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13-036 (4) 360 NORTH KING ST BP-2017-0266 GIs 4: COMMONWEALTH OF MASSACHUSETTS Map:Block: 13 -036 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 4 BP-2017-0266 Projecta JS-2017-000456 Est.Cost: 58476.00 Pee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: ()se Group: CDA ROOFING & SIDING COTRACTORS, LLC_ Lot Size(sq. ft.): 63292.68 Owner: MINN JAMES A &ROSALEEN T �Zon_>_ne: Applicant: James Quinn An 360 NORTH KING ST Applicant Address: Phone: Insurance: 360 King Street NORTHAMPTONMAO1060 ISSUED ON:8/31/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:ROOFING 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: FeeTvpe: Date Paid: Amount: Building &31/20160:00:00 54000 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Fn :g Llepartmertusn onl/ 1 n ECEIVED V Cinj of Northampton � 4e of Pemrt { I Build'ng DepadrnentCurb C4uDriveW y Fermit yyyy+ +� p C /RA 2 9 2016 212 Man Street ewu @l tic s II Illej - Room 100 WatergelIAvalabJlty. - ^ ;n ,�¢uu>ruo ms'rTcnotu Northampton, MA 01060 Imo- r�sof5 ruacr al plans '• flONt 01" -.-ne413-5871240 Fax 413-587-1272 PIorfaap Plans ' - I r I_ APPLICATION TO CONSTRUCT ALTER,REPAIR,RENOVATE OR C='NOLIS i A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address' This section to be compieted by office j6j'p Al. /7 _71 Map Lo - Umt ,e' 444m1:^2'+ * 2'op 'O reriay Gts rfct,�;, Elrn t D t et' 'GB.Deeret - SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Teive4' C24,,„..".7 Nance(Print) �'+ /�^�� p� ,/'� Currant Malang Address: .Ce-e C....corr .e4'G�t Telephone p Q ) Slynature i `A - "SI, 1..,2 Authorized Agent: . f / C4/0,0 /47os2t,•+ � / � K.,7'-r. AC'( — Name(Pnnt) / Curare Adaitieo Agirmas: G .. arm Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS item Estimated Cost(Dollars)to be OFfical Use Only completed by permit applicant 1. Redding it,/7c: 0(> (a)Bedding Permit Fee 2_ Elecfiwt {h)Estimated Toted Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5_Sire Protection 6. Total= 1 +^ ' 3+4+5 I ' ,Che _.._ ( ) Check Number This Section For Official Use Only Building Permit Number: I Date issued: II Signature r �� d ; '�� I 1/BuuEdin40ommEsmneoMspestcrof 8ulltlin5s Date Section 4. ZONING All information Must Be Compreied. Permit Can Be Denied Due To lnccmplete Infornabon I Existing Proposed I Required by Zoning 1 I I ds CONDEIW be Utica in by 1 Building Department .. Lot S34-0 . --_-__ ___.__ ...._: . ,. .. .._ Frontage -------R----_40._ Setbacks Front Side L'- R ._.. R —_ Rear - — Budding Height - ' m Bldg. Square Footage _ Open Space Footage ---% I -- --- 1Lot area minis b dg&paved -..-- Petle.g) o:Parking Spaces -,-- - File a .� ..__.- (volume&Location) 1� A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO : DONT KNOW 0 YES 0 IF YES, date issuedd 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 0 DONT KNOW 0 YES 0 IF YES, has a permit been Cr need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , 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 E. Will the construction activity disturb(cleaned grading, excavation, cr tilling)over 1 acre or is it part of a common plan that wig disturb over l acre? YES 0 NO 0 IF YES,then a Northampton Storm Water Management Permit frcm the DPW is required. X10 e ROOFING & SIDING ,.A, • el CONTRACTORS . CDA Reotag and Siding Contractors•(MA Reg#128355CT Reg-#603213) •, -1775 Main St.,Agawam,MA•1413)733.4080•(413)7884081•1-844.86.4081•FAX 418.786-2196 cdroofer@comcast.net - .t 1 Camey Avenue West Hartford CT 06110(860)9053-5730 WWW.CDAROOFING.NET Proposal Submitted to: Date: Phone ass - Home: - - , Cell: Street Mak Ta City.State,Zip Code: Special Requkemenfs: Proposal to furnish andinstall the following ❑ Re•Roof O Tear-Oft Complete Roof Preparation O Home exterior to be protected by tarps and plywood 0-Shrubs,landscaping,trees to be protected 0-Entire existing roofing material to be removed to existing decking Q Site to be cleaned everyday with roll magnet debris removed at project completion O Oelenorated existing decking replaced at$2.50 per sq.ft.!$50.00 per sheet of plywood O Metal drip edge installed at eaves and rakes O White O Brown D s inch O's inch • O New flashing will be Installed where necessary 0 cut load into chimney c Cr Install new pipe boot flashing O'We shall acquire all appropriate permits etc.for all roofing work O All roof related debris removed by means of dumpster Complete Roofing System O Ice,water shield installed at all eaves to protect against ice dams(and meet Codes in the north) D on 0 an O Ice,water shield Installed at valleys,around penetrations and chimneys to protect critical O 15 pd. reinforced underlayment installed over entire decking D-syn herlc andedayment Shingles dertelnreed O GAF QTiunko D Owens coming yyear 0 50 year Q Color C.a'ri,aa a a`?^ �a•"�'+,�" 0 Reliable ridge vent will be installed 67 0- Ridge cap shingles Warranty Options 0-We guarantee our workmanship for 10 fun years All prices include dumping fees unless noted otherwise. We Propose hereby to furnish materials and labor-complete in accordance with above epecklcanons for the sum of: Total Sale Price$ �pd Down Payments c% Upon Completion$ ACCEPTANCE OF PROPOS :T e efiove prices,specifications and conditions are satisfactory and are herby accepted.You are authorized to do work specified.Payment will be 1/3 down upon signing and balance due upon completion.Unpaid balances shall accrue with interest at 19%per annum, Purchaser(s)will pay for an costs,expenses and reasonable&home ' t•vz incurred by CDA Roofing and Siding Contractors LLC to recover sums due under this contract. Date: 8124//e /e Signature: - Phone: Date: Estimators Signature: -- - Estimates are honored forthirty(30)days from above date ATTENTION HOMEOWNERS,Please cover all personal belongings in the attic,garage or storage areas due to the possibility of roofing debris or dust vl// coming through the cracks of the wood.CDA Roofing and Siding Contractors LLC will not be responsible for debris or dust in the attic or storage areas. ^CAROOF-02 SirOV.h,CS , ----- n CERTIFICATE CF LIABILITY INSURANCE a,MNLD0I ) � -^'' 811112D1B THA. CERTIFICATE EE iS ISSUED AS A MATTER OF :NFO.MATt0N ONLY AND COY RS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE ODES NOT An9RMATWELY OR NECATWELY AMEND, EXTEND OR ALTER THE CO'tERAGE A FORCED BY THE THE POLICIES . BELOW. MIS CERIiFICATEE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING tNSURER(S),AIUTHORi2E0 I REPRESENTATIVE OR PRODUCER,AND THE CERTIFICA EHOLDER, QAPORTANT: if the certificate holder is an ADD IOt'AL INSURED the pailcy ies)mus`be endorsed. If SUBROGATION-S WAiVEL,subj ;;to the terms and condigone of the policy,ae'lain polities may require an endorsement A statement on this certificate does not gott might to the certificate holder in ilea of such endarsementfsi. _ PRODUCES OE5 C= ,MCCrelunoeAgency.inc. Iro Ln2n 1 li ?G3 Va Cmane,3ve. t c ".91-8711 AAAI. Ila .r U(415)7.31-854p West3 dngfeld,NIA 010R9 ADORE=ss: :NSLa.'-_Ri O!APEORDRIS Cat/MARE NFICu !. I ASURLA$Ac First Mercury tnsurance Co; .. 1 __.R„ ,ASERERs;Continenta IRderanfty Co, CDA R.-.Eng 8>d�ng Cantr'oaos,LLC INSURER C: _AAAI.. 1776 Main St ft SURER ! Agawam,MA 6100: 1 nsuR_=E=_: YER::GES CERT'FCHTE NUMBER': REVISION NUMBER: :, EBEEN - _ :_ 1 THIS TO GERW. ( THAT THE P� E OFI `MENTI, 11 OR 6NDI IO HAVESJ QCT OR OTHER UME,NWTH RESPECT TTOLICYERIOD INO..LAICD. NPTff Ir;ISSUED ANY REQUIREMENT,H TEEM AN cO-AFTORD D ANY CONTRACT 0.2 DESCRIBED HER DOCUMENT HEREIN IS SU SUBJECT TOT LO TiEl eRMSS ! ! E_C IDA IN,gVON 191 NS OR . H PERTAIN, THE INHOW.:M YHAV CE EY THE PO_ICPNDCDCR'BEO HEREIN IS SJ6J�CT'O ALL THE Rn9. cXCt11510N54Nt7OUtlq'ttPNSU SJCk;aCL4E1E5.:AIRS 9901NN MAY H4V-_6EEN REDUCED E-SY-hRR : hLUFpS- �in�I ELAE`REASO4ARRE CC NOPELH Ar !IVWDROBRIP$ :-!!:APER Epp i n. u.7. 4 X G ik=Rcu1 CENERAL LIERRA' H OCCURRENCE 15 :000, I I commooAos. IX(occaR NJC,Gl..00000566510 108,01201.08(091265 Oq,hls ('ane= �; E 5030P! ! _ .ec SONE5 GAOV uORf F LNLAODO. GEER.AGGREGATE LEM A Lis PER- ( NEDAL. CP E 200D,O�'. oLm.r a o- in Loc - PRODUCTS-COMP,!--77-17G, la... e00r000, 5 ' AUTORIOIRLELARLAR F PISINEDSAGLE i LIAR S �ANY E3OAIDYJNAIRYTAP5AREi A t ALL RARER 44"ED-BD 3S]"v M,Li4Y(PJe�m_nIJ 9 Ca"' NON-wt./NEL) F R ' R1 DAMAGE _CALTOS IATOE dl, IS I I I UMBRELLA m I O.AOR I _A HOC^..URRENCE 5 L 1]EJ I IRE NTIoN_i i S ORRPRECOMaENan9JN IE<- AND cMPLCYERSLL42LT' - c1ACC ER B no I ER E. v cnr In A554441.70101 0&182018 0611W2017] ,EAHACAREAT I- ^ DDGJCO! .CFROEREAR HH)EY w.-L. -H HP!E. S H . ftcr eN'H) I FLR£EASE-ER EMPLOY 5 10AD00G 47 leY DEED D R w.QOHN .. R ..,W w_a. ........ i EPASE-Po ARLIRA y9 g ^.OQD 1 DESCRPfQN Off OPRtM OtS r t OCA1oNsI Y-HICLAS ACORD 101,nddrnonaI Rema'%e N'dL,iz, .M_¢nnae<a more 5455:5IE mgMredJ OERT;citATE RD1DER...... CANCELLATION _w.___. _— SHOULD ANY 3F THE A90VE DESOWBED Ho.:Jcies Fa . NELE J SE DELR ..y, ' EXPIATE THEREOF, fE ,, ACOOP.].ANCE WIT:` HE POLICY a.7C;�,::Otia. i I{'JgTH�, LR JRD OPPRESENTARS _.....�... _ AAAI... @ 3 O;S ACOED CORPORA:CIE. All r..Ho-,s_zsd. AGORD 2 ..2O14;'0':, The ADORD name and log _ 6isfe-ed DICERS Of ACORD The Com:i en-wealdl' e➢r Mata.vaar am Rio to Deparim !cf3't2a'zraa „rdAcei enn it Office off Tao s roes %zitrrq Li' 6O9 Waas$aang cA Streea' °y_ is Bosan, .'sig 02111 >vvvuv.me.Es,n.g w/edict orlken' CctnmentaiiecusEwan-ease , Tfcia it: I.esfiliderrs/Contiractortirtl ctriep.aknalialmtix, s Applicant;information Please Ps-int Etee.uWy Name (Businessrorealestenflndividuai): C-On7 zfaszv +'y rare' �ieuJ Pari Address: /'7 TJy,2,pc-:a ,Jaz .�%ylilt's"' T f Citm State/Zip: _s ,a,ayy� - ,q,/ D/D©f Phone #: (�f4. ) 're-a- ` eldel Are you an employe Check the appvopriate box: Type of project (required): WI am a employer with C/JJST 4. Q I am a general contractor and I r employees (full and/or part-time).6 have hired the sub contractors 6. Liiv z<v construction 2.H Iamasoleproprietororpartner- hated an the attached sheet 7. fl Remodeling ship and have no employees 'these sub-contactors have 8. Demolition worlan forme in anycapacity, employees and have workers' g P p'- . insuranc z 9. Building addition [No con workers' comp. insurance p remitted.] 5. We:are a corporation and its 10._ Electrical repairs or additions 3.7 I am a homeowner doing all work officers have exercised their I1, ing repairs or additions myself No workers' comp. right of exemption per MOI, 12. Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' t3.0 OtherT_ comp.insurance required.) Any alicant that checks box M 1 must also Cllr oat the section below showingtheir' els worker compensation policy infonnation. Ho meowne:s who submit this affidavit indicating they are doing all work and thea 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 state whether or not those entities have employees. If[hest/di-contractors have employees,they must provide their workers'comp.policy number. T, mer an employer that is providing workers'compensation insurance_Pr my employees. Below is the policy and job site information. Insurance Company Name: Policy ft or Self ins. Lic. k: Expiration Date: lob Site Address: City/Statte/Zip: 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 o, 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one-year imprisonment, as well as civil penalties in the font 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 Sotwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ter* under the pains and penalties of perjury that the information provided above is true and correct Signature: (t-4- -. Date: Phone if: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License if 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 #: City of r lcrt ampton +^—r s'- ricAte Idassachusetts � ti 1 r ' BUILDING INSPECTIONS :119e MC � r�� 12 Main St2retMunicipal Building thr --1112,M7 Northampton, MA 1106D -:21h f�f INSPECTOR Louis Hasbrouck Chuck Miller euildino Commissioner Assistant Commissioner HOME OWNER ETdv1PTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 7800MR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill). sonotube holes (before pour), a rouch building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made understand the above. (Home owner/resident's signature requesting exemption) will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location SECTION E-DESCRIPTION OF PROPOSED WORK(check all applicable) New House I Addition Replacement Windows AlteraPion(s) • Rooidmg Or Dr Doors C Accessory Bldg. Ti Demolition • Mew Signs [p] Decks (= Siding [Dl Other[El] Brief Description cLR ^posed Wk or /t�.- e9,4,:os "Poo (-1 Az,e° if'<//nccA/e•�- Alteration of existing bedroom Yes No Adding new bedroom Yes No AUached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ga. If New houseandoradditron to existing housma. cornolete the following. a. Use of building One Family Two Family Other b. Number of rooms in each family unit ,.umber of Bathrooms c. Is there a garage attached, d. Proposed Square footage of new construction. Dimensions e. Number of stories? E Method of heating, Fireplaces or Wocdstoves Number of each g. Enemy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i_ Is construction within 100 °. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement k cellar floor below finished grade k. Will building • nform 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, V-4141aS Qu;nr] as Owner of the subject Properly hereby authorize crRe 4/�p./ea/ .,7 ..k,Z to act on my behalf, in all matters relative to work authorized by this building permit application. Signature et Owner Date "-7/19r� � ^e 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. C%ri 2214^e Print Name Signature of Owner/Agent Date SECTlOT1 a.COMSTRUCTIOPI SERV/CES S. Licensed Construction Supervisor: Not Applicable E Name of License Hole 7/4 ,(7o.-e 5: a Y"Y 16/ Cheese Numbe, lye , Co' sV n4 /4 o 7Ar, ao 7? Address / i Expiration Date ePlyrffir Signature Telephoneel 9 .Reois4ered Homelmprovament Conkraaor Not Applicable E C04 .^7o 2oy �:afirw.lw_t Company Name ,/ — Registration Number Address r� Expiration Date /I' '3r /2141-'^ JV q# i elsPh Yoe/ SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152, G 250(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result in thedenial of the issuance of the building permit Signed Affidavit Attached Yes E No E 1.12 - Romeo wirier ExedEamt1DS., The current exemption for"homeowners"was extended to include Owner-oemauied Dweli➢nes of one(I) nr 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.Penin(s)who own a parcel of land on which he/she resides or intends to reside,on which thore is,or is Intended to be,a one or two family duelling, 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 o the Building Official,on a torm acceptable to the Building Official,that he!she shall be responsible for all such work performed under the building hermit. As acting Construction Supervisor your presence on the joy 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 i`3(Liability of Employes to Employees for injuries not resulting in Death)dent Massachusetts General l..awsAmrotated,you may be/it for masonry 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