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23A-039 (3)
RK November 19, 2012 Mr. Louis Hasbrouck Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 Dear Mr. Hasbrouck I request that you grant a modification to waive the requirement for controlled construction for the insulation and weatherization of 56 Maple Street (1 buildings total) because the work is of a minor nature, will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of controlled construction is considerable when compared to the cost of the proposed work. Please accept this stamped letter as an indication of my support for this request. Thank you for your consideration. Sincerely, c, - W/ 47Le ( PW.61371/ -✓ NoR E AcT ^ f „ z �� 1 , Wayne E. Benson, Jr. RA President RKB Architects t`ta�l t l [�r� #ry. ` �� ai 1 t€ > � '- o ^�t;tra �w E° .,r}9 =Tr ucTc t` s '`t.„ <�* € �; TM ° Lire se: CS 102978 sir €ct-ed is ; 00 N f BRIAN MACHADO :. 47 MALBONE ROAD'' ASSONET, MA 02702 =9 �_ _ —r✓ Expirattr,n' 5126/20/3 t ;raraaui ci.aa ^a` Tr, 102978 rfrrxtrt.vrrtrcrr % ffi rl 1(a� ,rrr: /rr :tr;�7a e ffice of Consumer Affairs & Business Regulation License or registration valid for individul use only before the expiration date. If found return to: 5 . � !ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation t 'registration: 166075 Type: 10 Park Plaza Suite 5170 Expiration: 4121/2014 - Supplement Card Boston, MA 02116' ADVANTAGE WEATHERIZATION, INC. BRIAN MACHADO 1150 WEST CHESTNUT STE 13 BROCKTON, MA 02301 Undersecretary Not valid without signature NOTICE TO PROCEED Low - Income Multi - Family Retrofit Program The Low - Income Energy Affordability Network (LEAN), administrator of the utility- funded energy efficiency program for low- income multifamily properties, is hereby authorized to have its contractors, employees, and other representatives access the property and perform the work contained in the attached Work Order, including final inspections. A copy of this document shall be carried by LEAN's contractors, employees, or representatives and presented upon request. Site Name: Tobin Manor Street, City/Town, Zip: 56 Maple St NORTHAMPTON 01060 Contact Name & Phone at Site: Jon Hite (413) 584 -4030 Signature: �l Printed Name:,./ cav■ Title: c Organization: /.} r ()QS %. �� ► Date: (c) ! 2 ` 1 1 2 Acknowledged by LEAN's representative: John Wells, Vice President for Energy Services, ABCD Please sign and date two originals. Retain one for your records and retum the other to: James Collins Energy Services, 4 Floor ABCD 178 Tremont St Boston, MA 02111 fax: 617- 357 -4661 james.co llinsnbostonabcd.org Program Administrators: LEAN, Bay State Gas, Berkshire Gas, Blackstone Gas, Cape Light Compact, National Grid, New England Gas, NSTAR, Unitil, WMECO 1150 W Chestnut St ' AI: VAN'IACJ Suite � ""�''�� "``�``'� " " Brockton, Ma 02301 [ N 1. C? [2 P Q R. A I F=. U Dated 11/15/2012 AGENCY: Action for Boston Community Development, Inc. ABCD 178 Tremont St. Boston, MA 02111 PROPERTY: Tobin Manor WORK TOTAL 56 Maple St., Northampton, 01060 Building #1 49 Unit(s) ORDER $91746.50 Date of Walk Through: N/A CE Report Rcvd. ` 11/15/2012 Job cos #: 14095 Work Order # 20 -056 -1 DESCRIPTION I QTY. I UNIT IUNIT PRICE' TOTAL PRICE DOORS Weatherstrip w / Q -Ion or equal 7 ea $45.50 $318.50 Automatic Sweep 1 ea $23.00 $23.00 Repair / Refit Door 1 ea $51.00 $51.00 MISC. MEASURES Weatherstrip (Q -Ion or equal) & R -30 attic hatch 24 ea $33.50 $804.00 Attic / Basement sealing with two -part foam 114 man /hr $75.00 $8,550.00 Page 1 of 1 " yam The Cornmornvenith of Massachusetts - 1 ` _ • - . DepartnuerttofIndtistrtalAcdde rtis . w,7 ► fir Office of Investigatioris • • - - ; +n= d • 600 Washirtgfon Street . € =Mil ti Bostort, MA 02111 , •. Yvww.mass.gov /die ' . Workers' Compensation Insurance Affidavit: Builders /Conti: actors /EIectx•ic1ans/Plumbers _ • ,Applicant Information Please Print Legibly Nano ( Busleesslo tzatlonTh1dlvldua.,: , ' \\U(1\Caz?.y �c0_ Z�A \vn \nom . • ' • • Address: \ ' � • . a :• t1 '> e - City/State /Zip: t r -. .'C7aZUl Phone. # - *i \ V % ' 4. X5,1 Are you an eMploy Check the appropriate box: , '• type of pi•o j ect (required) :, ' 1, I an a ernplo er with 'O 4. 0 I atn a general coytraotor and 1 t y 6, 0 New construction • employees (full and/or part timo),* have hired the sub- contractors 2, ❑ I aria a 'sole proprietor or partner- listed on the•attachedshcct. 7. 0 Remodeling ship andhaveno employees These sub-contractors 8, 9 Demolition working for me in any capacity, employees andlrave wo rker? ._ .. , 9', - 0 Building addition • [No workers' comp, insurance comp. insurance,$' { q S. 0 We are a corporation end its 10.0 Electrical repairs or additions 'I 9 I am. a homeowner doing all work officers have exercised their • 11.0 Plumbing repairs or additions ' • 'myself. [Noworkers' comp, right b£axeinptionparMGL 12,0 Roof repairs • insurance required.] f o, 152, §1(41 anti wo have no - employees, [No workers' i3.[1 Other • comp. insurance regdired0 *My applicant that cheeks box 111 must also fill out lha station Wow showing thotrworkers' oompensattonpolleyiuformation. 1 • 1 Homeowners who submit this affidavit indicating they aro doing all work and then hire outsldo coatmotors must submit a now amdavitinditating such. iConhactors that check this box must attaohed an additional sheot ahoaring the nama of the sub•cohtraotors and statowhother or not those entities havo employees. If tho sub•contmetors havo employees, thoymusttlrovidb their workers' comp. polloy number. • • • I am au eatployer•lhaf !:providing workers' compensaflo t insurance for uty employees Below is thepoliay and Job site information. Insurance Company Haile; V.. 0(10...& ; Mt, \ #or Sclf- ins.Lio,#: - -O\ Expiration Date: lR`ZO` Policy 1 > > 2 � n`l 3 • • Job Site Address: ' 4 \ 0� C • • • City /State /ZIp: A ,-* N'C l \ i. Attack a copy of tho•workers' coinpensation policy declaration page '(showing the polioy number and expiration date), • Failure,to secure co'erage as required tinder Section 25A of MGL o, 152 oan 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, 13o advised that a copy of thin statement :tray be forwarded to the Offtoe of Investigations of the DIA for insurance coverage verification. . f ilo hereby oert(/' under the paius•and penalties of erJr that the information provided above le true aria correct; • ' Of tmature: �N ' e Date( \ \ \ \5\ \ • . . Phone #: . � :.51* - L_ Allik _ — • - Official rise only..bo not write In !h 1} ea, tb be completed by city or rerun official • • City or Town: . Permlt/License # Issuing Authority (circle one): • .1. board of Health Z. Budding Department 3. City/Town Clerk 4. Electrlcal Inspector 5. Plumbing Inspector i 6.Other . r - • , Contact Person:_ . • • !hone.#: • - 1 • .i -- "r1 ADVAN -8 OP ID: PS AWR Er 06 /21 CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 06/21/12 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 pollcy(ies) must be endorsed. if SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on thls certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONT 781.642 -9000 NAME Eastern , States Insurance Agency, Inc 781 - 647.36701 N tD 11•00 0): 50 Prospect Street ADDRESS: Waltham, MA 02453 INSURER(3)AFFORDING COVERAGE NAIC N INSURER A; Liberty Mutual Insurance Co. - INSURED Advantage Weatherizatlon, Inc, INSURER B : Berkley Assurance Co 1150 West Chestnut Street INSURER C ; Navigators Insurance Company Brockton, MA 02301 INSURER 0 : _ INSURER E : INSURER F: , COVERAGES CERTIFICATE NUMBER: 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 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 ADDL SUER POLICY EFF POLICY EXP TR TYPE OF INSURANCE , : ,, • POLICY NUMBER NUM YY ,, Drm LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY VUMA0000891 04102/12 04/02/13 DAMAGE TO RENTED PREMISES (Ea occurrencll $ 50,000 CLAIMS -MADE X I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL &ACV INJURY $ 1,000,000 GENERAL AGGREGATE $ _ 2,000,000 GEM. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 — 1 POLICY [3j t1 LOC — $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1000,000 (Ea ecc ;dent) $ r A ANY AUTO ASJ -Z11- 261011.032 06/20/12 06/20/13 spoils( INJURY (Per person) $ AUT OWNED x AUTOS LED BODILY INJURY (Par accident) $ X HIRED AUTOS X NON•OWNED PROPERTY $ A UTOS (Per acddenn_ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,000 A X EXCESS LIAO CLAIMS -MADE THC -Z91- 261011.042 06/20/12 06/20/13 AGGREGATE $ 5,000,000 BED 1 1 RETENTIONS $ WORKERS COMPENSATION X TOR I WC STATU• TH ITR ER 1 0- AND EMPLOYERS' LIABILITY Y LIM , A ANY PROPRIETOR /PARTNER/EXECUTIVE Y© N / A WC1 -Z11. 261011 -012 06120112 06/20/13 El. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 Ityes, describe under OE3CRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT , $ 1,000,000 C Excess Liability NYIIEXC711931V 06/20/12 06/20/13 Excess 10,000,000 Excess 6 Million 5 Million DESCRIPTION OF OPERATIONS /LOCATIONS1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 11 more space IS required) CERTIFICATE HOLDER CANCELLATION EVIDENC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTH REPRESENTATIVE I ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010(05) The ACORD name and logo are registered marks of ACORD s : Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10 STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Northampton Housing Authority 1, as Owner of the subject property Advantage Weatherization, Inc. hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date Advantage Weatherization, Inc. , 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. Brian Machado Print Name 11/15/2012 Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Brian Machado 102978 License Number 1150 West Chestnut St. Suite 3, Brockton MA 02301 05/26/2013 Address Expiration Date (401) 641 -1493 Signature e Telephone SECTION 13 - 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 Version 1.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name (Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor II , tlpdA.✓T)4CE Eq TNF6c.2 ,,ri`„e!, Not Applicable ❑ Company Name: i - A n / ffiAewol b O Responsible In Charge of Construction Address � �� sent rA e•G �.�� 7 7/3 7 Signature Telephone r Version1.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING 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 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO (:) DON'T KNOW 0 YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q 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: 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. Version1.7 Commercial Building Permit May 15, 2000 • SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ 1 Brief Description Weatherization: Weatherstrip doors. Air Sealing. Of Proposed Work: SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly El A - ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ 1-1 High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 1St 1s 2nd 2 nd 3rd 3r 4th 4th Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system E3 Version1.7 Commercial Building Permit May 15, 2000 Department use only City of Northampton Status of Permit: RECEj __ uilding Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability No ' 2012 Room 100 WaterlWell Availability orthampton, MA 01060 Two Sets of Structural Plans • ho - 4 3- 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans DEPT. OF BUILDING Itis ?EC then Specify NORTHAMPTON MA 01 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 56 Maple St. Map Lot Unit Zone Overlay District EIm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Northampton Housing Authority 49 Old South St Name (Print) Current Mailing Address: (413) 584 -4030 Signature -�(<'.. r \ '- - ‘, \- Telephone 2.2 Authorized Agent: Advantage Weatherization, Inc. 1150 West Chestnut St. Suite 3 Brockton 02301 Name (Print) Current Mailing Address: (508) 510 -6866 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building $9,746.00 (a) Building Permit Fee 2. Electrical $0.00: (b) Estimated Total Cost of Construction from (6) 3. Plumbing $0.00 Building Permit Fee 4. Mechanical (HVAC) $0.00 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number , Jgg9-- Ir(Q This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date f File # BP- 2013 -0569 APPLICANT /CONTACT PERSON ADVANTAGE WEATHERIZATION INC ADDRESS /PHONE 1150 W CHESTNUT ST SUITE 3 BROCKTON (508) 510 -6866 PROPERTY LOCATION 56 MAPLE ST MAP 23A PARCEL 039 001 ZONE GB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �(X/� �� Fee Paid QQ QQ Tvpeof Construction: WEATHERIZATION, WEATHER STRIP DOORS & AIR SEALING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 102978 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO MATION 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 Commission _ Permit DPW Storm Water Management -• oli '. D- )00Pr°° 7/—/ Signature of Building Officia 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. 56 MAPLE ST BP- 2013 -0569 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23A - 039 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 PEIRNIIT Permit # BP- 2013 -0569 Project # JS- 2013- 000922 Est. Cost: $9746.00 Fee: $60.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADVANTAGE WEATHERIZATION INC 102978 Lot Size(sq. ft.): 64904.40 Owner: NORTHAMPTON HOUSING AUTHORITY TOBIN MANOR Zoning: GB(100)/ Applicant: ADVANTAGE WEATHERIZATION INC AT: 56 MAPLE ST Applicant Address: Phone: Insurance: 1150 W CHESTNUT ST SUITE 3 (508) 510 - 6866 WC BROCKTONMA02301 ISSUED ON:11/27/2012 0:00:00 TO PERFORM THE FOLLOWING WORK:WEATHERIZATION, WEATHER STRIP DOORS & AIR SEALING 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 11/27/2012 0:00:00 $60.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner