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44-090 (6) BP-2024-1253 964 FLORENCE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 44-090-001 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-2024-1253 PERMISSION IS HEREBY GRANTED TO: Project# ROOF -HOUSE AND SHED 2024 Contractor: License: JEREMY SAWYER DBA ALL Est.Cost: 16500 EXTERIORS Const.Class: Exp.Date: BERGERON LEONARD & MARY ELLEN & Use Group: Owner: VICTORIA L BERGERON Lot Size (sq.ft.) Zoning: SR Applicant: JEREMY SAWYER DBA ALL EXTERIORS Applicant Address Phone: insurance: 121 WEST STATE STREET 413-478-1536 6S6OUB2E12612823 GRANBY, MA 01033 ISSUED ON: 09/30/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF HOUSE AND SHED POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: 1leter: Footings: Rough: Rough: !louse # 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: Fees Paid: $127.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildine Commissioner FiE.0 IV E-D &, The Commonwealth of Massachu SEP 2024 F R W Board of Building Regulations and S nda s Massachusetts State Building Code, 80 0 Ni 'of NI SB LITY Building Permit Application To Construct,Repair,Reno N f :evis Mar 2011 ' crro , One-or Two-Family Dwelling �''A°,aso Ns This Section For Official Use Only BuildingPermit Number: AQ- ~ r vZ7 �1Jj� Date Applied: " " i/R6 A- 9.3e-GY Building Official(Print Name) It' gnature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 96 4/ ../ore-)r r 2c/. 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 R) Frontage(fl) 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: /_Pae)ered/ aPr,--con Nsraycei,fo., /72/9 O/06a Name(Print) City,State,ZIP 9 b'/ %`/o rid, c 72ci 5AY-8-0 yo No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied prt Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other )d Specify: --(-, Brief Description of Proposed Work2: 12. 'M e✓-e c , p /5 c--4_ peo o-c s e ✓. f 4.c h o J-t 4 G ,),4r .5,4 / Q e c/l h.er,f . l Q SD sf •P--E,, SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 16 s'`&o 1. Building Permit Fee: $ Indicate how fee is determined: / 0 Standard City/Town Application Fee 2.Electrical $ - 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire Suppression) $ Total All Fi f �''�� / Check No. /JU 14eck Amouil: � Cash Amount: 6.Total Project Cost: $ l 4/ gi(30 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) /0 G 836 f re ell __cc. L�� License Number L'x 'ratio ate Name of CSL Holde/ List CSL Type(see below) L No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) C i c.;i I-) J 9 C I C ? R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 7S/S3 /Pk4-e r_s- e ,1.4,f, CU-' 1 Insulation Telephone Email address! D Demolition 5.2 Registered Home Improvement Contractor(HIC) ` ��Sd rg�aS/�� _z•Te re'"V' 5 --SG HIC Registration Number Expirati n Date HIC Company Name or HIC Regfstrant Name S4-4 e S ,ciffX r/ofs Z �, yyyti . i CQ.2i No.and Street Email addfess Corcnh4 r'fiq 6'/03g 6i/3)z/7cfr_c_76 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 J 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 7'rr,. ...50, ,U to act on my behalf,in all matters relative to work authorized by this building permit apgfication. ora( aerct-r-o,7 9/o y Print Owner's Name(Electronic*nature) ate 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. re 9/c)V4 Print Owner's or Authorized/Agent's Name(Electronic Signature) ate 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 • Information on the Construction Supervisor License can be found at :_:_.,, , •_• 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 • ,,°ti• SAC s'•' Massachusettse (il , If ti 1-- !. • ' x' DEPARTMENT OF BUILDING INSPECTIONS �'. ': 212 Main Straat • Municipal Building "?' Northampton, MA 01060 rfklY-. ,roc 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: G/R_? £ J(i1 S The debris will be transported by: Name of Hauler: y/ 3 C, /VI Signature of Applicant Date: cJ' ay/d The Commonwealth of Massachusetts Department of Industrial Accidents 3�AMON =h. Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/Individual): —3-e P Sc:(J i�/ () BA 1)1/ , i 07 j Address: J 1 / /�,, _S'-�c, -�- City/State/Zip: rein y /2 2 O/0.;3 Phone#: ( 2 3) / Are you an employer?Check the appropriate box: Type of project(required): 1.ER1 I am a employer with / 4. ❑ I am a general contractor and 1 6. Q New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.Q Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no 1202oof repairs insurance required.] t employees.[No workers' comp. insurance required.] 13.0 Other *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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: -T1 e J7 L T� �v ro'( Policy#or Self-ins. Lic.#: 6S 60 l) d? 0, /,) 6/a k a y Expiration Date: if/f,/c9-T- Job Site Address: 9 6Y ,/a lf'l c , aer City/State/Zip:JE(-fL f.1 41 d/06.2 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 the pai spa penalties of perjury that the information provided above is true and correct. Signature: - ' - Date: ..) Phone : 47//3) L/7 E /.S-? 6 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 Board of Building Rewulations and Standards Const on'1i'pgrvisor CS-106836 _ d gcpires:05126/2026 JEREMY SAWYER .� 121 W STATL:ST GRANBY MAt01033 Or; Commissioner THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 174528 02/25/2025 JEREMY SAWYER D/B/A ALL EXTERIORS JEREMY SAWYER 310 COLD SPRING RD 1e4,`4 BELCHERTOWN,MA 01007 Undersecretary STATE OF CON'.ECTICUT II EP1 RT11E v'T OF CO:\'.Sf'a1FR PROTEC'TJO•\' HOME IMPROVEMENT CONTRACTOR JEREMY SAWYER 121 W STATE ST GRANBY,MA 01033-9614 Rcgistratiou# Effcctive Expiration HIC.0636067 04/ 4 03/31/2025 SIGNED JEREASA-01 ANGELA AC J RO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �� 8/20/2024 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 Angela DiAugustino NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street WC,No,E,rt): (413) 594-5984 (ac,No):(413) 592-8499 Chicopee, MA 01013 EA AREss:angela@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC INSURER A:The Cincinnati Insurance Companies INSURED INSURER B:Selective Insurance Co Of Southeast 39926 Jeremy A Sawyer dba All Exteriors INSURER C:Hartford Underwriters Insurance Company 30104 121 W State Street INSURER D: Granby, MA 01033 ' 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 TYPE OF INSURANCE ADOL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR 1NSD WVD (MM/DD/YYYY1 (MMIDD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CSU0151382 6/3/2024 6/3/2025 DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 _ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JPERCT O- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER. , $ B AUTOMOBILE UABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO A 9105120 4/16/2024 4/16/2025 BODILY INJURY(Per person) $ — OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accdent) $ X X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE _$_ _ __ — EXCESS LIAR CLAIMS-MADE AGGREGATE $ _ DED RETENTION$ $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE 6S60UB-2E12612-8-24 4/16/2024 4/16/2025 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? T N/A 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRPTION OF OPERATIONS!LOCATIONS:VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Workers Compensation Policy Includes coverage for the following 3A States:MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ALL EXTERIORS ROOFING - FLAT ROOFING REPAIRS - SNOW PLOWING fVE ARE LICENSED FULLY INSURED (413) 478-1536 FACTORY TRAINED OSHA CERTIFIED Jeremy Sawyer O%%ner MA Registration#17-1528 121'West State St. HONEST&RELIABLE CT Registration#OG3GOG7 Granby MA 01033 MA C.S.L.#106836 Allextcriorsl agmail.com Proposal Submitted To: Date: 7/}0,7 Phone#'s: C: Lr c, ,1 c . a ii -r.] C :�e.-\- H:. .e/ ' �G'c/G) W: Street: Email: 7- �� City,State,Zip Code: Special Requirements: f—lcrri r /'/1 0 / 0CD. ❑ Recover yStrip goys e `7- S klc-' . / ;?5-0 Se/ (.{) Complete Roof System j We shall acquire permits for the work ix Home exterior and landscaping to be protected Do Not Do: n,f>t'. S k;d - (f Strip existing roofing to the decking and dispose of it in a proper landfill jki Deteriorated existing decking will be replaced for$P)Lper sheet of plywood after a full inspection. rg Install Ice&Water Barrier at all eaves,valleys,chimneys,pipes and skylights(6'min.on all eaves) K Install(1b.feltynthetic)underlayment over remaining decking area 03 Install metal drip edge at eaves and rake F5/C6 hi own/copper) Install manufacturers starter shingle on all eaves cg Install new pipe boo (stndar copper) tif Install new ridge von Rol Rigid) Shingles: (6 nails per shingle) 6 �% T) f Shingles �'HDZ Lifetime❑Ultra HDZ Lifetime Color7e(A' 4 r 1 t- c e-) f Ridge cap shingles Warranty Options: R) GAF System Plus Warranty We guarantee our workmanship/ for 10 full years(see our warranty coverage) !Estimated Start Date /// /c r W Estimated Completion Date / .)// 7 a Options: Lead Counter Flashing ❑ 4"Box Vents(Black/Silver) ❑ 12"Box Vents(Black/Silver) J wo propose hereby to furnish materials and labor-complete In accordance with above specifications for the sum of: Total ($ / 6,SZi U) ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions aro Down Payment(S S,S-0 C) satisfactory and aro hereby accepted.You aro authorized to do work as specified.Payment will be 113 down,and balance due the day of completion. Balance Duo Day of Completion($ / `''� /:, V C G ) Do not sign unless all sections are filled out. �/ �}j /� j / 9 ///. Op! (Print) tie , 1uy(.l 1�� 1� (Sign)�l i, /L :.-, � Lf/�/ Date: Owner. Print 7 r Date. Estimator:(Print).- ) rt e", -� �r�}/ t (S' Estimates are 'onored for sixty(60)days from above d5te ATTENTION HOMEOWNERS:Please cover all personal belongs in the attic,garage or,storage due to the possibility of roofing debris or dust coming in through cracks of the wood.All Exteriors will not be responsible for debris or dust in the attic or storage areas.