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18C-115
0 75/28/2014(MM/DDIYYYY) A�Ro CERTIFICATE OF LIABILITY INSURANCE 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). CONTACT PRODUCER JAMES J DOWD & SONS INS AGCY INC NAME, 14 BOBALA RD PHONE FAX HOLYOKE, MA 01040 y"c "° EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA: LM Insurance Corporation 33600 INSURED INSURER B: CO OP POWER INC 15 A WEST STREET INSURERC: WEST HATFIELD MA 01088 INSURERD: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 20313592 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR I S WVD POLICY NUMBER MMIDDIYYYY MMIDDNYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 05 TO 11NTEb- CLAIMS-MADE n OCCUR AEMI E Eoccurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ POLICY JECT PRO ❑LOC PRODUCTS-COMPlOPAGG $ OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION WC5-31S-388245-013 11/2/2013 11/2/2014 ,/ START UTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? FN N!A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. CERTIFICATE HOLDER CANCELLATION THIELSCH ENGINEERING, INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 195 FRANCIS AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. CRANSTON RI 02910 AUTHORIZED REPRESENTATIVE } LM Insurance Corporation `f ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 20313592 Lucy G—f-Ld 5/28/2014 2:37:04 PM (EOT) Page 1 of L 'ACoOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 6/16/2014 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 NAME: Debbie MacNeal James J. Dowd & Sons Iris PHONE FAX 14 Bobala Road A/C No Ext:413- - A/C No: - - Holyoke MA 01040 ADDRESS: dmacneal @dowd.com PRODUCER CUSTOMER ID#:COOP INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA:MOunt Vernon Fire Insurance Company Co-op Power, Inc. INSURERB:Safety Indemnity Company 33618 15A West Street West Hatfield MA 01088 INSURER C: INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1817062271 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD UBR POLICY EFF POLICY EXP LTR INSR W D POLICY NUMBER MMIDD/YYYY MMIDDIYYYY LIMITS A GENERAL LIABILITY CL1566148A 11/8/2013 11/8/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 CLAIMS-MADE F—I OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $l,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 POLICY PRO- g LOC $ B AUTOMOBILE LIABILITY 6212701 113/23/2014 3/23/2015 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ Comprehensiv 1 1 $ A X UMBRELLA LIAB OCCUR CUP1550265A 11/8/2013 11/8/2014 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DEDUCTIBLE $ X RETENTION $0 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers' Compensation Certificate of Insurance to follow separately from the carrier. Certificate Holder is named as Additional Insured per written contract in regard to general liability only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Thielsch Engineering, Inc. 195 Frances Ave. Cranston RI 02910 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents v Office of Investigations w I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ley-ibly Name (Business/Organization/Individual): Co-op Power Address:15A West Street City/State/Zip:West Hatfield, MA 01088 Phone#:(413) 772-8898 Are you an employer? Check the appropriate box: Type of project(required): 1.9 I am a employer with 10 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 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. E] Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' 13.9 Other V\/e qtI6 e ri Zq( comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the 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 thepolicy and job site information. Insurance Company Name:Liberty Mutual Insurance Company Policy#or Self-ins. Lic. #:WC5-31 S-388245-013 Expiration Date:11/02/14 Job Site Address: '5'9 f'�)l)t so n S�, City/State/Zip:No(_k� l q wt( �7 ►iVlai� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)v CN/�a Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 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 certi under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#• H (7Z.)'" 7 72'C,�-q 1 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �.; V Office of Consumer Affairs and Business Regulation � '. 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration 165217 Type: Corporation Expiration: 1/2112016 Tr# 256968 CO-OP POWER, INC. MICHAEL SUTER 12A WEST ST WEST HATFIELD, MA 01088 Update Address and return card.Mark reason for change. 20M-05/11 SCA 1 C7 Address [] Renewal E] Employment [7] Lost Card Vlte (pON7Lht4�2lGBR�o�C�I�LQ.Od�tlldP.�d ` Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Registration: 165217 Type: Office of Consumer Affairs and Business Regulation f 10 Park Plaza-Suite 5170 Expiration: 1/21/2016 Corporation Boston,MA 02116 CO-OP POWER,INC. MICHAEL SUTER 12A WEST ST f WEST HATFIELD,MA 01088 Uodersecretary Eot vaI tllwt signature Massachusetts - DupartM nt of Public Safety Board of Building Regulations and Standards Constructioll License: CS-107864 t MICHAEL SUTER Ja PRATT COMER R A"'D r Shutesbury MA 01072 a + .•• +r xpiration Commissioner W1212018 OWNER AUTHORIZATION FORM (owner's-Name) owner of the property located at 0i t 25 , (Property Address) (Property Addre ) " hereby authorize Co `"o0Rcr�e I- (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. `� C7wner's Signat Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: c Not Applicable ❑ Name of License Holder: ��t C _ A\ 0— `14. t?C 1 0 License Number 15 I/ ( ;� z Address Expiration Date _ L{ 13 - 7 cz�zq ::;C Signature v Telephone 9._Renistered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Lo-5 .0 Fovyf /2 1 / 1 ,(o Address l L L n I,,,,'�1 u �1 QQe,� Expi a on pate wC 51 St, W,00 0Ia f Q(Or,l'r't�F Telephone_?�3-7 7«14 O!Og 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....... 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 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors I] Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding [O] Other[8F Brief Description of Proposed Work: PU r CP G f �v�Sin A� �f rN� b f 1✓aR Qf--,'e4 L f D 2 Alteration of existing bedroom Yes A�— _No Adding new bedroom Yes "C No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 8a. if New house and or addition to existing housina, 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, R a C-he I W Y So fte r as Owner of the subject property p hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. gee Signature of Owner �^ Date l VVN�C VA q �,A Jf-e_r 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. 1(\n(L1n Print Name Signature of Owner/Agent �^ Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage _. Setbacks Front ! } 1 Side L:r R:i } U 4 R:I Rear Building Height l 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 © DON'T KNOW Cj� YES IF YES, date issued:; _ I IF YES: Was the permit recorded at the Registry of Deeds? NO © DON'T KNOW Q YES O IF YES: enter Book ! Pagel 1 and/or Document# B. Does the site contain a brook, body of water or wetlands? NO © DON'T KNOW .(a—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 eF 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: 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 © NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status'of Permit: uilding Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability 0 `LW Room 100 Water/Well Availability No hampton, MA 01060 Two Sets of Structural Plans 87-1240 Fax 413-587-1272 Plot/Site Plans tubing&MA p1060 tytectriao tndr p 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 95-t-\ St, Map Lot Unit Noc-i (r\qy�,�P�y� � ff\AOt bl oho p Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: cache( WysolCQr 5N �111t'Sr�-, Sf, No�-�+jQw2Ettm,M.6 Name(Print) Current Mailing Address: �C1� y, 3- (� 9!-:i- S e e PtA-�k 0f 1 Z fiCAC)' EjCr\ Telephone Signature 2.2 Authorized Aaent: vv\'�c.V,ae t S'4 t'ec- i s 1\ We sf Sf. W,NgfRe di V A al oe Name(Print) Current Mailing Address: `l 13- 7 7 2 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 3 0 (a) Building Permit Fee i 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total= 0 +2+3+4+5) , (o Check Number This Section For Official Use Only Building ermit Number: Date g Issued: Signature: Building Commissioner/Inspector of Buildings Date File# BP-2015-0284 APPLICANT/CONTACT PERSON CO-OP POWER INC ADDRESS/PHONE 15A WEST ST WEST HATFIELD (413)772-8898 Q PROPERTY LOCATION 54 ALLISON ST MAP 18C PARCEL 115 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: INSTALL ATTIC INSULATION,AIR SEALING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 107864 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOR�I'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 em Delay Sign re o Bu ding fficial D to 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. 54 ALLISON ST BP-2015-0284 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C- 115 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2015-0284 Project# JS-2015-000544 Est.Cost: $3680.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CO-OP POWER INC 107864 Lot Size(sq. ft.): 42209.64 Owner: WYSOKER RACHEL WYSOKER REALTY TRUST Zoning: URB(100)/ Applicant: CO-OP POWER INC AT. 54 ALLISON ST Applicant Address: Phone: Insurance: 15A WEST ST (413) 772-8898 O WC WEST HATFIELDMA01088 ISSUED ON.911512014 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL ATTIC INSULATION, AIR SEALING 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 9/15/2014 0:00:00 $55.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner