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Unit cr» Lifits roc EUERCY 9t.LR • • cagio (f) : 110 ctt\acn, Noctn Cant.aL, 9o,Uh CantraL, 1fo•.CAa■n. - c C1 �nlcLad aa1111U . part 11 (s) N'E�iGf �� ' .1- cc?Ldnlai) DTcikai 311R: Noctr, • . • Oct • Nt Cantcal, 9 .ac Central, 9..c.. • " I17D: Rain 00 /Class 3/32'Jli —Rii ' te3tcd 911a: 3C' w C) . • - IND: Raf,eczo 00 /vldrLo 2.31 tsM {K - .R-1) ' pp : 4 S / — 45 = &auto pcobado : 91.1 cn ,a I CO c_t . E�9 ^Cs . 10771- '. 1.(3 lioffean 2931110 Carp flea htbel (or ;amble DiaG( SW akin. To Iron more kit rev merg�tiari • ' '' fivarda till alhNrta pro gasibles Mmboiros DiEt61 STUt bas mnau rrm ooRn de isto, Ile vrocenupytttat t .. ✓, e i�arrvrnaneuea.4�i o4 / & a a Board of Building Regulations and Standards h p W- 1 = HOME IMPROVEMENT CONTRACTOR S s a l- ' ` . -mil-' Registration: 126893 ,= ••• Expiration: 8 /3/2010 Type: Supplement Card The Home Depot At -Home Service RICHARD FALLONE 2690 CUMBERLAND PARKWAY S �..e„.4.fe .,...„ A 5thff GA_30339 -- ACORD TM CERTIFICATE OF LIA ILmITY INSURANCE DATE(MM/DD/YYYY) 02/20/09 F'RODUCER 1 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ;ax: USA, 3nc. I ONLY ANE) CONFERS NO RIGHTS UPON T1)E CERTIFICATE c,::■ pot.c-rtr ;: cts;: r: h.c -,c I tsI THt E E FOF(DE1) LY L PulI01. S FELOW 3475 Pieduton`. Rd N' :', Su.1 -t =e 1200 Atlanta, GA 30305 Fa:* (212) 942 -0902 I INSURERS AFFORDING COVERAGE NAIC# INS' RFD IIISURER4 Steadfast in CO i 2530/ 11/0 At -Home Services, Inc, f -- - --- -- --- - -__ - -- - - - -- -- - - - -' 11/500605 . Zurich American Ins Co 16535 2690 Cumberland Parkway INSURERC :NATIONAL UNION FIRE INS CO OF PITTS 19445 • Suite 300 [ Atlanta GA 30339 INSURER 0:New Hampshire Ins Co 23841 INSURER E Natl Ins Co 23817 COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AMYL POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DO/YYI DATE(MM /DD/YY) LIMITS A GENERAL LIABILITY IPR 3757 608 - 03/01/09 03/01/10 EACH OCCURRENCE $4,000,000 X LIMITS OF POLICY ARE EXC PREMISESORENTED 1 ,000,000 C OMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ _ CLAIMS MADE X OCCUR "OF SIR: $1,000,000 PER 3CC" MED EXP (Any one person) $ EXCLUDED PERSONAL B ADV INJURY $ 4,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4,000,000 POLICY PRO- LOC X JECT B AUTOMOBILE LIABILITY BAP 2938863 - 06 03/01/09 03/01/10 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY • (Per accident) $ NON -OWNED AUTOS X SELF INSURED AUTO PROPERTY DAMAGE $ PHYSICAL DAMAGE (Per accident) GARAGE LIABILITY , AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS /UMBRELLA LIABILITY IPR 3757 608 - 03/01/09 03/01/10 EACH OCCURRENCE g 5,000,000 X OCCUR CLAIMS MADE AGGREGATE • $ 5,000,000 • $ DEDUCTIBLE $ RETENTION $ $ C 0 3/01/10 X WCTA STU- OTH- WORKERSCOMPENSATIONAND 3566916 (CA) 03/01/09 TORY LIMITS ER D EMPLOYERS'UABwTY 3566915(AOS) 03/01/09 03/01/10 EL. EACH ACCIDENT 51,000,000 . ANY PROPRIETOR/PARTNER/EXECUTIVE E OFFICER/MEMBEREXCLUDED? 3566917 (FL) 03/01/09 03/01/10 E.L.DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 OTHER D Workers Compensation 3566918 (KY, MO, NY, WI,WV) 03/01/09 03/01/10 F TX Employers Excess TNSC45694422 (TX) 03/01/09 03/01/10 Occurrence /SIR 25M/2M C Workers Compensation 4801323(QSI) 03/01/09 03/01/10 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS RE: EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THD AT - HOME SERVICES, INC. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR 2690 CUMBERLAND PARKWAY SUITE 300 REPRESENTATIVES. ATLANTA, GA 30339 AUTHORIZED REPRESENTATIVE y{ , USA ACORD 25 (2001/08) ckomraus_hd © ACORD CORPORATION 1988 11172180 The Commonwealth of Massachusetts 11',F --j Department of industrial Accidents i(i Vv 'i; ' /I `c Ss/ F6, MA: 0.2 r IJ Wi)_Ot :Fs'' COIII 3 ;2t_r• i. MCC: /t l: C-O. /if: 134(x . f't /COliI,,I c/ . i .i 3 Piiz._ :< A_ iaea�tt �t orimli a - —_ -- _ .. __-_ __ -_ ' i d', °;r )tt j ` 1'_ Name (Business/Organization/Individual): ! ) c s'■` r — r Address: — - -- , rat 0 ,04.1 kD1 . • City /State /Zip: 4 6, -?)D`�j Phone. #: os � i 'r Are yoy an employer? Check the appropriate box: 'Type of project (required) : 1. k �l a employer with 100 4. n I am a general contractor and 1 �. 6. 1] New construction employees (full and/or part-time).* have hired the sub- contractors 2. n I am a sole proprietor or partner- listed on the•attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑Demolition working for me in any aci employees and have workers' g y ca p ry 9. 0 Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. Li We are a corporation and its 10.0 Electrical repairs or additions 3. n I am a homeowner doing all work officers have exercised their . 11 .❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roo epairs insurance required.] t _ c. 152, §1(4), and we have no 13. they tP j /,' 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 subcontractors 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. i , insurance Company Name: 1 t ) 1 - - 1 1 ( _ Policy # or Self -ins. Lic. #: 34f::;9 ic / Expiration Date: 3 l C2____ Job Site Address: 14-1 t Oe��r,V . City /State /Zip: '� livit- tip; Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to $.1,5.00.00 and/or one -year imprisonment —a :... . . - .. E :2 _ . _ . _ ! ' • ! '_ D I.!, - ' • _ . .. of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certi unwr e p s an penalties of perjury that the information provided above is true and correct. Signature: ,r �( t.e Date: 00 J Phone #: c. 0 / 195—V633 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: • • Restr ted lo: WS 1A - Masonry only ' RF - Roof Coreriag WS - Windows and Siding SF- Solid Fuel Haring Devitea DM -Demo/Mon only Failure to posies, a current edition of the MMaesachuMtts State )3uilding Cods is roue for re-vocation of tdut liccntc. Refer to: WVYW.Maas,GovIDPS • • 1 -1-= \f4. suchusetn - Dcllaiiment of Public S:tict) IP Board ,if Ririldin2 Rc and Standard Construction Supervisor Specialty License Licknset CS SL Et Restric1ed to: WS ' I VLAD(MiR SHEVCHUK I • 5 OGDEN STREET i CHICOPEE, MA 01013 —.,.=,-----x Expiration: 10!171X111 i (..-6,i,„,, Tr::: rA200 r • N ' I. il lr i VI) 1 N 16444 , 4 L A \P Lp\ir\e . i • • ., nOCrnCCC'Tn /tr:nT pggZ /TG /Cra Vn�J ln7uC yn�rne+in -n ..� -4.4 . Branch NBryK�, Boston. Date t O . Sold. Furnished and Installed by; �y .. . !. /.. TFID At Home SotviaPG' Ina. ":r' • .. . d /bta Ike Home Depot At -Home Services .' .345A Gzepuwt,U. Sur=e J. 1ltiit 2, W orceste C MA'0I 07. , Branch plumber: 31 Toll Free .($t'l0 }.65'1 -5 S2;' Fax . , C1' $tl Ul 7 6§8460 Li C0z4 c1 1 RI L (S0$)15,6 -8823 ' • F ;iS4 • R lac+P ;' Flame Ii�provemeni Contractor Reg $1.1Z6893 TnstallAtiott Address t ` f L a+ : -. ►1 4� t N \l A a t C16 C � • City., State 40 Purchaser(s): . , 'Wk1' • ohinte:' Rome:Rhnne : .CelPhone: . Ps r Rome Addrers: • • (If.different from Installatio Address), City State Zip • E -mail Address tto r ccivc,project.commumcations grad Hemp D.epcl updotcs) • • D.,t bO NOT. rn wish to receive any arketini entails from, The Homo Depot.'.' , . .. . . . • Froleet lnititritntln Undersigned (" Customer"), .the.owners. of the property Iocatcd at the, above installation: address, gees to buy, and TIID Ad-Holtie ,Services, Inc, ( "The Honig Depot ") a$xpas to: furnish, :deliver and a2range r the iat4alkat7(?n. of all materials described on • the below and on the referenced Spec Sheet(s), all of which ate eorporated into this Contract by this reference Meng with any applicable State Supplement and Payment Summery? attached hereto'and any Change Orders (colleeti'Ve1y, < y "Contract")! • • .tiA Jab #t ttnrc"nf Rde.na) . . - . '. !duets: ' ' . •S Sheet i 0 : • ' ' Project Amount . • ORo6flntl' Sd.mg .wr ,ndnws O lnntlat ou 4 514 4St9 Q6ttttera) Covers in$.ntty t oots::{7 ' , ` q S $ 7 7 (1L . prtaoiirig C]sidi 1=i Wm l 0n L J l tt ek • c loi4-,�r skirl , i , • . t ' x r • OJRoofing QSiding • 0 Windows D Insul " ' $ . DGilttera / Covers DEntry toot!' 0 ' .. • °Roofing OSiding 0 Windows U.Instiatt'an• • • • • . [Dutton ! Covers • [Enty .Doors 0 .:'. .. ' , , • $ &bnlmutn 25 %Deposit of Contract Annum d'uc tenon executionot't Total Conteadt: lkm'aa11 S .. . • IN. - lac Purchasers may not deposit more than One oftlw CpntricE.da.aiat Customer agrees that, immediately upon corripletion of the'.work'ftir•each Custotrieivva.execute• a Gdmpletian'Certifictite , (one for each 'Product as defined by an individual Spec •Sheet} .and. pay any balance due.'.:As'applicable; .cacti :Customer under this Contract agrees to be jointly and severally obligated and liable hereunder- .. ' The Horne 13epot reserves the right to issue a Change Order or term this Contract n or any Individual Prodpctot) included herein, at its discretion, if The Home Depot or its authorized service providryti,tleterminCS thatit.cannot perfotiil its obligations due to a •stiuctnral problem. with the home, environmental hazards such as mold; az}ieetr.s or lead gaunt other safety concerns: pricing errors of because work required to complete the job 'was not included in the Contract - • • Payment Sulnmarv: T he P ayment Summary - . � •-3 , 1 ncluded as, o ttti C A ntrac t,.sets forth the . t ota l Contract amount and payments required for the, dcpoaiis,andfinal payttsents byl?tpdt ot.(gs apD�icablc). •, • . . NOTICE`TOCUSttM'Eit ..• .. You are entitled to a completely filled- in 'copy. of the Contract, at the time you g a .. Do'nat'sign a Completion Certafieitte (note: there Is one Completion Certificate for each listed Product. as defined' by hndlvldual.Spec.Sheets) beiore work on that Product is complete. In the event of termination of this Contract, Customer agrees to pay The Rome De� the coats of materials. labor. expanses and services provided by The Home Depot or Authorized Service Provider Hiroo the date of termination, plus any other amonnta set forth In this Agreement or allowed under applicable law. TIIE ROM DEPOT MAY WITFIHOLD AMOI3NTS OWED TO THE HOME DEPOT mom THE DEPOSIT PAYMENT OR OTYDER PAYMENTS MADE, WITHOUT ' LIMITING THE HOME DEPOT'S OTHER REIVIEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and.understauds that this Agtcetnent lathe' entire agreement between Custotuns - and The Home Depot with regard to the Products and Installation services and Soper a all prior diacusaion$ and agreements, either oral or written, relating to said Products and Installation. This Agreement cannot' be assi or anietided except by a writing. signed ' ' by CuntOnter and The Home Depot. Customer acknowledges and agrees that Customer has read, understands, volturtarily accepts the tcrms of and has received a copy of this Agreement- j Submitted 1 X • ' i A •6 I S7. • 79 7C s_ !i. . 1 .7. , Customer'E R.•.? ture Date Sales Consultant's Sig into Date ' . X Telephone No Customer's Signature Date Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL THIS (asappliosbie) AGREEMENT WITHOUT PENALTY OR OBLIGATION • BY DEEIVERTNG WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THUS AGREEMENT. THE - STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE. NOTICE; ADDITIONAL TERMS AND CONDITIONS Alin: STAf ED ON THE REVERSE SIDE AND ARE FART OF MIS CONTRACT 4-20 -09 C -SC White - arench.f•Ile Yellow, - Customer. Pink' -0eloa Consultant • 1'' I SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Su • - rvis • : Not Applicable ❑ V �// / Name of License Holder : 'nj 54)Z V 99 License Number I . 61 Am a oNfr a t ii I ( cil >,) Address / Expiration Date (((( M u, ' . /A g oy Sign. • - Telephone 9.' Registered: HomeIrmorovementContractor ,..,, ,,,,, ,,. ,Fs.r... - . , ,- :,, , Not Applicable ❑ rTige-117314?e1C5F t Ote.7 Company Name Registration Nu ber Addr 01W Telephone Expiration �r�� O) / Telephone 1 ����✓ _ SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.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 buildin ermit. Signed Affidavit Attached Yes No ❑ 11 ~G�e ,e',!e ,.1 n T.he_current_exemption for "homeow_ners "mss extrnrderl to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 1083.5.1. Definition of 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. 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 referenceto 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. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of - -_ - 1 0 ampton •retnances; a e anctL . i • - . •o .- ,, ._ - __, ,, , .... F, -t#s= General - );anus- Annotated. Homeowner Signature SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House [I Addition ❑ Replacement Wi rows Alteration(s) n Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [[:=1 Siding [D] Other [0] -r-- Brief Description of Proposed Work: ' t 1 • I 4 ■ 41 _ 1,1 i ► 11 1)11441 Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa if New' hot se°and 6 additiorito'e i ialiouslnct, %coi litete:the foi[owtha: 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? 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 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, a4-1-6e4--- , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit applicat' n. r Signature of Owner Date 1, Ai/ I ill-7-e_____ as Owner/Authorized Agent hereby declare that the to ements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains lip ienalties • • - ' , . A . t A , i - Print N- - Sign ure o •wner /Agen Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L. __. _ R::_.____. L: _..... __.. R. _. Rear Building Height Bldg. Square Footage ` % Open Space Footage (Lot area minus bldg & paved ..__. parking) # of Parking Spaces Fill: (volume &Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book Pagel and /or Document #= B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D re th re - any proposed c >(anjes to or a rtions o sons intend for the property ? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. * 'N , io �e 1 City of Northampton S o6f`P f s ' ,. - Building Department } Out!'`�X , A i . .212 Main Street : e�itei$ sf ; vast °t i o 1 1, , ; -iCUg Room 100 a " Nprtha pton, MA 01060 e « e a � � NV phone 412 -587- 240 Fax 413- 587 -1272 6 to is " i Y�L h g ✓ ✓% Otl a e4 } ° 4, APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit 9 l I 1 4 RIA)e /�e1,4 / Zorie Overlay District ►�yr lif EIm Bt. CB District SECTION 2- PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Recor , fIi Name (Print) 1 j Current Mailing Address: r✓' .- (0,,a, Telephone Signature 2.2 Authorized Arlen Name (Prim / Current ailing Address: Signatu - Telephone SECTION - 'ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building . 7t r 7 (a)Building ' Permit Fee 2. Electrical C e' (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total +2 +3 +4 +5) .-7)'74..-7)'74.4) � `'x Check Number o / f-35 — This Section Far official Use Onty Date Building Permit Number. Issued: Signature: . 'Building Commissioner /Inspector of Buildings ° Date Ro .4 BP- 2010 -0210 GIS #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -0210 Proiect # JS- 2010 - 000258 Est. Cost: $7176,00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 126893 Lot Size(sq. ft.): 13198.68 Owner: WHITLEY NANCY B & HEATHER P WHITLEY Zoning: SC(100)/ Applicant: HOME DEPOT AT HOME SERVICES AT: 144 RIVERBANK RD Applicant Address: Phone: Insurance: 345 GREENWOOD ST (401) 935 -2633 () Workers Compensation WORCESTERMA01607 ISSUED ON:8/24/2009 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 8/24/2009 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo