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32A-044 (11) BP-2024-1096 13 CHERRY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-044-001 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-2024-1096 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: ADAM QUENNEVILLE ROOFING & Est. Cost: 11497 SIDING 070626 Const.Class: Exp.Date: 08/21/2025 Use Group: Owner: EDWARDS, DANIEL & EDWARDS, SUZANNE P. Lot Size (sq.ft.) Zoning: URC Applicant: ADAM QUENNEVILLE ROOFING & SIDING Applicant Address Phone: insurance: 160 OLD LYMAN RD (413)536-5955 AWC4007012861 SOUTH HADLEY, MA 01075 ISSUED ON: 08/27/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOI 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: I inal: 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: 1742. Fees Paid: $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ,CEVE- AVc , & The Commonwealth of Mass hus is 2024 Board of Building Regulations a d S FOR W Massachusetts State Building C e 0 , inco►Nn MU [CIPALITY �a m ►Ai USE Building Permit Application To Construct,Repair, Renovate unr i» °^► Rev sed Mar 2011 li One-or Two-Family Dwelling t }li�yS lion For Official Use Only Building Permit Number:46/40'(1" IV.1 Date Applied: Building Official(Print Name) lgnature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 13 Cherry St Northampton Ma 01060 1.1a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Usc Lot Area(sq tt) 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: _Daniel Edwards Northampton Ma 01060 Name(runt) City,State,ZIP 13 Cherry St 413-374-5420 dkesp4@gmaa.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building lie Owner-Occupied 0 Repairs(s) I Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units I Other IX Specify:_ Brief Description of Proposed Work : New reef,remove and replace existing roofing,install new aynthetk underlay went,drip edge,ridge vent,pipe boot flashing and Ice and water barrier SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 11,497.00 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: ai(�n 5.Mechanical (Fire Total All Fees:$ ,/� /; Suppression) $ ut� eck Amount: l/ Check No.1 S"1 Cash Amount: 6.Total Project Cost: $ 11,497.00 0 Paid in Full 0 Outstanding Balance Due: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: 13 Cherry st Northampton Ma The debris will be transported by: Adam Quenneville Roofing&Siding • The debris will be received by: Adam Quenneville Roofing&Siding®160 Old Lyman Rd South Hadley Building permit number: Name of Permit Applicant Adam Quenneville ow wens., 08/21/2024 L1a►/I Quennel/1�e OI/2IU 4 Date Signature of Permit Applicant GAF N ' A D A jut i--.- MASTER ELITE° i w. QUENNEVILLEi. ;ef y L d x it a t Yy( r t5<, 1 `ir ,4, . t d p..t� .fit. . I 46 1* *0,. 1 --.ys 1 y� `�a`' ,� '.2may. GAF ROOF REPLACEMENT DANIEL EDWARDS AUG 16,2024 13 Cherry St Northampton,MA Adam Quenneville Roofing &Siding Inc. 01060 Residential-Commercial- Industrial AUTHORIZATION PAGE GAF BASE $0.00 Name: Daniel Edwards Address:13 Cherry St, Northampton,MA The estimate remains valid for a period of 30 days from date of origination. Selections Description Line total O Left&Right Side Upper Mansard $5,499.00 Full Ice and Water © Back Middle roof sections $3,499.00 © Back Lower roof sections $2,499.00 Quote $0.00 Selections $11,497.00 Final Price $11,497.00 Customer Comments / Notes My Product Selections Shingle Color TBD Daniel Edwards: DaJf,Edu-rirc Date:8/20/2024 TERMS AND CONDITIONS NOTICE OF SCHEDULE CHANGES The contractor agrees that when delays become known to the Contractor,the Contractor will advise the Owner as soon as reasonable. DELAYS IN THE COMPLETION SURE TO HIDDEN CONDITIONS The Owner hereby acknowledges and agrees that in certain remodeling work,the demolition of portions of the pre-existing structure may reveal additional defects,conditions,or the need for additional work,which must be repaired,altered,or carried out to commence or complete the work described under the contract. In such case(s),the Owner agrees that the duration of the work and the scheduled date of completion may differ from the date on the front,and that such variation.which is not avoidable by the Contractor shall not be a violation of the contract. ADDITIONAL WARRANTY INFORMATION All warranties for equipment supplied by the Contract under the Agreement shall be those given by the manufacturers of such equipment,which shall be and are hereby passed through directly to the Owner.Under such manufacturer's warranties,the Owner may be required to register or mail in a warranty card or other evidence of ownership and use of such equipment to activate such warranties.The warranty gives the Owner specific legal rights,and Owner may also have other rights which vary from state to state.Under Massachusetts law,sale of goods carries an implied warranty of merchantability and fitness for a certain purpose.All material is guaranteed to be as specified.All work shall be completed in a workmanlike manner,according to standard practices.Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders and will become an extra charge overestimate.All agreements are contingent upon strikes,accidents,or delays beyond control. SUBCONTRACTING Contractor agrees that,notwithstanding any agreement for materials and/or labor between Contractor and third party, Contractor is responsible to owner for completion of all work described in a timely and workmanlike manner. NO ACCELERATION OF PAYMENTS BUT ESCROWING ALLOWED The Contractor may not require payments to be made in advance of the times specified in the Payment Section (front) for the reasons he deems himself or the payments to be insecure.If,however,he deems himself to be insecure,he may require,as a prerequisite to continuing the work described herein,that the balance of the payments under this contract that are in control of the Owner,shall be placed in a joint escrow that requires the signature of both the Contractor and the Owner for withdrawal.You agree to pay cash according to the terms shown above or,if we approve your credit,to sign a note provided by us for payment of the amount due.You also agree to sign a completion certificate upon completion of the work.If you fail to pay according to the above terms and have not signed our note, the entire The unpaid amount becomes immediately due,and you must pay a collection cost equal to our actual collection costs up to 15%of the total amount you owe,plus attorney's fees and court costs.In addition,you understand that by failing to pay according to the above terms,the Contractor may have a claim against you which may be enforced against your property in accordance with the applicable lien-laws. INSURANCE Contractor will be responsible to Owner or any third party for any property damage or bodily injury caused by himself, I acknowledge that I have read and understand this page.Initials: DE his employees,or his subcontractors in the performance of,or because of,the work under this Agreement.The contractor agrees to carry insurance to cover such damage or injury.The Contractor recognizes his obligation to maintain a workers'compensation insurance policy to cover his employees.Contractor further recognizes the obligation of any,and all subcontractor to maintain a workers'compensation policy to cover their employees. Contractor maintains a liability insurance policy with minimum coverage limits of one million dollars($1,000,000.00) CONSTRUCTION RELATED PERMIT ACQUISITION The Contractor under provisions of Chapter 142A of the General Laws is required to apply for and obtain all construction-related permits.The Contractor shall not be deemed responsible for delays in the work described in this Agreement caused by regulatory permit granting or inspectional agencies,authorities,or individuals. COMPLETENESS OF AGREEMENT FOR EXECUTION The Owner is hereby advised that he should not sign this Agreement unless and until all blank sections have been filled in or marked as void,deleted or not applicable,and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. COPY OF AGREEMENT TO BE GIVEN TO OWNER The Laws of Massachusetts shall govern this Agreement.It must be executed in duplicate,and an original,signed copy hereof shall be given to the Owner at the time of execution.No work under the Agreement shall begin prior to the signing of the Agreement and transmittal to the Owner a copy thereof. LIABILITY Company is not responsible for damage or loss caused in whole or in part by:the acts or omissions of other parties, trades or contractors;lightening,gale force winds(+110 mph), hailstorms,ice damage,ice damns(caused by thawing and freezing of ice,water or snow) hurricanes,tornados,floods,earthquakes or other unusual phenomena of the elements;structural settlement;failure,movement,cracking or excess deflection of the roof deck;defects or failure of materials used as a roof substrate over which Company's roofing material is applied;faulty condition of parapet walls,copings,chimneys, skylights,vents,supports or other parts of the building;vapor condensation beneath the roof,penetrations for pitch boxes;erosion,cracking and porosity of mortar and brick;dry rot;stoppage of roof drains and gutters;penetration of the roof from beneath by rising fasteners of any type;inadequate drainage,slope or other conditions beyond the control of Company which cause ponding or standing water;termites or other insects;rodents or other animals;fire;or harmful chemicals,oils,acids and the like that come into contact with Customer's roof and cause a leak or otherwise damage the Customer's roof.If a Customer's roof fails to maintain a watertight condition because of damage,by reason,of any of the foregoing,any applicable written limited warranty shall immediately become null and void for the balance of its term.The company accepts no liability to indemnify or hold Customer harmless for claims or damages to persons or property,except to the extent that such damage occurs during performance of Company's work and are the direct result of Company's error or omission. Notwithstanding the foregoing,Company shall not be responsible for damages to any area of the property upon which. Company's work has not been completed nor is Company responsible for slight scratching or denting of gutters,oil droplets in driveways,hairline fractures in concrete, damage to flowers or landscaping,or minor broken branches on trees,plants,or shrubbery.In no event shall Company be responsible for any type of damage resulting from vibrations,including,but not limited to,interior drywall damage, nail pops or disconnection of chimneys,flues,air ducts,ventilation shafts,exhaust vents,furnace vents or sewer vents. The customer understands and agrees that Company shall have no responsibility for damages of any kind to persons or property occurring after job completion. CANCELLATION The owner may cancel this contract within three business days of executing this document.Such cancellation must be in writing and delivered to the Contractor.The contractor reserves the right to cancel this contract at any time within thirty days of the date of this contract.If we cancel you will be promptly notified in writing by an authorized officer of Adam Quenneville Roofing&Siding Inc. If we cancel,we will promptly return any down payment(s)you have made. I acknowledge that I have read and understand this page.Initials: DE The Commonwealth of Massachusetts �' I Department of Industrial Accidents _; Office of Investigations — '= 600 Washington Street ==►�= Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information /�_! ` n Please Print Legibly Name(Business/Organization/Individual): Acte*w\ (aUCn�a)t ttt t-.r�Utl is YlAt Address: (LO 01 A City/State/Zip:_ Sou' - IIAtE 1k, ('�1b O1O1S_ Phone#:'1I3 -53(.'5 5T- Are you an employer?Check the appropriate box: Type of project(required): I am a employer with 15 4. ❑ 1 am a general contractor and employees(full and/or part-time).' have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' P h 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 I I.❑ Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.�Roof 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. t 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 t;seir 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: t'0"\ 01u lvewk �/1SU�cnCc. Policy#or Self-ins.Lic.#: A W C yU0-1 0 1 agL( Expiration Date: 04/29/2025 r I Job Site Address: 13 Cherry St City/State/Zip: Northampton Ma 01060 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 errtifv r:nderthe pains and nonottivc of neriu ttion provided above is true and correct. t ;'TM^=�.m.w 08/121/2024 Signature: q 41a�(,luennevil�e - Date: Phone#: "u f 3 5 3L - 5 f 5 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Commonwealth of Massachusetts Division of Occupational Licensure k Board of Building Regulations and Standards Cons 7 Wtl ervisor r .y CS-070826 * t Ares:08/21/2025 ADAM A QUOIN:.f 180 OLO LYMAN SOUTH HADW 1 __________7a J 1" Commtislonerev ,_ 1 THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home ImDro erent�Co tractor Registration )eirli) i(14' AI Type: Corporation ADAM QUENNEVILLE ROOFING AND SIDING, INC."-- ~V expiration: 3 1093 160 OLD LYMAN RD. --- Expiration: 03122/2026 2/2 SO. HADLEY• MA 01075 `w . . 1- 1 IC Update Address and Return Card. ���� \+ t.'t $ r �. \� �tF k � �t i.•. , �K �fi \7�/ � hk 4 /�: *' :~. Y ::4'..A \C,r ig'.4•10 SA'?- Qx-i•� ik •' n't , 5 '-;.1-. # ffi. • f 1 ,13 4 r 4 � 1 • ,::t #, :::1,. 3.i yr3ft � a, I ry- I STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION ;s s,, . '%�• )3e it known that ( ,- 3 til el. ,"•r. ADAM QUENNEVILLE I s .• \ 160 OLD LYMAN ROAD , , - =, ^° i SOUTH HADLEY MA 0075-2632 , ;.� F` has satisfied the qualifications required by law and is hereby registered as a ;-,; . i HOME IMPROVEMENT CONTRACTOR I ,. :qii: i ADAM QUFNNEVILLE ROOFING i } : x i Registration #: HIC.0575920 i `,` Effective: 04/01/2024 ' ,,, ;:',-.4 I Expiration: 03/31/2025 ,i- `t .. Bryan (.nnum� u n r t,,es 7{ Ih ACG aCERTIFICATE OF LIABILITY INSURANCE DATE(MM'DD/YYYY) �� 6/21/2024 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 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 Lauren Eckhardt NAME: Clayton Insurance Agency, Inc. PHONE H Ne�tic (413)536-0804 {ac,No): I'1ats14-,a,4 1649 Northampton Street Ao ADDRESS leckhardt@claytoninsurance.net P. 0. Box 989 INSURER(S) AFFORDING COVERAGE NAIC a Holyoke MA 01041-0989 INSURER A:Nautilus Insurance Company 17370 INSURED INSURERB:Green Mountain Insurance Company 20680 Adam Quenneville Roofing & Siding Inc. INsuRERc:Gray Surplus Lines Insurance Company 15889 160 Old Lyman Road INSURERD:AIM Mutual Insurance Company 33758 South Hadley, MA 01075 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER:2024 MASTER 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 ADDL SUBR POLICY EFF POLICY EXPM/ LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE RENTE A CLAIMS-MADE X OCCUR PREMISESO(Ee occuD $ encel 100,000 X BI i PD DED $2,500 BN965983 6/23/2021 6/23/2025 MED EXP(Any one person) S 5,000 PERSONAL &ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY n JET - LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) B ANY AUTO BODILY INJURY(Per person) S ALL OWNED R SCHEDULED 20047429 6/23/2021 6/23/2025 BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accidenll UNINSA)NOERINS MOTORISTS S 100,000/300,000 X UMBRELLALIAB X OCCUR EACH OCCURRENCE S 5,000,000 C EXCESS LIAR CLAIMS-MADE AGGREGATE S 5,000,000 DED RETENTIONS GSL101401 6/23/2024 6/23/2025 WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABIUTY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N!A E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? y D (Mandatory In NH) AMC4007012861. 4/29/2021 4/29/2025 E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.rely be attached if more apace is required) For Informational Purposes Only. Workers' Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B, no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires, or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued (unless the expiration date on the above policy precedes the issue date of this certificate of insurance) . The status of this coverage can be monitored daily by accessing the Proof of Coverage - Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Adam Quenneville Roofing & Siding Inc THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 160 Old Lyman Rd ACCORDANCE WITH THE POLICY PROVISIONS. South Hadley, MA 01075 AUTHORIZED REPRESENTATIVE >:ichael Regan/cM1' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS0251.'14)1)