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. rocessing. Only one per adjushnent form Only one order is due to quality issues, please include Return Explanation in Secion 2. `�J
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Purchase art Code Code ! Code Qty Rem Number Item Description Purchase Amount
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T npl6 please e ll a check or money order t cover the additional cost, plus applicable sales tax. Please do not send cash. TAX ft if
TOTAL AMOUNT ENCLOSED .
'ODES " PURCHASE CODES COMPANY USE ONLY
❑ S.S.R Payment Method
u ae G = Guest SA = Sample; Order D Visa Cr Mastercard
age 8 = Booking CS = Customer Service ❑ B.LS
and R = Hostess Dollars IN = Incentive Or (1 1 1 1 1 1 1 1 1 1 1 1 1 1
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Make check payable to The Longaberger Company.
Shipping Information
1 1 1! I 1 I l i l l I I I The Longaberger Company
State ZIP + 4 Attn: Adjustment Team
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I 1 1 I I I I I I I 11 Dresden, OH 43821
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11 SUMMER ST BP- 2012 -0360
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31B - 047 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- 2012 -0360
Project # JS- 2012- 000583
Est. Cost: $800.00
Fee: $60.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THEODORE TOWNE JR 722
Lot Size(sq. ft.): 3702.60 Owner: CALLAHAN EUGENE
Zoning: HB(100)/ Applicant: THEODORE TOWNE JR
- AT: 11 SUMMER ST
Applicant Address: Phone: Insurance:
P O BOX 503 (413) 297- 2916 0 WC
EASTHAMPTONMAO1027 ISSUED ON:10/12/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE ROOF ON DORMER
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: OK /O -- — j( C ff'
THIS PERMIT MAY BE REVO ! BY - E CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND :." Ole atb / Amxcle
Certificate of Occu.a ,/ ° ignature:
FeeType: Date Paid: Amount:
Building 10/12/2011 0:00:00 $60.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck – Building Commissioner