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18-030 HOME ThdPROVEMENT CONTRACT PLEASE READ 'I5 • $Y . le°" Date: TIID At-Home Services. I e. �( dlb/a The Home Depot At -Home Services 345A Oteeewood Street, Unit 2,Worcester, MA 01607 To11 Free (800) 65573182; Fax (508) 756 -8823 Braeeh 1V 31 Padua IDa754498460; NE Lie as C 02439; RI Cent Ltdk 16427 Cr # � l ' MA litem aee provset Contractor Reg,. 4126893 Installation Address: t ({ E.a n 4.1 LAT '�'�1 1 6 � i" h y stn okfthows)! w . .R o s 011 C� i* t 3 111.111111111111111111111111111.101111111111 Home Address' (If different from Installation Address) City • State Zip Entail Address (to receive project canunamicatio: s and Home Depot updates): I DO NOT wish to receive any marketing emaiis from The Home Depot � : Undersigned ( "O stonser" ), the owners of the propergr located at the above installation address, agrees to buy, of and all materials on below�and on the � d aalll of which ac inccrp into this this reference, along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders (collectively, "Contract Jab 0: 6rrarusr.4 s 0 Annamt ■ �'/4:' • . 1 laydatine 574f 41 $ t L� Rt - 7`7 l ❑ 3ub(c 2-74 O u Madam athadation S /Coves [lam Deem 1 pRoofing Des © Whdows Qtasoladon DOesera /Corers DEuirq Does El ❑Roo[m6 0Skliag ❑Wmrlows 0 headation Lithium /Ca ems prom Doors Cl htliraaa aa2511 Deposit et Comas Amon doe man wends. ° thkamrsn. Total contract imam $ more rerth iwy raepetitorresae aerdreC Ammt. :27q 3 Customer agrees thee, hemo:Cutely upon completion of the work for each Product. Concealer will execute a Completion Catiforte � (one for each Product as defined by an individual Spec Shat) and pay any balance due. As applicable, each Customer under this Contract agrees to be jay and severally obligated and liable hereunder. • The Home Depot reeves the rift to issue a Cheese Order or terminate this Contract or any individual Preduct(s) included herein. at its discretion, if The Rome Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the hawot, cnvimameutal Innards such as mold, asbestos or lead paint, other safety concerns. pricing errors or because work required to complete the job was not included in the Contract. Pavmmt Sea�sn: The Payment Summary S 1263 included as part of this Contract sets forth the total Contract annum and payments required for the deposits and final pa by Product (as applicable). NOTICE TO CUSTOMER Yoe are entitled to a crempietdy filled -in copy alive Contract at the time you app Do not sign a Comply Certificate (note: there is else Completion Certificate for each listed Product as defined by individual Spec Sheets) before work on that Product is complete. In the event of terminadeo of this Contract. Cestoarer agrees to pay The Some Depot the costs of materials, labor. expenses seed services provided by The Hie Depot or Authorized Service Provider through the date of termlnadon, pleas any other annum set forth in this Agreement or allowed under fie law, THE HOME DEPOT MAY WITHHOLD AM S • OWED TO THE HOME DEPOT E'ROM 111E PAYMENT OR O'er PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. A Customer agrees aed urxierstands that this Agreement is the entire agreement between Customer and The Home Depot with -mad to the Products and Installation services and supersedes all prior discussions and agreements. either oral or written, rel aWtg said Prvslaots and instillation. Ibis Agreement cannot be assigned or amended except by a writing signed by Customer and The 11o= Depot- Customer aclmowledges and agrees that guar has read. umdexRands. voluntarily accepts the terms of and has • ved a copy of thus Agteerotat. Cust S ignature 1:16 Sales e• s , Date X Telephone No. Customer's Signature Dave Saks Consultant License No CANC1dId.6TION: CUSTOMER MAY CANCEL THIS (ac war AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING 'MUTTER NOTICE TO T11E HOME DEPOT BY MIDNIGHT ON THE THIBD BUSINESS DAY AFTER SIGNING TENS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO • CONTAINS A FORM TO IJSE IF ONE IS SPECIFICALLY SEA B'Y LAW ' IN CUSTOMER'S STATE. NOTICE: ADDITIONAL TERMS AAND CONDO tONS MIS EMT= ON DIE NEVEM SIDE AND ARE PART OP TeX CONTRACT 83110 ORO Mee —Bauch FIe Yellow — Cu$#eer City of Northampton • .... de=0.4... _, _ 4, Massachusetts.` - r i p G.. � - " J z l ? DEPARTMENT OF BUILDING INSPECTIONS a ., 212 Main Street • Municipal Building cl 1 ; Northampton, MA 01060 � - .wot 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 • • tea The Commonwealth of Massachusetts ... _ - Department of Industrial Accidents IA y , � Office of Investigations c_ row _,� 1 ` 600 Washington Street Boston, MA 02111 z,, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): lit ace4 , - Ate ' Address: 2(6'1 Q if R ti City /State /Zip: k V1tA (t3 O3 / Phone #: 'W �'j Ii'? Are yo an employer? Check the appropriate box: Type of project (required): 1. I am a employer with R(� 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- These sub- contractors have listed on the attached sheet. 7. ❑ Remodeling ship and have no employees 8. ❑ Demolition for me in any capacity. employees and have workers' working Y P tY- 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. n We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.0 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' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I 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 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: )\\5 i t'6 CO Policy # or Self -ins. Lic. #: t ��c 735 ,2 Expiration Date: - Job Site Address: City/State/Zip: , tY P �',. �� i Attach a copy of the workers' compensation policy declaration page (showing the policy number and expi ation 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 .:. inst the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of th D IA '*r insuranc 4 overage verification. I d hereby cer - y • under t :, , ins 'd pe ' lties of perjury that the information provided above is true and correct. ___ .- Si a 1 : ■ i , ./i ,/ Date: A. - Phone #: 4Cr) I - Official 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 #: zSECTION 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Su erv��, Not Appgcabje Name of License Holder 050 License Number d 7/ Addres / Expiration Date i A.11 _ L ID! q3 c S! Telephone 7 i'r;=e; ... ere ;8' o. m® oveme :ontraic o ,. Not Applicable ❑ G q • - De. fa-- 1,C2 Company Name Registration Number :Address + Expiration Date •_.4( lJ elephone L ib 1 (��6� S ECT 9N. a ri7K RS connt MSATIan INSU a 1P AFFln WP 4MS , fy Workers Compensation Insurance affidavit m be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildin ermit. Signed Affidavit Attached Yes No 0 1ir`fs d,t8 9 °I to R @ 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 • • k y �f � S l F`,-., ? . � � 9 ^,'• ^ v. ,, '" c j` a .M, � r , : ,E - ar � c ar ' ! . t�... �'z- a, SECTION 5` D OF PROPOSED WORK (check all . New House ❑ Addition ❑ Replacement Wi ows Alteration(s) n Roofing n Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 , I l i I Sid[J] Other [O] Brief Description of Proposed - di P IA Work: _ 1 i . I 1 1 / I (4)G1 rr Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet Q t.1 fl."S ® � o ddh' & - a'exis in of in ante" L1t ;e, E v o,`', ono: 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 4SECT1ON 7a ,.OWNER.AUTh O IZATIO ` 10 BE W H EN 4 . l WNER Y AGEN' O O RA N PPLIES FOR BUILDING PE x I, G4.. ` r A 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. It efi / Signature of Owner Date jjCd,r as Owner /Authorized Agent hereby declare tha the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. • Signed under th and pe rs •f perjury. Ski Print Name � ariff/ �/iAAI -- Signature of i er /A!,ent Date Section 4. ZONING. All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Y Existing Proposed Required by'Lailing " r ,; , This column to be filled in by Building Department Lot Size I 3 ( _ 1 ..w:. . ,.., Frontage E 1 I I I Setbacks Front ( 1 ( 1 I Side L: —I R:+ t L:1 . 1 R: 1 1 , Rear = ( 1 1-1 Building Height ( 1 11 Bldg. Square Footage 1 ) ( % 1 1 ( 1 Open Space Footage -_ 1 % 1 1 � ( ( (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 0 DONT KNOW 0 YES 0 IF 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 I Pagel 1 and /or Document # i B. Does the site contain a brook, body of water or wetlands? NO (,) DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: I i C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: I D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: I 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 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 14 EMILY LN BP- 2012 -0135 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18 - 030 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: REPLACEMENT DOOR BUILDING PERMIT Permit # BP- 2012 -0135 Project # JS- 2012- 000198 Est. Cost: $2743.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 98785 Lot Size(sq. ft.): 12588.84 Owner: CORNER MARK D C/O RONALD R SMITH Zoning: RR(100) //RI Applicant: HOME DEPOT AT HOME SERVICES AT: 14 EMILY LN Applicant Address: Phone: Insurance: 345 GREENWOOD ST (401) 935 -2633 () Workers Compensation WORCESTERMA01607 ISSUED ON:8/4/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT PATIO DOOR 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 8/4/2011 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner � Q - r A . _ • • V \ 4' 4.. r e , SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone 9. Registered Home Improvement Contractor: 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 ❑ 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 1083.5.1. 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" ce ifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State Local Zoning L �nd S to of Massachusetts General Laws Annotated. Homeowner Signature G�4 � ir., 7 3 /d • SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition [} Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [D Siding [D] Other [W]' Brief Desmi on of Proposed, _ / Work: "Old, , OP S�tPd itfP f" 7 gjaret ' £t'dt � / r� anc/ ek nc ARi�iev3A. RC the Jaara �o �4Vie r-� IC o F �/ + .JA lr ej / Alteration of existing bedroom Yes //No Adding new bedroom Yes 1, 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 . 1. 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 , 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. Signature of Owner Date R°P3P116 S M() / DAM fll. . 17t 1'Yi3'-,SIY - r -' , 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. 13b0PcQ . S°0\41 / SARA m. Al3FtmT -- Sm Print Name .. ■ . • Section 4. ZONING All 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 Aa s\ Lot Size / i 6 7 o2 g� x IO�L X S' Frontage Setbacks Front tie / -- t�ht Side L: 1 R: 0 L: 13 R: Rear 51 — - S'vn Building Height 35 / Srom6 Bldg. Square Footage /) 3 // % /)4/2 Z ii ..l Open Space Footage % rQ0 (Lot area minus bldg & paved y �(/ parking) ICS 29 ?I /0 n ° �+ # of Parking Spaces ( /3 i Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW O YES O IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO ® DON'T 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 O NO g 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, exca tion, 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. t • • Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability, Room 100 WaterANell_AvaitOity, Northampton, MA 01060 S u6tiFa}1 phone 413 - 587 -1240 Fax 413- 587 -1272 fit/ Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR EMOL O NE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: section to be completed by office �v LC", L 4� ko 01 er 0 o c o Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: f f , ;I . t . ' . 5rni- 1 ►4 rZa i)1. Adams -�rm � � 1 5d / /I/ L ./A/ , 1 I4ek{ � -� iV / o / O6O Name - fit) Cu ent M ilir(g Address: i l � , 4'3) 3y/ t377 . a . /. .. y . ,.luf• Teephone Signature 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 permit applicant 1. Building /400 ( 5 j (a) Building Permit Fee 1 � 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) /q(j 0 e 00 Check Number This Section For Official Use Only Building Permit Number: I sssuu ed: Signature: Building Commissioner /Inspector of Buildings Date * , S s BP -2010 -0085 GIS #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: shed BUILDING PERMIT Permit # BP- 2010 -0085 Project # JS -2007- 001702 Est. Cost: $1400.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 12588.84 Owner: CORNER MARK D Zoning: RR(100) //RI Applicant: RONALD SMITH & DARA ADAMS -SMITH AT: 14 EMILY LANE Applicant Address: Phone: Insurance: 14 ENILT LANE (413) 341 -3772 () NORTHAMPTONMA01060 ISSUED ON: 7/24/2009 0:00:00 TO PERFORM THE FOLLOWING WORK: I N STALL 8 X 10 SHED 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 7/24/2009 0:00:00 $25.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo