.
Customer Signature-----
•
uLnn011InL II!) IUR.14100004404 Igdy LO LU11 11 :01 r.UI
NOTICE NOTICE
TO ._
TO
EMPLOYEES =? . EMPLOY c
• The Commonwealth of Massachusetts
DEPARTMENT OF INDUSTRIAL ACCIDENTS
600 Washington Street, Boston, Massachusetts 02111
617- 727 -4900 - httpJ /Www.maSs.gov /daa
As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that
I (we) have provided for payment to our injured employees under the above- mentioned chapter by iusuriug
with:
Technology lnsu sauce Co.
NAME OF INSURANCE COMPANY
ADDRESS OF INSURANCE COMPANY
TBI +WC 2011 05/27/2011 - 05/27/2012
POLICY NUMBER EFFECTIVE DATES
Berkshire Insurance 31 Court St., (413)562 -3659
Group, Inc. Westfield, MA 01085
NAME OF INSURANCE AGENT ADDRESS PHONE #
Hometown Structure 627 Southampton Rd,
Westfield, MA 01085 (413)562 -7171
EMPLOYER ADDRESS
EMPLOYER'S WORKERS' COMPENSATION OFFICER (IF ANY) DATE
MEDICAL TREATMENT •
The above named insurer is required in cases of personal injuries arising out of and in the course of employment to
furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers'
Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may
select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid
by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring
hospital attention, employees are hereby notified that the insurer has arranged for such attention at the
NAME OF HOSPITAL ADDRESS
TO BE POSTED BY EMPLOYER
•
• Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor License
License: CS 98186
-
ANDREW KURTZ
295 BROMLEY RD
HUNTINGTON, MA 01050
• Expiration: 8/3/2013
( , Tr#: 20132
?7k t. ad
= = Office of Consumer Affairs and usiness Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 159772
Type: Ltd Liability Corporation
Expiration: 5/27/2012 Tr# 296849
HOMETOWN STRUCTURES
ANDREW KURTZ
627 SOUTHAMPTON RD
WESTFIELD, MA 01085
Update Address and return card. Mark reason for change.
Address ] Renewal ( 1 Employment L Lost Card
DPS -CA1 e1 50M -04/04- G101216
•
•
The Commonwealth of Massachusetts
=-4, Department of Industrial Accidents
Ph = ;N I Office of Investigations
if= _ 600 Washington Street
" _ "►.. Boston, MA 02111
#. www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name ( Business / Organization /Individual): 14 &jr c fires
Address: (r) d 7 Sp oi h-w, n (4 ,
City /State /Zip: L3.1+• Lk.)t-f+•kC IA into 6/05'5 - Phone #: '//3 - d *7 I — 7 /
Are you an employer? Check the appropriate box: Type of project (required):
1. El I am a employer with /V 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub contractors 6. 1111 New construction
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
g Y P h f 9. ❑ Building addition
[No workers' comp. insurance comp. insurance..
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3. ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c. 152, §1(4), and we have no jj
employees. [No workers' 13.E Other CI r t_.e s so `i .
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information. .
Insurance Company Name: 812.14 s h . i .5 L.' r ` %A `" V p
Policy # or Self -ins. Lic. #: T + L + LU C ? f I E xpiration Date: S c �O 1
Job Site Address: 1 Xs-in C ; /e l< City /State /Zip: F(o c.Q MA O /0 tog)
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and /or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: . ;� Date: I O • do ' DG i
Phone #: V/5 7 / `7 )
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit /License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
• City of Northampton
Massachusetts
14 E c k
r , " DEPARTMENT OF BUILDING INSPECTIONS ` s
212 Main Street • Municipal Building
Northampton, MA 01060
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her
construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which
he /she resides or intends to be, a one or two family dwelling, attached or detached structures
accessory to such use and /or farm structures. A person who constructs more than one home in a two-
year period shall not be considered a home owner."
The building department for the City of Northampton wants any person(s) who seek to use the home
owner exemption, to act as their own construction supervisor, to be aware that by doing so you
become responsible for compliance with state building codes and regulations. The inspection
process requires that the building department be called to inspect work at various stages, which include
foundation /footings (before backfill), sonotube holes (before pour), a rough building inspection
(before work is concealed), insulation inspection (if required) and a final building inspection.
The building department requires these inspections before the work is concealed, failure to secure
these inspections can result in failure to obtain a certificate of occupancy until the work can be
inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be
responsible to make sure that the trades hired secure their proper permits in conjunction to the building
permit issued, and that they get their required inspections. Failure of the individual trades to secure
the permits and inspections as required can DELAY the project until such time as the proper permits
and inspections are made
I, �j c �-�� `�G understand the above.
(Home own /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit issued to me.
Date \ \ Z c=> C z�
Address of work location r C\� -Q
kr VV q\ d l L G
The Commonwealth of Massachusetts
Department of Industrial Accidents LL
F. " Office of Investigations
=1.11=. 600 Washington Street
* � Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders /Contractor• ectricians /Plumbers
Applicant Information ' lease Print Legibly
Name (Business /Organization/Individual):
Address:
City /State /Zip: Pho.,- :
Are employer? appropriate ,� I •
you an er? Check the PP rate box:
Y P Y P ype of project (required):
1. ❑ I am a employer with 4. ❑ I am a gen ral c. tr.. t• /
employees (full and/or part- time).* have hire the s �� -c tr. ors \--/
6. ❑ New construction
2. ❑ I am a sole proprietor or partner - listed o tae attac • ed s ee 7. ❑ Remodeling
ship and have no employees These su- contra ct•rs h. ve 8. ❑ Demolition
working for me in any capacity. employ an. hay. wor . • rs'
g Y P tY• ee • 9. ❑ Building addition
[No workers' comp. insurance comp. ins -:
required.] 5. ❑ We are a c. .oratio and its 10.0 Electrical repairs or additions
3. ❑ I am a homeowner doing all work e ` cers hay- ; xercised their 11. ❑ Plumbing repairs or additions
myself. [No workers' comp. of exe , • on per MGL 12. ❑ Roof repairs
insurance required.] . § 1(4), . d we have no
p
loy es. [No orkers' 13. ❑ Other p.. nsurance required.]
applicant that checks . x #1 must also fill out ction : owing their workers' compensation policy information.
t Homeowners who submit t • 's affidavit indicating y e doing a 1 work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this •ox must attached an ad dj1 g the name of the sub - contractors and state whether or not those entities have
employees. If the sub -con , . ctors have employees, y ust provide their workers' comp. policy number.
I am an employer tit t is providin: worke somp nsation insurance for my employees. Below is the policy and job site
information.
Insurance Company I a •
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: City /State /Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required trader Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one -year irrprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the viola r. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone #:
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of H 2. B Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other •
Contact Person: Phone #:
SECTION 8- CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: ) ll . ( ?' iU1'
License Number
d 9S 6A,(0/12- /. P nii.() MA vlosu 8'.3 -- doi3
Address Expiration Date
Signature 00 . /� Telephone
9:: Wistered rNomOmprovementiContractorc � . 7 77;' d r _ . Not Applicable ❑
i ion- trk,....^ ..S care 1 s`/ - 77 d
Company Name Registration Number
loa' So, t /v2- ...p �., Rel . 3 dog a
Address t Expiration Date
L4)e.4-04) /mg 0/05.5- Telephone ,fib, " 7]
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M C L c, 152, §
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes Vi No ❑
a y
Iv "' , Is fia)*' .e. -m 1)416n
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside; on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner " shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local a \ ng Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature 1
r * 1S
•
SECTION 5-DESCRIPTION OF . PROPOSED WORK (check all applicable) ; !
New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing n
Or Doors E
Accessory Bldg. ® Demolition ❑ New Signs [0] Decks [E] Siding [0] Other [0]
Brief Descriptiqn of Proposed
Work: c ), v o Q^C -assc n Ili- ) 0 S
Alteration of existing bedroom I Yes )C No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement Yes K No
Plans Attached Roll - Sheet
sa §l ewhouse and or;,additian.to existi.ny ousing;'compiete,. he.3followi'nq:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each '
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a OWNER AUTHORIZATION TO RE COMPLETED
OWNERS A GENT OR CONTRACTORAPPLIES FOR BUILDING PERMIT
of Cq v � [ � /+ � (144.c L � , as Owner of the subject
property t
hereby authorize Ht+rr�'1V+..,n .5 tru re.f
to act on my behalf, in all matters relative to work authorized by this building permit application.
1111111 _ 11116. /0 d d
Signat of 0 .11 ■11i Date
lv 1^ � �� ✓� S �� � ;kJ , as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
lSn �
Print Name
Signature of Owner /Agent Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
b
Existing Proposed Required by 'Zoning ,
This column to be filled in by r
Building Department
t
Lot Size ` 1 I i s
I
Frontage
Setbacks Front 1— -- i
i
Side L f R:' f 5 L: i R:''
Rear 7371
Building Height
Bldg. Square Footage r I 1 " i % I 1 s I
Open Space Footage %
(Lot area minus bldg &paved r !
parking)
# of Parking Spaces
Fill: # I i
(volume & Location) = 7
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO Q DON'T KNOW YES 0
IF YES, date issued::
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES 0
i .
€ i and /or Document #
IF YES: enter Book 1 Page
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW (3 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ` Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO 4
IF YES, describe size, type and location: !
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
• ,,, i�r p, ' ! ru
[.�r m .> ',€oiy `�s,,t % . �x - "^".- -`
CEIVE City of Northampton stat stiff Pe z
4 '/ /�) Building Department C r Cu Dr„lyeha Pe rmi t �m b
!/} 212 Main Street Se erSepc ° ua' a bi(I�° -
UC� L j)" . � W1 fin& .
Room 100 Wter v euA�rara. ��
orthampton, MA 01060 vuo �s �Sfr an
�r i� °:_
. O��' iuin : '- 587 -1240 Fax 413- 587 -1272 P a
k
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR D A ONE OR TWO FAMILY DWELLING
S ECTION 1 - SITE INFORM
T his section to be com office
1.1 Property Address: � " ; ,
C irc?C '.Ma a " L ot- "'�' 4 -. r >u v* Urte.
"k1 �, Si n IY! �
i I0rer�Ice- / ') 0/06d one Overlay Distrtct' zl
a�, ^a r sr - �
`;Elm St.District _' CB Distract . ,`.
S ECTION 2- PROPERTY OWN /AUTHORIZED A N T
G E'.
2.1 Owner of Record:
�° � Q \ � v� � e .� ") A L' s - I;n C ; r -c )€ , F !O _ .. � ✓'� A
•� 'rint Current Mailing Address: �3 3 a� - a
t � - 3 s � �
��1t: e Telephone
Signatu -
2.2 Authorized Agent: i I 1 f
Name (Print) Current Mailing Address: 1..
ice. 1 f - 7 / - 1 I (1,3-56.
Signature Telephone
SECTION 3 •- 'ESTIMATED CONSTRUCT COSTS
Item Estimated Cost (Dollars) to be Official Use.Only
completed by permit applicant
Electrical
1. Building r (a) B Perm
2. `� (b) Estimated Total Cost of '';
'Construction from. j6) . ,.
3. Plumbing Buil P er mi t Fe . ,.,. .
:.E....,,,,...,„„.:,•:r;..„•-•:42:.:;..-,,•,,•:•,,,,-„•:,i,:•-:,::;:,:',':--,'-•iV."••:,:',,-:",''':•,'••".'•''•-'-',''''' s' ':.'-'":::"' '''?''.6( -'-'-'.-•
4. Mechanical (HVAC)
5. Fire Protection
•
6. Total = (1 + 2 + 3 + 4.+,5) � �, (? 3 Check.N � � .
. =Thi Section For Offici Use Only
Buildi P is .
Issued: '
,/�f
Building Commissioner/Inspector of B uildings Date
File # BP- 2012 -0412 n ) o
APPLICANT /CONTACT PERSON MATCHETTJACQUELINE (L 0
ADDRESS/PHONE 37 AUSTIN CIRCLE FLORENCE (413) 320 -3919 0 ( 1
PROPERTY LOCATION 37 AUSTIN CIR p ` ik " c5\ ® +
MAP 29 PARCEL 370 001 ZONE URA(100) //WSP cS ` 1 t \
k°
SECTION FOR OFFICIAL USE ONLY: `C)
PERMIT APPLICATION CHECKLIST j
ENCLOSED REQUIRED DATE 4
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ]�_
Fee Paid ,/
Typeof Construction: ERECT 12 X 20 SHED
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included: Owner/ Statement or License 98186
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved Additional pe required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance* CJ
Received & Recorded at Registry of Deeds Proof Enclosed lI
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
/4—"' ,t) 2;
g Building I
Signature of Buildin Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
37 AUSTIN CIR BP- 2012 -0412
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29 - 370 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: shed BUILDING PERMIT
Permit # BP- 2012 -0412
Project # JS- 2012- 000657
Est. Cost: $4635.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: HOMETOWN STRUCTURES 98186
Lot Size(sq. ft.): 13111.56 Owner: MATCHETTJACQUELINE
Zoning: URA(100) //WSP Applicant: MATCHETTJACQUELINE
AT: 37 AUSTIN CIR
Applicant Address: Phone: Insurance:
37 AUSTIN CIRCLE (413) 320 - 3919 0 WC
FLORENCEMA01062 ISSUED ON:11/1/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: ERECT 12 X 20 SHED
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: House # Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 11/1/2011 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner
l