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24D-210 IkAxopx 10 OIS4: now r : i' F f k � t { y t n 1 } r F VON r �Cov e,� s' /'✓ Route 5 & 10 Doerfleld4 71e S r ' {office of Consumer Affairs and Business Regulation 1.0 Parr Plaza - Suite 5 170 Boston, Massachusetts 021. 16 Home Improvement Contractor Registration Registration: 1 20052 Type: DRA LAMQRE LUMBER & SON Expiration-, 1011012015 Tr# 24431 WILLIAM LAMJRE —. _ _ 724 GREEN FIELD RD. DEERFIELL, MA 01342 Update Address and return card.Mark re.ison for change. �;cA I Address �! 1jenewa E:111p3oy3txeut _' Lost Card Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction SujwrNmir License: CS-076123 } ►Ham R 1 1smom'7 t' 724 Gmenfleld RoAd Elefrfleld MA 01342 'I [it Expiration Commissioner 05123120`116 N Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 m3)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Cone is cause for revocation of this license. TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE VVCUOOUO1 ( A) POLICY NUMBER: (6HUB-02481\115-4-15) RENEWAL OF (6HU8-0248N15-A-114) INSURER: THE TRAVELERS INDEMNITY COMPANY OF AMERICA 1. NCC| CO CODE: 13438 . . INSURED: PRODUCER: LAMORE , WILLIAM R . DBA PARTRIDGE-ZSCHAU INS L4MORE LUMBER CO. 25 MILLERS FALLS ROAD 724 GREENFIELD ROAD TURNERS FALLS MA 01376 RTE 5 & 1O DEEepIELD M4 01342 Insured ieAN INDIVIDUAL Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period isfrom 04-08-15 to 04-08-16 12:O1A.K8. at the inoWnad'u mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the utate(a) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies tn work in each state listed in item 3.A. The limits 0f our liability Under Part Two are: Bodily Injury hyAccident: $ 100000 Each Accident Bodily Injury byO|moaan: $ 500000 Policy Limit === Bodily Injury byDisease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three ofthe policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 08 0SA 0� �~~�~ D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information |ssubject to verification and change by audit tnbe made ANNUALLY. DATE QFISSUE: 03-30-15 WC ST ASSIGN: M4 OFFICE: ORLANDO INDUS AFF 161 PRODUCER: PARTRIDGE-Z3CHAU INS 25DJJ 000378 ~=°~~ TheCominomw*uzlth of Massachusetts DepartntenyofIndustria{Accidents / Congress Street, Suitt, /00 Boston, MA02Jy4-2017 ivwwumass.gowdim -- Workers' Compensation Insurance Affidavit- BuilJors/Cnotrmctoru/Eicotr|oiuns0,|umnhczm- TmmE FILED WIT{7HE PERMITTING AUTHORITY. Applicant Information Please Print Leziblv Nozun (Buxineos/3rgao{zuhuoVodi'iJvd): VViUiann R. Lemoru dba Larnnre Lumber Address: 724 Greenfield Rd City/State/Zip: OoerUo|d, MA 01342-9752 Pliouc 4:413.773.838O Are you an employer?Check the appropriate box: Type of project(required): I E]I aina employer with (full and/or part-time).* 7. 23-<ew constrUction 2.f7i ania.Sole PtOI)Tictor or partnership and have no employees working for une in 8. Remodeling any capacity.[No workers'cornp.insurance required.] 9. Demolition 3.[j 1 am a homeowner doing-all work myself,[No workers'conip.insurance required.]t 4M I am a homeowner and will be hiringcontractors to conduct all work on my property. lwill 10 E] Building addition ensure that all contractors either have workers'compensation insurance or ate sole I I.Fj Electrical repairs or additions proprietors with no eniployces. 12. Plumbing repairs or additions 5,[7 1 am a general contractor and[have hired the sub-contractors listed on the attached shect, 13. Roof repairs These sub-contractors have employees,aid hive workers'comp. insurance.t 6,R We are a corporation and its officers have exercised their right of exemption per MGL c. 14,Fj Other 152,§1(4),and we have no employees.[No workers'conip.insurance required.] I *Any applicant that checks box#I must also fill out the section below showitip their work-cis'compensation policy information, t Homeowners who submit this affidavit indicating they are doing all workand then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional shce[showing the name Of the SUb-contractors and state whether or not those entities have emplo�ecs. If the sub-ccnitractors have employees.they must provide their workers'comp.policy number. /ant onc*p6yerthat hyyo/vi/inu/owvkcxv'comPeosotiouinsuruvco/7rmycnly/m*zc Belo w/xtAepo/iej�uod/"8site information. Insurance Company Name: The Travelers Indemnity Company Policy 9orSdf-ins.Lie.#:OHUB'0248N1S-4-15 Expiration Date:U4/O8/10 Job Site Address: City/State/Zit): O^)/�� Attach nvopynYt6x,*nrk*rs` compensation policy declaration page(m]'un/|ugQho policy ovouboru"d,obYru6ondxtc). Failure to secure coverage uo required wider M(]Lu. 152, §25A iau criminal violation punishable byofi000p\n$l'5OO.0O 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 dkv against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verifi .�andp�i ties 'perjui:17 that the information provided above is trite and correct. Phone P1. Qjjicial use only. Do not write in this area,to be completed by city or town offi-cial City or Town: Perinit[License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical I nspector 5.Plumbing Inspector 6.Other Contact Person: Phone 9: 24D-0612, Y ` as 24D-220 '3 387.1 56 fib ��.� 24D-2 9 2 y 24D-219 62 752 k . ". 24D-218 78 24D-3'40 62 { 72 5, 5Q D-217 ! tps ! €3.3 � 85 so.7 24D 122 72:G _ rs.55 24D-213 ,zaz.s 24D=9,23 11x; s�.5. sz 240. 2 s6 ts5. 24D 211s� tz5 24D-.126, " 5r 24D-12411.9 24D-29�k 88 :` �3s 1`10 .24D-125 : 171a , 65s 17 58 62 11Q;' i � � 72.6 -295 72.6 #{�_�a5 24©322s.� } 63 62 fi7 24D-326, 71� - 24D .5x.327. 53. . 62 -: 24D 326 fix 211 1 a 2 j vt. 82 5 7 5 t-4D 12740+. ;. �' ;61 as : 24D-324 . 62.4 24D 199; 0 01 1 140 25 24D-323 62 sT� 85 , tos 24D-13; 100.25 xs 's4 28 D 1981 j..,. - z:2s s z i- 24D-928 i 748 24b-132 s7 38.5 ' - ,dx.i` 526 97, 1os �°24D-196'8oD�19Z 54 48 � 24C?-208 20 24D-130; �24D-131 �' ��'42 s5, { 24[3 240 6s o toT r 65 :? 24b-1956.r5� sa -- o' 700 64.5 52 5 84 169`, az s 72 54 -< �.. to7,� r 7oz WARFIE� � { b { r27 tai -129 ": �-- _ L a . — T` 8e.az �. 55.24D- 07 55 7r.j. x2.7. sa r-~ i 6o.75' {"s5"24D-209 66 ". _ 84".; 786 as s 73: 48,tod-19 2 _. 7 127.67 85 �. " =— { 24D-943a 2 D-139 T . 7z 4 aE ° x6.421 24D-193 - 100: 47 �24D-194 I a { ! "62.3 cn } 84.78' 60 f " 1 ao "24D-206 ao �� 1 ty I 7{ :x3 67.6 {� 24D-191 mm„- 75 to i E 165 1651 i 6° 85 �� 113a 13s{ 106 � i `24D- 24D-144- i 154D-�4Qr 145 , zta \ �' { ( l 1 24D-202 1 __ { 775 tts 73.x, 77.5 (" 84.16!"" 53 53 $8 ' 2407-989 6o.,s 1 } 762- 162; ` 24D-142 6s t � - ;24D-19067 2D-20324D=204 f ( } 87 i l 77.7 &5 7a 4 f aD-141 fff a 248 6 60 a5 � 52.5 52.5 TO — 1 FINN ST FINN,ST FINN ST' S F9 A7 .�` 155 81 v i 40 SO 62 ` 62 24D-449 , ?4D-15f 7(? 43 SS.8 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 properl licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: Z4 (0 debris will be transported by: The de A l p ' The debris will be received by: Building permit number: Name of Permit Applicant � S Date Signature of Permit Applicant City of Northampton ,L Massachusetts f DEPARTMENT OF BUILDING INSPECTIONS ✓ =z 212 Main Street • Municipal Building :r ' Northampton, MA 01060 ss 'lrt 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/footings (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 ins TC,ions An understand the above. (Hom wner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date 4 S Address of work location r The Commonwealth of Massachusetts _ Department of Industrial Accidents Office of Investigations x 600 Washington Street r Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: BuH tiers/Contractors/Electricians/Plumbers Ay]2licant Information .Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. E] I am a general contractor and I 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 ship and have no employees These sub-contractors have g. Demolition working or me in an capacity. employees and have workers' g y P t3'• 9. ❑Building addition [No workers' comp. insurance comp. insurance.t required.] 5. [] We are:a corporation and its 10.0 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 12.0 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. #: 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 o hereby c ti under th ndpenalties ofperjury that the information provided above is true and correct Si ature: Date: Phone#: _ b 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ Name of License Holder: License Number Address Expiration Date Signature Telephone 9 Reaistered::HomeamprovementContractor Not Applicable £ Company Name Registration Number 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 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 an assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, tate nd Loc 1 oning Laws and State of Massachusetts General Laws Annotated. omeowner Signature t SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House F7 Addition [❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. Demolition ❑ New Signs [0] Decks [M Siding [0] Other[o] Brief Description of Proposed Y, i b Work: ��(w</'l! 1 X�� wa a ST D Aft- . O D ) q _�_ �_ Alteration of existing bedroom Yes No Adding new bedroom Yes No M Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.:'If New house and or'addition.. o exislinq".h"odif complete fF a 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 !t I IV -� 1 ► as Owner of the subject 0 property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date 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. Sig#-d u der the pains a alties of perjury. I") 'V\ 1'G �L Pri Name JJ Signature of ner/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 — � -- ------— -- F Setbacks Front L.-Tf T, j Side L:= R:'- - L:;� R7 Rear _~-� Building Height 1 -----yi Bldg.Square Footage Open Space Footage % (Lot area minus bldg&paved ? 1 l J parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO W DONT KNOW Q YES Q IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW Q YES Q IF YES: enter Book J Paged and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q 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 O NO 9 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. i . f ;.; Department use Drily t ©f Northampton 5tatusofPermrt 4 �� I - B 11,ing Department Ct rh`eut«nrce+uay Permit j n ifr 4 r r � : ,"1�'2 Main Street SewerfSeptic Avait'a'bEll{y 4 S� f'' t SEP 92015 J Doom 100 Electric, Plu, --_._ No ha pton, MA 01060 TwaSetsrbES#rtictural Plans " ter�4 � 1240 Fax 413 P[of/SltePlans`d "; _t _e h r 't Ncrtl �n�pi i t4�q 70�o Othei Speo�fyr, 1, 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: n�y/. C>-'�.� (�� • MaP Lot M�n�,rn n�f4 MA of O Go Zone Overlay District �- 1,, J _- I :Elm St Distract r CB Di§tact - SECTION 2. PROPERTY OWNERSHIP/AUTHORIZED AGENT: 2.1 Owner of Record: ' J o W.6 11-A - tf--SS ?-�-J'�v s7)i1`E _3 - N a Y',-�pfW MA- Name,P 'nt) Current Mailing Address: �t-(),� Telephone It 3 r� 3 91 Z G/'13 5.0 6 J OO Signat re 2.2 A horized Agent: Name(Print) Current Mailing Address: 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 Feb 2. Electrical (b)Estimated Total Cost of Construction`from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(l +2+3+4+5) Q Q� Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Comm issioriei/Irispector'of Buildings Date File#BP-2016-0294 APPLICANT/CONTACT PERSON POWER JOHN P&RACHEL C HASS ADDRESS/PHONE 246 STATE ST NORTHAMPTON01060 Q 584-3912 Q PROPERTY LOCATION 246 STATE ST MAP 24D PARCEL 210 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiniz Permit Filled out Fee Paid ' Typeof Construction: CONSTRUCT 14 X 16 SHED m tAsT 177 pa s nn New Construction ;V+4SS PE51 XtJT14(, ODE Non Structural interior renovations Addition to Existiniz Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan 1 THE FOL LMWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9R, IRATION PRESENTED: pproved Additional permits required(see below) `�`� N t? 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 P it DPW Storm Water Management Demolition Dela 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. 246 STATE ST BP-2016-0294 GIs#: COMMONWEALTH OF MASSACHUSETTS MU:Block: 24D-210 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: shed BUILDING PERMIT Permit# BP-2016-0294 Project# JS-2016-000480 Est.Cost: $6000.00 Fee: $45.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 10541.52 Owner: POWER JOHN P&RACHEL C HASS Zoning: URC(100)/ Applicant: POWER JOHN P & RACHEL C HA SS AT. 246 STATE ST Applicant Address: Phone: Insurance: 246 STATE ST () 584-3912 () NORTHAMPTONMA01060 ISSUED ON.912112015 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 14 X 20 SHED-must meet prescriptive requirement of mass residential code 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 9/21/2015 0:00:00 $45.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner