Loading...
18C-119 30 ALLISON ST BP- 2011 -0363 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C -119 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2011 -0363 Project # JS- 2011- 000605 Est. Cost: $3894.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 7492.32 Owner: HANLEY KAREN M & LAURIE A MEUNIER Zoning: URB(100)/ Applicant: ADAM QUENNEVILLE AT: 30 ALLISON ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536 -5955 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:10/21/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 10/21/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit OCT 2 1 2010 212 Main Street Sewer /SepticAvailability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans ' phone 413 2 1587 - 1240 Fax 413 587 - 1272 Plot/Site Plans Other Spedfy APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 3o All ∎ s-f- Map Lot Unit NOr- }11pwAP Jot. t /a. Pc 0 (oft 0 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: /qua; Mevn 3o At Se s +. /Vpr4ko,P.i,PAA 01 0t.0 Name (Print) Current Mailing Address: �i13-S>rG -GQt) Telephone Signature 2.2 Authorized Agent: flaa+r+i Qvtnntyi I�t 14 o O I 1 1 n.,a+� So u4.4., Hall�� ,P�AcdoTS' Name (Print) Current Mailing Ad 4 ^5:3 -5'4g Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building b 3 g 9y ,o o (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) $ 3 gdty Check Number a 6 a e„ y 31/45' This Section For Official Use Only Building Permit Number: Issued: s g I Signature: Building Commissioner /Inspector of Buildings Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW O YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO © DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained O , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Dcl Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding [0] Other [0] Brief D scription of Proposed Work: Vv. 11e-s QZ � 3 c vevvk , Soil boe. (��►�acwr - �Kd` Alteration of existing bedroom Yes No No Adding new bedroom Yes x No Attached Narrative Renovating unfinished basement Yes 7 No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, L G v `e- Mc V) Q C , as Owner of the subject property hereby authorize & Siding, Inc, to act on my behalf, in all matters relative to work authorized by this building permit application. t CO -I$-to Signature of Owner D ate Aim Q • loafing Siding, Inc, , as Owner /Authorized Agent hereby declare that the statements an information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Aduv" Qv- Print Name Signature of Owner /Agent Date 6 040 4 6 ekok AlabliewittsPtCoNili, SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: _Y. r N�ott Applicable ❑ Name of License Holder : Ad!® �1 Rii'fw License N ` N . r 160 L RRoad umber H id $"a\ - 1 t Address k'MA 01075 � Expiration Date it13`53G- 51S'S Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Ada Quevile Roo* & Ste, IK. raoRCg a Company Name lit O Lynam Road Registration Number South Hadle MA 01075 3 - a S- I Address f Expiration Date Telephone tfi S3G 55 - SECTION 10 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 fit No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature egg' 14 ill ;AIL:, III goad ;gnu Maw Kfoipt . e lgfoot' Ii.stItti (04 Pilf3o ijVI1 011i.VUti)r li o e ut 3 'Re A DA A Name � / C /, Cust. # �� / G✓,, r L.f / QUEN NEVILLE ROOFING & SIDING, INC. Street Address City State Zip 1.800 • NEW ROO 4-11,L5,,,. , �/,1 O /oGo 413.536.5955 �v 1800NEWROOF.NET Home Phone # q Work Phone # E -mail 160 Old Road COMMERCIAL . RESIDENTIAL nS I D E N TI otovs ("/I) S-S6 _ G !/7 k/.1;//," e Go...-rc ,s',N, Hadley. I hereby authorize you to proceed with the diagnosis for a minimum charge of $ - SS C PL I X StraightForward Pricing° ���� �4�, . 3o _,Z c lace 4 SQ of .shingles teptlash /Counterflash 41' to 50' of wall, Replace 51' to 7 65' of va ley. REtlas to chimney, Construct cricket and flash 3' to 6' wide chimney. Roof or Siding cleaning 22,001 sq. 1 1 . 3 . 1 ) 1 6 1 sq. Il. Cover fascia of rake with Aluminum 51 65' Replace 2 -311 slues. Quantity x $1637 ea = /43 7 Replace 3 SQ of shingles. Stepflash /Counterflash 31' to 40' of wall, Replace 41' to 6 50' of valley, Reflash 16' to 20' chimney. Install 71' to 110' of ridge vent, Roof or Siding cleaning 1.501 sq. ft. - 2,000 sq. ft. Cover fascia or rake with Aluminum 41'- 5(1' Replace 16 -20 slates. Quantity x $1277 ea = Reel rc SQ of shm rles Stepflash /Counterl ash 21' of Si)' of wall Install 51' to 5 7(1' of ridge cent Replace 31' to 40 of s all ey. Reflash or replace place up toe Customer Supplied skylight (es intermrtnm work). Install 2 50' to 350 of drip ed Reflash 13' to 16' loot chimney. Roof or Siding cleaning 1.1101 sq. ti. - 1.500 sq. rt. Cover 9 fascia or rake Nv ith Aluminum 31' - 40' Replace 11-15 slates. Quantity x $839 ea = 8 3 Replace I SQ of shingles, Stepflash /Counterflash I I' to 20' of wall nst tl l 3l' 4 of ridge yen Install 21' to 30' of valley, Clean 251' to 350' of gutter, Reflash 9' to c umney (perimeter) or small stone chimney, Replacement of customer supplied skylight (no interior trim work). 'fear oft' and re- shingle 2nd story bay window. Install 101' to 200' of dripedge. Roof or Siding cleaning 501 sq. ft. - I,(00 sq. ft. 1 GOO Cover fascia or rake with Aluminum 21' -30' Replace 7 -10 slates. Quantity X $694 ea = Reflash up to 1' perimeter chimney. Replace I to 2 bundles of shingles. 3 Stcpfash /Counter (lash 6 to 10' of wall Install 51' to 100' of drip edge. Install 4 to S hat cents. Dryer hose connections. Replace up io 15' of valley. Tear off and re- shingle I st story bay window. Install up to (0 of ridge vent. Minor tuckpointing and walersealing of chimney (<1' in heig tl Re- stepping and IceGuard 2x4' skylight, Installation of curhnuaunt skylight. Clean 150' to 250' of gutter, Install t( tt 51' to 100' of drip edge. Coyer fascia or rake with Aluminum I I' -20', replace .2 )' 4 -6 slates. Roof or Siding cleaning up to 500 sq. ft. Quantity/ x $559 ea = Z. -Soil boot replacement Replace up to I bundle of shingles or up to 20 shingle tabs, Stepflashing .ounterflashing less than 5' of wall, Installation of up to 50' of drip edge. Installation of up to 3 hat vents, 10' or less of gutter /fascia replacement, Clean 31' to 150' of gutter, Reflash electric pole /heat stack, Crop up to 30' of valley. Replace 1 -3 slates. Cover fascia or rake with Aluminum 10' or less. Install rubberized crown on chimney cap. Install stainless steel cover on chimney flue. Quantity x $387 ea = 1 Roof certifications of Gutter cleaning (up to 30') Quantity x $159 ea = (Add 30% for roof pitches greater than 6/12) Custorrpp;;,� ��/ Reques'�'�eu- "e'UC. `J O Mn) l'L R& Quantity x $ ea: = • -40 ► ■ - - ,.e Quantity i x $ ea: (07 J = ‘)5 °� r Y1 a 0:. • ' entity x $ ea: / " 1 = L "-= - Reco - - -.. • • � _ PVR f✓ I hereby authorize you to proceed with the above StraightForward Price' of $ MC v isa AE CC heck ( �7 Credit Card Diagnostic Fee = 3 8°f`/ �U i , Exp. Total Due today $ / CO O6 5K Work performed to my satisfaction Pb NP Scheduled Arrival Time Actual Arrival Time Thank You! The Coaunonwealth of Massachasears Department of Industrial Aeddents '! = ��, Office of Investigations ,,.� � 600 Washington Street Boston, MA 02111 ^ ?L_ www.rnass.gov/ata Workers' Compensation Insurance Affidavit: Btlilders/Contractor . . Annlicant Iifa►rmatim Please Print LeElbly • Name ( ) i t. a e . ' . I ' a a ` lie — Address: 16() ()Id City I • • Oa b ! Phone #: t - Are you an a mpiuryer? Cheek the appropri•be box Type of project (required): 1.Ni I am a employer with 5 4. [] I am a general contractor and I (full and/or �rme • have hired the sots 6. ❑ New construction ( P� )- listed on the attached sheet 7. 0 Remodeling 2. ❑ I am a sole proprietor or partner - ship and have no employees These sub-contractors have 8 [j Demolition working for me in any capacity. employees and have workers' 9. 0 B .ing addition [No workers comp. insurance t required] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions right of exemption per MGL [� worims comp. 12. Roaft+eparrs insurance ] t a 152, §1(4), and we have no 13.E Other employees. [No workers' comp. insurance rewired.] *Any nephew that checks box 11 mast also SI out the section below Wonting their mothers' omrpeenoon policy information i Home m a r s v th o subsoil this affidavit i n th m e i t t g they sae doins at! walk matt tb b * outside 000mctors most submit* now e — dicstisgatcb. kosaemesfiat dint ads baxassatatr eiotanstiatismleheetshowingtUenameoftbeaabossaaolassndseetewLetheronset Shone entides hare e nsloyses. HIM wb.asnhactom bars employees, they must psovide their nothas' comp. policy number. I are an employer that laproviding workene compensation l esiwauce for Aga employees. Blow tr the policy andJ b site Insurance Company Name: : V r i o �. , is , ' • P o l i c y # o r � f - i n s . lam. #: k)c. 7 o lag o 1 o L won Date: l i/a a / a61 I lob Site Address: 30 At l '‘ S oh S+ &�4c en P 404‘ . , Xt A Cit 0 tO (e 0 Attseh a copy of the workers' compensation policy declaration page (showing the policy number aarl swpfradse date) Failure to sectae 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 efo hereby ant& un mulpenahles ofpulxry that the information prattled prattled—above is awe and Sig e; ff Date: 10 ' 1C w Phone It: zit 3-53 to -5 ss o, d use only. Do not write in this area, to be completed by dty or mare dlidal City or Town: Permit/License # lamina Authority (circle one): 1. Board of Bad* ulIb 2.1 g Department 3. City/Town Clock 4. Electrical Inspector S. Plumbing Inspector — 6: Otter Contact Person: Phone #: - .,l'i.. ' t °1 - he ' • : 0 laions ari • tan• ar • s .— , oar. 0 .0 'mg egu • .5 . � - c 1 � One A Place - Room 1301 f Boston ,.Massachusetts 02108 Construction Superviso License • • .. License CS: 70626 • , ' •:...... • Restriction: 00 , ... ' Birthdate: 8/21/1971 tion. 8/21 /2 Tr# 3712 E xD.lra Oil AQAM A ' QUENNEVILLE 1'60 OLD 'LYMAN RD . •.. - -- S MA 01075 , _ _— ✓/U .C� i 4 I 4'/4 w I _ f Office of Consumer Affairs and usiness Regulation f= 10 Park Plaza -Suite 5170 =;- Boston, MassaR., usetts 02116 Home Improvement (': ry m ctor Registration Registration: 120982 a" __ _ _ __ Type: DBA ' " —r--- F Expiration: 3/25/2012 Tr# 293069 ADAM QUENNEVILLE ROOFING... _, ADAM QUENNEVILLE i,: —= > 160 OLD LYMAN RD 1 .. SO. HADLEY, MA 01075 :)�. ", Update Address and return card. Mark reason for change. ❑ Address 0 Renewal E Employment 0 Lost Card DPS-CM 0 50M- 04/04- G101216 ECTION ,t STATE OF CONNECTICUT + DEPARTMENT OF CONSUM +'R PR(�T Be it known that " or ADAM QUENNEVIT.T F.. 160 OLD ‘ 00.:-.., ROAD SOUTH . 9 _ ; i _175-2632 � � r% 'tA 5 -2b32 , W A is certified by the Dep rto' n!( `s'� .. ., tectio n as a registered" i � ail .r I: . HOME IMPR ® A �,�;.' �0 . r *. � S NTRACTO'R f t "L' � � s of -" l I Regis i t , r �4 .RANSil tip r` 1 1t 1 ADAM QUENNEVILLE ROOFING I' : Effective:12 /01/2009 Expiration: 11/30/2010 - . Jerry Farrell, Jr., Commissioner 1 P ID DM DATE (MWDO/YYYr O ACORD CERTIFICATE OF LIABILITY INSURANCE ID D 1 06/24/10 MMFDO PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Remillard Insurance Agcy, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 79 Lyman Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Hadley MA 01075• Phone: 413 -538 -7862 Fax :413- 538 -7179 INSURERS AFFORDING COVERAGE ! NAIC # INSURED INSURER k AIM Hutual !new:anes Company INSURER B: Travelers Ins. Co. Adam Quenneville Roofing & INSURER C: First Speciality Ins Corp Siding Inc & Guttershutter P y , 160 Did Lyman Road INSURER0: Hanover Insurance Company 22292 South Hadley MA 01075 I INSURER E: COVERAGES THE POLICIES OF INSURANCE USTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR• TYPE OF INSURANCE POLICY NUMBER DATE (MDDNY) DATE (MM /D MIUNITS GENERAL LIABILITY I I EACH OCCURRENCE S 1000000 I 1 UAMAGb IUKENIEU C X COMMERCIAL GENERAL LIABILITY I TBI 06/23/10 06/23/11 PREMISES(Eaocourenca) $100000 CLAIMS MADE 31 OCCUR ' MED EXP (My one person) 35000 PERSONAL &ADVINJURY 1 $ 1000000 GENERAL AGGREGATE S 2000000 GEHI. AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOPAGG 32000000 7 POLICY n PRO- n LOC f JECT ! AUTOMOBILE LIABILITY B �_ ANY AUTO BA7450L946 11/01/09 11/01/10 I E M �"" SINGIELIMIT S 1000000 ALL OWNED AUTOS BODILY INJURY J SCHEDULED AUTOS IPer Parson) ) I X I HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accident) i $ 1 I PROPERTY DAMAGE I . Ir-- ■ (Per accident) I $ • . I GARAGE LIABILITY • f I AUTO ONLY • EA ACCIDENT 1 3 ANY AUTO I OTHER THAN EA 3 AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY I EACH OCCURRENCE S :......_• OCCUR n CLAIMS MADE AGGREGATE S _ S —^ DEDUCTIBLE S I RETENTION S $ WORKERS COMPENSATION AND I TO Y I AI U. I I H EMPLOYERS LIABILITY I A ANY PROPRIEfOR/PARTNERJEXECUTIVE AWC701286101 04/29/10 04/29/11 1 E.L EACHACCIOENT 51000000 OFFICERIMENBEREXCLUDED? ' E.L. DISEASE - EAEMPLOYEEIS 1000000 II yes describe Linder SPECIAL PROVISIONS below I j E.L. DISEASE - POLICY UNIT : S 100 0 0 0 0 OTHER D Equipment Floater IHN7140610 02/01/10 02/01/11 Rental Equipment $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES !EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SERVMAG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTOO O REPRESENTATIVE ACORD 25 (2001!08) @ACORD CORPORATION 1989