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38A w rOffice of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Corporation Registration: 118239 SEXTON ROOFING &Siding Inc Expiration: 02114/2019 P.O. Box 6327 Holyoke, MA 01041 Update Address and return card. Mark reason for change. cC:.i •�o ?OL+.n n n �.._.,,.., n o:....,....,i r1 c n+ n t na+cn'4 Commonwealth of Massachusetts �! Division of Professional Licensure Board of Building Regulations and Standards Constructiotj,s'd�rrvrisor Specialty CSSL-099689 E5cpires: 10l0512019 a EVERETT J SEXTON PO BOX 6327% 1 ' HOLYOKE MA 01041 Commissioner t/^ STATE OF CONNECTICUT DEPAREIIENT OF r PROTECTION HOME IMPROVEMENT CONTRACTOR EVERETT J SEXTON SR 102 Pine St HOLYOSE,MA 01040-2411 SEXTON ROOFING&SIDING CO LMC.J REG NO. EFFECTIVE EXPIRES HIC.4605383 12/0112017 11/30/2028 SIGNED AC4--)Jzf:>' CERTIFICATE OF LIABILITY INSURANCE nAlEWzsrloiS S CERTIFICATE IS ISSUED AS A NIATfER OF INFORMAT1ON ONLY AND CONFERS No RIC4iTS UPON THE CERTIFICATE HOLDER.THIS ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVMY AMEND,ErreMORALTERTtiECOVERAr.EAFFOFMMErYMiEPOUCIES BELOW TM CERMCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURENS}, AUTHO REPRESENTATIVE OR PRODUCHR.AND THE CERTIFICATE moLDER.. PORTANT:if the certificate holder is an ADDITIONAL INSURED,the pofity{ies)must be endarsed.If SUBROGATION IS WA11fW,subject to ih arms and conditions of the policy,certain Policies may require an endorsement.A statement on this cerUftcate does not Confer tights to th ertificale holderin lieu of sach endorsement(4 PRODUCER CONTACT NAME:Kaihi Hutchinson Orncshy,insurance Agency.Inc. PRONE(A7C,No Ext):(413)rJ74 00 IFAXJAENor. PO Sax 718 E-MAILADORESS:khurd8pson@orUn;bY-rCQm West Springfield.MA 01089 INSURERS AFFORDING COVERAGE NAICd INSURED INSURERA Co"Insorance Com -39993 Sexton Roofing and Siding Inc INSURER B: PO Sax Er'w INSURER C: HoVoke.MA 01041-633 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 0 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICAATED.NOTWnJWANDWG.ANY REOUREMETTT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CSMRCATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND COMMONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EM POLICY EXP N OOT SURR DATE DATE LTR TYPE OFINSURANCE NSRD WVD POLICY NWABER LILTS A 101GU=59903 625x1 s 6{2572019 EACH OCCURRENCE 51,0001000 X COMMERCLAL GENERAL LIABILITY CLAIMS MADE D X OCCUR DAMAGE TO RENTED 5100.000 PREMISES Fsl oaxnrerrcci MED EX'(Arra'one person) 55.000 PERSONAL&ADV INJURY 51,000.000 GEN'LAGGRE-GATS LIMIT APPLIES PER: GENERAL.AGGREGATE 52.000,000 Y POLICY MJFGM'T D LOC PRODUCTS-COMPIOP AGG $Z000,0W OTHER: COMBINED SIGNED LIMIT S AUTOMOBILE LIABi1.JTY (Ea Wdd—) ANYALrTO BODLYIN.AM(Perperson) 5 ALL OWNEDSCI EDULED BODILY INJURY(Per 5 AUTOS AUTOS ) HIRER]AUTOS NON-OWNED PROPERTY DAMAGE S AUTOS aeodent) S Rs t E a LTA$ CCl1R EACH OCCURRENCE S ClExCESS LIAR MS MADE AGGREGATE $ S ED I WENITON S VVORI(M COMPENSATION AIID STAIWE ER EMPLOYERS*RS*LIABRJrY YIN --- ANYPROPRIETORIP EL EACH ACCIDENT S OFFICERI ENSER EXCLUDED? NTA Narww-y in NH) EL DISEASE-EA S EMPLOYEE IF yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT IS DESCRIPTION OF OPE3RATEOusi LOCATEONS I VE MCLES(ACORD 1II1,Adt65ongPi marks sd,eWTe,irame spatx is m4lamd) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBi%I POLICIES BE CANCELLD BEFORE THE EEXPM-noN DATE THERMF,NOTrCE W01-BEDELNERED IN ACCORDANCE 16WM THE PDUCY PROMONS. AUTHORUM REPRESENTATIVE 10AI - ACORD 25(21 4X4 I) 01988-2044 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD s ® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYlr7 07123/2018 TIFICATE 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 and endorsement. A statement on this certificate does not confer rights to [the certificate holder in lieu of such endorsemen s. PRODUCER CONTACT NARIS A COSTA INSURANCE AGENCY PHONE FAX 2 FRANKLIN COMMONS (AIC,No,Eat): (AIC,No): FRAMINGHAK MA 01702 ADDRESS: 783BY INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA. TRAVELERS INDEMNITY COMPANY OF AMERICA LDG HOMES IMPROVEMENT INC INSURER B: INSURER C: 18 SPRING ST 1 ST FL INSURER D: INSURER E: MILFORD,MA 01757 INSURER R 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 PAIAFFD LAI BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERNS,EXCLUSIONS AND CONDITIONS OF SUCH POLIOS.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR - ADD ISUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (IQ1 MMYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE I$ COMMERCIAL GENERAL LIABILITY CLAIMS MADE r--1 OCCUR DAMAGE TO RENTEDI$ occurrence)REMISES(Ea occurrence) WED EXP(Arty one person) Is GEMERSONAL&ADV INJURY is AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE is POLICY ]PROJECT E]LOC RODUCTS-COMP/OP AGG is AUTOMOBILE LIABILITY COMBINED SINGLE i$ ANYAUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY ($ SCHEDULE AUTOS (Per person) HIRED AUTOS (O�DIILYYIINJURY �$ NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA L1AB OCCUR EACH OCCURRENCE is EXCESS L1AB CLAIMS-MADE AGGREGATE Is DEDUCTIBLE Is RETENTION $ 1$ A WORKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-1K196202-18 021212018 02212019 LIMBS ANY CERIME B R/PXCW EEY? CUTINS � NIA E L EACH ACCIDENT I$ 100,000 OFFlCERIMEMBER EXCLUDED? (Mandatory In NH) EL DISEASE-EA EMPLOYEE 1$ 100,000 If yes,descnbe under DESCRIPTION OF OPERATIONS below E_L DISEASE-POLICY LIMIT I$ 500,000 DESCRIPTION OF OPERATIONSA=ATIONSIVEHICLESIRESTRICTIONS!SPECIAL f IFNs THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION SEXTON ROOFING&SIDING INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 102 PINE ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 6327 AUTHORED REPRESENT L HOLYOKE,MA 01040 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1SM2010 ACORD CORPORATION. All rights reserved. The Commonwealth ofMassachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass govldia Workers'Compensation Insurance Affidavit Builders/Contractors(Electridans/Ptambers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Let?�ibly Name(Business/Organizaaonlindividual):LDG Homes Improvement Inc Address:18 Spring St 1 st floor City/StatelZip:Mitford, Ma.01757 Phone#:(774)2146239 Are you an employer.Check the appropriate box: Type of project(required): 1. ✓0 I am a employer with 5 employees(full and/or par[-time).• 7• ❑New construction 2.[:]l am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling any amity.[No workers'comp.ix---required.] 3.C]I am a homeowner doing all work myself[No workers'comp.m.requiredl t 9• ❑Demolition 4111 am a homeowner and will be hiring contractors to conduct all work on my property. Twill I O O Building addition ensure that all contractors either have workers'compensation insurance or are sole I LD Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.C]I am a general contactor and I have hired the sub-contractors listed on the attached sheet. 13•J]Roofrepairs These sub-contractors have employees and have workers'comp.insurance.: 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[:]Other 152,§1(4),and we have no employees.[No workers'comp_insurance required.) *Any applicant that checks box#I must also frill out the section below showing their workers'compensation policy information. t Ilomeownes 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 subcontractors amu.state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number_ Iam an eWloyer that is providing workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name Travelers Indemnity Company of America Policy'#or Self-ins.Lic.#:UB-1 K196202-18 Expiration Date:02/21119 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 MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisoumnt,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day ae ainstthe viol or.A copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verificati I do kerehy lee the pains and penalties of perjury that the information provided abpve is true and correct. Sium ature: Date: f / Phone# 1 239 Official use only. Do not write in this area,to he completed by city or town official, City or Town: PermitlLicense# 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#: The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www nzass.gov1dia Workers'Compensation Insurance Affidavit:Buildeers/ContractoxsXlect-ticians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):Sexton Roofing&Siding Inc Address:P.O. Box 6327 City/State/Zip:Holyoke, Ma,01040 Phone#:413-534-1234 Are you an employer?Check the appropriate box: Type of project(required): 1.M I am a employer with 5mployecs(full and/or part-time).* 7. F1 New construction In I am a sole proprietor or partnership and have no employees working for me in 8. F1 Remodeling . any capacity.[No workers'comp.insurance required.] 9. 0 Demolition 1[]1 am a homeowner doing all work myself[No workers'comp-insurance required.]t 10[J Building addition 4.(11 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I Ln Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5,M I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.FlRoof repairs These sub-contractors have employees and have workers'comp.insurance.! 14.[]Other &[J We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees,[No workers'comp.insurance required.] *Any applicant that checks box#1 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. :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. 1am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. InsuranceCompany Name:Travelers Property Cas Co of Am Policy#or Self-ins.Lic.#:7-PJUBGo7898212 Expiration Date:6/4/19 Jab Site Address: AZ &Ick City/State/Zip: -pc.g --- V, Attach a copy of the workers'compensation policy declaration page(showing the policy Lumber an expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify a . /pf�t the pains and penalties of perjury that the information provided above is true and correct Signature Date: 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#: i x � i .'ro t k :a. it i a 9 i . L' f � f Y Ewe d � r. n t p{411.S41W',, 9' rtfak Cyt .7 u413'S3 l ;•;w� � "� t• ,�, #1 R� fY _ Sulfi@ s z .F NEE .f r. - d� $ ,:- � ` +" � � ` �� ��3t�'`�> � �'#�$`: zd `�,p � s✓r" �h t_x " �.d+- r a d .r k r d _g X}. 4 � 7M BMW ��i� � �... ,. �;t� � ✓r ax �. ���, a� '�` C F '�'` n dr.h� X� � �� ar,e� kf�t>, r..��a dna" #,. �� � ,€4.`��,, (5#tiYw. -tF•"� is �'a xt��' ,x rr .: a �aye a. City of Northampton (� Massachusetts �• D"ARRENT OF BUXLDING INSPECTIONS 212 Main Street •Municipal Building Northampton, MA 01060 Debris 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. The debris from construction work being performed at: (Please pent house n—umber and street name) Is to be disposed of at: /,�C4,3, i (Please print name and location of facility) Or will be disposed of in a dumpster onsite.rented or leased from: (Company Name and Address) Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. City of Northampton . , Massachusetts ��{ �►- c,<< r.r c ' DEPAR2NMr OF BUZLDnFG INSPECTIONS �y 212 Main Street s Municipal Building b Northampton, MA 01060 Jbssj ��bt` AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M,G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building'be done by registered contractors. Note.If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: Est.Cost: Address of Work: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000-00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: (to J 4 rz s :�g�j Date Contractor Name �� HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor- 11 Not Applicable ❑ Name of License Holder: = —� rlJ License Numler Add 7,--- _ Expiration Date ©5.gys Signature Telephone 9,Realsbwed Home Improvement Contractor; Not Applicable ❑ �ool t 15�l.L Cg,Mny Nan Registration Number , oX Al'-Z-6 g Address IExpiation Date Q l 6�L �Telephone S /Z 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...... ❑ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Atteration(s) IDRoofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [CI] Decks [0 Siding[CI] Other[CA Brief Description of Proposed n / Q Work: �1CJ� ;4 C /Z CcrJ—S Alteration of existing bedroom —Yes—No / Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. ff 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,- :3 ,c F* :D)A{✓v as Owner of the subject property " hereby authorizeac,� 0 LV 4- to to a on my behalf, in all matters relative to work authdfized by this building permit application. Signature of Owner Dat I, f1le"Ap as Owner/Authorized Agent hereby declare that the statements and information o4 the foregoing plica on are true and accurate,to the best of my knowledge and belief. Sig under the pains aCnaltie of perjury., Prin Name _.� ky e of Owner/Agent Date Department use only City of Northampton Status of Permit Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability `�. Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,AL ER, M(ERO&VC61DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: Tfi is section to be completed by office DEPT.OF BUILDING IMCTrOKS Lot �^ Unit NORTHAMPTON,MA 01060 Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) / Current Mailing Address: 044A.4-r Qt 4-r(/I Telephone Signature 2.2 Authorized Agent: Sa- Name(Print) Current Mailing Address: 0(641 4: 3 v / z- 3 / _ Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit 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 v 6. Total=(1 +2+3+4+5) Check Number p2 d/ This Section For Official Use Only Date Building Permit Number. Issued: Signature: ., /I019 Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 26 BURTS PIT RD BP-2019-0545 GIS#: COMMONWEALTH OF MASSACHUSETTS Map-.Block: 38A-002 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categor:ROOF BUILDING PERMIT Permit# BP-2019-0545 Proiect# JS-2019-000886 Est.Cost: $16500.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin SEXTON ROOFING CO 99689 Lot Size(scl. ft.): 18817.92 Owner: DAN JEFFREY Zoning: URB(100) Applicant: SEXTON ROOFING CO AT: 26 BURTS PIT RD Applicant Address: Phone: Insurance: P O BOX 6327 413) 534-1234 _ WC HOLYOKEMA01041 ISSUED ON:11/6/2018 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: FireDepartment Fireplace/Chimney: Rough: ,©moi c Insulation: Final: Smo e� 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 11/6/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner