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23A-291 (7) 3 y/ J/w//-�7 -S�e-7-s Z3vsrclC�w � I('k" �-N MODEc MILY DFNTiSTRY GIS#: COMMONWEAL T'H OF MASSACHUSETTS Map:Block:23A-291 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2015-0754 Proiect# JS-2015-001459 Est. Cost: $229930.00 Fee: $1379.00 PERMISSION IS HEREBY GRANTED TO. Const. Class: Contractor: License: Use Group: KEITH MODESTOW 58467 Lot Size(sq.ft.): Owner: MODESTOW IAN E&MICHELLE M KERSBERGEN Zoning: GI000) Applicant: KEITH MODESTOW AT. 190 NONOTUCK ST - MODESTOW FAMILY DENTISTRY Applicant Address: Phone: Insurance: 36 BURLEIGH RD (413) 566-0286 WC HAMPDENMA01036 ISSUED ON:112912015 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT & DEMO 2 WALLS & INTERIOR RENOVATION POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring L.P.W. Building Inspector Underground: Service: �/ kA f, 1: Meter:j_�'' Footings: Rough: Rough:z J-tr House# Foundation: Driveway Final: c w� Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: ^ Final: Smoke: Final: .7,,f O� THIS PERMIT MAY BE REVOK D Y THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND RE TIO Certificate of Occupancy Si nature: 7 / V/r FeeType: Date Paid: Amount: Building 1/29/2015 0:00:00 $1379.00 212 Main Street, Phone(4'3) 587-1240, Fax: (413)587-1272 Louis Hasbe(.m(1h Building,Commissioner