Loading...
13-094 (4) 24 STONEWALL DR BP-2019-0987 GIs#: COMMONWEALTH OF MASSACHUSETTS Map'Block: 13- 094 CITY OF NORTHAMPTON Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) CateeOrv:&air BUILDING PERMIT Permit# BP-2019-0987 Project JS-2019-001622 Est Cost$8000.00 Fee—$65 00 PERMISSIONIS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sa.ft.), 16988.40 Owner: RUDNITSKY ALAN N &SUSAN K Zoning; Applicant. VALLEY HOME IMPROVEMENT INC AP 24 STONEWALL DR Applicant Address: Phone: Insurance: P O BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON:3/15/2019 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE FRONT LANDING AND APRON TO DRIVEWAY 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: Qjl; 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 FeeTvpe: Date Paid: Amount: Building 3/15/20190:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0987 APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESSIPHONE P O BOX 60627 FLORENCE (413)584-7522 PROPERTY LOCATION 24 STONEWALL DR MAP 13 PARCEL 094 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLIC IST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tweof Constmctiom REPLACE FRONT LAND KNTD APRON TO DRIVEWAY New Construction Non Strucmrel interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 077279 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 Spacial 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 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 we granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. Departmerduseonly: City of Northamp n status of armi �. --- Building Departm nt MAA 1 1 gppI�Cuts riv y-Pemjlt 4 tot =s u �u 212 Main Stree Sewer/Se ticA habil �(p firi + a Room 100 WataiMre lAvai abifity � 1 \'\ ` Northampton, MA006®FaT ural Plans `.` phone 413-587-1240 Fax h'. ? OthefSPecafij t . APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION I-SITE INFORMATION (60-o. %v? 1.1 Property Address: This section to be cyomppl`et�ed by office Un -Zone Overlay District 1, 1EIrn SEDistdct DB Dhshict _ SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.11 Owner of Record: � <J)Sal 1 1 H�5 �tit Fj 8 '20-L n--{JI'4f'sA �L''LR"�OL X,,b Name Current MailingAdtlress' // 413. 584- 2510, Telephone Sgnaiue 2.2 Authorized Agent: I�J�r P-Q �OX bob�l �lorencc_ 'l�'((F �IC�(oZ Name(Pont) �^ Cunent Mailing Address: 413-584- 522 Signature Telephone SECTION 3=ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be - Official Use Only com feted e"it applicant 1. Building (a) Building Permit Fee 2. Electrical (o)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) Check Number _��q f ' This.Section Far Official Use Only Date - Building Permit Number. Issued Signature: Building Commissioner/Inspector of Buildings Data EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) I Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Trod,column W be Sled in by BuSding De,oumaI Lot Size 1 Frontage Setbacks Front i Side L:i � R:L_ L:; J Rear I_J L_- Building Height L- r Bldg. Square Footage L Open Space Footage % _ (Let area minus bldg&paved arldn ) #ofParldag Spaces Fill (volume&Coeallou) I A. Has a Special Permit/Variance/Finding ever b en issued for/on the site? NO 0 DON'T KNOW Q YES Q IF YES, date issued:'.,`_ IF YES: Was the permit recorded at the egistry of Deeds? NO © DONT KNOW © YES IF YES: enter Book I Page�I j and/or Document#�I B. Does the si/the a brook, ody of water or wetlands? NO Q DON'T KNOW C) YES 0 IF YES, hit bee or need to be obtained from the Conservation Commission? Needs toined Q Obtained Q , Date Issued: C. Do any sigthe property? YES 0 NO 0 IFYES, dze, type and location: D. Arethereaed changes to or additions of signs intended for the property? YES 0 NO C) IF YES, dze, type and location: _ —_ E, WIl the construction activity disturb(clearing, grading, excavation,or tilling)over 1 acre or is it partof a common plan that will disturb over 1 acre? YES Q NO O IF YES hen a Northampton Storm Water Management Permit from the DPW is required. SECTION S.DESCRIPTION OF PROPOSED WORK(check all applicable) New House F-1Addition ❑ Replacement Windows Alterations) ❑ Reel ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [01 Decks "/K Siding j❑j Other[❑f Brief Description of Proposed !� ,,. t�/� 1 te. Work: 01,ACC 'F�j LAVO;NG 4 RP,0KVN \/0 UWIVrLWIfi Alteration of existing bedroo Yes No Adding new bedroom Yes X No,, _ Attached Narrative Renovating unfinished basement _Yes Nc Plans Attached Roll She sa If New house and or addition fo eitistino`housina, comalete(Fie 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? / J, Proposed Square footage of new construction. /Fireplaa ns e, Number of stories? f. Method of heating? oves Number of eachg. Energy Conservation Compliance. ompliance form attached? h. Type of construction i. Is construction within 1DOft.ofwetlands? Yewithin 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_ Privatewell_ City water Supply_ SECTION 7a-OWNER AUTHORIZATION-TOBE COMPLETED WHEN '..OWNERS AGENTOR CONTRACTOR APPLIES'FOR.BUILDING PERMIT I, &,� u- A'L 1C.Urkn 4&W as Owner of the subject property r hereby au ' w7o e m to act o> 111na}te tali o work authorized by this builtling permit application. 3 /4 Signna�l a of Owner Date I. i dFr° MYl & I\If YmQ» \/)-I'= 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. e�er1 I ver Print Name Signature of Owner/ e t Date I SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Constructions[Supervisor: C Not Applicable ❑ <We_Name of License Holder: i License Number c�lo3 Fomer�Za Sc 4hQm n Via oii t, IaI lap Address�/ - Expiration Date mature / II3-58y-�5aa Signature --7U Telephone 9.Re ISteed Home lmpiovement Contractor -_ ! Not Applicable ❑ �IIL IPu none- IC)C56N3 ComoanvN aI Registration Number Ooh 'lC� e 2C �} 01�1O2 -1 � 7-0 Address -Expiration Dale Telephone 13-rj8f-/-752 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.O 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...... ❑ City of Northampton a {. Massachusetts- ® ri; D2 MOF BUILDINGINSPECTIONS 21Mains 212 in tveet • Mu"icipal Building d _ Northampton, !W 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and. subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC'). M.G.L Chapter 142A requires that the"reconstructloq alteratoq renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has d. yrs contracted with a corporation or LLC,that entity must be registered. Type of Work r� L000I PJ6 Est.Cost: Address of Work: a?-{ Skcr LJa-" --f c Date of Permit Application: I hereby certify that Registration is not required for the following reason(s): _Work excluded by law(explain): _lob under$1,000.00 _Owner obtaining own permit(explain): _Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE NUMBING PEANUT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of pegury: I hereby apply for a building permit as the agent of the owner: 1lallr� �am�Tin�✓dscmrr,�z�Inc. 1055y3 Date Contrac rName HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date - Owner Name and Signature - City of Northampton a � �"-� Massachusetts c is � �. DEPARTMENT OF HOZLDING INSPECTIONS ' 210 Main Street • Municipal Building Northampton, M 01060 Massachusetts Residential Building Code Section 110.R5.1.2 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. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if ahomeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. 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. City of Northampton s Massachusetts DEPARTMENT OF BUILDING INSPECTIONS F 212 Main Street ,H ni—pal Bailtling Northampton, . 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: rrtE- (Please print house number and street name) Is^to be disposed (�off at: (PI a p—rin�Fffe and IocaHon of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth ofMnssaehusetts 'O�,�I Department oflndustrialAccidents - 1 Congress Street,Suite 100 Boston,MA 02174-20177 wwwmass.gov/dia Workers'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Avvticant Information 1_ '1 Please Print Legihiv Name(Business/Organizatioa/Individaap: �y/ 'I�I,I } ']/ Mn prp 1a?f]']-fr± e MI Address: pz Q-jnp City/State/ZiP: V\D(ex 4.Z, V4W Olhb2 Phone#: 't13-58'1-15a"a Are you m employer?Check the appropriate box: Type of project(required): l.9l ons a employu,no 7. ❑New construction 2 I am a sole proprietor orparWership mdhave vo®ployeea works, forme s ❑any caacity.Mo workers'comp.m—.c required] S. ®Remodeling p 3 I ansa homeowner doiag a❑wadensYsef Mo worers'comP ivsumnee require d]l 9. Demolition 4.❑I am ahe.—and will be hiring contenders to coodut all work on any property. I will - 10❑Building addition gimme[ tallcono-actencihahaveworkm'cumpessationimmance waresole 11.❑Electrical repairs or additions PrePrietam ah.employees. 12.❑Plumbing repairs or additions s f7 lam agevaalemtmcror-dlhave lived the mb-contractor Thstood slice[ex sub-ronhactors have em to dhave wod-s'comp.immancer 13.❑Roof repairs P Ycn- 6.❑Ws are acorpomtionead a,offrcashave exemisedtheUdghtofexempecinporMGL c 14.❑Other 152,§1(4),and we have no employees.(No workers'wrap.announce required] .Any applicant don checks box#1 must also fill out[he section below showing Werk workers'compeusatom polity h&omenti-. t Honseuwn<n who wbvut this affrdevit sLicaing they are doing all work and then hire outside conhactors must answer,a new affidavit iadi,ste,sucb. tCounactors that check this box must attached ass additional sheet showing she mine of the subcovtacton and state whether ornot those entities have employees. Ifthe subconswerm have employees,they must pmvide Weir workm'comp.policy number. I am an employer that it providing workers'compensation insurance for my employees. Below is the policy and job site information 1 /' lasarance Company Name: be11c� LnaUr0,Cx 6 Via Policy#or Self-ins.Lic.q#.11 001ES 0302\5 t Expiration Date: aI I (2 t�� Yob Site Address: 5k(Y%k.11)CtjQ Q- City/State/Zip: IC✓t I rIY- �LOb� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expatiation date). Failure to secure coverage as required order MGL c. 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 copy of this statement may be forwarded to the Office of Investigations of the DIA for insurame coverage verification. too hereby certify under the pains anndy enalties/�oJ,fgp��JfJr�iarry that the information provided above is true and correct Signature ;""1J �+'--�-�',, �/ Date- �I 1-6[ 19 Phone ft: t9j-6'Sq—,giro Official use only. Do not write in this area,to be completed by city or town official City or Town: Permlt/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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as".-every person in the service of another under any contract of hire, express or implied,oral or writma." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therem,or the occupant of the dwelling bouse of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),addresses)and phone number(s)along with their cerlif terf(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the - members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for cmdumation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sine that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or town)"A copy ofthe affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bur leaves etc.)said person is NOT required to complete this affidavit The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents _ 1 Congress Street, Suite 100 ' Boston,MA 02114-2017 Tel #617-727-4900 ext 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.tnass.gov/dia Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states'Neither the commonwealth nor any of its political subdivisions shall cuter into any contract for the performance ofpubhc work main acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to you situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Departmeat at the number listed below. Self-insured companies should enter their self-insurance license number an the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fiu out in the event the Office of Investigations has to contact you regarding the applicant. Please be sue to fill in the per imlicense number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating cumem policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit most be filled out each year.Where a home owner or cit¢en is obtaining a license or permit not related to any business or commercial venture(i.e.a dog hceuse or permit to bum leaves etc)said person is NOT required to complete this affidavit. The Deparhnent's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston,MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 ry w.mass.gov/dia Foam Acvecd 02-23-15 ®� Commo of ProeslMass achueer6 piNsion ul Professional Licensure Board of Builtling Regulations antl Slandartls Con stru�cPl�Sr ilpervisor CS-0]7279 > I E3'pires:06/21/2020 STEVEN A SILVERMApi' ^ 268FOMER ROAD S SOUTHAMPTONjv1A 01;3r X Commissioner V'"^' Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement�Contrector Registration -/ Type: Corporation -/t7 Registration: 105543 VALP.O.BO 60627 IMPROVEMENT INC /'� F�Jiration: 07/16/2020 P.O.BOX E,MA FLORENCE,MA 01062 Update Address and Return Card. I O cem-09A rmrnrcea�i[��aJ�Je/11 Ofrice MConsumer AM &Business Peg Wation HOME IMPROVEMENTation CONTRACTOR beforet the expiration for individual te. Itfouneonly etur TYPELorooraExp before of Affairs and Business to: Re isk'a`tlo a Expiration Office of Consumer Affairs antl Business Regulation 1955 07/162020 One Ashburton Place-Suite/301 VALLEYHOMERfiIVERRVEJD[ C Boston,MA 02108 STEVEN A. RIVERSIN,NQj01062 Undersecretary NORTHAMPTON,NA" (-J Not valid Without signature NO