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25C-244 (4) 249 BRIDGE ST BP-2017-0582 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:2K-244 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:window replaced BUILDING PERMIT Permit# BP-2017-0582 Project# JS-2017-000944 Est.Cost: $5396.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group SERGIY SUPRUNCHUK 104327 Lot Size(sq.ft.): 5096.52 Owner: DEITNER WANDA A&CHRISTINE M&JANICE L&THOMAS J Zoning: URB(100)/ Applicant: SERGIY SUPRUNCHUK AT: 249 BRIDGE ST Applicant Address: Phone: Insurance: 536 EAST MAIN ST (413) 883-3802 WC CHICOPEEMA01020 ISSUED ON.•10/26/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT 10 WINDOWS AND 1 ENTRY DOOR (FRONT) 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 10/26/2016 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use on City of Northampton of Feorriti"- ' " " vil Building Department Cjrb Cut/Driveway Permit s zX.1 212 Main Street Sewer/SepticAvailabulty Ifi S rn Room 100 YlateerfeliAvaUab7ity IN Northampton, MA 01080 Two SetsafSfrootural Pians CJt phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans" _ (= 11 Other Specify - APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 6P- ! "58A _T This section to be completed by office Map Lot U 1.1 Property ,(Address: 21/ g (/ Q y''Antd�' t � e C t NO r 1 A -60,,, t >4 P 6r oco ni( Zone Overlay District Elm St.District GB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 1 3.1 Owner of Record: ( Waldda pits- r 2q9 Ancol 0e Name(Print) Curet.)tittI np_Ad&r7s-/i ?it / Telephone +:• Signature C: tit G.' 2,2 Authorized Agent: get 4 t . u \rte../ f k ,35 els:C Qe s�- a:e?ej� Name(Print) Il. , Current Mailing Address. _•:r a ._ Y(3 193 3202 Signature Telephone .... .TION 3- itc !MATED ONSTRUCTIO COSTS item Estimated Cost(Dollars)to be Official Use Only completed b mit a licant 1, Building 5-199 ° " (a) Building Permit Fee 2 Electrical 7 (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection ,.{� cifi- `_ 6. Total=(1 +2+3+4+5) Check Number ( ()may C71C//j This Section For Official Use Only / Building Permit Number Date Issued: Signature: ''i �� f "'g�`/ U Building Commissionerinspector of Buildings Date Section 4. ZONING AB Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing, Proposed Required by Zoning This column to be filled Ia by Building Department Lot Size _______ _ .—.J 1 _. r Frontage Setbacks Front f.... -,. Side L �R:� _ La At_ _ __ „ _ ) Rear i _ _ Building Height _____ _I L 1__ Bldg.Square Footage _ i % , j Open Space Footage _ I / .. - (Lotareaminusbldgkraved ;, I ' ......_, parking) d of Parking Snares - Fill: (volume&Locatlan) --, . - --- A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW O YES Ca r 1 W YES, date issued:, t-2 permit DONT KNOW Registry of DeedY 0 — IF YES: Was the recorded at the ? NO DO © YES -, IF YES: enter Book I Page{ and/or Document#, 5, Does the site contain a brook, body of water or wetlands? NO `l/J DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the ConservationssCCommission? Needs to be obtained O Obtained 0 , Date Issued: _ C. Do any signs exist on the property? YES O NO i 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. WII the construction activity disturb (clearing, gradings excavation.or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO (fyC7�•''t IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House n Addition ❑ Replacemen ndows Alteration(s) n Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ I�/�NNee�- / New Signs [0[0] a Decks SidingJ' [CI] -/Other Work 5 Brief Description aj Prooyed ti ) O N 1, "WI (Ol✓> 61.••••—iI €44-4- l�'//J doer _ Alteration of existing bedroom Yes >4 No Adding new bedroom Yes 7` No Attached Narrative Renovating unfinished basement Yes 'P.C.No Plans Attached Roll -Sheet Ba. If New house and or addition to existing housing, complete the following: a. Use of building : at 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, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of OwnerQQ Date I. JP�c t Jc„, c'-enn t ,as Owner/Authorized Agent hereby de4re tt the statemels and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signedunderthe pains and penalties of perjury. I't /t 6r.�nL� tt tn."–Q__ U V (lit e / Print Name !1�d /0/2- 7 l41 Signature o Owner/•.ent Da Y SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor:vi / (/,j ����/ Not p licablle ❑/� y` Name of License Holder ;(/ )" L% G7 (61 a e t 044?2 7/ _ 1�7' License Number S e 0 • d o 5 (' .` e-c_ _1112 91 Atltlr: s iii..�� _ )/ �j (j7�J2 �yA Expire ion Date e is Telephone 3e Q a �+ 3C] rico rr / 9. Ristpred Home-Improvement Contra tor. Not Applicable Ell 4ii tCA.eie go......e lip rQfe ... (I.A.0 /5 ey212 Company Name Registratio Numb r 315 eiG�ct 5L. 2 f20�/ 7— Address U Expiration Date x,113S!.18,1 Telephone"! ' �E 3 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(I) 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 ads as supervisor.CMR 780. Sixth Edition Section 10R3.5.1. Definition of Homeowner:Person(s)who own a parcel of and 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 stmemres 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,duringand 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 de State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature 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: 2 'J prig/ e A/Crpr'il,a e The debris will be transported by: S t ( The debris will be received by: 7) 5 4 Building permit number: t Name of Permit Applicant ifiII r , /440(^^-,a a e Date Signature o P-imit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents "_—_ Office of Investigations —17,40= ° 1 Congress Street, Suite 100 Briton, MA 02114-2017= - Y www.mass.gov/dia Workers'Compensation insurance Affidavit: Builders/ContractorsfElectricians!Plumbers Applicant Information Please Print Legibiv Natme(l3usiness/Organization/Individual): j /.... 0 s int, 0 u'e_ Address: 3 5 .t„ ' a eP - NA- '/� ry ppp3 3�� CifytState;Zir 'r—�''...!7 .., Phone 4: � > 6��pp Are you an employer?Check i l appropriate box; 4. I am a general contractor and 1 Type of Newprconstruction(required): 1 eamaemployer with ❑ 6. CLinStNCtt6➢ employees(full and/or purl-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. Q Demolition working for me in any capacity. employees and have workers' comp.insurance.; 4. E)Building addition [No worker' comp. insurance P required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11-0 Plumbing repairs or additions myselfworkers' right of exemption per MGL / Y [No comp. 12Roof repairs u ,/ insurance required.)i employe§1(4),and we have no C ,Q6 <� employees. [No workers' 13ya Other 1/J comp. insurance required.] *Any applicant that checks box Hl must also fill out the section below showing Nett 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 indicatingsuch. tContra;tors that check this boa must attached an add t onat sheetshowang the name ofthe sub-contractors and state whether or not thoseentidcs 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 far my employees. Below is the policy and job the information. (� k Insurance Company Name: AA GA4e � )3002 ,5# k ct4 f�^yyi oz C C. ti = _' Policy#or Self-ins,Lio. #: 'T VM A 3 0 O�2 S Expiration Date: A 2 etCC e pp �J Job Site Address', 2�'7 at f O g"� City/State/Zip:_O/�s het Attach a copy of the workers'compensati policy declaration page(showing the policy number and expi :ion 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 imprisomnent,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insuranc- -_ 'orifi a an. de Ido hereby eertiht a;or a pains a , tie 4 er'ury that the information provided above ' true and ear act. Signature: 4- llgg� Date: 67 25 J �/ Phone#: 1( 7 12 /50—a —.—..— Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone k: • *hatable Av home improvement conwacmrs and n ibrpmactms engaged to home ampmvemeat contracting unless specifically ewmpt from �I� i registration by Pmvinons of Chapter 142A of the general laws, 4Hrepoa41 l must be redrtere) with the Commonwealth of Massachusetts. 'lllOLSEka ]�(4L Inquiries about regStraion and status should be made to the Y .( __ .. 1 t1eDirector. Home Improvement Conran Regbaadm, One l� Ashburmn Place,Rom 1301,Boston,MA 02108(617)727-85f 536 East Man St 11�1JlI � �.1 Chicopee,MA 01020 Phones:(413)883-3802 (413)331-4351 .r a MA Lic#154218 Cr ucn0635847 fax:(413)331.4358 on Dan Pay more,but you can't buy bett°' wwwAitance$omemc oro i t JA ( rimy SUBMITTEpp TO: Phone: 4J? 2Z)' Ilcjc Cell: 413 516 -.1771 ;` Bleak- lid ale 413. 536 - 76441 4 .;� T+ A Email; � (limo We hereby submits and estimates for work to be Performed and materials to be used: 1: ' .3t € kitaLl T0,2., Mc� cttIii:440 / t eMahj .{Mert skCS H p6S !. JASt(ttt 4 kt4i/ti,t yenta b , Ha,. 5 47.0 :AM/(tLa' r J 7:2:z - hitt )1,6,04, „by 4&d . (ia 1.X12)(y' /4 ra .> a Litlitia 1 ersta44 }WI RR.44.41 iter[I� Ate a # .e?0& ��•,1!//((`t' +�:h c fr .. SPOikl1 An inti 4-. . YPr y l2L !! pd r�f� ,II,�d�minum Trim ❑Alliance Trim ❑flat Coil 0 PVC Coil ❑GB Coil Color. p l y1 ❑Corners Color: ERLiU1 cOWS Grids:❑YES []MO ❑Flat ❑Contour ❑Colonial ❑Diamond ❑Other: gBow many? f0 215/Mi 2215 1 0315 pe!ot-r 02Lt/Csmt ❑31A/Cmt_ EtAWN C. ❑HOP_ BOW(4or 5 lines) ,---aad��^❑^ Bay full Screen:❑YES .SNO G 0 Wood grain Interior: Color: U /Ev Exterior Color:OYES n0 Color: MulAlirES ❑NO ❑How many? o Glass Option: Type: ❑ClimaTech 4CIimaTech2 0ClimaTechTG2 ENTRY DOOR:24S ONO Crypt C7 *WNL.kef,.,. .340.4 @Style: ft AV /1tA4tutl 61/47 ❑STORM DOOR:❑YES .A1TO 0 Type: hj Oa*: l'aiilaterial Location: 'a fl alitCii 2ste Disposal: / t4(.fl,. WORK SOEEaDfAUqIEn.�eR 1 ”' t n4®1 A� 1�r�c TY Wowing sstNu%will be aaeemd to;stet tlrytmma�hits m Nmol arise lir t (p a.eaNmmann.I..an�mudum& I oeb.lm®aantl%Pbw.MatYmMYsnnNd Contrasted meek may not begin tall ora patties Save reeled.Ulu emomed atm NKee mrma:eam tethee day maastm wren lasaaglren.me awe tombs aMuwltafeaand aces ttm meweduling data appmNau andWthat Mat en notawb b dbd'e Contractor Indu@btu m u, l MnlrcMiW Mengesd to se.AofGadMengesrematerh4,KcldeAv and all other deism hewn m lis mutt,sluth sot be nconsidered as vielatkoss of this Agreement. WARRANTY AllmateMbnaw wrrenty emumMrvinywNed by manututun.Laborandaoknum4lp have a wormy of one lull rvrfun the date MlmoWrbn. PSI work us en Inc w,bowi manner wanting a apubN pm mu miaMRYnm devaWntWm Me stew spall Loris snowing otnwao waYaemWmrY uranwratee unseen*will Moorea amen tMMwe we Wow du"Mises, PaYMenia We propose hereby tofiaedsh mater an - in avnmra:a pm P,anenom be matinssffolws:: above a°n • th sum aft +/S ors 1 ilk a IMUM signing Cmvue _r _ A.t .4. •••., t_ : ' A "'82Mars O ¢ WJ/ - . /tors /. / Y)wen dewenm eateries: 14�1g1.� -� r. _tun Mite, lanaremenarr Name of Salesman , 4in,1, Z' 1k WO /Ig9tEN forthwith f�a l��a �wcompletcompletion work uWihbaaract Authorized Signature Ms customer hereby brWunanherW amen to pat finance dump of IS%par marsh ler armual percentage Me of ISM more autumn*.bah . . :..d Wkhh 30 Sys asst mptetan or mer.NpymmC rwl,i Mmmmpbu tes4u r meMUtast ast un.cnMmn stargss am den to outstanding balances.nt erant at,. a aw+u herebywanwvtlow a sand aeelts0ra, aamw tiem aMenBeatlNwbµ,atmatt anweudtett selection'uMr WrCrumr WYadgpytbs Mvor:a[.dit aIMVINIb ma*at°kt MNmlMmeM Mea (,pati,IudthmtlnnaM nfl,y stated. ito ii d that*oft emryMys Wnquel ateof Mutts(c n.Cncelan,mAshadesa Inulin. DO NOT Payments will berum*T W THEEalms,.M nnANE nay mud MubaruanbnrtaM time Mor bmidngMof oft*ant bmiwpWYaaerMetleuofMbinnaeM.GmIbIMn mitMMn in writing. Lp1lOTMON THIS CONTRACT KTNEREAREANr WANE SPACES. la Signaturt}4`.1: Cattr •Signature Date NOTICE OF CANCEIJATION'you MAY CANCEL THIS TRANesrICN,wH10Ur MT PENALTY OR M CADOO,WallNTNREE BUSINESS DAYS FROM DIE MOW DAM IF YOU CANCEL,ANY PROPERTY IBAOEDIN,ANYPAYMENT MADE BYY0U UNDER THE CONIRAcroa SALE,AND ANY NEGDTMOLEINSTRUMEM EXECUTED BY YOU WILL 12.E RETURNED Wf1IIN TEN BUSINESS DAIS FOLLOWING RECEIPT BY ME SERER DETOUR CANCEUATM1 NOME,AND ANY SECURITY'MEREST MUSING OUT Of THETRMacnoN WILL BEGNCBAMI.TO CANCEL THISTMNSSLTION,MNL OR DELIVER AUGHT()AND DATED COW 0f NIS CANCELLATION NOME CP ANY OTHERWRTIEN NOTICE,m SEND ATELEGRAMTO:=NICEE OPROWNERT,ING,SMEASTMAN n.,OIKOICA MA COO Igo.Sunday;NW holidays exci.dedi I HERESVCAUCELTHISIRAY64CION @Mrs S'aatnae) t'oRrt CERTIFICATE OF UABIUTY INSURANCE aa,""nn+s" 77M OVIIR7AY0 N t00I0E AS A NATTER OP SI ONLY NO COSHES NO I N IT5 UPON St OVaN,CATE HOLDER.1101 'NNSPICNAnn DOM NOT ANi0rAMWaY aR N000A7MIV.Y ARIA NOVO ON ALIAV M COSVNON AMMO) WY TIE MIM= eVONO. T700 CIIIMPICNIE OF INSURANCE OOHS NOT CON011NWE A CONTRACT See TIE MISLENS OWINISSIS AUTHORIres PIS NININIm171PE ON PNOOIICR,AS THE'ATE NO1OR. OVYNWAND Rao BINS hers k M AONIOINL OWNIO.as 9440441 Det M aed Asa- N10110RORA710M N Sm.9.14994 is Os Om awl 44410110. .14 - OsOmadmANPNR MID PNOq.sea NOON we mph M OSOTIN - A_____ea IS pslNeola dr aaa St ASO kr oNlw IOW rNN sisa le 0194a4N41. aOwrre Pi A NIS tawnnasaLSway 4440Awry 92Webb OMtt (4 S 13)T32-0137 - Ir.Nep73)mean welt Spinelli,la MON QOmEaaam MaaMaaaaaMOOaNMw a .RNV.: SWABS kenos CUPIDS SOAM In 5Naos 7 i OB Street .Awa; SAFETY VVIRANCECOKRNY 39454 CM:4 l ,elk MOD tab eaaMwCaatMMOT A0335 ., P han PPS e: SSP; 0.449144366 OIRIOitAT010NNElC NN9NION1iAINVC MSC color(SW DIE MOM OF INSURANCE tE1NI BELOW PALE a NBEDm TE NOSVm IWONABOME Pat TE lC[CV PM= .ENAe ROMIrtosp E my Imo:TBE CS 00NNNIR OF MW COMIC?OR MiIER OCCwNIR MSN RENNOC'TD MOCK THIS fSCIMtA1E WYE MED OR NOT PBtn"TRO NNOANCE AMOR=MY TE POLICIES OOILMB®ANAAI N SUBJECT 1O RUM*TBON. ECOMIC RANDa04E1101NOF MOOR POURED MOS MOM MAY IWSE REIN REDucED BY PEIICCIAmNS_ �j TnaOFaRNwaM laIS 1mt Ate'^Q MS% _ all A 1RIKtrourt PSPEOSOD15 0YA24201S CV12OS17 E�resox,�Np,7a 1,109901 aasNrarMa7w.uisaiv .... a1NIINaar�.� _ 109100 aaAswtE �mcla ImWNrYMaoal . ... SI ......_ iOapaaaAwwwv 1.000.000 _ oaaaa.AeORaAM 1 2,1 .101 ' IR61®a9I8littateain NPO , a moucis-a $m a VI POLLY ri 2a niAa a 11111100101111.6 IS 3233453 1110413116 WOROVI1 Enwa lIN ._ NaAAa BSOIIeaPPaa.q S 260009 AUKS . emYu+aaaar�.aio $ 6m.9/9 a�AIPa. 4 ISOS � a tailM r r wade NSIICGI as ,M e — ®tM a ssima wORaaa s no I IaallonNas 4 c MIEMatarRAIYNR�a - S5 inn1S 12K4120$6 I it aaaa - 0.NIA at.SSW. a 109001 IaaLk�A•IN�aa EON' EL®�E-EANwaaag 4 ...... tOO,00) tatrI oPnae11assa . Et-DraE-DSCItor 4 300.009 .Valla—Waa moNa_AYAMNWSMN 9raaallo'U,- ak.aeaww4 aam•.wak moms CROWS*aoeNM-Ntine* • CgWne*TENOUNS CANCELLATION ANON m..ISO(Snlort lac sN4AO ANada tat mCOMOSINDEDUCISSEasoNDON SME NNe Sala TIE ESNA11M 147E TIIRSOF. Ca St E COMM N 0404144A Mote ACCCe 'ma tllaTaE�FOIICYYFNORNNN. 1 O 70E201O*COM AA risOts award ACOND 20{1-3) MaACORO Mote al V; (tom �oa3trse& b/ ? ci fi Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration - Registra6m: 154218 - Type: Priv Carpo afion - - aphelion: 22012017 Tri 281497 . ALLIANCE HOME IMPROVEMENT, INC SERGIY SUPRUNCHUK - - - 536 MAIN ST CHICOPEE, MA 01020 Update Address and rehire mrd.Mark reason for dnugo at o 201.114911 _ Address ji Reanat ❑ Enploym '-L1 Lint CSN ---- -&L .,onnerad n/: /(:>,dr at. :h). I ar_a_AtLis&ntvmm nearebw Ikea ar*egistratmavaTd for mdiddel are only before the expiration date_ If fond astern to .� - 4 • , 15418 Type: OfficeofCreamerABa"vs Megalith= j 2010117 RivCorponion IB Park Playa-Sake MT0 Eashio,MA 02776 a2wncettaEsnowman;utc 2 26 EAST surlaaT �� astnsr Wan sr � _ YIXAPEE,MA 01020 �, omrasamrJ Massachusetts Deportment of Public Seep/ Board of Building Regulations and Standards License:CS-104927 C. SERPI( "' 53€ PAST Mail greet r. w l - Cr9coPff MA 01020 - - Commissioner 11/1911017