32A-088 (14) BP-2022-0063
25 GRAVES AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32A-088-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0063 PERMISSION IS HEREBY GRANTED TO:
Project# 2021 FIRE DAMAGE Contractor: License:
Est. Cost: 80000 MARK DAVIAU 056785
Const.Class: Exp.Date:09/09/2023
Use Group: Owner: GANDARA MENTAL HEALTH CTR INC
Lot Size (sq.ft.)
Zoning: URC Applicant: BAYSTATE RESTORATION GROUP
Applicant Address Phone: Insurance:
69 GAGNE ST (413)532-3473 UB-1K7923 1 3-2 1
CHICOPEE,MA 01013
ISSUED ON:01/25/2022
TO PERFORM THE FOL L O WING WORK:
REPAIRS DUE TO FIRE
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:
Gas: Final: Final: Rough Frame:
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: (�
II . �
�r 3Q •
II
Fees Paid: $560.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
;. F C_ . 'i--: I‘t/ .
The Commonwealth of Massachuse s `
*lik JAN 1 g 2022
Ii(` / Office of Public Safety and Inspections
I Massachusetts State Building Code(780 CMR)
" Building Permit Application for any Building other than a One-'or Twor ` , it„i t,,,i
/' (This Section For Official Use Only) ��y),11H.' pi,.-)N tv oiot;o
- - -_ ____ .
Building Permit Number: .1.g " C'3 Date Applied: Building Official:
5 C'ra t5 SECTION 1:LOCATION
Mor-Vr Ppniv001‘.. Olo(4 CitaAzir►ro- `A.P k IAA C-A4
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Building Er Repair d Alteration 0 Addition❑ Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0
Is an Independent Structural Engineerin Peer Review re uired? Yes 0 No 0
Brief Description of Proposed Work: 'e 1QA�,( raw. t M, n.+&o 1. t t u.rgk l ttpaW'
`, bakti , 1L�kc,�.e.n K"rv�oml e,\ v 46 Rre a 1 n 3 uJ },'ztn . Cl.
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Adb 0/1
9_, Eistii-,-, Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub ❑ A-3 ❑ A-4 0 A-5 0 B: Business 0 E: Educational ❑
F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1 0 I-2❑ I-3 0 I-4 0 M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0
S: Storage S-1❑ S-2 0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IAD IB 0 IIAD IIB CI IIIA ❑ IIIBD IV CI VA 0 VB 13
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
Public 0 Check if outside Flood Zone 0 Indicate municipal 0
A trench will not be Licensed Disposal Site 0
Private CIor indentify Zone: or on site system 0 required 0 or trench or specify:
permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECT] k PROPERTY OWNER AUTHORIZATIOI
Name and Address of Property Owner
30e.. PArAr-its ')-5 ('rrawes 3 fr Vur-i--tkot oupivn Of o
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
- - 413-M-51411 - 3,(vkr AS02, a14oia 'Qr<kof
Title Telephone No.(business) Telephone No. (cell) e-mail addr ss
ce
If applicable,the prol erty owner hereby authorizes:
Name Crf e Street Address City State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O.
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
%� s- 9\askuc cv\ Cr row
Compar i Name
YV\at'Y.- V-., Zav%cAv C•5" 0567SS V(Nees;-‘ ;c. Ck
Name of Person Resnon-a .t^'1r Construction License No. and Type if Applicable
(gq Gickc S i. C,1e1'.w c ‘CAI
Street Address City/Town State Zip
141 5.5 -3y 7 3 (bi7 - 008 r t o,fY--.okowi ow @ bcAk3s+cAlc.rcA.c 0)41 -
Telephone No.(business) elephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes Er No D
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ 700o0 Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ 5 C/G0 appropriate municipal factor)=$ .
3.Plumbing $ 5OOO
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
irrffliMili $ 6 0 000 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my n ,I hereb st under the pains and penalties of perjury that all of the information contained in this
application i cura e best of my knowledge and understanding.
art 00,Aiavo— kJQX 4n-S 3a3Lt7 ) 119/))--
Please print and sign name Title Telephone No. Date
c.q ..2__ Sc C\A;c..aQ-ee, Mk 00\'� 05,Altaicatkui4c4ck rc oA
Street Address City/Town State Zip Email Address
J`c
Municipal Inspector to fill out this section upon application approval: t _�
Name Date
,.ity of Northampton
SXC
Massachusetts 53f3K L z'c
4
DEPARTMENT OF BUILDING INSPECTIONS
e 212 Main Street • Municipal Building 3y ^gab
max+ Northampton, MA 01060 y,V, 1VO1
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
V �
Location of Facility: ` I 1 " V `
The debris will be transported by:
Name of Hauler: QNR.c .)\k),V..,
Signature of Applicant: �N ;��— Date: I��
The Commonwealth of Massachusetts
Department of Industrial Accidents
= •
,=
1 Congress Street,Suite 100
.7v Boston, MA 02114-2017
,
www.mass.gov/dia
'24=0
Workers'Compensation Insurance Affidavit:BuilderslContractors/ElectriciansiPlumbers,
TO DE FILED WITH THE PERM!!TING Al 11101UTY.
Applicant Information Please Print Let:ibis
Name alusincss,OrganizationlIndividutt1): 051—GViT 1 ,SAtArrci CAA rrikAP
Address:
City/State/Zip: C.,\AI CrApek-1 AAA—CikOk 1> Phone#: 97 5-S)--. 47
Art yin to attployer!Cheek the appropriate box: Type of project(required):
1.2rant a employer with 1)5 employees(fhll arudjor part-time).* 7.. CI New construction
_ I am a sok petiprietor or partnership and have nu erycloyeeni working for ate in 8. Remodeling
any capacity.[No workers.'comp.insurance
nsu De
10 I am a homeowner doing all work myself.[No*rickets'comp.irance r red.equi ]' 9. D molition
1 0 D Building addition
4.0 I am a homeowner and will be luring coluracrors to ooniluet all work oo my property. I will
ensure that all contractors either have%O&M"Ourraperl.%4Iun insurance in art Malt I.0 Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
50 I am a itcriend contractor and I have hind the sub-contractors listed on the attached sheet
13.0 Roof repairs
These sUb-entgraitiOrS.broe employees and have*Laken.'comp.insurance.:
14.nOther
e are a isorporation and its officers have exercised their right of exempthat per likiL c.
152,fit 1,and We have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box t 1 mint also an utx du.-section belfry/showing their waiters coMpensation policy ullorinatwn.
t tionieowrters who submit dm affidavit indicating they are doing all work and then tire(amide enektraketkos must subniit a TIi,.affidavit indimtng such.
tenntraCIOra that check this box must attached an additional sheet showing the Bathe of the sub-contraetors and state.lahtrihcr ur nut those entities have
employerti. if the sub-euntraetors have enzployees.they mast provide their vvorkers'comp.pulley number,
I am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: A A (N.NeA.,c cxv.\ /Sex\(-61,;,
Policy#or Self-ins.Lic. tJQExpiration Date: k ACit),(X
Job Site Address: 1).5 Cr"(tAtt.Si IVJe"I City/State./Zip:MdCW0164, 1W- \,C)(4)
Attach a copy of the workers'compensation policy declaration page(showing the policy number and e piration date).
Failure to secure coverage as required under hiGL c. 152,*25A is a criminal violation punishable by a fine up to$1,500.00
andfor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 a
day against the violator.A copy of this statement may be forwarded to the(Mice of Investigations of the DIA for insurance
coverage verification.
I do hereby certify e)it1 and ion' es of perjury titer the information provided above it true and correct.
Signature:
Phone#: LkkrS S.S1 e5til 3
Official use only. Do not write in this tired,. 14)becompleted 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 S.Plumbing Inspector
6.Other
Contact Person: Phone#:
11111
„--- - DATE(MM/DD/YYYY)
,aer-IR 3 • CERTI LATE OF LIABILITY INSURANCE
01/25/202 1
TAila.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 and endorsement. A statement on this certificate does not confer rights to
the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
BERKSHIRE INS GROUP PHONE FAX
138 LONGMEADOW STREET (A/C,No,Ext): (A/C,No):
E-MAIL
LONGMEADOW,MA 01106 ADDRESS:
78T3H INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A: ACE AMERICAN INSURANCE COMPANY
BAYSTATE RESTORATION GROUP LLC INSURER B:
INSURER C:
INSURER D:
69 GAGNE STREET INSURER E:
CHICOPEE,MA 01013 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 ADD SUB POLICY EFF DATE POLICY EXP DATE
LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MM\DDIYYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE I$
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 5
CLAIMS MADE n OCCUR. PREMISES(Ea occurrence)
MED EXP(Any one person) $
PERSONAL&ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY n PROJECTI—I LOC PRODUCTS-COMP/OP AGG $
AUTOMOBILE LIABILITY COMBINED SINGLE $ '
ANY AUTO LIMIT(Ea accident)
ALL OWNED AUTOS BODILY INJURY $
—
SCHEDULE AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
—4
DEDUCTIBLE $
RETENTION $ $
A WORKER'S COMPENSATION AND X WC STATUTORY OTHER
EMPLOYER'S LIABILITY Y/N UB-1K792313-21 01/14/2021 01/14/2022 LIMITS
ANY PROPERIrOR/PARTNER/EXECUTIVE I�I N/A E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? I I
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERIINCATE HOLDERAI'r1CTING WORKERS COMP COVERAGE.
REP.
LACES
INSURED'S MA WORKERS COMPENSATION POLICY AND ITS L1MI1'rt)OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS
MADE BY THE INSURED'S MA EMPLOYEES IN STATES OTHER THAN MA. NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER
THAN MA IF THE INSURED BIRDS,OR HAS HIRED EMPLOYEES OUTSIDE OF MA. THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B DELIV D
IN ACCORDANCE WITH THE POLICY PROV
AUTHORIZED REPRESENTATIVE
•
•
O 0
�—"41 BAYSRES-01 ANGELA
,c►c CERTIFICATE OF LIABILITY INSURANCE DATE(M 0
�----� 1/22/2/202121
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 have ADDITIONAL INSURED provisions or 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 Angela DiAugustino .
Phillips Insurance Agency,Inc. PHONE I FAX 413 592-8499
97 Center Street (AJC,No,Ert):(413) 594-5984 (A/C,No)a(
Chicopee,MA 01013 • E-MAILDSS:angela@phillipsinsurance.com
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Admiral`Insurance Company 24856
INSURED INSURER B:Cincinnati Insurance '
Baystate Restoration Group LLC INSURER C:
69 Gagne St INSURER D:
Chicopee, MA 01013
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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTRINSD WVD (MM/DDIYYYYl,(MMIDDIYYYY)
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X OCCUR FE1-ECC-28228-00 1114/2021 1/14/2022 DAMAGETORENTED 50,000
PREMISES(Ea occurrence) $
MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $ 2,000,000
POLICY X JECOT-
LOC' PRODUCTS-COMPIOPAGG $ . 2,000,000
OTHER: $
•
AUTOMOBILE LIABILITY Ea accc dentSINGLE LIMIT)
$
ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS ( BODILY INJURY(Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $-
$
A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $
1,000,000
EXCESS LIAB CLAIMS-MADE FEI-EXS-28229-00 1/14/2021 1/14/2022 AGGREGATE $ 1,000,000
DED RETENTION$ $
WORKERS COMPENSATION PEPERTUTE OOER
TH
AND EMPLOYERS'LIABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N IA
(Mandatory in NI-I) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below . •
E.L.DISEASE-POLICY LIMIT $
B Bailees Coverage TBD 1/14/2021 1/14/2022 750,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
•
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
�yvv"YE'
M
Commonwealth of Massachusetts
Division of Professional Licensure
• Board of Building Regulations and Standards
Construct onSj}pervisor
CS-056785 Expires: 09/09/2023
MARK R DAVIAU Fri.
75 GILBERT RD f.
SOUTHAMPTON MA 01073
Commissioner �..��
0
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
BAYSTATE RESTORATION GROUP, LLC Registration: 180478
Expiration: 11/18/2022
69 GAGNE ST
CHICOPEE, MA 01013
Update Address and Return Card.
Office of Consumer Affairs &Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE: Corporation before the expiration date. If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
180478 11/18/2022 1000 Washington Street -Suite 710
BAYSTATE RESTORATION GROUP, LLC Boston, MA 02118
MARK DAVIAU
69 GAGNE ST [ h'.l��Gh°k
CHICOPEE, MA 01013 Undersecretary Not valid without signature