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�: SITE PLAN LAND SOLUTIONS
ca
CD o O PREPARED FOR
co ? n. SITE PLANNING
m �D ENVIRONMENTAL CONSULTING
p ' cr CHIP AND LISA KLOC DEVELOPMENT DESIGN
O ,o ° ��� , 87 HIGH STREET PERMIT PROCESSES
N Two Amherst Road-P.O.Box 121
o NORTHAMPTON, MA 01060 Sunderland,MA 01375-0121
413/665-4777 Voice and Fax
. ul
PLANS
I
I WINDOWS AND GLASS DOORS:
[ ] I 1. U-value: 0. 35
For windows without labeled U-values, describe features:
I # Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
I
DOORS:
[ ] I 1. U-value: 0. 35
Comments/Location
I
I FLOORS:
[ ] I 1. over Unconditioned Space, R-25
I Comments/Location
I
BASEMENT WALLS:
[ ] 1 1. 5.0' ht/4.0' bg/4.0' insul . , R-11
I Comments/Location
I
I AIR LEAKAGE:
[ ] I points, penetrations, and all other such openings in the building
I envelope that are sources of air leakage must be sealed. Recessed
I lights must be type IC rated and installed with no penetrations
I or installed inside an appropriate air-tight assembly with a 0. 5"
I clearance from combustible materials and 3" clearance from insulation.
I
VAPOR RETARDER:
[ ] I Required on the warm-in-winter side of all non-vented framed
I ceilings, walls, and floors.
I
MATERIALS IDENTIFICATION:
[ ] I Materials and equipment must be identified so that compliance can
I be determined. Manufacturer manuals for all installed heating
I and cooling equipment and service water heating equipment must be
I provided. Insulation R-values and glazing U-values must be clearly
I marked on the building plans or specifications.
I
DUCT INSULATION:
[ ] I Ducts in unconditioned spaces must be insulated to R-5.
Ducts outside the building must be insulated to R-8.0.
i
DUCT CONSTRUCTION:
[ ] I All ducts must be sealed with mastic and fibrous backing tape.
Pressure-sensitive tape may be used for fibrous ducts. The HVAC
I system must provide a means for balancing air and water systems.
I
I TEMPERATURE CONTROLS:
[ ] I Thermostats are required for each separate HVAC system. A manual
I or automatic means to partially restrict or shut off the heating
I and/or cooling input to each zone or floor shall be provided.
I
HVAC EQUIPMENT SIZING:
[ ] I Rated output capacity of the heating/cooling system is
I not greater than 125% of the design load as specified
I in sections 780CMR 1310 and 74.4.
I
MISC REQUIREMENTS:
[ ] I Refer to 780 CMR, Appendix 7 for requirements relating to swimming
I 001s, HVAC piping conveying fluids above 120 F or chilled fluids
I below 55 F, and circulating hot water systems.
----NOTES TO FIELD (Building Department Use Only)-------------------------
Page 2
PLANS
I I
MAScheck COMPLIANCE REPORT I I
Massachusetts Energy Code I Permit #
MAScheck software version 2.0 I I
I I
1 checked by/Date 1
I I
CITY: Amherst
STATE: Massachusetts
HDD: 6614
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 5-22-2002
DATE OF PLANS:
TITLE:
COMPLIANCE: PASSES
Required UA = 84
Your Home = 74
Area or insul sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
-------------------------------------------------------------------------------
CEILINGS 480 38.0 0.0 14
WALLS: wood Frame, 24" o.C. 357 19.0 0.0 21
GLAZING: windows or Doors 19 0.350 7
DOORS 39 0.350 14
FLOORS: over Unconditioned space 468 25.0 18
BSMT: 5.0' ht/4.0' bg/4.0' insul . 5 11.0 0
-------------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building ppans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable standard Design conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% of the design load as specified in
sections 780CMR 1310 and 74.4.
Builder/Designer Date
—
0
MAScheck INSPECTION CHECKLIST
Massachusetts Energy code
MAScheck software Version 2:0
DATE: 5-22-2002
Bldg. 1
Dept. 1
Use
I
CEILINGS:
[ ] 1 1. R-38
Comments/Location
I
1 WALLS:
[ ] 1 1. Wood Frame, 24" O.C. , R-19
1 Comments/Location
Page 1
06-20-00 14:,03 DEPT OF PUBLIC SAFETY ---- V V J rat dl
ENERGY CONSERVATION APPLICAFI4-FO?RM FOR
LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADDITIONS
780 PMR Appendix J-(eftective 3/1/98)
Applicant-Name: .sll��l,t�f� 14 /° SiteA&lress: 6 o
Applic&rtt Address: 1 - CityfTown:
F1�r7 L x,*7'¢ D914-4 Use Group:
_ Date of Application:
Pt�^rr-: Si 2�
A►�pll�-'�!nt ..N}�Ii�atlGil �i�a�i1�
Cemp"Mce Path(check one)
Q Prescriptive Package(Limited to 1- or 2- family wood 4rame-buitdings heated with fossil fuels only)
Package(A through KK from Table J5.2. lb). — Heating Degree Days (HDD s)from Table J5.2 la:
(For items d. through i., fill in all values that apply from Table J5.2)
a. Gross wall Area sq. rt f, wait f?Mahm- R-
b. Glazincr Areal sq. ft g. Flc�or R-Va!L:e �-
c. Glazing%,(100 x b+a) gb h. Basement wall g
d, Glazing U-yar n- 11. slab Porimeter R. _
e. Ceiling R-value R- i. Heating-AFUE
❑ C_-mpc-)et i Fervrrnancv- *Manual Trade Off` (limited to wood or metal lramed buildings only)
Ciirnate ZonLe(from Figure,J6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14
Attach Trade-Off Kbrksheet from Appendix J, [and NVAC Trade-Off Worksheet, it applicable)
❑ �AAScheck Software
Attach.Compliance Report and inspection Checklist printouts,
a Systems Analysis OR Q_ Renewable Energy Sources
Attach Mass Registered Architect or Engineer Analysis
ALTERNATIVE FOR ADDITIONS ONLY:
a. Gross Wall +Ceiling Area'7-f-7 sq. ft. b. Glazing Area' sq.ft. c-Glazing (100 x b+a)
R'-ADDITION with Glazing% (c.)up to 40% may use 780 CMR Table J1.1.2.3.1 below:
MAXIMUM U-r61ur Minimum R•Valucs
F&*stration Ceiling 1Na11 Roar basement Wall I Slab Perimeter, Dept
0:39- R 37 R 13 R:19 R-10 R•10,4 ft.
❑ -SUNROOM'addition(greater than 40% glazing-to-wall and ceiling gross area)
Attach `Consumer lntormation Form" from 780 CMIP Appcndix$,
Official's Name: Official's Signature:
Application Approved ❑ Denied Date of AFp uvallDenial:
flnoa Sv-nfs) Ivf Denial: (praYidc additional details as needed on back side)
1 Glazmsz.t ea=xy be tithe Rauch Opening oz Unit Thm =si
06-26-00 14 :01 TO:DEPT OF PUBLIC SAFETY FRON:413 4999444 P01
4�ttAAfP�0
9 g Grxt� of wart4ally toll
$ 6 �:iaxch«sctta'
e ,
�. DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE ATITITDAVIT
(li ceusee/permi flee)
with a principal place of business/residence at:
(phone#)
(str WCity/statfhip)
do hereby certify, under the pains and penalties of pegury, that:
O I am an employer providing the following workers compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Hxpiraaon Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(aftacl3 additio"sbcci ifneceuary to inchfde information pertaining to ell eo�ra.don)
( ) I am a sole proprietor and have no one 'working for me.
I am a home owner performing all the work myself.
NOTE:please be aware that whilo homeowners who employ pcccom to do mn acaj�comir=co er repair work on a dwelling of
not morn than threo units in which the homoowncr r mdcs or on the'grounds appurtenant tb=to arc oot gcnaally omn6cmd to be
eraployen under tho worker's.00mpen 4aa Act(GL152„ss i(5)),appLication by a homeow=for a U—C or permit may evidence the
legal ctahrs of an amp loyor under tho Workoda Compaxj&tion AcL
I undcntand that a copy of this statcmcnt may be forwarded to tbo Dcpartmco2 of Dial Aoad.'i OfSoe of La;unnoa for tba
oovexge vcrificstioa and that failure to&==oovcmp under soeioa 25A of MGL 152 can Icad to tbo imposition of criminal pmt ks
ooaustmg of a fine of up to S1,500.00 andlor imprisoamcai of tip to orx year and cio peaattia in the form of a stop Work Ordtr and a
fine of 5100.00>t day tguinst tae.
For dcprat we —caly
permit Number
Maid Lot#
, .,..: ic=scc/Permittce
SEGTION�8" CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
RetlI�ome;im vv menC n ra r� �r� Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
SECTIOK 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(K.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...... ❑
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 a as es responsib'lity for compliance with the State Building Code,City of
Northampton Ordinances, State.and Loc ng La ate of Massachusetts General Laws Annotated.
Homeowner Signature
,
t
SE TIOt5.�DESCRIPTIONIIOFIPROPOSED WORKS checkall a licable y
Wt ex 9n ws a .r,W -z . a uwxygynyn m x 'n -a1�SnE
r
,s
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: �'/?
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet 0
6a, IfNehouseand oraddition..to ezistin using,4co m°`IetetFSe followin
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: G/9 Number of Bathrooms—
c.
Is there a garage attached?
d. Proposed Square footage of new construction. �i Dimensions
e. Number of stories? ` I
f. Method of heating.
Fireplac or Woodstoves Number of each L
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
h. Type of construction -'L/4 S 4TrATe-f4cc)
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 an Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
.SECT ION"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
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.
Print Name
Signature of Owner/Agent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Sized ti
Frontage .� ✓6
Setbacks Front 3 p f- n 0
Side L: t,„2 R: 6�� L: R: o�
Rear t7,r t
O
Building Height 076 35-
ti
Bldg.Square Footage Q%d 0 %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces l'
Fill:
volume&Location 4
A. Hasa Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:6�
IF YES: Was the permit recorded at the Registry of Deeds?
NO
DON'T KNOW YES
IF YES: enter Book �b Page �O �G' and/or Document #
CEO o
B. Does the site contain a brook, body of water or wetlands? NO _ DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES
No
IF YES, describe size, type and location:
i
�U� I Northampton
�; } !S ly i i g Department
1 Main Street
MAY 2 3 200 i
om 100
or ton, MA 01060
87. 240 Fax 413.587-1272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This section4to;be com' leted by office �re
1.1 Property Address: °3
Map Lot
,7 X .; yx
l
�r
1, r �
;Elm St:Di'strict �9 CBbiri rcf
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: 4/G'6 Z-
rC
Name Pri ) Current Mailing A dress: _
Z//?
Telephone
Signature --
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTi'ON-3�- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed b . ermit applicant
1. Building %�J�:� (a) Building Permit Fee
2. Electrical ?�j (b) Estimated Total Cost of
,1 Construction from(Q
3. Plumbing
Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (I + 2 + 3 + 4 + 5) G C Check Number
This Section For Official Use;Onl .
Bulld Date Issued:
k
Signatures r
oj
Buildl�B Commissioner/Inspectbr of Bwings
File#BP-2002-1042
APPLICANT/CONTACT PERSON KLOC STEPHEN S III&LISA J
ADDRESS/PHONE 87 HIGH ST (413) 584-4526 Q
PROPERTY LOCA1
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 26 X 18 BEDROOM ADDITION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved V 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: § 9, ?
? •S/� S —
Finding V 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 Co ion
66 06 200
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.
OCT 1 0 2002
DEPT 0�BUILDING IN
NORTHAMPTON,MA 01060
10-OCT-2002 11:00:26 Hampshire County Registry of Deeds Receipt No: 180120
Marianne L. Donohue, Register of Deeds
33 King Street
Northampton, MA 01060-3298
Name: STEPHEN KLOC Addr: 87 HIGH STREET
FLORENCE MA 01062
STEPHEN
Receipt Type: OR
Payment
Total Pages: 0002 Fees Taxes
Fee: $ 10.00 Cash: $ 0.00 $ 0.00
Tax: $ 0.00 Check: $ 30.00 $ 0.00
Misc: $ 20.00 Charge: $ 0.00
Charge Code:
Comment: DECISION REGARDING FINDING
Receipted By: LINDA Status: PAID
DOCUMENTS: 992230704 to 992230704
------------------------------------------------------------------------------------------------------------------------------------
Type Page Doc Mref Consider$ Record Fee Excise Tax Stat Misc Fee Record Date Document# Book/No/Page Status
---- ---- --- ---- ----------- ----------- ----------- ---- ----------- ----------------- --------- -------------- ------
MIS3 002 0001 0001 0.00 10.00 0.00 20.00 10-OCT-2002 10:59 992230704 OR /6825/0271 INIT
Page 0001 of 0001
File#BP-2002-1042
APPLICANT/CONTACT PERSON KLOC STEPHEN S III&LISA J
ADDRESS/PHONE 87 HIGH ST (413)584-4526 Q
PROPERTY LOCATION 87 HIGH ST
MAP 17C PARCEL 108 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction• CONSTRUCT 26 X 18 BEDROOM ADDITION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFSTRMATION 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 Co sion
47 1 1- c70
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.
H BP-2002-1042
GIs#: COMMONWEALTH OF MASSACHUSETTS
L L a CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2002-1042
Project# JS-2002-1676
Est. Cost: $30700.00
Fee: $186.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor_
Lot Size(sq.ft.): 161 17.20 Owner: KLOC STEPHEN S III&LISA J
Zoning:URB Applicant: KLOC STEPHEN S III & LISA J
AT. 87 HIGH ST
Applicant Address: Phone: Insurance:
87 HIGH ST (413) 584-4526 O
FLORENCEMA01062 ISSUED ON:10122102 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 26 X 18 BEDROOM ADDITION
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/22/02 0:00:00 93 $186.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
87 HIGH ST BP-2002.1042
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block: 17C- 108 CITY OF NORTHAMPTON
Lot: -001
Permit: Buildins?
Category BUILDING PERMIT
Permit# BP-2002.1042
Project# JS-2002-1676
Est. Cost: $30700.00
Fee: $186.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor _
Lot Size(sg. ft.): 16117.20 Owner: KLOC STEPHEN S III&LISA J
Zoning. URB Applicant: KLOC STEPHEN S I i I & LISA J
AT: 87 HIGH ST
Applicant Address: Phone: Insurance:
87 HIGH ST (413) 584-4526 Q
FLORENCEMA01062 ISSUED ON.10122102 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 26 X 18 BEDROOM ADDITION
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:
8//Q Rough Frame:
l
Gas: Fire Department _ '� � 1 Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: ' J7K Final: 457
THIS PERMIT MAY BE REVOKED BY THE CIT OF NORTHAMPTON UPON VIOLAA,49N OF
ANY OF ITS RULES AND REGULATIONS. -°
Certificate of Occupancy, si nature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/22/02 0:00:00 93 $186.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Conmussioner-Anthony Patillo ¢''