Loading...
12C-119 (4) z CS-091207 ',ELLLS 142 JAMS Ri? GELL MA 01354= _ .._r.r...�s._....,- IOIIW2016 Ofrree Of Consumer Affairs&Rusiness Regutanoa JIOME IMPROVEMENT CONTRACTOR z Registration: 146,402 Type: Expiration: 422/2017 Private Corporatioi IDEAL HOME IMPROVEMENT INC. JAMES ELLIS 142 SOYLE RD A GILL.MA 01354 Underserretary AC R CERTIFICATE OF LIABILITY INSURANCE DATE(MM DD YYVY) `,,.. 11/19/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DO ES N OT AF FIRMATIVELY 0 R N EGATIVELY AM END, E XTEND 0 R AL TER T HE C OVERAGE AF FORDED B Y T HE P OLICIES BELOW. THIS C ERTIFICATE 0 F I NSURANCE D DES N OT C ONSTITUTE A C ONTRACT B ETWEEN THE I SSUING I NSURER(S), A UTHORIZED 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 CON Rist A H Insurance NAME: Berkley Assigned Risk Services PO Box 391 AIC.No.E.1): 800 634-4589 (n/c.No.): 866 215-8118 t IL AoDRESS: PolicyServices@berkleyrisk.com Turners Falls,MA 01376 INSURERS AFFORDING COVERAGE NAIC# INSURER A: INSURED Ideal Home Improvement Inc INSURER B: INSURER C: 78 Eleventh Street INSURER D: INSURER E: Turners Falls MA 01354 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. LTR TYPE OF INSURANCE POLICY NUMBER I LIMITS INSR WVD MM/DDIYYYY MM/DD/YVYY GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ ❑ CLAIMS-MADE ❑ OCCUR 11 PREMISES Ea occurrence MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ G ENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMPIOP AGG $ PRO- POLICY JECT ❑ LOC $ AUTOMOBILE LIABILITY El El Ea accident $ ANY AUTO BODILY INJURY Per person) $ ALL OWNED F-1 SCHEDULED AUTOS AUTOS BODILY INJURY Peraccident $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ ❑ $ UMBRELLA LIAB ❑OCCUR ❑ ❑ EACH OCCURRENCE $ EXCESS LIAB 1:1 CLAIMS-MADE AGGREGATE $ DEC) ❑ RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN X TORY LIMITS ❑ ER ANY PROPRIETORIPARTNER/EXECUTIVE El EL EACH ACCIDENT $ 500000.00 A OFFICE/MEMBER EXCLUDED? NIA E] WC-20-20-004440-02 11/18/2014 11/18/2015 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000.00 El DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Election Category Election Status Name All Entities/Insureds: Officer Exclude James P Ellis Ideal Home Improvement Inc Ideal Home Improvement Inc CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Ideal Home Improvement,Inc. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 142 Boyle Road ACCORDANCE WITH THE POLICY PROVISIONS. Gill MA 01354 AUTHORIZED REPRESENTATIVE l ® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/19/2014 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 CONTACT Trace Kuklewicz NAME: Y A.H. Rist Insurance Agency, Inc. PHONE , (413)863-4373 FAC No• (413)863-9658 159 Avenue A E-MAIL ADD P.O. BOX 391 INSURERS AFFORDING COVERAGE NAIC# Turners Falls MA 01376 INSURER A:Nautilus Insurance Com an INSURED INSURER B:Commerce Insurance Company Ideal Home Improvement, Inc. INSURER C: 142 Boyle Road INSURER D: INSURER E: Gill MA 01354 INSURER F: COVERAGES CERTIFICATE NUMBER:Nov 14 liab 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 SUER POLICY NUMBER MM POLICY YYY POLICY DD/YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES $ a occurrence A CLAIMS-MADE OCCUR NN179788 11/19/201411/19/2015 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 Ea accident _ 000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED X SCHEDULED 12MMBBXL36 11/17/201411/17/2015 BODILY INJURY(Per accident) S AUTOS AUTOS - X X NON-OWNED PROPERTY DAMAGF. $ )TIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR F.ACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I RETENTION$ c WORKERS COMPENSATION WC STATU- 07fi- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A ---- (Mandatory in NH) E DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.I..DISEASE-POLICY LIMIT 1$ ` DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Classification: Insulation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ideal Home Improvement, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 142 Boyle Road Gill, MA 01354 AUTHORIZED REPRESENTATIVE C Tracey Kuklewicz/TJIC ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 •l• ' www.mass govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ,` D!' j�� Please Print Lezibly Name(Business/organizatiorAn-diividual): /,aK& &LAV= Address:— City/State/Zip: Phone-#:— L1/3-_ K-2a 3 a/ Are u an employer?Check the appropriate boa: Type of project(required): 1. I am a employer with (b� 4. (] I am a general contractor and 1 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have g. []Demolition working for me in any capacity. employees and have workers' 9 E]Building addition o workers'comp.insurance comp.insurance.t required.) S. [] We are a corporation and its I O_n Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their i 1.1--1 Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12TI R f 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#I 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. tContractors 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 i;the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: L:Z O O4 4'40 U Expirton Lam // L k k l 5 Job Site Address (J L City%State/Ziz: ,(,t 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 thepains andpenalties of perjury that the information provided above is true and correct. Signature: ^� Date: Phone#: I 3 3 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#: 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: q(P / /(_ �.�/,- , �b I t n C,_ The debris will be transported by: r ,[�(— The debris will be received by: a- Building permit number: Name of Permit Applicant oc��cs Q-- � ( S Date Signature of Permit Applicant City of Northampton -- • sus �� s`�'� Massachusetts W � P y ti DEPARDENT OF BUILDING INSPECTIONS yLL. 212 Main Street • Municipal Building Jtirp�' Northampton, MA 01060 Property Address: ► U F �'�! Y n Ck-- Contractor V-t— Name: C jaynkP L I t i S Address: rb Ut( (s i( City, State: �1 01'-� d 15 5'� Phone: Property Owner Name: Gl.I,, AI(, A, )gobInSG� Address: 9 LQ ift UL t_r City, State: E01 -C in CR (Kk, 01 QLd I, \,RPA e � PAM S (contractor) attest and affirm that the building I intend to insulate does not have any open air (knob and tube)wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. Contractor signature Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: CM 1 �J Cam'I S '71A 67 License Number I "d, i v��� �" i I ( I've C�i 3 �l i o°I(D-1 b Address , + Expiration Date LJ Signa re Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ 1 00—al 1–fckyu /M Company Name r— Registration Number Address pI, Expiration Date Telephone+4 W g 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 germit. 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"ce ifies an assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State an ocal oning 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 [O] Decks [Q Siding[0] her[ t1n(A .� Brief Description of Proposed. Work: al r'5 WJ Ina l-,o b f -f-b91r7 rl M (n is WOs-f a)V I n Cx_aAA3 .sPacc 'J f Alteration of existing bedroom Yes ✓fVo 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 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, (h(d (A al ,( io19,h SG n as Owner of the subject property 1J hereby authorize �Gv+ ' t,� k S to act on my behalf, in all matters relative to work authorized by this buildNX[J6-it application. JV_01� Signatu er Date YYM S S as Owner/n„tbQdzed 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. ame u,rn_L. X11 I S or gu"Z�� � :s dul ) Sig ture 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 Side L R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Find Bever been issued for/on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW ® YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 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: E. Will the construction activity disturb(clearing, grading, exc vation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only 287-1240 ty of Northampton Status of Permit ilding Department Curb Cut/Drivwmy Permit AUK 13 L06 212 Main Street SewertSepticAvailability Room 100 WaterNVell Avail2rbiliElectric. PIUr 'ir'C& — iw' hampton, MA 01060 Two Sets of Structural P1oE 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 Proper�tyy Address: This section to be completed by office �"I l.Q ►\l cx br. Map Lot Unit j 1 f 6 v-r)cl- rv\� Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 6 {� lr� �l (�C. [fir I--Ty t-e.n u Na a(P'nt Current Mailing Addressr Telephone Signatu 2.2 Authorized Actent: c�cu rvu I ? I S' I LloZ ►'yc�f lQ GL. . �1/ I'�'� Nam Current Mailing Add, ss: S' nature Telephone ECTION 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 TOO Total=0 +2+3+4+5) 7v© Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/inspector of Buildings Date File#BP-2016-0183 APPLICANT/CONTACT PERSON IDEAL HOME IMPROVEMENT INC ADDRESS/PHONE 142 BOYLE RD GILL01354(413)863-2128 PROPERTY LOCATION 96 RICK DR MAP 12C PARCEL 119 001 ZONE RI(100)/URA(100)/WSP(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 ZD Typeof Construction: INSTALL INSULATION New Construction Non Structural interior renovations Addition to Existing- Accessory Structure -- Building Plans Included• Owner/Statement or License 091207 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: proved 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 lit e 40 Si re of Building 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. 96 RICK DR BP-2016-0183 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 12C- 119 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-2016-0183 Project# JS-2016-000311 Est. Cost: $1700.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: IDEAL HOME IMPROVEMENT INC 091207 Lot Size(sq. ft.): 10846.44 Owner: ROBINSON ROBERT C&MARY LOU ROBINSON Zoning: RI(100)/URA(100)/WSP(l0o)/ Applicant: IDEAL HOME IMPROVEMENT INC AT. 96 RICK DR Applicant Address: Phone: Insurance: 142 BOYLE RD (413) 863-2128 WC GILLMA01354 ISSUED ON.811412015 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL INSULATION 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 8/14/2015 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner