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18C-127 (6) 86 BLACKBERRY LN BP-2020-0404 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: I8C- 127 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-2020-0404 Project# JS-2020-000683 Est.Cost: $15205.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PHIL BEAULIEU & SON HOME IMPROVEMENT 062638 Lot Size(sq.ft.): 19384.20 Owner: SULLIVAN NEIL Zoning: URB(100)/ Applicant: PHIL BEAULIEU & SON HOME IMPROVEMENT AT: 86 BLACKBERRY LN Applicant Address: Phone: Insurance: 217 Grattan St (413) 592-1498 Workers Compensation CHICOPEEMA01020 ISSUED ON.9/30/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.STRIP & SHINGLE ROOF POST THIS CARD SO ITIS 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 Sig(nature: FeeType: Date Paid: Amount: Building 9/30/2019 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587- 272 Louis Hasbrouck—Building Commissioner It–c-)CU (— Department use only City of Northa tatusP f Permit: Depart :C:E Building DepaI V E rb C t/Driveway Permit 212 MaimStre t S wer/ eptic Availability i � q Room 100 SEP 2 7 2019 v�yate, ell Availability Northampton, MA 1060 Tro Sets of Structural Plans phone 413-587-1240 Fax 13-587- t/Sit Plans SS er S DEPT.OF CilJll DING INSPECTI ttl beclfy NORTHAMPTON.MA 01 06 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION U, z — C/V y 1.1 Property Address: This section to be completed by office Map " Lot Unit 86 Blackberry Ln. Northampton Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Neil Sullivan 86 Blackberry Ln Name(Print) Current Mailing Address: d,'L Telephone C y l 3 Sig ature 7 a7 - a0(, :5 l J 2.2 Authorized Agent: Beaulieu Orme ImprayPmeof a/7 Gro lfan 5f. G hi cooee Name(Pr Current Mailing Address: (413) Sqi - )yg8 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)to be Official Use Only completed by permit applicant 1. Building CO (a) Building Permit Fee 15 5 - 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee n 4. Mechanical (HVAC) V 5. Fire Protection 6. Total = (1 + 2 + 3 +4+ 5) Check Number 44(13 This Section For Official Use Only BuildingPermit Number. Date Issued: Signature: �- Z 7 -2019 Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONIN 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 L Setbacks FrontCJ Side L:C R: j L: RE I Rear C Building Height Bldg. Square Footage % Open Space Footage % —� (L.ot area minus bldg&paved arkin #of ParkinR SvdZces Lu e&Location J A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DON'T KNOW (D YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DON'T KNOW a YES Q IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW 6 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O 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,t2�pavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO 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 ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing 21 Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding[O] Other[d] Brief Description of Proposed Work: Stc;� All layers, ��' ice/ wafer r RnRec i173la11 a sy Alteration of existing bedroom Yes 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 un' : Number of Bathr s c. Is there a garage attached? d. Proposed Square footage of new construc n. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. ZZ Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within'0 . wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of baseme or cellar floor below finished grade k. Will buildi conform to the Building and Zoning regulations? No . I. Septi ank City Sewer Private well %Yes water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, W 1 1 as Owner of the subject property hereby authorize P g rl to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date T as Own Authonz Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best o my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Phil Beaulieu&Sons Home Imp.,Inc. 217 Grattan Street,Chicopee,MA 01020 License Number HI REG#100073 Exp.6/7/20 CSL#CS62638 Exp.6/13/21 Alain Beaulieu Expiration Date PH:(413)592.1498/Fax:(413)594.6008 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Phil Beaulieu&Sons Home Imp.,Inc. 217 Grattan Street,Chicopee,MA 01020 Registration Number HI REG#100073 Exp.6/7/20 CSL#CS62638 Exp.6/13/21 Alain Beaulieu Expiration Date PH:(413)592.1498/Fax:(413):594.6008 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...... ❑ City of Northampton �? Massachusetts DEPARTMENT OF BUILDING INSPECTIONS F 212 Main Street • Municipal Building 4D` Northampton, MA 01060 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("Inc"). 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: R 00 f i nq Est. Cost: 15 1205 Address of Work: `Z o 810(Kbeify L„ Date of Permit Application: g 1 d 5 III 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: Phil Beaulieu&Sons Home Imp.,Inc. 217 Grattan Street,Chicopee,MA 01020 HI REG#100073 Exp.6/7/20 I hereby apply for a building permit as the agent of the owner: CSL#CS62638 Exp.6/13/21 Alain Beaulieu q111 pe N T PH:(413)592.1498/Fax-(413)594.6008 — 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: ail a� llg DT Owner Name and Signature City of Northampton Massachusetts - �� lj 7 J wr DEPARTMENT OF BUILDING INSPECTIONS y 212 Main Street • Municipal Building Northampton, MA 01060 J�Y`10Cb .- � 31J Massachusetts Residential Building Code Section 110.R5.1.2 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. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. 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 Commonwealth of Massachusetts Department of Industrial Accidents a 1 Congress Street,Suite 100 Boston, MA 02114-2017 ^M www.mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Phil Beaulieu&Sons Home Imp.,Inc. Name(Business/Organizstion/Individu � 217 Grattan Street,Chicopee,MA 01020 HI REG#100073 Exp.6/7/20 Address: CSL#CS62638 Exp.6/13/21 Al Beaulieu City/State/Zip: PH;(413)592.1498/Fax:(413)594.6008 Are you an employer?Check the appropriate box: Type of project(required): 1.®I am a employer with /0 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10❑Building addition 4.❑I 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 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑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#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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and,job site information. Insurance Company Name: AIM Policy#or Self-ins.Lic.#: WI K% to;LOS Expiration Date: A.1 d 5 ,Zo Job Site Address: AV 8/0 Blackberry In City/State/Zip: NarfhamOfa,� Attach a copy of the workers'compensation policy declaration page(showing the policy number and xe number 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. Ido hereby cern t?egiins and penalties ofperjury that the information provided above is true and c rrect Si afore: zzzle Date: / A /J Phone#: �< l/" 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#: City of Northampton Massachusetts �• DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building Northampton, MA 01060 rsY •.. ��� 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: �(a Ia(Kbefry LN (Please print house number and street name) Is to be disposed of at: All Waste (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) 114 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. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia PHILBEA-01 CHRISTINE ACORO CERTIFICATE OF LIABILITY INSURANCE DAT 3//13/213/2019D 97 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 have ADDITIONAL INSURED provisions or 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 Christine Sullivan NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street AIC,No,Et): 413)594-5984 (FAME,N.,.(413)592-8499 Chicopee, MA 01013 E-MA'L .christine@phillipsinsurance.com INSURERS AFFORDING COVERAGE NAIC k INSURER A:Ohio Security Insurance Co 24082 INSURED INSURER B:Ohio Casualty 24074 Phil Beaulieu&Sons Home Improvement Inc. INSURER C:A.I.M.Mutual Ins.Co. 33758 Phil Beaulieu 217 Grattan Street INSURER D: Chicopee,MA 01020 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 NUMBER POLICY EFF POLICY EXP LIMITS LTRA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE FX�OCCUR BKS58415578 2/25/2019 2/25/2020 PREMIDAMAGETORENTEDSES occurrence) $ 500,000 MED EXP(Any oneperson) 15,000 PERSONAL&ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3,000,000 X POLICY 1 j T F] LOC PRODUCTS-COMP/OP AGG 3,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) 1-- ANY AUTO BAS58415578 2/25/2019 2/25/2020 BODILY INJURY Perperson) $ OWNED X SCHEDULED AUTOS ONLY AUTOS yy p BODILY INJURY Per accident $ X AUTOS ONLY X AUTO O*� PROaca ent AMAGE B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 1,000,000 EXCESS LIAR CLAIMS-MADE US058415578 2/25/2019 2/25/2020 AGGREGATE 1,000,000 DED X RETENTION$ 10,000 C WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY YIN WMZ-800-6205-2019A 2/25/2019 2/25/2020 1,000,000 ANY PROPRIETOR/PARTNER/EXECU I IVE I E.L.EACH ACCIDENT FICER/M,MBER EXCLUDED? N NIA 1,000,000 andatory m NH) E.L.DISEASE-EA EMPLOYE If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT A Equipment Floater BKS58415578 2125/2019 2/25/2020 Leased Equipment 200,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD G � A Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation PHIL BEAULIEU&SONS HOME IMPROVEMENT, INC. Registration: 100073 217 GRATTAN STREET Expiration: 06/07//22 020 CHICOPEE, MA 01020 Update Address and Return Card. 4,�6mewlonftw Office o€Consumer�lffair &Businessegu�ation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 100073 06/07/2020 1000 Washington Street-Suite 710 PHIL BEAULIEU&SONS HOME IMPROVEMENT,INC. Boston,MA 02118 ALAIN M.BEAULIEU \,Q 0 --- 217 GRATTAN STREET U CHICOPEE,MA 01020 UndersecretaryNot valid without signature Commonwealth of Massachusetts ; it Division of Professional Licensute Board of Building Regulations and Standards Constructibn''80 pervisor CS-062638 41pires: 06/13/2021 ALAIN M BEAULIEU 217 GRATTAN$TREE CHICOPEE MA 01020 Commissioner ��