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Architecture
Interior Design JIM HARRITY
142 Main
Steet
Northampton,,Massachusetts 01060 28/0,
(413)586-5775 2,'_3 qYF-5 5-TMT Al
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To: Building Commissioner 3/31/04
Northampton,Ma.
From: James Harrity
AFFIDAVIT
This affidavit is submitted with application for permit to construct an accessory
apartment at 28 Keyes St. Florence to satisfy requirements of section 10:10 of the
Northampton zoning regulations.
As owner of the property and builder of the accessory apartment I guarantee that
before I sell the premises and prior to issuance of certificate of occupancy, I will have
filed either a homeowners affidavit of residency, or deed restrictions to make the 2 units
owner occupied.
/4
J es Harrity date
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REScheck Compliance Certificate
Massachusetts Energy Code
REScheckSoftware Version 3.5 Release 1
Data filename:C:\Program Files\Check\REScheck\keyes apt.rck
CITY:Northampton
STATE:Massachusetts
HDD:6404
CONSTRUCTION TYPE: 1 or 2 Family,Detached
HEATING SYSTEM TYPE:Other(Non-Electric Resistance)
DATE: 03/30/04
COMPLIANCE:Passes
Maximum UA=245
Your Home UA=245
0.0%Better Than Code(UA)
Ceiling 1:Flat Ceiling or Scissor Truss
Wall 1: Wood Frame, 16"o.c.
Window 1:Vinyl Frame:Double Pane with Low-E
Door 1: Solid
Basement Wall 1:Solid Concrete or Masonry
Wall height:7.5'
Depth below grade: 7.0'
Insulation depth: 0.0'
Floor 1:All-Wood Joist/Truss:Over Unconditioned Space
Permit Number
Checked By/Date
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
483
30.0 10.0 13
1500
19.0 3.0 71
139
0.320 44
42
0.280 12
455
0.0 10.0 89
483 30.0 0.0 16
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,specifications,
and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts
Energy Code requirements in RES checkVersion 3.5 Release 1 (formerly MECchec4 and to comply with the mandatory
requirements listed in the RES checklnspection Checklist.
The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design
Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the
design load as specified in a ions 8/OCR 1310 and J4.4.
Builder/Designer Date
REScheck Compliance Certificate
Massachusetts Energy Code
REScheckSoftware Version 3.5 Release 1
Data filename:Untitled.rck
CITY:Northampton
STATE:Massachusetts
HDD:6404
CONSTRUCTION TYPE: 1 or 2 Family,Detached
HEATING SYSTEM TYPE:Other(Non-Electric Resistance)
DATE:03/30/04
COMPLIANCE:Passes
Maximum UA=63
Your Home UA=55
12.7%Better Than Code(UA)
Ceiling 1:Flat Ceiling or Scissor Truss
Wall 1: Wood Frame, 16"o.c.
Window 1:Vinyl Frame:Double Pane with Low-E
Permit Number
Checked By/Date
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
361 38.0 0.0 11
456 13.0 0.0 35
27 0.320 9
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,specifications,
and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts
Energy Code requirements in REScheckVersion 3.5 Release 1 (formerly MECchecI4 and to comply with the mandatory
requirements listed in the RES checklnspection Checklist.
The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design
Conditions found in the Code. The HVAC equi ent selected to heat or cool the building shall be no greater than 125%of the
design load as specified in Sectio OC 1 0 and J4.4.
Builder/Designer Date 7 A/Z f
�_ � �: '(rif� rsf '�nLfIj�TTi}ifon
Mme. DEPARTMENT OF BUILDING INSPFC">-I01.S
1':SPECTO2 2]-2 Alain SirccL A2unic1pnl IIuildin�
?�`brLhnmp�ori A11tics- 010GO
Square Footage
1sc Flax- @ $
2nd Floor E $_30 � �b
1/2 Floors, Attic, Garage $_15
Deck Porches $_Ij
d-k> A-, yr s
TOT'
Fr
0�31�
i
1:
Amount
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Florence Office (413)586-8355 �-
Shelburne Falls Office
(413)625-6366
South Deerfield Office
(413)665.3771
CAM's
;_gency Disclosure
.;; lz-rt*ers it;ate Wus is represent the setter,
:A the buy", in the matke", rK- obatN and
;ale of property, unless otherwise disrtag .
However, the Broker or Salesperson has an
r:hi e ate{twat obligation all a show her aiy anr! 28 KEM�7 i� FLORENCE
::3imess to the buyer In alt transactions. ,
All information supplied by owners. PRICE: $176,000 STYLE: Farmhouse AGE: 1900
:,gtorP-Massamont disdaims any and a!l ROOM$: 7 BEDROOM: 3 BATHS- 1
t:presentations as to the accuracy of this
111orrnation. TowN., Northam ton LgT jim .25 Ac.41- 1426'+/-
Superb load ion in the heart of Flmnce.This 3 Bedroom horse needs a bit o(spnx ing up,but is well worth the effort
` Walk to town,close to bike path.All appliances to nerrrain.
t
STRUCTURE ' ROOMS APPLiANCE8 : BfERYiCEs FINANCIALJLEQAI.
Cacr _ White 1st Hoor *Otte Yes _Sewer Public Zling URB
Exwfia: Aluminum Ba eatin *Pddoer&r Yes Wata: Public TaxValue. t1s,5oo
C ngnxt Wd Frame DilfmgRcon *DL4masber No Heat STM Tapes $1,944.00
Roof Slate&Asphalt LivingRooni *Disposal• No Fud: Natural Gas TaxYew 2003
Walls Plaster yRam *Vattf in- No HotWaler: Natural FmtiaF ' +/-
Insi-dom UnknownH0° *Washes Yes R�IaI: Yes gk&p� 2257/49
FaudatiotL_ Brick&Stone * Yes Hec1nc 100 Amp CB Qy: Negotiable
Bait Full/Crawl 2ndBoor *Wood"e: No WashezrConn:' Yes
BasmntFL• Concrete TbieeBedrmns * DrjwCom- Yes
Room Wood +Vinyl * CHTVAvatl Yes
PavedStteet Yes * TvAnletm
f�tvedDtivmW. No Schools
Ckuage: None 3tdRocr Leeds IIem
Deddptia Patio JFK Middle
Rich: No The 1leins so Northampton High
Qtbidgs No ?narked should ld tie Baxngt H, y. Yes WasherHodaip indwiiAiii*Y' in.vjwcied
and the broker makes
Figlaoes 1 see disc. n" :arrrrn!y as n, ;hear
Woodslow HU: No working condinun MLS# 30794691
Excluded From Sale: shed in yaW ROBJ
Disclosures: Possible lead paint Possible Asbestos Disposal inoperable Fireplace is not in use
Directions: Off of Main or High Street
Exclusive Area Affiliate,SOTHEBY'S International Realty
k:•uoK• web Sites:www.uptornrrtassamont.com Out Of State: 1-800-LANDE1'C ,,,,�,,,,,■,.
EMM 8T
66
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..., �r►7G149 625 1701 50
150 aZ � 70151
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STG 16 166 166 17054
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17Cr295 ti x ti 170147 54.17 �.
140 19616
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17G2g3 tT � �
7263 160 14426
70.66 5956 1TG1a6
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741 142 64 170401
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17C-221 25
170248
60 337 2932 43 y7
300 3 46 .1
S7Cr211 �1T 17C-196
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170214 ,ea 216 497 TG 66s 1
1065 t7C� 291.1 44
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1551 45 151 4
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�RT'i{4S x
(IlcenserJpemuttee)
VA a princip2 place ofbusloes�resideace at
(phonell)
(street/ci tylstate/zs p)
do hereby certify, under the pains and penalties of perfury, that
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
f.
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Hxpiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiation Date)
(attach additioail sheet if noaesiary to include infmmstioa pertaining to all oo.t ctors)
(� I am a sole proprietor and have no one worming for me.
( ) I am a home owner performing all the work myself.
NOTE:please be awatc that while homcowvcrs wbo employ pcaom to do mAiatc ,ncr construction or repair worts on a dwelling of
not mote than Hiroo units in which the homooavcr rcudcs or oo the g ouadi appurtcnard thereto arc not gcocrnlly oomidatd to be
employes under the worker's oxnp=s 4oa Act(GL152,=1(5)),application by a homeowner far a Uccax cc permit may cvidcaoc d-
legil status of an employer under tho Workoes Compooaation AcL
I understand th=t a copy of this rtxtcmcnt may be forwardod to the Dqert.r of Lodusfrial Ac6&-&OfSoo of 101'�for the
coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal pCn Wcs
oomistiag of a fine of up to S 1,500.00 and/or imprisoumctrt of up to ow year and civil pcmltics is the form of a Stop Wark Ordtr and a
fum of S 100.0o a day against me.
For dcpu�uao o°ly
permit Number
3 sl ! 3 Map f__Lot#
Si of LiccnseeRermittee 2
o
a Grit 7 laf wart[ja111pf oll z
�tI3a ACI)ttSCt15
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S CONEPENSATTON INSURA-NCE { AVI'T
(li�li SerJpel-mi ttee)
with a principal place of business/residence at:
(phone#)
(streeucity/scatdzip)
do hereby cer y, under the pains and penalties of pequry, that:
( ) I am an employer providing the following workers compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
O I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
r.
(Name of Contractor) (Insurance Company/PoLcy Number) (Expiration Date)
(Name of Contractor) (Innirance Compauy/Poky Number) (Hxpization Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional shod ifntc�to in Jude information pertaining to all ocatrnctors)
(� I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that While homcowvcra who«aploy pert to&MALICamact,a o-5�oa or irpau work on a dwelling of
not=o than tbrre units W Which the bxno"Uv r r=dc3 or oa the g-ounr}s appurtcna�thereto ata oot gracrnlly oomidacd to be
employes under the woriccr's ceci�on Ad(GL152 fs 1(5)),application by a homeowner for a Locnsc cc permit may cvidcnoc the
legal datuo of an employer under tho Workcez Compemation AcL
I undCn"nd t uL a copy of this rtatcmcat may be forwarded to tbo Department of ln& ial Aoc7dw&Oftioo of rnsuranco for tbn
covcraga vcrificmtioo and that failure to acotre coverago under soeiioa 25A of MGL 152 can l d to the imposition of-mi W pcaall:cs
consisting of a fine of up to S1,500.00 and/or imps isonmctu of up to em year and civil pcnaltics in the form of a Stop Work Ord and a
find of 5100.04 a day rtgaiwl ttx
Foe departm-,nl use only
tt permit Number
L �l / ,3 fat Lot#
Si of LicczsclPermittee e
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : ^L-5 111f ct r r
License Number
Address Expiration Date
!0 s`� rL
Signature Telephone
Regis'eied Hommmbrouernent'Cgnt actors „ ,`;�� ;»,»
gg
,E E. `.,,is Not Applicable ❑
Company Name Registration Number
Address Expiration Date
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....... ❑ No...... ❑
�E
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 eriod 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°sOF PROPOSED WORK(check all applicable)
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. Demolition❑ New Signs [ ] Decks [ ] Sidin ] 0th r [ ]
Brief Description of Proposed Work: NS'l�i�`� GJ-SS6�� /IATO,,l 'c d./
Alteration of existing bedroom Yes No Adding new bedroom_ Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet o
6 Ifi New=horlse and or`�tltlition to':eicist'ing=dousing;'complete="the- olloWWn :
a. Use of building : One Family Two Family Other A,
b. r
b. Number of rooms in each family unit: >S/ Number of Bathrooms /~Z
c. Is there a garage attached? hl 0
d. Proposed Square footage of new construction. ` Dimensions
e. Number of stories? l{I
f. Method of heating? W Be Fireplaces or Woodstoves /"0 Number of each
g. Energy Conservation Compliance. le' Mascheck Energy Compliance form attached? y�
In. 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
G'
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer�_ Private well City water Supply _
SECTION 1 -OWNER AUTHORIZATION -I TO BE COMPLETED' WHEN
OWNEkt,AGENT;;Oa CONTR'ACTOR APPLIES-FO'R 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.
6Signature of Owner Date
I`,- 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
1 Signature of Owner/Age Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size QU
Frontage e C' l d
Setbacks Front 1.s-" A n
Side L: R:—I/ L: R: l `�
RearD /7
Building Height q S 7
Bldg. Square Footage V' /7 % 13 9T f�
Open Space Footage %
(Lot area minus bldg&paved 0I
parking) 0
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW K YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO X 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 K
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:
• s
City of Northampton 5 _
Building Department
212 Main Street S r -
Room 100 a
Northampton, MA 01060y;.. � , a.
phone 413-587-12.40 Fax 4 ,}1 72[ Plo ISitea �b
,t�ter_Spt±ctfy
APPLICATION TO CONSTRUCT,;ALTER, REPAIR, RE ATE,CT DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION- -
1.1 Property Address: This section to be completedy office
Map Lot' (1rllt
Zone Districts R ",
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
-1.4-c e - r' - 4_ / e'0G cIFLG�
Name(P t) Curre Mailing Address:
Telephone t�l
Signatu e _
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone _
SECTION 3- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building dQC' (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
�U c) Construction from 6
3. Plumbing v v Building Permit fee
c�
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 +4 + 5)
Check Number
This Section For Official Use Only
Building Permit Number: 11PA `` Date Issued:
Signature:
Building,Commissioner/Inspector of Buildings Date
File#BP-2004-0942
APPLICANT/CONTACT PERSON JAMES HARRITY
ADDRESS/PHONE 77 MAPLE ST FLORENCE (413)585-8025
PROPERTY LOCATION 28 KEYES ST
MAP 17C PARCEL 145 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 23 X 21 ACCESSOORY APT, 10 X 10 DECK&2ND FLR BEDRM TO
EXISTING SINGLE FAMILY
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 052260
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF91MATION PRESENTED:
Approved Additional pen-nits 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
y��2 _pZ/
Signature of Building OfficiaV 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.
28 KEYES ST BP-2004-0942
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C- 145 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-2004-0942
Project# JS-2004-1395
Est. Cost: $65000.00
Fee: $585.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JAMES HARRITY 052260
Lot Size(sq_ft.): 11238.48 Owner: JAMES HARRITY
zoning:URB Applicant: JAMES HARRITY
AT. 28 KEYES ST
Applicant Address: Phone: Insurance:
77 MAPLE ST (413) 585-8025
FLORENCEMA01062 ISSUED ON:415104 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 23 X 21 ACCESSORY APT, 10 X 10
DECK & 2ND FLR BEDRM TO EXISTING SINGLE FAMILY
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• Receipt No: Date Paid: Check No: Amount:
Building 4/5/04 0:00:00 3125 $585.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
To: Commissioner Patillo
From: Jim Harrity
Re: 28 Keyes St
Dear Commissioner Patillo,
nIEI
The building permit for this property was issued for a renovation and an accessory
apartment. Due to some unforeseen circumstances I was not able to construct an
accessory apartment and will not construct one in the future. Also,the renovated dwelling
will not be used as an accessory apartment. The renovations are complete.
Thank you for your attention to this matter,
Sincerely,
L'
Jim H
COMMONWEALTH OF MASSACHUSETTS
Hampshire, ss.
On this 25th day of June, 2004, before me, the undersigned notary public,
personally appeared JAMES V. KENT, proved to me through satisfactory evidence
of identification which was personal knowledge, to be the person whose name
is signed on the preceeding or attached document, and acknowledged to me that
he signed it voluntarily for its stated purpose.
CUSSa Notary Public
My mmission Expires: 4/21/11
i r__ t:
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Metcalfe Associates FLOOR PLANS
Architecture
Interior Design JIM HARRITY
142 Main Street "2/28104
Northampton,Massachusetts 01060 2f� S�Tf^F�T _ Al
(413)586-5775
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