Loading...
32C-135 Ra ICS J.D. Rivet & Co., Inc. ROOFING • SHEETMETAL • 1635 PAGE BOULEVARD SPRINGFIELD, MA P.O. BOX 51068 INDIAN ORCHARD, MA 01151 April 24, 2012 TEL 4 543-3373 Vtrestone Dimension Realty LLC � N 1 R P.O. Box 60376 Florence, MA 01062 BUILDING ''f PRODUCTS RE: Public Health Building - Service,Center Road Northampton, MA – 13,300 Sq. Ft. — ottiq Z 9, f Scope of Work: 1. Furnish and install 1 ' / <" EPS flue filler insulation. 2. Furnish and install 1 %2" polyisocyanurate insulation over the infill insulation. 3. Furnish and install Firestone 80 mil TPO mechanically attached roofing system complete with all associated flashings. 4. Furnish and install new pressure treated wood nailers with height to match thickness of the new insulation. 5. Furnish and install new sheet metal fascia wraps which are uniform along all eaves. 6. Furnish and install new .032" painted aluminum K -Style machine gutter complete with rain leaders and appropriate attachments. 7. Clean jobsite of all roofing debris. 8. Furnish owner with a 20 year Firestone labor and material warranty. PRICE = $89,750.00 (Eighty Nine Thousand Seven Hundred Fifty Dollars) *Plus building permit fee of $538.20 Al 0 aid Amti2. »i P es L. Tras President • cceptance of Proposal — The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment terms are net 30 days unless otherwise agreed in writing. All material is guaranteed to be as specified Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire and other necessary insurance. Owner responsible for all building permit fees. All accounts not paid within 30 days are subject to a late charge of 1 h% per month on the unpaid balance. In the event that legal action is instituted to collect any sums due under this agreement, the undersigned agrees to pay all costs incurred including reasonable attomey's fees. PAYMENT TERMS: 25% DUE UPON PROPOSAL ACCEPTANCE, 25% DUE UPON MATERIAL DELIVER, BALANCE (50 %) DUE UPON COMPLETION. NOTE: THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED WITHIN _60 D Signatur • a l i *iv 4r s Date: _____ o_____Ai____ 9 ea tfYMe//eo d ce 19 60 Ted Greenlaw P.E. 183 Columbia Rd. Hanover, MA 02339 tel# 781 -826 -8369 fax 4781 -826- 8399 E -Mail tedgreenlawpeyahoo.com November 17, 2011 Jack Fortier 23 Service Center Rd Northampton, MA RE: Building Analysis/ New Roof I have finished the analysis of the 80' rigid frame steel structure designed and fabricated by Butler Buildings in the early 70's. I have found that the structure is designed for loads consistent with those days, I was designing steel buildings in Mass in those days. It is my opinion that the re -roof is acceptable causing only very minor added loads that 1 feel are insignificant. Respec . , THEODORE t ? . L C. cn iv • / ed G Tnlaw P.E. GREENL W ) 1 / ,, NO. 28; F., IN ' r '. r 41 i �• AW J.D. Rivet & Co. Inc. • ROOFING • SHEETMETAL 1635 PAGE BOULEVARD SPRINGFIELD, MA P.O. BOX 51068 INDIAN ORCHARD, MA 01151 Louis Hasbrouck TEL. (413) 543 -5660 Building Commissioner FAX (413) 543 -3373 City of Northampton 212 Main Street Northampton, MA 01060 I request that you grant a modification to waive the requirement for control construction for the project at 23 Service Center Road in Northampton because the work is of .a minor nature, will not affect health, accessibility, life and fire safety, or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work. Thank you for your consideration. Respectfully, Operations Manager J.D. Rivet & Co., Inc. P.O. Box 51068 1635 Page Boulevard Indian Orchard, MA 01151 Cur C 't �C??I?� m izce /960 A�°R° CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) 05/02/2011 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 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 1 - 630 - 773 - 3800 NAM EACT Christopher Mowery Arthur J. Gallagher Risk Management Services, Inc. (A/C, No, Ext): 312 - 8 ° 3 - 6 3 7 5 I (A/C. No): Two Pierce Place E Chi Certificates @AJG.com ADDRESS: Itasca, IL 60143 INSURER(5) AFFORDING COVERAGE NAIC # Christopher Mowery INSURER A: ARCH INS CO 111150 INSURED INSURERS: NATIONAL UNION FIRE INS CO OF PITTS 119445 J.D. Rivet F. Co., Inc. INSURER C : 1635 Page Blvd. INSURER D: Springfield, MA 01104 -1752 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 20987545 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO 7 HE 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 IADDLISUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER I LIMITS INSR WYD IMM /D DM'W) � (MM /DD/YYYY) A GENERAL LIABILITY 1 ZAGLB9131200 05/01/1]j 05/01/121 ! EACH OCCURRENCE 1 $ 1,000,000 DAAGE TO X I COMMERCIAL GENERAL LIABILITY PREM SES Es occur ence) 1 g 300 , 000 I CLAIMS -MADE f X I OCCUR MED EXP (Any one person) ! $ 10,000 X 5,000,000 All Projects PERSONAL A ADV INJURY $ 1, 000 000 GENERAL AGGREGATE :$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS . COMP /OP AGG ' $ 2,000,000 POLICY PRO- . X JFCT I I LOC $ A AUTOMOBILE LIABILITY ZACAT9115300 05/01/11 05/01/12 COMBINED SINGLE LIMIT ' X (Ea accident) !$1,000,000 ANY AUTO BODILY INJURY (Per person) iI $ ALL OWNED SCHEDULED BODILY INJURY (Per accdent) $ AUTOS L AUTOS ON-O f PROPERTY DAMAGE 1$ HIRED AUTOS AUTOS NON-OWNED (Per accident) I 1 1 I 1 I l Physical Damage IS 1,000 Comp /Co ":_ 5 1 X UMBRELLA LIAB 1 X OCCUR 9788956 05/01/11 05/01/12 EACH OCCURRENCE $ 5,000,000 1 EXCESS LIAB CLAIMS- MADE �i AGGREGATE • $ 5,000,000 DED IX I RETENTION $10,0DO • $ A WORKERS COMPENSATI ^AWCI9235300 1� 05 /Olj 12 X WC STAT U- IOTH AND EMPLOYERS' LIABILITY Y/ N 0 5/ O 1/ 1 TQRY IMITS FR 1 ANY PROPRIETOR /PARTNER/EXECUTIVE i E.L. EACH ACCIDENT 1 $ 1,000,000 OFFICER /MEMBER EXCLUDED? N N 1 A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If ves, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE . POLICY LIMIT 1 $ 1,000,000 ': IC I DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Coverage THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I © 1988 -2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD __ -_ - _mow _.5E7545 l __ l Print Form The Commonwealth ofMassa: zi. C .S �1 Department of Industrial Accider s G ,� Of[Lc of Investigations 600 1 T'a_s12i12,; tali Street • Boston, . 11 02111 _ - IVWW. 112a.SS. 0-ovidia Workers' Compensation Insurance Affidavit: Buil ders/ Contractors/Electrician s/Plumbers .Applicant Information Please Print L.c ib1v Name ( Business 'GrQarrization /1ndlvidua J . B . Ri 0 Co., Inc. Address: 1635 Page Boulevard Ci - /State/Zip: Springfield, MA 01104 Phone +13 -5143-5660 Are you an employer? Check the appropriate box: Type of project (required): 1 1 am a employer with 50 f, 1 am a general contractor and 1 employees (full and/or part- '_ime).* have hired the. sub- contractors 6. New construction listed on the attached sheet. 7. ❑ Remodeling -. ❑ 1 am a sole proprietor or partner- ship and have no employees These sub contractor s have 8. ❑ Demolition working for me in any capacity, employees and have workers' j [No workers' comp. insurance comp. insu:ance.� ❑ Building addition required.] [_J We are a corporation and its 1 0.❑ ElecbHcal repairs or additions 3. P 1 am a homeowner doinu all wort: officers have exercised their 1 1 . I Plumbing repairs or additions myself. [No workers' comp. rieht of exemption per '�7GL 12. of repairs insurance required] t c. 152, §1(d), and we have no emplo [No workers' 3.❑ Other comp. insurance required. *Any applicant that checks box #1 must also fill out the section below showing, their workers' enmpensation policy information T 1-'1orncoo ners who submit this affidavit indicating they are doing, all wort. and 01C11 Yai1 outside contractors must submit a new ,affidavit inchamiltu such -Contractors that check this box must attached an additional sheet showinu the name of the soh-contractors and :date whether or not those entities have employees- if the sub - contractors have employees, they must provide their 15orhers' comp. policy rumba. / ant an emploler that is prot'icling workers' compensation insurance for rrrp employees. Rclow is the policy and job site information_ Instuance Company Narne: Arch Insurance Company Policy f or Self -ins. Lic. -: ZAWCI92353 / 00 Expiration Date: 5 - - �J Job Site Address: a3 L/eiviC312 l�- I'ii ( 4,1 City /State /`Lip: ik 1C,m ict eN0Gb Attach a copy of the workers' compensation policy declaration page (showing the policy number and expirati date). Failure to secure coverage as required under Section 25A of l.4GL c. 152 can lead to the imposition of criminal penalties of a fine up to 511,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S a day against the violator. Be advised that a copy of this statement may he forwarded to the Office of Investigations of the DLL for insurance coverage verification. 1 do hereby certify under the pains and penalties of perjurr t1,4c.a the information provided above is true and correct_ Sis_nature - w Date: Phone T. 413 -54- Official use only. Do not write in this area, to be completed br city or town official Cite or Town: Permit.'Liccase Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Ci:s Toss n Clerk 1. Elecirical Inspector 5. Plumhing Inspector 6. Other Contact Person: :'hone_ • i Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (MO CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes (2 No O 's SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN ' OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 1,4t T 1 -K 'T C�ll ?Res ►D' T 4 )(V51 , as Owner of the subject property hereby au' a ■ e J.0 (; 4 CO =1..•C . f--- �a -- �r 2 ✓ to act on - f, in al ative . work authorized by this building permit application. Sign- • reof• !D //tI., D, 1 t J 4 cc, ._.i.. C • &+n r't■1 - Gib , as uthorized 3 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 • Y _ J ar1. • Print Name Ai i AI t /a Signature of • .•Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: � 5 so�3 � • or Not Applicable ❑ Name of License Holder : 4 Py II License Number L fr L f - t�.x�.s ►dam ,,j-t Motaoik � 61©6") O7i 91 f 1 Z Address Expiratio Date 494 . -6.o Signature 400/ . Telephone SECTION 13 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 !Dui permit. Signed Affidavit Attached Yes No 0 . I Versior.1.7 Corm roia! Perm , M v 7, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDiNGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 790 cri,R 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) I , 9.1 Registered Name (Registrant): c 4.5...15 -,01, C. $C 1fih �� }' Trf,G l$ Registration Number Address i 1� I 1 r , un �' !) Expiration late Signature eiegho -e 9.2 Registered Professional Engineer(s): I � � r Name Area o' Responsibility Address i Repistration Number Signature .e Expiration Date Name — Area of Resoonsioiiity Address Registration ' Signature 'Telephone 1 Expiration Date Name Area of Responsibility Address Registrauon Number Signature Te+epnone I Expiration Date Name Area of Responsibility 1 � Aaaress i Registration Number I ! I Signature Teiepnone Expiration _,ate 9.3 General Contractor 1: FF. F ; o, - C_; • C . IJC AppiiCaSle ❑ Company Name st : Responsible in Charge of Construction Address Srpnatp -e _, e, p'ip'i Version l .7 Commercial Building Permit May 15, ?000 8. NORTHAMPTON ZONING Existing Proposed j Required by Zoning - f h s column to be filled in by f / Building Department Lot Size Frontaue Setbacks Front Side L: R: L R: Rear Building Height . i ie) Ai/1i ,-, $tdg Square Footage PI iqz o % Open Space Footage !� (Lot area minus bldg K paved parkins;) # of Parking Spaces Fill: (volume g Location) A. Has a 5 ecial Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW 0 YES O IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO K) DONT KNOW 0 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O Date Issued: C. Do any signs exist on the property? YES ON NO 0 IF YES, describe size, type and location: G c�• 1 '� x D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 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 wit disturb over 1 acre? YES O NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Version1.7 Commercial Building Permit May 15. 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition El Repairs Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs Roofin Change of Use ❑ Other ❑ Brief Description Enter a brief description Here a1i o1ztywctt', ccu x � Cxtsk r tj (-col'''. - Of Proposed Work: (J N(,')1 - t : gee attar . SCc W Cr ( . SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1A ❑ A-4 ❑ A -5 ❑ 18 ❑ B Business 1 2A ,❑ E Educational ❑ 2B ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A .❑ I Institutional ❑ 1-1 ❑ I -2 ❑ 1 -3 ❑ 38 ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify. M Mixed Use ❑ Specify: S Special Use ❑ Speci y. COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA OFFICE USE ONLY BUILDING AREA EXISTING PROPOSED NEW � CONSTRUCTION Floor Area per Floor (sf) / �/ - 1 si 1 st ���111 i 2.0 2 nd .,rtl 3 ftl J 4 4 Totals (sf) Total Proposed New Construction (sf) Total Height (ft) \ ‘-Ci\ : \ A 1 Total Height ft 3/4 t 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Pubiic ❑ Privae ❑ Zone Outside Flood Zone❑ 1 Municipal ❑ On site disposal s■stem❑ 1 ( 1 I Versionl .7 Commercial Buildin Permit Nfay 15, 2000 E (+ _ Department use only ots ' i ZAZ p Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPUCATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWEWNG SECTION 1 - SITE INFORMATION This section to be completed by office 1.1 Property Address: Z3 Sant ice. dentel- R.ometi , Map Lot Unit • 1\12iriNAW/r\e -w1 11' 010026 Zone , Overlay District , Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Li AN ens / Ian.- Aca.l4 LL-C- p. O - i 2)C GO sax, Name (Print) ii 'a il V/ Current Mailing Address Ff ariefIC y frfi 01 O a Signat ��r.../- A 11116.111Whallaid T elephone 4 3- 5g7 - ' / 0-- 2. Authorized A . . — "' _ / ' �j n1�O ..391A09,-- . '';f Co vac, P. 0. (3ci 5-/o N. a (Print Current Mailing Address: �} a I S .,,t\ b., -r- nd � r ' Signature --- Telephone 1?_5L 3-- $ (o 0 SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee • 2 Electrical (b) Estimated Total Cost of 0 Construction from (6) 3. Plumbing 6j Building Permit Fee 4. Mechanical (HVAC) j 0 5. Fire Protection p Q f 6. Total = {1 + 2 + 3 + 4 + 5) / rJO _ C hec k N umber 10 0 0 7 53,Y0. b i This Section For Official Use Only Building Permit Number Date Issued Signature: . Building Commissioner/inspector of Buildings Date File # BP- 2012 -0985 APPLICANT /CONTACT PERSON J D RIVET & CO INC ADDRESS /PHONE P 0 BOX 51068 INDIAN ORCHARD (413) 543 -5660 PROPERTY LOCATION 23 SERVICE CTR RD MAP 32C PARCEL 135 001 ZONE GB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Fee Pa Permit Filled out Fe U v 7 00 6'3 2, JD e id �� Tvpeof Construction:_INSTALL MEMBRANE OVER EXISTING ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 050230 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: V 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 Special 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 ar rbs-1( 2, 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 are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. 23 SERVICE CTR RD BP- 2012 -0985 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C - 135 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 -0985 Project # JS- 2012- 001708 Est. Cost: $89750.00 Fee: $538.50 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: J. D RIVET & CO INC 050230 Lot Size(so. ft.): 17336.88 Owner: DIMENSION REALTY LLC Zoning: GB(100)/ Applicant: J D RIVET & CO INC AT: 23 SERVICE CTR RD Applicant Address: Phone: Insurance: P 0 BOX 51068 (413) 543 -5660 Workers Compensation INDIAN ORCHARDMA01151 ISSUED ON:5/16/2012 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL MEMBRANE OVER EXISTING ROOF 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 5/16/2012 0:00:00 $538.50 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner