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18C-133 ti ADD ADDITIONAL PT2X8 ADD HANGERS TO EXTG DECK STRUCTURE \ TO JOISTS AT THIS END - 11111=11 =MI MI= - ADD (3) PT2X8 BEAM - - ADD (2) P05T5 TO EXTG DECK STRUCTURE @NEW BEAM -o (TYP) EXTG DECK - FRAMING MODIFICATONS - 1/4 " =1' BOURKE BUILDERS (413)- 548 -9214 RUSSELL RESIDENCE U1 77 LONG HILL ROAD 80 BLACKBERRY LANE ° LEVERETT, MA 01054 NORTHAMPTON, MA J s L 2x4 — \ 2x10 RIDGE BEAM (2) 2x10 ROOF BEAM (TYF) \ ✓" 2x8 1 b "OG \ � - _M ATCH EXTG OVERHANG 1 1 ROOF FRAMING PLAN FOR PORCH - 1/4 " =1' BOURKE BUILDERS (413) -548 -9214 RUSSELL RESIDENCE -� 77 LONG HILL ROAD 80 BLACKBERRY LANE ° LEVERETT, MA 01054 NORTHAMPTON, MA i t ROOF5Y5TEM ASPHALT-F6 SHNGLS 0/ SYNTH - - -- - - UNDRLYMNT 0/ 5/8" SHTHNG 0/ 2X8- - 1 6'0.G. Wl I & W I N VALLEYS -\\ ` __VINYL SOFFIT -ALUM WRAP NEW SCREEN SYSTEM - 1 ; 1 1 • EXTG DECK T ` 1 ( 1 1 1 J I - -EXTG STEPS AND RAIL NEW BEAM- \ 1 I \ , 1 L SCREEN BTWN EXTG JOIST SOUTH ELEVATION AT SCREENED PORCH - 1/4 " =1' BOURKE BUILDERS (413)- 548 -9214 RUSSELL RESIDENCE Val 77 LONG HILL ROAD 80 BLACKBERRY LAN E ° LEVERETT, MA 01054 NORTHAMPTON, MA J r t I . �4 1/2" +/ SCREEN SYSTEM I / NOT SHOWN HERE / NEW SCREEN SYSTEM 'IN 1111 NEW PT4X4 W/ 1X ___ WRAP AND ALUMINUM � 11 (TYP) ; I • EXTG RAIL t I ' I I n NEW MIDSPAN l BEAM BEYOND - --EXTG PT POSTS 1--- , EAST ELEVATION AT SCREENED PORCH - 1/4 " =1' BOURKE BUILDERS (413)- 548 -92U RUSSELL RESIDENCE 77 LONG HILL ROAD 80 BLACKBERRY LANE O LEVERETT, MA 01054 NORTHAMPTON, MA r � g L 1 BATHROOM: -NEW TOILET -NEW VANITY L i - REPLACE TUB W/ SHOWER UNIT -NEW LINOLEUM FLOOR Z �' -KEEP TOWEL BARS W U � Z}. Z' cii az 0 a W Q �.. .. RELOCATE BB HEAT Lli CO \ -i .1 s J U Q D L., / ' 0 ® , m 04 v, 1 O O cz‘ RELOCATE / EXTG DOOR ® (2)2x10 HEADER -- \ 1 RELOCATE t�-- / LANDING AND ___... -- - -- -- /'"" STEPS TONEW as DOOR LOCATION I NEW (2) 9 1/4" 1.9E .% CO LVL FLUSH BEAM t - ABOVE I b, b ADD NEW In / Q �- RAIL @ STEPS t HALF WALL HT TBD— / UP M �___,-/ a EIS O O r /-, Li cL m v„...----.....„ w V � - - Z LLI 5/7/10 Page # FIRST FLOOR PLAN ft BEDROOM 1/4 " =1' L • REFERENCE: BOOK 3172, PAGE 166 PLAN BK. 67, PG. 59 NOTE: o SUBJECT TO EASEMENTS AND shed RIGHTS OF WAYS OF RECORD. ' -H b) N LOT #11 N t Pot co,. To u_ -J C .cIUSTR..w. -t'St. G W b ' / // i r > H #80 > T N / , Z J � V M m co H 111.O1'± x -< SURVEYOR ?O /4-J l 99, �. I n a t" °F kis I I RANDALL PREPARED FOR E. � ZER y ' MARGARET H. & JOE W. RUSSELL, JR. /3 5032 SCALE: 1"=40' JUNE 15, 2009 �' r HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY -- MASSACHUSETTS • 4.( .P, BOURKE J BUILDERS ritgl DESIGN & CONSTRUCTION Russell Addition and Remodel 80 Blackberry Lane Northampton, MA 01060 SUBCONTRACTOR LIST FOR INSURANCE AFFADAVIT Lee Edelberg, Electrician 263 Long Plain Road Leverett, MA 01054 Worker's Comp Policy #: AWC7004354012008 Havey Rivard, Plumber 189 Long Plain Road Leverett, MA 01054 NO EMPLOYEES Richard Fay, Drywall 60 Chapel Road Amherst, MA 01002 NO EMPLOYEES Peter Waters, Painting 88 West Street Wendell, MA 01379 NO EMPLOYEES 77 Long Hill Road, Leverett, MA 01054 • 413.548.9214 www.bourkebuilders.net Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub - contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self- insured companies should enter their self - insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit /license number which will be used as a reference number. In addition, an applicant that must submit multiple permit /license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617- 727 -4900 ext 406 or 1 - 877 - MASSAFE Fax # 617 -727 -7749 Revised 4-24-07 www.mass.gov /dia The Commonwealth of Massachusetts .�. Department of Industrial Accidents _ Office of Investigations 600 Washington Street ali MOM .1011.6 Boston, MA 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print Le2iiblly Name ( Business /Organization/Individual): NL k. (lc)LUe.k_ ,l L. 6E >i "�-� -- �`�� Address: ') 7 l.�'�&; * City /State /Zip: L J � tA,kt 4 - 0105 4 Phone #: 4t5 548 ° ZI 4' Are you an employer? Check the appropriate box: Type of project (required): 1. [ I am a employer with 4 4. [x I am a general contractor and 1 ❑ employees (full and/or part- time).* have hired the sub - contractors 6. New construction listed on the attached sheet. 7. [ Remodeling 2. ❑ I am a sole proprietor or partner- ship and have no employees These sub contractors have g. ❑ Demolition working for me in capacity. employees and have workers' g any p ty 9. [g] Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.1g Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.( ] 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 employees. [No workers' 13.0 Other 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: 'NO^I. A 5u oktx.5C.- Q0. Policy # or Self -ins. Lic. #: Expiration Date: of 1 Job Site Address: 0 -Vick. tQt-`f City /State /Zip: NC) X4 #W 4TOt 1 Mk' 0(060 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 c i under the pains and penalties of perjury that the information provided above is true and correct. Signature: `""�-- a, Date: J fiz/ I° Phone #: 1' '- 5 +8-ct u ¢ 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 #: , SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ PAW- �/� Name of License Holder : Y A - I • License Number 7 7 Low G Lc. a Liuccoierc 04, Glci5et ..S 5- ( 7 Address c-2? Expiration 1 G �( Date Signature Telephone 1 9. Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number ` ∎14. .kk-- Oce4.5 LLB Address Expiration Date 77 LA 6, a 2� l..s -t-�; tuft - ��v� - ne 61 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) 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 No ❑ 11. - Home Owner Exemption 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 fans 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 Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature . , , , Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size c 3Q3 pLYeS • .3 14o-e_5 Frontage Setbacks Front _3S 3 Side L: 1 R: 20 L: ( Rear 36 J � 6 Building Height I /6/ 0,440 Bldg. Square Footage /$ 9 % i 9 ,o Open Space Footage (Lot area minus bldg & paved / f O t / 5 O6b f5.10 parking) # of Parking Spaces Fill: I volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES Q IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO #®i DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO t 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 j 9 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. , + 1 ■ SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition En Replacement endows Alteration(s) 5ifj Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [Q Siding [❑] Other [❑] Brief Description of Proposed 4 D yze- Poa.cA.k- 1 R-- 9 44x al) E.14, E$IYfLJC, I Edc_ ' Work: I-Do 4 wk►..)zc .,:s le vtov 1.i-- 9 Uc i1 1 NW(' ALL_WieraR i 4 Y2.. 1 -04-W . t IS cttIc.: j /2`tatiovfe. rut. k 4 LAZE ciit'H SFio -1 INI ise+FC, i3o4 ; lntvrl4W NQ`.c;'TL∎ r �t v besikhiNi -`o{' Alteration of existing bedroom Yes No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes _No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family X Two Family Other b. Number of rooms in each family unit: (: Number of Bathrooms Z c. Is there a garage attached? ye 5 1 t d. Proposed Square footage of new construction. vgZ. S 5, F. Dimensions / �^ % / p'ORCI\ TO (ow fr i e. Number of stories? Ot EA t VV 6 /5 ' )(/' 5' ` �j c� f. Method of heating? N/ 1A-` Fireplaces or Woodstoves N Number of each g. Energy Conservation Compliance. N) Vk' Masscheck Energy Compliance form attached? k/ ) IA h. Type of construction Wan A &adnJ. i. Is construction within 100 ft. of wetlands? Yes X No. Is construction within 100 yr. floodplain Yes y No j. Depth of basement or cellar floor below finished grade N' A- 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 BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I . -S9 EL4L , as Owner of the subject property �A \ \ Ou-AkS -- ..4 xv�)cE t l u C hereby authorize 7 , to act on my behalf, i ters relativ t w authorized by this build permit application. [ ' 1V q, rte ignature of Owner Da I, PAW— I. ,DUM .._. , as.QamwertAuthorized 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. Print Nam GL, CZ- .AIt.t.. -- _51 i 2- I'D Signature of Owner /Agent Da 1 r r Department use only , City of Northampton Status o Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability r e.. \ Room 100 Water /Well Availability k v Northampton, MA 01060 Two Sets of Structural Plans t P, s , phone 41 3 - 1240 Fax 413- 587 -1272 Plot/Site Plans ` y. Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office Q uy cje:B _0-1 (,v0\-)E Map Lot Unit )),CYZ'C1-\)4r1itA / W' Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: ski k W�veYe- 14 -s1C ��S�� Z 3 1'V1 (tYC / c c � attak / 61x1 02 me ( Print) r Current Mailing Address: Sig ature Telephone . Authorized Agent: P \. ? x � A r 6 4 - C i •l�. S Si <t s, l l c 77 lr�w6 k� I,O. Liu i�tsZ arc, (>r/l�4 6161 - Name t) Current Mailing Address: 0,...„....__Q _ ( ..�. v -<.�._ 4(3 -- 548 -_(. 2-i 4 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building , °C)() r o (a) Buildi (; ng Permit Fee 2. Electrical (b) Estimated Total Cost of I Con struction from (6) 3. Plumbing 660, ©® Building Permit Fee 4. Mechanical (HVAC) 011‘C 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) I t 00. 0 Check Number 02-- 01 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date r File # BP- 2010 -1016 APPLICANT /CONTACT PERSON BOURKE BUILDERS ADDRESS/PHONE 77 LONG HILL RD LEVERETT (413) 548 -9214 PROPERTY LOCATION 80 BLACKBERRY LN MAP 18C PARCEL 133 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 'j� ' Oa Fee Paid 0 Typeof Construction: CONVERT DECK TO ENC PORCH,WINDOWS,RENO BEDRM,1ST FLR BATH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 055137 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: /(pproved Additional permits 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* Received & Recorded at Registry of Deeds Proof Enclosed 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 _ S./ /to Signature of Building a facial 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. 1 80 BIJ CKBERRY L ` BP- 2010 -1016 GIS #: COMMONWEALTH OF MASSACHUSETTS Map :BIck: 18± 18C-113 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -1016 Project # JS- 2010- 001497 Est. Cost: $31000.00 Fee: $186.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BOURKE BUILDERS 055137 Lot Size(sq. ft.): 17119.08 Owner: RUSSELL JAY & MARGARET Zoning: URB(100)/ Applicant: BOURKE BUILDERS AT: 80 BLACKBERRY LN Applicant Address: Phone: Insurance: 77 LONG HILL RD (413) 548 -9214 Workers Compensation LEVERETTMA01054 ISSUED ON :5/21/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: CONVERT DECK TO ENC PORCH,WINDOWS,RENO BEDRM,IST FLR BATH 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 5/21/2010 0:00:00 $186.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo ILACKBERRY LI BP- 2010 -1016 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C -133 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -1016 Project # JS- 2010- 001497 Est. Cost: $31000.00 Fee: $186.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BOURKE BUILDERS 055137 Lot Size(sq. f.): 17119.08 Owner: RUSSELL JAY & MARGARET Zoning: URB(100)/ Applicant: BOURKE BUILDERS AT: 80 BLACKBERRY LN Applicant Address: Phone: Insurance: 77 LONG HILL RD (413) 548 -9214 Workers Compensation LEVERETTMA01054 ISSUED ON :5/21/2 01 0 0 :00 :00 TO PERFORM THE FOLLOWING WORK :CONVERT DECK TO ENC PORCH,WINDOWS,RENO BEDRM,1 ST FLR BATH 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: _. -,r House # Foundation: ' y ,, Driveway Final: l: Finalig : , Final: ` � " I ° Frame: c�'�S, (3 I I +� Rough Frame. � Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: ok -' 5-16 C r/ THIS PERMIT MAY BE REVOKED BY THE CITY • "'NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REG 1 • . I • �� 0 gs• 40VA410 Certificate of OCCUpanc ` �� ' Signature: FeeType: Date Paid: Amount: Building 5/21/2010 0:00:00 $186.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo