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39-060 (7) City of Northampton r f ‘. Massachusetts 0 r a l., > DEPARTMENT OF BUILDING INSPECTIONS - '$ ? fo r �` f.� .t.,74' 212 Main Street • Municipal Building -'. Northampton, MA 01060 INSPECTOR Louis Hasbrouck Fax: 413 - 587 -1272 Chuck Miller Building Commissioner Phone: 413 - 587 -1240 Assistant Commissioner CONSTRUCTION CONTROL DOCUMENT (For professional Engineers /Architects responsible for Entire Project) Project Title: /V &Ps/ �N6G ANO /77i nit 4 7 cx- u 6• Date: " - - ZU -- / Project Location: 3'- Fc-" 6 AT//o72 t'z . Map: Parcel: Zone: Scope of Project: A/.& T E/VANT' /= tr OL' /N ex i °ter /^v6 fu /L /A/(5 In accordance with the Eighth edition Massachusetts State Building Code, 780 CMR Section 107.6: I, \J #4MC f3K Mass. Registration # 6 `/e) eJ , Being a registered professional Engineer /Architect hereby CERTIFIES that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] ENTIRE PROJECT For the above named project and that to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable Laws for the proposed project. Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that the above mentioned portions of the work proceed in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 10.7.6.2.2: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction documents as submitted for the building permit, and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code - required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed In a matter consistent with the construction documents. I shall submit periodically, in a form acceptable to the building official, a progress report together with pertinent comments. Upon completion of the work, I shalt submit to the building official a final report as to the satisfactory completion and readiness of the project for oc " y . - r� P"' cg0Pt U ,AHe, ~_ Signature and Seal of Registered Professional ® <4, c�` „.---- E J/ /,,„), e \ J---.--,, "------- 1 * ' 4 n N!o.5908 �, • 4 a LOr,GP. :,,, , v E) 2 c Day of PC6 20 / .3 kit, �w r �b /1-As of MP,' . ►n,,1ad GENER -1 OP ID: DM .4coRC/ CERTIFICATE OF LIABILITY INSURANCE DA 02/119/19/1 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 413- 789 -3995 CONTACT Cana Blomstrom Ins. Agency Debbie Marino 868 Springfield St 9 enc NAME: y 413- 786 -7004 MVO. EMr 413 789 - 3995 ( No): 413 - 786 -7004 Feeding Mils, MA 01030 -2151 E -MAIL Joanna Williamson ADDRESS: dmarinoc�Canaryblomstrom — INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Travelers Insurance Company INSURED General Contracting Solutions INSURER B : Citation Ins Co. Inc. — — 229 College Highway INSURER C : Southwick, MA 01077 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER !(MM/DD/YYYY) IMM/DDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A COMMERCIAL GENERAL LIABILITY 680- 7229N192 06/24/12 06/24/13 DAMAGE ( ENTED R 300,000 PREMISES (Ea occu rrence) $ CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 X Business Owners PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY . LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ B ANY AUTO RVN390 08/02/12 08/02/13 BODILY INJURY (Per person) $ 250,000 ALL OWNED x SCHEDULED BODILY INJURY (Per accident) $ 500,000 X AUTOS X NON OWNED PROPERTY DAMAGE $ 200,000 AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ OED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ PROPERTY 1,060 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION NEWEN -2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN New England Dermatology ACCORDANCE WITH THE POLICY PROVISIONS. 8 Atwood Drive Northampton, MA 01060 AUTHORIZED REPRESENTATIVE e tb o AA-L L .1'Y) aA ux' © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD GENECON -01 MOSU AC °R ° CERTIFICATE OF LIABILITY INSURANCE D D/YYYY) 2//19/219 /2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER (508) 676 - 0309 NAMEA Suzette Moniz Viveiros Insurance Agency, Inc. PHONE FAX 375 Airport Road E-MAIL Co. Ext): 5O8- 676 -030 (wc, No): 508 - 324 -9147 Fall River, MA 02720 ADDRESS: smoniz @viveirosinsurance.com INSURER(S) AFFORDING COVERAGE NNC # INSURERA:GUard Group 31470 INSURED General Contracting Solutions INSURER B : 61 Forris St INSURER C : West Springfield, MA 01089 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSR S W D POLICY NUMBER POLICY EFF POLICY EXP LIMITS IMM /OD/YYYY) (MM /DDlYYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PR S a o RENTED PREMISES ( (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ _ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GE 'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG _ $ POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS NON -OWNED PROPERTY DAMAGE $ _ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE _ $ DED 1 RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER Y / N A AN YIPR OPRI E T OR EXCLUDED? ECUTIVE N / A GEWC326763 6/16/2012 6/16/2013 E.L. EACH ACCIDENT $ 500,000 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space la required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE New England Dermatology THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 gy ACCORDANCE WITH THE POLICY PROVISIONS. 8 Atwood Dr Northampton, MA 01060- AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 5. Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No O SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, 3 Q'� - ( 1 - 4 - 5.4. l'�\ . i ) 'i-i� \ .... L C , as Owner of the subject property ii r - hereby authorize �-e.. ��A\ 6-04ctxL ^C .' t' i , �s f -L n L C \vur, R ScA 6 t-} \ i ■ ) to act on my behalf, iio. - s relative to work author' ed by this building permit application. ,, ,v- I lid a a $ I3 Signs "re o • , n - e . " 11.1— Date I, 0 A otiNf r#3 Si 1 ;lr'tA\ Lc \( , h1... C- , 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 . • • - - _ .. ` ,° d pen- ies of perjury. car ((� A S 'A -* V vhlV..r- Print Nam Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: l Not Applicable ❑ Name of License Holder : - k. AV,i2,`c - E5(7�J\ ff `�. 1 License Number Z2 \ e oft 3 r. V-\L) . `J()u�t. :c., ,M` , 0 t0�1 IO \ ? t Address Expiration Date t�/�- ------ L 1) ' ; z.c - s�C''t 3/ 2c� `t Signet. a Telephone SECTION 13 - 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 ja No Versionl .7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name (Registrant): . 1,6 l Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date k / 9.3 General Contractor y �; c. Cl.x e \ CIo Y \\.k,.-N.::--f)‘- n ei >7 \ ;' , , Not Applicable ❑ Company Name: t 'Ni,) 9 Responsible In Charge of Construction Address / Ir /L zi13, 4--1--, sC'.. S ' ture Telephone Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING 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 Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO © DON'T KNOW © YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained © , Date Issued: C. Do any signs exist on the property? YES ® NO o IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO 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 O NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Version1.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions El Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs R• •fang Chan. - • / se ❑ Other Brief Description Enter a brief description here. "11 i Of Proposed Work: y \ \ SECTION 5 - USE GROUP AND CONSTRUCTION TYPE `} USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ A-4 ❑ A -5 ❑ 1B ❑ B Business ® 2A ❑ E Educational ❑ 2B F Factory ❑ F -1 ❑ F -2 0 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1 st 1" 2nd 2 nd 3rd 3rd 4 th 4"' Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system El Version1.7 Commercial Building Permit May 15, 2000 Department use only RECEIVED City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit - ( FEB 2 6 2013 212 Main Street Sewer/Septic Availability ROOM 100 Water/Well Availability L_._ ____ _._ __ _ Northampton, MA 01060 Two Sets of Structural Plans DE NORTHAMPTON : M�, os 'l 413- 587 -1240 Fax 413 -587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office Ak Dr, Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: ' c'Clktf A w.\ ' k , \..\-.c . o .130,A Q. S a..).. ) A\ Name (Print) Current Mailing Address: — d L(13 `7 - Signature .ice - Pi s 1Q9 TY own Telephone 2.2 Authorized Acient: // Name (Print) Current Mailing Address: ' � �f 13 ' 61 ` C $ . 37 I, Signature /(_/ Tel ephone SECTION 3 STIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 1 ' L p( 2 . �(- (a) Building Permit Fee i 2. Electrical Z , 000 ' o 19 (b) Estimated Total Cost of Construction from (6) 2.. 000 � � J 3. Plumbing \i' c.i aoo 00 Building Permit Fee 4. Mechanical (HVAC) oCY'D r-.,(j 5. Fire Protection Z Si 6. Total = (1 + 2 + 3 + 4 + 5) h Z (' //. 000 `}c) Check Number 02 30 ? ( 4 ;%) This Section Fo r Official Use Only �! uilding Perm Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2013 -0786 � — / o t4 (4 APPLICANT /CONTACT PERSON GENERAL CONTRACTING SOLUTIONS INC �� n w �' ` �` cY ADDRESS /PHONE 229 COLLEGE HWY SOUTHAMPTON (413) 626 -5593 , VD �`� PROPERTY LOCATION 8 ATWOOD DR - 3RD FLR - NE DERMATOLOGY MAP 39 PARCEL 060 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid �'� ,p ( � Building Permit Filled out C ?��'v / �Y I Fee Paid Typeof Construction:_BUILD OUT 3RD FLOOR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: 444,14/—LP---// Owner/ Statement or License 104921 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN 1 I MATION PRESENTED: Approved 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 3 f ljl Signature of Building Official Date 1 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. 8 ATWOOD DR - 3RD FLR - NE DERMATOLOGY BP- 2013 -0786 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 39 - 060 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit # BP- 2013 -0786 Project # JS- 2013- 001340 Est. Cost: $240000.00 Fee: $400.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GENERAL CONTRACTING SOLUTIONS INC 104921 Lot Size(sq. ft.): 194756.76 Owner: ATWOOD DRIVE LLC Zoning: Applicant: GENERAL CONTRACTING SOLUTIONS INC AT: 8 ATWOOD DR - 3RD FLR - NE DERMATOLOGY Applicant Address: Phone: Insurance: 229 COLLEGE HWY (413) 626 -5593 WC SOUTHAMPTONMA01073 ISSUED ON:3/12/2013 0:00:00 TO PERFORM THE FOLLOWING WORK: BUILD OUT 3RD FLOOR 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 3/12/2013 0:00:00 $400.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner