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32C-120 (20) 413-534-1234 SEXTON ROOFING AND SIDING INC HIC#118239 P.O. Box 6327 HOLYOKE, MA. 01041 1 request that you grant a modification to waive the requirement for control construction for the Roof project at 11 Conz in Northampton because the work is of a minor nature,will not affect health, accessibility, life and fire safety,or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of the proposed work.Thank you for your consideration. "Mass Amendments,sections 107.1 allows for an exclusion from control construction for this project" Respectfully, 4eyrett J.Sexton,Sr.President Sexton Roofing and Siding, Inc. P.O. Box 6327 Holyoke, Ma. Proposal SEXTON ROOFING AND SIDING INC www.sextonroof!ng.com M/ R I+�AS'TE Setting the Standard P.O. Box 6327 p. 413.534.1234 Holyoke, MA 01041 f. 413.539.9906 MA HIC# 118239 sextonroofin hotmail.com SUBMITTED TO Eagle Crest Property PHONE 256-3442 DATE 10-1-15 Management STREET 55 North Pleasant St. JOB NAME Rental Managed Property CITY,STATE,ZIP Amherst,Ma. I JOB LOCATION 11 Conz St.Northampton,Ma. SEXTON ROOFING HEREBY SUBMITSSPECIFICATIONS AND ESTIMATES FOR: 1) Strip and remove existing shingles and dispose of in proper landfill. 2) Inspect roofing deck and replace as needed. ( $2.75 per sq.ft. ) 3) Install new metal edging to rakes and eaves of roof. (8") 4) Install ice and water shield on eaves ( 6'), around chimney, vent stacks, skylights, in valleys, and at intersecting roofs. 5) Install #15 synthetic roofing felt on remainder of roof. 6) Install new flanges over existing vent stacks, 1 new bath exhaust. 7) Install starter shingles on eaves and rakes of roof. 8) Reflash chimney with new lead. 9) Install IKO Architectural style roofing shingles as per manufacturers' specifications. 10)Install new cap over ridge vent. 11)Install fully adhered EPDM membrane roof on upper flat section,front and back porches. 12)Supply manufactures lifetime warranty and SRC 25 yr. workmanship warranty. ALL CONTRACTS INSURED WITH PROPERTY LIABILITY AND WORKMANS-COMPENSATION. We Propose hereby to furnish material and labor—complete in accordance with the above specifications, for the amount of Seventeen Thousand Eight Hundred Dollars($17,800.00)Payment to be made as follows: Due in full upon corn letion Al[Material is guaranteed to be as specified. All work to be completed in a Authorized workmanlike manner according to standard practices. Any alteration or Signature deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Not responsible for water damage during Note: This proposal may be withdrawn by us if not accepted construction. Owner to pay responsible legal fees for non-payment,and within(14)days. applicable interest. Acceptance of Proposal The above prices, specifications and conditions are satisfactory and are Signature hereby accepted. You are authorized to the work as specified. Payment will be made as outlined above. 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: I � �'o ry 5-/-- T The debris will be transported by: Ax;j.,el-e�The debris will be received by: PAW,a- Building permit number: Name of Permit Applicant �✓ O Date Signature of Permit Applicant DATE(M M/DD/YYYY) ,a D CERTIFICATE OF LIABILITY INSURANCE 08/05/2015 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 LEANDRO GUIMARAES Universal Insurance Agency,Inc. PHONE FAx 374 Belmont Street ac No Ext: (508)752-9333 (AIC,No),(508)752-9303 M Worcester,MA 01604 ADDRESS: leandro @univ8rsalinsagencycom INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: WESTERN WORLD INS CO INC 13196 INSURED ALG Construction Inc INSURER B: AIM INSURANCE COMPANY 18929 116 Chapel Street INSURER C CherryValley,MA01611 INSURER D 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 ADOL SUBR POLICY EFF POLICY EXP LIMITS LTR 15 VV POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A GENERAL LIABILITY NPP8236633 08/01/2015 08/01/2016 EACH OCCURRENCE I $ 1,000,000 \/ COMMERCIAL GENERAL LIABILITY PRREMSES OEa onr''ance $ 100'000 CLAIMS-MADE 2 OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GFNL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ - 2,000,000 POLICY PE� LOC $ �/ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION VWC-100-6019905-2015A 03/10/2015 03/10/2016 ✓ WC sTATU- OTH- ANDEMPLOYERS'LIABILITY TORY I IMITS ER ANY PROPRIETOR/PARTNER/EJECUTIVE N/A E.L.EACHACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SEXTON ROOFING THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 102 PINE ST ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 6327 HOIyDICE,MA 01041 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD /r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ` . 5Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): i �1 �:��_�1 F(,�o.�1 1 n n T_(-1(1, , Address: ���� City/State/Zip.: r12.i-i"',1 ��± (.'� 1 !�F (�1 fj I Phone #: Are you an employer? Check the appropriate box: Type of project (required): re 1.I I I am a employer with _ 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time)." have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. $ E] Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] 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. 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 their workers'comp:policy information. !am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: l Policy# or Self ins. Lic. #: i�� I �� i! ) �_� � �� Expiration Date: U� 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 do hereby certify under-the-pains and penalties of perjury that the information provided above is true and correct. ature: Date- Sign Phone 4: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License 4 Issuing Authority (circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspecto 5. Plumbing Inspector 6. Other Contact Person: Phone 9: The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations o I Congress Street, Suite 100 Boston,lV1A 02114-2017 0^4 say �1f'f'r�ri�.ifs ash.go . Workers, Compensation lusu-ance Affidavit:Bi llders/Comtrac-tors/Electricians/Plumbers Applicant Information please)Print Legibly NalTle (Business/Organization/Individual): Sexton Roofing Co. Address: P.O . Box 6327 City/State/Zip: Holyoke, Ma. 01041 Phone#:41-3-534-1234 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees (full and/or part-time).T have hired the sub-contractors 6. ❑New cons-Lru4ion 2.❑ I am a sole proprietor or partner- listed on the attached sheet.. 7. ❑Remodeling ship and have no employees • These sub-contractors have 8. F-1 Demolition working for me in any capacity. employees and have workers' 9. []Btdlding addition [No workers' comp. insurance comp:insurance.t iequired.j We are a corporation and its 10.❑Electrical iepq:rs-or additions 3.❑ 1 am a homcowne= doing all work officers have exercised their 11.❑Phiftibing repairs or additions myself, o workers' coin right of exemption per MGL y � p 12.0 Roof rep airs c. 152, 1 4 and we have no insurance refired.] t § �] - employees. [No workers' 13. Other comp.insurance required.] -Any applicantthat checks box 41 must also fill outthe section below showing their workers'compensa impolicy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a aew 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 mustprovide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.. Below is the policy end job site information. Insurance CormpalyName: 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 e--piration 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 fne 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 insizaace coverage verification. I do hereby certify under thepains and peYiahies ofperjv_ry that the info,-rnationprovided above is true and correct. Signature: Date: Phone#: 4135341234 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/4owa 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 0 No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 14 as Owner of the subject property hereby authorize ✓U Ll to act on my behalf, in all matters relative to work authorized by this building permit application. e�� I-Ced 4 /j4/, /6 Signature of Owner Date I, )L4vK) ` C(-..'ms's vt 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 th arts and penalties of perjury. Print Name Signature of Owner/Agent Date SECTION 12-CONSTRUCTION SERVICES 10.1 Licensed Construction Suaervisor: ( Not Applicable [3 Name of License Holder. °, J 7 License Number Address Expiration Date �2G y- �s� r Sig ature Telephone a _ 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 No 4 Version 1.7 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: Not Applicable ❑ Name(Registrant): Registration Number Address 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 rlJ Roo l P" q Not Applicable ❑ Company Name:ve f4 se Responsible In Charge of Construction 6 L D Address 3 V/.;' -5 Signature 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: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved arkin #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DON'T KNOW er YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Regis ry of Deeds? NO ® DON'T KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 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 ® , 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 Q NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,exca lon,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES ® NO 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❑ Change of Use❑ Other❑ Brief Description Enter a brief description here. XI`PADU-e 4,1 Of Proposed Work: J�-�- /'� 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 ❑ 18 ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H Hi h Hazard ❑ 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor(so 1 1 sc st 2nd 2nd 3rd 3rd 4 t 4th Total Area(so 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❑ I Municipal ❑ On site disposal system[] Version 1.7 Commercial Building Permit May 15,2000 Department use only y of Northampton Status of Permit: Bljilding Department Curb Cut/Driveway Permit 1 12 Main Street Sewer/Septic Availability Room 100 Water/Well Availability o ampton, MA 01060 Two Sets of Structural Plans 50-T Cj';au DINa=P t1a 13-587-1240 Fax 413-587-1272 Plot/Site Plans r�� ,��r. t�roe,n:at�3��3� Other Specify APPLICATION TO CONSTRUCT, REPAIR, 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 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 1..8✓l J4 ta Telephone 2.2 Aut riz v A v 'RoV4 o x Name(Print) Current Mailing Address: 3V- 3 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 7 on 6. Totai=(1 +2+3+4+5) Check Number 0 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0898 APPLICANT/CONTACT PERSON SEXTON ROOFING CO ADDRESS/PHONE P O BOX 6327 HOLYOKE01041 (413)534-1234 PROPERTY LOCATION 11 CONZ ST MAP 32C PARCEL 120 001 ZONE URC(95)/NB(5)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: STRIP& SHINGLE ROOF New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included: Owner/Statement or License 99689 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: _JZApproved 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 oli ' elay Signa ture of Build rng 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. 11 CONZ ST BP-2016-0898 GIS#: COMMONWEALTH OF MASSACHUSETTS MapBlock: 32C- 120 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-2016-0898 Project# JS-2016-001520 Est. Cost: $17800.00 Fee: $126.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SEXTON ROOFING CO 99689 Lot Size(sq. ft.): 8929.80 Owner: SHEMESH AVRAHAM&MICHAL LOMASK Zoning: URC(95 /N� B(5)/ Applicant: SEXTON ROOFING CO AT. 11 CONZ ST Applicant Address: Phone: Insurance: P O BOX 6327 (413) 534-1234 HOLYOKEMA01041 ISSUED ON.•111 512 01 6 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: FeeType: Date Paid: Amount: Building 1/15/2016 0:00:00 $126.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner