Loading...
23D-011 (6) tnC Massachusetts iDepartment of Puipiic Safety Board of Building Regulations anti Standards (onctructitm Supervisor Spccuilh t :tense CSSL-099931 KEITH W DEVIN 3134 MOUNTAIN ROAP WEST SUFFIELD CT k �:,e�rniss�oner 01/09/2016 aUG-7-2014 07:20 FROMtWILLIAM J MIS INSUfRA 4135729191 T0:14133920241 P.5/9 1 CERTIFICATE OF LIABiLITY INSURANCE nATww*°°w") 100/01/2014 THIS CI!!RTN%ATG is IiiYED A!A A NATTIER Qf 4NFORNtATlQN oNt.Y a a0wittts NO RUM UPOM Y'Mi« CO"ItATt4 R Gg"FICATE OMS NOT AWW WATIM LY OR M4 nWLY AM�Na allo OR ALTEII THE COtERAGR A'10RM BY THE POWU 515LOW. YMIO CLIMPICATtt OF NMRANC[ DOES NOT CONSTITUTE A CONTRACT BITW UN THI Is tM* IN=UREft AUTMORIZRO PRPgiSlNTAT7WE OR PROW"A AND TNT CEK"W.ATE 4"04R. an 7wTw%Aj. IN ay(w) must M W the w+ne eed sandidma of the POIRry. esRatn p0sim mey ►e an an of A satnn.nt on UIRr esAMeats TIM not aft"W ryhts 10 the esrb4cits hMw In Wo of ewh andctaeewt(s). j Pwjmx 1R p WILLIAM MTS WILLIAM ,? HIS INOURAN= AmnrCY -513-56E-6111 Iwel,ag�13-b72-91D1 156 um afi DIx,LIDILii(I82NBU1tA .CCa _ 19989'FT.YIm, KA 01085 ItliINlWlil AP'MPIIwCOYrRAQe MAID e ulr�I. �►rAVi.I.e ra�R! oa . __ S71MI00 LLC DBA - 4 VISTA Hma IMPRC7mm a 2003 RIVLEmus STmzT - WZST OPRSI4(WXZLD WA CLOOP r; COVSRAGPS lammICATE N)MBITA: REVicloN NLR wft: 7419 to TO-CiATry 5 OF IN u I YM THC POUCY PcAlco INVIt;ATFD NOrMTHSTANDM ANY RRQUIREMEMT, TPM OR CONDRION OF CONTRACT OR OTHER OOCUMQNT WITH RESPECT T4 *C" TK6 sum ,CCRTFICATE MAY N i$&L*D OR MAY PRRT,uN, lHk IN5URANC; AFFORDED r THE POUGIES DESOR ISEO MEAERN N SLGJECT TO ALL THE TVWS, �pF.XCLUSIONS AND CONOMIM Of&JCw POUMS.LIIMTS CROWN MAY NAVG APPN AAOUC OY PAW CLAb4 T"R G WOURAWi Y ! POI.Cy NUNIM plyippaOyY'/ e�UAIU" �AC,�oOCURRaNa i 2,000,000 A eow�reecuL nLLIAiRrry a6/aV203 00/03./203161 „ � i 1,00,000 dIAW"aoa OCCUR i ( ueD 1*ww.ne Foal,► i 3,000 i ! rnao►wL.�,rn.auURe► is 2,000,000 a�+F><ALAOenwya i 2,000,000 wtiAOOReeAtr wr�.PUee raR� PnoOUtTa•CoLroP.Lee + Z,000,000 POUOY ..M I,00 ' ••w A1yy000OU UMIRM NW AvTQ f OOOAy NJURy @yt PM�OM i pNy Niy PW iNd i AVTOI AUra4 i i rnmoAuTOe Autos ( ! or aswagall i woNCUALVA Oecun eAa+0=uft"YA 't {� •W. curn�rlADe AD 1141GATO t AND SwLOYM L0 1M VENT 0"l0 Rf yo Q NIA ! GL EACrI ACCOST 1 ow(..ww r N wl I.l OWrAK-eA IPdPLOyfR f �iGRIPy�OPCRATiOHS bwor '•.E L Oiabi!•POUCy l#MIC t I 1 of AWT`*NOPOPWAVIaM/uxATMIGiYPOOLtliIMniACOROTM.Aewm.iNamem ftWON,e word 400M CHRT)/ICATE MOLDER NCELLAT*04 TOMM OT NEST SPRi1 rZt%D ISM► 1 $MOULD ANY OP M ASOVI D11*10 D POUCH! 1,R CAKIRU d •VORt a UPIRATION DATA TNRRROP, NOTICII V^L M Dl MMO IN kfiANCt NTH Tilt Pouty PRO"16%* NoNRrn A 1 TION. AS slplltt tlMdtvStl. ACORD to f2OiW%i The ACCAD mom am woo are 7lK4rRd of ACORD - Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 162058 Type: LLC Expiration: 1/12/2017 Tr# 262537 SAMBRICO LLC dba VISTA HOME IMPROV BRIAN RUDD 2003 RIVERDALE ST WEST SPRINGFIELD, MA 01089 Update Address and return card.Mark reason for change. scA t5 zoM-osin Address Renewal Employment Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ki ... ." egistration: 162058 Type: Office of Consumer Affairs and Business Regulation xpiration: 1/12/2017 LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 SAMBRICO LLC dba VISTA HOME IMPROVEMENT BRIAN RUDD 2003 RIVERDALE ST WEST SPRINGFIELD,MA 01089 XalidUndersecretary hout signature rESTATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION Be it known that SAMBRICO LLC I 2003 RIVERDALE ST e W SPRINGFIELD, MA 01089-1060 I I i is certified by the Department of Consumer Protection as a registered HOME IMPROVEMENT CONTRACTOR Registration # HIC.0621848 I ® VISTA HOME IMPROVEMENT ! e I Effective: 12/01/2014 Expiration: 11/30/2015 William M.Rubenstein,Commissioner I' CERTIFICATE OF LIABILITY INSURANCE (M YYY1 121131161201- TW&GEftTIFICATE 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 IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endomemen s. PRODUCER CONTACT NAME: SOUTHWICK INS AGENCY INC PHONE FAX PO BOX 100 (A/C,No,Ext): (AIC,No): E-MAIL SOUTHWICK,MA 01077 ADDRESS: 28TKC INSURER(S)AFFORDING COVERAGE NAIL S INSURED INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA SAMBRICO LLC DBA VISTA HOME IMPROVEMENT INSURER B: INSURER C: INSURER D: 2003 RIVERDALE ST INSURER E: WEST SPRINGFIELD,MA 01089 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 ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MWODIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY [AMAGE OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. IS TO RENTED $ IS ES(Ee occurrence) EXP(Any one person) $ ONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: RAL AGGREGATE S POLICY []PROJECT LOC UCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X FNC STATUTORY OTHER EMPLOYER'S LIABILITY YIN LIB-2072183-15 03/12/2015 03/12/2016 IMITS ANY PROPERITOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT - $ 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF WEST SPRINGFIELD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 26 CENTRAL STREET SUITE 4 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. W.SPRINGFIELD,MA 01089 AUTHORIZED REPRESENT ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1888-2010 ACORD CORPORATION. All rights reserved. City of Northampton s Massachusetts 4 °¢ DEPARTIWNT OF BUILDING INSPECTIONS x, W„ 212 Main Street • Municipal Building rJy., ;b43 Northampton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s)who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footinqs (before backfill) sonotube holes (before pour) a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Y Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): s`] (` � &�e r Address: 9-065 �,1icascick� ' City/State/Zip: b7j Phone#: 0 -253C) -((q7 Are you an employer? Ch ck the appropriate box: Type of project(required): 1 a employer with �_� 4. 0 I am a general contractor and I 1111 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 These sub-contractors have ship and have no employees 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑ Building addition coin P• [No workers' comp. insurance 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 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. tHo 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. #: UZ "2E0_72,1 3-- I c Expiration Date: 3 M Job Site Address: t�y N©�� t� City/State/Zip: C 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 under the pains and penalties ofperjury that the information provided above is true and correct. Sig-nature: ---�-�--- _._.. Date: ? It I t Phone#: co 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#: r City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: r?0 I jo Qa CJ The debris will be transported by: 0� S The debris will be received by: Building permit number: Name of Permit Applicant Date Signature of Permit Applicant w SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: 1'1Q� �+�v ^ % (? 3I License u b 3 c`3�c'►IV1c;��-ti.-,J '(��� t��. �y.`mac\ �-� �fa�`� ��� ��� Address Expiration Date SM ,S30�i natu Telephone 9.Registered Home Improvement Contractor .._ _. „ _,. _ Not Applicable £ Company Name Registration Number C) c5s I by-1 I--I Address Expiration Date Telephone 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 Y .. .... £ No...... £ 11: - Hame 0 'er:EXemptio 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 [M Siding [❑] Other[❑] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a: fNew house and or'ad"dition to existing housing cornpfete the followitict: 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 as Owner of the subject property hereby authorize to act on behalf, in all matte s relative to work authorized by this building permit appUcation. Signs ure of Owner Date as Owner/Authorized Agent Here R e are that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed underthej2ains and penalties of perjury. ) - /- 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 I f ' 1 1 Frontage Setbacks Front Side L:= R:.��1 L:(�—__—_— R:= I Rear L__j Building Height Height 's 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 Q YES Q IF YES, date issued:! .._._,_.J IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES Q IF YES: enter Book _�r T Page and/or Document C i B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q 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 Q NO Q 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. + ty of Northampton hStatus,oi Permd, m4+ 51 � ' 4 ,% ,L,. AL 5 206 ilding Department ,curb Gut/1?riyewa+Ferrrll# f 12 Main Street SewerlSepticAaifabllrty " gib; g uns mdt Room 100 VVaterl�felG�uatla6ilit� Eiectnc.P' °_ North arrptor. ampton, MA 01060 TwolSfs of 5trttrirai Pia€rs T P ec hone 413-587-1240 Fax 413-587-1272 Plof/Sit rd-l' "t %o, .. rt M - a Other S i' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be;completed by office 1.1 Property Address: Map Lot Unit r Zone Overlay District C� (U Or')cj-Tx 1C inn. t District CB District . SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ay �ycxvc�l c�c S-E �t �'tic _ N Name(Print) Current M Ilipg Address: I 12S- , Z U Telephone Signature 2.2 Authorized nt: Nam (Print) Current Mailing Address: Ignature Telephone SECTION 3-ESTIMATED CONSTRUCTION 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) Z Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date 20 NONOTUCK ST BP-2016-0063 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D-011 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:ROOF BUILDING PERMIT Permit# BP-2016-0063 Project# JS-2016-000113 Est. Cost: $12967.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: VISTA HOME IMPROVEMENT 099931 Lot Sizes .ft. : 10585.08 Owner: ELDREDGE STEPHEN S&LAURIE F WOJTUSIK Zoning:URB(100)/ Applicant: VISTA HOME IMPROVEMENT AT. 20 NONOTUCK ST Applicant Address: Phone: Insurance: 2003 RIVERDALE ST (413) 382-0249 WC WEST SPRINGFIELDMA01089 ISSUED ON.711512015 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF 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: FeeTvne: Date Paid: Amount: Building 7/15/2015 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner