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38D-006 (2) i LOWEs CONTRACT # 0001713 MASSACHUSETTS EXTERIOR SOLUT!^1NSTALLED SALES CONTRACT INcALLED SALES SPECIALIST NUMBER CUSTOMER t I t y STORE NO. STREET ADDRESS STREET ADDRESS r i 1. CITY - STATE ZIP CITY STATE ZIP _ t _ C TELEPHONE TELEPHONE ; .,,7 l r_.._ , DATE LOWE'S HOME CENTERS, INC.'S MA HIC NO.. 148688 CASH BANK LCC REG / FEIN - 56- 0748358 CARD CHARGE This is only a quote for the merchandise and services printed below. This becomes an agreement upon payment. Upon payment, the entire agreement, including the specifically completed pages of this document, the Terms and Conditions included with this document and any other addenda and attachments hereto, shall be referred to herein as this "Contract.' PLEASE READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS PAGE AND FOLLOWING PAGES BEFORE SIGNING. INSTALLATION STREET ADDRESS CITY : STATE ZIP I (4 / p / l'1( j`'r / f r t • , f °` + a +; Contract Total / 1.-2,- ---- ---- '..) ' Are permits required for this installation ?: [ J)6s [ ] No *applicable tax included NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. PHOTO RELEASE: Customer grants to Lowe's and Lowe's employees the right to take photographs of all work performed at the Premises related to this Contract, and irrevocably grants to Lowe's all right, title and interest in and to the photographs for use in all markets and media, worldwide, in perpetuity. Customer authorizes Lowe's to copyright, use and publish the photographs in print and /or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, including, but not limited to, marketing, advertising, publicity, illustration, training and Web content. By initialing here, Customer agrees to the foregoing. [Customer to initial to the left]. Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s) which is anticipated to be [fille in date]. Estimated completion date is / / [fill in date]. Said estimated substantial completion date is not of the essence. A statement of any contingencies that would materially change said estimated substantial completion date is as follows: (if applicable, insert statment of such contingencies). IF THE CONTRACT TOTAL IS $1,000.00 OR LESS Customer must pay in full. COMPLI�TE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS $1,000.00: [ � stomer to Pay in Full; OR [ ] Customer to use the following payment schedule: (1) Deposit $ to be paid upon siging contract. Deposit should be 1/3 the total contract price; and (2) Payment of $ to be paid anytime after this Contract is signed and before commencement of installation, I/We authorize Lowe's to do one of the following (check appropriate box below): [ ] Charge my /our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or [ ] Deposit my /our check for the amount of the payment indicated above anytime after the date this Contract is signed; and (3) Final payment of $100.00 to be paid upon completion of the installation and both parties' satisfaction. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c.142A LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT- IVE OFFICE OF CONSUMER AFFAIRS AND BUISNESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROI'IDEIjIN M.G.L,c.142A. / ", , // ( By: I . it"! ' t_ c.;L �w _ f r'C ) Date: ' Lowe's Home Centers, Inc. By: Date: Owner Signature THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L. c.142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT. BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CON' ACT. YOU AR NTTTL D TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. WITNE S OUR HAND S) q SEAL( . ELOW THIS DAY OF " 7, " r f 1 Lo Ho e e t t l / ' F �1 . Spe li or b• e� t f Owner Co -owner or Witness Cust er acknowledges eceipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof. You, the buyer, ma: cant I this transaction at any time prior to midnight of the third business day after the date of this transaction. See the attached notice of cancellation form or an explanation of this right. © 2004 by Lowe's.® Lowe's and the gable design #90981 (Rev. 12/10) FILE COPY are registered trademarks of LF Corporation. https://owa.myloweslife.com/owa/X-AttachView/bin/print.html... • [Ills page is intended for printing only. Retrieving data from server ... 1 AcQRP. CERTIFICATE OF LIABILITY INSURANCE DATE DIDEMPYWO 1 09/17/2010 610101:11/CER ' THI8 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Richard ' Green Insurance Agency. Inc HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11 Allen Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. iHaineden, MA 01036 INSURERS AFFORDING COVERAGE i NAIC INSURED ' 41' , 141`114 Travelers Insurance i ' ; •, I KO ftekarnp Construction LLC. •,t5.,,yeoe te Liberty Mutual . !Brywl Konekamp ., %VS i1,104.: y; - I 27 Butter Road ,,, illOrt:Ott MA 01057 COVE RAGES ..,.............._____.......—._ -7--- 7 4 P IC,. ii '; ,.): I.V:k..44ANCt I, v;TED KELOV,' Wovf LI ISS;;ETO 10 I 0,- Nf:1;,41:!:) NA'Ait.: AiY,::Vt, t'OR T if: POI. i;:Y Pt i'00DiNDIC:ATED NOTA1TH.SrAND1N ,...1.,, .;.,:•,, :;$4 4,1 ($5,4 tyAt C114.,, T tC.IN '1,5 .11.0.$f s OW RAC7 OF Or DOCUW,N uni RE spEC 1 IO WP:Cti TH1Z," CEPTP kw( i fS oP E ii iii 1. iF, ■ :ci Nficwp HE-RE,N Is S 10 N. t Ii' t Ci-^,MS EXCWSK)N$ ANO C,ONOVOON$ ,, • ' ' •,' '', ,',(' ,, 4E.O A rE iNcts.s 4! WY MAY ,, , , i ‘,..1 ( Q I: i%u"..t V .5 -3YI°11/1:112 W 40110 7YE 401.,1 EA/NOTION ,01:•00..., . . „ „ „UE.LAWANENNEELcE.— _yy n't. EINEE..1.$0401%&,V.1-4.-D.AIE.40100EVENY/-...--.- 100/43 • EA. reE1440, e.1.4010•15Y ENE/11 $ 1,000,000 q - -5r - rogrwn , i - ' ^ 00000 <;i.S , . ' '''''' IlW ''!',1; i l ' 5 i° 00 i 'nn-owned auto 6606565P31 A. : 02105/2010 02/05?2011 , 111ERS'/NA' a. cy, t',4J. 'RN i 01,000.000 ■., . hired auto 4.4140 : . ' Nt A A Ge.,R''''''A T" 12. 66b , ,,,,,, a , CO ,. 02.000,000 ._..... - ii _— , ,, 1 ' M0T00010NEE 0100 -i" U:34 b &w.; 4 4551545,555-.:4 1 AN 541.1 r44 .4 i 5; , 0445.545 54 $ 4,505y : . : RX/1 '1 I , ; ":1I .1$ INE1tt AD TO3 ' I i I `1-110:1:04,t1E;S , I 1101.7y,YN AA*. $ A e (5044.445'45; t ..,--... . — 4.--. ..-----, ........ ---■. ..1 DN. e • EA ACCAVN1 . $ , 1 ANY 4,0, — 1 SS , UMFOIF I t A L tAtx. Mr ' 5,4244545.55544455.•55.5. C. ■V ,,, 0.6....;',A 1 5 4. I i I i .44 5554 ■ : , 5 $ 1 4y,, 1 NE4111t. RS CONNIE NSAY1DAY ANO I B EN41 4:4 RS 4 lAtilt VrY . E , E • — . y 54544.444$4,4 ' $ 1 004 V 000 '' WC 1-31S-37466 I-010 0912 0912412011 i. : ,,,,,,,, 6 .,,,, A I • , r 1 : . ,,1 • 1 -, AN31 A I. '1 Nt A wtst • YA E Wet ./.1,1 t lk.A. i .'" IPP 1 • .,,. i E7t5C4IP, ■VIN CT' 0.;RATIOliS I. t$G14 I 4144$ , VENICZEDIEXCLUSEMS ADDEVir ENDORSEMENT $$ PROVIi44;5 4 Subject to pir terms and conditions 1 ! owe 's Companies. Inc. and "any and all subsidiaries are named as additional insured as respect to I General Liability and Automobile Liability" I INon-Owned(blired Auto is included On Travelers Policy 6806565P31A CERTIFICATE HOLDER CANCELLATION I , 1 *MOULD ANY Of Tut ADMEDEDCTDDED AO, iGI( s SE CANCELLED &MAE THE eX1541A I i Lowe's Companies, Inc, (Attn: IS Insurance) EIATE TREREO0, .0141$10 OisugER wts.1 DiOcAvoR DO 444 „.„.a, DAYS WRITTEN IP 0 Box 1111 NONCE TO IRE CERNNEATE 010000E N NAMED TO Oft LET. DUI FAILUDE TO DO $0 SEALL NO rth Wilkesboro, NC 20 IMPOSE NO (55541.443/4110$4 ORt1/4$51.4155 Or ANY KINO UPON TK INSURER. at MUNI'S CM otepRE5,1•54/55150ES. — ...--5—__- 45,511150R141514; REPRESENTATIVE ----';'"- --"- ACORD 25 t2001/e8) el ACORD CORPORATION 1988 I of "7 07/05/2011 04:10 PM PAGE 01 / 4t2 fi . ?_. �diu 1w.: U 41 L..wwt b 4t.tmliatilm l.i.t .i.GJ 4 vvo m : I : U Ari wit,t , L! (1.i$ r$X eir - vesr eN The Commonwealth of Mas ;hrersetts Department of Industrial Accidents ::: „ .41 ,.. : ....' Of of investigations 600 Washington Street O ' Boston, MA 02111 :' www.mass gov+ldia Workers' Compensation Insurance Af'gdavitt Buildtr IContractorcl ,ElectriciansfPlwnbers A , 1 - w nt Mnto ,,i. -: on ,.M ..___ Please Pr .... _ Name 0: 14:i iueNstOrganixationtlndlviduaq ". /' 4r / L/ -'r , 4 e. .Address: I t` Apo i .AL i AC!. City /State /dip; r k' itvz> e #; — `IL Are you an employer? Check the appropriate boar. Typo or project (required): !. ❑ I t 4. n a employer with ❑ I am a general contractor and T b, d New construction employees (full and/or part -tiMe) x have hired the sub- contractors 2. I. am a sole li3tcd on the attached sheet 7. Remodeling pt^pprietor or partq�- T hcsc sub•oontrtatorsnave ship and have no employees S. ❑ Demolition working for me in any capacity. employees and have workers' 9 Q Building addition [No workers' comp, insuranee camp. insurance,'t required.] 5• ❑ Wo are a corporation and its 10,0 Electricoi repairs or additions 3. ❑ I an a homeowner doing all work officers have exercised their 11. CD Plumbing repairs or additions myself; [No workers' comp, right of exemption per AM 110 Roof r ire insurance required.] 't c. 152, § t 0), and we have no f employees. [No workers, 0. , then n....e?i-r l 0 _ _ . -.,-.� comp, inslt['dtteeiequired,j l. ,..• "Any appttcaot that cheeks box $1 mat also Mom Are section baba stowing then watbws' compr usttlon policy Inforenslioa, t nonkownets, FWD submit ibis dfildrrvit inditatinp they are doittp nit work eat than bin outsldn contractors mist submit a rice affidavit indicatthe au cit tCoatmetors that check this t o% must attached fur addltiooal shoat atowlagtOc maul of the tub.:onhactor; acid :AM wbetber or mot Mors cuini= taw cmp1oyccs, if tie sub -ep itractaes hove employes. they must providotbch workers' eosip poky =bat _ _._. — _ . — — .t am an ernj,floycr that is providing wortr s's' compensation insurance form employees. Below is the polity and fob site information. Insurance Company Name: L- f 1., e_c 1 ! - Polley # or Sett -ms, Lie. #:, it 1 1. C r L c — 324 W.01 '' a 0 Expiration Date: 7 0P-`{' — i Job Site Address: s � Tr CitytStute/Zip: fiat ky ,w p - J a mac Attach a copy of the workers' compensation policy declaration page (showing the policy number and cxp$ atom date). Failure to secure coverage as rcquircd under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of it fur. up to 51,500.00 axidler one - year imprisotument, as wen as civil penalties is the form of a STOP WORK ORDER and a fine of up to $250,00 a day aguinat the violator. Dc advised that e copy of this statement may he forwarded to the Office of Investigations of the T)IA for insurance ooveragc verification. _ do hereby cc •,,, �' r . o pal . , i • attics of perfary that the it fofmadoa provided above is true and comet. 4r ' f ar . ' �� —r+ r _ t P rZne # --. , .. ^- -- ^- ---- -- Official use only. Do not write in this wee, to be completed by city or town of iicfaL City or Town: Parse iit/L+ceusc r _ _ Issuing Authority (circle one): I. Board oillealth 2. Building Department h. City/Town Clerk 4. electrical l Inspector 5.I`hunbing Inspector 6. Other - Contact Person: Pone fi: _ i/Z d 9+7ZO•22S(E147) « g2Z0 985 £1,h OSi 91,61, sarlol rn:Ot. £0- 90- nl.np Llb.P.::5, 21J18 06: 58 41 32673390 PAGE CI1 i'Ii IF Board of Building Regulation:4 and Standards Construction Supervisor License . Officcaoittirkregiaistifiktifiree' License: CS 96999 \ ' \ --;:------ N HOME IMPROVEMENT CONTRACTOR I it. ' - . Restricted to• . 00 ; 7. l •:., Reemotration: .„.:465816 Type: - 7 .;" Expiration: *454012 LLC TODD KORTEKAMP ... ... ...----' v .,,,,-, , z,.;: - :•: 1 ' •, ;"',. 'fi :i.:.6 ' . " runner i navoet::, ,:: Z 7: ' :':,,,::, .• 27 BUTLER ROAD i 'S - 't' ":;;; MONSON, MA 01057 ..; TODD KORTEKABIP ., 2,:. '• , .,.', ..'/ .7.: 27 BUTLER RD 4 ".1-:::: ... ..".....ew.-.- ..-gef.' .....--.., Expiration: 8/26/2012 MONSON, MA 01057 , -,.....-- : Undersecretary ( 91i1illi3Siuliwir Tr#: 27751 — — . . . . . . . Restricted to: 00 License or registration valid for individul use only 00- Unrestricted before the expiration date. If found return tin 1G - 2 Family Homes Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 Failure to possess a current edition of the Massachusetts State Building Code , f , NallIPIr '" is cause for revocation of this license. Refer to: WWW.Mass.Gov/DpS Not valid without Si. ,, *lure ' _ ..... a.. id ol,r/koaacitadeas - Office of Consumer Affairs & Business Regulation License or registration valid for individul use only ". EV OME IMPROVEMENT CONTRACTOR Supplement Card before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 148688 Type: 10 Park Plaza - Suite 5170 Expiration: 10/18/2011 Boston, MA 02116 LOWE'S HOMES CENTERS INC JAMIE SPOFFORD 136 TURNPIKE RD. SUITE 100 -47-4-/-----p-e-5------ _____ SOUTH BOROUGH, MA 01772 Undersecretary Not valid without signature g i - ,,, ,,,,,,,,...a of 76,,,,a,dadea Office of Consumer Affairs & Business Regulation License or registration valid for individul use only T ,-,_ before the expiration date. If found return toulation : 1. =_ IMPROVEMENT CONTRACTOR - 4 1 .7, Office of Consumer Affairs and Business Reg ''( It '_-_- Registration: . . megistration. 148688 Type: 10 Park Plaza - Suite 5170 , ----;-----. `-,; Expiration: 10/18/2011 Supplement Card Boston, MA 02116 .1 LOWE'S HOMES CENTERS INC ) 17 i ,,...... „. RUSSELL POWELL 136 TURNPIKE RD. SUITE 100 .-. '. -, • 1 -- SOUTH BOROUGH, MA 01772 undersecretary Not vali I without sil. ature ----------•'mm."""mm.""mmlgilliI.1""oiemoim PAGE 02/ C12 1. /1_1 .21L1 : 4132673390 SECTION 5: CONSTRUCTION SERVXCES 53 Licensed Construction Superviisor License rtumbcr Rxpimtit+n Date tio f liolpler ( /►, .r�l . + ( Last CSL Typo (set below) - Addrwr1 ./J t_ �, Type_ Description ff!!` 1 U Urmcufcted u to 35,000 Cu. Ft. U. ►' Signature R Ctcstricttd tdt2 Family AvvctGrt num Matson cm Telephone • Resider sal Roofs » Coverin • W Rccidential Window and Sidiea SF Residential Solid Fuel Bumin; A , , liaacc Imtallimo n _ D Residential Demolition S.2 Ite� c d Hn �mprovem C tract (C) HIC Coney N;unc,o 14tC R 'grad. ante Registration Number cC� 1 .auk i. t - +, ..I lbw Lt Addrtias + LAP_Jlr ' `I! " _6 40 Expiration tom. Sign e. r r Telephone SECTION 6: PRICERS" C • ENSATION INSURANCE AFFIDAVIT (M.G.f.. c. 152. 2SC(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 t building permit. Signed Affidavit Attached? Ycs r~% No p SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WI 3EN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT e- j► ;IS Owner of the subject property hereby authorize - C to act on my behalf, in all matters relative to work authorized by this building permit application. Sigrwttt.: orOwoer I)wc SECTION 7bt OWNER' OR AUTHORIZED AGENT DECLARATION 1. l. er. <l -1.6r L! 6i Owner or Authorized Agent booby declare that the stateme is and information on the foregoing application arc true and accurate, to the best of my knowledge and behalf, /91 � c.) Print 2 — [/ Sig ► .r4 of Owner or Authorl Agent Date (Si ed under the .ainoend - alien of NOTES: t . An Owner 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 (RIC) Program), will et have access to the arbitration progenn or guaranty fund under M.G.L. c. 142A, Other important information on the BIC Program and Construction Supervisor Licensing (CSL) can be found in 7811 CMR Regulations l 1O.R6 and 1 respectively 2, When substantial bs n at work is planned, provide the in ormation below: Total floors Mee (Sq. Ft.) _ �. , �,.._ (including garage, finished basement/attics. decks or porch) Gross living ma (Sq. Ft.) Habitable room count . Number of fireplaces Number of bedrooms _ Number of bathrooms - — Number of half/batiti 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 d 9WO- ,ZS( ) «« 8LZ0 99 £6� �8I 9bd6 5 0 1 L�i�O� ���go�o�na - , wle , 7 ' 3X't,..: : i:..' .„ I - i z r-...2c.f A r r) ; i 1 1 ..„... . 4,, ,..,........ a The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR, 7 edition MUNICIPALITY { I USE 1 Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised January 1 �t One- or Two - Family Dwelling 1. 2008 This Section For Official Use Only Building Permit Number: Date Applied: Signature: Building Commissioner/ Inspector of Buildings Date SECTION 1: SITE INFORMATION 1.1 Property Address• 1.2 Assessors Map & Parcel Numbers ct OArd (.O S > 4 . 1.1a Is this an accepted street? yes no Map Number Parcel Number 13 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area (sq ft) Frontage (ft) 1.5 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c. 40, §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public ❑ Private ❑ Zone: Outside Flood Zone? Municipal ❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2 Owner of Lord: Name (Print) Address for Service: -5e-1 Signature Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction ❑ Existing Building ❑ Owner - Occupied ❑ l Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other EUlpecify: ' rep c4)s-.r 1 Brief Description of Proposed Work a c r•c; - 3 ). c t .j 3 vl -S SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item (Labor and Materials) Official Use Only 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ ❑ Standard City/Town Application Fee ❑ Total Project Cost (Item 6) x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 1-2 2 5 ❑ Paid in Full ❑ Outstanding Balance Due: 9 CHARLES ST BP- 2012 -0023 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38D - 006 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: windows replaced BUILDING PERMIT Permit # BP- 2012 -0023 Project # JS- 2012- 000047 Est. Cost: $1729.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOWE'S 96999 Lot Size(sq. ft.): 5009.40 Owner: FENNESSEY CLARE K Zoning: URB(100)/ Applicant: LOWE'S AT: 9 CHARLES ST Applicant Address: Phone: Insurance: 282 RUSSELL ST (413) 588 -0270 WC HADLEYMA01035 ISSUED ON: :7/8/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT WINDOWS 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 7/8/2011 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner