2007 Chevrolet Suburban - BrownForm 03-Vehicle
City of Northampton
Application for Vehicle Registration - Vehicle for Hire
PRINT ALL INFORMATIO (except signature)
(Check one) Taxi Vehicle Livery Vehicle Today's Date: ZO Z, i
Name (First, Middle, Cast) `� Q � f �G I � M., 1 t0
Residential Address 24 1
Business Address
.d
J�17
Mailing Address
Number Street City Town State Zip Code
Telephone Number y12j 61P7
j Vehicle information
Make �/ I eVQrro Registration Number rA 2 Gel %-7 -7 _
Model 6ubU r-tG ,n Vehicle Id Number 3 (r' F I IT-661y
Year Z0017 Seating Capacity �•
(exclusive of operatvr)
Color Number of Seat belts 17
Attach the following: Insurance Policy for this vehicle; child safety seatplan: copy of vehicle inspection; color photo
of vehicle
Liability Limits: $100,000/$300,000 injury or death; $50,000 property damage
Polity must show that the policy shall not be cancelled without giving the City clerk 10 days notice thereof.
Sworn to this day of 14"- , 20,,2/ , before me.
In City Council,
FOR LICENSING AUTHORITY USE
voted that this petition
Attest:
City
is
is not granted.
Clerk to the City Council
3er City Ordinance c. 316 s.19
Appeal Filed ? Date
MASSADILISEM
Commonwealth of Massachusetts Motor Vehicle Inspection and Maintenance Program .
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_Vehicle Inspection Report
CteanerAir • SahR Road -
Please Review This Important Information
Your vehicle has PASSED both its SAFETY TEST and its EMISSIONS TEST.The results are summarized in this report.
Ouestions? Visit www mass govlvehictecheck or call Customer Service at 1-844-358-0135. Customer Serxice is staffed from 7 a.m. to 5 p.m.
Monday, Wednesday, Friday, and Saturday, and from 7 a m to 8 p.m on Tuesday and Thursday.
Overall Result: PASS Vehicle Information Station Information
Safety Result
Emissions Result
Start Test Dalefrime
End Test Datefrime
Test Type
Sticker Number
;rispecbon Type
inspection Counter
PASS
PASS
3/20/2021 8:16 AM
3/2012021 8:23 AM
Regular
221003358
Initial
1
Safety Inspection Resu!ts
VIN
License Plate
Plate Type/State
Vehicle Type
Year/ Make
Model
Fuel Type
Engine Cyl / Size
GVWR
Odometer
3GNFK16367G155614
TA26977
TAN IMA
TRUCK
2007 Chevrolet
Suburban
FLEXIBLE
8/5L
8000
ERNIE'S GARAGE INC
72 KING STREET
NORTHAMPTON MA
(413) 584-0716
Station Number
PBi00149
Workstation Number
MAWOODO0648
Inspector Number
"'"0933
Inspection Fee $35.00
L ee Ase Plat 44oun'ang and :.ond- ian
PAG5S
Se-in.v 0;akw
Horn
PASS
Stop Lights and Tail Lights
PASS
Headligh• Aim and Operatic .
PASS
Lighting Devices and Reflectors
PASS
Directional Signals and 4-Ways
PASS
Front End
PASS
Steering and Suspension
PASS
Frame
PASS
Windshied Wipers and Cleaner
PASS
Safety Belts
PASS
Air Sags
N/A
Muffler a' ,d EXhaL.;1 SyStem
PASS
Window Tint
PASS
Windshield
PASS
Rear View Mirror
PASS
SumpervFenders/Extenor Sheet Metal
PASS
Fuel Tank Filler Cap
PASS
Fuel Tan',( Filler Neck and Cc:liponents
PASS
Visible Smoke
PASS
Altered Vehicle Height
PASS
Tires
PASS
Cther
PASS
inspection Comments
None
Gn-Board Diagnostic (OBD) Results OBD Readiness Monitor Results OBD Additional Data
Tampering Check
PASS Catalyst
READY Miles Since Code Clearing 76
Connector Result
PASS Catalyst Heater
UNSUPPORTED Warm -Ups Since Code Clearing 6
RPM Result
PASS Evaporative System
NOT READY Pin 16 Voltage 14.9
Key -On BuibCheck
NIA Secondary Air System
UNSUPPORTED
OBD Diagnostic Trouble Codes
Engine -Running Bulb Check
N/A A/C System
UNSUPPORTED
Scan Tool Check
N/A Oxygen Sensor
READY
Communication Result
PASS Oxygen Sensor Heater
READY
MIL Status Result
PASS EGR and/or VVT System
UNSUPPORTED OBD Permanent Fault Codes
Readiness Result
PASS
V'IR Number
! 111111111111111111111111.11111111111[1111111i1111111
Scan to visit website
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*Oslo CERTIFICATE OF REGISTRATION
M.G.L. Chapter 90 section 24B makes it a crime to alter Phis certificate
REGISTRY Cs HOTCR %tHKLES MASSACHUSETTS DEPARTMENT OF TRANSPORTATION
Plate Type Registration Type Plate Number Effective Date Title Number Month Year
TAN TAXI NORMAL 26977 01-Dec-2020 BV081520 11 21
Model Year Make Model JBody Style Color(s) Vehicle Identification Number
2007 CHEV K15SLA SUV BROWN 3GNFK16367G155$14
Residential Address (If Different than Mailing) Total Registered Weight for Commercial Vehicle or Trailer
Garage Address US DOT Number for Commercial Vehicle
241 HAYDENVILLE RD LEEDS MA G10539768
Name(s) of Owner(s) and Mailing Address
I'I"lItIIIIIIII[IIIIIIIIIII�llhllllllll��ulllilllllll[II'IIIII insurance Company
ARBELLA PROTECTION INSURANCE COMPANY
003445--AUTO-5-DIGIT 01060
JEFFREY D MILLER Maximum Seating Capacity for Vehicles for Hire
160 MAIN ST STE 8
NORTHAMPTON MA 01060-3187 7
Not.Valid Without Official
Signature of Registrar
Lesseelin Custody Of
Special Message Change of Address L] Residential []Mailing ❑ Garage
Information for Vehicle Owners
• Certificate of Registration: Every person operating a motor vehicle shall have the Certificate of Registration for the
motor vehicle and/or trailer, in the vehicle, in some easily accessible place. The records of the RMV constitute the
official status of the vehicle registration.
M Change of Address: By law, you must report any change of address to the RMV within 30 days. Visit Mass.Gov/RMV
� to change your address. Once you have reported the address change to the RMV, please write corrected address in box
provided above.
• No insurance Card Required: Massachusetts law does not require an insurance card. M.G.L. Chapter 90, section 34_
C and Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motor vehicle liability insurance
__pGric or bond for bodily n ury coverage and_property damage insurance. The insurer is required,_y law to electronically
notify the Registry of Motor Vehicles if coverage lapses. The vehicle owner is then notified by the RMV to obtain new
r insurance within 10 days or the registration will be revoked. Bonds are filed with the State Treasurer's Office.
N
• Transferring Your Plates: Massachusetts General Law
(M.G.L. Chapter 90, Section 2) allows you to transfer valid registration
plates from this vehicle to a 'newly acquired new or used motor vehicle or
trailer while you obtain insurance and a new registration. See the
Transferring a Registration Section on the RMV's website at
www.mass.gov/rmv for more information.
• Cancel the registration plates If:
- The vehicle has been sold or junked and the registration is not going to
be transferred to another vehicle.
- You move to another state and you register the vehicle in that state.
- The insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy_
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