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28-049 (2) THE COMMONWEALTH OF MASSACHUSETTS For DPS Use Only. Department of Public Safety Board of Building Regulations and Standards Registration No: u : r One Ashburton Place,Room 1301 Boston,MA 02108 Effective Date: Application for Registration as a Home Improvement Contractor or Sub-Contractor Expiration Date: S�v (MGL c. 142A;780 CMR 110R6) 1. LEGAL NAME OF APPLICANT: e.P'4 r (MUST BE EITHER AN INDIVIDUAL,CORPORATIO ,LLC,LLP,TRUST,OR OTHER LEGALLY FORMED ENTITY) 2. APPLICANT TYPE: AINDIVIDUAL _ CORPORATION _LLC_PARTNERSHIP _LLP _TRUST (CHECK ONE-MUST BE SAME AS IDENTIFIED IN#1) 3. IF APPLICANT IS DOING BUSINESS UNDER ANY NAME OTHER THAN THAT LISTED IN#1 ABOVE,PLEASE IDENTIFY THE NAME(DBA): (SEE INSTRUCTIONS REGARDING THE ENCLOSURE OF A CITY OR TOWN REGISTRATION CERTIFICATE IF DBA IS LISTED) 4. MAILING ADDRESS: 210, (30X A(6 AI®/'JLl//U�'J/d/ �. a�©� 5 STREET / CITY STATE ZIP �f 5. PERMANENT ADDRESS: �j / ��fNGl� ,,t�/ �/��'lc �'✓ j� ' (IF DIFFERENT FROM#4) STREET CITY STATE ZIP (PLEASE NOTE THAT A P.O.BOX IS NOT ACCEPTABLE FOR PERMANENT ADDRESS) 6. APPLICANT PHONE#: ��3 023 -S'30517 APPLICANT EMAIL ADDRESS: 7. SOCIAL SECURITY#OR FEDERAL TAX I.D.OF APPLICANT LISTED IN#1 ABOVE: �/ '4500�2 146 7 7 8. NUMBER OF EMPLOYEES: O 9. A) HAVE YOU REGISTERED PREVIOUSLY UNDER THIS LAW? AYES _NO B) IF YES,PLEASE PROVIDE THE NAME AND REGISTRATION NUMBER UNDER WHICH YOU WERE PREVIOUSLY REGISTERED: / � NAME: COl' t Z. "g-lV!// HIC REGISTRATION#: 10. A)ARE YOU CURRENTLY OR HAVE YOU EVER BEEN AN OFFICER,PARTNER,OR CO-VENTURER OF AN APPLICANT WHO PREVIOUSLY APPLIED FOR OR HELD A REGISTRATION UNDER THIS LAW(G.L..C. 142A)? _YES -XNo B) IF YES,PLEASE PROVIDE THE NAME OF THE APPLICANT AND NAME OF THE BUSINESS(IF DIFFERENT)AND REGISTRATION NUMBER: NAME: HIC REGISTRATION#: 11. A)ARE YOU CURRENTLY OR HAVE YOU PREVIOUSLY BEEN EMPLOYED BY A REGISTRANT OR APPLICANT FOR REGIST ATION AGAINST WHICH DISCIPLINARY ACTION WAS TAKEN BY THIS DEPARTMENT? _YES TNO B) IF YES,PLEASE PROVIDE THE NAME OF THE INDIVIDUAL AND BUSINESS(IF DIFFERENT)AND REGISTRATION NUMBER: NAME: - HIC REGISTRATION#: 12. A3 HAVE THERE EVER BEEN ANY COURT JUDGEMENTS OR ARBITRATION AWARDS ISSUED AGAINST YOU? _YES X No B) DO YOU OWEIMONEY TO THE GUARANTY FUND? _YES No C) IF YES TO EITHER,PLEASE IDENTIFY BY DATE,CASE NUMBER,OR DOCKET NUMBER: 13. PLEASE PROVIDE THE NAME,SOCIAL SECURITY#AND TITLE OF THE INDIVIDUAL IN THE CURRENT BUSINESS THAT IS RESPONSIBLE FOR THE OVERSIGHT OF HOME IMPROVEMENT CONTRACTS: LAST FIRST SOCIAL SECURITY# TITLE 14. A) DOES THE APPLICANT OR RESPONSIBLE INDIVIDUAL HOLD ANY OTHER CONSTRUCTION-RELATED STATE, CITY OR TOWN LICENSES OR REGISTRATIONS? YES NO l B) IF YES,PLEASE FILL IN INFORMATION BELOW. ATTACH ADDITIONAL SHEETS IF NECESSARY. LICENSE TYPE ISSUED BY LICENSE/REG.# EXP.DATE LICENSEE_NAME s el, ter, 15. LIST ALL PARTNERS,TRUSTEES,OFFICERS,DIRECTORS,AND MAJOR OWNERS(10%OR GREATER OF OWNERSHIP)OF AN APPLICANT PARTNERSHIP OR CORPORATION,BELOW. USE ADDITIONAL PAPER IF NECESSARY AND INCLUDE NEEDED PAPERWORK(SEE INSTRUCTIONS). PLEASE INDICATE BY AN "X"IN THE LAST COLUMN THOSE INDIVIDUALS WHO REQUIRE AN APPLICATION FOR ADDITIONAL REGISTRATION I.D. CARDS. USE ADDITIONAL SHEETS IF NECESSARY. FULL NAME TITLE %OWNER ADDRESS 16. IS THE APPLICANT CLAIMING AN EXEMPTION FROM THE REGISTRATION FEE AS A CSL HOLDER? X YES _ NO r 17. REGISTRATION FEE ENCLOSED: $ �>C GUARANTY FUND FEE ENCLOSED: T /du+ 0o PLEASE INCLUDE TWO(2)SEPARATE CERTIFIED CHECKS OR MONEY ORDERS,ONE MARKED "REGISTRATION FEE" AND ONE MARKED "GUARANTY FUND." MAKE CHECKS PAYABLE TO "COMMONWEALTH OF MASSACHUSETTS." PERSONAL/BUSINESS CHECKS WILL BE PROCESSED BUT WILL TAKE AN ADDITIONAL TEN (10)DAYS. 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VuIIIV u111I111'II' - - : _ IIIilIllll11111111111 1IIIV1I1�1I11I11111111IIIIII�1 t. I'11111i ° ADDRESS I11ill Ij '11111111'°i ni 1111 I ,��Illllll�ll 111 �II1U11I�'111'I II = - _ d II 1111„ I IIIIII 11 _-,111111.1 11.11111. I III - 1 Ilou 111111 IL 1��1'111 Ii ILIU' II III11h o1 ,:I 4 1. i I „11 I1II iI61II - - - - - .:I II 111 II II: ,.IJIIII I I PJ II IIII11pI°,11 - t; 'II�111�11I1,,:-1111'111111 IIIVIIr iII14VII�IIlIIIIII 1IIIIIII1111�h1II1111111II11 ��� __ _ - - IpdV1:IIlII BIIIlI11lI0Iltl111111111II1JII,IIWI JIuuIIP� ! iLiIL11111111� �"� - - ii' i 5 i 180114 1: 2 1113 ? i 6881: 19800 56 ? 5911' 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, express 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 local 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 i 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)along with their c_ertificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP)with no employees other than 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 confrnnation 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 have 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/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) 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 applicant as proof that 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 pernzit to burn 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-NIASSAFE Fax_#__6.17-_72..7-7749 Revised 4-24-07 www.mass.govfdia The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street h^ -�- � * ' Boston, MA 02111 H 4 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): %� Y°ir`r�l ��4i��-7�p "J _ Address: City/State/Zip: o/ `f .n 7� Phone #: -V/ ` _3 Are you an employer? Check the appropriate box: Type of project (required): I.M I am a employer with 4. M I am a general contractor and I 6. .F71 INew construction employees (full and/or part-time).* have hired the sub-contractors 2.A am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. M Demolition working for me in any capacity. employees and have workers' 9 M Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. M We are a corporation and its 10.0 Electrical repairs or additions 3.F-1 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions right of exemption per MGL myself. [No workers comp. 12.M Roof repairs insurance required.] T c. 152, §1(4), and we have no employees. [No workers' 13.M 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 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 the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: 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 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 certify un er the pains tyioenalties of perjury that the information provided above is true and correct. Sim-iature: Date: Phone #: �� 3 ' c � '�� Official use only. Do not write in this area, to be completed by city or town official Citv 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#: r i I r� A00l 14 I C,t Alo 10 6 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: j Not Applicable ❑ Name of License Holder: �L G 14 r GL h d r y r License Number Address Expiration Date . Ajiu-4 J,I C) l ` �L ' 'S"3 CS 11 cx -A L1-oZ Of 0 Signature Telep e --9.Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number T Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MG.L.c. 162,§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-vear 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 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[!T-- Siding [17-1] Other[0] Brief Descripf n'Of Proposed Work: X42 V Alteration of existing bedroom Yes No Adding new bedroom Yes '` No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa 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, A % ' til(Do %e� as Owner of the subject property \ hereby authorize l�t' -.J'A'\ L..-N N"o to act my behalf, in all matters rela ive to work authorized by this building permit application. 10 I tI.1 0 Signature 0whK Date f as Owner/Authorized Agent he eby declare that the statements and information n the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. �Q Prin ame 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 r� _ ...._,. ... . _ . ., �..... Frontage Apt. /50 _. Setbacks Front j Jl Side L: .. .' R: L: .. R fS Rear ' .: 3 Building Height Bldg.Square Footage Open Space Footage % (Lot area minus bldg&paved _ U parking) #of Parking Spaces -M- Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 0 YES 0 IF YES, date issued:. IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q 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 0 YES 0 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 Q 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. Department use'only City of Northampton Status of Permit: Building Department Curb Cut/Driyeway.Permit �r 1, 212 Main Street sewer/seprc 'voila� y Room 100 WaterNV4Availability R Northampton, MA 01060 Two Sets of Structural Plans 7 PRA 413"-587.-1240 Fax 413-587-1272 Pf6t/5fte Pfans Other Specify APPLICATION TO�Qa+ISTRU J4 ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SETiON 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office o ,A , A4-y 1 k__A r3 Map Lot Unit N C V-w1%, d i 0(6- Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: -P,cc,�--5 -* 1-:Zt441RE (`�MAc)0 S A,fwL me(Print) Current Mailing Address: "�__ Telephone Si nature 2.2 Authorized Agent: Name(Print) Current Mailing Address: -IF/3 a- Signature Telephone SECTION 3-ESTIMATED CONSTRUCTI COSTS Item Estimated Cost(Dollars)to be Official Use Only completed 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 This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2009-0429 , APPLICANT/CONTACT PERSON GERARD P LANDRY ADDRESS/PHONE P O BOX 146 WORTHINGTON (413)238-5308 PROPERTY LOCATION 94 CAHILLANE TERR MAP 28 PARCEL 049 001 ZONE SR(100)//WSP 11 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: CONSTRUCT 6 X 20 REAR DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 38629 3 sets of Plans/Plot Plan THE Fq LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN O //. ATION 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 Commission Permit DPW Storm Water Management Demolition Delay f 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. . BP-2009-0429 GIs#: COMMONWEALTH OF MASSACHUSETTS 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-2009-0429 Project# JS-2009-000583 Est.Cost: $6700.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GERARD P LANDRY 38629 Lot Size(sq. ft.): 16247.88 Owner: MAHONEY JAMES&ELIZABETH Zoning: SR(100)//WSP II Applicant: GERARD P LANDRY AT. 94 CAHILLANE TERR Applicant Address: Phone: Insurance: P O BOX 146 (413) 238-5308 WORTH INGTONMA01098 ISSUED ON:1012712008 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 6 X 20 REAR DECK 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 10/27/2008 0:00:00 $55.002693 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo BP-2009-0429 94 CAHILLANE TERR COMMONWEALTH OF MASSACHUSETTS GIs A CITY OF NORTHAMPTON l May:Bock: 28-049 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Lot: Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2009-0429 Project# JS-2009-000583 Est. Cost: $6700.00 Fee: $ s.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GERARD P LANDRY 38629 Lot Size(sq. ft.): 16247.88 Owner: MAHONEY JAMES&ELIZABETH Zoning: SR(100)//WSP II Applicant GERARD P LANDRY AT. 94 CAHILLANE TERR Applicant Address: Phone: Insurance: P O BOX 146 (413) 238-5308 WORTH INGTONMA01098 ISSUED ON:1012712008 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 6 X 20 REAR DECK 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: Z-1 Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final:0 K f /-,6'-©L<� THIS PERMIT MAY BE REVOKED BY THE ITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULA IONS. �1�%'� Si natCertificate of Occu anc _ Feel e: Date Paid, Building 10/27/2008 0:00:00 $55.002693 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo