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24A-133 (3) f t ^ vT wa�t� 1 ! w_ Li 14%JII-6 P-000 t( TI S } j ? W>akl'L- /�R^�ir<irJPN n `I e9 Air,& x/44 —� z Wwi 1 7ti'If�lTti- ftp , i i E OPr� it i ? City of Northampton Building Department Plan Review 212 Main Street Northampton, MA 01060 TE AcoRo® CERTIFICATE OF LIABILITY INSURANCE DA8/6/DO/15 8/6/2015 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 policyiies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terns 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 NAMEA T Christine Wallin, CISR FAX(Bell & Hudson Insurance Agency IA/CNN Ext);.. (413)323-9611 (ALC (413)323-6117 AIC No 19 N. Main Street -ADE-MAIL cwallin@bellandhudson.com INSURERS AFFORDING COVERAGE NAIC# Belchertown MA 01007 INSURERA Main St. America Assurance Co. INSURED INSURER B:NGM Insurance Company, Inc, Michael Flynn, DHA: Flynn Electrical INSURERC: 110 Kennedy Road INSURER D: INSURER E BelchertoWn MA 01007 INSURER F COVERAGES CERTIFICATE NUMBER:MASTER 15-16 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 CONDITIUN"UF ANY"CONTRACT UR 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. INSRI ADDL SU R POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/Yl YY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMA E E 500,000 A CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ X $250 PD Deductible MP063005 5/28/2015 5/28/2016 MED EXP(Anyone person) $ 10,000 per claim PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO- ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 X JECT OTHER: AUTOMOBILE LIABILITY Ea accciden INGLE LIMIT $ I BODILY INJURY(Per person) $ ANY AUTO _ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS ALIO OSWNED Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ OT - WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100 000 OFFICER/MEMBER EXCLUDED? N/A B (Mandatory in NH) WC063005 10/24/2014 10/24/2015 E.L.DISEASE-EA EMPLOYEE $ 100,000 Ives describe under E.L DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS below — '`---"' I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) ELECTRICIAN- NO ALARM WORK SOLE PROPRIETOR IS EXCLUDED FROM THE WORKERS COMPENSATION COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Kris Thomson Carpentry THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 362 Kennedy Road ACCORDANCE WITH THE POLICY PROVISIONS. Leeds, MA 01053 AUTHORIZED REPRESENTATIVE M Tetrault CPCU, CIC/ J .cr c- cmc fE' 7G +c> ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) ,�►�oRDP CERTIFICATE OF LIABILITY INSURANCE DATE 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). EA PRODUCER Cynthia Henderson, CISR Webber & Grinnell PHONE AIC,No.Exd: (413)586-0111 FAX No): )566-6481 8 North King Street E-MAILADDRESS.chenderson@webberandgrinnell.com INSURERS AFFORDING COVERAGE MAIC# Northampton MA 01060 INSURERA:Travelers Indemn. Co. CT 25682 INSURED INSURER 8: John T. Geryk Plumbing & Heating, DBA: John Geryk INSURERC: 20 Jackson St Apt 1, 1st FL INSURER D: INSURER E Northampton MA 01060 1 INSURER F: COVERAGES CERTIFICATE NUMBEROaster Exp 03/2016 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE 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. POIJCY EFF POLICY EXP INSR TYPE OF INSURANCE POLICY NUMBER MM/D MAID LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 T100,000 A CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence $ I660201M9512TCT 11/15/2015 11/15/2016 MED EXP(Any one person) $ 10,000 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECT LOC PRODUCTS-COMPIOPAGG $ 2,000,000 -i- OTHER: AUTOMOBILE LIABILITY Ea accident)COMBINEDSINGLELIMIT $ BODILY INJURY(Per person) $ ANY AUTO — ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED Peraccident $ HIRED AUTOS AUTOS $ UMBRELLA LIAOOCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ $ DED I I RETENTION$ WORKERS COMPENSATION STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVE ANY EACH ACCIDENT $ 100,000 OFFICERIMEMBEREXCLUDED? NIA A (Mandatory In NH) IEtJB3B02981315 3/12/2015 3/12/2016 E.L.DISEASE-EA EMPLOYEE $ _ 100,000. M yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS bebw DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may/be attached K more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C Henderson, CISR/CINe� ~' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 onwi l City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: PygS The debris will be transported by: ) _Q_a L jc,(c,'►-� The debris will be received by: Building permit number: Name of Permit Applicant le�x J !s t T//) C;Vvi SOy-\ 2 � i Date Sig -ature of Permit Applicant City of Northampton. ' Massachusetts DEPARTMENT OF BUILDING INSPECTIONS * 1 212 Main Street • Municipal Building Northampton, MA 01060 sSW :'Nati, INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for 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 regulations. 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 i The Commonwealth ofMassachusetts • Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, M,4 02111 4y- www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): r 15 d VAA 5 O h Address: City/State/Zip:L.-cak 5 AA R- 010 Phone#: Are you an employer? Check the appropriate box: Type of project(required): 1.09 I am a employer with 2—'-- 4. I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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 for mein any capacity. employees and have workers' 9. ❑Building addition [No workers' comp, insurance comp. insurance.$ required.] 5. 7 We are:a corporation and its 10.®Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.®,Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 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. tHo meowners 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. Insurance Company Name: •2: GY r C� Policy#or Self-ins.Lic.#: 9 (- -7 ' Expiration Date: Job Site Address: 39-7 do AfAOLCity/State/Zip: ,AA t& 0 10 4,0 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. Ido hereby cefy uyderhe Pains and penalties of Per that the information provided above is true and correct. signature: T. Date: Phone#• Ci r • ��g Of use only. Do not write in 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 87 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: r' s a I V I S a License Number 2 .n -c JZ-d� •�-. c� U Iv 53 cS - O'Z 4 ) �5 2— Address Address Expiration Date \C4, !413 4/q ) ) -7 Sign t Telephone i9.Reaistered.Home Impfoveinent Contractor `_,._.... T,,._.._.w___,,_ ___ = Not Applicable £ 5 1 -11543 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...... £ Home Qwner`Egempt>Ion 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, i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ ReplacemenWindows Alteration(s) Om Roofing E7 Or Doors `— Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks Siding [❑] Other[❑] Brief Description of ProposedLL Work: Lye*'tc G. t1w-w k. T GAn?-to ; " n0-wOc01"'( CA VN Alteration of existing bedroom Yes No Adding new bedroom Yes _No Attached Narrative Renovating unfinished basement Yes _'No Plans Attached Roll -Sheet sa;af New hour"e and._0 adtl]:tlorY. 6bxisti'ng fiouslng;colmplete the:.followlnc: 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 a-l Vta `x)o � as Owner of the subject property hereby aut riz r to act on y b all, in all ers r e w a 6rize y this building permit application. L - Signat a of Ow r Date K 6 Ij /�d(/�Sb 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 penalt' of perjury. r\ Print Name Signature of Owner) Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning 71iis colunin to be filled in by Building Department Lot Size Frontage Setbacks Front Rear Building Height Bldg.Square Footage Open Space Footage % (Lot area minus bldg&.payed #of Parking Spaces (volume&Location) A. Has aSpecial Permit/Variance/Finding ever been issued for/on the site? �—� NO �~�_�� DONT KNOW YES �� IF YES, datebsued: IF YES: Was the permit recorded at the Registry ofDeeds? / NO �� YY D�NlKMO 'ES ' �~� IF YES: enter Book Page and/or Oocument# B. Does the site contain a brook, body of water orwetlands? NO DONT KNOW 0 YES 0 � IF YES, has permit been or need to be obtained from the Conservation Commission? Needs tobeobtained °�v~� Obtained �-«_�� Date� ' . C. Doany signs exist onthe pvoperty ��� YES ��, NO IF YES, describe size' type and location: D. Are there any pmp�sed changes tooradditions ofsigns intended for the property? YES 0 NO 0 IF YES, describe size' type and location: E. Will the construction activity disturb( ring. gnadingor�||ing)ovor1acnaorio�pa�ofocommonp|an that YEGy 1 NO excavation,�°� . v~^`^ ` IF YES,then a Northampton Storm Water Management Permit from the DPW is required. � � | lvturrJ_ peparfinent usIT 1.2.52 ity of Northampton Stafus,ofP�rmtt 2.. ,.4Ofs uilding Department OP. cutlDrl+[e�uay Permif 212 Main Street SewerlSeptieAvalfafiility i " - r r Room 100 IIDEpr OF B FILDINGHlflg NCRTHA?oPTON t ,r ,<, N rthampton, MA 01060 Twi3,Sefs of Str�cturai Plans 51 t phone 4'f -587-1240 Fax 413-587-1272 Efflite PEans' t APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE.INFORMATION This se to e: - _ - _._..... fob..._c__om lete.tl_b.::>offic:e:=: =- 1.1 Property Address: — 0. ......—....va -- ,�_- 1. Map . 4 rt ti. 010 G U - _ElmrSt.,D SECTION 2.-PROPERTY OVI/NERSHIP/AUTHORIZED AGENT -: 2.1 Owner of Record: Name(P' t Current Mailing-dress: I F(3- Telephone Sig ture 2.2 Authorizednt: 3 2 f! -2 to vAe-A LA W( L r i 5 b ay-, -/U C, - 0 1.0 3 Name(Print Current Mailing Address: +13 . fv7 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS. . Item Estimated Cost(Dollars)to be Official Use Only com feted by permit applicant 1. Building 000 (a) Building Permit Fee 11 2. Electrical 000 (b) Estimated Total cost of Construction from 6 '' 3. Plumbing 2 0 CDC—? Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) (p1 0 00 Check Number This Section For Official'Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector'af Date Buildings File#BP-2016-0981 APPLICANT/CONTACT PERSON KRIS THOMSON ADDRESS/PHONE 362 KENNEDY RD LEEDS01053 (413)549-1027 PROPERTY LOCATION 397 PROSPECT ST MAP 24A PARCEL 133 001 ZONE URA(100) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT 7/7� Fee Paid 10V 24-0&0 Building Permit Filled out Fee Paid Typeof Construction: RELOCATE NEW KITCHEN New Construction Non Structural interior renovations Addition to Existing AccessoKy Structure Building Plans Included: Owner/Statement or License 084152 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ) 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 --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 Demoli ioqj)e ay SO Izr— Sign-a—ture of BuildCg 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. 397 PROSPECT ST BP-2016-0981 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24A- 133 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateeoa:renovation BUILDING PERMIT Permit# BP-2016-0981 Project# JS-2016-001665 Est. Cost: $67000.00 Fee: $436.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KRIS THOMSON 084152 Lot Size(sq. ft.): 22694.76 Owner: WOHL CARINA Zoning_URA(100)/ Applicant: KRIS THOMSON AT. 397 PROSPECT ST Applicant Address: Phone: Insurance: 362 KENNEDY RD (413) 549-1027 O LEEDSMA01053 ISSUED ON:2/5/2016 0:00:00 TO PERFORM THE FOLLOWING WORK.-RELOCATE NEW KITCHEN 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 2/5/2016 0:00:00 $436.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner