32C-052 Secondary_C_C_Document_TDA_ARCHCity of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ● Municipal Building Northampton, MA 01060 INSPECTOR
Louis Hasbrouck Fax: 413-587-1272 Chuck Miller Building Commissioner Phone: 413-587-1240 Assistant Commissioner
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(For professional Engineers/Architects responsible for a portion of a controlled project)
Project Title:______________________________________________ Date:__________________________
Project Location:___________________________________________ Map:_____ Parcel:_____ Zone:_____
Scope of Project:__________________________________________________________________________
In accordance with the Eighth edition Massachusetts State Building Code, 780 CMR Section 107.6:
I, _______________________________________________________ Mass. Registration # ______________,
being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans, computations and specifications concerning:
[ ] Fire Protection [ ] Architectural [ ] Structural [ ] Mechanical [ ] Electrical
[ ] Other (specify) ___________________________________________________________________
for the above named project and that to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices
and all applicable Laws for the proposed project.
Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that the above mentioned portions of the work proceed in accordance with the documents approved for the building
permit.
Upon completion of the work, I shall submit to the building official a final report as to the satisfactory Completion of the above mentioned work.
Signature and Seal of Registered Professional
_____________________________________
_____Day of _______________20____
(seal)