30B-111 f - / . _._ ..... w.. }}
Boa r " B 1 n r' t `oa [QS
Construction Supervisor License
License: CS 96159
Birthdate: 7/13/1985
Expiration: 7/1312010 Tr# 96159
Restriction: 00
EDWARD RICKEY
4 311 BRIAR HILL ROAD
VVILLIAMSSURG, MA 01096 Commissioner
� 133G' 6w,moNw4 a1 E , t fl':..rf211�L17
Board of Building Regulations and Standards '
- �'�° HOME IMPROVEMENT CONTRACTOR
1 � Registration: 150840
Expiration: 5/3/2010 Tr# 266363
Type: Individual
EDWARD RICKEY
• . EDWARD RICKEY
56 RESIVOR RD. �.G..,C.
WESTHAMPTON, MA 01027 Administrator
Lt S+}Lil.l"an t1 1 — G - /"'G /G 1v .:ftT. U 1'ft] — YAM - 'L7 tTt1'L — t 'aII LM L V OL
ACORD. CERTIFICATE OF INSURANCE DATE (MMIDDIYY) 09 -23 -09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
BLAIR CUTTING & SMITH HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
INSURANCE AGENCY ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW.
25 UNIVERSITY DRIVE COMPANIES AFFORDING COVERAGE
AMHERST, MA 01002
COMPANY
7723R A HARTFORD GROUP
INSURED COMPANY
5
RICKEY EDWARD DBA
EDWARD RICKEY AND COMPANY COMPANY
PO BOX 62 C
WILLIAMSBURG, MA 01096 COMPANY
D
COVERAGE
THIS is TO CERTIFY THAT THE POUDES OF INSURANCE LISTED SELOW HAVE BEEN ISSUED TOTHE I4SItRED NAMED MOVE FOR THE POLICY PERgO SUNCATED,
NOTrRMBTANDIN5 ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT 0R OTIIER DOCLMBIT WITH RESPECT TO YASCH THIS CERTIRCATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUcIES DESCRIBED HEREIN IS SUSJECT TO ALL THE TEISNS, EXCLUSIONS AND CONDITIONS OF SUCH MMES.
LJ•UTS SHOWN MAY HAVE BEEN REDUCED BY PAST CLASIS.
CO POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER DATE(NM'ODLYY) DATE LIMITS
GENERAL LIABILITY GENERAL AGGREGATE $
COMMERCIAL GENERAL PRODUCTS- COMP/OP AGO. $
CLAIMS MADE OCCUR. PERSONAL BtADV.INJURY $
OWNERS 88 CONTRACTORS PROT. EACH OCCURRENCE $
FIRE DAMAGE Any are tire) $
MED. EXPENSE (Any one person) $
AUTOMOBILE LIABILITY
ANY AUTO COMBINED SINGLE LIMIT $
ALL OWNED AUTOS BODILY INJURY (Per Person) $
SCHEDULE AUTOS BODILY INJURY (Per Accident) $
HIRED AUTOS PROPERTY DAMAGE $
NON -OWNED AUTOS
GARAGE UABIUTY
ANY AUTOS AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGREGATE $
EXCESS UABILITY
UMBRELLA FORM EACH OCCURRENCE $
OTHER THAN UMBRELLA FORM AGGREGATE $
WORKER'S COMPENSATION AND
A EMPOLYER'S LIABIUTY UB- 9890M980-09 09 -01-09 09-01-10 STATUTORY LIMITS X
THE PROPRIETOR/ EACH ACCIDENT ; 100,000
PARTNERS/EXECUTIVE X INCL DISEASE - POUCYLIMII $ 500,000
OFFICERS ARE: EXCL DISEASE - EACH EMPLOYEE $ 100,000
OTHER
DESCRIPTION OF OPERATKMIS/ LOCATIONS IVEHICLE9/RESTRICT10NS1SPECIAL ITEMS
THIS REPLACES ANY PRIOR CEDU1 ICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE.
RICKEY EDWARD TS COVERED BY THE WORKERS' ODMPENSAT!ONPOLICY.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CHRISZFT DELUE EXPRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
100 MILTON ST FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE 1 OELNIATION OR LIASuTY OF
ANY KIND UPON THE 0011ANY. tTS AGENTS OR REPRESENTATNES,
FLORENCE, MA 01062 AUTHORIZED 5EPRESENTA1YE
ACORD 25.5 (3/93) Rarnani Ayer
CERTIFICATE OF LIABILITY INSURANCE 09/ 9 / 09
PRODUCER (413) 549 -4971 FAX (413) 549 -4974 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Blair Cutting & Smith Ins. Agency, L.L.C. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
an Encharter Ins LLC Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
9 y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
25 University Drive
Amherst, MA 01002 INSURERS AFFORDING COVERAGE NAIC #
INSURED Edward Rickey INSURER A: Preferred Mutual Insurance Co 15024
DBA: Edward Rickey and Company INSURER B:
PO Box 62 INSURER C:
Williamsburg, MA 01096 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN
IADDI R TYPE OF INSURANCE POLICY NUMBER D EFFECTIVE Y �m LIWTS
GENERAL UABIU Y CPP0120587778 07/11/2009 07/11/2010 EACH OCCURRENCE $ 500,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100 000
PRFMISFC (Fa nrr„rnnra) $
CLAIMS MADE I X I OCCUR MED EXP (Any one person) $ 5,000
A PERSONAL & ADV INJURY $ 500,000
GENERAL AGGREGATE $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000
POLICY I—I . n LOC
AUTOMOBILE UABILTTY COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS BODILY INJURY
NON -OWNED AUTOS (Per accident) $
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
T ) OCCUR l I CLAIMS MADE AGGREGATE $
DEDUCTIBLE _ $
RETENTION $ $
WORKERS COMPENSATION AND M7111-81 OTH
EMPLOYERS' LIABILITY FR
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPIIO N OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Chri szel Del ue BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
100 Mi 1 ton St OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Fl orence, MA 01062 AUTHORIZED REPRESENTATIVE rr� tt�A,- Ladd..
Willi Dowd , Acct Exec . /NOIVA.
ACORD 25 (2001/08) ® ACORD CORPORATION 1988
v .n,
•
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 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
regulntinns The inspection_processieguires that the building department be called to
inspect work at various stages, which include foundation /footings (before backfill),
sonotube holes (before Dour). 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 -tot sssued,_ 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, understand the above.
(Home owner /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Address of work
location
i
.+. .r
The Commonwealth of Massachusetts
_ --- Department of Industrial Accidents
j irs y
— '='1 ��-=- V' Office of Investigations •
E E: h 600 Washington Street
r Boston, MA 02111
E. www.mass gov /dia •
-Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/PIumbers
Applicant Information Please Print LegibIv
J tt1ay
Name ( Business /Organization/Individual): &lwj i' C • ^ e—
Address: Pa. goat 6 R.
City /State /Zip: Za /h4,11, i4, • MA 61Ocil Phone #: 41/ 696" `745
Are you an employer? Check the if propriate box: Type of project (required): /,
1. D I am a employer with 4.. 0 I am a general contractor and I
Ployees (full and/or part-time).* have hired the sub- contractors 6. ❑ New construction
2. 1i I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling;
These sub - contractors have
ship and have. no e. Ioy ees 8. 0 Demo, on
for me in any capacity. employees and have workers'
working
Y p t'• 9 C1 Building addition
[No' workers '' comp. insurance .�. COZIf�i- iitaIlCe=
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.0 I -am'a homeowner- tiering -all -work __fee_rs_ha_ ve exercis _ed_theiz _1-1.-0--Phmabing 1epairs or additions
myself [No workers' comp. right of exemption per MGL 12.2 repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.(irOther
comp. insurance required.j
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who subrnit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
1 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:
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 nninber 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 and/or one -year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a , re
of up to $250.00 a day against the violator Ile 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 iStrue utcorr-ect __:
/ _
�/�
Signature: Date
Phone It: 7(03 .:615 - -7059 -
Official use only_ Do not write in this area.; to be completed by city or town official
City or Town: P #
Issuing Authority (circle one): -
I. Board of Health 1 Building Department 3. City/Town Clerk 4. Electrical IT • ector 5. Plumbing Ins• ector __
6. Other , _
Contact Person: Phone #:
.
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor. Nqt Applicable ❑
Name of License Holder : Gthhetra. Q
1 15 9
License Number
Pte. Qo �a ?.c/dh
!at , VA Ola % J/ jt1Q
Address Expi on to
� y /3 ,y9 -745
Signature elephone • r + : * •
9.= Registered.Home:•linprovemertit ntraetor Noltpplicable ❑
0 4. / 4 - l5 CLIO
Company Name Registration Number
4. . f _ 37/3
Address / Expiratio a
Telephone 3 7
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 ❑
The_current_exemption for "homeowners" was extended to include Owner 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
o am pton inances;Staf at - • • - e - s-General - LaaysrAnnotated.
■
Homeowner Signature �� �• Noy" '
•
(f
•
V
f
J
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House El Addition El Replacement Windows Alteration(s) ❑ Roofing
Or Doors 0
Accessory Bldg. El Demolition New Signs [0] Decks'[ 4 Siding [0] Other [o] '
Brief Descr tion of Pro os QQ ,
Work: �G�etRd dl1air-
Alteration of existing edroom Yes
g 1/ No Adding new bedroom Yes 1/ No
Attached Narrative Renovating unfinished basement Yes ]/ No
Plans Attached Roll - Sheet
§e',' 46'W fiouse:arid:ofici iitlorko'existinc housing; compiete.tP a fotiowlfic :' .
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 BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Ckt s Le. \, S. P , e Lo e , as Owner of the subject
property Q
hereby authorize a cA ` I c-V\e•/
to a. • my behalf, in all I - ers r tive to wq( authorized by this building permit application.
Signature of O r r Date
I' C kri ze 1 S. < € LL)
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.
Print Name
4 • %/ ®L _ 'dr 31 1. LAC__
Signs ure of • /r /Agent Date
,
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 _____ .._ _ _... _ ._..
Frontage _..._,._
Setbacks Front
Side L :..._._ __ R.:._.,._...,._" L:______: R _ __
Rear
Building Height
Bldg. Square Footage `___ % i
Open Space Footage ,_..._ _
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill: 5 P; 1
(volume & Location) J ... , w . _ _1 :...�._
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW ef YES
IF YES, date issued::
IF YES: Was the permit recorded at the Regis ry of Deeds?
NO 0 DONT KNOW G YES 0
IF YES: enter Books Paged i and /or Document # .
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 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
IF YES, describe size, type and location: - - .
-- " `D: — AFe trefe'any proposed c anges to or a itions o siins'intefided - tor the property ? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, ex ation, 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.
�' � fie art€rxant
City of Northampton tturf Peirn
Building Department Cu,kis a Cffi 6 atyTe,
212 Main Streeter Se aiiab y�
Room 100 i�teel}ab�ii
Northnpton, MA 01060 efso ' 9� s
phone 413-587-1240 Fax 413- 587 -1272 p.
flft�el; S pe�alj± �' �~
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
t o (D l ' :'t 6 R cS Map Lot Unit
C'€. b�1� • c t o G 2
{� a Zone ' Overlay District
EIm St District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.t Owner of Record:
— lQo l_1 ► (tom �. r to c enC�1 t 1,4k
N. e (Print) / 64a, C urrent Mailirq Addre / 413 -s SLI- 19.4
Telephone
ignature i
2.2 Authorized Agent:
G r4 . - 1 I Melee/ /°• Q&*- ,y,2 2./Ole . Z 0
Name (Print) Current Mailing Address: d'
•
if /3 - 6 95 -7as9
Signatur- Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building coo. 00 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection , I L/G_
( ? ....._.. _ _– y 6 00
Check Number /T O 4
6. Total 1 +2 +3 +4 +5 Ch e
This Section Far affrcial Use Only
Date
Building Permit Number: Issued:
Signature:
Building—Commissioner/Inspector of Buildings° - Date
File # BP- 2010 -0360
APPLICANT /CONTACT PERSON EDWARD RICKEY
ADDRESS/PHONE P 0 BOX 62 WILLIAMSBURG (413) 695 -7059
PROPERTY LOCATION 100 MILTON ST
MAP 30B PARCEL 111 001 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
Fee Paid 7 I&
Typeof Construction: REPLACE SIDE ENTRY STAIRS & REPAIR ROOF
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 96159
3 sets of Plans / Plot Plan
THE F O WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN ATION PRESENTED:
A 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
______7°-/i1---- A Z../0
Signature of Building Officia Dat•
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.
100 MILTON ST BP- 2010 -0360
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 30B - 111 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 -0360
Project # JS- 2010- 000481
Est. Cost: $4000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: EDWARD RICKEY 96159
Lot Sizetsq. ft.): 15986.52 Owner: DELUE CRISZEL
Zoning: URB(100)/ Applicant: EDWARD RICKEY
.�.y . 100 :'..1!1
�Sf e €-..•v'
Applicant Address: Phone: Insurance:
P O BOX 62 (413) 695 -7059
WILLIAMSBURGMA01096 ISSUED ON:10/6/2009 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE SIDE ENTRY STAIRS & REPAIR
ROOF
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:
Ins Illation:
Final: Smoke: Final :GiK i .
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATION?
•
Certificate of Occupancy r Signature:
FeeTvpe: Date Paid: Amount:
Building 10/6/20090:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo