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38A-106 (2)
3 _11r- Board of Building a ulations One Ashburton Place, m 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 09/18/1956 Number: CS 074416 Expires:09/18120/0 Restricted To: 00 GARY W BRUNELLE 125 CREST LN GRANVILLE, MA 01034 Tr. no: 392.0 Keep top for receipt and change of address notification. 1S-CA1 0 50M-05/06-PC8490 le./e • , 4 ' Boars o guile in ' e g ulat�Ions an• an•ars s tiro g I_E One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 151246 Type: Ltd Liability Corpor Expiration: 5/23/2010 Tr# 269266 ACE FIRE & WATER RESTORATION GARY BRUNELLE 18 ELIZABETH ST. W. SPRINGFIELD, MA 01089 -- -- Update Address and return card.Mark reason for change. U Address ! Renewal pi Employment i_ Lost Card PS-CA1 0 50M-07/07-PC8490 i . Boar. o :ui •ing' egula ons an. • , ' �' an are s �_(= One Ashburton Place Room 1301 �" � Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 151246 Type: Supplement Card Expiration: 5/23/2010 ACE FIRE & WATER RESTORATION THOMAS HOWE -18 ELIZABETH ST. W. SPRINGFIELD, MA 01089 Update Address and return card.Mark reason for change. )PS-CA1 0 50M-07/o -PC8490 L] Address f, Renewal El Employment ❑ Lost Card Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, expel s or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s).name(s), address(es)and phone number(s)aloes with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)wi i n• _ •i. . ••.- an the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a.policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you ye-any questions regarding-the law-or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The.Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. .in addition,an applicant that must submit multiple permit/Iicense applications in any given year,need only submit one affidavit indicating current policy information-(ifnecessary)and.under"Job Site Address"the applicant should write"all locations in (city or town)."A'copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the ,s applicants proofxhat.-a-valid affidavit is-on file for future permits or licenses A new affidavit must be filled out each year Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture. (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call.. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Depart icent-off dustrialAccidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Faxi 6_17=227-7749 -Revised-4-24-a7 _ _ - www.inass.gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ADOlicant Information PIease Print Legibly Name (Business/Organization/Individual):_ 4 Ls Fns' Aran U J A-- ✓�cs5rD2/�T/or) Address: / £? E LI24 i3 e'TH sr ©dpS9 City/State/Zip: 60 '1- SP/z) & 'Cc mil, Phone#: 13) -750 -SZOt3 Are you an employer? Check the appropriate box: Type of project(required): 1. '; I am a er with employer 4• El I am a general contractor and I p Y 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 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 capacity. employees and have workers' 9. ❑ ;;wilding addition [No workers' comp, insurance comp.insurance.: J re q uired. 5. ❑ We area corporation and its 10.0 Electrical repairs or additions 3. am a homeowner doing all work i officers have exercised their 11.1=1 Plumbing repairs or additions ❑ I rig exemption per of exemtion er MGL myself. [No workers' comp. 12.Li Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp:insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Ho meowners who submit this affidavit indicating-they are doing all work-andthen 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 sub-contractors 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. Insurance Company Name: (,GN r,zgi ti S.%2 A Po c C v r.-i P,4 y Policy#or Self-ins. I,ic. #: w 4-113(00-1-7 45- [o-PL.,4+ tp if 50 J Expiration Date: "°`i i c'•S'09 Job Site Address: City/State/Zip: 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 ofMGL c. 152-can lead'to the nnpositivn of Criminal=-penalties ofd fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$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�,rr-rr der t lairs and penalties of perjury that the information provided above is true and correct, Signature: Date ? 3° ©q . ;.�.��cs :� i Phone#: `J 3 ' 530 - 6,76 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.EIectrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 7/ 3/10/1UU9 11:U2 1LNE oup merle rroulx->Llnaa 1/s AGOIRD DATE ITnM/DDlYYYY) TM CERTIFICATE OF LIABILITY INSURANCE 03/26/2009 PRODUCER Phone (413)781-2410 Fax 413-731.9539 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION INSURANCE CENTER OF NEW ENGLAND ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P 0 BOX 1175 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR WEST SPRINGFIELD MA 01090-1175 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Central Insurance Company 20230 ACE FIRE AND WATER RESTORATION,INC. INSURER B: 18 ELIZABETH ST INSURER C: WEST SPRINGFIELD MA 01089 INSURER D: INSURER E: COVERAGES THE POLICIES OF NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE T4SURED NAMED ABOVE FOR THE POLICY PERIOD PDICATED,NOTWITHSTANDNG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR O11-ER DOCUMENT WITH RESPECT TOWHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.1HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERENI IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICES.AGGREGATE LMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS !NCR ADM_ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSRO DATE(MNWD/YY] DATE(UTAeD/YY) GENERAL LIABILRY GP L916164501 10105/08 10/05/09 EACH OCCURRENCE S 1,000,030 X COMMERCIAL GENERAL LIABILITY DAMAGE To RENTED 3 100,000 PREMISES(Ea=We're) CLAIMS MADE X OCCUR MED.EXP(Anyone person) S 5,000 X CONTRACTOR'S POLLUTION PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEM AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG. S 2,000,000 n POLICY nI jE 4 n LOC AUTOMOBILE LIABILITY BAP8614736 07/01/08 07/01/09 COMBINED SINGLE LMT ANY AUTO (Ea occident S 1,000,E ALL OWNED AUTOS BODILY INJURY (Per person) X SCHEDULED AUTOS A X HIRED AUTOS BODILY INJURY S X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACODENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS I UMBRELLA LABILITY EACH OCCURRENCE S OCCUR I CLAMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION $ S WORKERS COMPENSATION AND WC8614745 07/01/08 07/01/09 Ir.c sTnMi s j OTHER EMPLOYERS'LIABILITY E L.EACH ACCIDENT S 500,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S 500,000 I yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY UHT s 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS To show evidence of coverage F#413-750-5201 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL M'OSE NO TOWN OF NORTHAMPTON OBLIGATION OR LIASLITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. 212 MAIN STREET NORTHAMPTON MA 01060 AUTHORIZED REPRESENTATIVE • Ned 4WWaynne M Kapinos ACORD 25(2001/08) Certificate# 40999 0 ACORD CORPORATION 1988 ACE FIRE AND WATER RESTORATION INC. Recap by Category O&P Items Total Dollars cyo ACOUSTICAL TREATMENTS 166.32 0.34% APPLIANCES 126.60 0.26% CABINETRY 2,396.71 4.84% CLEANING 295.00 0.60% GENERAL DEMOLITION 2,433.29 4.92% DOORS 276.52 0.56% DRYWALL 2,077.06 4.20% FLOOR COVERING-CARPET 1,836.19 3.71% FLOOR COVERING-VINYL 5,349.11 10.81% FLOOR COVERING-WOOD 1,766.78 3.57% FINISH CARPENTRY/TRIMWORK 835.72 1.69% FINISH HARDWARE 303.66 0.61% INSULATION 2,302.64 4.65% PLUMBING 812.50 1.64% PAINTING 19,130.06 38.65% Subtotal 40,108.16 81.03% Permit 300.00 0.61% Material Sales Tax @ 5.000% 497.95 1.01% Overhead @ 10.0% 4,090.61 8.26% Profit @ 10.0% 4,499.67 9.09% O&P Items Subtotal 49,496.39 100.00% 2009-03-14-0916 3/30/2009 Page: 2 ACE FIRE AND WATER RESTORATION INC. Client: VILLAGE @ HOSPITAL HILL LLC.INC. Business: (413)586-5065 Property: 51 VILLAGE HILL RD. Contact: (413)563-2404 NORTHAMPTON,MA 01060 Home: (413)586-5065 Contact: ANDREA PICHELTE Operator Info: Operator: TOM Estimator: Thomas Howe Business: (413)750-5200 Company: ACE FIRE AND WATER RESTORATION INC Reference: Business: (413)750-5200 Company: ACE FIRE AND WATER RESTORATION INC Business: 18 Elizabeth St West Springfield,MA 01089 Type of Estimate: Fire Date Entered: 3/14/2009 Date Assigned: 3/13/2009 Price List: MASP4B7D Restoration/Service/Remodel Estimate: 2009-03-14-0916 all electrical work to be performed by others. all electrical fixtures supplied by others. cooktop and oven supplied and installed by others. _✓ 1 or 2 Hr Rated Firestop for Blank ■ NS084902L Opening in Gypsum Wall Assembly Prepared By:Kevin Lang STI Using SpecSeal® Firestop Products I Date:03-25-09 --A 7-17 --A Section A-A 1. Wall Assembly(.1 or 2 Hr) --Gypsum wallboard/steel stud wall assembly (UL U400 Series Design). Max diameter of opening to be 1". 2. Sealant -- SpecSeal® Putty, SpecSeal®SSS or LCI Sealant installed into the opening to full depth of gypsum wallboard layer(s) on both sides of the wall. NOTE:The products used in this design have been tested as follows: op Apartments •ASTM E814/UL1479: Refer to System Nos.: Hilltop Project Name W-L-0016,W-L-1049, W-L-1222&W-L-1029 Northampton, MA •ASTM E119:Time/Temperature Exposure, Cotton Waste Ignition Address This Design Represents an Engineering Recommendation —-----_ - ——_- Ace Fire_&Water Restoration NOTICE:The information contained herein is based upon internal&third party installer testing which we believe to be accurate.This information is provided for engineering purposes only and unless otherwise noted,relates to fire-resistance properties only. Address The user must determine the suitability of the product and the design to the intended application.Since the use of the product is beyond our control,Specified Technologies Inc.'s only responsibility shall be to refund or replace materials found _ to be defective as per our standard warranty. Signature Specified Technologies Inc. • 200 Evans Way • Somerville, NJ 08876 • (800) 992-1180 • FAX(908)231-8415 Fig.1:METALLIC PIPE PENETRA11ONS-CONCRETEi1ASONRY FLOOR INSTALLATION INSTRUCTIONS GENERAL: Areas to be protected must be clean and free of oil,loose dirt,rust or scale.Installation, storage,and in-service temperatures must be below Putty Mortar Putty 120°F(49°C).No drying or curing is required. SYSTEM SELECTION: Please consult the STI EllI I. Product and Application Guide as well as the DLO y^4 Fire Resistance Directory for applicable through- penetration firestop systems. Concrete Concrete Metallic Floor -,....,,,,Metallic Floor Pipe FORMING:Some installations may require forming Pipe as either an integral part of the system or as an option — to facilitate installation.In systems where forming is UL System No.C-AJ-1090 UL System No.C-AJ-8055 required, mineral wool baits(min. 1-1/2"(38 mm) • F Rating:2hr•T Rating:Ohr F Rating:2hr•T Rating:Ohr nom.thickness,4lb./cu.ft.(64 kglm')density)are Steel or Iron Pipe:6",EMT 4" Steel or Iron Pipe:6",EMT 4" Annulus:Nominal 11/16" Annulus:P'to 61/2" recommended. Some gypsum wallboard systems Putty Depth:1" SpecSeal Mortar Depth:31/2 utilize fiberglass. Cut forming material oversize to Forming Material:Optional SpecSeal Putty Pad:1 Layer Encircling allow for tight packing. Recess torming material Fig.2:METALUC PIPE PENETRATIONS-WALLS at a depth which allows for the proper depth of fill material. Steel si FILL MATERIAL:SpecSeal0 Series SSP Putty may Sleeve Putty a .Putty be installed by hand packing into the penetration.Care ° should be exercised to work the putty into and against ® ■54 Itamll■ni all contact surfaces.Install putty to required depth. ®�® Work putty into all areas,exercising care to eliminate r ^•9 voids or seams.Where possible,space all penetrants o Electrical Concrete Cables adequately to allow putty to be packed into all voids •C ncarlete , ° Cables Wall and assure a good smoke seal.Most firestop system designs utilize a 1"(25 mm)depth of SpecSeal0 Series SSP Putty. UL System No.W-J-3090 UL System No.W-J-3046 PUTTY PADS:SpecSeal®Series SSP Putty Pads are F Rating-2 Hr•T Rating-3/4 Hr F Rating-2 Hr•T Rating-0 Hr p y Electrical,Telephone or Data Cables Electrical,Telephone or Data Cables available as a 7.25"x 7.25"x 3/16"(184 x 184 x 4.8 mm) Annulus:Min 0" Annulus:1/4"to 3/4" Putty Depth:1"of Putty on both sides. Putty Depth:5/8°of Putty on both sides. or a 9"x 9"x 3/16"(229 x 229 x 5 mm)poly release faced pad for protection of recessed electrical boxes and as a through-penetration sealant.The pad is sized Fig.3:CABLE PENETRATIONS-CONCRETEMIASONRY FLOORS&WALLS to fit a common 1-1/2"(38 mm)deep 4S electrical box. To install remove release liner from one side of pad. Concrete Align edge of pad to top of box and center pad.Adhere Mineral Wall pad to top of box and bring pad down over the back of Steel Putty wool the box.Adhering pad to all outer surfaces will create Sleeve Mineral Putty excess material at the corners.Pinch pleat material wool 11 together and told against sides of box or trim oft as desired.Putty pad must be applied to a uniform depth 1CI8� of 3/16"(4.8 mm)(one layer of pad)over the exterior lint Milltilli Steel surface of box for both 1 and 2 hour applications. Electrical Sleeve Optionally,additional putty may be packed into conduit Concrete Electrical Cables fittings to prevent the transmission of smoke through Floor Cables the conduit system. Pads may also be used in through-penetrations.Strips UL System No.C-AJ-3154 of pad may be cut off and packed around penetrants. F Rating-1,2,3&4 Hr•T Paling-0,1/2&23/4Hr Pad strips may also be applied to penetrants in a Optional Sleeve-PVC or Steel•Electrical,Telephone or Data Cables•Annuls:0"to 2'' Forming Material:Nom 4 pcI mineral wool •Putty Depth:1/2'of Putty;1"fa 4 Hr mortar system to create a firestop as well as a cushion to absorb movement due to expansion and contraction or vibration. 2 Technical Service 1-800-992-1180 =" STI Product Data Sheet • SSP firestop Putty 8 Putty Pads • FOD-5010 05/2007 p www.stifiresto .com STI. C Fig,4: CABLE PENETRATIONS-GYPSUM BOARD WALLS Putty Putty ill si 11111 I Electrical I Electrical Gypsum Cables Gypsum 1 Cable Assembrd I Assembly Assembly UL System No.W-L-3135 UL System No.W-L-3024 F Rating—1&2 Hr•T Rating—O Hr F Rating—1&2 Hr•T Rating—0,1/2,1&2 Hr Electrical,Telephone or Data Cables Electrical,Telephone or Data Cables Annulus:1/4"to 3/4" Annulus:0"to 1/4" Putty Depth:5/8"of Putty on both sides. Putty Depth:5/8"of Putty on both sides. Fig.5: EXAMPLE OF MAINTAINING STC VALUES OF WALL AND CREATING AN EFFECTIVE SOUND BARRIER / — � 0 0 • o 0 \ 0 0 • \ 0 0• \ ./ // Arrows show path of sound travel. Putty pad reduces sound transmission by blocking path of sound travel. INSTALLATION OF PUTTY PADS ON ELECTRICAL BOXES(Protective Wall Opening Material) It • . ..ft.r_::,, nit: _,_ - Iii f 111 _____.-- ,\01 . I p 1 STEP 1 STEP 2 STEP 3 STEP 4 Remove poly liner from one side of pad(Step 1).Align pad to the side of box partially overlapping the stud and adhere.Working to the opposite side of the box to the edges(Step 2).It wall membrane is in place,pack putty into gaps between box and gypsum board slightly overlapping inner wallboard surface.If membrane is to be installed after pad installation,overlap front edge of box so that putty will be compressed around edges of box as wallboard is installed.Cut slits in pad to fit around conduits or cables(Step 3).Press pad to surf ace of top,bottom,and sides of box(Step 4).Trim excess at corners and apply to conduit fittings connected to the box. Optionally,putty maybe packed into inside of conduit fittings to prevent passage of smoke. =.b./....:— Technical Service 1-800-992-1180 www.stihrestop.com STI Product Data Sheet • Series SSP Firestop Putty 8 Putty Pads• FOD-5010 05/2007 3 ST" MAINTENANCE Installations should be inspected periodically for subsequent damage.Any damage should be repaired using SpecSeal®products per the original approved design. CLEAN UP Remove excess material from all contact surfaces immediately.Clean hands or skin using a waterless hand cleaner.When using water- emulsifiable soaps,apply soap and work over areas of skin contact prior to applying water. TECHNICAL SERVICE Specified Technologies Inc.provides toll free technical support to assist in product selection and appropriate installation design.UL Systems, Material Safety Data Sheets and other technical information is available at the Technical Library at www.stifirestop.com. PRECAUTIONARY INFORMATION Consult Material Safety Data Sheet for additional information on the safe handling and disposal of this material.Wash areas of skin contact with soap and water.Avoid contact with eyes.DO NOT APPLY TO EXPOSED ELECTRICAL CONDUCTORS. AVAILABILITY SpecSeal®Series SSP Putty is available from authorized STI distributors nationwide.Consult factory for the names and locations of the nearest sales representatives or distributors. A: ORDERING INFORMATION CAT.NO. DESCRIPTION CASE QTY. SSP100 36 in3(0.6 titer)bar 6 SSP28 24 in3(0.4 liter)bar - SSP4S 7.25"x7.25"x3/16-084x184x5 mm)pad 20 1 SSP9S 9.00-x 9.00"x 3/16"(229 x 229 x 5 mm)pad 20 'B CITY OF NEW YORK MEA 30-92-M IMPORTANT NOTICE: All statements,technical information,and recommendations contained herein are based upon testing believed to be reliable,but the accuracy and completeness thereof is not guaranteed. WARRANTY Specified Technologies Inc.manufactures its goods in a manner to be free of defects. Should any defect occur in its goods(within one year),Specified Technologies Inc.,upon prompt notification,will at its option,exchange or repair the goods or refund the purchase price. LIMITATIONS AND EXCLUSIONS: THIS WARRANTY IS IN LIEU OF ALL OTHER REPRESENTATIONS EXPRESSED OR IMPLIED(INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR USE)AND UNDER NO CIRCUMSTANCES SHALL SPECIFIED TECHNOLOGIES INC.BE RESPONSIBLE FOR ANY INCIDENTAL OR CONSEQUENTIAL PROPERTY DAMAGE OR LOSSES.PRIOR TO USE,THE USER SHALL DETERMINE THE SUITABILITY OF THE PRODUCT FOR ITS INTENDED USE,AND THE USER ASSUMES ALL RISKS AND LIABILITY FOR SUBSEQUENT USE. No statement or recommendation not contained herein shall have any force or effect unless in an agreement signed by officers of seller and manufacturer. MADE IN THE USA -COPYRIGHT©2008 SPECIFIED TECHNOLOGIES,INC. _= Specified Technologies Inc. STI. Specified Technologies Inc.•200 Evans Way,Somerville NJ 08876•Phone:800.992.1180•Fax:908.526.9623 —� 4 Technical Service 1-800-992-1180 STI Product Data Sheet • Series SSP Firestop Putty&Putty Pads • FOD-5010 05/2007 www.stifirestop.com STI. • t PRODUCT DATA SHEET SpecSea11lll!1111ie SERIES SSP PUTTY & PUTTY PADS APPLICATIONS PRODUCT DESCRIPTION SpecSeal®Series SSP Putty and Putty Pads SpecSeal®Series SSP Putty is a non-hardening,intumescent compound designed to seal through- are used to seal through-penetrations as well penetrations as well as certain membrane penetrations against the spread of fire,smoke and toxic as construction gaps and blank openings. gasses.Spec Seal®Putty expands up to eight times its original size when exposed to high temperatures SpecSeal®Putty Pads are used to seal around or flames. electrical boxes to reduce sound transmission Requiring no tools,SpecSeal®Series SSP Putty is soft and pliable making it easy to install by hand (see Technical Update) and increase fire packing into openings.Its aggressive adhesion makes it suitable for use with all common construction resistance.These pads also provide a metered materials as well as cable jacketing and pipes.SpecSeal®Putty remains soft and easy to reuse or method of application when sealing through- retrofit. penetrations and in some applications, are SpecSeal®Series SSP Putty Pads provide this same level of protection in a release lined pad for easy used to provide a cushion to allow movement application to electrical boxes or other penetrants.The pad is conveniently sized to fit a typical 1-1/2" due to settling,expansion and contraction,or (38 mm)deep 4S box with no cutting or piecing required.Faced on both sides with a convenient poly vibration, liner,SpecSeal®Putty Pads are easily applied with no mess or excessive residue. FEATURES • Non-Hardening=Easy retrofit! • Two Stage Intumescence features aggressive expansion. • Endothermic Fillers absorb heat&release water. I Highly Adhesive formula Stays put.Allows movement. • Soft&Pliable for easy installation. CD • No Water-Soluble Expansion Ingredients means better water resistance! • Sound Deadening!Excellent sound attenuation properties.Reduces noise transmission. PERFORMANCE SpecSeal®Series SSP Putty is the basis for systems that meet the exacting criteria of ASTM E814(UL1479). Systems have been tested for all common forms of construction and most common penetrants with ratings • o up to 3 hours.Sound attenuation properties have also been tested as per ASTM C919 and E90. • Additionally,SpecSeal®Series SSP Putty Pads have been tested to UL263(ASTM E119.NFPA 251)and are classified for up to 2 hours as a Wall Opening Protective Material for use with both metallic and nonmetallic outlet or switch boxes installed in gypsum wallboard assemblies(steel and wood stud assemblies).Boxes protected with SpecSeal®Putty Pads have been successfully tested with box spacing reduced to less IN than 16"(406 mm).(Not tested nor approved for boxes installed directly back to back), pSSf ze INOERWRTERS LABORATORIES NC® C ® we REBoWALL Tn MATERIAL SEE RicWC TCATEGORY N IL PHYSICAL PROPERTIES FlIRERESISTANCE RECTORY US cum LLCVgON YcC FR eeALRAN REUECORSEE UL APPROVED PHYSICAL PROPERTIES Product Name: Series SSP Putry SPECIFICATIONS Colon Red The tirestopping putty shall be a one-part,two-stage intumescent,non-hardening compound.The putty, Odor: None when exposed to high heat or flame shall be capable of expanding a minimum of five times. Range Density: 1.45 kg2(12081t�gal) of continuing expansion shall be from 230°F to>1,000°F (110°C to>538°C). The putty shall be soft and pliable with aggressive adhesion and shall not contain any water-soluble intumescent ingredients. Solids: 100% The putty shall be UL Classified and/or FM Systems Approved and tested to the requirements of Expansion Begins: 230°F(110°C) ASTM E814(UL1479). Volume Expansion: >500%(free expansion) SPECIFIED DIVISIONS In-Service Temp: 120°F(49°C) DIV. 7 07840 Through-Penetration Firestopping STC Rating: 62 DIV. 13 13900 Spedal Construction Fire Suppression&Supervisory Systems VOC Content': 0.00 lbs/gal(0.0g/L) DIV. 15 15250 Mechanical Insulation—Fire Protection Shelf Limit: No Limit "ASTMD 3960 and EPA Federal Reference Method 24. DIV. 16 16050 Basic Electrical Materials&Methods Technical Service 1-800-992-1180 SD Product Data Sheet • Series SSP Firestop Putty&Putty Pads • FOD-5010 05/2007 1 STI. www.stifirestop.com ECOLOGICAL INFORMATION No data. Not anticipated to be environmental hazard. DISPOSAL CONSIDERATIONS Waste Disposal: Treatment,storage,transportation, and disposal must be in accordance with applicable Federal, State/Provincial, and Local regulations. TRANSPORTATION INFORMATION DOT—not regulated. REGULATORY INFORMATION U.S. Federal Regulations TSCA Inventory Status:Article. Section 313 Supplier Notifications. This product contains no toxic chemicals subject to the reporting requirements of Section 313 of the Emergency Planning and Community Right-To-Know Act of 1986 and of 40 CFR 372: OTHER INFORMATION NPCA-HMIS Rating Health : 1 Flammability : 0 Reactivity :0 Personal Protection rating to be supplied by user depending on use conditions. STATE RIGHT-TO-KNOW LAWS No substances on the state hazardous substances list,for the states indicated below, are used in the manufacture of products on this Material Safety Data Sheet,with the exceptions indicated. While we do not specifically analyze these products, or the raw materials used in their manufacture,for substances on various state hazardous substances lists,to the best of our knowledge the products on this Material Safety Data Sheet contain no such substances except for those specifically listed below: SUBSTANCES ON THE NEW JERSEY WORKPLACE HAZARDOUS SUBSTANCE LIST PRESENT AT A CONCENTRATION OF 1%OR MORE(0.1%FOR SUBSTANCES IDENTIFIED AS CARCINOGENS, MUTAGENS OR TERATOGENS): NJTSRN-SSP WARNING: SUBSTANCES KNOWN TO THE STATE OF CALIFORNIA TO CAUSE CANCER: Possible traces of formaldehyde and acrylonitrile. WARNING: SUBSTANCES KNOWN TO THE STATE OF CALIFORNIA TO CAUSE BIRTH DEFECTS OR OTHER REPRODUCTIVE HARM: None known. This information relates to the specific material designated and may not be valid for such material used in combination with any other materials or in any process. Such information is to the best of our knowledge and belief accurate and reliable as of the data compiled. However,no representation,warranty,or guarantee is made as to its accuracy. reliability or completeness. It is the user's responsibility to satisfy himself as to the suitability and completeness of such information for his own particular use. We do not accept liability for any loss or damage that may occur form the use of this information. Responsibility for MSDS : Specified Technologies, Inc. 200 Evans Way Somerville, NJ 08876 Page 3 of 3 MSDS-SpecSeal®Firestop Putty FOD-5011 r ' FIRST AID MEASURES First Aid INHALATION: Remove to fresh air. SKIN CONTACT:Wash thoroughly. EYE CONTACT: Irrigate eyes with running water for at least 15 minutes. Get medical attention if irritation develops. INGESTION: None applicable. FIRE FIGHTING MEASURES FLASH POINT>163 deg. C based on most volatile component. EXTINGUISHING MEDIA Dry Chemical; Carbon Dioxide; Foam: Water spray for large fires. SPECIAL FIRE FIGHTING PROCEDURES As for surrounding fire. ACCIDENTAL RELEASE MEASURES Safeguards(Personnel) NOTE: Review FIRE FIGHTING MEASURES and HANDLING(PERSONNEL)sections before proceeding with clean-up. Use appropriate PERSONAL PROTECTIVE EQUIPMENT during clean-up. HANDLING AND STORAGE Store under ambient conditions. No special handling required. EXPOSURE CONTROLS/PERSONAL PROTECTION EYE PROTECTION REQUIREMENTS. Safety glasses/goggles. SKIN PROTECTION REQUIREMENTS: Gloves. RESPIRATOR REQUIREMENTS: None. VENTILATION REQUIREMENTS. None. Exposure Guidelines None. PHYSICAL AND CHEMICAL PROPERTIES PHYSICAL FORM Red solid with minimal odor SPECIFIC GRAVITY 1.49 PERCENT VOLATILES none SOLUBILITY IN WATER Very slight STABILITY AND REACTIVITY STABILITY: This is a stable material. CONDITIONS TO AVOID Storage>55 deg. C HAZARDOUS POLYMERIZATION Will not occur. INCOMPATIBILITIES. None special. TOXICOLOGICAL INFORMATION Mixture not tested but based on components: May be irritating to skin and eyes and may aggravate existing skin and eye conditions. Irritation of the nose,throat, and lungs may result from over-exposure to vapors or mist from heated material. None of the components are listed as carcinogens. Page 2 of 3 MSDS-SpecSeal®Firestop Putty FOD-5011 f. STL Material Safety Data Sheet 01-JAN-2006 SpecSeal® Firestop Putty CHEMICAL PRODUCT/COMPANY IDENTIFICATION Material Identification PRODUCT NAME SpecSeal®Firestop Putty CHEMICAL FAMILY Mixture Company Identification MANUFACTURER/DISTRIBUTOR Specified Technologies, Inc. 200 Evans Way Somerville, NJ 08876 PHONE NUMBERS Product Information : 1-908-526-8000 Emergency : 1-800-255-3924 COMPOSITION/INFORMATION ON INGREDIENTS INGREDIENT NAME CAS NUMBER Proprietary mixture ---------------- HAZARDS IDENTIFICATION ************EMERGENCY OVERVIEW********** * Possible skin and eye irritant. Red solid. * Potential Health Effects: EYE: Contact may cause irritation and redness. SKIN: Contact may cause irritation and redness. INGESTION: Relatively non-toxic. INHALATION: Irritation of the nose,throat, and lungs may result from over-exposure to vapors or mist from heated material. CHRONIC(CANCER)INFORMATION: Not classified as carcinogenic. LONG TERM TOXIC EFFECTS: None known. Page 1 of 3 MSDS-SpecSeal®Firestop Putty FOD-5011 City of Northampton r J14AM{ Massachusetts 1 • DEPARTMENT OF BUILDING INSPECTIONS if-vp 212 Main Street • Municipal Building t„ Northampton, MA 01060 JS11Yfititit`' INSPECTOR ANTHONY PATILLO BUILDING PERMIT FEES Phone: (413)587-1240 BUILDING COMMISSIONER Effective July 21,2008 Fax (413)587-1272 DEMOLITION $ 20.00 ACCESSORY STRUCTURE $ 35.00 PRINCIPAL BUILDING—Residential $200.00 PRINCIPAL BUILDING -Commercial *NEW CONSTRUCTION $ .50 per square foot for 1st floor .30 " " " " 2nd floor .20 " " " " %floors,attic, basement,garage STRUCTURAL ALTERATIONS IN ALL USE GROUPS $6.00 per thousand dollars of estimated cost or fraction thereof, with a minimum fee of$55.00 $25.00 WOODBURNING STOVE *NEW ACCESSORY STRUCTURES one hundred twenty (120)square feet and over $ .20 per square foot with a minimum fee of$25.00 *NEW ACCESSORY STRUCTURES under one hundred twenty(120)square feet $25.00 per inspection *SWIMMING POOLS $30.00 for above ground $60.00 for in-ground *SIGNS&AWNINGS $30.00 *DECKS $50.00 REPLACEMENT WINDOWS $35.00 SIDING&ROOFING Residential $35.00 per structure Commercial $55.00 min. per structure OR$6/K of estimated cost TENTS $25.00 *ZONING REQUEST FORMS $15.00 (includes home occupation registration) REISSUE OF LOST PERMIT $25.00 CERTIFICATE OF ANNUAL INSP. $100.00 (minimum) Temporary Certificate of Occupancy $25.00 PERMITS REQUIRING ONLY 1 (1) INSPECTION WILL BE A MINIMUM OF$25.00;ALL OTHERS WILL HAVE A$50.00 MINIMUM. PERMIT FEES SHALL BE PAID TO THE ORDER OF THE City of Northampton AND SUBMITTED,WITH THE COMPLETED PERMIT APPLICATION,TO THE OFFICE OF THE BUILDING INSPECTOR. WORK STARTED WITHOUT PERMIT IS SUBJECT TO DOUBLE NORMAL FEE. !! NO CASH - CHECKS OR MONEY ORDERS ONLY !! *Filing deadline is 12:00 pm (noon)on Wednesday. Version1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , as Owner of the subject property hereby authorize to n my behalf, in all matters relative to work authorized by this building permit application. ature of Owner Date I, --,_ '1" CC VL-t. t-C:. , 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 pen (ties of perjury. Print Name Signature of Owner/Agent Date S CTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: G An-i R la° JNgt t_ License Number i25 e",/2s-r- Lrs C�/2A.v�,tc+: O/t1 C5 07 gill to Addr ss Expiration Date LAW-i - 4(),- D -�'.zov ..._____„Signature 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 building permit. Signed Affidavit Attached Yes No N Version1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name. Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Ace 1 )(k. ah4 vt)A et SO(,C+ 'I I n c Not Applicable ❑ Company Name: Responsible In Charge of Construction Ind_ rei-e,b-e 11 5 WQSe '' 1W � ().()g Ad s `1 13_- ignature Telephone Versionl.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING 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 ® YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW ED YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES ® NO 0 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 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 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Versionl.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❑ Repairs 12 Additions ❑ Accessory Building❑ Ol \ ` Exterior Alteration ID Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other ] ,� Brief Description Enter a brief description here. � " '`�`� Of Proposed Work: flE{)A I 12 g A N d t.� %�TL fz 'IJ A rn A g- / ' 5 SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly CI A-1 ❑ A-2 ❑ A-3 ❑ IAA I 0 A-4 ❑ A-5 ❑ 1B 0 B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ NI Mercantile ❑ 4 ❑ R Residential M R-1 ❑ R-2 ® R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B [ ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: 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 BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 1 st 1st 2nd 2nd 3rd 3rd 4th 4th Total Area(sf) Total Proposed New Construction (sf) Total Height(ft) Total Height ft 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public EL Private ❑ Zone Outside Flood ZoneD Municipal ❑ On site disposal system Version1.7 Commercial Building Permit May 15,2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural flans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify li 7,, i I APPLICATION TO CONSTRUCT, REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANC' OF>OR[DEMOLISH my BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING V SECTION 1 -SITE INFORMATION n Y ',i J t} n LCC9 1.1 Property Address: This section to be completed by officP� Hilltop Apartments I Map Lot Unit 51 Village Hill Road Zone Overlay District Northampton, MA 01060 Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: \h6(s-e c-�.�( 1 c.\u ltL cLhc1 .E Signature 1N-- ,• 6- i_L. �f Telephone 2.2 Authorized A Name(Print)' Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building L1 1.4 (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) Check Number 3/�jOL �� "� This Section For Official Use Only lo9 Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2009-0788 APPLICANT/CONTACT PERSON ACE FIRE&WATER RESTORATION INC ADDRESS/PHONE 18 ELIZABETH ST WEST SPRINGFIELD (413)750-5200 PROPERTY LOCATION 51 VILLAGE HILL RD MAP 38A PARCEL 106 001 ZONE PV(100)//SG b THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid / , a?d Typeof Construction: REPAIR FIRE&WATER DAMAGE(102,103,201,202,203,BASEMENT/1ST FLR HALLS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 074416 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: _ pproved 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 2-0 C 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. VILLAGE HILL RD x BP-2009-0788 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:38A- 106 <'# 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-2009-0788 Project# JS-2009-001172 Est. Cost: $49496.00 Fee: $270.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ACE FIRE & WATER RESTORATION INC 074416 Lot Size(sq. ft.): 82459.08 Owner: VILLAGE AT HOSPITAL HILL LLC C/O COMMUNITY BUILDERS INC Zoning: PV(100)//SG b Applicant: ACE FIRE &WATER RESTORATION INC AT: 51 VILLAGE HILL RD Applicant Address: Phone: Insurance: 18 ELIZABETH ST (413) 750-5200 Workers Compensation WEST SPRINGFIELDMA01089 ISSUED ON:4/6/2009 0:00:00 TO PERFORM THE FOLLOWING WORK:REPAIR FIRE & WATER DAMAGE (102,103,201,202,203,BASEMENT/1ST FLR HALLS 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 4/6/2009 0:00:00 $270.003162 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo