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31A-324
BP-2024-0586 8 PARADISE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-324-001 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-2024-0586 PERMISSION IS HEREBY GRANTED TO: Project# PRSIDENT'S HOUS ROOF 2024 Contractor: License: Est.Cost: 597675 MAHAN SLATE ROOFING CO INC 006760 Const.Class: Exp.Date:04/04/2026 Use Group: Owner: COLLEGE SMITH Lot Size(sq.ft.) Zoning: EU/URC Applicant: MAHAN SLATE ROOFING CO INC Applicant Address Phone:, Insurance: 699 SILVER ST (413)788-9529 6JUB-OW27493 AGAWAM, MA 01001 ISSUED ON: 05/14/2024 TO PERFORM THE FOLLOWING WORK: REPLACE EXISTING ROOFING WITH NEW SLATE POST THIS CART) SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Sery ice: 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: 49/2. Fees Paid: $4,186.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner • MAY 7 0 2024 The Commonwealth of Massachusetts Office of Public Safety and Inspections • Massachusetts State Building Code(780 CMR) Buiidingrnit Application for any Building other than a One-or Two-Family Dwelling �+�Q (This Section For Official Use Only) Building Permit Number:a( V- P(I Date Applied: Building Official: SECTION 1:LOCATION PARADISE RD NOKTNAN->R9J OIO63 SI-tt Fl C OLEG� - PR�CII)ErJ IS NUUSE No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used `l If New Construction check here 0 or check all that apply in the two rows below Existing Building fik Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other Specify:?-(tool- Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No .251. Is an Independent Structural Engineering Peer Review required? Yes 0 No 1RIf. Brief Description of Proposed WorkREPCACE EXISTl1..1G— Roo FIN)6-1.✓ITH NY.L) SLA-TF. QEi`tovv 6XttTiuG— R(or SIATT,RElUAdL DESK goitims.I kSS-r - k(! {1 i IC.E+ S y)..rt uc'Tlc OfcertiAil-rEr.rr. 11J.STALL S-J QvAL►r-r Sl1}T& SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional 1-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ IIA ❑ IIB ❑ ILIA ❑ IIIB [] IV 0 VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply Flood Zone Information Sewage Disposal: Trench Permit Debris Removal: A trench will not be Licensed Disposal Site X Public 0 Check if outside Flood Zone 0 Indicate municipal❑ required titor trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable l� Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or Nog Yes 0 No 0 N/4 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner \ AMES Luc EY ^'1 Zrtb lsc 2aA►7 Matz i 1-►AMPToi1 6IQ63 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Smag oct_ ce K67-?, - - 4i 5 a7ao SLucE Y St(Tt•{,EAu Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: 30 PM 11A+1,1 J (77 SIC.(/&& S i. A-GAL/Al-1 RA- a lao ) Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here*. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor /kAMAMQ SL.ATT Lo, I)0(._ Company Name -3-OHM MAw-wY.1 CS -00G760 Name of Person Responsible for Construction License No. and Type if Applicable _699 SIu.vE& S t- ikC 4-dmq I`114- Q(Oo Street Address City/Town State Zip 4-I3 -78S- 615a1 413 -330 _ 3A..CKG- I 1,1SLA-rE .cah Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes* No O SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor q r� / and Materials) Total Construction Cost(from Item 6) =$S 1 l\� 75.Ud 1.Building $ 597, (075.00 Building Permit Fee=Total Construction Cost x_(Insert here 2.Electrical $ appropriate municipal factor)=$ `' 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to NoRTHAlArRY I 6.Total Cost $5 97, /S,CO (contact municipality)and write check number here..JC 763 SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 t of my k owledge and understanding. THE s fp&)0Z- 413 -7gg-9Sa9 Please print and sign nam Title Telephone No. Date 677 SIc_t'Eig ST- A-Gi-A'JA-' /v14 O Ioo l (C@1"4Al-14uSLATT.Coi Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: //' 5-/4 2aZy Name Date City of Northampton ?oaYH MpO� S`S •-r s'C Massachusetts ? ._ '<< l ` ;�•.�k DEPARTMENT OF BUILDING INSPECTIONS y M v +. 212 Main Street • Municipal Building Northampton, MA 01060 � "•• j.1`� 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: ALL LiAsTE RE)-\ov1kL , I)C- TO, lok 117 }- P ►k Mt\ Oto7c The debris will be transported by: Name of Hauler:7EC0-E Rc R G- SE vicE Signature of Applicant: Date: S-7-a� CONSTRUCTION CONTROL WAIVER From: J O N, i mil/ u 1-01•l SLATE- RooFWG— , , (,99 74GALA -\ Yet 01001 To: Building Commissioner City of Northampton 212 Main Street Northampton, MA 01060 The Massachusetts Building Code,section 107.1 allows for an exclusion from requirements for construction control in certain situations. In accordance with code section 104.10, I request that you grant a modification to waive the requirement for construction control of the project at 3 r rW COLC.6G-6 - IPRES IbeksTS HouS6 ' . 1 i9fZA'bU "Kokk because the work is of a minor nature,will not affect structural elements, health,accessibility, life or fire safety,and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration 4 ea Type: Corporation MAHAN SLATE ROOFING CO., INC. Registration: 19 699 SILVER STREET r Expiration: 09//244// 2024 AGAWAM, MA 01001 - WNW Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8 Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 161091 09/24/2024 Boston,MA 02118 MAHAN SLATE ROOFING CO., INC • JOHN MAHAN III 399 SILVER STREET ;` ,ar, 4GAWAM,MA 01001 Undersecretary Not valid without signature 1111 Commonwealth of Massachusetts Construction Supervisor Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than Board of Building Re ulations and Standards 35,000 cubic feet(991 cubic meters)of enclosed space. Const tigitp �4''__ CS-006760 4, .� expires: 04/04/2026 JOHN F MAFi}1N u %.' 699 SILVER STREE . " C AGAWAM M01001 2..t. ti ; Oa ?` ,o , ...iiki,main MUIJ;Vd4� Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner et / Contact OPSI:(617)727-3200 or visit www.mass.gov/dpl/opsi The Commonwealth of Massachusetts "Y t' �iDepartment of Industrial.-I ccidents t=s 61 1 Congress Street,Suite 100 - Boston, MA 02114-20!7 y -v> www.mass.gor/dia 11 in-kers' ('ompensatian Insurance,Af iida'it: Buildersi( ontractorsiiElectriciansfPlumbers. it)BE t 1l_ia)N1 I ell I III PER011 11 INC At UJOKI i'l. Applicant Information `` Please Print Legibly Marine(Husincsa,Organ►ration'Individtal►:_ (V SLR t p.,OOFrk)G- CO-,113L, Address: 6.77 S l Lv K S ET" n q City/State/Zip:, A.L),7t'\ -_O(UQ , Phone P: 4- 3 -L 8� — ! SIC7 Atr y tin an employer?l'hcrk the approprlslr tax: -type of project{required): 1 i am a ernployc:with p�4' emplosees i tu3t arid'or part•tinrel-• 7_ D Ness construction 1 am a sole prupnctur or partnership and have no employees wurkueg tar rue in S. Remodeling :any capacity.[No workers'comp.nisuranix mowed.) v 301 am a homeowner doing all work mraelf.iNo workers'corer insurance ngeurvd.l' 4. ❑Demolition 4.0 1 am a Iornuowner and will be tiring oaaritra conductick c ors to all w on my property. I will 10 D Building addition caws:that all contractors either haw worker.'rorivensutaon insurance or ars:sole 11E1 Electrical repairs or additions pruprxturs with no employees.. 12.0 Plumbing repairs or additions S I am a grm.-ral contractor and I have hired the soh-contractors listed on the al ichesi sheet These subcuntactois have employees and base workers'comp.insurance. 14.'FOther r.G-g�F 13.❑RWf repairs 6.0 we an:a corporation and its officers bloc exercised their tight of exemption per Mt&c. 152,¢1111.and we have no employees.(No workers'comp.insenance required.] 'Any applicant that checks lox a I most also till out the seetion below showing their workers'co pserwauun policy infornuuion- Honieowners who submit this affidavit indicating Iluy arc dinng all work and then hire outside contractors must submit a new altedasit indicaang suck lCeintractun.that cheek this box roust attached an additional sheet show mg the name of the sub-contractors and state whether or not those.oboes base employce, If the sub-contractors base employees.they lutist pro,idc their ,sutlers*romp policy number. i am an employer that is providing is orAers'compensation insurance for nsi'employees. Below is the police'and job site information. Insurance Company Natiic J&LE(Z,S ,—__ Policy#or Self-ins.Lie. a: —ow ot./T93— —),." Expiration Date: )o2 "36 —).62J/— Job Site Address: g T .ANNSE 'ROAD City/State.'Zip: }'(�LC?KY, 16•- d 10 6 3 Attach a copy of the workers'compensation policy declaration page(shos.ing the policy number and expiration date). Failure to secure coverage as required under MGl.c. 152,§25A is a e.'rtminal violation punishable by a tine up to SI,500.00 and`or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DR for insurance coverage verification. I do hereby eery nder allies of perjury that the information provided ta�bove is true and correct Signature: c'+ — Date S - / - )-6.47L- Phone x: 13 -` 8 E -c�S..? Official use only. Du not write in this urea.to be completed by eite or town official. ('its or Town: Permit/License tY Issuing Authority-(circle one): I. Board of Health 2.Building Department 3.CO''l ustn Clerk 4.Electrical inspector 5. Plumbing Inspector fi. Other ('attract Person: Phone#: I! MAHASLA-01 JOCELYN ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 1/2/2 D/YYYY( /2/2024 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 Jocelyn M Douglas Phillips Insurance Agency,Inc. PHONE I FAX 97 Center Street (A/C,No,Ext): INC,No): Chicopee,MA 01013 E-MAIL SS:jocelyn@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:EMC Insurance Companies 21415 INSURED INSURERS:Palomar Excess&Surplus Insurance Company Mahan Slate Roofing Co,Inc. INSURER C:Travelers Property Casualty Company of America 25674 699 Silver Street INSURER D: Agawam,MA 01001 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUER POLICY EFF ` POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM!DDNYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 4X46352 12/30/2023 12/30/2024 DAMAGE TO RENTED 500,000 PREMISES IEa oocurrencel S MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEM_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X El LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ A AUTOMOBILE UABIUTY EDa dennttSINGLE LIMIT S 1,000,000 ANY AUTO 4Z46352 12/30/2023 12/30/2024 BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOSE� ONLY AUTOS BODILY BODILY INJURY(Per accident) $ X AUTOS ONLY X AlIOJTNO ONLY (Peracod accident) B X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESSLIAB CLAIMS•MADE 01-P-XL-P70000819-2 12/30/2023 12/30/2024 AGGREGATE $ 4,000,000 DED RETENTIONS $ C WORKERS COMPENSATION X PER H AND EMPLOYERS'UABIUTY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE 6JU6-0W27493-1-23 12/30/2023 12/30/2024 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,descnbe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S A Commercial Umbrella 4J46352 12/30/2023 12/30/2024 'Limit 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD