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N iv / i " _L:y V t't 1 .
THE FOLLOWING NOTICE OF CANCELLATION MUST BE IN DUPLICATE, ATTACHED TO THE
CONTRACT, FOR ANY SALE OVER $25 THAT TAKES PLACE AT THE CONSUMER'S HOME OR
SOMEWHERE OTHER THAN THE BUSINESS LOCATION. THE WORDING IS SPECIFIED IN MGL C. 93
Section 48. A SIMILAR CANCELLATION NOTICE IS IS REQUIRED IF THE CONSUMER'S HOME IS
BEING USED AS SECURITY IN THE CONTRACT. SEE CHAPTER 140D SECTION 10
THE NOTICE MUST' BE IN TEN POINT BOLD FACE TYPE
NOTICE OF CANCELLATION
date of transaction
You may cancel this transaction, without any penalty or obligation,
within three days of the above date.
If you cancel, any property traded in, any payments made by you under
the agreement, and any negotiable instrument executed by you will be
returned within ten business days following receipt by the seller of your
cancellation notice, and any security interest arising out of the transaction
will be cancelled.
If you cancel, you must make available to the seller at your residence,
in substantially as good condition as when received, any goods delivered to
you under this agreement; or you may if you wish, comply with the
instructions of the seller regarding the return shipment of the goods at the
seller's expense and risk.
If you do make the goods available to the seller and the seller does not
pick them up within twenty days of the date of your notice of cancellation,
you may retain or dispose of the goods without further obligation. If you fail
to make the goods availableto the seller, or if you agree to return the goods to
the seller and fail to do so, then you remain liable for performance of all
obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of
this cancellation notice or any other written notice, or send a telegram to
(name of seller) at (address of seller's place of business) not later than
midnight of (date).
I hereby cancel this transaction (date)
buyer's signature
•
•
•
•
PAGE THREE
CANCELLATION RIGHT
You may cancel this agreement if it has been signed by a party thereto at a
place other than the address of the seller, which may be his main office or a
branch thereof, provided that you notify the seller in writing at his main
office or branch thereof by ordinary mail posted, by telegram or delivery,
not later than midnight of the third business day following the signing of
this agreement. See the attached notice of cancellation form for an
explanation of this right.
DO NOT SIGN THIS CO TTRA ` THERE ARE ANY BLANK SPACES.
"?\
Home& ner(s) 1
Contra o \
NOTE IN ADDITION TO THE HOMEOWNER'S RIGHTS BY THE LAW, THE CONTRACTOR CAN REQUEST
ARBITRATION TO RESOLVE DISPUTESWITH THE HOMEOWNER IF THAT IS AGREED TO BY BOTH
PARTIES IN THE CONTRACT. IF THE CONTRACTOR APPLIES FOR ARBITRATION, THE HOMEOWNER
MUST DELAY ANY COURT ACTION UNTIL AFTER THE ARBITRATION HEARING.
OPTIONAL CONTRACTOR ARBITRATION AGREEMENT
The contractor and the homeowner hereby mutually agree in advance that in
the event that the contractor has a dispute concerning this contract, the
contractor may submit such dispute to a private arbitration service which has
been approved by the Secretary of the Executive Office of Consumer Affairs
and Business Regulations ..: he consumer shall be required to submit to
such arbitration as • ppr r ed i s MGL C.142A.
OP ‘1,
Contractor Homeowner .4e.
Notice: The signatures of the parties above apply only to the agreement of the
parties to alternate dispute settlement initiated by the contractor. The owner
may initiate alternative dispute resolution when this section is not signed by
the parties.
•
PAGE TWO
Materials Contractor Will Supply`�� `
Materials or Labor To Be Supplied By Homeowner(s) . P (r t
IF CONTRACTOR IS DOING WORK FOR WHICH CONSTRUCTION - RELATED PERMITS ARE REQUIRED,
THE CONTRACTOR MUST OBTAIN THOSE PERMITS FOR THE HOMEOWNER. HOMEOWNERS WHO
OBTAIN THEIR OWN PERMITS FOR THAT WORK CANNOT MAKE CLAIMS TO THE GUARANTY FUND
OR BE ABLE TO OBLIGE THE CONTRACTOR TO GO TO ARBITRATION. THE HOMEOWNER IS
RESPONSIBLE FOR OBTAINING ANY SPECIAL PERMITS THAT MAY BE REQUIRED UNDER THE
ZONING BY -LAWS, CONSERVATION COMMISSION ORDERS, ETC.
Contractor will obtain the following permits:
Building Demolition
Plumbing Electrical
Gas Other (Describe)
Total Contract Price ( in dollars and written out in words) 2 aQ G 0)
Downpayment of $ / must be paid by this date /®// yl---
THE CONTRACTOR MAY NOT TAKE PAYMENT OF MORE THAN ONE - THIRD OF THE CONTRACT
PRICE BEFORE THE WORK STARTS UNLESS A GREATER AMOUNT IS NEEDED FOR THE ACTUAL
COST OF ANY SPECIAL ORDER OR CUSTOM MADE MATERIAL OR EQUIPMENT WHICH MUST BE
PAID FOR IN ADVANCE. DO NOT PAY IN FULL UNTIL THE WORK IS COMPLETED AND INSPECTED
Schedule of Remaining Payments:
Amount 1 At What Point A 0 1 , -J 0..h 1
Description of Any Warranties By Contractor: 0 f'' yi-
Description Of ADy� rrOr Security Interest In The Residence As Part Of This Contract:
HOME OWNERS WHO DEAL WITH REGISTERED CONTRACTORS FOR WORK COVERED BY THE HOME
IMPROVEMENT LAW, MGL C. 142A, HAVE THE RIGHT TO REQUEST ARBITRATION OR TO SUE TO
RESOLVE DISPUTES WITH THOSE CONTRACTORS. THEY MAY ALSO MAKE CLAIMS TO THE
CONTRACTOR GUARANTY FUND FOR ACTUAL LOSES UP TO $10,000 IF THEY ARE UNABLE TO
COI I ECT THOSE LOSES FROM THEIR CONTRACTORS. FOR INFORMATION ABOUT ARBITRATION
AND THE GUARANTY FUND, CONTACT THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS
(617) 727 -7780
t
AIRK*10,
2 TECEIvED
OL ! 4 2011
HOM IMPROVEMENT CONTRACT
DEPT. OF BUILDING INSPECTIONS
This is the r >' irema eem� � between the contractor and the homeowner made on this
date dc- . t
Name of Contractor: f l c ir i 1/
Address: 1- 1_'S EZ--1 cs`T pi-A-(1 ON
( may not be a post office box) 7 l . 3 - ��g C 2y0
Telephone Number: _
Name of Salesperson (if any)
AS OF JULY 1, 1992, ALL HOME IMPROVEMENT CONTRACTORS AND SUBCONTRACTORS
COVERED BY MGL CHAPTER 142A MUST BE REGISTERED WITH THE STATE TO CHECK ON A
REGISTRATION CONTACT THE DIRECTOR, HOME IMPROVEMENT CONTRACTOR
REGISTRATION, ONE ASHBURTON PLACE , ROOM 1301, BOSTON, MA 02108,
(617) 727 -8598.
Contractor's Registration Number b 9+ 9
HOMEOWNERS WHO DEAL WITH UNREGISTERED CONTRACTORS CANNOT OBLIGE THEM TO GO
TO ARBITRATION AND CANNOT MAKE CLAIMS TO THE GUARANTY FUND UNDER THE HOME
IMPROVEMENT LAW. _
Name(s) of Hom�owner(s)
Address 2• I- RTC / 7 4 1: , ( - 6r - e „, e/ (9 `,
Home Telephone: II '5S l ' 3 / Work Telephone: f fr
Date Work Will Begin: / 8 // � } /1
Date Work Will Be Substanti y Co pleted: 0 ( a'
These dates may change because of delays in getting materials, permits, inspections,
weather conditions, subcontractors' schedules or other problems beyond the
subcontractor's control. The contractor agrees to let the homeowner know about any delays
immediately. Changes to dates, the work to be done, materials or price will be written and
then initialed by the contractor and the homeowner(s), and attached to h's contract.
Description of Work by Contractor: _F�O N` T d ' r
j a. ILtiY ci / s
els ,•: 4 _ 1 i-1'
KHR City of Northampton
��{ s �
Massachusetts ; ? E 1
DEPARTMENT OF BUILDING INSPECTIONS 4 x,
212 Main Street • Municipal Building t3b��'�b,
"" Northampton, MA 01060 sal 1 ~9'
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
. The Commonwealth of Massachusetts
•
Department of Industrial Accidents
7 w Office of Investigations '
= 600 Washington Street
_
_w
Boston, MA 02111 r
, " www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /Plumbers
Applicant Information Please Print Legibly
Name (Business /Organization/Individual): 61 f F/ IV At
Address: 13 - � ► �. I 0 - P1 ----
P'_ .-7--1--0 0 / 6
City /State /Zip: Phone #:
Are you an employer? Check the appropriate box: Type of project (required):
1. ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction
employees (full and/or part- time).* have hired the sub - contractors
2. I am a sole proprietor or partner - listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. ❑ 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 12.111 Roof repairs
insurance required.] t c. 152, § 1(4), and we have no 13. Other fd ? 'C.. .
employees. [No workers'
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:
------_J Ex Expiration Date:
Policy # or Self -ins. Lic. #: P
Job Site Address: City /State /Zip:
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 certi nde the pa' s and pe lties of perjury that the information provided above is tr a and orrect.
Signature: Date:
Phone #: 1 ---It/ 2 'J ' O 4 2.17
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 #:
5
t
SECTION 8 - CONSTRUCTION SERVICES . I
8.1 Licensed Construction Supervisor -
: � �� _ . Not Applicable ❑
Name of License Holder : a 1e- t " ' " '+)
License Number
1 7 1 3 is L .477% f - ' /gyp 01631 Sa g � g
Addres Expiration Date
8 6'2.0
Signature Telephone 7 1 7/2-,
e s eredFlocnePm •rave'tnen °anlractotis¢ µ ;ms .,,.,;' ., .?, �. Not Applicable ❑
Ric t /
Company Name Registration mber
d f-'r of039 l/3 6 7 7
"- -
Address , Expiration Date
Telephone 119 - Q 7 7 1
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIl1AV1t(M G : c 452, § 25C(6)) 4
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 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
•
x .
SECTION 5= DESCRIPTION OF PROPOSED WORK (check all applicable) b ,
.
New House ❑ Addition ❑ Replacement Windows Alteration(s) N, Roofing I
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding [0] Other [01
Brief Description of Proposed g / 7 /
Work: n hu ll� / 1'o ,"( ,e0 2
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
WI . evnith "cruse atid4O iadditionita`ex stln "o lsit c ; comp e telthe4a oW ng:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: 1., Number of Bathrooms 1
c. Is there a garage attached? t.' 0 0 d. Proposed Square footage of new construction. 0 Dimensions
e. Number of stories? 0-
f. Method of heating? 0 /L Fireplaces or Woodstoves 0 Number of each 0
g. Energy Conservation Compliance. N. ( 4 - Masscheck Energy Compliance form attached?
h. Type of construction (,../ C t' 1)
i. Is construction within 100 ft. of wetlands? Yes &` No. Is construction within 100 yr. floodplain Yes K No
j. Depth of basement or cellar floor below finished grade
6 0 6 "
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer 1 4 Private well City water Supply
SECTION 7a OWNER_AUTHoRIZ4TION „TO BE COMPLETES WHEN : i
'4 OWNERS. AGENT OR CONTRACTOR. APPLIE FORB PERM
I, , as Owner of the subject
property
hereby authorize i G^1( ' 2 1 N N
to act on m. ehalf, in all matters r- : v- o work authorized by this building permit application.
Signa .re of Owner q/ Date /e /
t f e /-4-fi , 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.
A .4 Jjt 61 o t tc ✓f
Print Name / / "
Sign. ure of Owner /Agent / Date !J ill
•
t
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed / Required by'Loning }
This column to be filled in by
Buildin Department
a
1:(2P:5 � � ' ' 1 ire *j. � , .
Lot Size ' ' „ �`Amr
e«r..
i i I MIF , 1
Frontage 1 _ �`� f
Setbacks Front 1 /.5i =___
1 R: I
Side L:' ! R L:i 1
Rear ME 1 -1 i `
Building Height j 1 y j
Bldg. Square Footage 11M I
Open Space Footage % - - - -
(Lot area minus bldg & paved t I 1 I = I
parking) -
# of Parking Spaces
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:: E
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DONT KNOW 0 YES 0
IF YES: enter Book ■ �� Page; r 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:
C. Do any signs exist on the property? YES 0 NO a
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:
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.
•
m� gepa; » 's o
RECEIVED ding Department of Northampton S use k #
B `
OCT 1 12 Main Street Ses e b vaia®itt : s . :°
2W Room 100 , � � 7;
• Y
o ampton, MA 01060 a ���
1 3- 87 -1240 Fax 413- 587 -1272 � ��
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION-1 SITEINFORMATION
1.1 Property Address: '" ti Thisisectro t b ompleted by office
� ] /7 , lj�fl �„ t.` / +i / /7 / - ZQ 6 .kz i ,,, T . �. .„ . *-x ,s 3 , .:+'w x + t�sd Overlay Distri - ?. 's, ':..n
li't� l I.� , ll ( V 11Q0 . s �e.:e 1�s nx
/ E lm S t. Di :7, A , , , . G CB District r f
SECTION 2 PROPERTY OWNERSHIP /AUTHORIZED A
13.q,� J �v 2 cs Li LA D 7 r - ti p" - FL 4 '"` �,
2.1 Owner of Record: '067'
Name (Print) Current ,a g 6 _ ... 9 X07
/ �� Telephone .''l /JJ
Signature f
2.2 Authorized Agent:
I N,�N6� S 4 M
Name (Print) Current Mailing Address:
S ,+or M 1
Signature Telephone
SECTION - ESTIMATED CONSTRUCTION COSTS
Item 3 Estimated Cost (Dollars) to be Official Use. Only x
completed by permit appl icant
1. Building 0 0 t "(a)'' Building Permit Fee ,
2. Electrical (b)Estmated Total Cost of
. Construct from (6) .:
3. Plumbing i ldin g Permi Fee
4. Mechanical (HVAC)
5. Fire Protection i
6. Total= (1 +2 + + 4 +5) - - O CR Check Number.
. This Se F,orOfficial Use Only .
Date
Building Permit Number: I ss ued .
Signature.
Building Commissioner /Inspector o Building Date
File # BP- 2012 -0385
APPLICANT /CONTACT PERSON RICHARD FINN
ADDRESS/PHONE 43 ELM ST HATFIELD (413) 548 -6240 0
PROPERTY LOCATION 25 LANDY AVE
MAP 23A PARCEL 294 001 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 /01Q26 J [p 6
Fee Paid O' �i 7"1"-"'
Tvpeof Construction: REBUILD 7 X 7 FRONT PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 050848
3 sets of Plans / Plot Plan
THE FOLL G ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN O ATION 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
Imo
1°1°.W.
,-° 76 7o
:nature 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.
. .
•
25 LANDY AVE BP- 2012 -0385
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23A - 294 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit # BP- 2012 -0385
Project # JS- 2012 - 000614
Est. Cost: $2000.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RICHARD FINN 050848
Lot Size(sq. ft.): 20473.20 Owner: YUSCAVAGE JOHN M & BARBARA A FUNGAROLI
Zoning: URB(100)/ Applicant: RICHARD FINN
AT: 25 LANDY AVE
Applicant Address: Phone: Insurance:
43 ELM ST (413) 548 -6240 0
HATFIELDMA01038 ISSUED ON:10/19/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: REBUILD 7 X 7 FRONT PORCH
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 10/19/2011 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner