Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
38A-045
C AL D) NMI Maser ,) � � DISCOVER Q U E N N E V I L L E www.1800newroof.net ROOFING 'Tr SIDING ■ WINDOWS We Are Licensed 160 Old Lyman Road • South Hadley, MA 01075 Fully Insured 1.800.NEW ROOF • 413.536.5955 y Email: info @1800newroof.net Website: www.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 P.P.C. 38710 Proposal Submitted To: Date Phone #'s C: H. ) W: Street Email: City, State, Zip Code Special Requirements: S f ❑ Recover ❑ Strip ; Complete Roof System ❑ We shall acquire all appropriate permits for all work El Home exterior and landscaping to be protected Strip existing roofing to existing decking and dispose of. Do not Do. El Deteriorated existing decking will be replaced at $3.47 per sq.ft. after full inspection. • Install Ice & Water Barrier at all eaves, valleys, chimneys, pipes and skylights Install'(151b. felt/ Synthetic) underlayment over remaining decking area • Install Metal drip edge at eaves and rakes (8" /'5 ") (white /brown /copper) (9 Install manufacturer's starter shingle on all eaves and rake edges BBB ci Install new pipe boot flashing (standard /copper) / vents `T ❑' Install Snow Country or Cobra rolled vent ridge vent Winner of the - .._ 2010 ❑ Install proper so ventilation TORCH AWARD Shingles: ( 6 nails per shingle) Shingles ❑ 25 year ❑ 30 year ❑ 50 year Color Ridge cap shingles Warranty Options: ❑ We guarantee our workmanship for 10 full years (see our warranty coverage) GAF System Plus warranty ❑ GAF Golden Pledge warranty Chimney Options: ill Lead Counter Flashing ❑ Water Seal & Tuckpoint ❑ Rubberized Crown ❑ Metal Chimney Cap We propose hereby to furnish materials and labor - complete in accordance with above specifications for the sum of: Total Due ($ { ) ACCEPTANCE OF PROPOSAL: The above rices, specifications and conditions are a P Pe M. -- - Gown Payment ($ ) satisfactory and are hereby accepted. You are authorized to do work as specified. Payment will be 1/3 down at start of job, and balance due upon completion. Balance Due Upon Completion ($ ) Date ` Q' Signature: - .:.. Date: Estimator: (Print Name) r _ (Sign Name) Estimates are honored for sixty (60) days from above date 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 Quenneville Roofing will not be resnonsible for debris or dust in the attic or storaoe areas. • • • ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(IAWOD)YYYY) 6/23/2011 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 POUCIES 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 holier 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 NA Lynne Methot, Ext. 102 Foley Insurance Group Inc. Est (413)214 -7474 FAX 37 Elm Street E M A ADDR; lmethot9foleyinsurancegroup.com INSURERS) AFFORDING COVERAGE NAIC S West Springfield MA 01089 -2703 INsusERA:Peerles6 Insurance INSURED INSURER B : Adam Quenneville Roofing & Siding Inc. INSURERC: 160 Old Lyman Road INSURERD: INSURER E : South Hadley Mk 01075 -2632 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1 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 POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED pppp PAID CLAIMS. MR � TYPE OF INSURANCE A ilys PAM POUCY NUMBER (MMBOQtYYYYI (NM LIMITS GENERAL LIABILITY EACH OCCURRENCE f 1,000,000 — X COMMERCIAL GENERAL LIABILITY PRM TO RENTED PREMISES (Es occurrence) $ 100 , 000 A CLAIMS-MADE X OCCUR 4006912267 6/23/2011 6/23/2012 MEDEXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE OMIT APPLIES PER: PRODUCTS • COMP /OP AGG $ 2,000,000 7 POLICY , X _ .7 LOC f AUTOMOBILE LIABILITY COMBINED LIMIT $ — ANY AUTO BODILY INJURY (Per person) $ — ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS AUTOS ED (P so r gj� MAGE $ I UMBRELLA LAB -----, OCCUR EACH OCCURRENCE _ f EXCESS UAB CLAIMS -MADE AGGREGATE $ DEO RETENTIONS f WORKERS COMPENSATION I WC STATU- OTH- AND EMPLOYERS' UABILITY Y 1 N TORY LIMITS FR ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/ MEMBER EX.GYUDED9 f I N / A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE • EA EMPLOYEE $ It yes, desc ribe u nd er DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT f DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 1 01 , Additional Remarks Schedule, it more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE Brian Foley /LYNNE r �' 1 I ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. I Jun•23 09:43 AM Remillard Insurance 1- 413- 538 -b01u ,,..•.�. OP ID: LL AGRD' CERTIFICATE OF LIABILITY INSURANCE DATE 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: H the certlticate holder Is an ADDITIONAL INSURED, the policy(Lee) must be endorsed. If SUBROGATION IS WANED, subject to the teams and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certt8ats holder In lieu of such mss). PROOUCea 413-538-7882 :. +c Remillard Insurance Agcy, Inc 413438 -7178 79 Lyman Street South Hadley, MA 01075 Comma ID ADAMQ - 1 Stephen E. Radon NEURERGs) WORDING CovaRAva RAC r >KauRID Adam Quenne' UIe'Roofing & sown A { AIM Mutual Insurance Company Siding Inc Pause a :Travelers Ins. Co. 180 Old Lyman Road C : MUM South Hadley, MA 01075 RAMP : uR1aG F COVERAGES CEJtTIFICATE NUMBER: REVISION : _ MS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD iNCl ATED. NOTWITHSTANDING ANY REQUIREMENT, TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MA' 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. OATS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIM& weir ork ermatesCC • M P9UCY 7 IM M ,!11,,;44. LIMITS ~AL LIANUTY SACK occu teNCE CCNMERCNL GENERAL LIABILITY 80111 4 ca ase-Ai oe E OCCUR 600 EXP Om au perms S PaatOONAL & JW V INJURY e GENERAL AGGREGATE $ GEM AGGREGATE UNIT APPLIES PER PRODUCTS • COMPIOP AOG f Poucv f gg. ( LOC �� a AUTOMONLE LIASLRY ` SSA 0015110140 MOLE UNIT 1,000.00( atziOunG S ANY AUTO BA7450L948 11/01110 11101/11 GOOEY INJURY (Pm pensiy s ALL ONMEC Autos BODILY INJURY(Wt e X MECUM AUTOS PROPERTY X MIRED AUTOS WON X N0N.OYVNE0 AUTOS ^' 5 UNDISU.LA LNa OCCUR EACH OCCURRENCE S EMU LIAR cukse4voe AGGREGATE _ e _ oEOUCnetE ~ W RETENTION a itriEdirx per MGM CONPONATION A , Af ferismert il ! � LI J SCLITNE - N/A AVIIC7012851 00/29/11 04/29/12 ELSACHACCIOENr 3 1,000,000 r malsto y In RN ) LL DRSAte -SA EMPLOYEE a 1,000,000 � OF OPERA7wHe Wow , , Lt.. DOME -POLICY UNIT ♦ 1,000,000 sascarros OF OPERATIONS / LOCATIONS I VEaMCLER Amon ACM Tel, Ae SScad JYmlra WNW" R am ipso, 4 riquked) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF 711E ABOVE DESCRMED PQUCRS are CANCELLED BEFORE 1TaE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE iN TH THH POLICY PROYRSIONS, AUTHORESS REPRESENTATIVE 09 . 414 1 - 04-d CoVorOsc4 C 1988-2009 ACORD CORPORATION. AS rights reserved. ACORD 25 (2009/00) The ACORD name and logo am registered marks of ACORD The Commonwealth of Massachusetts �--- Department of .Industrial' Accidents r- 1'` ' ' Office of Investigations � "�I s sit 600 Washington Street :1 Boston, MA 02111 a te ; v� www.mass govldia. Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibly Name (B : A (it WL Oakj t'L 'f: ILL K04li t S 1 Vi h1, i Yit Address: 1LE. O 01J 11 vn a n 0 . City/State/Zi a : 6,', +A kfrad 114 14 ofo #: 13 " C ale. -5i 5 Are you an employer? Check the approp to box: Type of project (required): 1. VI I am a employer with I 4. 0 I am a general contractor and I 6 employees (full and/or part time). a have hired the sub - contractors ill Nev" construction. listed on the attached shack 1. ❑ RcmodcRemodeling 2. ❑ I am a sole proprietor or partner ship and have no employees These sub contractors have S. El Demolition working !Dr me in any capacity. employees and have workers' 9. ❑ Building addition No workers' comp. insurance comp. . 'c # ur 5. L We arc a corporation and its 10❑ Electrical repairs or additions required) have exercised their 11. Plumb' 3. ❑ I am a bamcowncr doing al work ❑ Plumbing repairs or additions myself o workers' comp. right of exemption per MGL insurance ] i c. 152, § l(4), and we have no 12_p Roof repairs employees_ [No workers' '3_0 Other camp" insurance required) . 'Any applicant that chocks box ii I must also SU out the section below showing their woriears' compensation pokey informatioo. t Homeowners who submit this affidavit indicating they .m doing all work and then hire outside conhautom must submit a new af5davk indicating such 'Contractors that check this box oast attached an additional sheet showing the name of the sob -cant aches and state whether or not those certifies have employees. lithe subcontractors tere a aplvyees, they must provide their worker' comp. policy number. I am an employer that is providing wormers' compensation insurance for my employees. Bdow is the policy and job site information. Insurance Company Name: A T M m u to a( n S fit ra il e polic # or Scif-ins. Lie #: / /V C r/)/ a ( Iv 1 Expiration Pate: i4 " a L j 6 / j Job Si to : Or 6T0 t )T , /) f & fp p t7) AAt Cityls p : rail- i) l0 to g 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 5250.00 a day against the violator. Bc advised that a copy of this statement may be forwarded to the Of5.rf. of Investigations of the DIA for insurance coverage verification.. I do he rr-by ce - tiff / ► under the pains and penalties of perjury that the information provided above is true and correct aivaahtrt:: c % 2" - '"! Date: ` U 3 ' l j ehon4 #; _`i I3 -- 66- 4. )SS Official use only.. Do not write in this area, to be completed by Qty or loran official City or Town: Permit/License # n Issuing Authority (circle one): L. Board of Health 2.. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: _ Phone #: ....):;i .tolb0. it ghik0 44141* mebt, .N4 ,.2fOhir i ifikopi , iitikestim..io foRt,.f. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing la Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [[] Siding [0] Other [0] Brief Description of Propo -d L L fl- 117 i- bTh Work: ,. t• .l , rls, � ' r L (� f a ,e, L i-- r� gr...' `mac m :... F Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa. 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 , as Owner of the subject property p ',, i hereby authorize Ads * R & 5 pcJ �, LE. to act on my behalf, in all matters relative to work authorized by this building permit application. 5 62 00/7fraci - ere10 sed q f ( 95 , r � Signature of Owner Date Adam (ienn� RIO & Siding, Inc, , 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. kJt ii i' t /,4f l7 v2� ri I Print Name ?' g ,, // Signature • • - r gent Date itto Y e t S ft Department use only RECEIVED amity of Northampton Status of Permit 3uilding Department Curb Cut/Driveway Permit SEP 2 1 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability N lrthampton, MA 01060 Two Sets of Structural Plans 1/1331°F BUILDING 1 111216 41: - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPUCATION 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 / r 6(6(1.6 C '- Map Lot Unit f O r, y j1 et rm p t rl, 0106 Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Jt :: l )w sk i 1 � 6si vac S Nor lac, i n lV114 Name (Print) Gwent Mailing Address: l /3 - i D - 7 01O cot ILC- (OS -Q, Telephone Signature 2.2 Authorized Agent: Adam Quer ell; Ii,g& Siding, Inc, fi )/d q ni uti J2d Name (Prin Current Mailing Add ��' 1 Li/3 595' Signat Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building # c � o C) (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) 6, leg 0 Check Number 0 i 3 $3 6 This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date 175 GROVE ST BP- 2012 -0301 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38A - 045 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: roofing BUILDING PERMIT Permit # BP- 2012 -0301 Project # JS- 2012- 000488 Est. Cost: $6669.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 9365.40 Owner: BUCKOWSKI JENNIE A & JOSEPH S BUCKOWSKI & JOANNY WALSH Zoning: URBC100)/ Applicant: ADAM QUENNEVILLE AT: 175 GROVE ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536 -5955 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON: 9/27/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF & INSTALL NEW FLAT 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 9/27/2011 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner