32C-248 (6) 36 HOLYOKE ST BP-2017-0775
cls a: COMMONWEALTH OF MASSACHUSETTS
Map:Block:32C-248 CITY OF NORTHAMPTON
Lot: -01 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category;ADDITION BUILDING PERMIT
Permit It BP-2017-0775
Protect# JS-2017-001287
Est. Cost; $68900.00
Fee:$65,0 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: BARRON & JACOBS 60475
Lot Size(sq. ft.): 4181.76 Owner: KOZACZKA HARM MEGAN S LUTZ
Zoning:I)RC(103)/ Applicant: BARRON & JACOBS
AT: 36 HOLYOKE ST
Applicant Address: Phone: Insurance:
70 OLD SOUTH ST (413) 586-8998 Workers Compensation
NORTHAMPTONMA01060 ISSUED ON:12/19/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:BUILD ADD-A-LEVEL ADDITION OVER
EXISTING 1ST FLOOR, CONTAINING NEW FULL BATHS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring U.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House it 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:
FeeTvpe: Date Paid: Amount:
Building 12/19/2016 0:00:00 $65-00
212 Main Street,Phone(413)587-1240,Fax: (413)587.1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0775
APPLICANT/CONTACT PERSON BARRON&JACOBS
ADDRESS/PHONE 70 OLD SOUTH ST NORTHAMPTON (413)586-8448
PROPERTY LOCATION 36 HOLYOKE ST
MAP 32C PARCEL 248 001 ZONE URC(103)/ !�
THIS SECTION FOR.OFFICIAL USE ONLY: 71r /'y rt £" ' 'v/
/
PERMIT APPLICATION CHECKLIST Q./V
ENCLOS RE D DATE
Zi ING FOR FILLED OUT / rye' r' g
Fee Paid #' / 4(j ,rs- T
Building Permit Filled out G V (� V •Bat j
Fee Paid
TIypeofConstructionBUILD ADD-A-LEVEL ADDITION OVER EXISTING 1ST FLOOR,CONTAINING
NEW FULL BATHS
New Construction
_ Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statementor License 60475
3 sets of Plans/Plot Plan
ttoct
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON i
INFORMATION PRESENTED;
Approved Additional Additional permits required(see below)
trn�Q.1/VL
PLANNING BOARD PERMIT REQUIRED UNDER:§ PIA V"
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan ONE (EP""�
e
ZONING BOARD PERMIT REQUIRED UNDER: § 4t5 1�b
Finding Special Permit, Variance* SG Y
D
WlLL- T�
Received&Recorded at Registry of Deeds Proof Enclosed F
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability 12.106 YATtONSO iJdj
Septic Approval Board of Health Well Water Potability Board of Health A� ADD- 'i6 6' 'a
Permit from Conservation Commission Permit from CB Architecture Committee
1SC) p2A/CI1000
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay 08t 10 Ci
Signature of / [/ /( '- �� 1 9 164 t{�$aS{� \
gnBuilding 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.
\
QS' .a�C... \ city of Northampton Status of Permit: Department use only
,- Building Department Cum Cut/Driveway Permit
212 Main Street Sewer/Septic Mailability
Room 100 Water/Weil Availability
---' - Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Ste 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
1X. kitiltdLy x-fib. Map Lot Una
fur 3-\Ad N'V1c C�°r5.c Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSH/PtAUTHORIZED AGENT
2,t Owmer of Record:
L4Nr,,dA ne, (At Arr ` ave, It t pwAtif "-les VU.lr at `cxL,iv1e)')l+b .pkat- let
Name(Print) l Current Mailing Address:
Nl 'h5 21r I
Sts- ut*hc\(or i. tetisSleisiok ,(>< 240 fo-r (a, Telephone
Signature
2.2 Authorized Anent:
Ord k5 .lama,h/\• T CA Cr„
Name(Pnnn���t) Current Mailings
rg Address:
��i��
on 'GSSG <-116WS
S riat e l� Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
(tern Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 53, `'j06 (a)Building Permit Fee
2. Electrical f� `y �� (b)Estimated Total Cost of
1"A -T"' Construction from(6)
3. Plumbing Building Permit Fee
44.(o1CP
4. Mechanical(HVAC)
5. Are Protection y`�� ¢
6. Total=(1 +2+3+4+5) tubi 0107 Check Number Ltory $6/
This Section For Official Use Only j
Building Permit Number Date IP ,6
Issued'. C��-' ✓
Signature:
Building Commissioner/Inspector ate/Aldings Date
Section C. ZONING Alt information Must Be Completed.Permit Can Be Denied Due To Incomptete information
Existing Proposed Required by Zoning
This column to be tined in by
,NM )'G Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage .o
Open Space Footage
(Le:area minus We&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW Ill YES O
P YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained C) Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO
IF YES, describe size, type and Location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO
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 O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing n
Or Doors El
Accessory Bldg. ❑ Demolition ❑ New Signs [CO Decks ICI Siding WI Other[a
Brief Description of Proposed
Work: ih;;.\A /Nlgh-Grlgliti o4{hc' cJc- ')<SX\ i� -r • ti/1 •. r I ra.
Alteration of existing bedroom___Yes is No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement _Yes
Plans Attached Roll -Sheet
sa. If New house and or addition to existing housing,complete the following:
a. Use of building : One Family X Two Family Other
b. Number of rooms in each family unit: (O Number of Bathrooms
c. Is there a garage attached? ftC)
d. Proposed Square footage of new construction. IC 2.- S f Dimensions i c3r. A { €.
e, Number of stories? J--
f. Method of heating? Sine Fireplaces or Woodstoves VCS _Number of each }.tit) .,u...
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes A No. Is construction within 100 yr. floodplain Yes No
i. 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 )0 Private well _ City water Supply )4
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, L Al VA (Ad\c, (MA- OnW- A}-wwke r ,as Owner f the subject
property
hereby authorize ?it Gt/vV.t C.V 4 .1614
to act on my behalf,in all matters relative to work authorized by this building permit application.
txtx Azivtitgarea-'k C/ 2b,ik.�.. t'>
Signature of Owner ✓ Date
11.111.1111.111.1.111110111111111111111.111W-
I, Yxf t S r YwcYu ,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.
E-.ti'Xt.S
-.1-6 etc
Print Name
tihkCilk lc
Signet (Omer/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8,1 Licensed Construction//Supervisor: Not Applicable ❑
Nameot License Holder C: f'.cj SiXf-A":-SOS Lg - D0 -
License Number
LTi nv\ W' `Stt�5or =rF,ibr�- I lb'
Address Expiration Date
Signa rice r/ Telephone
9,Rerdatered Name Improvement Contractor: Not Applicable ❑
clporya.r 4 "SL,t.o1sS 1O 51
Company Nam , Registration Number
ov.k, t'Sa:}b. 41- 1>,,\(xi-\-O4"cv-A x }2'1}18
Address 1 Expiration Date
Telephone fCirin
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 wilt result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes
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 Demon 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 he 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
SIGNATURES
By signing below,you agree to items A.B and C.
DO NO7 SIGN THIS AGREEMENT IF THERE ARE ANY BLANK SPACES.
A. Alternative Dispute Settlement(Arbitration Clause):The Seller and the Buyer hereby mutually agree.in advance.that in
the event ofa dispute concerning this Agreement.the parties shall submit such dispute to a professional,state-approved
arbitration sen ice(cost. if any.to be paid by the submitter)prior to either party proceeding to legal action in the courts.
B. By signing this agreement.you.as the owner of record,are hereby authorizing Barron&Jacobs Associates Inc.to act
as your authorized agent in all matters pertaining to the building permit application.
C. This is a binding Agreement. You may not cancel it except as stated. This Agreement covers and supersedes all
conversations,statements and agreements.expressed or implied.between then epphaarties.their agents or representatites.
lFetI 1101'/iNit
You,the Buyer,may cancel this transaction Bu Date
at
at any time prior to midnight of the third ��� ��
business day after the date of this transaction.
See the attached notice of cancellation form Rayer V Date
Mr an explanation of this right. i /�
Seller retains an equal right to cancel. J , i_ AL 111 aitIza
B:fon& Represematiye Date
cram•rasa r n rraarx rmit narr.r+rrrrrr.rrrsakz tea raa.araar*s r r anima r arsaaaa»rrarr.ts r rraaaara
Designer/Salespersons Registration Numbers
0 Cecil R.Jacobs MA WC 100809 0 Christopher R.Jacobs MA I IIC 100809
CF HIC 0518617 Cl HIS 0554397
0 Adam Skibe MA Id1C 700809
Baron and Jacobs- Key Personnel Contact Information:
Office Cell Home
Office Manager:Sandy Scavotto 413586.8998. M00
Vice President and General Manager: 413586.8998.x103 413.250.6677 413.665.9113
Chris Jacobs
President:Cecil 2 Jacobs(Jake) 413586.8998,x101 413150.2327
Purchase Agreement
Page 28 of 28
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 budding 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: %`j C.,
The debris will be transported by: Pny -ry 3cicc,b5
The debris will be received by: VA.,' i rnr's 'c
Building permit number:
Name of Permit Applicant Lr ‘s,
(2, I
Date Signature of Permit Applicant
The Commonwealth of Massachusetts Print Form
Department of Industrial Accidents
•
_- Office of Investigations
Z Congress Street, Suite 100
n c Boston, MA 021 14-2017
4`F% 'y www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organiza[ior.Qndividual): Barron & Jacobs Associates , Inc.
Address: 70 01.4 South Street
City/State/Zip: Northampton, MA 01060 Phone #: (413) 586-8998
Are you an employer?Check the appropriate box: Type of project(required):
.® I am a employer with ` 4. Q 1 am a general contractor and 1
employees(full anddor part-time).' have hired the sub-contractors 6. n New construction
I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have S. J Demolition
workingfor me in any capacity. employees and have workers'
p' X 9. al Building addition
[No workers' comp_insurance comp. insurance.:
required.] 5. (J We area corporation and its 10.11 Electrical repairs or additions
officers have exercised their I L[ Plumbing repairs or additions
;.0 I am a homeowner doing all work
myself. [No workers' comp. right of exemption per MGL 12.J] Roof repairs
insurance required.] ` c. 152, §I(4),and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
my applicant that checks box k must also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:omractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
nployees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
[formation.
isurance Company Name:.,., Webber & Grinnell Insurance Agency, Inc.
olicy#or Self-ins-Lic. #: k^iZ 800-8006365-2016h Expiration Date: 3/I/201?
ib Site Address: y](p k'trUz.�.v ` ;. ._,...- City/State/Zip; .-. MTV ctot>U
.ttach a copy of the workers compensation policy declaration page(showing the policy number and expiration date).
ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
ne 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
f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
avestigations of the DIA for insurance coverage verification.
do hereb certify under the pains and penalties ofj?jury that the information provided above is true and correct
ionature: Dated( l;t-!`"1.J.)�
hone#: xiPo- OC•= wi°i$
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License#i,
Issuing Authority(circle one):
I.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
ACORD N CERTIFICATE OF LIABILITY INSURANCE DTEIMIASO 6'
3/10/2
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. 0 SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate dopa not confer tights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACTLaura Cannon
f1,iME. _ __
Webber b Grinnell EAU- (413)586-0111vse,,,i,4,(.41A35134-6•01
8 North Sing Streetg'SSMS ss.lcannonewebberandgrinneli,com
INSURERS)AFFORDING COVERAGE NAICp
.. _. -. ._
Northampton MA 01060 wsuRER A Main Street America/MSA 29939
INSURED INSURER BNQ{/MBA _
."
Barron S Jacobs Assoc. Inc. wsu{ERC A.I.,M. Mutual/A.1.m, __ _
Attn: Cecil R. Jacobs INsuRERO:
70 Old South Street INSURERE: _
Northampton MA 01060-3833 INSURERF:
COVERAGES CERTIFICATE NUMBERMaster Sap 2017 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. NOTW THSTANDING 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,
Alli'
NSW 00L
iA4CR' - POLICY EFF POLICY ESP -
TYPE OF INSURANCE ' WIINVO POLICY NUMBER IIMMNDIYYFYI IMMIOOTTYYYI LIMITS
X COMMERGAL GENERAL LIA&UTY EACN OCCURRENCE 5 1,000,000
A CIAIMS MAO€ X OCCUR - OPRRMAGE T U 500 000
EM5E5 Ee ONGl%ClemMre) t
I 1121904 93$ 3/9/2015 3/9/2017 I MED EXP(Any one Pms031 S 10,000
.. _
• PERSONAL eADV INJURY $ Y,000,000
'GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 5 3,000,000
-_ _
X' POLICY, PrIO-T 'LCC PRODUCTS•COMPCP AGC- S 3,000,000
OTHER.. ...EPO .s 10,000
AUTOMOBILE LIABILITY I COMBINEDSINGLE LIMIT $
- L9 accident)
R ANY AU10
BODILY INJURY person) 5 1,000,000
-ALL OAIEDSCHEDULED
AUTOS A AUTOS �M1Ta0690 3/9/2016 3/91201, BODILYINJURY OSA amaenp 5
T WREDRUYOS R NONOVMED PROPERTY DAMAGE 5 -
--_AUTOS .(Pm amass)
Meaisl AsSmenrs S 5,000
UMBRELLA UAB OCCUR EACH OCCURRENCE S
a EXCESS LIAB CLAIMS-MADE AGGREGATE _ $
"DEO X RETENTIONS 10,000s
CLTt'8069B 3/9/2036 3/9/2017
:WORKERS CCL91EUABIUN PER
EERH
INC PLOYERS'UARNR/ TIN.
ANY PROPRIETOR/PARTNER/EXECUTIVE - E L.EACH ACCIDENT S 500,000
O at AEMISR EXCLUDED? ".NIA
D ives ,mandatory In eel -- 3/M280063/352016A3/M280063/352016A 3/1/2016 3/1/2010 EL DISEASE-EA EMPLOYEES 500,000
l
DESCRIPTTION OF OPERATIONS Wow v, EL DISEASE-POLICY LIMIT S 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(SWORD 101,Additional Remarks Schedule,may be attached it mon space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATiYE
M Horan, CIiSR/LAGu r.- 1----
—"--
019N-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014(01) The ACORD name and logo are registered marks of ACORD
INS025emnin.
c-__1 4e yznin� c>>rcaeccN a/ ^747.5.;ad uicfl
v Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 100809
Type: Private Corporation
Expiration: 6/23/2018 TO 419291
BARRON & JACOBS ASSOCIATES, INC.
Cecil Jacobs
70 OLD SOUTH STREET
NORTHAMPTON, MA 01060
Update Address and return card.Mark reason for change.
SCA- 0 enm.oa:I, Address Renewal Employment —. Lost Card
..
-IL t.„,,.,.,,,...,d//(7 -arr„,rifii„,./.
.- Office of Consumer Affairs&Business Regulation License or registration valid for individual use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 100809 Type: Office of Consumer Affairs and Business Regulation
Expiration: 6/23/2018 Private Corporation 10 Park Plata-Suite 5170
Boston,MA 02116
BARRON 8 JACOBS ASSOCIATES,INC.
Cecil Jacobs
70 OLD SOUTH STREET
—
NORTHAMPTON,MA 01060
Undersecretary - -- - -
Not valid without signature
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: MRoe047y
Construction Supervisor
N D NORTHAMPTON
_
TtAAMR(M4 M(M'0.
•
_/�`'^^ Expiration:
Commissioner 11/1!/201!
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