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38B-004 (6) c ) BP-2007-0955 GIs#: COMMONWEALTH OF MASSACHUSETTS Q9 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-2007-0955 Project# JS-2007-001555 Est. Cost: $4750.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groin VERMONT ROOFING CO INC 092255 Lot Size(sq. ft.): 19819.80 Owner: MASSACHUSETTS ELECTRIC COMPANY Zoning: SI Applicant: VERMONT ROOFING CO INC AT. 130 WEST ST Applicant Address: Phone: Insurance: P O BOX 1535 (802) 442-2899 WC BENNINGTONVTO5201 ISSUED ON.4111120070:00:00 TO PERFORM THE FOLLOWING WORK.-MINOR SLATE REPAIRS 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 4/11/2007 0:00:00 $50.002307 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo Versionl.7 Commercial Builtlin Permit May 15,2000 � p City of Northampton Building Department V 212 Main Street seine . Room,100 e Northampton, MA 01060 -g _. .. phone 413-587-1240 Fax 413-587-1272 , APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE TH4 USE OR-OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWCI FAMI 'Y,DWELLING _SEC_TlO iTEfNFORMATION' -__ -"-ProEerty Address: T;>s circ �e camptefed 6y I ce_ i e e�13w5 7c . m^ 3nW NOA Er St DistrrCf r` _ CB Disfrfct- ::aawa. SECTION:2 PROPERTY OWNEF2$HIPIAUTHORIZEDACENT r' 2.1 Ow f rd: Name(Print) Current Mailing Address: Ll } Signature // Telephone J 2.2 Authorized t: V M d Alj O 0 FIAI-2 -LL7 /V� 5 F-p,&, Name(Print) Current Mailing Address: 'r Be iv v ./V� To 'G,�- a 7-4) 10 c�� Signature Telephone �G�2 7 G, 2- c 9 q"- rs b �- SECTION-.3..ESTimkTED'CCONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Of lot UsgOnly completed by permit applicant 1. Building (a Bui{ding PeAl rinitFee . ta' 2. Electrical Estimated Total Cast of E Canstcuctionfmrn6} 3- Plumbing 71 '.B.uilding.PermitFee 4. Mechanical(HVAC) # 5. Fire Protection } 6. Total=0 +2+3+4+5) f,7 , -Check Number :This Section For ficial"Use Ont Buii'dang;Permit Nuirtbec` 'Dte is ued: Signature. Building.Commissioneifinspector of Buildings Date Version 1.7 Commercial Building Permit May 15,2040 SEGTICIIV ONSTRUCTION SER1/1GES_FORPR60'ECTSLESS THAN35,400 CUBIC FEEfOF.ENCLOSEDSPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing 2"Change of Use❑ Other❑ Brief Description ;Enter a brief de ription here. Of Proposed Work:I SECTIs�JSE Gl2C1UP Ai t oNSTRIrc€�arlgm USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A-1 ❑ A-2 ❑ A-3 ❑ 1A _m -- A-4 ❑ A-5 ❑ 1B ❑ B Business 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard IT 3A ❑ I Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility >"❑ Specify: i M Mixed Use Specify: S Special Use Specify: COMPLETE THCS SECTION CF EXISTING'BUILC)ING UNE)ERGQIi+IG$EIVOVATLO(VS AI�[?Cl t6N$1XNI%/OR CHANGE INN,USE Existing Use Group: ' Proposed Use Group. Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION"BCRL'DINOHEIG[=J7"AND AREA. BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION ` Floor Area per Floor(sf) °as 1St ' ! 1St 2 i 2 "a..^iw a e s wy ,au^rr 3 r 3rd 4u' Total Areas i ( f} Total Proposed New Construction(sq Total Height(ft) i Total Height ft � y 7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: P-blic ❑ Private ❑ Zone i Outside Flood Zone[] Municipal ❑ On site disposal system E] Version 1.7 Commercial Building Permit May 15,2000 00 Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front i i Side L R:= L r �= Rear Bldg.Square Footage % i �--- Open Space Footage % (Lot area minus bldg&paved -parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 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 'age; and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES 0 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 0 NO 0 IF YES, describe size, type and location: j 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 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. i Version 1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONISTRUGTIO1 BERMICES-FOR-BUILDINGSANDSt1B:tEG'f.TO CONSTRUCTION CONTROL PURSUANT`TQ 7WCMR`I I fi(CONTAINING MORE THAN.35T000 C:F.OE ENCLOSED,-SPACE) ' 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): i Name Area of Responsibility I Address Registration Number Signature Telephone Expiration Date t i Name Area of Responsibility E Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility I Address Registration Number i ; Signature Telephone Expiration Date 9.3 General Contractor f/ /�-j C12��/L. (f, Not Applicable❑ Company Name: 10 I� 5 �e ti /315 N Responsible In Charge of Construction IP�6,6 !t/ L 7 T 6 5'2 a 1 Address Signature Telephone Versionl.7 Commercial Budding Permit May 15,2000 SECTION 10-STRUCTURAL PEEIZREI/IE11V(780 CMR'11011 Independent Structural Engineering Structural Peer Review Required Yes No 0 SECTION.11-OWNEKAUTHORIZAT - 10N-,TO BE COMP- ET LED:'WHE OWNS S AGENT.OR CONT Ri4CTORAPPLIES FOR mrr X1 ; as Owner of the subject property hereby authorize! Q r M iv �a //1!Gy �/��- to act on my behalf,in all matters relative to work authorized by this building permit application. s Signature of Owner - Date G I, 4-i"Y( All C:•C' Av•C, as Ownen6zoriziD gent reby declare that the statements and information on the foregoing)application are true and accurate,to the best of my knowledge elief. Signed under the pains and penalties of penury. - e-O t. i Print 3428V0 7 Signature of Owne g nt pate `=SECTiO'N 7-CONSTRIIC CIOI�I;SER�/fEES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: r i License Number Cl 2 Address Expiration Date Signature Telephone SECTION 13 WORKERS'EON(P SATTON"INSURATVCEAFFtpAVIT(N�GL.c;i52£§ZbCE§j 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 V40 No 0 r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washinaaton Street Boston, MA 02111 www.massgov/dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information q'� / NPlease-Pyr-int Legibly Name(Business/Organization/Individual): (Jj�_ -/xip /y / I1 o p G'/ � CU 1 Address: )2.p,� JS 3 5' 17`�rCy66 City/State/Zip:60/V,Ezti,,76,y b %- 052,-)1 Phone.#: 2— Are you an employer?Check the appropriate box: Type of project(required): tf 1. tam a employer with 30 4. F] I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, F-1 Demolition workingfor me in an capacity. employees and have workers' y p �'� # 9. �Building addition [No workers' comp.insurance comp.insurance. required.] 5_ F-1 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.V,-Koof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#I 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. IContractots 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. (� n Insurance Company Name: I Ch-Al S Co 6 Policy#or Self-ins.Lic.#: 271 2 (� (3r 9t' Expiration Date: 7 �/'� //' Nd 1'Th G evAi p7 /v ,Job Site Address: I U (-tJ Q� S F�'1C) Q [ P C5y City/State/Zip; /y }i 0/ o do 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 file 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 coveraee verification. Ido hereby ce under the pan and penalties of perjury that the information provided above is true and correct Signature: LS Date: -3 a/ -7 _ Phone#: © � — `7 Y�� ; l �- - a '7 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#: r ACOR CERTIFICATE OF LIABILITY INSURANCEDATE (MMIDINYYYY) PRODUCER 11860-560-2766 HIS CERTIFICATE IS ISSUED AS'A MATTER OF INFORMATION;: Arthur d. Gallagher Ri*)c'Management:SerA4ceP1' Inc. NLY AND CONFERS.NO :RIGHTS UPON THE ":CEATIFICATE OLDER THIS CERTIFICATE DOES NOT AMEND; EXTEND OR 10 Columbux Boulevard ALTER THE'COVERAGE AFFORDED BY THE POLICIES BELOW. Hartford, CT 06106 INSURERS AFFORDING COVERAGE MAIC# INSURED. IN�URERA:Ccntinental CXX Co 20,443 Vermont Roofing Company Inc, IN URERB:American Cas Co Of Reading PA 20427 P.O., Sox 1535 IN DRERC: 1325 Harwood Hill . Bennington, .VT 05201-8107 IN URERD: IN UREREi COVERAGES 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.BL.,ISSUED OR" MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS,OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS; INSR: D - _:POLICVNUMBER -POLI YEFFECTIVE_ POLICY EXPIRATIOMMIDDIMNTYPE OF INSURANCE _ - LIMITS A GENERAL LIABILITY 271226303 05/01/06 05/0.1/07 EACHOCCURRENCE $1r000,0C0 X COMMERCIAL GENERAL LIABILITY DAMAGE TO 'S 30 F0,000 CLAIMSMAOE OCCUR MED EXP"An one person $10,000 PERSONAL6ADVINJURY 3:1,0;00,000' GENERALAGGREGATE 5'2;000,000 GEN'L AGGREGATE LIMIT APPLIES PER: r PRODUCTS>COMP/OPAGG $2,000,000 POLICYX PRO- LOCIE A AUTOMOBILE LIABILITY: 2 7122 6 527 05/01/06 05/01/07 COMB INE DSINGLELIMIT $1,000;000 X ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS. (Per parson) $ X HIRED AUTOS BODILYIN3URY $ X NON-OWNEDAUTOS (Per accident) PROPERTYDAMAGE $ (Par accident) GARAGE LIABILITY AUTO ONLY'•EAACCIDENT $, ANYAUTO OTHERTHAN EA ACC $.,, AUTO ONLY; AGG $ A EXCESSIUMBRELLA LIABILITY 2084939215 05/41/06 05/01/07 EACHOGOURRENCE $10,000,000 X OCCUR CLAIMS MADE AGGREGATE $10i000,000 .-a s DEDUCTIBLE. $ X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND 271226091 05/01/06 05/01/07 X CSTA U- 1 7 OTR- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1,000;000 ANY PROPRIETORIPARTNEWEXECUTIVE'" INC OFFICERIMEMBEREXCLUDED? EXCLE.L.-DISEASE•EAEMPL OYEEI$'1,000 i GOA ` it yac,deacdbe under SPEC IAL PROVISIONS below E,L.DISEASE-POLICY'LtMIT 51,000,000' OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS'ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 10 days.notice due to non-payment of-premium SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION' SAMPLE INSURANCE CERTIFICATE: DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TOMAIL .30 DAYS WRITTEN 'NOTIbE TO THE CERTIFICATE HOLDER NAMED TO(THE LEFT,`BUT FAIL URE�To DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Bennington, VT 05201.8107 AUTHORIZED REPRESENTATIVE //� / � r VSA nvd«�-ff• ACORD 25(2001108)andtay 4250961 0ACORD CORPORATION 1988." �rl _ q4MONI 1,0FING COMPANY, INCORPORATED P.O. Box 1535 + 1325 Harwood Hili;Bennington, VT. 05201-8107 * 802-442-2899 • Fax#802.442-9961 ACOUSTICAL•ROOFING•SHEET METAL•WATERPROOFING CONTRACTORS March 7, 2007 National Grid ?L 60 Brown Street l North Adams, MA 01247 Attn: Frank Zojac, Manager Phone: 413-664-5815 413-586-3680 (Paul at North Hampton, MA ) Reference: Slate roof, Route 66 West; North:Hampton;'MA (next toSmith College) Dear Frank, Please find enclosed the roofing quotation requested. We have had to adjust our prices due to increases in materials, fuel, labor and Insurance. CONTRACT;PROPOSAL 1. All work performed by Vermont Roofing Company, Inc. will follow the safety rules of O.S.H.A. Our desire is to limit your'liability as a building owner. 2. Maintain 'the premises"in a safe, orderly, and workmanlike manner during -all= .phases of the contracted work. 3. Although we don't anticipate the need, any necessary deck repair/replacement or structural modifications would be an "EXTRA," completed on a "Time & Material" basis and wQuid be discussed with you priorto any of this work being started. 4. Throughout the field of the roof, replace broken and/or missing slate at the contractor's discretion, matching as closely as possible the existing slate in size and color. 5. On one eave edge, remove cut off gutter straps, repair holes using bronze bibs. 6. Remove slate ridge. (Has been cemented and repaired many times.) 7. Install a grey metal ridge cap. 8. We are pleased to quota you a price of 4750.00'for the work above. (Pius wood repairs.) 1 OFFICES IN RUTIAND, VT.• BENNINGTON, VT. TO 3Jttd SWVaV N 153-13 SSdW, L185-099-8Tb ZS:60 ZOOZ/127/60 R ROOFING M0 COMPANY, INCORPORATED P.O. Box 1535 . 1325 Harwood Hill, Bennington, VT. 05201-8107 . 802-442-2899• Fax# 802-442-9961 ACOUSTICAL- ROOFING•SHEET MEf AL•WATERPROOFING CONTRACTORS Note: 1. May need to trim vines in front. 2. On most slate roofs, the underlayment has deteriorated to a point of providing no water tightness even though slate appears o,k. You may experience leaks in periods of heavy rains, high winds, and ice back up. (No warranty.) *PLEASE NOTE: Because the cost of many roofing materials and accessory components are steadily increasing, we are unable to guarantee your pricing (listed above)for longer than 30 days. After which we would need to review your file to ascertain the need, if any, to adjust your pricing. Thank you for your understanding in this matter. Lr e carry Workman's Compensation, Publiq Liability, and Property Damage Insurancenclosed is a copy of our insurance coveraige. We recommend all potential customereview and compare all insurance coverage. Payment is due at completion. All accounts past 15 days will accrue interest at 1 1/2%. If this account is turned over for collection, customer agrees to pay all reasonable costs of collection and attorney fees. If any asbestos is found during the course of work, it would be handled according to state guidelines and would be invoiced as an EXTRA to this contract proposal. If you are in agreement with contract proposal, please sign your approval below. Return one copy of the signed contract to Vermont Roofing and retain a copy for your records. Vermont Roofing Company, Inc. policy dictlates our contract proposals must be signed before job is assigned scheduling. This is in addition to your verbal agreement, purchase order number, or your own required contract; Thank you for calling Vermont Roofing Company, Inc. VERMONT ROOFING COMPANY, INC. 3-1.;?ih A oriz Signature Date George Lewis, Sales Consultant 2 OFFICES IN RUTLAND, VT. • BENNINGTON,VT. Z0 3Jt1d SWdQti N 103-13 SSt1W LT85-1799-8T17 25:60 L0031 -� � Board of Building Regulations and Standards One Ashburton Place Room 1301 Boston. Massachusetts 02108 Home Improvement ,CjQ4tractor Registration . .. ..:.::.. :.+ Registration: 106905 4 Type: Private Corporation Expiration: =7/28/2008 VERMONT ROOFING CO., INC NEIL HOAG PO Box 1535 Harwood Hill Bennington, VT 05201 Update Address and return card. Mark reason for change, oas•ca, a eoM•osios-Pceaso Address Renewal Employment Lost Cat ,i,'� '�lie �o»tnnfrruuecz�Ch c�✓�/lezeaac�u�dett Board of Building Regulations and Standards License or registration valid for Individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: \ � Registration: 106905 Board of Building Regulations and Standards Expiration:. 7/28/2008 One Ashburton Place Rm 1301 Type:'.Prlvate Corporation Boston,Ma. 02108 VERMONT ROOFING CO., INC, NEIL HOAG r r10 Box 1535 Harwood Hill Bennington,VT 05201 Deputy Administrator Not valid without slgnatu I , Construction Debris Affidavit (for all demolition and,ronovadon word) in accordance with the provisions of MGL c 40 Number , S 54, a condition of Building Permit of in a pis that the debris resulting from this work shall be disod roperly licensed waste disposal facility as defined'by MGL c 111SOA S 1 p . The debris will be transported by; (namc of hauler) The debris will be disposed of in (locatffa of facility) sign�t'uro o cgrmlt applicant date 10, 67 ie z Board of Buildingg Regulations - - One Ashburton Pace Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 06/25/1964 Number: CS 092255 Expires:06/25/2009" P� � Restricted To. 00 NEIL F HOAG 36 FLOYDS WAY POWNAL, VT 05261 Tr.no: 92255 • Keep top for receipt and change of address notification.. DPS-CA1 G SOM-04105-PC8698