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11A-016 (3)
ACC E CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 11/22/2011 _ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NNAME: Shannon Pala»o James J. Dowd & Sons Ins PHONE No. Exn -413- 538 -7444 FAX NoI :413- 536 -6020 14 Bobala Road E-MAIL Holyoke MA 01040 ActoREsspalazzo@dowd.com INSURER(S) AFFORDING COVERAGE NAIC iI INSURER A :Safety Indemnity Company INSURED COOP INSURER a rea1 American Insurance Companies Co Op Power, Inc. INSURER C:U. S. Liability Insurance Company 324 Wells Street Greenfield MA 01302 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1050225280 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION CF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR T YPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR ' INSR Wyp POLICY NUMBER (MMIDD/YYYYI (MMIDDIYYYY) C GENERAL LIABILITY CL1566148 11/6/2011 11/8 /2012 EACH OCCURRENCE $1,000,000 MAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREM PREMISES (Ea occurrence) $100,000 CLAIMS -MADE OCCUR MED EXP (Any one person) $5,000 _ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 POLICY JR-IT X LOC $ A AUTOMOBILE LIABILITY COM6212701 3/23/2011 3/23/2012 CUMHINED SINGLE LIMIT (Ea accident) I $1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED X SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $1,000,000 AUTOS (Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS -MADE AGGREGATE _ $ DED I RETENTION S $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/IXECUTIVE E.L. EACH ACCIDENT S OFFICERMEMBER EXCLUDED? N I A (Mandatary In NH) E.L. DISEASE - EA EMPLOYEE $ If yea describe under DESC RIPTION OF OPERATIONS belca, E.L. DISEASE - POLICY LIMIT $ B Directors & Officers Liability EPP1117553 5/2/2011 5/2/2012 1,000,000 5,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Waiver of Subrogation Applies. CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Honeywell Utility Solutions ACCORDANCE WITH THE POLICY PROVISIONS. 65 Shawmut Road Suite 4, 2nd Floor AUTHORIZED REPRESENTATIVE Canton MA 02021 -1461 r f�j�, . ©1986 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AC R ® CERTIFICATE OF LIABILITY INSURANCE DATE( "' 11/29/2011 2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Joseph Judd Blackmer Insurance Agency Inc. + N EMI (913) 625 -6527 F (413) 625 -8210 1147 Mohawk Trail A QRESS:j @blaclmlers.com INSURER(S) AFFORDING COVERAGE NAIL it _ Shelburne MA 01370 - 9707 INSURER A ITIgin City Fire Insurance Co 29459 — INSURED INSURER B: CO -OP POWER, INC. INSURER C: PO BOX 688 INSURER D PC Box 688 INSURER E: GREENFIELD MA 01302 INSURER F: COVERAGES CERTIFICATE NUMBER*Iaster 11 - 12 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY - PERTAIN THE INSURANCE AFFORDED EY THE POLICIES 'DESCRIBED HEREIN 16 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POUCY EFF POUCY LICY EXP LIMITS LTR INSR WVn, POLICY NUMBER IMDD/YYYY1 (MWDDIYYWt GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREM SES (Ea�oTEDrreri} $ CLAIMS -MADE I OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY S — GENERAL AGGREGATE S _ GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG S Ti POLICY ri P 0 . I1 LOC AUTOMOBILE LIABILITY C OMBI�NED LIMIT - ANY AUTO BODILY INJURY (Per person) S — ALLOgN� SCHEDULED BODILY INJURY (Per accident) S HIRED AUTOS NON -OWNED PROPERTY DAMAGE $ AUTOS Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS -MADE AGGREGATE $ DED I RETENTIONS ` $ A WORKERS COMPENSATION I M A I 1 AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y N E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N D SWECIC6666 11/1/2011 11!1/2012 (Myyaeen�sdatory In NH) EL DISEASE - EA EMPLOYEE $ 1,000,000 D ESCRIIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 5 1,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, II more space is required) Operations usual to energy efficiency services - energy audits, air sealing, insulation and solar hot water system installation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Honeywell Utility Solutions ACCORDANCE WITH THE POLICY PROVISIONS. 65 Shawmut Rd, Ste 4, 2nd Flr Canton, MA 02 021 61 AUTHORIZED REPRESENTATIVE S Deneauit, CISR /BLAJ -J ACORD 25 (2010105) ©1988 -2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD CO -OP It p POWER BUILDING COMMUNITY -OWNED SUSTAINABLE ENERGY Affidavit of Waste Disposal I Paul Schmidt, Energy Efficiency Program Director of Co -op Power certify that Co- op Power will remove all waste from the job site located at: ( Z _ pAkivi.F7 0 r [. ► ( T. LE , kit Owner Name Street Address Town /State/Zip Waste will be disposed of at our dumpster at our facility in Hatfield, MA. Our removal service is Waste Management. 0 /-'- e '7 t 4 1 3)f Paul Schmidt Date Co -op Power, 324 Wells St., Greenfield, MA 01301 or Mailing Address: Box 688, Greenfield, MA 01302 ph: 413.772.8898 or 8772667543, fax: 413.517.0300, info @cooppower.coop, www.cooppower.coop • The Commonwealth of Massachusetts Department of Industrial Accidents ` � Office of Investigations 600 Washington Street • l i ` Boston, MA 02111 7'"%, www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /organizationilmlividual): C0- C Address: 32- t{ u'& (( S s City /State /Zip: Cu d ._ �_ )'hone #: t Are ou an eumployer7 Check the appr I + r ___ —___ ate box: Type of project (required): _ 1. II am a employer with 1 t 4. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub - contractors 6. New construction 2.0 I am a sole proprietor or partner listed on the attached sheet 7. 0 Remodeling ship and have no employees These sub - contractors have 8. (❑ Demolition working for me in capacity. employees and have workers' g any aP tY 9. 0 Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0 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 v1S (/t, comp. insurance required.] *Any applicant that checks box #1 must also till out the section below showing their workers' compensation policy information. t 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: t WW1 C i 678169 F C (6-' -�"'hS t yr v\ C O� , Policy # or Self -ins. Lic. #: C� R' t�1 e C. (_ 6 Expiration Date: 14 -- t 2. & 19--"" - ' 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 G. 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 cer • under the - ' ' nd p , 'es of perjury that the information provided abo e is true and correct. Signature: �• - ' Date: Phone #: [ ?Es 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/Fown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: r{� g - 6 2 0 0 , �0 0 / 4' hv =W �!_ Office of Consumer Affairs and Business Regulation , 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 165217 Type: Corporation Expiration: 1/21/2014 Tr# 220702 CO -OP POWER, INC. PAUL SCHMIDT 324 WELLS ST GREENFIELD, MA 01301 Update Address and return card. Mark reason for change. Address El Renewal El Employment 0 Lost Card DPS -CAI w 50M- 04104- G101216 gi w a/ v License or registration valid for individul use only Office of Consumer Affairs Si Business Regulation g y =* HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: —= Re istration: 165217 Type: Office of Consumer Affairs and Business Regulation 1 ITIE 9 Expiration: 1i�21/2014 Corporation 10 Park Plaza - Suite 5170 wt Boston, MA 02116 COP POWER 1114= , PAUL SCHMIDT 324 WELLS ST \., g� � ,p GREENFIELD, MA 01301 Undersecretary Not v without signature Massachusetts - Department of Public Safct% V) Board of Building Regulations and Standards Construction Supervisor License License: CS 103635 ' Restricted to: 00 PAUL SCHMIDT 24 CHESTNUT ST HATFIELD, MA 01038 -, . , 4 . x ; �` Expiration: 5l20f2013 Con:lm i..in rner Tr#: 103635 SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Paul Schmidt Name of Lic! se Holde 24 Chestnut St. Hatfield, MA 01038 I , —�� �S # 103635 U Addre I Exp. 5/20/2013 413- 772 -8898 Signat re' Telephone Home Improvement Contractor: 9. Registered Home Impro ement Contractor: o -op Power Inc. / Paul Schmidt 324 Wells St. W Greenfield, MA 01301 Company/Name 4165217 'il� /� Exp. 1/21i, — Addre .iv 413- 772 -8898 paul @cooppower.coop SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) Workers Compensation Insurance affidavit ipust be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildi : permit. Signed Affidavit Attached Yes n 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. CM R 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 resuLing 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 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 L________ ______.1 L.._... ��_w_.._.._._.... f_.__ ®_ Setbacks Front I r 1.- _ _ Side L:l.______i R:t.- ._._..__r L:[..w..___I R:I . (._ __ Rear __. [ ___.__ _ i L __ Building Height 1 - Bldg. Square Footage - -" % I -- i - { -- 71 Open Space Footage 3 (Lot area minus bldg & paved _ t____ __ parking) # of Parking Spaces i_ i L. - __ Fill: .____ _._____ __ (volume & Location) [-- -- — �'' _____ i t_ __.. _ A. Has a Special Permit /Variance /Finding er been issued for /on the site? NO 0 DON'T KNOW YES IF YES, date issued:Li ___ i IF YES: Was the permit recorded at the Regist ,of Deeds? NO 0 DON'T KNOW YES Q IF YES: enter Book 4 1 Page and /or Document #1 B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW YES 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 It --°'- 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 0--- 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 0, IF YES, then a Northampton Storm Water Management Permit from the DPW is required. --1 j. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) . 1,i1 - New House n Addition D Replacement Windows Alteration(s) Roofing 11 i 1 Or Doors D .,F Accessory Bldg. 1 I Demolition 1 New Signs f p] Decks [D Siding [D] Other [p) Brief Description of Proposed n I /( Work: I Iv iv 648 47 4 'j 1' I f 11 C LeN� p nN bi'l. 1Y� ('l. L N; t/Y1't — ( q Alteration of existing bedroom Yes Nc Adding new bedroom Yes Nc Attached Narrative Renovatinc unfinished basement Yes No Plans Attached RclI - Sheet 6a. If New house and or addition to existing housing. complete the following: • Use cf 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 I, f I t • GIA, .( 4A , c.iL A , as Owner of the subject property hereby authorize u�- to act on my b half 'n allrs relative to work authorized by this building permit application. Signature of Owner Date I, , vi l gl- , as Owner /Authorized Agent he by declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belie . Signed under the pains and penalties of p rjury. %.t // 2 - f rt�� Print Name', Signature of. Owner /Agent '' 111 . 111 " . Dat- RECE Depariment only Cit of Northampton Status of Permit Bui ding Department Curb Cut/Driveway Permit. a ll I 6 01 12 Main Street Sewer /Septic Availability ( �J 2 Room 100 VVater/Weli Availbility DEPr. oF +_ ort ampton, MA 01060 Two Sets of Structural Plans "1OR11 . ' 3- 87 -1240 Fax 413 -587 -1272 Plot/Site Plans ma c,.., 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 C-. -<' SA— Map Lot Unit Zone Overlay District C7 L e; Elm St. District CE District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) Current Mailing Address: Telephone - Signat - 2.2 Authorized Agent: L �j, i !� ? 3 L t. f t i i (T. l -? rvrriv, vv f MA 0 1 ; Name (PrintE) Current ailing Address: 4 413) 3 ' Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 4 D ' , +© (a) Building Permit Fee U 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) -C FO ,girt) Check Number &6l7 7 a-- This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0903 APPLICANT /CONTACT PERSON PAUL SCHMIDT ADDRESS/PHONE 24 CHESTNUT ST HATFIELD (413) 247 -5739 PROPERTY LOCATION 48 EAST CENTER ST MAP 1 PARCEL 016 001 ZONE URA(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid �0'! $5 Typeof Construction: ATTIC INSULATION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 103635 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQRMATION PRESENTED: 1 ' 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 Commission _ Permit DPW Storm Water Management Demolition Delay C77/ (-1/ZC/r- 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. 48 EAST CENTER ST BP- 2012 -0903 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 11A - 016 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit # BP- 2012 -0903 Project # JS- 2012 - 001590 Est. Cost: $840.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PAUL SCHMIDT 103635 Lot Size(sq. ft.): 38855.52 Owner: MANSFIELD MICHAEL R & SOVINA P Zoning: URA(100)/ Applicant: PAUL SCHMIDT AT: 48 EAST CENTER ST Applicant Address: Phone: Insurance: 24 CHESTNUT ST (413) 247 -5739 WC HATFIELDMA01038 ISSUED ON:4/30/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: ATT I C INSULATION 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 4/30/2012 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner