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23D-090 (2)
1 , - 7......, sss3,. s.sT't , As' SZ fr- k.-, x L i ,-,,,. t i I: &. E.L..-=1 ,-1 =16' , t in a CCOrd DC,e -,„ the Drc of NICL c 41 '4, ! adknowl as a i condition Of the Buildinq permit, -- aH debris: resukina from cc_Int Pc-tnvity governed by bills Building Permit shall be disposed of a ' 1 1 0 IL c-\f) 10 1. -----1 i l i i i 4 i E : a pi-op tic._-e.r- scslci ,„,,,' a S t F2 f dc.iy es Tine.ci by i ! ..'' --------,--- --,;-,,,----,-,,,- _,--, ---- // / ) (/' • '.. 4 0 F - - : 1 ' T T ; =-- O E FL L L 0 WI ;,:= C; I F C - I - f, : 1 i [ -.:)._ ,--- L i (47 E 0,F PE! f 7 AP Pi _I I- .4 N '1 5 - - t-- — 1 TO i.=;-r-= DUSPC),3E27 OH I I / L 5 -', ( ifilii ( FR CP F RP( A D D )7. ,=-- 3 .S ) 1 t 't i I 1 ? 1 l i 1 1 i i . . i..• d c. 7 c. 1 07q: 07 Li- 11: AlFrD in -, The C'otnntonwealth of Massachusetts — Department of Industrial Accidents 1 r --.4,1 Office of Investigations F ;�; 600 Washington Street . ' 2, := d Boston, MA 02111 , i , wrvrv. m ass.gov /dia `Yorkers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print Legibly 0 Name (Business /Organization /individual): tr r ,.\ (0? ,) , (;: ) i .. C ( r r _ t 1 4, ( • LO 0 0 1 I s Address: 1 0 . City /State /Zip:/ P ii , : , `,,,,..; p f < , , ) AI, ( » { Phone #: 1 " 6 >( . `: cicI Are you an employer? Check the appropriate box: Type of project (required): 1.R I am a employer with 1 '1 4 . ❑ I am a general contractor and I 6. Nev ❑ 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. * 7 • ❑ Remodeling ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. 54 Building addition [No workers' comp. insurance 5. E. We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.1 1 I am a homeowner doing all work right of exemption per MGL 11.111 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.111 Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.0 Other *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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. _ Insurance Company Name: C' 4? ,..j ^r., tk ; -, ; e.r' (_ c ,\";(_Ji, v',� >, t; Policy # or Self -ins. Lic. #: C. 6 3 ) J (� cK, A I Expiration Date: �j 1 ) I , ,(T% I 1 Job Site Address: 1 1 �� Ce. cierd ) - 1 City/State /Zip: �(Gr_evice 1 AAA CI OC4 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 cove ge verification. I do hereby certi "under the pans and Ae hies of perjury that the information provided above is true and correct. Sienature: G " // .r~ 7 Date: C / j 4 is ✓ U (�� Phone #: -! ( , 6 , . e Official use only. Do not write n 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 #: A- vu1.oyuui r Iu y, morn r rage 1 Cl 1 uate:Cr 1 01:44 rM rage:1 or 1 CERTIFICATE OF LIABILITY IN$3URANCE OP ID SF eare(MM!DDm °r) EARRT50 06/21/10 THIS CER1 IFICATE IS ISSUED AS A MATTER OF INFORMATION IRM Insurance Agency, Inc. ONLY ANC CONFERS NO RIGHTS UPON THE CERTIFICATE Barry M. Stephens, CPCLI HOLDER. "'HIS CERTIFICATE DOES NOT AMEND, EXTEND OR 75 North Main St. -P 0 Box 564 ALTER TH 3 COVERAGE AFFORDED BY THE POLICIES BELOW. East Longmeadow MA 01028 Phone:413- 759 -0010 Fax:413- 759 -0017 INSURERS PFFORDINGCOVERAGE NAIC • INSURED Cancral L•uuranc• Co:mpanlas 20230 INS_R- ." B: Barron & jacobs Assoc. Inc. INS_Rg C: 70 Old South Street INS_R::n D: Northampton MA 01060 INS_REP. E: COVERAGES ME_ POLICIES OF INSUPA\CE USTED BELOW/ HAVE BEE\ ISSUED TO THE IN_UPED MAIMED ABOVE FOR T -E FOLIC' PERIOD NCICAT - =G NOPNIT- STANDING ANY P.EDU REME'P, TERM OR CONDITION OF ?N' CONTRACT OR OTHER DOCUMENT '!/I H RESPECT TO WHICH THIS CERTIFICATE E MAY BE I OR MA P THE NSURANCE AFFORDED BY THE POL CIES DESCRIBED HEREIN IS SLEJEGT TO AL_ THE TERMS, E XCLUSIOrJ=_ ?ND ONDRIOrJ_ OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY RAVE EEEN REDUCED BY PAD CLAIMS. INK ,ALL L POLICY NUMBER POLICY =Pi- EC [NE PULI CY eAPIRA, ION LTR INSRC TYPE OF INSURANCE DATE (MI VDDIYYW) CATE (MMlDDPNYY) LIMB GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A CMMERCI?L SSENERALLIABILITY CC/57933 03/09/10 03/09/11 RE IS ~°• - X C PREGIIES (Ea occu $ 300000 CLA MMS MADE X CCCUR NED EJIP (Any one person) $ 50 0 0 RE.S_NAL3 ?DV NJ_RY $ 1000000 X GL Plus Endorseme GENEP'ALAGGTEGAE $ 2000000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - CONP,'OP AGO $ 3000000 X POLICY n JEC rI LOC AUTOMOBILE LLAELI Y A. AN' AUTO BA_8612961 06/22/10 06/22/11 CONFINED =I\GLE _IrJ1T o COMBINED cent) $ 1000000 ALL OWNED AUTOS • BCD LY IPIJLJR'' $ X SCHEDULED AUTO'S (Par perscr) X HIREDA_TO? BCD LY INJUR" x X NON- CWWNED AUTOS (Per accdert) PROPERTY DAMAGE (Per acci'ert) GARAGE LLABILITr AUTO O \L" - EA. ACCIDENT I $ AN' AUTO OTHER T-AN EA ACC $ AUTO 0•L" DD $ EXCESS i UMBRELLA LIABILITY EACH OCCURRENCE $ 10 0 0 0 0 0 A X I rSCUR I I CLAIMS MADE CXS7933762 03/09;10 03/09/11 AGGREGATa $ 1000000 DEDUCTIBLE X REFECTION $ 0 WORKERS COMPENSr,TON WC. JiA U GAY AND EMPLOYERS" LIABILITY YIN TORY LIMIT_ I ER A ANY PROPRIETOR/PART \ER/ERECUTvi: WC837586817 03/01/10 03/01/11 EL.EAC- IACDIDE'.T $ 500000 OFFI:E.rMEMBER EXCLUDED? N (Mandatory In NH) EL.DISEASE - EAEMPLOYEE £ 500000 If yes. desxibe Inter SPECIA_PROvI =IONS below EL. DISEASE - ROLCY_IWIT $ 500000 OTHER • DESCRIPTION OF OPERATIONS! LOCATIONS f VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROM SONS CERTIFICATE HOLDER CANCELLAT ON SHOULD AMY C % THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION PROOFOF DATE THEREOI . THE ISSUING INSURER WILL ENDEAVOR TO FLAIL 10 DAYS WRITTEN NOTICE TO TH( CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OE .IGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR Proof of Coverage REPP.ESENTAT VES. AUTHORIZED RE'RESENTATNE IPI1 Insurance Agency Inc. ACORD 25 (2009/01) ©19 18.20(19 ACORD CORPORATION. All rights reserved. The ACORD name and logo ars registered marks )f ACORD • \la,,achu >ctt. - Dcl1:ulnn•nt of Public'afct' Buartl of Built1in2 RC,ulatiun■ and "tantlar(I. �+ Construction Supervisor License License: CS 30739 Restricted to: 00 CECIL R JACOBS OLD SOUTH STREET , ,, A NORTHAMPTON, MA 01060 Expiranon: 9/21/2011 ( :iiiiiii „•r Tr=: 2429 t96 inln- o- nwea(tf- 0 /kSae/ ceoet Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 100809 Type: Private Corporation Expiration: 6/23/2012 Tr# 296962 BARRON & JACOBS ASSOCIATES, INC. Cecil Jacobs - - - - -- - -- 70 OLD SOUTH STREET NORTHAMPTON, MA 01060 Update Address and return card. Mark reason for change. Address Renewal Employment Lost Card DP: -CA, 50M-04 '/X EG ntmc;ttyvv zll. ((a,kku<«J.e. Office of Consumer Affairs & Business Regulation License or registration valid for individul use only ii HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to t; t Registration: 100809 Type: Office of Consumer Affairs and Business Regulation Expiration: 6/23/2012 Private Corporation 10 Park Plaza - Suite 5170 • '_ Boston, MA 02116 BARRON & JACOBS ASSOCIATES, INC Jacobs 70 O — G % -- 70 OLD SOUTH STREET l �. • NORTHAMPTON, MA 01060 Undersecretary Not valid w' o signature SIGNATURES By signing below, you agree to items A, B and C. DO NOT SIGN THIS AGREEMENT IF THERE ARE ANY BLANK SPACES. A. Alternative Dispute Settlement (Arbitration Clause): The Seller and the Buyer hereby mutually agree, in advance, that in the event of a dispute concerning this Agreement, the parties shall submit such dispute to a professional, state - approved arbitration service (cost, if any, to be paid by the submitter) prior to either party proceeding to legal action in the courts. B. By signing this agreement, you, as the owner of record, are hereby authorizing Barron & Jacobs Associates Inc. to act as your authorized agent in all matters pertaining to the building permit application. C. This is a binding Agreement. Ycu may not cancel it except as stated. This Agreement covers and supersedes all conversations, statements and agreernents, expressed or implied, between the parties, their agents or representatives. You, the Buyer, may cancel this transaction at any time prior to Byy® ' l Date midnight of the third business day after the date of this transaction. See the attached notice of cancellation Buyer 7: Date form for an explanation of this right. Seller retains an equal right to cancel. /Q /7) 2_ / Barron & Jaco s Re /sentative Date 1 ************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Designer /Salespersons Registration Numbers ❑ Cecil R. Jacobs MA HIC 100809 ❑ Christopher R. Jacobs MA HIC 100309 CT HIC 0518617 CT HIS 0554397 C David J. Satkowski MA HIC 100809 ❑ William J. Bonini MA HIC 100809 CT HIS 0554600 CT HIS 0553918 Barron and Jacobs - Key Personnel Contact Information: Office Cell Home Office Manager: Sandy Scavotto 413.586.8998 Operations Manager: Bill Bonini 413.586.8998 413.672.1009 President: Cecil R. Jacobs (Jae) 413.586.8998 413.250.2357 413.584.4447 Purchase Agreement Page 27 of 27 SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ 2 , Name of License Holder : C �< < ( ( CAC, - 501 ) License Number . 1 0 n i 4 pApec ) /V1 C I /a 1 I Address Expiration Date P(3j 5`,?1( Signature y Telephone 9. Re • istered Home Im • rode ent Contractor: / Not Applicable ❑ Company Name 1 Registration Number 10 o i kA -- 1, 3 f N0 MA 0/060 6(ta y/; o i Address Expiration Date Telephone (---f 13� 5 7)6'0 — 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 bulding permit. Signed Affidavit Attached Yes Nr / 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 fo 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 .ror you under this permit. The undersigned "homeowner" certifies arid 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 ❑ Addition 0 Replacement Windows Alteration(s) 1 Roofing n Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [El Siding [El] Other [El] Brief Description of Proposed /J, /J/ Work: New rear porch with airlock // O, (,) \ e 6I l ) (J / 1 rL- i1)/ fh , r icier /C Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family x Two Family Other b. Number of rooms in each family unit: n/a Number of Bathrooms n/a c. Is there a garage attached? no r n r n d. Proposed Square footage of new construction. 99 7 6 X 13 - e. Number of stories? 1.5 f. Method of heating? none Fireplaces or Woodstoves n/a Number of each 0 g. Energy Conservation Compliance. n/a Masscheck Energy Compliance form attached? n/a h. Type of construction Conventional i. Is construction within 100 ft. of wetlands? _ Yes X No. Is construction within 100 yr. floodplain Yes X No I j. Depth of basement or cellar floor below finished grade 11 Pk (CA J IC' ICS L ; Cs i- C k. Will building conform to the Building and Zoning regulations? v' Yes No . I. Septic Tank City Sewer y/ Private well City water Supply - SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR ( -- BUILDING PERMIT I, $ e c / C�i -e Ak C'i 4 9," I -C ,,,n I 6I 0 J 1,,,, Arc) At (1 e , as Owner of the subject hereby authorize P)t.,.( o yN r>- CC' b.s A 55 0 (1 r. .Z.v, C, to act on my behalf, in all matters relative to work authorized by this building permit application. 5 /-1 i. --c-e— &e,+ 99.3 J ,11 I 7 irvn I) 5 (L-1 vc ci h,-� Av e oive C) \-.;) I�,ei Signature of Owne Da I, V r, I I R . \ �. (. L ?� 5 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 penal ies of perjury. C- -,t III . Print Name ci - ig of iwner /A Date 7 Section 4. ZONING AB Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning e_cy. C f k ! .1 This column to be filled in by Building Department Lot Size 20500 SF 20500 SF Frontage 135' 135' Setbacks Front 30' 30' Side L : 38.5' R : 72' L : 36.5' R : 72' Rear 80' 80' But ding Height 12.5' 12.5' Ate, 4' O; ! Bldg. Square Footage 940 �r % 1015 Open Space Footage (Lot area minus bldg & paved 191a 93.5 4 191 a 93.5 parking) r f (.71) / / 7 # of Parking Spaces n n/a Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES O 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 O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained C� Obtained O , Date Issued: C. Do any signs exist on the property? YES O 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 O NO O 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 0 NO O IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit L 212 Main Street Sewer /Septic Availability C; 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, 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 t' (d irL I Map Lot Unit l of ehC Cr) 41A. I () i OGt Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: iktLIe Pkilap Le c e Ila Ce �¢.r�� � FI tk C MI o o Name (Pri t) — Current Mailing Address: S C C 1(y pm 114 Pc , 1— • � 3 Telephone Signature • 7 � 2.2 Authorized Agent: �/ �/� IT c:A ��c,LUVJS /15606e-45 L- 10 \i'�� .� i.� ��) �Yi 1,1 (;ri Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ES ATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 1(6 `5 3�,O (a) Building Permit Fee . c; 2. Electrical (b) Estimated Total Cost of �� , Construction from (6) 3. Plumbing Building Permit Fee , CiC� 4. Mechanical (HVAC) 5. Fire Protection `J � 0 0 � r 6. Total = (1 + 2 + 3 + 4 + 5) C-i� y �} Check Number T J this Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date Amtrawswire File # BP- 2011 -0351 . c l APPLICANT /CONTACT PERSON BARRON & JACOBS r ADDRESS /PHONE 70 OLD SOUTH ST NORTHAMPTON (413) 586 -8998 �- N"� PROPERTY LOCATION 172 FEDERAL ST MAP 23D PARCEL 090 001 ZONE URB(10 THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �/ Q Fee Paid A5 n O zeU 15' Typeof Construction:_CONSTRUCT REAR PORCH & MUDROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 030739 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOXVIATION PRESENTED: Approved 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 D- • .'.. Delay ale—. �' --A-C"-------- / 0 - ‘ of Building 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. „, ��, i 4I BP- 2011 -0351 GIS #: COMMONWEALTH OF MASSACHUSETTS ” s �r CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2011 -0351 Project # JS- 2011- 000588 Est. Cost: $19326.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BARRON & JACOBS 030739 Lot Size(sq. ft.): 22999.68 Owner: LAZARO REYES C/O PHIL COX Zoning: URB(100)/ Applicant: BARRON & JACOBS AT: 172 FEDERAL ST Applicant Address: Phone: Insurance: 70 OLD SOUTH ST (413) 586 -8998 Workers Compensation NORTHAMPTONMAO1060 ISSUED ON:10/25/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT REAR PORCH & MUDROOM 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 10/25/2010 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner