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31A-049 (3) OWNER AUTHORIZATION FORM I, pwrie'$ ) owner of the property looked at (Property Address) "'A 0&:) M*: C � (Property Address) hereby authorize A M(ZX�c a n 1 n 5+at t Q�; o n c , (Suboontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. s Sib re Date i j 2615 ';, I i I Federal ID#054405626 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 A division of Thieisch Engineering CT Contractor Registration No620120 ;. 60 Shawmut#2,Canton,MA 02021 CONTRACT ,. 339-502-6335 r-7109 FAX 339-5024345 R I S E Page 2 PROGRAM THIS CONTRACT IS ENTERED INTO BEMEEN RISE ENGINEERING CMA-HES EN004ELMM AND THE CUSTOMER FOR VMK AS MCMDED BELOW CUSTOMER PHONE -DATE CLIENT f VMM ORDER Jeffrey Caplan (413)586-2378 08/10/2015 419139 00002 SERVICE STREET BR1N0 STREET 235 Crescent Street 235 Crescent Street SERVICE CITY.STATE.ZIP BILLING CITY,STATE,DP Northampton,MA 01060 Northampton,MA 01060 JOB DESCRIPTION Total: $3,273.00 Program Incentive: $2,732.25 Customer Total: $540.75 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF "Five Hundred Forty S 751100 Dollars $540.75 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE N FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY U PAID BAMANCE AFTER 30 DAYS.SEE FOR IMPORTANT INFORMATION ON GUARANTEES.RIGHTS OF RECISION,SCHEDIRLIO.AND CONTRACTOR RE.00TRATION. l>D NOT SIGN THIS CONTRACT IF THERE ARE ANY BI,ANit SPACES SKINATURE-RtSE qla ANCE NOTE:THIS CONTRACT MAY BE VATHDRAWN BY US F NOT EXECUTED WRHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT-THE ABOVE PRICES.SPECIFICATIONS AND CONDITIONS ARE 30 DAYS. SATISFACTORY TO US AND ME HEREBY ACCEPTED.YOU ARE AUTHORIZED TO 00 THE WORK AS SPECIFIED.PAYMENT WILL BE MME AS OUTLINED ABOVE i ' �I �' A!,'v' 1 1 2015 Federal ID*054MS626 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 A division of Thiclsch Eagincering CT Contractor Registration No620120 60 Shawmut#2,Canlon,.IA(12021 CONTRACT -� 339-502-035 X-7109 FAX 339-,502-6345 R I S E PROGRAM Page 1 THIS CONTRACT IS ENTERED INTO BETWEEN/USE ENGINEERING CMA-HES BELOW aalaroMeRroRwoacaS CUSTOMER .... .. PHONE DATE CLIENT WORK OrmER Jeffrey Caplan (413)586-2378 08/10/2015 419139 00002 SHMCE STREET _. SMJANO STREET 235 Crescent Street 235 Crescent Street SERVICE CTY,STATE,ZIP SPLUNO CRT,STATE ZUP Northampton,MA 01060 Northampton,MA 01060 JOB DESCRIPTION AIR SEALING:Provide labor and materiuls to seal areas of your home against wasteful,excess air leakage. "this work will be perforated in concert will,the use of special tools and diagnostic tests to assure that your home will be left with a healthful kwcl of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics,basements.attached garages and other unheated areas(windows are not generally addressed.) This will require(8)working hours.A reduction in cubic feet per minute(cfm)ofair infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the%%vathcri7ation work,and at no additional cost to the homco%Ticr.a final blower door and/or combustion safety analysis will be conducted by the sub-contractor to ensure the safety of the indoor air quality. 5680.00 AIR SEALING ADDER: (4)working hours. 5340.00 KNEEWALL SLOPE:Provide labor and materials to install 2"FSK faced semi-rigid fiberglass board insulation to(588)square feet ofknecwall rafter area. 52,058.00 BASEMENT CEILING:Provide labor and materials to install(60)linear fcet of R-19 unlaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. 5105.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will only be billed the Net amount. Cumntly, for eligible measures.Columbia Gas offers 75%incentive.not to exceed S2.000 per calcrTdar year,wid an incentive of 100%for the Air Scaling measures up to the first$680 and an additional 5340 if savings are justiticd by the auditor. For the safety and health of your home's indoor air quality.we will be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the weathericttion work is complete.We will also conduct a full assessment of the combustion safety of your heating system and water heater.This has it value of 590 and is at no cost to}ou. Total allowable weatherization incentive is S3.1 10. S90.0O 1 1 2015 j AUG � Massachusetts -Department of Public Safety Unrestricted-Buildings of any use group which Board of Building Regylations and Standards contain less than 35,000 cubic feet(991M)of i onstruc,on iui�ei-ri iir i'�'� C11VtVJGU space. License: CS406178 WESLEY COUTCiE 166 NORTH MAIN S IF South Hadley MAE 01 r Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. wli' Expiration Commissioner 0912912017 For DPS Licensing information visit: www.Mass.Gov/DPS �! - 1 Office of Consumer Affairs anti Bush ss Reg-lat;on 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 175982 Type: LLC Expiration: 6/27/2017 Tr# 265208 AMERICAN INSTALLATIONS, LLC. WESLEY COUTURE _ 130 COLLEGE STREET SUITE 100 --- SOUTH HADLEY, MA 01075 - -- Update Address and return card.Mark reason for change. 20M-05/11 SCA 7 :',: Address [--j Renewal F-] Employment Lost Card �'�l1f' lfaariH.clua('CF�fi/c�n/��rrJ.9n�rr rrlP�fi ter`--Office of Consumer Affairs&Business Regulation License or registration valid for individul use only (NOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 17ggg2 Type: Office of Consumer Affairs and Business Regulation l,. Expiration: 6127/2017 LLC 10 Park Plaza-Suite 5170 `- .•�. Boston,MA 02116 AMERICAN INSTALLATIONS,LLC.' r WESLEY COUTURE ---- 130 COLLEGE STREET SUITE 100 G, SOUTH HADLEY,MA 01075 Undersecretary N valid without signature ACORO® CERTIFICATE OF LIABILITY INSURANCE °�'�`�"I°°"'F'"' 11/26/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER171RCATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMA7IVELY 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 terns 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 endorsernen s. PRODUCER NRA T Denise Blais Metras Insurance Agency PHONE 413 536-1493. rAx N . (413) 532-8522 2030 Memorial Drive A)CRESS- dblais @metrasinsurance.com Chicopee, MA 01020 INSURERS)AFFORDING COVERAGE NAIC# _ INSURER A:Travelers Ins. Co. INSURED �---�-- -- --- -- INSURERB:Safety Insurance Agency American Installations LLC INSURERC:The Hartford 130 College Street INSURERD, Suite 100 I R6tE• South Hadley, MA 01075 INSURER F• COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICES 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 TYPEOFINSURANCE ADD POUCYNUMBER -w �AOOfYYYY ------ LINTS — A GENERALUA61LITY y 680OF862052 9/4/14 9/4/15 EACH OCCURRENCE s 1,000,000 X COIMIERCIALGEAERALLIABIUTY OAMAGETORENTED $ 300,000 CU1MMADE ❑X OCCUR WED Ed'(Any one person) $ 5,000 PERSON4L&ADVINJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'LAGGREGATELMITAPPLP-SPER PRODUCrs-COMPIOPAGG S 2,000,000 POLICY PRO- LOC $ B AtITOrr°BILEUABIU7Y bnT1301Q 10/22/14 10/22/15 COt��rtSINGLELMm S 1.000.000 ANYAUM ODDLY INJURY(Per person) $ ALLOWN-eD SCHEDULED AUTOS AUTOS e0D0.Y1NJURY{Poraccident) S NON-OWNED PROPERTY DAINIGE S HIREDAUTOS _AUTOS eraradera S UMBRELLA LIAS OCCUR EACH OCCURRENCE S EXCESS LUU9 CLAIMS-MROE AGGREGATE S DED RETENTION S C WORKERS COMPENSATION UB2E40118-0-14 9/4/14 9/4/15 g I WCSI'ADi OTH- AND EMPLOYERS'LIABILITY ANYPROPRIETORIPARTNERIEXECU IVE Y� NIA EL.EACHACCIDENT $ 00,000 OF FICERMEMBFR EXCLUDED? (Mandatory InNH) E.L.DISEASE-EA ENPLOYEE 500,000 Nyyas desaibourder DES6RIPTIONOFOPERATIONSbelow EL.DISEASE-POI ICY'MIT S 50n-00O DESCRIPTION OF OPERATIONSILOCKMONS)VEHICLES(Attach ACORD 101,Additional Ranmks Schedule.It more space Isrequired) Conversation Services Group has been named as additional insured on a primary 6 non- contibutory basis per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTA Denise M Blais ®1986.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fan: EEMall: alice.mullane @scgrp.com t o The Commonwealth ofMassachusetts to ; Department of Industrial Accidents ' Office oflnvestigations 600 Washington Street Boston,Mass 02111 www.massgov/dia ` Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Dame(Businesss(Organization4gdividual): !t M Pal'i r'A d1 �11�S�Q�� �'t�d(�4 LL C . . Add ress:_3 _CQ I)L/-?/N City/State/Zip:s � 9—V A dI���6���PPhhhoneff:_ 4 J3-.1;, - ()go() AXIOaunan:merpiloyer oyer?Check the appropriate box: Type of project(required): 1 with J�_ 4.01 am a general contractor and I 6.17 New construction 2.®employees(full and/or part time).* have hired the sub-contractors 7,p Remodeling 1 am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8.0 Demolition working for me in any capacity. employees and have workers' 9.(]Building addition [No workers'comp.insurance comp.insurance.$ required] S.QWe are a corporation and its 10.❑Electrical repairs or additions 3.0 lam i homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions y [No workers'comp. right of exemption perm MGL insurance required]t c.152,§1(4),and we have no 12.0 Roof repairs employees.[no workers' 13.XOther�ujq}&_ comp.insurance required *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowuers who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach 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'coma aolicy number. lam an employer that is providing workers'compensation insurance for my employees Below Is the policy and job site information. ` Insurance Company Name: Af �- (' ( y) P t;a)r;TCC'S Y1S M"Vi t,p— _{y d►�tl_ Policy#or Self-ins.Lie.#:, � 0 i D Expiration Date• Q-!q Job Site Address:Q (_�('IZSC ink S�CQ e.A City/State/Zip:T4 on hcz mg4no . M6 01 6Ca O 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 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 $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby cert under the pains andpenalties ofperjury that the information provided above is true and correct. Si, nature: Date: �—2-(�' Print Name:c�tt�nnnio .���-��it't� Phone 4. y13 R D�Oa 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): I.Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#• SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: W 25(9-, a)(X-k U C 2. i--- 1 O(p 19F License Number (3o C��P s+c� Soc�kti c1dIP�-Pry Address J Expiration Date l 3-S�2-62 de Signature Telephone 9.Registered Home Improvement Contractor: _ Not Applicable ❑ W.esle.e C-�-,�A -1-vCer . ,2nQCiC-na tn54CkI Ctk10(ns lK) 5°i89, Company Nam4b Registration Number 130 �IIP�s? Si-�ez Soya kh d-ic� d ey , rYl� O�Or15 Le-arl-I r1 Address Expiration Date Telephone Lf 13-S S 2-a 2.<C7 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 S e2. C-0 r)A'�' Q:: . 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 [M Siding[❑] Other�j ns JI Brief Description of Proposed p`r S� C��� Kn2QAJPtl I os 0 (LJi on Work: Alteration of existing bedroom Yes-X—No 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. 1. 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 1, . 1 Q F F f 9LJ GQ 1 (� ,as Owner of the subject property hereby authorize Pt MP-C i r.3 n a+',O n S to act on my behalf,in all matters relative to work authorized by this building permit application. S 012 CAO cacfi 8-at,—LS Signature of Owner Date 1, n1MPC nS+Q(tck100S as Owner/Authorized Agent hereby declare 1hat 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. Print Name American Installations 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 Side L: _! R: I L:= R:= Rear Building Height Bldg.Square Footage _-�-j — % -, -- Open Space Footage _ % _ (Lot area minus bldg&paved parking) #of Parking Spaces Fill: I i—------- --- volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES, date IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'f KNOW O YES O IF YES: enter Book } Page_ V ' and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date Issued: 1 C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O 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 O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit: r \, Building Department Curb Cut/Driveway Permit z \ 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural`PianS:.: ;%j bone 413-587-1240 Fax 413-587-1272 PIot/Site Plans �e ,, `'" Other.Spec N 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 a3s "C -S xr� �j}�2t-r Map Lot Unit N o c t ho,m e--o rN , M A O I O(o 6 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ce Coo,c�1a n oZ3S e��cQ n� S+c'ee'* Name(Print) —� Current Mailin Address: C4 IS- �RI,a3n8 S Q Q Cana-C C C 4' Telephone Signature 2.2 Authorized Anent: 1 Qy Go LA k U C e. AMo (`iCan 130 CO\IP,aQ cW SIZIufh Nadu Name(Print Current Mailing Addres tk )p a 0 fYIA Oldr?S -fir Ll 13-,Ss -oao Signature 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) Check Number 3 �/ This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0331 APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEY01075(413)552-0200 PROPERTY LOCATION 235 CRESCENT ST MAP 31A PARCEL 049 001 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 Tyneof Construction:_INSTALL KNEE WALL&BASEMENT INSULATION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 106178 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 em ' ' e Ir e of7ulilding45ffilial 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. 235 CRESCENT ST BP-2016-0331 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A-049 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-2016-0331 Project# JS-2016-000531 Est. Cost: $3273.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq. ft.): 8929.80 Owner: CAPLAN JEFFREY&ANN Zoning URB(100)/ Applicant: AMERICAN INSTALLATIONS LLC AT: 235 CRESCENT ST Applicant Address: Phone: Insurance: 130 COLLEGE ST (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON.911612015 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL KNEE WALL & BASEMENT 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 9/16/2015 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner