36-034 (2) a1��o
A Orco-,house Forlinn
17 Strert. Unit ? 'Chic-opLac. NIA 01013 " Phone:41.1-420-0140 Fax: 41 420-0147
The enclosed permit package is for the proposed building of a three-season sunroom
on a new wood deck. There Hill be no Electrical Work or Plumbing s't'ork.
package:
f0 This. �P�
UiGL �D/Ll� SF/�EIZ�Qj�`Gy IV 7�)L ication
n
plicable)
;ion to represent them in securing this permit
t!rmation form for Sunrooms
Acense and Home Remodeling Licensee
mpensation Coverage
r your assistance. Please call with any, additional
Best Regards,
Michelle L Grassi
413-420-0140
1
A FFI D_A V I T
In ,iccc;'cl:tncc \\ iih .A;-,,Icle 1 Scc:ion 114. I.: ,\f the '�1 s�:tchuscils $I:1te Buildlllg CO:Ie. j
Ccl'11I\ ihJl :.I �c111'I� 1Y�lli111?`? lri�l;l \ii�1l ati��lclaleCl 1\ 1t11 Pc1'n11t i~'
he prc\perl\ di•h;�:e,1 of at 1�'ast: "�? 1n:I cn�ew. licensed solid \\a,te d f. — will
defined h\ NIGL C1 1. S 150.A. 1 acilit� as
Andre\\ M.110 lie / Betterli\ inc Stln1'c,on75 of S;,rinRfield
Print Namc t,fAh ,licant Si NI'tture of Permit Applicant
�
S 17 Meadnw Street. ti)-lit ?. Chicn ee. h9.a
ignature of Permit Appli cant .�dt1J'ttiti
Effecii\c Sepiemher 12. 1991 the Department of Health/Code Enforcement actin`
t)nd
Chapter ? Article 1 31 of the 1986 NVorcester Re\ ised O:-dininces requires proof•of er
disposal of debris gernerated is a result of this hermit. The proof shall be a dated and
signed receipt from the licensed clispos:d facility containing the follo\Vino information
A description of the debris. the "ei-2111 and Volume of the dehris and the location of ilte
disposal facility. The receipt mint also ha\e a si��naturc of the m\ ner/operatorof the
di\posal facility.
Failure to comply v. ith the requirements of this Ordinance \\ ill result in enforcement
action by the cit\-.
✓,4® �a/vr�,ea4ue�ea.db, of',.RLaeaac'rFao�..
Board of Building Regulations and Standards
License or registratian valid fOr Indivldul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date, If found return to:
w Re916t>`61i0R:1,138971 Board Of Bulldin;Regulations and Standards
Eplratlgn;, 6!2/2005 One Ashburton Place Rxn 1301
TYp� 'Prrvat®Corporatlon Boston,Ma. 02108
O ROOMS Jr AM ICA
Y
JOHN ESLER
78�onNPl� Ra
.�
WESTB ROUGH, MA C1561 � � I . vFeC�
Administrator Not valid without signature .......
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 082450
Birthdate: 07/08/1971
Expires: 07/08/2006 Tr. no: 82450
Restricted: OD
CHARLES E COFFEY
804 PARKER ST
EAST LONGMEADOW, MA 01028 Administrator
Jan 27 D3 04 : 59p BetterLivin6 5083512994 F
c+ :9 YCN _, 6 :S F�� "J1 :67 EA:_ °ersenel & CDr.t:den::a. �cc
i ACORD_ CERTIFICATE OF LIABILITY INSURANCE DATE rmmlbb:rn
C•.'27,20C3
.AOau c>< THIS CER'IFICATE IS ISSUED AS A MA 1-1 ER DF INFORMA?PJN
ONLY AND COS(PM3 NO RIGHTS UPON The CERTIFI:;J.'E
Jzsc-ph HOLDER. THIS CERTIFICATE DDES NOT AMEND, EXTEND DR
y JP Ll--Ke;-ne Agency. 'nc AL-ER THE COVERAGE AFFORDED ov TN>: FD�IC155 SEI�w
t'Q. O.^X 323 IMSUAERS AFFORDING CnVFRA;F
I Ann ti'DO' FYI 48196-C333
IticuR c =stic Ro^mt o'$a in^f�1C INSDIC.R A "e-ferc onsvrance_of Ine MiowES'--
ebE FE•iErLivi-)C Pa:« Room; M'SJt'_F IS
'! .ira=ate S: C
D�,1;,o�ee.NA :1C13-22e2 ��•s_•aR� _ -- _ �
COVERAGES '
7HE PD:I-.IES OF Ins.RANGE:IS7EC BELDw NAVE SEEN 155UECTO1HE INSURED NAMEDABOVE%CFI THEP--L::ZY PF.RtCD!NDICA-ED
ANY REOUIREmEtJT,YEaI✓ OR CDND.TIDN OF ANY COn RACT OF OTHER DOCJMENT Wl'H RESPECT TO Wml=C-THIS LEA71rICATE MAY BE ISSUE"0
b:AY DER7AIN 1nE INS.;RANGE AFFORDED EY'HE POLICIES D_SCR:BED HERIr)N 7S SUBJEC'T 7D ALL`HE'ERNS,Ex;;_U51OKS AwD CONL11,Dn5 O'SUC+t
POLITIES.AGGREGATE OW-75 SmOvyh MAY HAVE 6EEN REDOCEC 6Y PAID CLAW$. :
tA�pR TY•s OE'At�'AAA=[ POJtY NLwsrR ; A Nw I •TF Ytut/01•T JN'tt
4 5BA PA3963 01/15/2002 :01/15,120r,4 occuPREA:E < <.DOC.cJD
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COtSU"vIER INFOR]NIATIO'\ FOR'\7 - "SUNROOYIS"
�� i n�'l Massachusetts State Building Code (780 C11R, Appendix J, Section J1.1.2.3.1)
The Massachusetts State Building Code (780 C11R) includes provisions to ensure that houses and
house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION
FORM is to be tiled as part of'the building permit application when a bull der.'contractor or homeowner,
constructing'installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a
special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR,
Appendix J, Section J1.1?.).1). This FORM is not intended to prevent a homeowner from selecting a
sunroom" of any size, configuration, orientation, form of construction or percent glazing, but rather is only
intended to assist homeowners in becoming_ aware of some of the important energy conservation and year-
round comfort considerations involved in selecting and utilizing a "sunroom" addition.
The connection of "sunroom" structures to residential buildings may create comfort and energy
consumption issues due to uncontrolled solar- gain or uncontrolled radiation cooling of the main house. In
the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list
of product and design considerations that a homeowner may wish to consider before actually
constructing/installing a "sunroom". It is recommended that consumers carefully review these options with
their designer, builder, or contractor, in order to minimize potential energy consumption and/or house
discomfort :issues. In addition. the qualifications and reputation of the company or individuals to be hired
are important considerations.
PRODUCT AND DESIGN CONSIDERATIONS RELATED TO "SUNROO11IS"
• Solar Orientation and Natural Shading
• Type of Glazing
• Insulating value
• Solar heat gain
• Frame materials
• Glazing to frame sealing and gasketing materials/seal durability and/or
weather tightness of the sunroom
• Adequate ventilation- Operable windows and fans
• Applied Shading Systems
• Insulation level in floors, walls, and ceilings
• Possible Sunroom isolation from the main house via a wall and/or door or slider
• Heating and Cooling Methods: Efficiency, Zoning and Controls
Homeowner Ackno-vvledgment
The Massachusetts State Building Code, Section 71.1.2.3.1, requires that the actual property owner (not the
owner's agent or representative) acknowledge receipt of this CONSUMER INFORMATION FORM prior to
issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential
building. ht accordance with this requirement. the undersigned hereby acknowledges that shc!he has read
the information in this document concerning sunroom comfort and enemy conservation.
p(cblo3
Signature of.Actual Bt*lding Owner � Date
3 N K(Tt
Print Nance Address of Permitted Project
Owner Address (if different than r)roiect location) Owner's telephone number
Property Owner :Must Complete and Sign This Section If Using A Builder
I. C 140 4 tkw3 ) C F-� (-toapAy _ as Owner of the subject property
hereby authorize 13etterliving Patio Rooms (d.b.a. — Patio Rooms of America) to act on
my behalf. in all matters relative to work authorized b% this buildin`a permit application,
for(address of job)
SW
rb � t6 �� 3
Sign of w�ner Date
Owner or Builder(as Agent of Owner) Must Complete and Sign This Section
as Ow ner'A t on
hereby declare that the statements and information on the foregoing application for
(address of job) ��[ �jttF �,ejU�__e6o,F,t/�'� , are true and
accurate, to the best of nav knowledze and belief.
Signed under the pains and penalties of perjure.
Print N,an,,:
Sianature of Owner': _ Date
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Betterliving
SUNROOMS
31-/ MEADOAST UNIT 2 CHICOPEH—M,01013
Phone(413)420-0140 Fax(413)420-0147
i
r
SGT C.mc �
A..� Caa' ca�..
TO: SPRINGFIELD T-NSTIT'UTION :+R 5AVZNG5 a
r:Rs- AMERICAN TITLE INSURANCy CCMPANY
I HERESY REPORT T•IAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATiON ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHO^' AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT ONES.
EXCEP" AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A F,_OOO PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY # 2 5 0' 6'
SURVEYGr,; I• -NOTE-
THIS P!AT ;FOR MORTGAGE JOAN PURPOSES
AND DOES NOT CONSTITUTE A PROPERTY SU!
tiv, s -MORTGAGE LOAN iNSPEC71014 PLAT--
1 NORTMMPTQN, MAS5ACHUSETTS
om PREPARID FOR
SET v BEY
5CALL: 1 "-310 ' NOL'EN.3ER 2 4
► HAROLD L. EATO'� AND ASSOC,ATES. INv.
RECISTEREC WROFESSiONAL LAND SURVEYS 1
Dl rcSCi ti STREET m — .��
rvv iiv..r .�� EE 7 : ADLEY - M ASSAuHU
TOTAL F.0:
t
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Ff'ashington Street
Boston,Mass. 02111
Worker's Compensation Insurance Affidavit
]Appticant Information----------------PLEASE PRINT LEGIBLY-------------------____
Name: Uit'r�f/�
Location:
City FLD,eEti/PF /yIl� D/ova Phone#
❑I am a homeowner performing all work myself.
❑ I am a sole proprietor and have no one working in any capacity
9 1 am an employer providing workers'compensation for my employees working on this job.
Company Name: irE2uy/rl/G �Siiti2oD,uc
Address: _3"7 /YEADD rc./
City: ly4 D/e/j Phone# 11j,-Y/wo O/yD -xr S;'
Insurance Co._ _ �� l�A�TFG/Z1I Policy# &5- N/BLt
❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed
below who have the following workers'compensation policies:
Company Name:
Address:
City: Phone#
Insurance Co. Policy#
Attach additional list if necessary
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine
up to$1500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of
$100.00 a day against me. I understand that a copy of this statement may he forwarded to the Office of Investigations of the
DIA for coverage verification.
I Do herebl•certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature Date //-ao-03
Print Name Phone#_13-Y_2e-G/1G 0'7- 5-W
Official use only do not%rite in this area to be completed by city or IwAn ollicial
City or Town: PermivlAcense is ❑ Building Department
❑ Licensing Board
❑ check if immediate response is required ❑ Selectmen's Office
❑ health Department
Contact Person: Phone t ❑ Other
(revised 3195 R.)
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: �J Not Applicable ❑
Name of License Holder:---------�-</444157S_ f e? --------------------------- ------ Y yo---------------------
License Number
-�Q Awe, ,5 7, - --tea�`------------------- ------7_ 4---------------------
Address Expiration Date
Signature Telephone
9' Restlstered Home Improvement Contractor: Not Applicable ❑
------------------------- ----- -q J__z-----------------
Comvanv Name Registration Number
Address ''// Expiration Date
- ------- Telephone_,{/ �!e---------
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 building permit.
Signed Affidavit Attached Yes....... 1r No...... ❑
I L - Home lOwner Exem don
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 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[�
---------------51
------------------------------
Brief De ription of Proposed
Work: Ad XZS/' R SMS / s Q
/E{dj W" A-�N Tf/E,4-_ K/i a.6',*eX_e4
Amq&416 ov 7*s 1W_,ce-e7'
Alteration of existing bedroom------Yes No Adding new bedroom-- ----Yes � No
Attached Narrative Renovating unfinished basement -------Yes ____No
Plans Attached Roll -Sheet
6a.if New house and or addition to existing housing complete the following:
a. Use of building : One Family--_yl_— 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._____1` __ '
_ --------- Dimensions__JD1�/-------------------------
e. Number of stories? /
--------------------------------
f. Method of heating?------A*41------------------------ Fireplaces or Woodstoves �/q Number of each
g. Energy Conservation Compliance.—__ks-------------- Mascheck Energy Compliance form attached?
h. Type of construction AlAt!/1/f4&ZZ "� jjQj,R/E;�j� y jq�Ef�J Cs/ sS
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___-(4
------------------
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
prooperty perty REF__1� 1t -------------------------------------------------------------- as Owner of the subject
hereby authorize ----&MM. /ylit/l� —
---------------------------------------------------
to act on my behalf, in all matters relative to work authorized by this building permit application.
---------------------------------------- --------------------------------------
Signature of Owner Date
I, -- ---- , as Owner/Ated
A,�=X 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.
-------A'lwa-- '---------------------
--------------------------------------------------------------
Print Name
—
------ � L �r` -- ---------------------
-------- Q�Q Q3—
--------------------------------------
Signature of Own er/ Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
this column to be tilled in by
Building Department
Lot Size 7, 00 Le-
Frontage z z
0"0
Setbacks Front
Side L: R: L: 31 R:��
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking S aces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW I/ YES
IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES. enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO _ate DON'T KNOW
YES
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 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
No
IF YES, describe size, type and location:
Department use only
City of Northampton r," ; b$"s p4e 4:
Building Department Curb CWDriveu ay Permit _
212 Main Street
go�a+eqseptic A4alliblltty y
Room 100 W"eterlUYll, alaility
Northampton, MA 01060 Two Sets of Structurat Puns ..
phone 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
Map----� -___ Lot_ Unit
3 Wl1/7� 41&C l�.Q/Z Ata"LF h1A /7/D(o� Zone_ A -- Overlay District
Elm St.District CB District_-_
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
E__d11/ ��------------------------------ 111�!i1�" JamF�LIL�_� �- _
Name(Print) Curre t Mailing Address:
��J -- 3-s ----------------------------------
- �� u!vj----------------------------------- Telephone
Signature
2.2 Authorized Agent:
- ------------------------
Name(Print) Current Mailing Address:
-- -- ------------------
----�1 D_ h-------------------------------
Signature � Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
com leted by ermit 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) Check Number ( D
This Section For Official Use Only
Building Permit Number:-- Issued:`--------
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2004-0649
APPLICANT/CONTACT PERSON BETTERLIVING SUNROOMS/PATIO ROOMS OF BOSTON
ADDRESS/PHONE 317 MEADOW ST,UNIT 2 CHICOPEE (413)420-0140(5)
PROPERTY LOCATION 3 WHITE PINE DR
MAP 36 PARCEL 034 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid c i,67 I 0 5_0
Typeof Construction: CONSTRUCT 14 X 10(3)SEASON SUNROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 082450
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO,PAATION PRESENTED:
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 Co ion
O le6`�'-e
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.
3 WHITE PINE DR BP-2004-0649
GIS#: COMMONWEALTH OF MASSACHUSETTS
MapBlock: 36-034 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0649
Project# IS-2004-0930
Est. Cost: $50.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: BETTERLIVING SUNROOMS/PATIO ROOMS OF BOSTON 082450
Lot Size(sa. ft.): 11020.68 Owner: MURPHY JEFFREY S&CYNTHIA 0
Zoning URA Applicant: BETTERLIVING SUNROOMS/PATIO ROOMS OF BOSTON
AT. 3 WHITE PINE DR
Applicant Address: Phone: Insurance:
317 MEADOW ST UNIT 2 (413) 420-0140 (5)
Workers Compensation
CHICOPEEMA01013 ISSUED ON.1215103 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 14 X 10 (3) SEASON SUNROOM
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 Occupant Signature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 12/5/03 0:00:00 3511 $50.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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Building 21�3 tl . 3511 $50.00
212 Malty P (413)5$9-1240,Fax:(413)587-1272
Buil,6ig Commissin Anthony Patillo
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