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35-005 / ':.. E 0102 ^01'1 ©2011, RR Donnelley. All rights. reserved. - 5637 r t LOWEs CONTRACT # 000 1 6 e 4 El11AS T,T E EXTERIOk OL UT IONS 1NSTALLED`S4LES ROOF CONTRACT INSTALLED SALES PE('3AtIST NUMBER • CUSTOMER STORE NO. STREET ADDRESS STREET VDDRE Cl STATE ZIP . CITY J — STATE ZIP •' lam ^ am< TELEPHONE - . • I TE PH NE TELEPHONE - as 3 -sue ilo DATE ' LOWE'S HOME CENTERS, INC.'S MA HIC NO.: 148688 } e CASH BANK LCC RES i FEIN:56 0748358 CPS° CHARGE /Jr ThI4 Annie, ie#q� 11iine¢handise and S .4rov4 This llecomes aq o eement ugonpayreenL Liebe payment the en6 m a agreeent mGudinp "the spec�raily completed pages ofihss docu_glen s`'a cogd8lons •lbc(4d�th thls document and'any o{he5eddinda and attachments he eto, shall be re herein as this 'Contract. ,P,1 E CC r£h)S41ND 1 Dm S PTTHEREV RSE SIDE OF THIS-PAGE AND FOLLOWING PAGES BEFORE SIGNING .. INSTALLATION STREET ADDRESS CITY STATE ZIP - 40.41f4 Color: _5114 5-t'Cc 13 3 Style: T U e. Accessories: I 3'/ // U t„,.. . Jt t) wt 100 t 1 f 3 * Show drawing where shingles or siding will be installed. 33 O d Contract Total c � — Are permits required for this installation ?: [ Yes [ ] 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, Custorrler agrees to the foregoing. [Customer to initial to the left]. Work is to omglence upon reasonable availability of Contractor and /or any special order cus er made Good(s) which is anticipated to be /G 131 d [fille in date]. Estimated completion date is j �7/ [fill in date]. Said esti ated substantial completion date is p�eqt of the essence. stateme^t of any continge eis ies th t would aterially angaid estimated substantial completion date is as follows: bp l(' CS V" d 5 } G �rf mot' t / / (if applicable, insert a statme of such contingencies). IF THE CONTRACT TOTAL IS $1,000.00 OR LESS Customer must pay in full. COMPLETE THIS SECTION ONLY. WHEN THE CONTRACT TOTAL EXCEEDS $1,000.00: [ ] Customer 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 CO )::• U R AFFAIRS AND BUISNESS REGULATIONS AND THE OWNER AL. E REQUIRED TO SUBMIT TO SUCH ARBITRATION AS I. j. � �e.142A. / By: ✓ `i . i� Date: ! o� L., o e enters, nc. BY �7- Uc�//, J. � Date: _ Owner Signature THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE CiSPUTE 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 CONTRACT. YOU ARE ENTITLED TO A COPY DF THIS CONTRACT AT THE TIME OF SIGNATURE. WITNESS OUR H' c(S) AND SEAL(S) BELOW THIS Iv DAY OF tic ` TC )sec Lowe's Hom ' - rs, Inc. pecialist or A. 0,- Owner ��� Co -owner or Witness 10/23/2012 10:13 5036346730 MASTERROOF UNIENVIOS PAGE 01/01 Rig21tt`aX DIZ-L 0/L3 / LV1L :J!: YPI1 rrsuL Gi via c, I. co..e. iGVi r i' CERTIFICATE OF LIA BILITY INSURANCE oA' � (MM/Direr 1 ) IFICATE IS ISSUED AS A MATER 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 SY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CEETIFICATE HOLDER. , IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poiicy(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 tho certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: MARKETING ASSOC :NS AGCY PHONE I FAX {AIC, No, Ext): J fA1C NdL 150171. AVE, #1 �101II1C ADDRFac' . PRODUCER NEWTON, MA 02459 CUSTOMER ID #f: 73K4P • INSURER(S) AFFORDING COVERAGE NAIL it INSURED INSURER A: ACE AMERICAN INSURANCE COMPANY VALDEZ, WILSON DBA MASTER ROOF & UN TENV1OUS - MA INSURER B: INSURER C; INSURER 0; PO BOX 83 INSURER E: MILFORD, MA 01757 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER; . : 4 a- 'AT ' • . 1 1 . • ' - + 1 -r. • ■ _ d.: d • TT '7 " E 3' ISSUED TO THE INSURBD NAMED A: • • * - • • E POLICY PERIOD INDICATED, NOPATTHSTANDRIGANY 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 ay THE POLICIES DESCRIBED HEREIN 15 SUBJECT To ALL THE TERMS. EXCLUSIONS AND CONCITi0NS OF SUCH POUci4s. Lt 5TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I NSR ADD $U5 POLICY EFF DATE POUCY PAP DATE LTR TYPE OF INSURANCE L R POLICYHUr,BER (MMUDDIYYYY) (MNDDDIYYYY) uM!TS GENERAL LIABILITY EACH OCCURRENCE $ M COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ XP CLAIMS MADE OCCUR. 3 REMISES (Ea occurrence) MED E (Anyone person) $ J' DERSONAL ACV INJURY $ OEM. AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ El POLICY El PROJECT D LOC PRODUCTS - COMP/OP AGC $ AUTOMOBILE LIABILITY COMBINED SINGLE $ NI ANY AUTO LIMIT (Ea accident) Nil ALL OWNED AUTOS BODILY INJURY $ . sot -SOULE AUTOS {Per person) - HIRED AUTOS BODILY INJURY $ {Per occident) III NON-OWNED AUTOS pROPEE2TY CAMAGE_ E$ ----.-. {Per accident) M UMBRELLA LIAE9 OCCUR EAGM OCCURRENCE $ FXCESSL CLAIMS -MADE AGGREGATE DEDUCTIBLE $ R TMNTION $ $ A WORKER'S COMPENSATION AND x WO STATUTORY [ OTHER EMPLOYER'S LIABILITY YIN UB- 4306P574 -12 03/15/2012 03/1512013 LIMITS ANY PRCPERITOR11'ADEXECU NE El E. L. EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Nand Amy in NH) E.L. DISEASE - EA EMPLOYEE $ 106,000 ryes. descade unoer DflGh:PTION OF OPERATIONS below g.„ L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES /RESTRICT•ONS/SPECIAL ITEMS TIES REPLACES ANY PR1r • PD TIFICATE ISSUED TO THE CERTIFICATE. HOLDER AFFECTINC3 WORKERS COMP COVERAGE TES INSUREDS MA WORKERS C0 V2ENSATION FOLIC Y AND ITS LIMITED OTHER STATES ENDORSEMENT AL:THORIZES THE PAYMENT OF BENEFITS FCR CLAIMS MADE HY TH8INSURED'S MA EMPLOYERS IN STATES OTHER THAN NIA NO AUTHORIZATION IS C#IVI?N TO FAY CLAIMS FOR BENEFITS IN STATES OTHER THAN MA w MB stsC .ED HIRES, OR RAS umcn EMPLOYEES ourSIDE OF MA THIS POLICY DOES NOT PROVIDE COVERAGE FUR ANY STATE OTHER IRAN MA. THH WORMS COMPENSATION POLICY DDE5NOT PROVIDE COVERAGE FOR VAL17E2, INE.SON. CERTIFICATE HOLDER CANCELLATION UNION CORRUGATING COMPANY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ATTN: HR DEPT. BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL : DEL IN ACCORDANCE WITH THE POLICY PROV . ,. - - PO BOX 229 AUTHORIZED REPRESENTATIVE (,,, .,,,f......._ PAYETTEVI LLE, NC 28302 AC• RD 25 (2009/09) 1988- 2009ACORD CO' •0'7: ■ 1 : S'''' - mad. 2011 -12 -05 11 i25 » !owes 1416 ISO P 5/5 5/5 i 2/05/2011 2.3' �ry 5025346 8k MASTRP,OOF UNIENV'IOS PAGE 05/05 2011 14:19 (owes 1916 ISO 413 588 0278 » 5086346780 P 2/2 The Commonwealth of Massachusetts ,,, :,� ;.,, Department of Industrial Accidents . K..:. "'. .. :1» office 0� 'Investi = om ► 600 Washington Street Boston, MA 02111 ' -rPY www.mass.gnv /die W+psrkers' Compeavation Insurance Affidavit: $ adders /Cbntractor ieetrician lumlfers Aulalicaud Znfoemat�on please I rI$ legibly Na me iousinewoIbtnlizulintilltlt{Itiitllltl);_ liA i/ ;i'� Mdclt'Q: S :.Ld6 c ... City /Slate & % /G Y4. PI1one. #L4 Are pp n einplo 'er? Citeck h 11pp oprim bn:�t Type of project (required): 1 ! 111 a cmptoyCr with, 4. 0 I am a general contractor and t • full ' Wive !nicer! the utl5 -c tt ie se; 6 . ❑ N W construction ampklyea I author pa - dine).* 2. [,1 t um n stole proprietor or partnirr- kat un the attached shoot, 7. 0 Remodeling ship and nave no employees These suinontractitt have ' 8. 0 Ikmuiitiott working for Ina in any capacity, employees :toud have workers' 9. ❑ Building menon ti {No workers' wimp. imuran con rc tp. 138Urttnee 1 retluirccl.I 5. 0 We ate a corporation anti its /10 Elf c:tritat repairs or adelstior 3.0 I sort a homeowner doing all wolf: officers have cadit:hhCtl ttreir I ..Q( Plumbing repairs or additions myself, INo workers' comp, right of neMption per MG. t ,{� Roof tepaiaw insurtm a required. l t c. t 52, §1(41, and we have too cmplt)yta:ti. itiio workers' • 13•0 Other comp. intalranee mini: M.1 'my :tppixant dint vI9trks Mx tit meat oinr+ rat Ma the tooth +m bar* ;th(wt ij their worke redtpereatiOti talky ininnttallon. 4 ' linntoown tx welt{ salmi lmi aux aftiidavit tnaidati ti1Cy tat" doing, alt vial. i'td town tu[e mug/de neintt.`{ti .. s moot abet* N now neftilavit n'litie'atatssuct. I CCIIIL .rcuxtc teat check dun box Elm attached an additional Awn xlNmhnp tlw nutnt` 4 th.- sub-mitarioa and sun %Outlier rot' not atone ci utt e% delve vtnpinyccs, h' atn sir ii: sartnuv titre t ttpinytvx. tbry monk paw* thrrr vvnitiere Mtbp. policy nurnto /am an employer that is providing waken' rowprw ativa insurance for my employees, Below +s rite policy aad job rite rnfurmarian. Insurance Company Name: Policy # or St~1f -ins. 0,, 4: _ Expiration Data: Jo Site Addros: City /Stxtcl74: Attxxb a copy of the workers' corpcusation T Oey deelcttation page (*min the policy number and expiration date), Failure to scone coverage :e4 reti airtxl node, Section 2$A of MGL c. 152 can load to tilt itnpcuititm of t;riminat penalti,u of n fine ip to $1,5OO.UV and /or ono•year irptisto ntient. ae well as e1vi1 penalties in the form an STOP WORK ORDER end a fine tot' up to $2$0,00 :t day against the viobtur. Be adviacd that a copy of this statement ntay be forwarded to the Office of Inveitl ,'Scions of tux DIA far intitll, I:e cllverage vl rilidtiiiun. 14 ltetrelo unify ; fie oleo , r x • rd penalties df perjury got the information p s, vdt d above is owe and eorrcet, _~ V 1 Ti Official use rrnly. Do nor write is this art', ro be cu nplared by city so town official, City or 1 own; — Permit/Litttense # 1 !.wino; Authority tetrcle one): i 1. Road of Health 2. >If tiild;rig Dcpartmcnl 3, Caylt own Clerk 4. ekctriati 1nnpw for S. Plumbing Inspscctor b, Other Coronet Person: ,. Phone # : . • 'Massachusetts - Department ttt' Public sittt't■ • Board of Building Regulations and Standards Construction Supervisor License. License: C$ 102403 estricted to: 00 ' ILSON VALDEZ . 61 MAIN STREET q.r w • ILFORD, MA 41757 • • 'y Expiration: 11/20/2012 C n�1►1'r.�wi <in r Tr#: 102403 • 4 Re to: OO Ot - Unrestricted 1G -1 2 PatniityRomes ure to possess a current edition of the ,:. sachasetts State Building Code is • - for revocation of this Um use. • ., er to: WWW.Mass.GovfDES : o flicc of Csasamer Oars rs & #usints Aegvtagou ' K' : =: - HOME 1MPFi4V1EAA�N'f• 4`oN��A•CT4�"! J !� a �ogiet��tioti -:- .d60577 94553 fairatieN! :14,11l2Q12 (i# 2 MASTERROOF •. • WILSON VALDE'�; 191 MAIN ST - T MILFORD, MA 017 r UnderseeretarY 2/6 d OSI 91,61. samol « SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ / 6102- Name of License Holder : - L SQN // / ! Uv � V 3 License Number /SL M 7u ST � �� A 0/ /i ao /7 a— Address Expiration Dat g' 3IJ- 7 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ 2 /v S / 4 3r Company Name Registration um er ` j ;,t /PO � // SQ 7z -e°fed(26 A /0 / b ?eV 3 Address // Expiration Date Telephone' /(J g�' 6 ?7 0 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 permit. Signed Affidavit Attached Yes No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended 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 108.3.5.1. 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 reference to 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 Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature 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. Hasa Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW OD YES 0 IF YES enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO (3 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended 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 Q NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Wina$6ws Alteration(s) Roofing Or Doors G7 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[] Siding [0] Other [0] Brief Description , Pro osed Work: L'N ,&)Cs-( / 1 S77 i/C /Z.,? 4i ( )O 4 Alteration of existing bedroom Yes )( No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: 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 I, 2)dAJ4L .4/V , as Owner of the subject property / hereby authorize Zo- CrJ DES to act on my behalf, in all matters relative to work authorized by this building permit application. 6761° J Tx --'r /94/, Signature of Owner Date 1, G e) W EJ , as Owner /Authorized 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. Print Name `-/ L‘rS /c)7 j6 /di / a-- Signature of Owner /Agent Date -- -- -- Department use only _ City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit oci 24 2012 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability Pr. OF SU�.�LN3 IN =. r�oNS Northampton, MA 01060 Two Sets of Structural Plans NORTHAMPTON, MA 0106 01 . 0 . 11e 413 587 -1240 Fax 413- 587 -1272 Plot/Site Plans Other Specify 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 / vR K6 c 7 / /LL Map Lot Unit (l U/LE.)C Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: l' Name (Print) Current Mailing Address: ( 1/2 err //d C &) 4 Telephone Signature 2.2 Authorized Agent: Z2 ,6 /44-/e 2LIss 6« Sr /h 6/ /4 Name Print) / Current Mailing Address: � �� _ l t,ie ��� y� j S ct �' 7 0 Signature 9 Telephone 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 Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection //--//- // 6. Total = (1 + 2 + 3 + 4 + 5) _ 1 ./?,;t6. 00 Check Number 64" to IJ 3 5 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date 92 TURKEY HILL RD BP- 2013 -0495 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 35 - 005 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- 2013 -0495 Project # JS- 2013 - 000782 Est. Cost: $4926.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOWE'S 102403 Lot Size(sq. ft.): 135340.92 Owner: STEFAN CECILE J & DONALD W Zoning: Applicant: LOWE'S AT: 92 TURKEY HILL RD Applicant Address: Phone: Insurance: 282 RUSSELL ST (413) 588 -0270 WC HADLEYMA01035 ISSUED ON:10/24/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: STRI P & SHINGLE 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 10/24/2012 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner