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17A-105 (2) uaizuizull ROM 17:15 FAX x' /002 t2len* 17700 YANNFS ACORN. CERTIFICATE OF LIABILITY INSURANCE DaTEINIMODIvren 0928/2011 . Mom TNM Clt.RS GATE IS OMB AS A MIMI OF INFORM/1T ONl Ic•+o & cusfMaau. hie. O O � ATE DOOM O WORM R King 3 Rim &treats ALTER its cdYamaa AFFORD= BYTIe3 MIMES BEAN►. P.O. Bat 447 Not0imi'les. MA 01061 M suite is APPORDMrO vOWIRAOE NM S 'NORM e01■■M: COMplily Yankee Florae Improvement, Inc. emume: Graffito Sate Mumma Company 82 ladles rid Drive INIUMIRO Northampton, MA @1060 MUNRO CON RAN* THEMUMS OFe ILINPNCEUMWMOWFYAMININ OWED TO7 ENSURED WAND MOVE FORTFEKUMAIRCOMolOMIM.NO WRNBTAWINGi ANY RWANDA, TOW ORCONDRgNOPANYOCRTRACTOROTHER000MNTIVITNRElPeTTDWIENTF ISCBt1FICATEWYS&&SUEDOR NAY PERM THE NSIMLIWCEAF WW1 POMOORWRElD SERBS ISSI C7TOALL THE'1■1 *E CLUMONSAt0 00MMONSOFSUdi POLICES. AMMAN LIMITS MOAN NAY NAVE MIN MU = PAC CLA■ L -- ' �� [S, TYFNOFeNI/vYNO • MCI �y'.- � i- _i .,:i i�'; a.�A LIM GALLNKJIY ( 411 �{ iAtyl000{/IIINIGE ra COMAEMPLOENtrAumSLflY * ' i 1 r ,'1 ■ �� CLAMS MACE ® Malt IIII agill r ,..' — —. I Nam RosRNANS LISTAFouRSFes r LL Pa= 111 ulC =MOWuMirrr :NW NTO 93nmrRq ets _ *LaAeMDNfl ■ WM WAY $O1lolImMfVs - $ II IMIMARO{ II mCOSONIONNOS SCOLY NARY proxiboN III P!W,tME $ SAWS UMW $ III M1YsMJ O orN�vuw MAW S II COMM AGG : NIORNRI sfldaAMURRY aACM0001et S ■ II OCCUR DaAerstaoe AGSM= S S S 11111 o,ouclMl>: ■ _ $ MUM SOMNORLIO ORAMO " . � , 1010v11 1012112 elOt+Ore><e'LMMRY A11Y $1.000.000 OPPeXiMM!■t■VJT W _ cneewear amairSIONaFG/S ICION S /LACA110111irOeRitlsCLtNOetA SY OCpa1MIR /OPegM.M0AMOlis , ceRfwPICATE HOLM CANCELLATION SNOOD A NY aF'R*Mallsue.esemo mums mname 1taD evespervvieveucnce The Homo Service Store & Costae ONSTI ONORDO MUMS NNI SIONU.NOW=TOAWL _ja DAYS WhoMstle ROTICRTO MS CSIOIRORTIROLONOMNINTO ThEUI TANTNNURITOINSO SO West Skeet- Suite 104 UP= NDCSYWT1011 Olt LMMiuYV CV ANY IMO UPON The eNt .IE$Aoouson YT 05701 AUT1M ■ MME ACORD ffi C201 of 2 08100131M10614 $M'F • ACORD CORPORATION 1959 r Ma ehuxetts - Department of Public S1fety Board of Building Regulations and Standards Construction Supervisor License License: CS 89442 Restricted to: 00 GERARD J RONAN -• PO 80X 675 EASTHAMPTON, MA 01027 ' °�- - +�' -!Y Expiration: 3F19r2)12 (bmmiwer Tr#: 18580 I �: • • e Ark e &9411010#6Weerld VeAratifileitea i Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Bost" Massachusetts 02116 Home Improvement Contractor Registration Registratiost 180584 Ti m Nob CaDombon 8/7/20/2 US 201019 YANKEE HOME IMPROVEMENT INC GERARD RONAN 82 INDUSTRIAL DRIVE NORTHAMPTON, MA 01080 Update Mavis sad rotors ear& Mark Tears lir ebotgr. 0 Ad*** 0 Rameme 0 Impiermest 0 LOSt CJIM4 OPSCAI 56‘41400413101216 'tont Porch Roof i(,Y LJNO - - - 2ear Porch Roof [es ONo Flashings des ONo )rip Edge It�JYes ONo Color LA b Location 6dh ere rt ro. cl GUTTERS Color Downspouts Color I -ayout Attached ❑Yes ONo Gutte .rolls ion OYes ❑No J Residential 5in ❑ Co tai 6in Downspout ❑ Residential ommercial ype Garage ❑Yes ❑No Location Porch Lives ON Color I ATTIC ENERGY BARRIER BLOWN -IN INSULATION ❑ Rafter Install 0 Floor Install ❑ Open Attic Blow Walls ❑Yes ❑No Kneewall ❑Yes ONo ❑ Net Blow �/ Area to be cleared by homeowner ❑Yes ONo Kneewall ❑Yes ONo Type of exterior Cladding Special Instructions t0 U. r-i-'Cc 7izy /2i h f" Cj +-t--- dr.'v' ,,1,A.. refs ecf ch s144e - ;ii .Mlncr ,-e • ;i1- ;.i - /Iece.f — -, . , t t ^ ` to d•4 •¢.°Ue : D a . , "A Mt" - i ::i /I . ` . 4a /` WORK SCHEDULE Coot or w I t begin the work or order the materials before the third day following the signing of this Agreement, unless spec!I ere?. Contractor will begin the work on or about a. (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by spec!, (date). The Owner hereby acknowledges and a Tees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including, ut n limited to strikes, Acts of God, shortages of Materials, accidents, and all other delays beyond its control, shall not be considered as violations of this Agreement WARRANTY the Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of �_ following completion and shall comply With the requirements of this Agreement. In the event any defect In workmanship or materials, or damage caused by the Contractor, its .. f'" ctors, employees or agents, Is discovered after completion of any job, Including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or ca •e to be remedied, repaired or replaced, such damage or such defect in materials and workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed -upon work YHI agrees to perform the work, furnish the material and labor specified above for the total sum of: 1 /'ik2, el 33 ($ J:aU ) upon signing contract; Name of Representative a f � I ts • Authorized Si.nature ______% ($ ) upon completion of —rt.. Li '/° ($ ! .21 - e') upon completion of S4:2.1+ i r Notice: No agreement for home improvement coot : ng work that require a down payment (advance ( (`r r $a upon deposit) of more than one-third of the total contract price or the total amount of all deposits or payments $ ) shall be made forthwith u n which the contractor must make, in advance, to order and/or otherwise obtain delivery of special order completion of work under this contract. materials and equipment, whichever amount is greater, ACCBptance of Proposal I have read both sides of this document and accept the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller, which may be his main office or branch thereof, provided you notify the Seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. Please refer to the Notice of Cancellation below contents of which are referred to above and incorporated herein by reference. DO ' OT SIG THIS CONTRACT IF THERE ARE ANY BLANK SPACES. 0 7 Sighatur -A r Dat= J�' 1 � Signature Date NOTICE OF CANCELLATION DATE OF TRANSACTION YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACTOR SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO: YANKEE HOME IMPROVEMENT, INC., 82 INDUSTRIAL DR., NORT MPTON, MA 01060 NOT LATER THAN MIDNIGHT OF 10 d I HEREBY CANCEL THIS TRANSACTION (Date. S ndays d holidays excluded) BUYERS SIGNATURE DATE Buyers) acknowledge r • ceipt ' o 1 I' %yam y • . ,1 copies of this notice on the date first above written hereof. Buyer's Signature Buyer's Signature • 6 Roofing /Gutters /Attic Barrier Agreement II Thousands of Satisfied Clients! Y I EE I N 82 Industrial Drive MA Lic# 160584 225 Cedar Hill St, Suite 200 Northampton, MA 01060 CT Lic# 0673924 Marlborough, MA 01752 HOME IMPROVEMENT 413 341 -5259 RI Lic # 33382 877 88- YANKEE The MOST Referred Contractor All home improvement contractors and subcontractors must be registered and any inquiries in New England about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 www.YankeeHomelnc.com Boston, MA 02116 Phone: (617) 973 -8700 /� Homeowner Information _/ Name Mntj,;; y can: /ta Street Address 3 1St: `� . f!! • City fkiri'!CP�-- State Zip Home Phone / '8G, C yes Work Phone Cell Phone E -Mail, J'"K.0 yen ; e , j uii0 eel,,) Mailing Address (If different) The Contractor agrees to do the fo/ %wing work for the Homeowner: I ROOFING Type , kO Color &Ictf -- Style r4:IC /* • I Removal of Existing Roofing es ONo Ice and Water Barrier 'ull ❑ Partial Removal of Garage Roofing f es ONo Ridge Vents fames ONo LIP it) Dumpster C -s ONo Replace Sheathing i es ONo Sheets fncl. Main House Roof Wes ONo Price per sheet 7 2 i ''D (as needed ) Garage Roof Q'es ONo Rolled /Low Slope ❑Yes 73Nb Front Porch Roof Illfes ONo Location Rear Porch Roof s ONo Flashings Comes ONo Drip Edge ❑No Color W+ / Location t'/4 i pe ft .02 r1 I GUTTERS Color Downspouts Color Layout Attached ❑Yes ONo ❑ Residential 5in ❑ Co oal6in Gutte coon DYes ❑No Downspout ❑ Residential ommercial YPe Garage ❑Yes ONo Location Porch ❑Yes ON Color m j I ATTIC ENERGY BARRIER BLOWN -IN INSULATION ❑ Rafter Install ❑ Floor Install 7- ------ ❑ Open Attic Blow Kneewall ❑Yes ❑No ❑ Net Blow ........7„,./ Walls ❑Yes ONo Area to be cleared by homeowner ❑Yes ONo Kneewall ❑Yes ONo Type of exterior Cladding Special Instructions I) vM p c-{-Cr 7 iO�r i oert`vv_ AI A _ref spe -- Ci'.nw - Zi M ; t f o r ►teePo;7 -:-, - n e e e l f , r —.roclu c(- 4 [• r .. . ie ei *SAC D i i. L I% — ' /J i :Mc " %'�j" /` WORK SCHEDULE or w I t begin the work or order the materials before the third day following the signing of this Agreement, unless ed here' ,Contractor will begin the work on or about (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by / (date). The Owner hereby acknowledges and a roes that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including, ut n limited to strikes, Acts of God, shortages of materials, accidents, and all other delays beyond Its control, shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of ._ f following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, .. ". - ctors, employees or agents, is discovered after completion of any job, including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or ca = to be remedied, repaired or replaced, such damage or such defect In materials and workmanship. The f. _ . warranties shall survive any inspection performed In connection with the agreed -upon work. YHI agrees to perform the work, furnish the material and labor specified above for the total sum of: 11114ME 33 % ($ S��$G� Cie) ) upon signing contract; - Ay: /J , Name of Representative + ( ' � / , �- Department of Industrial Accidents ;=i.:. Office of Investigations x — ° = M1 600 Washington Street Boston, MA 02111 1t'1i www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information /± � ' Please Print Legibly Name ( Business /Organiration/individual): )M4 f /7 t� 1.✓"l ; d1 MC�•� %lra ,,^d Pc.);-) Yi Address: dvf-(l^c a L City/State/Zip: / / /lt/iarfreein A44 O /C)CvO Phone #: L7 — 3 i// - 5�%.2- r9 Are you an employer? Check the appropriate box: Type of project (required): I. WI' am a employer with 10 4. ❑ I am a general contractor and 1 6. ❑ New construction employees (full and/or part- time).* have hired the sub - contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet t 7..arRemodeling ship and have no employees These sub - contractors have 8. 0 Demolition working for me in any capacity. workers' comp. insurance. 9. [] Building addition [No workers' comp. insurance 5. 0 We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 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 12.0 Roof repairs insurance required.] t employees. [No workers' 13.0 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_ f am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site Information. Insurance Company Name: G rc ✓i i' f S h iE'i J I1 S r.e, G C Policy # or Self -ins. Lic. #: ( 1) C UCH 97 d f 3 ( 7/ Expiration Date: /0/„2/ Job Site Address: 320 X32 DGe .E4 City /State/Zip: ie e , 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 [MA for insurance coverage verification. I do hereby certify under the • and penalties of perjury that the information provided above is true and correct i • : ture: Date: / / Z 12-0 ! / Phone t /3 3W -,5 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 : L' Pei) ti/ c 2 • o o License Number 6'2 :7 7R'1 ij (_ 1x11`(roxf MO tom. / 06 0 3 ti y I ` Z Address Expi io Date �f (3 •- 3444 - . S Sign Telephone 9. Restistered Home Improvement Contactor: Not Applicable ❑ / cI�C 2 1-1 T 16o .SS °+ O bmoanv Name Registration Number e2 . L`�I.D us - 7RiAL_ v 46 e'7XIA 7aN" J-i' (1, , U 1660 ? /2 c3 /Z Address - Expiration Date Telephone y- t 3.314 I -S 9j ECTION 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 buildi g 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 and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House El Addition El Replacement Windows Alteration(s) ❑ Roofing l25 Or Doors 0 Accessory Bldg. 0 Demolition EJ New Signs [D] Decks [[] Siding [0] Other [0] Brief Desc_rigtion of Proposed Work: t'i piotj -AXE) 26- 76Ac , i' ,ice f S4'd/C(s-- S Alteration of existing bedroom Yes /C No Adding new bedroom Yes .X No Attached Narrative Renovating unfinished basement Yes )l 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 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, 74/4 -716k/ y CAA! /l 4 iir4 , as Owner of the subject property / hereby authorize ilJle �/ / J /1 WCH&iLL .1 Go g7 Fd,� Am to act on my behal , in all matters relative to wo authorized by this building permit application. ©�l 78Ac 7 Signature of Owner Date l � ��' , 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 the pains and penalties of perjury. Print Name i Signatu - • • er /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 Setbacks Front Side L: R:.. L ::. R:' Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Findin ever been issued for /on the site? NO 0 DONT KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained O , Date Issued: C. Do any signs exist on the property? YES © NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES ® 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 Q NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. "`, JJECENED City of Northampton Sys dIr>a NOV — 4 2011 , Building Department Cur bt . i1veway Pem .' 212 Main Street rtic.Afhty -Y Room 100 Wat'et1We l Aval lty kPT OF BUILDING INSPECTIONS Northampton, MA 01060 Two Sta*Stiiiittutal NORTHAMPTON, MA 01060 pl4efie 413-567-1240 Fax 413 -567 -1272 Plot Pla C3thetlfy : T APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 2® - t ?I ASE r Map Lot Unit f i'1 ?– j4CC' , Nf fa O / o 2_ Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: - , 4/.177/® ac/ y CAS / GL / A 3 2U /3i2icoe , H p 0/ O6 Z Name (Print) Current Mailing Address: _ 4 1 3 Oti/ Cv ✓ ?i? c 7 Telephone /8P� Signature 2.2 Authorized Agent: derd/4773,k; �Aet/L%;C— itewc - rd-(�'k' /( F/�% i "fix '-1 11 Qa" Au L 2 rN. s 7 L? /9 1-1,1 01040 Na me (Print) Current Mailing Address: 3 „r �� 35 / -- S Z .�c Signature Telephone Sb 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 6. Total = (1 + 2 + 3 + 4 + 5) /5 , ENO "- Check Number 6 9 3 cg,35 — This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date 320 BRIDGE RD BP-2012-0457 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A - 105 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- 2012 -0457 Project # JS- 2012- 000745 Est. Cost: $15840.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: YANKEE HOME IMPROVEMENT INC 89442 Lot Size(sq. ft.): 26136.00 Owner: CANIGLIA ANTHONY J & KATHERINE Zoning: URA(100) //RI Applicant: YANKEE HOME IMPROVEMENT INC AT: 320 BRIDGE RD Applicant Address: Phone: Insurance: 82 INDUSTRIAL DR, UNIT 2 (413) 584 -8318 WC NORTHAMPTONMA01060 ISSUED ON:11/8/2011 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 11/8/2011 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner