12C-111 (2) -.Lx •J, F
f
T
f
.z ....., n-♦. rte_J",::�"- ,... ..�; r.;s
- - 8
IJ
n
3
S
rJ '`
g.
3.=
r.,
1
7 _
�--tx6 Pi S�tL c
fT
�f
WPA
�eJAA :
-,4 wc-\e A.
�l 6"�itr 122,s' A(v„�o�ta�(
J
jro
ffl
oQ
,
i
Q
j?7°Spq��.
rr � _ f
r
> t;
r
ro
DATE(WW0DIY M
-AC-gRD,M, CERTIFICATE OF LIABILITY INSURANCE 08/2212 NO
PRODUCER nr. 41 73 Fsx:419.96 is THIG CERTIFICATE IS ISSUED AS A MATTER INFORMATION
A.H. RIST INSURANCE AGENCY,INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
169 AVENUE A HOLDER. ThNS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O.BOX 391
we gun fvdu-
TURNERS FAILS MA 01376
INSURERS AFFORDING COVERAGE NAIC#
i
INSURED ,-
INSURER A: GENERAL CASUALTY INS CO
MITCHELL E.CLARK INSURER B: AMERICAN HOME A83UR.CO
67 HOOSAC ROAD AU)v 2 5 e08 Imwftm 0-
DEERFIELD MA 0142 INSURER D;
N$URT E:
COVERAGES
[POLICIES,POLICIES OF 1N5URANC LISTED B Bit !SUED TO THE' D ABOVE FOR THE POLICY PERIOD IND A D, NOTWITH#TANDIN
RROU1REMENT, 'PERM Oft CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY EF, ISSUED OR
Y PERTnIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IB SUBJECT TO ALL tfit=TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
AGGREGATE LIMITS SHOWN MAY PIAVE BEEN REDUCED BY PAID CLAIMS.
TYPE GF INSURANCE POLICY NUMBEt POLICY Ei�CIM POLICY ERMRATIDN uMDg
Naliff
604ERAL LIABILITY CCX03OS669 05102108 05102109 0001) fi $ 1,000,000
X COMMERCIAL GENERAL LIABILITY nnbu>a6 r4 c w g 60,040
I8E8 ,n ewalror
CLAIMS MADE a] OCCUR MED.EXP(Any Cn0 pamon) a 5,000
A PMRSONAL A ADV INJURY s 1,040,000
GeNERAL AOOREGATE E 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPW AGO. $ 2,000,000
POLICY M PRO nT LOC
AUTOAMfLE LIABILITY C13A 00396569 07128MO 07120MB COMMNED SINGLE,LIMIT
ANYAUro (EAaoCleent) S 500,000
ALL OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (Per P—m) S
A
HIRED AUTOS
BODILY INJURY S
X NON-OWNED AUTOS (Per eeekhmt)
X MASS POLICY FORM PROPERTY DAMAGE 3
(Per eaoieent)
GARAGE LIABILITY NIA AUT20 ONi-EA AC
�:l ANY AUTO OTHER THAN EA AC 4
AUTO ONLY, AGG S
EXCESS I UVORWAA LIABILITY NIA EACH OCCURRENCE 3
OCCUR U CLAIMS MADE AGGREGATE S
DEDUCTIBLE $
RETENTION 4 i
WORKEf4s CfifAPEN9ATlON AND WC170-386+4 0110310$ 01103109 T�oR�uAM11 fi Q�EN
ENPLOY6fL$'WADFLITY E.L.EACH ACCIDENT 3 600,000
B OrF10 11INCI rNOt U LIJBVtIItECUTnre E.L.DISEASiEMPLOYEE 3 $00,000
CFCxzERMIIe7a9eR nMaCLUomO
11P�C� a u1310NS below E.L.WSEAS"OLICY LIMIT S 600,800
THBRc NIA
DESCRIPTION OF OPERATIONS ILOCATIONSAM41CLESIEXCLUSIONS ADDE13 BY ENDORSEMENT/SPECIAL PROVISIONS
THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR MITCHELL CLARK
CERTIFICATE HO ER CANC TION
NORTHAMPTON BUILDING DEPARTMENT SHOULD ANY OF Ti ABOVE DESCRIBED PORKIES 09 CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 OAYB
212 MAIN STREET WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,Our FAILURE TO
NORTHAMPTON,MA 01060 DO 30 swALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS
EMT&OR REPRESENTATIVES,
A �F.N7ATIV
Attention; LOUIS HASRROOK, 413-074272 Trace J. KUkleW+cz
ACORD 26(2M=) Certificate 0 20379 0 ACORD CORPORA71ON 1988
08/13/2008 WED 13:39 FAX 1 413 247 8338 Rugg Building Solutions IA 002/002
Sc ou Khkkdal 8-13-08
Key]Bem 70 Rick Bit 1:20prn
Northamptia Ma. 1 of 1
Keybe-ag 4.503j
WnBemnPngud 4.30322
tTrgfwADa 8$7
McRlber Data
Description: Member Type:Beam Appilcation:Roof
Lateral Bracing:Continuous Top Slope: 0.00112
Standard Load: Moisture Condition:Dry Building Code:IBC/IRC
Dead Load: 10 PLF Deflection Criteria. 1-1240 five,U1 So total
Snow Load: 50 PLF Deck Connection:Nailed Member Weight: 11.7 PLF
Filename:KYB1
Other Loads
Type Trib. Dead Other
(Description) Begin End Width start End Start End Category
Replacement Uniform(PSF) 0' 0.00" 14' 6.00" 12' 300" 10 50 Live
Additional Uniform(PSF) U 0.00" 14' 6.00" 6' 0.00" 10 10 Lillie
0 1460
146 0
Bearings and Reactions
Loostian Type input Length Mir Re*dred Gravity Reaction Gravity UpIM
1 OI 0.000" Wall 5.500" 2.288" 5850#
2 13' 8.750" Wall 5,5QQ. 2.286" 5950#
NkWmum Load One Reactions
!)sad tog ap*ft point baft(or be bade)to awfyh9 asaaers
Dead Live
1
13&V 4616#
2 13&V 461
Design spans
13' 8.750"
Product l WWI 718 Versa-L urt SP 2.0-3100 2 ply
Component Member Design has Passed Design Chooks."
Onion assumes continuous ltderal bmaing along the tap chord.
Allowable Sta ns Design
Actual Allowable
Postu"Moment 20421.1# 21275.W Ca95%� Location 6.86, Total toad D+L
Shear 5092.# 7897.# 64% 0.01' Total toed 0+1-
Max Reaotlon 59501 14438.# 41% 0' Total load D+L
TL Deflection 0.7093' 0.9153" LJ232 6.88' Total load D+L
LL Deflection 0.5503" 0.6865" LJ299 6.40 Total load
control: Poslthe Moment
DOLs: Uvew100% Snow-115% Rooh125% Wind-133%
Manufacture)"s installation guide MUST be consulted for muill-ply connection details and alternatives
Ar pradW names ore fradernum of their reapbadve omwro
r
CopyftM(C)1988 M by Keyffft EatarPdses,LM ALL RI%M RESERVED,
IMMURisim LLC
"'Pasain8 b"nod as whoa Ye nemear,troy)Dfat.beamor"r,Ow"an this drmdrg weft eppkabre de ftn edWM for Leads.Looft Conalttoao,amd 9"kled on ft!BertL The
daipn mmt be revkvrod by a qusti9ed dealgiarordosipn
08/13/2008 WED 13:38 FAX 1 413 247 8338 Rugg Building Solutions (A 001/002
--- ----�- HATFIELD LOCATION
P • 2,4 WEST STREET
WEST HATFIELD, MA O 1 088
• V: 413.247.8300
BUILDING F: 413.247.8338
c,,,t' C[„_U-IFI C)N S www.RUGGBuiLDINGSOLUnONS.COM
Transmittal
Date:
To: G1 t�.5 r At: Zook
Fax: (.fY7 162, 72—
From: 10 f-�;, /.ill
Re:
Total pages including cover:
Message:
Notice of confidentiality:Yhisfacsimile transmittal is intended for the addressee named in the above section and may contain information that is
confidential and/or pni ileged,if you are not the addressee.or f tmy pages are missing or unreadable,please contact us as soon as passible
THIS PLAT NOT FOR RECORDING PURPOSES
' 100'
I
Plan Book 72 Page 33 f
Lot #30
i
i
i
I
#70 0
O O
r
r
I
i
!
l
i
100'
Rick Drive l
i
1 HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES,AND BASED ON EXISTING MONUMENTATION,ALL EASEMENTS,ENCROACHMENTS
AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES.I FURTHER
REPORT THAT THE PROPERTY IS NOT LOCATED IN A FLOOD PRONE AREA AS SHOWN ON FEDERAL.INSURANCE MAPS FOR COMMUNITY '
NUMBER 250160#
DATED: Au s t 10, 1993 NOTE
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES
SURVEYOR: NOT CONSTITUTE A PROPERTY SURVEY.
H aF
MORTGAGE LOAN INSPECTION PLAT
RICHAJO j
� LaeArtO�srt
134605
Fkhard J.LaBarge,Sr.,Registered Prorasskxud Lana Sumeyor
110 IGng Street,Northampton,Massachusetts 01060
• -r1 ffi%�fi' =.�r".�t%J J/
h
• R
Z
I-1..dQ 1 ;
7-?.00; _ j Oj�..'G�' w ' , M i wh hW'M to 1 ei 1l
Zor
' �t ' � 0� ��1• :fall �' � '� 1 �•``� \`�`�`�°�dv��`f
is's. t
�•�}A�Z \ Ji1AL �� - -� •31 111'1111 1/i'!/
/�� a'v _ - �d6.Q0 �._ - 27ao°'�.4'' dA AtfL
———— \ lir f: lilt
,V GJ=30 JF9=G/ -a- � `�Q,oT�t.�% y_\\ \� \ �-_S;%`' •• 'illr
_. T" G.7=30=70:�f Pry! '.7- 00 \ \ - \ _- R.33o•� `1,�� \�
7p.�1D'
f!�.
IA
IsrIII' ,r � �__ �I .�-\'.� � � � ♦ �� \ \ \
GOON.N -�iY/d/JAY/ `
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
i
i
1 a`:)
1 c.AI s'�l.
y i Afui?�b 0 j
It�0 1
a-
�oo , o�
TO: FLORENCE SAVINGS BANK &
FIRST AMERICAN TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY
_ —NOTE—
SURVEYOR: ,\ �• �- THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
—MORTGAGE LOAN INSPECTION PLAT—
OF SS�cy NORTHAMPTON, MASSACHUSETTS
RANDALL �� PREPARED FOR
�ZER H RICHARD L. PROVO
#35032 SCALE: 1 "=30 ' MAY 30 , 20.03
HAROLD L. EATON AND ASSOCIATES, INC.
suRV E� REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
V I'
4 1
r\gq! I
I
F .n tr I1
r
I� ,
: The Commonwealth of Massachusetts
Department of Industrial Accidents
,., Office of Investigations
ro 600 Washington Street
Boston,MA 02111
=s "4M mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information /1 f Please Print Lezibly
Name (Business/0 rganization/Individual):
i
Address: ,L Z
City/State/Zip: )) _ ,( 1 Phone#:
Are yo"n employer?Check the appropriate box: Type of project(required):
1.Vam a employer with 'y 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g• ❑Demolition
working or me in an capacity. employees and have workers'
g y p �'• 9. 51 Building addition
[No workers'comp.insurance comp.insurance.:
required.] 5. ❑ We are a corporation and its 10.El 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.❑ Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.❑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. C!�
Insurance Company Name:
1-7.
Policy#or Self-ins.Lic.#: �� (> °� Expiration Date:
— 1
Job Site Address: /ry 0 K City/State/Zip:^ , C i I C,
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 t p an n perjury that the information provided above is true and correct.
Si ature: Date:
z
Phone#:
Official use only. Do not write in this area,to be completed by city or town of w' iaL
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 u rvisor: Not Applicable
Name of license Holder:
License Number ,a
Address Expiration Date
Signature Telephone �c (��—C)
8.Registered o e Im v n Contiractor, Not Applicable
Company Name Registration Number
AA_dress f Expiration Date 1 \
1 \ t ` ► Telephone !
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(8))
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.......14 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 1083.5.1.
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 Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all ag)plicablel
New House E:] Addition Replacement Windows Alterations) Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [1:3] Decks [C] Siding[1--3] Other[p)
Brief Desic�tio f roposed
�
Work: 1`t �t_v
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa. If New house and or addition to existing- housina, complete the followin :
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?` SL
1 I
d. Proposed Square footage of newtr construction. t, Dimensions 'IT /\ G
e. Number of stories? /
f. Method of heating? VTo Q r oh ( 1_1 Fireplaces or Woodstoves 1 \ 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 y` No. Is construction within 100 yr. floodplain Yes No
i
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, c Y � as Owner of the subject
property +� r (� / u
her authorize 1NACh l �A11 t_�
to let gh my behalf, in all matters relative to work authorized by this building permit application. �Q
1 j 3
Signature of Owner Date
I, l as Owner/Authorized
Agent hereby declare that the statements and informatiorf on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
1
Print Name
Signature of ner/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 10,O -)Y Fl- /0 060 Sr F=�-
,4 Al ,
Frontage I `
Setbacks Front
Side L:1`1'R:2—q"/a y" L32--ql'R:-2-4,75+
Rear �d' ` 4�''`�' ,
Building Height
N's �,�.f i sit F
Bldg.Square Footage q60 2 %
Open Space Footage 'A' % 19 46.a 10
(Lot area minus bldg&paved �� yt t � ;Q
parking)
#of Parking Spaces 2
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO ® DONT KNOW Q YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DONT KNOW Q YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained O , Date Issued:
C. Do any signs exist on the property? YES ® NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(Gearing,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.
Department use only
-"I Northampton Status of Permit:
Buildinrtment Curb Cut/Driveway Permit
v 212 MAtreet Sewer/Septic availability
Room 100 WaterMlell Availability
Northampton, MA 01060'. Two Sets of Structural Plans
phone 413-587-1240 Fax 413--587-1272 Plot/Site Plans
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
Map Lot Unit
zone overlay District
/ 1 Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Pri 24: Current Mailing Address:��
�d Telephone
Signature
2.2 Authorized A ent: {
Name(Print) T Current Mailing Address:
Sign re Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by rmit applicant
1. Building WC-) •�� (a)Building Permit Fee
2. Electrical Z GC (b)Estimate Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) Check Number U /
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
I ile#BP-2009-0162
APPLICANT/CONTACT PERSON KIRKENDALL SCOTT A&STEPHANIE
ADDRESS/PHONE FLORENCE
PROPERTY LOCATION 70 RICK DR
MAP 12C PARCEL 111 001 ZONE URA lweQ
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
L-tuilding Permit Filled out
L,Fee Paid a 7
Typeof Construction: Dining Room Addition MUST (146 TA v-
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION 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 1,,c oew aFlc--
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
Signature of Building 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.
BP-2009-0162
GIs#: COMMONWEALTH OF MASSACHUSETTS
�.: CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:ry: BUILDING PERMIT
Permit# BP-2009-0162
Project# JS-2009-000209
Est. Cost: $31200.00
Fee: $157.20 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: MITCH CLARK BUILDER 1393
Lot Size(sq. ft.): 10018.80 Owner: KIRKENDALL SCOTT A&STEPHANIE
Zoning:URA/WSP Applicant: MITCH CLARK BUILDER
AT. 70 RICK DR
Applicant Address: Phone: Insurance:
67 HOOSAC RD (413) 774-3923 Workers
Compensation
DEERFIELDMA01342 ISSUED ON:812512008 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 14 X 16 DINING ROOM ADDITION
W/BASEMENT(MUST INSTALL GUTTERS,DOWNSPOUTS,DRYWELL)
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 8/25/2008 0:00:00 $157.20103
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo