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43-155 (9) BP-2024-0066 29 HAWTHORNE TERR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 43-155-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0066 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: NEXTGEN CONSTRUCTION Est. Cost: 30551 SERVICES INC 098654 Const.Class: Exp.Date: 08/19/2025 Use Group: Owner: DAVID MAYER Lot Size (sq.ft.) Zoning: WP/WSP Applicant: NEXTGEN CONSTRUCTION SERVICES INC Applicant Address Phone: Insurance: 1 ARCH RD (413)579-5798 WC-9098917 WESTFIELD, MA 01085 ISSUED ON: 01/22/2024 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: 1 . Pufy Fees Paid: $198.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner r ---_,-The- .Commonwealth of Massachusetts , W ,JA �; Board Building Regulations and Standards MUNICIOPALITY R 2 2 ssac iusetts State Building Code, 780 CMR USE Building_Permit App cation To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 ' ,,,__ One-or Two-Family Dwelling a '24 ,Cro"Ns This Section For Official Use Only Building Permit Number: 2-0-7J't-r ti( Date Applied: a ,1, ; ► ;,, as Building Official(Print Name) I Signature J� Drate SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 29 Hawthorne Terr c,i3-,L5-5-b o / 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: G4)P/L0:3P '2-,It acre- 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 0 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: David Mayer Florence,MA.01062 Name(Print) City,State,ZIP 29 Hawthorne Terr 970-764-7015 davereneemayer@msn.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building VI 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 $ 30551.79 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Total All Fees: $ Suppression) Gy 30551.79 Check No.279LCheck Amount4ir.— Cash Amount: 6.Total Project Cost: $ ❑Paid in Full 0 Outstanding Balance Due: C,ft A `his SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-o98654 08/19/2025 Rene Gauthier License Number Expiration Date Name of CSL Holder 1 Arch Road Suite 11 List CSL Type(see below) U No.and Street Type Description Westfield,MA o1085 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@nextgen413.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 11 info@nextgen413.net No.and Street Email address Westfield,MA o1085 413-579-5798 City/Town,State,ZIP Telephone eiMOA pennn;4• 1nLvL pttase7" 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 0 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 �, r✓ 1/9/24 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 Gauthier 1/9/24 Print Owner's or Authorized Agent's Name Electronic 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 pYNyMp,p S,S f' -ate a ;•� Massachusetts 4.?' DEPARTMENT OF BUILDING INSPECTIONS y d • 212 Main Street • Municipal Building Northampton, MA 01060 " .WOI 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 oio4o The debris will be transported by: Name of Hauler: NextGen Construction Service Inc. 1/9/24 Signature of Applicant: e,—0 Date: _. &." The('ommunwealth of Massachusetts pi `-- --1 Department of Industrial Accidents • ► --_ 1 Congress Street.Suite 100 Boston,MA 02114-201 - wwty.mass gov/din 11 Ili ken-Compensation Insurance Aftidasit:Builders'('untracturv'ElectriciansJ'Plumbers. In HI.FILED H'ITII IlDE.Pt i1NC171\G:ti I ORI I I. tpltlicant Information Please Print L reibis Name IHumnoi.v tganttanon 1mltt,duall:NextGen Construction Service Inc. Address: i Arch Road Suite it City/StateZlp: Westfield,MA oto85 Phone#: 413-579-5798 Are sou an rmptmre.Cho*Ihr appruprlate Itux: 1.0 I am a enilo)CCr*Oh— 12 cn4k'yora dull and u part-limn).• 7. 0 New construction 2Ll I am a auk pnlprictur or putnaill ipatd have no enq.koyer%working tin me in $. O Remodeling any capacity.INu soullsate comp Mara me mowed" 9. 0 Demolition ED I am a honwvwnerdniaa all want myself 1140 wtu►era•comp.i avuratrc mural"" 4.0 I am a home. err and will be hiring evintradem conduct to crrct all wurl.on my property. I w t11 1 additionw cmure that all emu:actors either have winker.'aompcnzatoat insurance in arc sok 11.j Electrical repairs or additions proprietors nail MI employer.. 12.0 Plumbing repairs or additions SO I am a amoral contractor and I has c hoard the sub-cuntract.ns hated on the attached sleet. 132 Roof These sate-rutuacton nea hair employees and have r►en'romp owuratre_• repaint ILO We are a commotion and its oflioers have esaes.rd then nettt.t exemption per Will .c 14.(3Odler 132.ij 1I4).and we hair no employees I'w VI VWkcrs"comp.msurancrrequirr,.1 'Any applxant that distils box t l mum alto fill out the archon brk,n Among their workers'compensation policy information. t llwnvw Wars who anima,tits atla4:l.it malt army they ate Jumg all work and then her mila,&contractors mtot sutitad a new aulidav it nalxzamy wch.. 4 untradoo that check ihas box must all..lied:In a.k,iittonal short show mg the name of the tudcaatti a,torte and male wIridia to nut done mastics have eii plv\'ema. It the sub-.unttaat.xs hate cmplox rye,,tli.m mart fine id4"their %Olken! romp.point 11'14 1,t[. I urn an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Na : Alera group Inc Name Policy 4 or Self-ios.Lie.> 73666580101 Lxpuauon Date:o7/14/2024 29 Hawthorne Terr Job Site Address: Ci Florence, Ma. 01062 ty?State.+Z,P Attach a copy of the workers'compensation policy declaration page Ishosning the policy number and expiration date,. Failure to secure coverage as required underMGL c. 152,425A is a etuninal s iokttt./n punishable by a tine up to SI.50(1.00 and/or one-year imprisonment,as well as civil penalties in die form ail Sit tP WI IRK(1ItDER and a tine of up to$250.00 a day against the violator.A copy of this statement may be fewarded to the,,bare of Ins c.tiiations of the DIA for insurance coverage verification• I do herby re rti/r under the pales and penalties of perjury that the information provided above is true and correct Signature: g�c ,/7 Date: 1/9/24 Phone : 413-579-5798 ` 1 Official use only: Do nut write in this area.to be completed hr city or town official ("its ur•fawn: Permit/License aef Issuing"luthorih (circle one): I.Beard of Ilraith 2.Building Department 3.City'le min Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other T_ Contact Peron: Phone# / ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ‘11.....-/ 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. C (413)586-0111 c (413)586-6481 (A/C, Ext): FAX No): Webber&Grinnell Division E-MAIL sherring@webberandgrinnell.com ADDRESS: 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 TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTRINSD MD POLICY NUMBER (MMIDD/YYYY) (MM/DD/VYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE T $ 1,000,000 RETED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 15,000 A 10180642CP 07/14/2023 07/14/2024 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE $ 2,000,000 POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG $ 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 XHIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY (Per accident) PIP-Basic $ 8,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE 10180646CU 07/14/2023 07/14/2024 AGGREGATE $ 1,00Q,000 DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? Y N/A 373666580101 07/14/2023 07/14/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,O0Q000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD IPI`. Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards Consrvisor CS-098654 ',414.' * , F spires: 08/19/2025 RENE E GA HIE", 82 PEQUOT OD Q SOUTHAMPtN MA ' . ' ' . .. Irelillifr eL 1O ci 7 VOL` sda��`ao 13 m 0 N % C o M o . O S�� m n Commissioner �WS� §____S., ,L, t I NN- ao to Es a'3ro ' ° to > o ,0 in r_ Q c _ N N $'w D� m- 3 WO_ 13 � O � Cn 2 �a L7 jcn , 02 -a; i Q m ' V c= E c 7 QJ R1 i= a rn o O LL N � ; r. cmcc Z Construction Supervisor O v,= o a , f,€2 2 Inrestricted - Buildings of any use group which contain J o w t , ,.*:_ gazo ss than 35,000 cubic feet (991 cubic meters) of enclosed °'c° N ¢ m°- w a .� � E space. z a3 0 o 0 O Shin i com E 0 o o a) z c OO ' u - g U � � 0 0 w5 � ¢ I N T. w i F-- (1 U) x �° Q < I `1 . ei 20 N c Z o co 0 O wi Le Z.g > CC O .�. O O W a O a o iilure to possess a current edition of the Massachusetts (30 o z € Er z Q r 7 ate Building Code is cause for revocation of this license. ox- o =�Z. For information about this license ~UI wa�W W O 0 5¢° Z...to�i i u ( Call (617) 727-3200 or visit www.mass.gov/dpl W w wa0 z tcrov, -Rip and remove entire roof and dispose in dumpster - repair damages sheathings$120 a sheet)8 included -cover over exsisting attic vents -install ice and water 6'from drip edges -install synthetic membrane to rest -install gaf starter course -install gaf shingles color tbd -install ridge vent and ridge shingles -install 1 solar attic fan(30%tax credit) 'install all new trashing to chimney - Install 2-3' lifetime pipe boots -install 2-velux skylights in rear with flashing kits Quote subtotal $30,551.79 Total $30,551.79 ally est. $420.68/mo https://lending.ally.com/qualify/5092/18881 AUTHORIZATION PAGE Nextgen Roof+ $30,551.79 Project: 2978 Name: David Mayer Address: 29 Hawthorne terrace, Florence, MA Estimates valid for 30 days from date of estimate Final Price $30,551.79 Customer Comments / Notes My Product Selections Shingle/Panel Color Metal Color Vent Color David Mayer: Dav rA er Date:1/7/2024 Exclusions: By signing this form I agree to and confirm the following:I certify that I am the registered owner of the above project property,or have the legal permission to authorize the work as stated.I agree to pay the total project price and understand that this work will be completed in accordance with industry best practices.