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46-027 7 FERRY AVE' BP- 2010 -0737 GIS #: COMMONWEALTH OF MASSACHUSETTS Map -Bloc 46 - 027 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- 2010 -0737 Project # JS- 2010- 001091 Est. Cost: $10386.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 5924.16 Owner: MANIN ALEXIA Zoning: SC(100) Applicant. ADAM QUENNEVILLE AT. 7 FERRY AVE Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536 -5955 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON :211812010 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP,PLY & 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 2/18/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo Department use only City of Northampton Status of Permit: FL ID 2010 Building Department Curb Cut(Driveway Permit 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 TWO Sets of Structural Plans phon e-413- 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING i SECTION SITE INFORMATION 1.1 Pro a Address: This section to be cgmpleted by office _ Map Lot unit ���` Zone. Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Current Mailing dd ss: Telephone Signature 2.2 Authori ed An ent: Name (Prin Siding, SIC.. Current Mailing Address: 760 Old Lyman Road 3(�� ys ature Telephone SECTION 31- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by ermit applicant 1. Building - (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbincl Building Permit Fee 4. Mechanical (HVAC) 5. Fire Prote tion 6. Total =01 +2+3+4+5) Check Number This Section For Official Use Onl Building Per it Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date i 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 p arkin g) I # of Parking Spaces Fill: (volume & Location A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO O DONT KNOW Q YES O IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES IF YES: enter Book Page, and /or. Document #' 8. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Q Date Issued: Do any signs exist on the property? YES Q NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 'NO 0 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 O 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 E] Replacement Windows Alteration(s) Roofing Or Doors [] Accessory, Bldg. ❑ Demolition ❑ New Signs [O] Decks [M Siding [0] Other.[�f Brief Description of Proposed i r Work: r ,' f _} c��r� J �S��'� T '(�Y:.J b�t�,�JO;� �k�r.0 "t' '�p;'� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes _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, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date n� AU/ as Owner / Authorized Agent hereby declare that the statements and 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. Print Name _ Signature of Owner /Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor NotA ^ p�plicable ❑ Name of License Holder: V 700 16 Mom O uenne ville Rout & Sidi Inc License Number 160 Old Lyman Road Address_ _ tilf-Mi Expiration Date Signature Telephone 9. Registered Home Imarovement Contractor. Not Applicable ❑ 0 Company Name Registration Number �►��1la�e�l Routing & id91J. Address w��Fnlg, n Expiration Date Telephone _5 J U 9.Sf� SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, g 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...... ❑ 1L - :;Home Owner Exernptiola 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. CNM 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 advisedthat 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 peson(s) you hue 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 �t 2 / Q VS1 V L L E www .1800newroof.net ROOF I G IDING, INC. 160 Old Lyman Road, South Hadley, MA 01075 We Are Licensed 1- 800 - NEW -ROOF 0 413.536.5955 Fully Insured Email: info @1800newroof.net Factory Trained MA Construction Supervisors Lic. #070626 MA Registration #120982 Factory Certified Installers Member of the Home Builder's Association of Western Mass. CT Registration #575920 Member of the Building & Trade Association Member of the Better Business Bureau P.P.C. 38710 Proposal Submitted To: Date Phone #'s Work: t �r ,r '. I d H: Cell: i Street ,.. Email: City, State, Zip Code f Special Requirements >r, f Complete Roof System 1 We shall acquire all appropriate permits for all work Pli Home exterior and landscaping to be protected 7 Entire existing roofing materials to be removed to existing deck rtg- " _ 0 Deteooratecrezisting e - �d cFing wl I e repi'ac'i d at4a- 44er- sq.tt: ( <, n Install Ice & Water Barr at all eaves, valleys, chimneys, pipes, skylights and sidewalls ® Install (15 lb. felt/ nthetic) u derlayment over remaining decking area Install Metal drip edge of eaves and raked (8')/ 5 ") (w'hi / brown / copper) J Install manufacturers starter shingle on all eaves and rake edges Install new pipe boot flashing standar� copper) Install new step flashing where necessary (standard / copper) Install Hand nailed rigid baffled continuous ridge vent ❑ Install proper soffit ventilation Shingles: (6 nails per shingle) Shingles ❑ 25 y ear 30 y ear - 9 Y ,L� Y ❑ 50 year Color (•: Ridge cap shingles Warranty Options: N We guarantee our workmanship for 10 full years (see our warranty coverage) ❑ GAF ELK System Plus warranty ❑ GAF ELK Golden Pledge warranty Chimney Options: i Q Lead Counter Flashing ❑ Water Seal & Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap i We Propose hereby to furnish materials and labor - complete in accordance with above specifications for the sum of: Total Sale Price $ / 6 s F.;, -, Down Payment $ Upon Completion $ i �` ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and are hereby accepted. i You are authorized to do work as specified. Payment will be 1/3 down upon signing, and balance due upon completion. Unpaid balances shall accrue with interest at 18% per annum. Purchasers) will pay for all costs, expenses and reason- able attorney's fees incurred by Adam 0 4enneville Roofing and Siding, Inc. to recover any sums due under this contract. Date: ` V Signatures 1 4w Phone t Date: 7- — I/- Estimator's Signature I ATTENTION HOMEOWNERS: Please cover all personal belongings in the attic, garage or storage areas due to the possibility of roofing debris or dust coming in through cracks of the wood. Adam Ouenneville Roofing and Sidings will not be responsible for debris or dust in the attic or storage areas. Iro9 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID LL GATE (MM /DD/YYYY) ADAM -1 1 01/29/ 10 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 A FFORDIN G COVERAGE NAIC# INSURED INSURER A: Ai Mutual in surance Company I H: T ravel ers I ns. Co. Adam Quenneville Roofing & Sidin Inc IN SURER C : Scott Ins Co 160 O d Lyman Road INS D: South Hadley MA 01075 - -- -- - - - -- --- __- __. -- - -___ -- - -_— INSURER E: COVERAGES 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 POI_ICIF_S. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'L, ..__-__..__ __ - ---- ---- ...- _._- -- - - -- ---- _--- --------- ---- -- EFFECTN _._.._.__...- - -- --- ...___.__... ...__. _. .... FOLTCY IVE f1DAjTEjMM/DD1YY) �Y €XF IRA — LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY LIMITS G ENERAL LIABILITY EACH OCCURRENCE $1000 C X COMMERCIAL GENERAL LIABILITY CPS1034980 06/23/09 06 DAIOfA" GE�O- AE�FTTED _ /23/10 _PRE $ 100000 CLAIMS MADE [X I OCCUR MED EXP Any one person) $ 5000 PERSONAL & ADV INJURY $1000000 GENERAL AGGREGATE $ 2000000 VEN'L AGGREGATE LIMIT APPLIES PER : PRODUCTS COMP /OP AGG $ 2000000 - POLICY -- PRO- - LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 B ANY AUTO BA7450L946 11/01/09 11 /01 /10 (Ea accident) ALI. OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) - - - - -. -- -- PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY EA ACCIDENT $ ANY AUTO - - - - -._ .._.-_ -- -- _. - THAN $ OTHER EA AC AUTO ONLY: AGGf $ EXCESS /UMBRELLA LIABILITY EACH O $ (OCCUR I CLAIMS MADE AGG REGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS X ER EMPLOYERS' LIABILITY - --- — .. -- -- -- -- _.._- - - -.. __._.-- -- A _ ... ANY PROPRIETOR /PARTNER /EXECUTIVE AWC701286101 04/29/09 04/29/10 E.L. EACH ACCIDENT $ 1000000 OFe ,descr E eunder CLUDED9 EL. DISEASE EAEMPLOYEE $ 1000000 If yes, describe under _. SPE PR OVISIONS below E.L. DISEASE, - POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SAMPLEO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 DAYS WRITTEN SAMPLE ONLY 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. AUTHOF�ZED REPR SENTATIVE � ��� ACORD 25 (2001/08) aCy © ACORD CORPORATION 1988