23A-008 (2) • Miscellaneous trim beneath the peninsula countertop, cabinet/wall junctions, etc.
• Air Sealing—Using low-expansion foam, insulate all cracks and voids on inside of sheathing prior to
cellulose insulation being installed
• Kitchen—Living Room Wall.
o Please note that there are unknowns here. MORE INFORMATION IS REQUIRED. There
is a potential for work beyond that listed below,to be necessary. It will be necessary to open-
up the existing walls,ceiling,and flooring,so that a thorough analysis can be made.
o This contract includes an allowance for(80)man hours and$1,000.00 for materials to complete
the structural work and any possible trim associated with this project.
o It is assumed that a structural header with posts continuous to the basement foundation will be
required.
o It is possible that re-wiring and/or re-plumbing may be required in this area. This contract does
not include an allowance for these items.
LIVING ROOM
• Framing
o All miscellaneous blocking,fire blocking,fire/draft sealing in walls and ceiling
o Installation of new strapping(furring strips) on ceiling
• Windows
o Demolish the existing(3)windows, interior trim,and exterior trim—back to rough opening.
o Install (3)new construction window units. This includes the following:
• Installation of window unit
• All associated flashing and weather/air sealing
• New exterior trim to match existing
• New flashing detail/drip cap above exterior casing
• New siding to match existing where required
• New interior,pre-primed pine for casing and apron
• New interior window stool using poplar
• This contract includes a$450.00 allowance for each new window unit
• Baseboard
• New baseboard trim in the living room area
MISCELLENEOUS
• Portable Toilet
• Dumpster
• Dust Control
TOTAL CONSTRUCTION COST (NOT INCLUDING SUBCONTRACTORS) $46,517.67
SUBCONTRACTORS
**PLEASE NOTE THAT SUBCONTRACTOR PRICES ARE ESTIMATES ONLY**
• Please see the attached Subcontractor Estimates for the following:
o Plumbing,Electrical,Drywall,Flooring,Insulation,and Professional Cleaning
TOTAL SUBCONTRACTOR EXPENSE (INCLUDING MARK-UP) $18,809.11
• Demolition and debris removal for the following:
o Existing cabinetry
o Existing appliances
o Existing interior drywall,or equivalent,on walls
o Existing drywall, or equivalent,on ceilings
o Existing flooring material to a sufficient base
o Existing wall and ceiling insulation
o Interior wall between kitchen and living room,as described in the section named: `Kitchen-Living Room
Wall'
o Windows—Full Tear Outs—As described in the respective window sections
KITCHEN
• Framing
o All miscellaneous blocking, fire blocking, fire/draft sealing in walls and ceiling
o Installation of new strapping (furring strips)on ceiling
• Cabinets & Countertops
o Please see the attached quote from r.k. Miles dated 05-09-13 showing all cabinet and countertop
specifications and pricing.
o The r.k.Miles quote includes countertop installation
o Keiter Builders will install all cabinetry,as shown in the plans generated by r.k. Miles.
• Windows
o Demolish the existing(3)windows, interior trim,and exterior trim—back to rough opening.
o Re-frame this wall to accept a triple-mulled,double-hung window unit. This includes:
■ Structural re-framing for new window opening
• Installation of window unit
• All associated flashing and weather/air sealing
• New exterior trim to match existing
• New flashing detail/drip cap above exterior casing
• New siding to match existing where required
• New interior,pre-primed pine for casing and apron
• New interior window stool using poplar
• This contract includes a$1,350.00 allowance for the new window unit
• Doors
o Demolition of the existing pantry room/kitchen door
• This contract includes a$300.00 allowance for a new,pre-hung interior door and hardware
• Installation of new,interior casing on the pantry and kitchen side
• Installation of any extension jambs,if required
o Demolition of the existing mudroom/kitchen door
• This contract includes a$500.00 allowance for a new,pre-hung door and hardware
• Installation of new,interior casing on the pantry and kitchen side
• Installation of any extension jambs, if required
• Miscellaneous
o Labor to install kitchen appliances
o Range Hood Venting—This contract includes venting the range hood via a 4"hard pipe duct to either the
roof or wall.
o Installation of 4"round,aluminum soffit vents on the eaves of kitchen and living room areas
o Installation of a new attic access hatchway in the pantry area
• This will include a flat casing against the ceiling,jambs,a plywood hatch,and foam insulation above
o Trim—This contract includes installation of the following:
• New baseboard trim in the kitchen and mudroom area
IL BUILDERS
SCOPE OF WORK
June 10,2013
CUSTOMER NAME: Jenn Basile&John Bartlett
ADDRESS: 38 Park Street,Florence,MA 01062
PROJECT ADDRESS: 38 Park Street,Florence,MA 01062
ESTIMATED START DATE: September 16th,2013
ESTIMATED PROJECT RUN TIME: 8-Weeks
THE FOLLOWING ITEMS ARE NOT INCLUDED IN THIS SCOPE OF WORK:
• Painting
• Removal of asbestos or insulation from basement area
• Appliances
• Lighting fixtures,except those listed in the attached Electrical Proposal
• Plumbing fixtures, except those listed in the attached Pluming Proposal
• Any work in the mudroom,except for the following:
o Demolition of existing baseboard and flooring to sufficient base
o Installation of new ceramic floor tile as stated in the attached Subcontractor quote
o Installation of new baseboard to match kitchen area
o Work on the doorway between the kitchen and mudroom,as described below
• Any work in the pantry,except for the following:
o Relocation of washing machine as described in the attached Subcontractor quote
o Installation of a new attic access panel as described below
o Installation of a new door between the kitchen and pantry,as described below
• Please note that this contract does not include the leveling or straightening of walls,ceilings,or flooring. An effort
will be made to make reasonable adjustments to floor, wall,and ceiling framing. The house has moved over many
years. It may not be reasonably possible to correct this movement during the scope of this project.
ADMINISTRATION
• Keiter Builders,Inc.will manage the following aspects of the project:
o Building permit application and associated fees
o Standing all necessary inspections
o Subcontractor oversight and management
o Materials ordering,receiving,and delivery
o Site set-up and break-down
o Certificate of Occupancy
KITCHEN AND LIVING ROOM REMODEL
DEMOLITION AND SITE PREPARATION
ENTIRE AGREEMENT, SEVERABILITY, AND MODIFICATION
This Agreement represents and contains the entire agreement and understanding between the parties. Prior
discussions or verbal representations by Contractor or Owner that are not contained in this Agreement are not a
part of this Agreement. In the event that any provision of this Agreement is at any time held by a Court to be
invalid or unenforceable, the parties agree that all other provisions of this Agreement will remain in full force and
effect. Any future modification of this Agreement should be made in writing and executed by Owner and
Contractor.
MISCELLANEOUS
This agreement is a Massachusetts contract, contains the entire agreement between us, any representations or warranties
not expressly contained in it are not a part of the Agreement, and it is binding upon our heirs, executors, successors and
assigns. This Agreement may be modified only by an instrument in writing signed by both of us.
This agreement is subject to and is intended to comply with the provisions of Chapter 142A of the Massachusetts General
Laws and its corresponding regulations.
YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN SIGNED BY A PARTY THERETO BY FORWARDING
YOUR INTENT TO CANCEL IN WRITING BY ORDINARY MAIL POSTED, BY TELEGRAM SENT OR BY
DELIVERY, NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING THE SIGNING OF
THIS AGREEMENT.
By signing this Agreement, you acknowledge that you have received a complete and original signed copy of the entire
Agreement and attached Addenda. Contractor may not start work until after this Agreement has been signed.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. THIS IS A LEGALLY BINDING
AGREEMENT. IF THERE ARE ANY PROVISIONS WHICH YOU DO NOT UNDERSTAND, YOU SHOULD
CONSUL "ITH AN ATTORNEY BEFORE SIGNING.
KEIT 'R ; ILDERS,INC. (CONTRACTOR) HOMEOWNER
qic(i3 b "Yott Keiter,President Date Date
Date
ADDENDA
The following have been attached to this Agreement:
1. PAYMENT SCHEDULE
2. SCOPE OF WORK
3. COPY OF INSURANCE
4. LIMITED WARRANTY
5. CHANGE ORDER(COPY AND EXPLANATION)
1 1
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to
this statute,an employee is defined as"...every person in the service of another under any contract of hire,express or implied, oral or
written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the
foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an
individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not
more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do
maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because
of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a
license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced
acceptable evidence of compliance with the insurance coverage required."Additionally,MGL chapter 152, §25C(7)states
"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,
supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability
Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to
carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit
may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date
the affidavit.The affidavit should be returned to the city or town that the application for the permit or license is being requested, not
the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance
license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must
submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy
information (if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or town)."A copy
of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid
affidavit is on file for future permits or licenses.A new affidavit must be filled out each year. Where a home owner or citizen is
obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to burn leaves etc.)said
person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,please do
not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
l Congress Street, Suite 100
Boston, 02114-2017
Tel. 617-2017-4900 Ext. 406 or 1-877-MASSAFE
Fax#617-727-7749
www.mass.gov/dia
Revised 7-2010
Z:\Workers Comp Aff-Highlited.doc
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
1 Congress Street, Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): 1ZS 1'1-E iz- Pv U l(_C>tg-5� /',IC- .
Address: JI Pr Plui--e...m S f
City/State/Zip: /kjb 1741.A.iil/tp AAA 0(6k6 Phone#: 4/3•&S("- ' gab
Are you an employer? Check the appropriate box: Type of project(required):
1. Elt I am an employer with 3 4. ❑ I am a general contractor and I 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors 7. Remodeling
listed on the attached sheet.
2. ❑ I am a sole proprietor or partner- These sub-contractors have 8. ❑ Demolition
ship and have no employees employees and have workers' 9. 0 Building addition
working for me in any capacity. comp. insurance.;
[No workers' comp. insurance 10.❑ Electrical repairs or additions
required.] 5. ❑ We are a corporation and its
officers have exercised their 11.❑ Plumbing repairs or additions
3. ❑ I am a homeownerSeattle8 doing right of exemption per MGL c. 12.❑ Roof repairs
all work myself. [No workers' 152, §1(4),and we have no
comp.insurance required.] ]' employees. [No workers' 13.❑ Other
comp. insurance required.]
*My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
1'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' mpensation insurance for my employees.Below is the policy and job site
Insurance p Y Com an Name: 717a V '`'�V 5 5u vat be--
Policy#or Self-ins. Lic.#: -L ZA-5!'O> 7 g a_ Expiration Date:
6 , /(. i'.
Job Site Address: All Locations Sg City/State/Zip --
Far-e44 t-e MA- 616
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.
I do hereby certify der the pains and penalties of perjury that the information provided above is true and
correct.
Signature: I Al; �_fl Date: (o` 2:7- 13
Phone#: 4( -s 86ac.)
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#:
Z:\Workers Comp Aff-Highlited.doc
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: 'V/ ��y/ Not Applicable ❑
Name of License Holder: V C..O`�T Ve I-re �- . C J - l a 2 4-s
License Number
61 ,1 4 t t e l k - HD`( Giwp P k - o (o(Q G fo • 2.0 . I L
ddress Expiration Date
VOL-
ignature Telephone
9.Registered Home Improvement Contractor: Not Applicable ❑
in" - VDU( Lc.)E.e 1 t gC • 1751 . 6
Com an N e Registration Number
SI h 'tka NorkwAke-6-), I - 6 tO (96
Address 2 Expiration Date
Telephone413.W0 $(66
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(l) 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
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement. indows Alteration(s) ❑ Roofing ❑
Or Doors ,
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [Q Siding[O] Other JI]
Brief Description of Proposed 4 /
L
Work: t�1C,-4 e/v� ✓ wt o d
Alteration of existing bedroom Yes No Adding new bedroom Yes 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.
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
, 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
I (,04-4—K-eA le[/ a� ref:4r (,u�Q�-Grs L • , as Owner/Authorized
Ag nt hereb declare that the s ments and information on the foregding application are true and accurate,to the best of my knowledge
9 hereby
and belief.
Signed under the pains and penalties of perjury.
SCOTT I� TOL_
Print ame
4.1 ■ a ■• . 17- 13
SisCure of• ner/Agent Date
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
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(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 DON'T KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES Q
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Q , Date Issued:
C. Do any signs exist on the property? YES Q NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Q
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 Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
RECEIVED City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
F______
'� `" s` Room 100
Water/Well Availability
_ orthampton, MA 01060 Two Sets of Structural Plans
DEPT.NORTHAMPTON tiAigilune 4 3-587-1240 Fax 413-587-1272 Plot/Site 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
36 Pa/a. t, Map Lot Unit
,Gt5re M f}- 0(O s' 2 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
1_,
K(T-e.l- t 3' t--
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
.S�o-�-E- I�-e( �{oC / r' r Bui r�-er� (kc 51 A— -�� � si- Mv4tamplav
1
Na (Print) Current Mailing Address: Q /d 66'
Lit-0.58k) - 5660
ignature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 6Z , 2(0 7e (a)Building Permit Fee
2. Electrical 2 a�O — (b) Estimated Total Cost of
Construction from(6)
3. Plumbing 5/ O d Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) 605/ 324' . 78 Check Number dL36 ØQ,/, gb
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2013-1251
APPLICANT/CONTACT PERSON SCOTT KEITER
ADDRESS/PHONE 51A HATFIELD ST NORTHAMPTON (413)320-9035
PROPERTY LOCATION 38 PARK ST
MAP 23A PARCEL 008 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out L ��
Fee Paid a 6/ .., 3$ 9
Typeof Construction: REMODEL KITCHEN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 102457
3 sets of Plans/Plot Plan
THE FOLL G ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN TION PRESENTED:
pproved 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
,00,
-.•. iti•• 15 elay
Or /.r '' --P-15
Signature of Building 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.
38 PARK ST BP-2013-1251
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23A-008 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: renovation BUILDING PERMIT
Permit# BP-2013-1251
Project# JS-2013-002060
Est.Cost:
Fee: $391.80 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SCOTT KEITER 102457
Lot Size(sq. ft.): 12458.16 Owner: BUCKLEY JENNIFER B
Zoning: URB(100)/ Applicant: SCOTT KEITER
AT: 38 PARK ST
Applicant Address: Phone: Insurance:
5 l HATFIELD ST (413) 320-9035 WC
N O RT HAM PTO N MA01060 ISSUED ON:7/3/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:REMODEL 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 7/2/2013 0:00:00 $391.80
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner