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38B-222(1)
.: -.._.....,__.__...—._..__ ..�.._.._,..q_. �..,—.._ -..e__, _ -...;... __ 1I1 T ,� �.i c4 to.. - —3 — F a it i - '.._ 2 _ �... - .- .,....._u N rkt 2 _ _..,._.. -.. _ _. a_ .._. __-_. -.. 11 `1'4' ^d . t .,..",(.....;,.,.; ,.. ,.„‘ .,._. .,. �.__1. Tr _ 3 _., ._- ._ _f.__,T.______ _ �__. , n 4. ,,*_... /CA), . ..' �— -• •= .- _._z _ ..� _ . . n e a ic � ,- Z. r 4y ' • I . ! • r 1--c.::: ' i'V.'? , "-''.-- '''a • • 3 L 7 1 _... . _ ....... 1,' I - t le, • ..._tom_-_. } l ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD1YYYY) 03/12/2013 L....------- 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 02056-001 ECONTTACT NAME: Viveiros Insurance Agency Inc A/C No Ex (508)676-0309 1,6 No (508)677-1653 375 Airport Rd Fall River,MA 02720 �� ESS ——_ ---- I INSURER(S)AFFORDING COVERAGE _! NAIC#____-. INSURER A: A.I.M.Mutual Insurance Company 33758 I SU INSURER B Benjamin Sylvia NSURED INSURER C: 123 Montague Road 1 INSURER D=_____ Wendell,MA 01379 (-INSURER E-' I 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. p�pLr {� -- - --- —- -- r oL1CyEFF PPpp CCyyEEXXpp— :-IN TYPE OF INSURANCE i INSf2 VBD� POLICY NUMBER (MM/DD/YYYIr -(MM D/YYYY)I LIMITS L GENERAL LIABILITY EACH OCCURRENCE !$ H--1 1 DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY I PREMISESjE_aoccurrence) i$ 1 . CLAIMS-MADE I OCCUR MED EXP(Any one person) I $ PERSONAL&ADV INJURY I $ )GENERAL AGGREGATE ;$ EN'L AGGREGATE LIMIT APPLIES PER: 1 PRODUCTS COMP/OP AGG ■$ � v ( , AUTOMOBILE LIABILITY OC I COMBINED SINGLE LIMIT i$ ALL OWNED SCHEDULED BO ILY accident)._ t■ - -- ANY AUTO ! BODILY INJURY(Per person) $ H TOSAUTOS ). AUTOS BODILY INJURY(Per accident)1)_$ I WNED ! PROPERTY DAMAGE AUTOS !(PeraccidenI) .--_ $_-..__._ I$ UMBRELLA LIAB OCCUR EACH OCCURRENCE I$ }EXCESS LIAB i I CLAIMS MADE IIAGGREGATE 1$ AND EMPLOYERS�LIABILITY __ .-.__ -- -- --1 --_.-._____-- _- - -__-� ----_-- ---{-- —_---� AMA I Vi- $ - - RETENTION $ I ) C MP S X A I ANY TUDEDXECUT0.rE N N!A VWC-100-6017163-2013A - 2115/201-3 211512014 !E.L.EACH ACCIDENT $ 100,00( OPRIETCR EXCLUDED? Y/N_' I(Mandatory in NH) = i I EL_DISEASE-EA EMPLOYEE I I-$ 100,00( DtSSCRIPION Y)F OPERATIONS below j E L.DISEASE-POLICY LIMIT $ 500,00( ■ DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Andy Cole Builders 469 Main Road SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Gill,MA 01354 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE . Cyz ©1988-2010 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 2/21/2013 D/ ) 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 NAME: Clark Mortenson Insurance (a°.N o.Ex 3:603-352-2121 FAX,N o):603-357-8491 P.O. Box 606 E-MAIL Keene NH 03431 ADDRESS:csr24 @clark-mortenson.com INSURER(S)AFFORDING COVERAGE NAIC# _ INSURER A:Merchants Insurance Group A_ INSURED HAYN INSURER B:Liberty Mutual-Involuntary Market 0 Jeremy Hayn INSURER C: iverport Insurance Company 40 Elm Street INSURER D Winchester NH 03470 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:526592640 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 TYPE OF INSURANCE 'ADDL SUB W % M/POLICY EFF POLICY EXP —, LTR INSR VD f POLICY NUMBER (MDD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY IBOPI055268 2/8/2013 2/8/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY R T R N PREMISES(Ea occurrence) $500,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $included GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 — } __ PRO- I POLICY JECT X LOC $ A AUTOMOBILE LIABILITY CAPI054374 2/8/2013 /8/2014 COMBINED SINGLE LIMIT (Ea accident) _11000000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS X AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AONOOWNED (Per accident) $ — UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ 3 WORKERS COMPENSATION WC131S380832013 /10/2013 2/10/2014 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N WC288300451402 /8/2013 2/8/2014 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? Y I N/A - — (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) JVorkers Compensation Insurance applies per the workers compensation law of the State of NH on policy#WC288300451402. Workers compensation Insurance applies per the workers compensation law of the State of MA on policy#WC131S380832013. Jeremy Hayn,sole proprietor, is excluded on both workers compensation policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I Andy Cole Builders ACCORDANCE WITH THE POLICY PROVISIONS. 457 Main Road Gill MA 01354 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 74 ( i/ ' ge'y/(: /<4 Address: /tC i.0 ,/ ,4 City/State/Zip: (I/?S Phone#: ��S_3 2 5 -/3 V 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 employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.Cl I am a sole proprietor or partner- listed on the attached sheet. 7. V5Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' g y p $ 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 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill 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. tContractors 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. �2 Insurance Company Name: 7 mac°/6/1S-- /l Policy#or Self-ins. Lic. #: C�/� �//� —�g 7,P 7' 9— /3 Expiration Date: 7- G / 7 Job Site Address: / �CAi, �v' City/State/Zip:A/7/"/1,47//7/0.41 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 certify er the pains and penalties of perjury that the information provided above is true and correct. l� / Signature: Date: — l 2-° 13 Phone#: 9/3 77-3-7 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor:`� Not Applicable ❑ Name of License Holder: ,4/7 L4/ v ( e 12/6C License Number '4 I'"n4- /rd. I -2 F 7-6, 3 Address Expiration Date G.-// ,41,1 Q/3SL/ 4/73 3 LS /3 g.3 Signature Telephone 9.Registered Hole Improvement Contractor: Not Applicable ❑ /47diw,ib✓ �.�c/e' / SZ,7 8 4' Company Name Registration Number Vilm G a/e' 84,r/de-ies f 2?- zGiV Address Expiration Date !rte,:, rd ó // 7,)55' Telephone Y13 3 Z S—/JYJ SECTION 10-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 ❑ 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.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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors El Accessory Bldg. ❑ Demolition El New Signs [D] Decks [D Siding[O] Other[D] Brief Des ription of Proposed Work: ipb1/1Q0e (1�GtPh 4h / /4/0 N/' /45. Alteration of existing bedroom Yes >( No Adding new bedroom Yes k No Attached Narrative Renovating unfinished basement Yes x No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following:, a. Use of 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, Ao a.L14 H oopE2 , as Owner of the subject property hereby authorize ,7o' (.,D/c_ to act on my be i ,in all matt -lative to work authorized by this building permit application. ilk (r /2-7/13 Signature of Owner Date I, A,1 `P , as Owner/Authorized Agent hereby declare at 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, %° _____z . Print Name 7-72: 742/-1 Signature of Ow Agent Date 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 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 (.^) DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT 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 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO 0.4 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO 0 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 O NO e IF YES,then a Northampton Storm Water Management Permit from the DPW is required. RECEIVED Department use only `i 12 2013 City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability DEPT. L:Dlt .3 , ^ACTIONS NORTHAMPTON MA 01060 Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans 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 3 / G/rvie�) ,4V( Map Lot Unit Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 4 1 1 3.061-4, 14 co exit. 3 t F4 t R\ r w N v kN o rt, Name(Print Current Mailing Address: tit 3 -- s (0-2A744 Telephone Signature 2.2 Authorized Agent: Air / 56(0//t i2/ �/ Ml J/Jr Name(Print Current Mailing Address: Y73?2s 1?FY Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of J v Construction from(6) 3. Plumbing 5'/ U-00 Building Permit Fee I/1/ 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) (it2 y/ 00 O Check Number This Section For Official Use Only Building Permit Number I sssuu ed: Signature: _� '.L ! /,/ Building Commissioner/Inspector of Buildings Date File#BP-2014-0040 APPLICANT/CONTACT PERSON ANDREW COLE ADDRESS/PHONE 469 MAIN RD GILL (413)325-1383 PROPERTY LOCATION 31 FAIRVIEW AVE MAP 38B PARCEL 222 001 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 nay j Fee Paid �t cJ [ Typeof Construction: REMODEL KITCHEN&2 BATH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 92165 3 sets of Plans/Plot Plan THE FOLLO G ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN O ION PRESENTED: proved 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 !em '• delay 7—/j7 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. 0 31 FAIRVIEW AVE BP-2014-0040 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B-222 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-2014-0040 Project# JS-2014-000071 Est.Cost: $24000.00 Fee:$144.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ANDREW COLE 92165 Lot Size(sq. ft.): 5532.12 Owner: FOUNDS STEVE&SANDRA C/O ADELINE HOOPER Zoning:URB(100)/ Applicant: ANDREW COLE AT: 31 FAIRVIEW AVE Applicant Address: Phone: Insurance: 469 MAIN RD (413) 325-1383 WC GILLMA01354 ISSUED ON:7/19/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:REMODEL KITCHEN & 2 BATHS 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 7/19/2013 0:00:00 $144.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner