29-337 (5) 4U-04 rAA 1 4ia /s1 Ubl1 KEIES & MA'I'TSON 001
e r l
ACORD CERTIFICATE OF LIABILITY INSURANCE CSR 1 DATE(MM,DD/YYYY)
. I*oRVx-1 10 25 05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Berkshire Insurance (croup, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
138 Longmeadow St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Longmeadow KA 01106
Phones413-739-5803 Fax14l3-731-0671 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA: Nautilus insurance C an
INSURER B. Arbella Proteetloa insurance C
For-V Home Builders, Inc. INSURER C: Granite State Insurance Co
Patriot •Some Imp rovement
820 Unio��pp St get INSURER D:
West Springfield NA 01069
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 RAVE BEEN REDUCED BY PAID CLAIMS.
LTR NS TYPE OF INSURANCE POLICY NUMBER pq M MM/D LIMITS
GENERAL LIABILITY EACH OCCURRENCE S ,OOO,000
A X COMMERCIAL GENERAL LIABILITY NC3 519 0 8 05/02/05 0 5/O Z/0 6 pREM ISES(Ea ocaronce) $50,000
CLAIMS MADE -1 OCCUR MED EXP(My One person) $11000
PERSONAL&AOV INJURY $1,000,000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PEAT PRODUCTS-COMP/OP AGG _11 000,0 O 0
POLICY "EC LOC —
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY NJURY $250,000
B X SCHEDULED AUTOS 291494000 11/16/04 11/06/05 (per person)
X HIRED AUTOS BODILY NJURY
X NON-OWNED AUTOS (Per accident) $500,000
PROPERTY DAMAGE $ lOO,000
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC I
AUTO ONLY: AGG S
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR � CLAIMS MADE AGGREGATE S
S
DEDUCTIBLE $
RETENTION $ $
T I
WORKERS COMPENSATION AND X I TORY LIMITS ER
C, EMPLOYERS'LIABILITY WC872-54-86 02/23/05 02/23/06 E.L.EACH ACCIDENT $100 000
ANY PROPRIETORtPARTNER/EXECUTIVE
OFF)CE"EMBEREXCLUDED? E.LDISEASE-EAEMPLOYEE $100,000
tt yes,describe under
SPECIAL PROVISIONS below E.L DISEASE-POLICY LIMIT $500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEH{CLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
AAAAO O 1 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,BUT FAILURE TO DO SO SHALL
For Proof of Insurance IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
A�RG�RE�
R rt C. Proulx
ACORD 25(2001168) 0 ACORD CORPORATION 1988
PATRIOT.
HOME IMPROVEMENT
820 UNION STREET
WEST SPFLD,MA 01089
800 458 8082
April 12,2002
To Whom It May COMM
I,Ray Foucher,President of patriot Horne Improvement,give permission to Ewald Kuchciak to sign for any and
all building permit applications in Massachusetts and Connecticut on behalf of Patriot Home improvement(Ma.
LAc.#115804,Ct. Tic.#546-192 Any questions,please feel free to contact me at the number above.
ay Foucher
President
Of Patriot
=•r
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PATRIOT HOME IMPROVEMENT d
A Division of For U Builders Inc.1
820 Union St.
W. Springfield, MA 01089 All home improvement contractors and subcontractors
i engaged in home improvement contracting, unless
1-800-458-8082 specifically exempt from registration by Provisions of
Fax 1-413-739-3332 Chapter 142A of the general laws, must be registered with
Submitted lGn/ w�or the Commonwealth of Massachusetts. Inquiries about
To: registration and status should be made to the Director,
Home Improvement Contract Registration, One Ashburton
���6 2 Place, Room 1301, Boston, MA 02108 (617)727-8598
�I
PHONE DATE r
ORK N
?
We hereby submit specifications and estimates for work to be performed and materials to be used: I
SD ��
t/""r) t
,/ !//[G-c✓' yr�L f t/f ��'1.�.�': ?a Tv� . d?�•1 F� (t� t��'C�
iAu Ga��T
IVD ��t 7'>'GE} G 42 C--ll!�-l iff
/(�cy G►i 49dw �✓�ZE-41.pr�-( r D /.�e� �B,Q
SIDING ❑Contractors/Reprooessed ❑Dealers/Co-Extrusion ❑speclattyMrgin• ❑Polymer/Llfetirne Transferable
❑ Grade Size Color Style Colonial Dutch or Clapboard
insulation' ❑Tyvek ❑Shelter Wrap ❑High Density Poly Stlrens
Strip YES O NO a Gable Vents(Louvers) YES❑ ONO
J Blocks&Dryer Vents YES❑ NO❑ Porch Interim YES❑ NO❑
siwtters YES❑ N0❑ N of Paka Color - Profile
Gutters&Down Spouts YES❑ NO❑ ❑ Lite ❑Heavy(Seamless)
ALUMINUM TRIM Wrap Window&Door Casing'(PVC with Anderson Bends) ❑Color Wrap Window&Door Casings(Flat Coll) ❑Color
SOFEFff FACIA Use Vented Soffit?YES❑NO❑ Color Cover Porch Collings? YES❑ NO❑ Wrap Beams&Poste YES❑ NO 0
Locations?
NDOWS Type? NOR'EASTER I NOR'EASTER II Grids YES❑ NO� Configuration?
How Many? D/F( -� Pic 2 LS /C LS CAS HOP OW(4 ors Lite) Bay AWN
Casing Covers)YElt NO❑ ❑Flat Coll PVC w/Anderson Bonds ColoEr n
DOORS Steel Core Entry M Style torm_ N Style
rl :Rtrin'❑ ❑'Color Ice Barrier YES❑ NO❑ Ridge Vent YES❑ NO❑ /1 rr' r A
e
SIDING ❑Contractom/Reprocessed ❑ Dealers/Co-Extrusion ❑Specialty/Virgin, ❑Polymer/Lifetime Transferable.
Grade Size Color Style Colonial Dutch or Clapboard
Insulation" ❑Tyvek ❑Shelter Wrap ❑High Density Poly Stirene
Strip YES❑ NO O Gable Vents(Lowers) YES❑ ❑NO
J Blocks&Dryer Vents YES❑ NO❑ Porch Interiors YES❑ NO❑
Shutters YES❑ NO❑ # of Pars Color Prortle
Gutters&Down Spouts YES❑ NO❑ ❑ Ute ❑ Heavy(Seamless)
ALUMINUM TRIM Wrap window&Door Casing(PVC with Anderson Benda) ❑Colon Wrap window&Door Casings(Flat Coll) ❑Color
DNDOWS Use Vented Soffit?YES❑NO❑ Color Cover Porch Ceilings? YES❑ NO❑ Wrap Beams&Posts YES❑ NO 0
Locations?
Type?� NOWEASTER I " : NOR'EASTER II Grids YES❑ NO� Configuration?
How My? D/H S PIC 2 LS /C LS CAS HOP OW(4 or 5 Lite) Bay AWN_
Casing Covers)YES NO❑ ❑Flat Coll PVC w/Anderson Bends Color � �
DOORS Steel Core Entry# Style torm Style (cJ`
ROOFS Shingle O Strip`❑ ❑co lor Ice Barter YES❑ NO❑ Ridge Vent YES❑ NO❑
WORK SCHEDULE (�
Contractor will not begin the wo*or order Ow materials barons the third dayfolowMg its signing of thin Agreement,ursine spsolMd hpri In wrMtrnl.Contractor w1111 begin the work on or about (date)
Barring delay caused by ckoumstanoes beyond Contractor's oontrol,the work will be completed by rdahj•The Owner hereby aptaasvlsdges and sq—thal the soheduhq dates are approx-.
mate and that such delays that are not avoidable by the Contractor stall not be omsidered as violations of tin AVearrol.
WARRANTY
The contractor warrants that the materiels fumished shell be free from defects for a period of following completion,and shin oonply with Itw retruiremenis,of this agreement.N the
event any defect In workmanship or materials,or damage caused by ft Contractor,his subcontractors,employees or ag",in di covered wIft one year sitar oonpledw of any job,inoludirt cleanup,the
Contractor shall,at his own expense,forthwith remedy,repair,dorreol,replace,or cum to be remedied;nspafrod,or roplsoed;such damage or such doled In materials.AN wor imam nip Is warranbeed for a
period of one year.The foregoing wsrrantles shall survive any Inspection performed In coranecdon with the agres"pon work.,
We Prose hereby to furnish terial and labor-complete in accordance with above specifications for the sum of:
K Z11 � tri����t� �-. dollars($ ).
Payment to be made as follows.
%($ ) upon signing Contract; Name of ContraotodDesignsled Registrant
PATRIOT HOME IMPROVEMENT
%($ ) upon delivery of material; stnwAddmn
820 Union Street,West Springfield,MA 01089
Plane
%($ ) upon 1/2 job completion; 1-800-458-8082
Registration No.
% ($ S3k} shall be made forthwith upon completion MA#115804 CT# 6-192
work under this contract Name of Salesman
Notice:No agreement for home improvement contracting work shall require a down payment Authorized Signature
(advance deposit)of more than one-third of the total contract price or the total amount of all
deposits or payments which the contractor must make,In advance,to order and/or otherwise
obtain delivery of special order materials and equipment 'Wb&l avQ-AMQS1Rt-IB.QreRte
Acceptance of Proposal I have read both sides of this document and accept the prices,specification and conditions stated. I
understand that upon signing,this proposal becomes a binding contract.You are authorized to do the work as specified. Payment will be made
as outlined above.
You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after tht
date of this transaction. Cancellation must be done in writing. See accompanying cancellation.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
gfuro Date /Q-Z'7-Ofl Signature Date
IMPORTANT INFORMATION ON BACK
• r
PATRIOT HOME IMPROVEMENT
REGISTRATIONS
R Board of Building Regula ions acid Standards
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home improvement Contractor Registration
w Registration: 115804
r; Type: Priyaie Com-oralion
Expiration: 4119/2006
r FOR-U BUILDRESIPATRIOT HOME IMPR. -
' ..,RAY FOUCHER
820 UNION ST
�r WEST SPRINGFIELD, MA 01089
¢S tiAM p�, o�:�•
f_Grify of Xarthamptan
�I1835AthliB[�t! �
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DEPARTMENT OF BUILDD,,1G INSPECTIONS
INSPECTOR 2'12 Main Street • Municipal Building '>o
Northampton, MA 01060
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as has/her construction sup<:r,,isor. The state defines "Homeowner" as, "Person(s)
who owns a parcel on which he/she resides or intends to be, a one a tiwo fame y _-
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 small not be considered a
home owner."
The Udil tng depart-merit tfor 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 fegulations. 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, 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
Date
Address of work
location
r
_4�111�.Y-f ATE J
F 6 UI��7 t7{ �\Tc rilja ]3toil
4. DEPARTMEI.rT OF BUILDDIC INSPECiiol S
212 Main Strcct Municipal Building
Northampton, Mass. 010GO
i
"ORIa-R'S COi IPENSATIO.N M S UR NCE A Avl"I'
-K o V AN
>>rith z principal place of businessfresidencP- zt: -
T (J'lione') j�%7�Q
I
j do hereby certif}=, under t1)c.pzins azd penalties of pe9U-FY- �tl.'.l
j ( ) I arD an employer providing the foIIowing!workcr's colnocnszti OF,, covery for my
I emplovices ivorl3ng on this job:
lob
i (Lstzr�c onr ) (Polio:
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
f the con-gaCors Esltd below wbo have the ioIIOvimg Worker's GOalptp_"26on policies:
i
(1-;=c Oi con=-,or) (InR rants- Comma )-/Pobc:i (Y\PlFduon.D.ltc)
I
(N=c of Concaaor) (Ins-a=cc Comoam-1polim, Num-c_r) (L -pira6on Date)
(Name of coaaZe[d;) (I).sur ace Corlpar,)ROL-q- N=bz-,) (repimdoo Dam)
I -
(Name of Conaaaor) (lL'St1raIl Comp
>zy/Policy Numb:r) Dal.-).
� (nII]!�:ddi�oo.I rx�,ifa ^}-w cc?uct iaforta.aoa pctaiaias w.]l Corse-s) _ _
O I am a sole proprietor and have no one wor4dDg for me.
( ) I am..a home owner performing all the work myself.
NOTE_plcsc be atxzm rfi*•M:-.0 ao spicy F=-.A=Lo CSC rtes,ork on L d.•JL^Z of
not tnott Lr ttso �i a is-imt b ttx bomoowac rcvdo a oo Lb.V xa apyartcaaa Lb c c ox Cyr-Ily 01-�-ni to t+
caip1c)-=ure-a the K ¢c--;>==i�eo Aa(GU452-a 1(5)),=-ppli=Soo by a b n— -oc,fc a bye cc pe=rt c_y--id—t1~
Ic-p 1 nm=ic of en c=ployx uad� dtn Woke.Coompoo3.-L Act_
i
uodcrzcad d-a Dopy or tbi+-w m.-d�y be rw--,ded to tbo Dopertmcoa o t Ind.zYiicl/cddrsu Off oe or l--for the
cov=es vt iGetioa end the L-i t==to Stowe Covered.-e um6t-locx3on 23A of MoL 131 an I=d to the i=astioa of crimiasl pcc-%h c=
oomi.z:i ora fiat crup to 51500.00 andfoc orup to ooc yr r Lod Cull pea+tua is`x fortxt or.Stop Wort;OrdC ead.
fl=of:;I oo.00.d_y Lp�=
i - For dq.nm=-+1 u,c ody -
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pCtm]t Nt1IDl>Cr
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SiP-ttu>:of Lia=IScJPcm-iac-- �Ce
A*.
SECTION'8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
9 2era s > kI»rne rp o alma Ant C4iYtcc�o
Not Applicable ❑
Company Name Registration Num er --
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATIONINSURANCE'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-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 buildine hermit.
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 L aws Annnotated,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
r
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'
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House [_� Addition E]_, Replacement Windows Alteration(s) Roofing
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [o] Decks [C7 Siding[O] Other[o]
Brief n of Pro ose
Alteration of existing bedroom /V Yes No Adding new bedroom Yesv No .
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa[f N'erV: ao ise'an or a d�tion 6e6 IS o slna tempi# tf fow ria:
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 FIOR BUILDING PERMIT
as Owner of the subject
property
hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
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
Signature of Owner/Agent Date
M,_.. 1 a
Section 4. ZONING All Informatibil 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 I
Setbacks Front -i I
Side L: R: L: R•'
Rear
Building Height --
Bldg.Square Footage %
i
Open Space Footage % ---
(Lot area minus bldg&paved
kin '
r--
i
#of Parking Spaces
Fill:
�?
(volume'&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW 0 YES
IF YES, date issued:'
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES 0
IF YES: enter Book Page' and/or Document#!
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES 0
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 0 NO 0
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 ,. NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
•� . ��Depaitmenfiuse only.
City of Nortf ampton tagr o Parml
Building Department - utyesua �-
k
212 Main Street
Room 100
Northampton; MA 01060
phoni�i`413-587-1240 Fax 413-587-1272 .4V,
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 --SITE INFORMATION
This section to be completed by office
1.1 Property Address:
4
Ilap n Lot unit
CGJYoG
zone overlay n,stricf.
lor -w ce
'Elm St Oistoct I - CB DLstnct
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGE NT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
Name(Print) / Current Mailing Address:
ri
Signature Telephone
SECTION 3-ESTIMATED'CONST.RUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed bv permit applicant
1. Building ] (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6`
3. Plumbing Building Permit Fee
4. Mechanical(H AC)
5.Fire Protection
6. Total=0 +2+3+4+5) Check Number
This Section For Official Use Only
to
Building Permit Number.` Date
Signature:
i
Building Commissioner/Inspector of Buildings Date
f
042296ACREBROOK DR BP-2006-0740
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29-337 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category BUILDING PERMIT
Permit# BP-2006-0740
Project# JS-2006-1138
Est.Cost: $6638.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: PATRIOT HOME IMPROVEMENT 115804
Lot Size(sq. ft.): 10018.80 Owner: PURDY MARILYN A
Zoning: Applicant: PATRIOT HOME IMPROVEMENT
AT. 228 ACREBROOK DR
Applicant Address: Phone: Insurance:
820 UNION ST (413) 731-8082 WC
WEST SPRINGFIELDMA01089 ISSUED ON:112412006 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS
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 1/24/2006 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo