17B-018 r V t�C�!/Y �J 4J4✓J Ci' Xons `isiN 1. i./ '°./L6 L Board of Building Regula and Standards
1?-
One Ashburton Place - Room 1301
=` Boston, Massachusetts 021.08
Home Improvement Contractor Registration
Reqistration: 151711
Type: Private Corporation
Expiration: 6/26/2008
STURDY HOME IMPROVEMENT
ADAM LUCEY
PO BOX 51033
INDIAN ORCHARD, MA 01151
Update Address and return card. h1ark reason for chan�,.v.
Address Renewal Emplovment I.,ost ( :,, -
DPS-CAI 0 50M1-05/06-PC8//4901
ff7� d..nC-Jl?))tlr ltf./rPliL�/t L dLU 33CCClIll3E,b .
:��• _-,_ Board ol'Building Regulations and Standards
License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 151711
Board of Building Regulations and Standards
-r Expiration: 6/26/2008 One Ashburton Place Rm 1301
Type: Private Corporation Boston,Ma.02108
STURDY HOME IMPROVEMENT
ADAM LUCEY
34 FRONT ST
iNDiAN ORCHARD. MA 01151 Deputy Administrator Not valid without signature
,'filar• F%Dora✓xrr>rttir'm✓s""� r/,. ad'c ,snrr_;etdJ
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 093603
Bi rthdate: 08/07/1965
Expires: 08/07/2009 Tr. no: 93603
Restricted: 00
DAVID DIAZ
270 TREMONT ST r
SPF AGFIELD, MA 01104
Commissioner
FROM : MARY BENANDER PHONE NO. : 678 361 5561 Sep. 30 2005 09:13AM Pi
J 'S Cc?
VOWW.Sturdyhorne.com AII home improvement contractors and subcontractors
P.O.Box 51033•Springfield.MA 01151 engagW!nhoffwimproveffwvtcontradWcjunlasspoeftatty
D exempt from r tration b Provisions of Chapter 142A of the
AM
1-877- b94nft0tT Fe 1Hom* Improvement Contract
413-543-1681 t Place,Room 1301,Boston,MA
VA RE 1143M
Mf �edteri ' ►!
cT .111SL5 Fiy ir ;ia
DATE
-_(41 Fax`f-413-543-3200
o �! 611 ya,
We hereby sutxmt spsciticatione and estimates fpr work to be paAormad and materlaia w be used:
Nit' SIR1P f )WG 0r-5014045 0r-5014045�
s5j t,f06
*;wl.
`'wbjw.L R� W i" P)ry,° PO
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'Nlt,i� Sp y �NS7Ai-.�. CtR�strvs � R40FCM VV"'Vr 1,}av��A.�`t
,11 il^t.r SUPPLI :TN•��lyt�.t..
,j,/tt..t, s��`� � i1NJ�MLL �`.+tLI wPJ�vV � .°��..+tr�`4 j711G �a`�'t• ':� :y _r�
�t+tiv. SJPPu{ S SSt'�{, 4LL N740
it,(tides 1 ,• . .. ...... .....
�{vCLJ�fS rj-�j�)� 1=�t(.�;titStliL to '1k. t, ►w..xz� �rv��G,+t'c�C. -..
Av a-l- So� k Au, N Q ijet,t� C e Vss Ud4 N.,es a fikNt Dr- 4601A
.L� *kf. (yu $146 C71' 1460r) 6,01 t Y►Ua i�/�y
vl- , �.ob y 1+ "W ,w k, C.4e r,* t�U+�, ;jlr jp - Qp b A*V, l,(
o�'Si*34 Etvtfi'ds ge A rD 97 4 p./� Pf` rVovrJd
lrpx+-
�t t�tla'�fS Au. f oTf tlavS t L4ha,Tex �3)5i'�J � or- W t 6,Bw if•116 N a%D
sIDINO O Contractordgeprocessed O DealanwCoadrLsion U Spsciariylvit" O PWymeryW0me Trans is
Grade Size cola
Insulation U Tyvek U Poor Board O High Density Poly StkoneGreen Board
Strip YES U NO u Gwo vents(Lowers) YES O NO Q
J Blocks&Dryer Vents YES O NO O Porch Irxsriors YES O NO U
Snuhsrs YES D NO O •of Pahl Color Louvered or Raised Patel
Gtftm 6 Downspouts YES O NO O O Lira D Heavy(SeanNsa)
AL UMMUM TM Wrap Wkxlow 3 OOa Casings(PVC wM ArW w Bends)CObr Woo windows&Owr Casings(Flit Coil)Color
SOFFIT FACIA Ussd Vented SOW YES O NO O Color Cover Porch CeMNV? YES 0 NO O Wrap Beams&Ponta YES O NO O
Locations
WINDOWS Typo Slimine Momotaire Grids YES NO Configuration
Mow Many DrH_2 LS—SLS_CAS— HOP_ BOW(4 or 5 Me)_____ Say_AWN
Casings Covers YES O NO O Fiat Coil O PVC with Anderson Ballds Cokx
DOOM ROOFS Sh"Ie ld 3rriDd��CMw�}y 1y�lL� _ Ica Owler`YES: NO O Ridge Yea YES U NO O
00_
Ws Propow i moby to fwnish anawMs a�ngd�"w-cesrptsss in aceerdencs wNh atlew s'ppea teatiera for the sum of: �CZ�
`0 �`'. .__ ddlars(S `)yrCY[5 1.
ACCEPTANCE OF PROPOSAL:TIN atv"prismm spwjft sons we eondlaons we sepafactory ane are hm"accapteM You we authroised m dD
work",pwithd.Payment W M be 113 0~a(tt mn lof job,and bNsnea due upon oaMtistt m l
Data: Signature:. ,,e��k�!`! — w_Phon4 M 4/13
9-28-2006 7:S9AM FROM ORCHARD INSURANCE 4135d3d9lb
DATE(MMffiDIYYYY1i
ACORP, CERTIFICATE OF LIABILITY INSURANCE 09/08/2006
PRODUCER (411)543-3344 FAX (413)543-4918 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ORCHARD INSURANCE AGENCY HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
144 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O.BOX 51088
INDIAN ORCHARD, MA 01151 -INSURERS AFFORDING COVERAGE NAIL
iNsumE6 .Sturdy Home DWrovement, Inc. INSURER A: Western World Iris.
P.O. Box 51033 INSURER 0. Granite State Insurance Co.
Indian Orchard, MA 01151 I;6VRER C:
INSURER 0:
INSURER E,
COVE RAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TH_—EIN-S— RED 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 HE 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 CLAMS.
FEC -il
MR PNO A 9 TYPE Of INSURANCE POLICY NUMBER (1111420nVE a—LICY—EMPTIR—At—CON 0ML
GENERAL.LIAMUTY NPP979233109/02/2006 08/02/2007 EACH OCCURRENCE s 300 0.
ir ,
COMMERCIAL GENERAL LIABILITY EYO 4,iN io M 3 100.0m
CLAIMS MADE OCCUR MED EXP(Any as e parson) 5.000
A PERSONAL&ADV INJURY
300,000
GCNERAJ.A,3cA63ATE 1 600,000
CN.J.AGGREGATE LIMIT APPLIES PER' PROOLIC18•COMPIOP AGG 5 600,000
E]POLICY E],P,%O, F-�LOC•
AUTOMOBILE UAGILITY COMBINED SINGLE LIMIT
{Em accidunU
ANY AUTQ
ALL OWNED AUTOS OODILY INJURY
6CHf0ULEOAUTOS (Per ww)
HIREOAUTOS BODILY INJURY
(Per socioent)
NON-OwNeD AUT03
PROPEATY DAMAGE
(F-ef accident)
GARAGE LIABILITY AUTO ONLY FA ACCIDENT 3
ANY AUTO OTHER THAN 'ACC $
AUTO ONLY, AGG is
SXCS$S/VM81tELLA LIABILITY EACH OCCURRENCE Is
OCCUR CLAIMS MADE AGGREGATE
DEDUCTIBLE
RETENTION
WORKERS COMPENSATIO14 AND 10# 13102 06/20/2006 06/70/2V67-7 I WC STATU- I IOTH_
EMPLOYERT LIABILITY
E.L,EACH ACCIDENT S 100 000
ANY PROPRIETORMARTNEWEXPCUTIVE --L--------=ZZIZ=
O;nCERfmEM8GR"CLLIOED? C L.DISEASE-EA EMPLOYEE 3 100 000
It VaIi,aescfte under
E.L.DISEASE -
SPECIAL PROVISIONS bekh-, -POLICY"MIT S00,000
OTHER I
OFSCRIPTION Or OPERATIONSI LOCATIONS!VEHICLES I EXCLUSIONS ADDED 9V rNOORSDAGNT/SPECIAL PROVISIONS
qOme Improvement Contractor-
S500 deductible / occurrence*
*Irv*
it.,?v�I,V.,1"V,0 V1 ff 1t Y, "I *v 0 ft,*Yr IT%v o
'1 0*Y,*
CERTIFICA LDER
SHOULD ANY Of!THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPMA'AIDN'DAYE THEREOF,THE ISSUING INSIMPR MLL*)MX%*=MAIL-it
TO WHOM IT MAY CONCERN",** MAIL
*-a*i�l,-4c vV0 loff Vf?* NO DAys wpjT7cr4 NOTICE TO THE dERT1FICATE HOLDER NAMED TO THE LErt,
k
mK*"mU)wXK"m%KX%"wwftwXXXXXXXX
V*1?Irr XX AUTh90RMED RUPRESENITATWE
Jennifer Lawt9K el,
ACORD 25(2001/03) FAX: (413)543-3ZOO �kACORD CORPORATION 1988
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 numbers)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 permittlicense number which will be used as a reference number. In addition,an applicant
that must submit multiple permittlicense 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 bum 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
Revised 5-26-05
Fax#617-727-7749
www.mass.gov/dia
The Commonwealth of Massachusetts
Lh Department of Industrial Accidents
Office of Investigations
600 Washington Street
IV Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Pri t Le 'bl
T
Name(Business/Organization/Individual): , l J ��
'Lit It
Address: �' - n , >
City/State/Zip
�{�l /��J / Phone#: /
Are you an employer?Check the appropriate box: Type of project(required):
1.0 I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet.$ ?. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers'comp.insurance. 9. ❑Building addition
[No workers'comp.insurance 5. ❑ We area corporation and its
required.] officers have exercised their 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself.[No workers'comp. c. 152,§1(4),and we have no 12�"Roof repairs
insurance required.]t 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 their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. C__� L
Insurance Company Name: 4,�r( '' s�I \1"4� ins
Policy#or Self-ins.Lic. Expiration Date:-! 7�
r , rr , ,• n � t �`
Job Site Address: 1✓ o o bS l�l y. ' :� "r �� i�r' .1/F l % City/State/Zip: f�C '1(I� - ) f
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 certi er the pains and penalties of perjury that the information provided above is,true and correct
l
Si afore: -__--� /� ! � i" ��� Date:
Phone#: ( S(
Official use only. Do not write 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: NootS Appliccaable ❑/
Name of License Holder: IJ1 2, 3603
License Number
Address Expiration Date
Signa Telaahnne
�7 r
9. Realstered Home ImDrovemerlt extractor: Not Applicable ❑
Company Name Registration Number
Address Ex iration Datb
iZ MA F; Telephone /
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.....
zy
. 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 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 applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing
Or Doors ❑ 1 f`�'
Accessory Bldg. ❑ Demolition ❑ New Signs (O] Decks (171 Siding[01 Other[a
Brief Description of Proposed (
Work: S�Q � .t c 1 Q (d C�, `� T ��X� T�z i ' ^4r1G� ,. la
Alteration of existing bedroom Yes No Adding new bedroom Yes 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 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
1, SCL 1+ ' L� �!` as Owner of the subject
property SA hereby authorize
to act on my behalf, in all matters relative to work authonied by this building permit a ication.
Signature of Owner Date
as Owner/Authorized
Agent hereby declare that the statements and information on th6 foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under ft pains and penalties perjury.
Print Name
Signature`o OA6e/Ag Da e
Section 4. ZONING Ali 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 %
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 O DONT KNOW YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES Q NO
IN
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
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing, gradingavation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
c Department use only
�y 1` City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
QC�
No ampton, MA 01060 Two Sets of Structural Plans
ph94413-5 7-1240 Fax 413-587-1272 Plot/Site Plans
Other S eci
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
10PT 14/5, �'� � )Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
S 7
P-d ikv
Name(Print) Current Mailing Addr
//-? 6s 1(W
Telepii"
Signature
2.2 Authorized A ent:
RLI P)c X us'3
Name( ) ! went Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
com is ed by ermit applicant
1. Building p (a)Building Permit Fee
C' _4
2. Electrical (b)Estimated 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 This Section For Official Use Only
Building ermit Number: Date
g Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
435 BRIDGE RD BP-2007-0384
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17B-018 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category: BUILDING PERMIT
Permit# BP-2007-0384
Project# JS-2007-000571
Est. Cost: $7300.00
Fee: 25.Q0 PERMISSION IS HEREB Y GRANTED TO:
Const. Class: Contractor: License:
Use Group: STURDY HOME IMPROVEMENT 151711
Lot Size(sq. ft.): 9191.16 Owner: BIDDLE JOHN SCOTT JR
Zoning: URB Applicant: STURDY HOME IMPROVEMENT
r.ry; is - =11
Applicant Address: �i Phone: Insurance:
P O BOX 51033 (413) 543-5906 WC
INDIAN ORCHARDMA01151 ISSUED ON:101512006 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE 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:
Rough: Oil: Insulation:
Final: Smoke: Final: DK 1 o
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLA ION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 10/5/2006 0:00:00 $25.001198
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo