31A-324 Amherst College .cts
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Jonathan Devins
sp- -.ai.=. - i^ a ®f.—s3 16 paradise st
Northampton ma
01060
EXTERIOR HOME IMPROVEMENTS, Inc_
� :mod` 413/563 -6354
. Special requirements:
ESTIMATE
Scope of work: Estimate includes the rear flat roof that face the woods away from
the street and the 2 valleys bellow that flat roof
We will provide all the necessary insurance certificates, permits, supervision, labor,
materials, equipment, and supplies as required to complete the following. All OSHA
safety standards will be followed.
1.) Strip and remove existing flat roofing/ both valleys under flat roof and dispose of
in proper landfill.
2.) Clean/ inspect decking (rotted plywood or re sheathing replaced @ $ 50.00 per
sheet extra cost)
3.) Install 1" iso board insulation to achieve R value to rear flat roof
4.) Install fully adhered .060 gauge epdm rubber to rear flat roof
5.) Make necessary transitions/ flashings from rubber roofing to shingle roofs /walls
6.) Install new white aluminum drip edging F8" to shingle areas (C6" on flat roofs)
7.) Install ice and water barrier in valleys (under shingles)
8.) Install new pipe boot flashing as needed
9.) Flash any chimneys in described area on back section
10.) Install 30 yr architectural style roofing shingles to manufactures specifications
using 6 nails (color to match existing roof Certain teed slate blend )
11.) Install new flashings where necessary
12.) Roofers buggy will be used for clean up and keep job site in a safe manner
We will remove and properly dispose of all contract work related waste and debris
daily and maintain in a clean and safe manner.
We will guaranty the shingle roof not to leak for 20 yrs under normal weather
conditions.
We will guaranty the flat roof not leak for 10 yrs under normal weather conditions
We purpose to provide the material, labor, waste removal, and permitting to complete
the work to the above specifications for the sum of:
$3250.00
$- 1500.00 down payment amount
$1,750.00 balance due upon com ion
Authorized signature: date 4 /j
Customer's signature date -'
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends 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
home owner."
The building department for the City of Northampton wants person(s) who seek to use
the home owner exemption, act as their own construction supervisor, to be aware that
by doing so you become responsible for compliance with state building codes and
regulations. The inspection process requires that the building department be called to
inspect work at various stages, which include foundation /footings (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
ermits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
I, understand the above.
(Home owner /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to
Date
Address of work
location
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.41 •.,„. -,
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. The Commonwealth ofMassczchusetts
--_--z-7----,-- - , Department of Industria I ACcidents
h i, . ..,- A 1
E i =="Z. E Office of InVestigationg
,t-airlo.._- ,;,,, • 600 Washington Street • •
e. vaif= 47 Boston, MA 02111 • .
• . • ::,
-, -- -- •
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, www.mass.gov/dia . . . : ..
r..-.,:.
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers , ..
Applicant Information . Please Print Lea*
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, _. .
Name (Businesdorpnizalionandivirlmo: . 0 6 LL:-.....1-c,-,, 1 i‘ (_ • . ,
. . .
: • . .
• • Address: 7 1' c i v
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City/State/Zip: ( /6„ , / , 1-14 - o I 6 - 5 ) Phone .#: Sle 3 G• .
Are y u an employer? Check the appropriatebox: . . •Type of project (required):. i
. 1. am a employer with ....3 .
pc,
employees (full and/or part-time).* 4.. 0 I am a general Contractor and I
have hired the sub-contractors 6. 0 NeW co — "on
7. 0 eattach sheet: Remodeling • , .
2...0 1 ani a Sole proprietor or partner-
listed on th ed
• . These sub-Contractors have.
ship andlia.ve nn . .)loyets .8. D Detholition • .
worldng for-rae in any capaaity. NAg..9.3%.cg-_i14 workers ,.„. .=.7....,_ ,, • •
• # ' • Y: LI -1101111nTiM autumn •
[No viorIceP comp. insurance ' - 'comP--il!timmee-- • - - - _ __-___:.:-.._. . . • . : . . . .
req 10.0 Electrical repairs or additions
- •
uired]
5. 0 We are a corporation and its
3. 0 I am a homeowner dOrag all work officers haVeCerCised their . 11.0 Plunibing repairs or additiOns
•
myself E/sTo worimrs' comp. • . nett of exemption per MGL
12. 0 .koof repairs - . •
insurance required:3 t ' • ,
: c. 152, §1(4); and we have no • . - •
13.1.] Other er • • r
employees [No workers'. .
- .
, - • • ..
comp msurance required.]
*Any applicant -that checks box #1 mustalso fill out the section belowshowing theirworitere-compensation policy infotmatkut. . • . ' " . •-',. .
l' Homeowneri who subinit INS affidivitinclidating they are doing all work and tett hire outside contraatora must submits new ifErdavit indicating such.
:contractors that chick this box mtistattached an additional sheet showing the name of the stzbcontractors and State whetitercrrnatthose-entides have
einploye es. s lf the sids-contraimrshaVe employeeS, they mint provide their wOricers7 comp policy number. : : - , . ,.: -, 2- : •-•.; . ' . ..
. .
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lam an employer that is providing workers' compensation insurance for my ethplOyees. Below is the policY and job site
information. . .
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Insurance Company Name: . 4,6 eti,, , r e 1:,..., . • . .. . .
. . .• .
• . ..
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• • • . • / ..„, . , -- 1 , , , , • A
Policy # or Self-ins. Lic. #: AD 2.7A) g - L'3• A 1 / -- / Expiration Date - I .'" .50 - iA •
. . ,
„Tob Site Address: /t/ 0 y 7 . ••
. .6-)/‘ .. . . - • • -'- -Wil,. ift,41 - bi
. City/State/Zap: . 4/9/ , /
• Attach a copy of the workers' compensation policy declaration page'(shcrwing the policy rimnber andespirition date).
Fall= to secure coverage ii re:gaited' tin Beetibil25A MGL'e: lead d the iiiitiiiiiiiii ifilCifiMidrial: - 'Penalties of a
fine Up to S1,500.00 and/or one.-year bnprisonraent, as well as civil penalties m the form qf a STOP WOXcOP.DER. and a fine
__,...
of rip lb S250.00 a day against the violator 'Be advised that a copy of this statement may be fOrWardediOdie:0 iKceof , . • . .
- ffit
reatlikiiis 5ftliiDIA for msirratide coverage verification _ . . .. ' _•_. _ ..:.„ ..-,..-;:::_, _•__-:,.....,:;,....-...;.,..,,:......,....„..'. _1 . , ..........
, I kerebysertift y 2_ the . , _ . ; and penalties olperjtay thaithe itifirmationpravitleiLabtiOciii.trai:andibrreet.'
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Phone 0: SP Cp 3 c ---1 _ . . .
. - OffiCial Use orily. Do not write iii this area, to be compkted by city Or toWizOfficiaL
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City or Town: :
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Issuing Authority (circle one): • , , ., :.
"- Permitillcense #
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:1. Beard of Health 2. Building Department 3. City/Town Clerk 4. Electrical,Inspector 5. Thumbing Inspector
6. Other ,
.
Contact Person:
Phone #: .
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SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : „ v\ , 3.-e / r c ✓ 7 (e S
License Number
Address ' Expiration Date
Sig ature �� Telephone
8 =Realstei -Cliit i llrrtproS► rtier ttarit±ract 3 S i A a n „1 Not Applicable ❑
Ik/ fv CX 'k i - V c ; f C ((/ 7 — 76/
Company Name _ Registration Number
- 7 ( kii,( c r (2- 0147 114 g , )3 - I
Address / { 7 Expiration Date
6 .. Telephone .J 0 �? 7 7
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 No ❑
The current exemption for "homeowners" was extended to include Owner - occupied Dwellines 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 buildine 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
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
Q ,( fc„, r
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing J`-�
Or Doors El 111"``--
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [f=] Siding [0] Other [0]
Brief Des ption of Pro osed f (r 1
Work: 2'� D�>o S hcl Q [�L'! A-ok- RA 7 4 ILL LC 1 Ker Lf lk 1 Flci f ) ND ;Y-t-
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
sa : lf eu r`h+Dl s . 1t~t.' r. i it l ' tc e i i a. oe srnq , ofmptet th `foita t:
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? / J
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
( ✓1(/ 5 o I f e ` et--1
De. ; . , as Owner of the subject
property
hereby authorize i+9 01.' J. I/t
to act on my behalf, in all matters relative to work authonzed by this building permit application.
Signe ofEwner Date
I, 14/14,) )(1't' // L-4/ S / frk , 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 ains an Zof perjury.
Pri Name
nature of Owner /Ag
Date
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a
Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be tilled in by
Building Departnient y
y
C. e
Lot Size i I I , s '
r .
_
Frontage l _ ? _ ;
Setbacks Front n l I 1
Side L: R:= L:L j R: 1 t
Rear — 1 E
Building Height i 1
Bldg. Square Footage """"' I-1 % 1 1-1 1
Open Space Footage : %
(Lot area minus bldg &paved j 1,,,_J
parking)
# of Parking Spaces 1
Fill: 1
(volume & Location) ----- —
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:1
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book Page and /or Document # j
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ® Obtained , Date Issued
C. 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 Q NO Q
IF YES, describe size, type and location: I '
s
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 Q
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
O Cit of hampto .' ,41--1==1,0
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�. Building Department C ' ' �4�*g
0 ! 212 Main Street o l e 7
Q � v . t, Room 100 t ''_ ` -�
0 C3 ■ '. rthampton, MA 01060 m m.;E ° 1 <. . . °
X413- 587 -1240 Fax 413- 587 -1272 t ° t: , r k� = f ?,,
0 09 0 � � ,
i'" g' TI TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SEC ION 1 - SITE INFORMATION
This section to be completed by office
1.1 Property Address: Q
6 p�,r 0, ( �`. r C/� Map Lot Unit
` Zone . Overlay District
N- ,- ,�- v -,p)o— r ., b t e .
Elm Sk District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
,?, I --).. ND VA ■ ---- % A 4.....x..4...-‘1, I I 4
Name (Print) Cu Lit Mailing A ddrres : _ � �
v
9 12- fi=t 4 c- L c` c ffk•� --V& -t `"�. -- Telephone
gnature
2.2 Au Agent: /
Name (Print Current Mailing Address: J
cx r,e___.-- 2
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building (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 4) � -
6. Total = (1 +2+3+4+5) 3 Nort5 (76 Check Number 3
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
16 PARADISE RD BP- 2011 -0805
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A - 324 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- 2011 -0805
Project # JS- 2011- 001325
Est. Cost: $3250.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: NRB EXTERIORS INC 99565
Lot Size(sq. ft.): Owner: SMITH COLLEGE OFFICE OF TREASURER
Zoning: Applicant: NRB EXTERIORS INC
AT: 16 PARADISE RD
Applicant Address: Phone: Insurance:
7 PHILIP CIRCLE (413) 563 -6354 WC
GRANBYMA01033 ISSUED ON:4/7/2011 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF INCLUDING 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 4/7/2011 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner