The URL can be used to link to this page

29-612 (3) BP-2023-1436 629 BURTS PIT RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-612-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1436 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: NEXTGEN CONSTRUCTION Est.Cost: 22195 SERVICES INC 098654 Const.Class: Exp.Date: 08/19/2025 Use Group: Owner: MUNOZ KATZ ELIZABETH &LETICIA Lot Size (sq.ft.) Zoning: SR Applicant: NEXTGEN CONSTRUCTION SERVICES INC Applicant Address Phone: Insurance: 1 ARCH RD (413)579-5798 WC-9098917 WESTFIELD, MA 01085 ISSUED ON: 10/18/2023 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I • ' I• yg . + ''1 • Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner */VE The Commonwealth of Massa use OR 1f1y �O Board of Building Regulations an Sta rds�Cr J 6 ALITY Massachusetts State Building Co e, 7$Fp MR USE Building Permit Application To Construct,Repair, z°F lish a Revi ed Mar 2011 One-or Two-Family Dwelling h,,,Toti P" cr, ON This Section For Official Use Only Building Permit Number: ' g- A3 / 3 0 Date Applied: l ap,5 ///, /D-I8 2.5 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 629 Burts Pit Rd 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public l7 Private 0 Zone: Outside Flood Zone? _ Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Leticia Munoz Florence,Ma.01062 Name(Print) City,State,ZIP 629 Burts Pit Rd 413-588-8930 munozkatz@comcast.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work': Remove and replace Roof to code and manufacturers specifications. Please see estimate for details. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 22195.92 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Cost (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire Suppression) Total All Fees: $ ,i]1 Check No., U)9 Check Amount: 1,(,' Cash Amount: 6.Total Project Cost: $ 22195.92 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-o98654 o8/19/2o25 Rene Gauthier License Number Expiration Date Name of CSL Holder t Arch Road Suite tt List CSL Type(see below) U No.and Street Type Description Westfield,MA 01085 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-579-5798 info@nextgen4i3.net I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) NextGen Construction Service Inc. 196063 06/27/2025 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 1 Arch Road Suite it info@nextgen413.net No.and Street Email address Westfield,MA 01085 413-579-5798 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) 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 ® No .❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Rene Gauthier to act on my behalf,in all matters relative to work authorized by this building permit application. Rene Gauthier ..� 10/11/23 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Rene Gauthiergu,,,c��'� .,` 10/11/23 Print Owner's or Authorized Agent's Name Eleeonic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton •�'� `, Massachusetts ��{ x-• '<< • o a f DEPARTMENT OF BUILDING INSPECTIONS j 4 212 Main Street • Municipal Building k � Yy f_a� Northampton, MA 01060 st-jy 3,')`-\.� CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: Casella Waste 686 Main Street Holyoke,MA o1040 The debris will be transported by: Name of Hauler: NextGen Construction Service Inc. Signature of Applicant: Date: 10/11/23 The Commonwealth of Massachusetts n ;ems Department of industrial Accidents catu ��— 1 Congress Street.Suite 100 `- Boston,MA 02114-2017 ^: „.ari www:mass..gov/dia 1111rkers'Cd►uipensation Insurance Affidavit:BuildersIContrartursil•:lectricians?Pluuthers. It)HE FILED WITH THE PERMI li ING AUI'Ut)RI l. Annlicant Information Please Print Lreihh Nat11C IBustttcssi(.Ellen aeon Individual):NextGen Construction Service Inc. Address: 1 Arch Road Suite 11 City/State/Zip: Westfield,MA o1085 Phone#: 413-579-5798 sec suu an rnihitrr!1 beck Ilk ap s priate bat: Type of project(required): ILO Jan a cnekotcr with 12 amphatcc'ttidl;Mil Of part-timer.* 7. 0 New construction tt-.-.jl 2 t I ani a soli propi iota of partnership and hate no emph.t'ees working tot nu:ing. O Remodeling any caraway.[..`a.%takers'a.nnp.insurance taminta.l 9. ❑Demolition ij I am a lantwn.w nee doing all troth to?self[No workers'cone.utsurance retpina+l.l' 4.Q 1 am latnttaiwnor and will be l hies c oeenrtlurx to conduct all work on my property I will 10 Building addition ensure that all crrataaturs either have worker'a-umpentim insurance tar are sole I 10 Electrical repairs or additions propm:it tt with no employees. 12.0 Plumbing repairs or additions SO 1 am a general contra:kir and I have hind the subto itr:atora listed•the atateiai deem 132 Roof repairs These sub-ccmuactors has a employees and has a+►'oaken'comp.irrnuare.t 14.El Other an: 6.0 we a a corporation aid its officers lase exercised then right tit exemption pc-r IL c. — — ._ IS?§1(4).and n c base ins conplusaxa.INo workers'comp insurance required..' •Any applicant that checks bast 61 YY sans fill out the caution below Amorist dolt Worriers'compensation policy 'II ttianxatn n. *Homcvwnrs who submit this attldwfeltrditatmg they are cluing all work atddm hire outside contractors must submit a tiers attittat at uditattnc such. :Contractors that check this hot rime eeeerisd a.additional short shuwing tie Yang of this sulrcormact.rs anti suit la h ethat us not these cintaws haw w cinployaes•. It iota sub-ccwtuactwx bore employees.they must plot do their markers'comsat..polic:k number. I ass an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. insurance Company Name: Alera group Inc Policy#or Self-ins.Lic.#37366658otot Expiration Date:07/14/20�4 Job Site Address: 629 Burts Pit Rd CitytStatc zip:Florence,MA.01062 Attach a cops of the workers"compensation polic t declaration page(showing the policy somber and elpiratioe date). Failure to secure coverage as required under MGL e. 152,1125A is a criminal violation punisbabk by a fine up to$1,500.00 andlor one-s ear imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the t iolator.A copy of this statement may be forstarded to the Office of Investigations of the DiA for insurance coverage tciilieatton. I do hereby certi/i'under the pains and penalties of perjury that the information prutided above is true and correct Signature: £C. ' d1' U.itr_ 10/11/23 Phone#: 413-579-5798 Official use only. Do not write in this area,to be completed by city or town officiaL 1 ('its or"town: l'ermitiLicense# Issuing:Authority(circle one): I I.Board of Health 2.Building Department 3.('itrfiuwn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: !. ------""N ® CERTIFICATE OF LIABILITY INSURANCE ` DATE(MMIDDIYYYY) C AORO 07/14/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Stephanie Herring NAME: Alera Group,Inc. PHONE (413)586-0111 FAX (413)586-6481 LA/C.No,EMI: (A/C,No): Webber&Grinnell Division A-DD RILSS: sherring©webberandgrinnell.com 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: State Auto Insurance Companies 14923 INSURED INSURER B: Applied Underwriters NextGen Construction Service,Inc INSURER C: 1 Arch Road INSURER D: Suite 11 INSURER E: Westfield MA 01085 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 7/2024 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL"SUBR POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INSD WVD POUCY NUMBER (MM/DDIYYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE . CLAIMS-MADE n OCCUR PREMISESO(Ea occuErrence) $D 500,000 MED EXP(Any one person) $ 15,000 A 10180642CP 07/14/2023 07/14/2024 PERSONAL BADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY n jRa n LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 _ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED BAP248470200 07/14/2023 07/14/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) PIP-Basic $ 8,000 X UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000, - 000 A EXCESS LIAB CLAIMS-MADE 10180646CU 07/14/2023 07/14/2024 AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABIUTY STATUTE ER YIN 1 000 000 B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA 373666580101 07/14/2023 07/14/2024 E.L.EACH ACCIDENT $ , , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) Rene Gauthier is Excluded from Workers'Compensation coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN "`Evidence of Insurance*** ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1.1111.._ D y,�--Yap 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD IPIL'. Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regulationsti� and Standards Cons ~ i a,,%rvisor :314, ty CS-098654W ' Expires: 08/19/2025 RENE E GALJ HIER, R '" 4 82 PEQUOT RD ►r SOUTHAMPT9gN MA 01073 f? O ii i E ' 2 d O E �`1'O tv 1ct2•' _ - N 1 a O Q C C ~ a d d Commissioner _S.,,,,Le s� 3�2 > i ; a I oy � co N . to' ,c Q Y am 7 U o o) NVii I. E m C7oL Q aD .ccx % ; C L o °- m 0. D- EQ DN N N A>- rno 5 lL C N s C QaVLc Z cn 5 o Construction Supervisor o ms m€ O f lnrestricted - Buildings of any use group which contain J g m% o a ss than 35,000 cubic feet (991 cubic meters) of enclosed g'< � = GW° -m space. 2E ° oECo0 f ` 0om m Z m O 0 E w 9. 9 _ V 0 = Q ¢P g W = U 1_ U Cl) ueQ a o 0 Z m U a U ° r Z Q O m � = gWg O y� 2 § w oa 0 iilure to possess a current edition of the Massachusetts "o o Z t a� Z¢.-W ate Building Code is cause for revocation of this license. o¢- � �� For information about this license Wa5w °s ° '¢ ql Call (617) 727-3200 or visit www.niass.gov/dpl .-4 W Wad