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25-069 (2) t I VE F4 C tiE i..i I RRNlt i...i Tri«q. �>3 4,..ti4GI tE{J#4 Rear Porch Roof Dyes O Flashings es ONO Drip Edge l 5ffes (]No Color�L Location GUTTERS Color Downqp4uts Color Layout Attached 13Yes O GZype DYes ©No C1 Residential Sin D Commercia In Downspout Residential 11 Comm al T Garage DYes ❑NO L _ _.. Porch DYes F lNo Color ATTIC ENER21 R IER BLOWN•I SULATION Cl Rafter In L� Open Attic Blow ZNo Walls 0Yes ONO Knee DYes ❑No CI Net Blow Area to be cleared by homeowner QYes ONO Kneewaii DYe Type of exterior adding Speclallrrstractiavrs 3l WORK SCHEDULE r it n the work or order the materials before the third day following the signing of this Agreemerrt unless n r(datc),actor will begin the work on or about 4idate).Barring delay caused by circumstances beyond Contractor's control,the work will be Completed by The Owner hereby acknowledges a agrees hat the sc tedulinp dates are approximate and that such delays that are not avoidable by the Contractor ineludln es� 191* ages at materials,acci dents,and all other delays beyond its control,shall not be considered as violations of this X,17�LY ment. ((���j The Contractor warrants that the work fumishsd hereunder shall bs free frcu'rt t atel` and for a p at _following campis' a shall comply with the requirements of this Agreement.in the event any defect in workmanship or mate ge Cau Tay"0is Contractor,ItsµSliev"rs,employees or agent,is discovered after completion of any job,Including Cleanup,the Contractor shall,at its awn expense,torthwith remedy,repair,correct,replace,or cause to be remedied,rep r r ch dams or such defect in materials and workmanship.The fa warranties shall survive an inspection performed in connection with the agreed:I pon work. YHl agrees to perform the work,furnish the material and labor spewed above for the total suT Of: {$_. u Wing canrrtraCt(113 max' um), Name of Representative {Ss t�o6mpietian of Authorized Signature �a> # {$ W�l�n npletion of � deposi No momJim fat hwne f the to al oo tract p i work shoal require a down epos"o(ay"W s deposit)at mare than chic-third of the totat crnxract price the fatal amlwni of aH dspasEts ar paymsrhts ( I made forth U n which the ContraCtor must make,In advance,to order andlor c dwnylse obtain delivery of,special order Completion of work under this Contract. trweriala and equipment,wRstr�ver er�uM greater Acceptance of Proposal I have read bath slues of this document and accept the prices,specifications and conditions stated.I understand that upon signing,this proposal becomes a binding contract.You are authorized to do the work as specified.Payment will be made as outlined above. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller,which may be his main office or branch thereof,provided you notify the Seller in writing at his main office or branch by ordinary mail pasted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement.Please refer to the Notice of Cancellation below contents of which are referred to above and incorporated herein by reference. QT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. r Signature Rate Signature _ ._. Date_,, DATE OF TRANSACTION YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE.IF YOU CANCEL., ANY PROPERTY TRADED IN,ANY PAYMENTS MARE BY YOU UNDER THE CONTRACT OR SALE,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 CANCELLER. 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: YANKEE HOME IMPROVEMENT, INC., 82 INDUSTRIAL DR., NORTH , 01000 NOT LATER THAN MIDNIGHT OF (J ------ � t HEREBY CANCEL THIS TRANSACTION ([late.&-xiw;and ex;Cluded) BUYERS SIGNATURE DATE Buyer(s)acknowledge r t a we complete fft[led in copies of this notice on the date first above written hereof. Buyees Signature Buyer's Signature r t.,i t,f,)'( f N W r4__ Roafin utters/A apjbr Agreement housand Sati ed Clients! YAN�� 821n fal Drive MA Lic#160584 1224 Mill Street,Big B 224 No pton,MA 01 060 CT Uc#0673924 East Berlin,CT 06023 P O M P I M P P. 0 V rZ G I T 413 341-5259 RI Lic#33382 877 8 8-YANKEE The� o iilli !�ui I'lllllllll IAI P Vioi� II S Referred�,��1°�I o All home improvement contractors and subcontractors must be registered and any inquiries fit Ne'vv England I about a contractor or subcontractor relating to a registration should be directed W Office of Consumer Af'f'airs and Business Regulation Ten Park Plaza,Suite 5170 www.YankeeHomeinc..com Boston,MA 02116 Phone:(617)973-8700 Date �u — Homeowner Information Name Email Street ! Town Shat Phone 3 H (circle)ALT# -- HWG Best Time Update The ConftclaraVgreews to da the,fotkawtrrg woi*for the Rome wwr ROOFING Type 4 Color Awagg&j Style _� 7114S Removal of Existing Roofing es E]No ',� G��,f "" Ise and Water Barrier ull F1 Partial Removal of Garage Roofing ' CIYes DKO < Ridge Vents es ONO Dumpster Wes []No Replace Sheathing __. es []No Sheets Incl. Main House Roof es DNo Price per sheet (as needed) Garage Roof ClYes wo Rolled/Low Slope ❑Yes i o Front Porch Roof DYes o Location _ Rear Porch Roof it [' Yes Wo Fleshings es QNo Drip Edge 5ffes DNo Color_� Location GUTTERS Color Downsp&ts Color Layout Attached DYes o C] Residential Sin 11 Corrimercia In Gutte�Pon C]Yes C]No Downspout Residential [] Comm al Type Garage: DYes ONO tion Porch DYes ONO Color ATTIC ENERGY,8R IER BLOWN-I SULATIQN Rafter In Open Ac Blow Walls 0Yes ❑No Knee 0Yes ONO D Net Blow Area to be cleared by homeowner ElYes ONO Kneewall DYes�No Type of exterior adding special lrrstrueflr 17S WORK CHEDULE In the work or order the materials before the third stay following the signing of this Agreement,unless Mfted'to actor will begin the,work on or about date).Barring delay caused by circumstances beyond Contractor's control,the work will be completed by e).The Owner hereby acknowledges an agraas the scheduling dates are approximate and that such delays that are not avoidable by the Contractor inciudl d es of C ges of materRA accidents,and all other delays beyond its control,shall not be considered as violations of this X22 ment. tV (,>CC t��f� ��O enol The Contractor wa+vants that the work furnished hereunder shalt be free€rom i rtnate and ns far a of__ ntir foitawing earn shall camRh/ with the requiremernts of this Agreement.to the event any defect in workmanship or mate taus Contractor,Its su actors,employees or agents,Is discovered after completion of any job,Including cleanup,the Contractor shall,at its own expense,forthwith remedy,repair,cortect,replace,or cause to be remedied, red.0 r re ch damage or such defect in materials and worEctnansh' .The foregoing warranties shall survive any InsLection performed in connection with the a reed-u work YHI agrees to perform the work,furnish the material and labor specified above for the total su 7 of: ( !__..)upon Wing ccnttact(i!3 maximum), Name of Representative The Commonwealth of Massachusetts Department of Industrial Accidents d I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lezibly Name (Business/Organization/Individual): Yankee Home Improvement Address: 36 Justin Dr. City/State/Zip: Chicopee, MA 01022 Phone #: 413-341-5259 Are you an employer?Check the appropriate box: Type of project(required): LQ I am a employer with 25 employees(full and/or part-time).* 7. ❑New Construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.E]1 am a homeowner doing all work myself.[No workers'comp.insurance required.]' 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.[7 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.- 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[:]Other 152,§1(4),and we have no 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. 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: Phillips Insurance Agency Policy#or Self-ins.Lie.#: 13HUB-61301814-6-15 Expiration Date: 05/25/2016 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 MGL o, 152,§25A is a criminal violation punishable by 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.A co y of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and r e pains and lties of perjury that the information provided abo a is t ue and correct. Signature: Date: Phone#: 413-341-5259 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#: 'Iol Bard 0�j3uilding Regulatic;,-'S I I- CS-�OSS442 GERARD J RONAN pi)BOX 675. AW T Oli A& P 03 Z r-T ('-=ffice of Consuai r Affairs and business Regulation (', Pq..rk Plaza - Sui Le Tviassach,,,isetis 02 kome, linprovenient Conftacto.r Rk-,-�istration P,.,.gislration: 160584 !-ype: Private Corporation Expiration: 8/7/2016 Tr# 255873 YANKEE HOMF W",WEIVIENT INC, GERARD RZONAN , 82 INDU,1')'!-R'AL DRIVE UNIT NORTHA�,11:'T" Upeace z;dfla�ss aad return card.Mark reason for change. Address ❑ Renewal D Employment ❑ Lost Card SCA I 20M-05r11 ICD—, Office of Cua�;uoje� eL Su-.,inessRegulation License or registration valid for individul use only '"ME I.efore the-:Cpiration datt, ff found return to: 0 Tv P e Office of Consumer Affairs-4vri Business Regulation IV)ej,g istrati o.-.� 1 3, I xpiration: 8,'7/2016 Private Corporation 10 Park Plaza-Suite'-;170 Boston,MA 02116 YANKEE HOME IMPROVEM N7 GERARD' RONAN 82 INCUSTRIAL DR'V- NORTHAMPTON,M,%01(;6;1 YANKE-3 OP ID: CG ACORL7" DATE(MMro CERTIFICATE OF LIABILITY INSURANCE DA TE(MMIDnmr) 2015 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 endomement(s). PRODUCER CONTACT PHILLIPS INSURANCE AGENCY INC NAME: Chrystal Greenleaf 97 CENTER STREET IPA .,1:413-594-5984 FAX No:413-592-8499 CHICOPEE,River MA 01013 ADDRESS:chrystal@phillipsinsurance.com Chris Rivers INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Insurance Company 136161 INSURED Yankee Home Improvement,Inc. INSURER B:National Union Fire Ins Co. 119445 Ger Ronan 82 Industrial Drive,Unit 2 INSURER C:Seneca Insurance Co.,Inc Northampton, MA 01060 INSURER D:Selective Insurance 12572 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD C X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE 7x OCCUR BAG-1030548 05/25/2015 05/25/2016 PREMISES Ea occurrence $ 100,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY a JEC 7 LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ea accident D ANY AUTO A9099741 07/31/2014 07/31/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,00 B [�+' EXCESS LIAB CLAIMS-MADE BE 044156792 05/2512015 05125/2016 AGGREGATE $ 1,000,00 ED RETENTION$ $ WORKERS COMPENSATION PER OTH- 1AND EMPLOYERS'LIABILITY X STATUTE X ER _ A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 6HUB-61301814-6-16-MA 05/25/2015 0512512016 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? FN-1 N/A ((Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if 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. AUTHORIZED REPRESENTATIVE ryx ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD SE�#�d1�I 5''CUN�"I Ri7CTI @ITT SERVICES • .'° : 5.1 Construction Supervisor License(CSL) 9�4 2 3 �q Zvl6 �_,eXAr—d License Number Expiration Date Name of CSL Holder \ I I List CSL Type(see below) lam. No.and eet� �+ ' �✓ ype, F}escnption V-2-2- U Unrestricted(Buildin s up to 35,000 City/Town,State,ZIP R Restricted l&2 Family Dwelling M _Masonry RC Roofing Covering WS Window and Sidin SF Solid Fuel Burning Appliances Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) �X) � ��� HIC Registration Number NXPDpiion Date HIC Name orLIIC Registrant Name No.NJ Street Email address ` e_ c?X022 4t3 3yt-S�� Ci /Town,State,ZIP Telephone m 5 � WQR1I :RS' T'E1�15ATIGN I>`ISI R NCR +IDA 'I`.(M G Lr c. 52 '2 5 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........... ❑ ORMI;K'1i 0W1R�UTIiC)RIZATI(iN 14 B CAILET 'r , �_�., �NG.�1!�'F ��J�1�1';.CR�C�` �tP�IlC'S�F BkI�iLI���I; I �E �" ,•, . L I,as Owner of the subject property,hereby authorize �(r.Q 1 V��.e✓T� to act on my behalf,in all m_a_ttt eerrs relative to work authorized by this building permit lipplication. Print Owner's Name(Electronic Signature) Date T-00040 s By entering my a elow,I hereby attest under the pains and penalties of perjury that all of the information contained in is lication is true and accurate to the best of my knowledge and understanding. /� ��- Print Owner's uthorize gent's Name(Electronic Signature) ate 4 w I. An er who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mqaL.&ov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" 'rin�1; yS+ it� iC�N�F I� h wi�i�l dk� C;i( tfrt�' y tt, iI , New House © Addition Replacement Windows Alteration(s) Roofing Or Doors 0 1 A Accessory Bldg. El Demolition ❑ New Signs [0) Decks [Q Siding[0] Other[o] Brief Description of R osed �` `- W o rk; + a" r b D'1- Dvi Alteration of existing bedroom Yes No Adding new bedroom_yes_.__.Yes ..._.. . ._.No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet a. Use of building ;On D Family Two Family Other F b, Number of rooms in each family unit: Number of Bathrooms c. Is there a garage a ached? 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 1h iJ1NNE�A417H�1 17 i k7N `1 D�I ;�f t li�tM �f�t '1lVH N o trNt �'A Eaii`t i as Owner of the subject property hereby authorize to act on my behalf, in a I matters relative to work authorized by this building permit application. Yl i W nature of Owner Date I, Gn A?'rGi`f '"-' '' -40-Y" , as Owner/Auth ized Agent hereby declare th t the statements anq information on the foregoing apr1ication are true and accurate,to the best of myl,t owledge and belief. Signed under the pai s ancipenalties of perjury. Print Name Signature of Q r Age Da e 3 i RECEIVED 0111112015 02:46AM 08/20/2016 11:28 14135871272 NTON BLD DEPT PAGE 01/88 Varalonl.7 Commerelal flufldlnR Permit May 1$ 200 t 1+7ONtint ii w 1i of Northamptonf � , �4 Blding Dopartmont bult�crtl�'rwvsstrt ��- 21 2 Mein Street fi' AUG 2 a Room 100 ida t+sf�tatallilshtllhitlll "I' L hampton, MA 01060 ww�$eta � iatwal r�lrrs lectric, r phone 413- $7-1240 Fax 413-587-1272 laj�P+IIrte ; , APPLICATION TO cd-N TRt7CTREPAIR,RENOVATE,CHANGE TW 1J5V OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1-31TE INFORMATION 1.1.1'rewky Address; This Section to ho C=ompleted by CflIGe Map Lot Unit Zone Overlay DisMr-t _.....__...-_.......- ElrnStI)Istrlat CQDimriat SECTION 2-PIkOPRItTY OWNERSHWAUTHORIZED AGENT 2.1 Owner of ReaoM: Npme 1'+rint 1 CurTent Mallln Ada...-.. .. . _. . SI nature W'L C b>R ToMpnone At 4 2.2 Authoft Name(Print) � 1 Curfe Mailing Address $Sgnaturn Telephone 3- ATCi90 CON ucnoN C0839 Item Estimated Cast(Dollars)to be Official Use Only completed by elm t applicant ng � (a)PulldiN Permit Fee ..._.,-.._.__...-.__......._...... ..........._, ...-- i 2. Electrical (b)Estimated'rotal Cost of Construction frnrrt 3, Plumbing Building PRrrnFfi Pee 4 Mechenlcel CVRC? 5-Fire Protection G. Tat di-L1 +2+3+4�5 (.`� l Q Check Numbar This Sfttlun For aificial Use Onl Building Permit Number Data Isaued Signature: BuIlding Commissionernnspectvr of Budding v Date 59 RIVERBANK RD BP-2016-0215 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25 -069 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2016-0215 Project# JS-2016-000363 Est. Cost: , 12116.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: YANKEE HOME IMPROVEMENT INC 89442 Lot Size(sq. ft.): 13155.12 Owner: LANG JESSE L Zoning: Applicant: YANKEE HOME IMPROVEMENT INC AT. 59 RIVERBANK RD Applicant Address: Phone: Insurance: 36 JUSTIN DR (413) 341-5259 O WC CHICOPEEMA01022 ISSUED ON.812012015 0:00:00 TO PERFORM THE FOLLOWING WORK.STRIP & SHINGLE ROOF 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 8/20/2015 0:00:00 $35.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner