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10B-092 191 MAIN ST LEEDS BP-2017-1099 GIS#: COMMONWEALTH OF MASSACHUSETTS Map Block: 10B-092 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:demolition BUILDING PERMIT Permit# BP-2017-1099 Project# JS-2017-001866 Est.Cost: $12641.00 Fee: $82.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: DAVID R LESSARD 102065 Lot Size(sq. ft.): 89733.60 Owner: ROMAN CATHOLIC BISHOP OF SPRIN C/O OUR LADY OF THE HILLS CHURCH Zoning: URB(1I0)/WP(50)/ Applicant: DAVID R LESSARD AT: 191 MAIN ST LEEDS Applicant Address: Phone: Insurance: 20 HASTINGS ST (413)433-5011 WC FEEDING HILLSMA01030 ISSUED ON:4/3/20I7 0:00:00 TO PERFORM THE FOLLOWING WORK:MINOR INTERIOR DEMOLITION ** note : flood restrictions may apply 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 4/3/2017 0:00:00 $82.00 212 Main Street, Phone(413)587-1240.Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-1099 APPLICANT/CONTACT PERSON DAVID R LESSARD ADDRESS/PHONE 20 HASTINGS ST FEEDING HILLS (413)433-5011 PROPERTY LOCATION 191 MAIN ST LEEDS MAP IOB PARCEL 092 001 ZONE URB(100)/WP(50)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST �� q ENCLOSED REQUIRED DATE 1 dl0•r•`Y ZONING FORM FILLED OUT /1 ���z`�� Bee Paid a9# j „C/ c_...- Building Permit Filled out Fee Paid 6/, lypeofConstruction: MINOR INTERIOR DEMOLITION T 6° New Construction ! 0 /Il/// Non Structural interior renovations �Dl e/ U d(.f�(/�j/�/ Addition to Existing //{y!��� Accessory Sed:re Building Plans Included: Owner/Statement or License 102065 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOMM.iTION PRESENTED: pproved 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 m itio' relay / 7- 3-77 store o oil mo Offs tat 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. 03/27/2017 16 10 14135435010 #4820 P. 002/009 g � "^ ` v c, City of Northampton h Building Department 212 Main Street Room 100 { I`- �` •'+ + �'d" �.�„; Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 ° " " h+ 14- f ;.y.+t* y^• . d', x.8 .13 arh} 'x'..:' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTIO N4:3tLfrffOFa1AiKkJ 1.1 Property Address: ;2%;?-Wr4a - h .r t ` ,3W ,r ec /9/ Alain $S u Lee-JS, in,4 0/66 02 54 a_ rh rt7 a. _ tnektoj SC4C110N2-PROPERTY 9#11151;3FNp/!$r tioRFT. DA,GENb 2.1 Owner of Record: _ Jodi-Page-Layoff 191 Main Street,lnlc MA 01062 Name(Print) k CeR Meiling Address 413-923-1924 yy hmTelephone 2.2 Authorized Anent: Wn-frEcClr�% / 2/ .�7[ri� � �jr& i��--� (6-en: rzS eo' rvirca•rr �PC� /5a Csn-{er6+,, Chrcopee ,P. 4 fi Current Address' 0 /Oil Signalize Telephone SECTIOR :ca`r r ATED COMSTRUCTPOttCOSTS.' 92 g- jqs- (7 - JU s iaa Oct hem .. completed by pemollappJi t -c O b3ltlge Elly `S I 1. Ruadm9 -V r , 7 {a}8�¢din¢PannRFee:, 2. Electrical l}EsEnrated`TGtaPGo6tot Consbi innlmnlJ6 3. Plumbing !wJdhi PerytlRfee 4. Mechanical(HVAC) 5.Fire Protedlon ^ ('y(1 6. Total (1+2+3+445) CJhedc tfnPdier YD"�#. h• "i�— :Yfua`SecUon PorOfWM1 tKse Owr _ .Sigoatute^ ✓c BIihB[!g, Nepedo!d9s. . . Date 03/27/2017 16 . 12 14135435010 04820 P. 003/003 Section 4. ZONING Alt Infomution fust Be Completed.Permit Can Be Denied Due To Incomplete Lamination Existing Proposed Required by Zoning This cob=to be fillet in by Building Depvment Lot Size ..._ ' _ ___. _ _Frontage l _ Setback$ Front _ '.. Side L:i.— R:T ' LtLI re: ___J f Rear Building Heigbt „_1 Bldg.Square Footage r—� , i. _ . Open Space Footage (Ler artamirva Nog&paved < I #ofParkmg Spaces ;.--- Fill: i_ (volume&Lcmmn) --- r _ A_ Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW Q YES IF YES,date issued:1 i IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES IF YES: enter Book , Paget —1 and/or Document1} # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW ® YES IF YES,has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained 0 , Date Issued: ! 1 C. Do any signs exist on the property? YES 0 NO010 IF YES,describe size,type and Location: Pik D. Are there any proposed changes to or additions of signs intended for the property? YES O NO IF YES,describe size,type and location: 1 iIj L P' E. WII the construction activity disturb(clearing,grading,excavation,or Rang)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO qp IF YES,then a Northampton Storm Water Management Permit from the DPW is required_ 03/27/2017 16 12 14135435010 :4820 P. 004/009 SECTION#+9FfirCRNBfW2FUFPROPSTLE OR(tchack fH'Y1lCPcai ii - New House 0 Addition ❑ Replacement Windows Altewtion(s) Q Roofing ❑ M;nOC y Or Doors O Accessory Blld�g. ElDgmoll on IJP=' New Signs [p] Decks in Siding fl Other ILO ( I Brief Work cep-ldOE4t its art, �Ksr Liti i Poen. Mws+�&4Pcc.�rr CloseAj 'N&ILWay�)04, .S Alteration of existing bedroom_Yes__V- No Adding new bedroom Yes No n'pm4 Attached NanatNe Renovating unfinished basement Yes V No a K.007*'L Plans Attached Roll -Sheet a. Use of bolding_One Family ✓ ITem Family Other b. Number of rooms in each family unit: �` Number of Bathrooms 2— Ac. Is there a garage attached? Q d. Proposed Square footage of new construction. Dimensions e. Number of stories? 2 1 f f MeMethod ^�iad of heating? (�/ / rUYntif v._ Fireplaces or Woodstovea o Number of each g. Energy Conservation Compliance.tt r^ Masschede Energy Compliance form attached? h. Type of construction W0<)J Frr1 nt e_— i. Is construction within 100 R of wetlands?_Yes _No. IsCconstruction within 100kyr- floodplain Yes_No j. Depth of basement of cellar floor belowfinished grade � Stt"j C1l( Attir.xs+ k. Will building conform to the Building and Zoning regulations? ✓ Yes_No. L Septic Tank City Sewer Private well City water Supply SRCTloN. maihilON-TCNgCOMP6 gf:O' OWiNa*AGENTs $TRACTOR APPINEA ECT039ki_N,- G . � vdt Pay — Loco '6 .as Owner of the subject Property J -- -by authorize P&U ( v tS aCiV ftC 1fr-Y 1 a. . m�call. relative toy authorized by this building permit aPPGration. rin ofilk 3—a-7-20/7 .Oxner Dale CSI Q —i4r ETC a�Ovmer Agent hereby declare that a statements and information on the foregoing application are true and accurate. pest of my Imo's/edge and belief. Signed under the pains and penalties of perjury fid; �4 E— L-of-e-Kr— �.NanC . . .,::• tip Date 03/27/2017 16113 14135435010 #4820 P. 005/009 'SEc tcM3 CONSTRiet10NSERYICIES 8.1 Licensed Construction Supervisor: K. kSSn I -_ J Not Apphceble ❑ Holder ='/ Name of License Noer- 5111CJ O A CS—/0a0W'5— License Number as-1-1n�S S-bre -, �e ��0 J4 4 Il4 /i/d/�,ani� Address J • .. � O's'i ectrauon Dare Signature �._•_ Telegram ' . znsv='r .ark �u'r '"ta .+e i4rev„e ,+` Not Applicable ❑ "Mut,' Lessard — pathckvisSycleLxai 1111 un /76442 / Company Name 44. Registttab'pn Nu ber ChpS"l-rs0'F 6+, 2'��Stf^�'14�it1rl, k+�-t711A") p/;/at/ `/ dress - OLD 4DD, ccs' ✓ ExpDate Aeci Address: /5& L'erri-erS4-,, ehktpee1MA- Telephone (°113Y#33-601/ 010/3 SECTI Nk48-WORKERS;COYPE teArotkasunARCE AFFSr4WfplG4.,C.14.f5GgSM Workers Compensation Insurance affidavit must be completed and submitted vain this application Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit A/lathed Yes tier No ❑ is1mm b a i m . "Mei"; ;-�,5,4'. .r g J I ll d :i n The current exemption for`homeowners"was extended to include Owner-occupied Dwellings afoot(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 108351. Defmmition 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 stratums.A person who constructs more than one home in a two-yeaweriod shall not be considered a homeowner. Such"iwmeownrs"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall be responsibk for all such work performed under the building permit As acting Construction Supervisor your prrvwre on the job sitc will be required from time to time,during and upon completion of thc 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,von 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 03/27/2017 16113 14135435010 :4820 P. 006/009 The Commonwealth of Massachusetts Department of Industrial Accidents w? � Office of Investigations _l mil, 1 Congress Street,Suite 100 -''ip= Boston,M4 02114-2017 �Y wwwmass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name(Busiaessiorntvieanndv-iduap: Paul Davis Restoration Address:152 Center Street City/State/Lip:Chicopee,MA 01013 Phone#:413-543-5001 fire you an employer?Check the appropriate Ilea: Type of project(required): V/1.0 i am a employer with 7 4. A7'(V1 am a general contractor and I 6. (]New construction (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- • ed on the attached sheet. 7. ® Remodeling ship and have no employees These subcontractors have a. ®Demolition—l&i no r- emo— wotidng forme in an ca employees and have workers' -avievp r Y capacity. 9. Q Building addition Wal[S [No woticess' comp.insurance comp.insurance.: required-] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ lam a homeowner doing all week officers have exercised their 11.0 Plumbing repairs or additions myself [No workers' comp. right of exemption per MOL 12❑Roof repairs insurance required.]t c. 152,§I(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] *Any applicant that chttla boxxl must also fa wt the section below showing their corkers'mmprawtion policy inrwmthwr. t Homeowners who submit this affidavit indicating they arc demo all work and thou imc outside COMMONS moat submit a new affidavit mdicaung such. :Contractors that check this box must attached an additional sheet showing the name of the sub conic ors and state whether or not those entities have employees. lithe mbeeairaetws have Taptnyees,tiro must provide tach workers'comp-policy number I am art employer that u providing workers'compensation insurance formy employees. Below is the policy and job site information. Insurance Company Name:Acadia Insurance Canpany Policy#or Self-ms.Lie.#:WC-20-20-005687-01 Expiration Dam 6-1-2017 Job site Address: 191 Main Street City/state/zip:Leeds,MA 01062 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 5250.00 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 coverage verification. l do h. •nim wit 0,aim and in ofperlury the the ibformationprovided above is true and correct. 3-27-2017 1.2( d Lc 55 Wt-CI phone g: 413-543-500 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 fY. 03/27/2017 16: 14 14135435010 t4920 p, 007/009 Massachusetts Department of Public Safety Board of Building Regulations and Standards License:CB-104065 Construction Supervisor DAMP LESSARD aHASTIFEEDING HASTINGS • 'Lodi» Expiration: Conmissio 12/21201/ y-//..✓../....//. a^� Office ofComma Altars&Basilica RCIM!a E IMPROVEMENTCONTRACTOR tram; 413865 TYPO: Nation: 7f02047 IndNduai DAVID R.LESSARD DAVID LESSARD 20 HASTING ST. FEEDING HILLS,MA 010321 Usfasecr ary 7/,.'Cs.............<.rr(N,ey r//.,a rA,.. ORIN of Coesaaec Arises&Business Regulation IMPROVEMENT CONTRACTOR 189900 Type. radon 8/41S2017 DBA PAUL DAVIS RESTORATION&,.- REMODELING OF NORT43 $T'IM. DAVID LESSARD 480 PLEASANT ST LEE,MA 01238 Unilaxccnaarry Office or came Afhin&Beaaaa Regeladoa IMPROVEMENT CONTRACTOR 178121 TYR*: gfj1TL83T. Private Corporation PALL DAVIS SYSTEMS :FN CTY INC. • DAVID LESSARD 191 CHESTNUT ST.2-C Q�.�..�8. — SPRINGFIELD,MA 01103 1.3a0axee<an 03/27/2017 18 14 14135435010 #4820 P. 008/008 - ' PAULDAMOS K@ORGAS 9O Y IDATEnterffen CERTIFICATE OF LIABILI NSURANCE 6 TICS CERT@ICATE 18 MAIM AS A MATTER OF INFORMATION ONLY ANO CCIWU S NO MONTS UPON TR CEItpjtATE HOa.OELTIRB CERTIFICATE GOES NOT APFlRMATWE.Y OR NEGATIVELY MIMI, EXTEND OR ALTER THE COVERAGE Aft SWIM MIXES BELOW. 'RES CHOSICATE OF RISURANCE (MES NOT CONSTITUTE A CONTRACT*ETWFFlI T@ flsG Nentecie WORMED REPRESERTATNE OR PROCUCER.AND THE CERTIFICATE Nara IMPORTANT: le in agUtlsb holder le FN ADDITIONAL INSURE%da fa4'On)NOR W endc..d. WSIRR08ATEN is WANED,amen b am tams and condIitlons at las many,MNMn Toads May tsgrinN endolaantatL A guinnent On thb c..Notle does net ante COO bate certifies*holder N Boo Omen rtlNNmesgy. . PRaNCEk Fu .`MOImgTL ,. .gaNY .. :�t TaDTz,sss awn(MO) HolSeven o 2213 040 anNIMPTA IIITEIT Holyoke,MA Mb NatERNa aaaoaesb LSVenes sae. I*flA:Nautilus Insurance Company 17370 aawTF Pad Cans mt*N+a HAN anion Cwnty.Inc des Paw David .I mom a.CammNo•h,NNNT si Company 54754 RSPeabn of MASS annexe: Dana Testa Construction TLC Gm Paul Davis Rastoesion eslaso: NordNest RA NN Pan Davis Rastantlon a RswdeNq of Regiment MA 1St chestnut Sne.t,2C INIENra: SprNgINW MA Sties _3333(: coVERAGES CE2TWa8,4TE MN®Eit RaNNONNUltictE THIS is TO CERTIFY OKI THE Pn v'tc4 OF NSLRANCE U$TED SOW HAVE BEEN Nato TO THE'WOW?MIIEDASCVE POR THE Pact!MOD INDICATED. NOT'NRHUTANONO ANY i MPS NT.. TERM OR rGCOXIN OF ANY CONTRACT OR Ostia DOCUMENT Ems REpY&T TO VM04 TIM LI cERTIOCATE MAY SE ISSUED CR MAY YCWSIONs AND CONDITIONSAIH POUGES�UNITS bmWM NAY SAYE MEN REDUCED BY PAM CLAMS. THE INSURANCE Anonotro Err THE lot igirS DESCRIBED NERENIGmALECfTO ALLTNETEWLO. Mt Tan ca RWiNCY FOXY Neat I tY1Iu'.:s �+r SYS A X u%.R RwaRINaLtlAsxeT DL1AvMe�OXmAMIEraf I 1AOP.070 I c aNat€ Xi ecu I X ••• ECY101400T.,1 mown. OSIDIGENT TETaN2tevaN.sen1 ,1054100 X fS,000 Per Oct Dad MOW Ryon Pone .5000 WNawUDYINAPT 1.000500 ItAMMNK'W�SEIYN F (FTCBIER I ONWLIaNRMTE 24100.000 fi M KT—X1 LJ in, 1 , treaceTs-maaaoa. 2500500 Dance AwwaN.E twain 1,0005005 1I—Amurro ISa$1WV 08001n010.05N11207 a0ntraNAn O+vPaaN • n ALL VANED X BCIIL2UIID MOLY UNARY 6rmann) e5 I aama UMII X 1 ane ... EKNORwBM% t 000500 Fl 4, A X�rzcEswa IpLArrlAn FFX2D14d06103/014010 05101/2017 AoaataAre $ 4500.000 I Deo AmINICNa_. a I want*ccopeargotiI [ YAM: Isobi fl I 1 ail?SA T aFrUP�IrAalNE Doi IA.(yardage 1141.041 . I IP1 d8FAE.EA 134ROI6:• t cFUWnfMceopmATrlyH bevy i 1 I eaDi-PoUNE I p o-CAn.wde ' EEPm45m-i, -ow1ns.'OCRIe T8¢000 DOD O.eWV LIMON i I I I I 1 PEa4ENc01I1.a, a,Ia0 I LOCA1CNS1 mints Nanates AYMW boob Mann Na Is Mann Den ata le won* Had hawed; Paul Wok RnNnaWn of Ilerosiden Canty,Inc&is Paul Dab Itiostonnen of MAN DES lessaid CaMVclbn TLC db PNN Davis Rstn&o of Nordwron MA tln Paul Wvle RnnMradan&RNsdWrO ofNatwt MA , Adttlaut L otatlen: 480 PIsesMlt steal L.A MA CONTRACTORS P(*LUTTCN ISM ITTY.Nautilus Poky SECPf.014WI41 6F.on 61/Ain* 01500,000 Each Pollution FNidNC Deductible: 055/0 Faith Pollution bntbw SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION IPAUL DAMS - -... . -_ EMNS MT OF THE ABOVE pEocWem routed USDA/fatal,NEFa1N emoala arisneene THE EMMATION DATE T101E0F. signet Mu. EE DELIVERED N Paul Davis Restoration ACCORONICE MIR THE POLICY PROV 152 Caner Street Chicoprq MA 01013 ale //E1PE,}I,�`''MATRE . pi `... . R.QM C19✓ IACORO CORPORATION. Ai din tNNvid. ACORD 25‘2014/01) The ACORD nam and boom rsplsMNsd naris Of ACORD 03/27/201? 18.14 14135435010 #4820 P. 908/009 PAU.DAV42 MSOREAS ACORl3 lannY E.aNin CERTIFICATE OF LIABILITY INSURANCE =MOW THIS CH TSCATE IS ISSUED AS A MATTER OE A'DvORMAT ON ONLY AMD CONFERS NO MEET"UPOM7IRCEPTFICATMalletNIS oomomoAil we NOT A ossmapnvnLY CR NEnATMaY AMBc RIiHR OR ALM THE COVERAGE AiVpMp@ BYTMRPDXES flow Is cornea a SEURAi10E Don Not CONStinnnn A COMPACT BEWIEEN THE ISSUING MSS AUNDR)IED REPRESENTERVECEI PROOUL9,AMD THE CFRTiMCATE HOLDER .. ■EA POORTAMT: V the cadtcy Ice la in AODIIIONAL INSURED,MO p4cyUn)Mel IN•ProamiL 1143141141003211114113 WANED,Nibloat to the boas wWm11dMo1M MIS Pemb celfp,prole may baa wA1Naemeef.A*t$ au.*an*4*aMMM Sass Idea swam ROM toda cathodehodrin lieu ofoadl adomemoopa} BOO WO Gaga lobo M. qaooy remPRE3574072 1453 Plams MO)SEE0992OwnSPE*Suits HalyoM MA Eli - __ atlNaaaaw Ac romecocoa I sem• Matmoss:Acadia lntibaHs Conpu6 131325 "Ia® Par Dab SYaMma etwsmtdan Comity,Mm dap tons Mara a= Ramrulbn of MASS 011a/t: _ Dadd Laaad Cmrmacdan LLC dm Paul Evia RRcton oa of NorthnSt MA — 1W CIMabad Saa•t.2C aawoa' Sp14np1MM.MAatim P MIRERP: J COVERAGES CODFICATE IRMDERt 411 .14_!!!!pismatito TMs M TO CPSinFY THAT TRE MUMS OF PMAPANCE LMTEC 66019 NAVE 51524 OWED TOTHEIssUREOISAMEDADOVE PORTIEPOUCY PECO MDICATED. NOTWM1STANtagG ANY NEC M BIENT. TOW OR CORMTI941 OE ANY CONTRACT OR GOM DQGABaWITH REspan TO VAMMI THS CERTEICATE MAYBE swim Oa MAY FAPTAM. TIE N81MWICE AFFORDED SY THE POUCIE:Dem TERM M 512121LITO Mi.TIE TERMS, OCCLUSIONSMA COIMRIONR OF SUCH FOXES LP.fIS SHOWN PMT HAVE MEN HtOuoc SY PAD CLAMS. ler near!---a Deena Pmiw,—km, S3E3 "` nI Sn I COMMIMOM i06L1CWnIfY 11404C =pIBA$ I `-41Aa@11VF ' 1 tam I I ifl1 66msinnnl (f MED mai Cl,n papa $ POMaVLAAa/a( IY it =,r�•LMadAMTEt)ai+R{REP@C • LMM$Ait �f —.MOM- LCC I N lam-M-O'J41.0POi ES OTTER 1 F '�'ql��y[. i V MICANIPIM UTY • 1 !ramps p':'y- LAfr f • ~I,.WYna!, I PGnnYMAwrwp way 11 v-t.t � J-�ltllPe t II 1°cotYmem PMlosso14 Mf.W QREL _LIMEM t - )a®/I1ftX WRR 11 uElEl6LLwyM IN!PAOCOMMWE i t �inN' RBMF —I G+y � 6Yl I i IM E 1t f g I1 -111 ocimmietirst IA1a ommonsr meads Y/YI I I X�Eft1N£ ` iS! ' MEMOS A ,�IOPPMIDERAZWIM I WC-20204056" PU12NS 106M1/101T'I f./.s•o+A®MR i i F>nLeson IN 1 aill 1 ��.�a•sa tp�•ro Eiowa-a6w.d�s 1,00ROW IDPsaeFnpt OFlPanhivr as.oogia-Pa1NYtaa[ t 1pM1 E00 • r4MIPIRap=Pm 110M1M ma.aDIC M MIOPDIa.AaMwN Maks k abs ttiYalwarbYaa•maYwaaa) ' p .tRoamed= M Paul Davis Rmyd=atpPdaltorero,Inc,191 alm Stmt.SuiteSuite2C,SpY18D4 W 1 011E3 ma Paul twit RostMbn of 11110,35 Ovoid Lsffad Cae>MdaP(.L4 tbsP4d Davy Ra#ulbn of NPRhwa t MA dba Paul DMa1MMNaSat&RMOda ng atMeremod MA.MISS Una Lap MA 01236 iwtSlane,Springlield.IMMO db.�Does Buganda.S Mom Lessard Cn a P gOaNP Int- dDuds RI SRamadaRS a Ma/SvnM d Lap MA mae CERWICATE POWDER CAHCDIATION u PAUL DAVIS -. . SCUDANVDFTPE Asovw MEMMm Palatal SE ANCEJ2^ �aL l �....:ewF THE MOMAHON DATE MEMS , nonce RSL in DRAINED IN Paul ypYy),Gaawa,wOD ACCORDANCE 111111 TEMMOWPA 1St Caner Street Chicopee,MA 01013 A1nIo®Iora6ia•rAat ciflSa014ACM)CORPORATION. Al INS tomenrod. ACORE 2$92414441) The ACO nada aid lcga ma m#.acsd maim ofACORO 03/27/2017 16110 101135435010 X4820 P. 001/009 Paul Davis PAULA IS � d,� ��ti Center ` RECOVER RECONSTRUCT• RESTORE Tel.4l3-543-50014aa 413-543-5010 Email:hcma@pauldavis.com TO: vc �f an 801 FAX: J4 l3 5.(S)Le a' �2� FROM: _( U lci �.eSSLt5G DATE: 3- a (} 00 RE: YJU i ( � i nn Perm 1-- alp l I CCS--1-7Z,h'l i CU PAGES: 9 including cover lJN 6� Message: p y 0,(•;4.) C�- t g te � .rc �� i ld?n I er`mt -71— {e77 Les-card — *0 e of g aa- tq l l` Lal . i e S fl oiorp � av-e L id ( 0413 5-00/ - 0 Cf kg# Paul Davis is your Mitigation,Restoration and Reconstruction Specialist, Customer Service is our#1 priority. Emergency Services available 74-bows a day at 413-543-5001.