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29-104 (9) City of Northampton Mail-Building Permit Architect Signature Page https://mail.google.com/mail/u/0/?ui=2&ik=39211afc3d&view=pt&se... City of• ' NdyfturWhn Charles Miller<cmiller @northamptonma.gov> Building Permit Architect Signature Page 1 message R H ROOFING, LLP <rhroofing @earthlink.net> Fri, Jun 19, 2015 at 12:22 PM Reply-To: "R & H ROOFING, LLP" <rhroofing @earthlink.net> To: cmiller @northamptonma.gov Hello Chuck, Attached please find the page with the architect signature for both the RK Finn & Leeds School permit applications. Also for RK Finn is a base layer of 4"and adding 1" plus a 1/2" coverboard for a total R-Value of 31.8. Leeds school is a base layer of 3" and adding 2" plus 112" coverbaord for a total R-Value of 31.3. If you have any questions please feel free to contact me. Thanks and have a great day. Tim Hopkins Partner R & H ROOFING, LLP 59 South Street Easthampton, MA 01027 (413) 527-9378 - PH (413) 527-8244 - FX www.rhroofing.org Northampton Permit Form-Signed by GR 2015-06-19.pdf 1030K 1 of 1 6/22/2015 10:04 AM --� R&HROOF-01 DMELLO FDA TE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 511 x2015 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 CONTACT NAME: HUB International NE LLC formerly FieldEddy PHONE 4 733-3 13 131 FAX No): 413)538-6010 79 Lyman Street A/C.No,E><U_t ) _.,..,,...__ South Hadley,MA 01076 ADDARESS: — •- ----- INSURER($)AFFORDING COVERAGE — - — -_ NAIC q INSURER A:Admiral Insurance Company 24856 _._............ ._ INSURED INSURER 8:safety Indent 33618 ..___—__..__._._.........._-_ R&H Roofing,LLP INSURER C:National Union Fire Insurance Co of Pittsburgh,P Henry Hopkins 59 South St. INSURERD:A.IX Mutual Insurance Co 33758 Easthampton,MA 01027 _INSURER E__ INSURER F: COVERAGES CERTIFICATE NUMBER: 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 POLICY NUMBER MMlDDNYYY (MM DDYYYy LIMITS LTR A X COMMERCIAL GENERAL LIA131LITY EACH OCCURRENCE $ 1,000,00 CLAtMS-MADE X occuR X CA000021599 05!2612015 05126I2016 PREMISES SES„(Ea occurrence) $ 300,00 MED EXP(Any one person) $ 6,00 PERSONAL&ADV INJURY $ 1,000,00 ..........--.--................-------------------.- ........,......_...-_...._..-..__----------- _..-_._.._.... GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 _ POLICY[7]PRO- I �JECT I J LOC PR^OD----UCTS_COMPlOP AGG $ 2,000,00 OTHER: '• --- $ - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 _ B ANY AUTO 2433476 08/26/2014 08/2612016 BODILY INJURY(Per person) $ ALL OWNED --- SCHEDULED -.--..._......- AUTOS ,...-,,.. AUTOS BODILY INJURY(Pox accident) $ )( X NON-OWNED PROPCRTY'DAMAGE HIRED AUTOS AUTOS UMBRELLA LIAR T� OCCUR EACH OCCURRENCE $ 5,000,00 C EXCESS UAe IMS-MADE X BE062829193 08/05/2014 08/05/2015 AGGREGATE $ DI RETENTION$ General Agg $ 6,000,00 WORKERS COMPENSATION PER H- AND EMPLOYERS'LIABILITY X STATUTE X ER ---------- ----- D ANY PROPRIETORIPARTNER/EXECUTIVE YIN AWC7017424 10/24/2014 10/24/2015 E,L.EACI4 ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? FNT] NIA ........................_...._._....._____--__.._....-..._-..__.....___._____._.___-..__•..... (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) The City of Northampton Is named as additional Insured in regard to liability, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCOggp Je'TH T POL Y PRO SIO S, 240 Main Street i-1Uk€�n[ernalOrla eW ng end, LLC Northampton,MA 01060 AUTHORIZED REPRESE ATIVF By: �3nzP`7__-..— w or ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD City of Northampton, Massachusetts Central Services Memorial Hall,240 Main Street Northampton, MA 01060 David Pomerantz (413)587-1238 Fax: (413)587-1248 Director of Central Services June 5, 2015 Lawrence Derosier R & H Roofing, LLP 59 South Street, Easthampton, MA 01027 RE: Roofmg Projects- R.K. Finn Ryan Road School & Leeds Elementary School Larry: Attached please find a signed and executed copy of the contract between the City of Northampton and R& H Roofing, LLP for the above projects. Return of the signed contract to you will serve as a Notice to Proceed. I know that STV, Inc., the OPM firm working for MSBA on this project, wants to set up a pre-construction meeting as soon as possible. Please proceed with the submittal process. Thank you. t rely, Pome tz for of C rural Services t Massachusetts -Department o. Puoiic Saf°t`` Board of Building Regulations and Standards Construction Super-isor License: C6442781 HENRY E HOPIMS 59 SOUTH ST - - BASTHAMPT014MA 01027 r /y 0 Commissioner 06/02f2016 =� -= Office of Consumer Affairs and Business Regulation - 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 105948 Type: Partnership Expiration: 7/21/2016 Tr# 253091 R & H ROOFING Henry Hopkins ---- ---- -- - 59 SOUTH STREET - - - - Easthampton, MA 01027 -- - -- Update Address and return card.Mark reason for change. Address Renewal r Employment Lost Card SCA 1 ca 20M-05111 Consumer rains& u ss ulatii�.�ell License or registration valid for individul use only Office of Consumer Affairs&Busihess Regulation g y OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 105948 Type: Office of Consumer Affairs and Business Regulation expiration: 7121/2016 Partnership 10 Park Plaza-Suite 5170 Boston MA 02116 R&H ROOFING Henry Hopkins �y 59 SOUTH STREET , Easthampton, MA 01027 Undersecretary Not jallid without signature The Commonwealth of Massachusetts Department oflndustrialAccidents w Office of Investigations w d 1 Congress Street, Suite 100 Boston, MA 02114-2017 5� www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): R & H ROOFING, LLP Address:59 SOUTH STREET City/State/Zip: EASTHAMPTON, MA 01027 Phone #:413-527-9378 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 20 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. F1 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 g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ 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 NEW ROOF employees. [No workers' 13.0 Other 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 the policy and job site information. Insurance Company Name:AIM MUTAL INSURANCE COMPANY Policy# or Self-ins. Lic. #:AWC7017424012014 Expiration Date: 10/24/15 Job Site Address: 498 RYAN ROAD City/State/Zip: FLROENCE, MA 01062 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 cer fy under t e pa' s and penalties of perjury that the information provided above is true and correct. 6/15/15 Si nature: �— Date: Phone#: 41352 9378 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#: Versionl.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes No 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 act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date HENRY HOPKINS __ , 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-arid penalties of perjury. _ iHENRY HOPKINS Print Nam m Signatu a of Own /Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder 'HENRY HOPKINS ACS 042781 License Number 59 SOUTH STREET, EASTHAMPTON,MA 01027 06/02/2016 Addres s Expiration Date � -- (413) 527-9378 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 G) No 0 Versionl.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: RAYMOND DESIGN ASSOCIATES, INC. Not Applicable . . .�...._.. _ ... _. .. ._ ._ _ 8182 Name(Registrant): _ R" 'RAYMOND DESIGN ASSOCIATES, INC. Registration Number Address _ (781)421-3480 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 R & H ROOFING, LLP Not Applicable ❑ Company Name: HENRY HOPKINS Responsible In Charge of Construction 59 SOUTH STREET,EASTHAMPTON, MA 01027 Address (413) 527-9378 SignatLVe Telephone pr. Versionl.7 Commercial Building Permit May 15,2000 ,N 9•PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO STRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE) Registered Architect: jR OND DESIGN ASSOCIATES,INC. — Not Applicable ❑ _ X8182 ! Name(Registrant): RAYMOND DESIGN ASSOCIATES, Registration Number Address l� _INC.. '*'t-0:23 r x(781)421-3480 Expiration bate Sign a 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 tt Registration Number Signature Telephone Expiration Date 9.3 General Contractor IR&H ROOFING,LLP J 4 Not Applicable❑ Company Name: ;HENRY HOPKINS Responsible In Charge of Construction 59 SOUTH STREET,EASTHAMPTON,MA 01027 _ Address (413)527-93781 Signat Telephone Version 1.7 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:1 L: R:; a Rear Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paved arkin # of Parking Spaces Fill: volume&Location Has a Special Permit/Variance/Findin A. a p g ever been issued for/on the site? NO Q DON'T KNOW Q YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW 0 YES IF YES: enter Book ! Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO Q 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 Q NO 0 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❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing El Change of Use❑ Other ❑ Brief Description REMOVE EXISTING EPDM, INSTALL V INSULATION, INSTALL 1/2" COVERBOARD Of Proposed Work: �& INSTALL 090 EPDM ROOF SYSTEM SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 213 I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 36 ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 513 ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: i COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: 11 Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): i SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(sf) 15t 1st 2nd 2nd i 3 rd 3rd tn 4th , 4 Total Area(sf) 1 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 ❑ Private ❑ Zone Outside Flood Zone[-] Municipal ❑ On site disposal system[] Versionl.7 Commercial Building Permit May 15,2000 D�pa1I►�tent use tl�tly City of Northampton 01WIM51 of PPf fill t g Department 0►�rkr�t�lruewa Prfnit Main Street ia "" 1Q ## bliir � , l ( i iii iul wl pli 17i S r rµy+� i�ili lyil IiI riMi+ dl .l(jN 1 Dom 100 1�atr�e ' rabil�y" uwHwul+u' ��'ih II i 8 2015 N pton, MA 01060 Electric, P;u,,,�_ one 41 -1240 Fax 413-587-1272 pitst!$Itlai n") lu" = s ,x ' NcrtharnPic I1;spECt i APPLICATION TO CONS PAIR, RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 498 RYAN ROAD, FLORENCE, MA 01062 Map` Lot` Unit Zone, Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: Signature Telephone 2.2 Authorized Agent: R & H ROOFING, LLP 59 SOUTH STREET, EASTHAMPTON, MA 0 Name(Print) Current Mailing Address: (413) 527-9378 Signature G Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building $441,510.00; (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of $22,210.00'sss Construction from 6 3. Plumbing $15,000.00, Building Permit Fee 4. Mechanical(HVAC) a 5. Fire Protection $22,800.00 6. Total=(1 +2+3+4+5) C1 0 1 Check Number his Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-1323 APPLICANT/CONTACT PERSON R&H ROOFING ADDRESS/PHONE 59 SOUTH ST EASTHAMPTON01027(413)527-9378 PROPERTY LOCATION 498 RYAN RD-RYAN ROAD SCHOOL MAP 29 PARCEL 104 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid lypeof Construction: INSTALL NEW EPDM ROOF SYSTEM awaa New Construction �i" / Non Structural interior renovations K i o t e -b Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 042781 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFfdRMATION 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 4a2rBuildrh1f ' n Delay re of fficial 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. 498 RYAN RD-RYAN ROAD SCHOOL BP-2015-1323 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29- 104 CITY OF NORTHAMPTON Lot:-00 L PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2015-1323 Project# JS-2015-002416 Est.Cost: $501520.00 Fee: $0.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: R & H ROOFING 042781 Lot Size(sq.ft.): 794534.40 Owner: NORTHAMPTON CITY OF RYAN ROAD SCHOOL Zonin : Applicant. R & H ROOFING AT. 498 RYAN RD - RYAN ROAD SCHOOL Applicant Address: Phone: Insurance: 59 SOUTH ST (413) 527-9378 Workers Compensation EASTHAMPTONMA01027 ISSUED ON:612212015 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL NEW EPDM ROOF SYSTEM AND 1" INSULATION OVER EXISTING 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: FeeTvpe• Date Paid: Amount: Building 6/22/2015 0:00:00 $0.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner