43-063 (8) 40 DUNPHY DR BP-2006-0685
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:43-063 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0685
Project# JS-2006-1014
Est.Cost: $3800.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grotto: Adam Quenneville 120982
Lot Size(sq.ft.): 15115.32 Owner: MCELROY PATRICIA L
Zoning: SR Applicant: Adam Quenneville
AT: 40 DUNPHY DR
Applicant Address: Phone: Insurance:
P O BOX 612 (413) 467-2426 n Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON:12/27/2005 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF
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 12/27/2005 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
City of Northampton _
Building Department
212 Main Street c
Room 100
Northampton, MA 01060 ,E
-`J phone 413-5871240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE MEGRIM/030N
1.1 Property Address b� face ', ,
10i�l[i� r 7.
elri_-0t'fict v'�a'wr n' 9 .' .''.
is ,-
SECTION 2 - PROPERTY OWNER571LPJ-5UTHOIZED` GENT..
2.1 Owner of Record:
TctieivaDonkq d7at e Flp.rwco /14
_SDName(Print) Current Mailing Adllress'
`/3 56'G- /S / /
Telephone
Signature
2.2 Authorized/� Agent:
/-bion\ Queno.„,k "Pooc Po 612. & O-i4- Aub hal oio7s
Name(Print) Current Mailing Address'.
-. 4113 y3G5 1S
Signature Telephone
SECTIONS ESTI M/CPED COON'S'CRUCTfbN.CO S'S
Item Estimatep Cost(Dollars) to be .Official Use Only
completed by permit applicant •
1. Building 3rao (a) Building Permit Fee
2 Electrical (b)Estimated Total Cost of
Construction from:(6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) ?PSJU Check Number
This Section.For Official Use.O-Only
Building-PermitNumber: - Date Issued:..
Signature. _.
;_ Budding Commissioner/Inspector'hi Buildings Date
•
•
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
Thb column tone filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear •
Building Height
Bldg. Square Footage
Open Space Footage Ye
got minusbldg&paved
puking I ,
it of Parking Spaces
Fill: ......, •
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page_ and/or Document it
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
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 NO
IF YES, describe size, type and location:_._„
D. Are there any proposed changes to or additions of signs intended for the property?YES _
No
IF-YES, describe size, type and location:
New House ❑ Addition ❑ Replacement Windows Alteration(s) 0 Roofing gr--
Or
g"-Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[
Brief Description of Proposed Work: PY'mo.K 'vt - lam. . •. .AiarjfC tins-141 AFin. Asoyii S6„,
Alteration of existing bedroom Yes No Adding new bedroom Yes , No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0 .Sheet D
a. Use of building: One Family Two Family „Other,,,,,,^
b. Number of rooms in each family unit: Number of Bathrooms
C. Is there a garage attached?
d. Proposed Square footage of new construction. ,Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves_ Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?_..
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No- Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes-No
I. Septic Tank . City Sewer- Private well City water Supply
a(9�q i� ut"tao ` ®N 4 F.Ot3 D ., s
CV as Owner of the subject property
hereby authorize ... to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
1. • - y ' `Eotw IK�;R�t _, as Owner/Authorized Agent
hereby dec are that the statements and inform io on the foregoing application are true and accurate, to the best of my
knowledge and belief,
Signed under the pains and penalties of perjury,
1})C2‘ w`Ev tiLP
Print Name
G`� 1 a0- US
Signature of Owner/A ent Date
•
9.1 Licensed ConstructionSupervisor: Not CSAppli-crable 0
Name of License Holder: n L3ar'tl LkvuRtrt\k. 070U r}.(p
{ License Number
Molt 08 / a! /dw7
Address Expiration Date
.5S6595,�
Signature �-"""— Telephone
Breen �::�i1C'e"zti - T . - _ ..-.., s-4 NotD
Rdau c� a( _. Applicable Iau92,
Company Name Registration Number
Po Ga &,,4•‘, • te.( ilk O)07c l / as/a�4-
Address U Expiration Date
_Telephone +-)13 53,S95r
' G7d sb1,e gS PEt. skflON ISS RANG AFFIDAVIT(MGI. 152 §25a ¢))
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 fir No D.
113 3Eli t USE qday "+fl .a
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 and 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 Officialthat he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the lob 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 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for persons)
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
d
fi uNntQ
i Uitu osurfan { ton
b 4.4- IE :Ch.d
itOn
4tR _
DEPARTMENT OF PLII!DING INSPECTIONS E� =i�
212 Main Street ' Municipal Building '^, vlh;:�
Northampton, Mass. 01000 r'
��RRWOI2.ICER'S COMPENSATION INSURANCE AITTDAVIT
•
I, _...a.Sni ( 1vne
c A .lJY.._1`9.aa.:k
(lic;rstercrniiucc)
with a principal place ofbusiness/residence at:
(n11 _aa,u i._J c)tew MA o/Q7 _. ___(phony trII35C34.S95J
(1 (s(recUal rap)
do hereby certify, under die pains and penalties of perjury, Char
( ini an employer providing the follov:inc worker's commcnsation coverage for my
employees working on this lob:
aiM Ms, wc- I AJC. 7i21dk 610 RCOS_ _.(VLq/oc
([nsurauo Corer rw) (Fold Nu-caber) (bciradon Dae)
( ) I am a sok p'opietcr, general coarre'mor or homeowner(rcc!e One) and have hired
the contractors listed below who have the following,worker's rnmpensat on eobues:
(Name of Contractor) (Ir. ancc ConccapPchc-t Numbs) (Ex;::r tier.Date)
—_
Mame of corn-color) llasora_ncc CoairavlPciic; Numbcz) ocivoiraina Dam)
(Name of Contractor) dirsurancie Ccantaindkoiicy t'unba) a .- -Con Date)
(Name of Contractor) (Ansa -an= Com^any.Poucy Numet) Ninrafmuor-Dare)
( ) I .un a bele proprietor add have no 11)111:11.1..1'11.11:11;11g for me.
( ) I tan a home owner ne crinin all i_._ self.
NOTE:plea be twaYttlat Wt.Ziktx. . .r cpo c - :qzv..,,*.`la:v..dtli-.3c
as uxre:tUP ttuca u, .td';hc ta.� .a r.4::,'..:app=r ear vct:c re not prrxvly o-v,: ::_:ck
t ears fUs2=
erl[Una clana�ct :Cacv.nr. ckct' (GL';?,cc.( P'.' ;o;L;nloamu•c for.Lie p- c:c_pn x'r..
Inyl ttvu.a(�aagley t+c.v. uWwkR.t,n_i.vucwn c.+c
I umcat.ad tie copy ofWuec4n.-.e,.ytofoa„•v.ln]to OA tkyuan..c ofl.�lcvlil d Giro of{tM.n<for tltc
mvrrge vciLaaoa and tact F_Sumw•muc cowmy-a ur.1 :ccuci 3A U ETOL 151 an lc+t to the enr+ tF.o cNr t pmvlio
enwttv„oraf orig.w;1$OOCO.,.u.e..-n:>-r_i.,._o(y lnre:y.:::.r.I ci:itxrullia in§z:inn of a Sc'i ? *erzeit_erde
fire of Sl rG_t)11 a day agvnA me
Fa-clevatitirscal Liao cinly 1
,e,<-....--. K.,—.)
I ,01
✓fie S��eae a/sacAiude%ta
;" 0 Board of Building Regulations
fi One Ashburton Place, Ism 1301
cr. Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 08/21/1971
Number: CS 070626 Expires:08/21/2007 Restricted To: 00
ADAM A QUENNEVILLE
160 OLD LYMAN RD
S HADLEY. MA 01075
• Tr.no: 3761.0
Keep top for receipt and change of address notification.
DPS CAI 0 50M 04/O5-PC8698
1.
'�=1`'' Board of Building RegulaJA.,e -670—ears (ions ant tan. art s
I One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement Contractor Registration
Registration: 120982
Type: DBA
Expiration: 3/25/2006
ADAM QUENNEVILLE ROOFING
ADAM QUENNEVILLE
P.O. BOX 612
SO. HADLEY, MA 01075
Update Address and return card.Mark reason for Chang
r! Address P1 Renewal E Employment 17 Lost Card
STATE OF CONNECTICUT f DEPARTMENT OF CONSUMER PROTECTION I .E
Beit known that
ADAM QUENNEVIJ.I.F
78 W STATE ST �. .i
G,RANB'l ItlA 31W
is certified by4 2
} y the De pathZ,,, _ _,__vu> z P ction as a registered
HOME IMPAHVEMEItIT CONTRACTOR
f ', 6tral.O5 120'---
Th z i
ADAM QUENNEVILLE ROOFING `R'4NST�t f
Effective: 12/01/2005
r Expiration: 11/30/2006fi
-uy-6UoD 11 : JG NM KemiLiara 1RsuranCe 141JJJnbi1V 1/ 1
MIDONYYr
A C ORD. CERTIFICATE OF LIABILITY INSURANCE ADCSR a j D°y;49!05
A�DllCEa 0H1) A B(�1 EayTSsyri 1 •�' TS UP0 THE CERT�ICAA�OM
`r•.,illard Insurance Agcy, Inc H \ n,,,i' J CA DOESNOTAMEND,EXTENDOR
79 Lyman Street ALT - HE. oven-GER n n.DBYTNEPOLICIESBELOW.
south Hadley MA 01075
Phone: 413-538-7662 Pax:415-538-7179 INSURERSAFFOROING COVERAGE iNAIC#
.:CURED INSURER A:
mLL etre t OPTans _ CO
Adam Quenneville Roofing ,NSURERo-. Arbella Protection Ins Co
& Siding Inc INSURER C:_ ART mtutl coeur-tzea Cmpn..y
AAda Box nue12 ille Roofing Inc
South Hadley MA 01075 LvsuncR u:
INSURER E:
0 VE RAGES
' �{' :++ I'a�lELOW RAVE BEEN K$UED TO THE INSURED NAMED ABOVE Vx[HE?OUCH PORCH 110 :E NOMIRIEJM1NGir
/, i3 A'Rtl"' col'': (ONCE ANY CpNImACT OF omr:R SOCWPii WIN PERFECT O wornThis CEM IC TE NV OE 55URO OR
I Y. IN y.RRRRRR 'NCRA SROM BY THE POLICIES DESCRIBED HEREIN IS SU B@CtT U THE TEAMS.EXCLUSIONS NO :!DIT HAT GE SUCH
POtKY NUMBER LIMPS
I 'wTE(SIMFDDIVY) MilINTTWOOrYDNI EACH OCCURRENCE !410000op
11.10ES.ACOREGATF LIMITS SHOWN MAY HAVE OREN REDUCED BY PAID CLAIMS,
a.
x 'HYPE OF INSURANCE DATE tMMN01YY) DATE(MMflWYY
GENERAL LIABILITY
A X„`CCREMERCUY L GENERAL HARLI 72LPB703070 06/43/05 06/23/06 arcws�t aavef:e} 450000
I CLAIMS MADE IX I OCCUR I MED EX (Any One persMl 45000
X Contractual Limb. PERSONAL amu INJURY S 1000000
I X Waiver of Subro. GENERALAGGRer>ATE $2000000
GENU ACOREG�ATE LIMIT APPLIES PER: I PRODUCTS-COMPIOP AGO 42000000`
—... roucv( I]¢CT Y i.
•
AIfFOMCB LB LIABILITY COMBFNED SINGLE I IMR I
b AMY AUTO 54906400002 11/01/04 [ 11/01/05 (E:accae"1
ALL OWNED AUTOS 54906400002 11/01/05 11/01/06BODILY INJURY 9250000
I X SCHEDULED AUTOS IIPEr eenml !!!
x:R�m*as BODILY INJURY s 500000
X NON-OWNED AUTOS Ipera:auenp
PROPERD(OAWAE 5100000
Per acd e.nt)
GARAGE LIABILITY AUTOOONLY-EAACCID_NT 5
ANY AUTO r- EATHAN EA COA4
]AUTO ONLY. AGO S
E'%CE64dTMRRELLAU591ITY I EACH OCCURRENCE .4
OCCUR I I CLAMS MADE ELATE S
DEDUCT/FILE' s
REFENfON 4 s _
WORKERS COMPENSATION AND I X TORYLIMI SI HR
EMRLovERs•LmBWr AWC7012861012005 04/29/05 04/29/06 ]E.L.EACH ACGIOCNT ]4100000
ANY PRCIPRIETOP(PAOTNEWEXECUTIVE -- i
OFFICEMMEMBEREXCLUSEW AWC7019733012005 09/16/05 09/16/06 EtDISEASE-EA Ell.F1.0VE9 4100000
Il yes.describe under
,SPECIAL PROVISIONS celcw 1E L.DISEASE-POLICY LMT)E 500000
Offi I
.
]E97UPTION OP OPERATIONS t LOCATIONS/VEHICLES$EXCLUSONS ADDEO SY ENDORSE/ABUT)SPECIAL PROVISIONS
This copy of certificate is for use by sales reps only. If job is obtained
p:ease call for a new certificate that will show the property owner whom the
.:ork is being done for, this will then become a legal document for proof of
insurance.
CERTIFICATE NOLtlER CANCELLATION
ADAM0UE SHOULD ANY OK THE ABOVE DESCRIBED POLICIES BE CANCELLEDBEFORE THEEXPIRATION
Adam Quenneville Roofing & DATE THEREOF ;) '�1OR TO MAIL _ GAYSWOTTEH
Siding Inc E Adam QYSenneaille Sella TO THE ' , Ai ®.' j#f FH '0” TIE LEEPT MET FAILURE TO DO SO SHALL
Roofing Inc IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER,R9 AGENTS OR
PO Box 612
South Hadley MA 01075 REPRESENTATIVES.
AUTFORIZEO REPRESENTATIVE
RIA Agency Financed Accounts
AGGRO 25 j2001/08) 6TACORO CORPORATION 1988
S cid
yti-issi �f B .._&11_/\._/‘' TiT T�( W
CQUENfEVILLE iJiJl�., �1r
ROOF1111.10 " The Premium Choice
78 West State Street, Granby, MA 01033 We Are Licensed
1.800-14EW-ROOF • 1-800-4-SIDING Insured
Email.info@l800newrooi.net Website:www.1800newroof.net Factory Trained
MA Construction Supervisors Lk.#070626 MA negisiratwo 812ea92 Factory Certified Installers
Member al the Home eases Asenoauce of Western Mass. CT Registration*575920
Member of the Building&Trade Association Member of the Better Business sureau PBC.313710
' Proposal Submitted To: Date Phone ifs - -413 "S 1
! Rkvg-c �s oy q- 1-C (H '4;1'58'615y/ Cell:
Street , I Job Location
4Cpn?ti — _ •
City,State,Zip Code , Spacial Requirements
f..t._J1 e G.iO .....— - &(k; leAD ,4?CI;., (Asim ter.
Proposal to furl•- i. ..,•.install the following A./'Q S irp P(AS!qv onp,c(2!Iry-,,.
illtRLIZWal .Near-0 j 0 Gutter I A-rkt y SA/c G ,,V& (�o 4 Y`
Co .... . -oaf Pro:7:-: on &er9_TC7r[ iO, e eac.f
AIX ome exterior to be protected by tarps and plywood I / v ,
-i=1-4 '�vc."—w
1,® Shrubs, landscaping,trees to be protected from damage tietit fug SA4are
jt Entire existing roofing material to be removed to existing decking, including flashing,etc.
Site to be cleaned everyday with roll magnet debris removed at pro act completioon to zchhy,~-
Deteriorated existing decking replaced at 4; Mee j P 0lj p,.'
I$
par u+.l y 2'rn.c,r4 a
` X 8 inch metal drip edge installed at eaves and rakes 0 5 inch for re-toaf only
Q IS New flashing will be installed where necessary(see Special Requirements)
S, X We shall acquire all appropriate permits etc.for all roofing work
Complete Rooting System
Q, m ELK Leak Barrier installed at all eaves to protect from ice darns(and meet codes in the north)
kELK Leak Barrier installed in all valleys,around penetrations,and chimneys to protect critical areas
15 pd.reinforced underlayment installed over entire decking
Shingles:
Q X ELK PrestiQee Series I2 30 year ❑ 40 year ❑ 50 year Color_,. tem € a''
R I] Mailable ridge vent will be installed _
RN ELK ridge cap shingles —f A( 3t'c r, e.
Warranty Options: IQ )))
(,v] We guarantee our workmanship for«full years Oh IdakSl, 'L'h' i 3�E'_C __
❑ ELKIO-Year Umbrella Coverage Limited Warranty upgrade. fi-lr-7--Ke ScC,acci
44 ELK15-Year Umbrella Coverage Limited Warr- - upgrade. l
a,"{ut �I L. . `actual.:�'. ...' oucwea
_ -"_`--. y ' I v m."
We Propose herety `nlorgLsh mater151ssptl labor-co ,nate In- „Trait ..- itica60 afor rnaf: -''''�,,,
'1r+ud-o Ft'�_J5/-f_Ycia vc,, { CJ�•e r 55CO'pt
total Sale Price$ J4 9OO r o c. Down Payment S Or a. m _ pan Completion$/ U.00
ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are satisfactory and are hereby accepted.
You are authorized to do work as specified.Payment will be la down upon Signing,and balance due upon completion.
Unpaid balances shad accrue with int st at 1a- per annum. Purchasers)will pay for alt costs,expenses and reason-
able attorney's tees incurred by Ad Ouenneville Roofing and`siding,Inc.to}recover any sumspdue under this contract.
Pate:�G 3/-4)7, signature,%f �� r62�q/ `^, . � C,i- pnona* Y/�-v CL =ti
Date: 99/ Saresp raon`s Siggrwture_ !y�, aa'
7�' Estimates ,nen tltor4lxtytBo)days from above date
ATTENTION HOMEOWNERS-.Please cover all personal betaigngs in the attic,garage fir storage areas due to the possiMty of rooting deb
or dust coming in through cracks of the wood Adam Ouennevllle Roofing and Sidings will not be responsible for debris or dust in the adl
storage areas.