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29-318 (3) BP-2024-0999 431 ACREBROOK DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-318-001 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-2024-0999 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: DAVE MINER EXTERIOR HOME Est. Cost: 8328 IMPROVEMENTS LLC CSSL099953 Const.Class: Exp.Date: 10/20/2024 Use Group: Owner: GLORIA LEDOUX LAWRENCE E JR & Lot Size(sq.ft.) DAVE MINER EXTERIOR HOME IMPROVEMENTS Zoning: WSP Applicant: LLC Applicant Address Phone: Insurance: 264 SOUTHAMPTON RD (413)374-0720 6ZZUB9F45112622 HOLYOKE, MA 01040 ISSUED ON: 08/12/2024 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 NORTHANIPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 172_ Fees Paid: $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner AUG � l The Commonwealth of Massaelti /I FOR cilii�:yBoard of Building Regulations and Standards ;1,spFCIPALITY Massachusetts State Building Code,780 C '4 o, oNs MUNI USE Building Permit Application To Construct,Repair,Renovate Or Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: . 2 • Z77/71Date Applied: S I Z'=LLB Pik IELl> a_ 6)"2-'27 Building Official(PrintName) Signature Date P SECTION 1:SITE INFORMATION 1.1 / ( Addsom: h.c, 1,- fi/Z 1.2 Assessors Map&Parcel Numbers 1.1a Is this an accepted street?yes no Map Number Parcel Number T 1.3 Zoning Information: 1.4 Properly 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 L6 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 Cl On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSIILP' 2.1 of Record: 6.iI4 L-r,P,vK Pe/e,tc4, /1'//- 5/062 Name(Priint) L City,State,ZIP ? No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 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 Work2: f 0, r - f G.:iC- _a___ S ei t / / e. ` e.iPl ,rr SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials 1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee . 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ _ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Foes:$ z Check No..j�,4 1 PCheck AmountItO Cash Amount: 6.Total Project Cost: $ �J...) (7 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) qnq�,3 ii I DS Do ij e L n P r License NumberExpiration Date Name of CSL Holder / Q v 1 � �l` V� List CSL Typo(see below) Rat No.and Street 4(, Type Description },,©I D Q U Unrestricted(Buildings up to 35,000 cu.ft.) d t b " i M i)i O O R Restricted I&2 Family Dwelling City/Town, tate,ZIP M Masonry RC Roofing Covering WS Window and Siding �y SF Solid Fuel Burning Appliances 41:h ?j] I+G 7 2O dove ' lM i frier 1-La r I Insulation Telephone Email address t,V)1 D Demolition 5.2 Registered Home Improvement Contractor(HIC) cr' 1 ! 6 HIC Registration Number Expiration Date HIC Company Name or HI Registrant Name dove w1 OOP 11 C Cbh1 No.and Street 41 /, /14- Email address 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 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 Da Da,e 14 t V)e to act on my behalf,in all matters relative to work authorized by this building permit application. Adi 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. DCWe? Milner l ( ° 11Y Print Owner's or Authorized Agert'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 Homo Improvement Contractor(HIC)Program),will 14 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,ntass.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 The Commonwealth of Massachusetts Department of Industrial Accidents r= 471 Office of Investigations I t?, .:-:A. i' Lafayette City Center :r�� 1 ,, _� 2Aversue de Lafayette,Boston,MA 02111-1750 = = www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 1Cl ie. M i vie r EXfer 1 or tiovne Lvty')rcvewtienfS - Address: &jo 1 oi-ill avvt ik Rot City/State/Zip: \C?tyCMe b.._ Q IC) 0 Phone#: 1 3 4?�2 -D O e�you an employer? Check the appropriate box: Type of project(required): 1. : I am a employer with 4. 0 I am a general contractor and I 6. El New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.r2iRoof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then 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 the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �L)Y" 1 G� _ Policy#or Self-ins.Lie.#: zZ V e,of 1`i' 'j l 1 a t.g A Expiration Date: ) O l a i i oL Job Site Address: 6 /1,-/ .) ci-- City/State/Zip: wt 11 I 4..,f v* r; 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 c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form 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 forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains and penalties of peijury that the Information provided above is true and correct Signature: c=/ - Date: / Ay Phone#: 141.3 &7`1`i - a il LZO Official use only. Do not write In this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 5E1Plumbing Inspector 6.0Other Contact Person: Phone#! City of Northampton o.. ^ro. `. . . si ? ,t ,5 C "" Massachusetts ',, kil DEPARTMENT OF BUILDING INSPECTIONS,yre212 Main Street • Municipal Building s_, , `` r: Northampton, MA 01060 Ih, 1,.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: Vc; ICY /lC `- i- ! ''')- I Ai 1� ( -,``'i,— The debris will be transported by: Name of Hauler: (�2 k'" CLf 1 4,1 ), ...."(.. Signature of Applicant: / � -----" Date: G/ / 7 /� 7 City of Northampton #°i , ° :0 , sir, ;!•''' Massachusetts <Y '.. Viy e; '< ( � • ; DEPARTMENT OF BUILDING INSPECTIONS ` � 212 Main Street • Municipal Building \Jj 1D. •`x. y.,:4 Northampton, MA 01060 '�s'f , {,•IC E`' 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: �'��< < err j �� �L 1 Ivi'l /e,, A.." 14._, The debris will be transported by: Name of Hauler: , /�J1 �''e /AI / i` '` " Signature of Applicant: , Date: 1:1 / 7 /:) Y bASTE MINER Date: Ulq )T*1 Exterior Home Improvements (413) 533-0481 www.DaveMinerRoofing.com 264 Southampton Road,Holyoke,MA 01040 MA Registration#186552 Customer Name: 10r la P jGts Y Telephone Number Address, City/Town, State: ( /\( f e b{(f I 1 f` 1 G r P rIc'C ^ CertainTeed Roof System • Strip off existing roof and remove all debris from worksite • Line all edges with 8" aluminum drip edge • Install ( feet of WinterGuard ice & water barrier along eaves and up any valleys • Install \ Roof Runner Diamond Deck synthetic water resistant underlayment • Install CertainTeed Landmark \ Landmark PRO Landmark Premium Other shingles to manufacturers specifications. Color:_ /ti1 or/r Pe, I • Install SwiftStart starter strip along_eaves \ eaves and rakes • Install using 4 nails \, 6 nails for maximum wind coverage up to 130 mph • Install a ridge vent along the length of house approx. 15" in from edge of roof • Install new vent stack collars • Replace step flashing as needed along walls and chimney • Re-flash chimney with lead flashing as needed. Install Cricket at chimney. • Plywood Install 1/2" CDX plywood `. Install 1/2" CDX plywood as needed @ per sheet • CertainTeed SureStart Plus V 4-Star _5 Star Warranty Coverage • All workmanship is guaranteed for 10 years unless otherwise specified. • Protect siding and exterior of house • Protect trees and shrubs • Magnet ground for loose nails • See Other below for any additional work or comments • Other: < , , - Contractor is not responsible for any damage to interior of home.Any loose articles on walls/shelves should be removed before work starts We Propose hereby to furnish material and labor-complete in accordance with the above specifications for the sum of: it- • _ 1) v r Jr-. J .L _: I� l if dollars($ " '�) ' A deposit of 1/3,$ )'(>r ,is to be paid before materials are ordered. A Payment of$ � is due at the halfway point,and the balance of$ 3 _ - paid upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above specifications involving extra costs will be executed upon written orders,and will become an extra charge over and above the estimate. Our workers are fully covered by Workmen's Compensation Insurance and Liability Insurance. Authorized Signature: Note: This Proposal may be withdrawn by us if not accepted within 30 days Acceptance of Proposal—The above prices,specifications and conditions are satisfactory and we hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature: Signature: ' _ . , • Date of Acceptance: // !' /) t/ This agreement may be cancelled by Customer within 3 days of acceptance for any reason as detailed in the accompanying Notice of Cancellation Customer's Initials