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32A-101 (3) 03/04/2011 12:17 4135850226 YOUNGROOF PAGE 04 wiAtiL: :.L :/ .1 i 1: I . f,',i1 ; ?A), i 'a.'% D t 01 00'; ACORD CERTIFICATE OF LIABILITY INSURANCE DATEMONDO"Y'"' n 03/04/2011 PRODUCER 413.5 56.0111 FAX 413.586.6451 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION • Webber & Grinnell Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR II North King Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. `torthampton, NA 01060 INSURERS AFFORDING COVERAGE _ I NAIL* mount) Young Roofing Co Inc I NELASPA — Firanaa's Irrs /Acadi T { PO Box 60056 ,NaREP 2 ACE P$C/TPA — _ t - — Fl orence, MA 01062 ��� T" — "� -- I=EU�EP C, - "Y.,:14F.F D • rr��J1EP E j COVERAGES _ THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. lE TYPE OP NSURANCE -." --Y PGLIl:YNUMBE Ft - -_w D LIMITS I GENERALLAALRY CPA004804022 01/01/2011 01/01 /2012 EACH OCC.ARENCE $ 1,000,001 h ' cDMMER(IW..^ENERAL LIAB!_Ir'r j PRE t xc u T enre: 4 250,000 _._ i „ LAIMS MALIE �X� 'v'C.,LR i MED EY:p (Any Gee persor) d �_.. 5,00 A j — i PERS3Nru. 3 Ac v iu R'. I $ 1,000, r .--f y.,...... : ....... — — — I DEraERAL AG s'TE ! s 2,000,00 e • ;, s: 3ATE;,IMIT APR 1E & 'EP j PROCUC • Cr,1n'.'.O AGr, 2 0000 • e T ALTrOMOWLG LABILILABILITY T i � I C OheBINEC� SINGLE _NI 7 I AN' Ate ' Wes sr,c Core) ALL [7wNEC AL'• J: i Y lhL :�t [OD Jr ...., . S ... I (Per Oeypn} I - D Aur_E• ' NrCI- .MVNED AUTOS I i (PSr ex;cld ____I f I PETY D. MA I rYfr kCjP Ooc __._L__ i —4. —'-- -1 GARAGE LIABILITY j AUTO ONLY - EA ACC DENT $ Ar4- AUn: E A ACC f "- - - ~� I ATtER' 1 EXCESS' UMBRELLA LIABILITY EM H GCC JRRENCE $ i. I T j (COUP J CLAIMS r/,'D A3GFI =GA � — r... $ I 1 D DUCT ELE I .�.......,... - -- - 1 i i RE r6N $ j : $ WORiTER* cGSPl9usIATON NWCC46396716; 01/01/Z011 ' 01/01/2012 X cP,`iIMIn _I .. AND EMPLOYERS' LIABLITY Y / N I . .._.._ .... __ . —_ _. ANY P POPRIETOkrPAP NEP Y.EC:J WYE '-1 F .. EACH ACC IDFI T $ 500.$14 {Mandldory M Mi) I I E _. DISEASE - EA EMW '�Y $ 500.441 CIAJ. PPC•V'E ,,, bepvi E._. CISEA.86 - FM. C'! LT 1 $ 500,000 O ;J: ... RfiSCRIP110N OF OPERATIONS I LOCATIONS 'VEHICLES I EtCWM1FK AOCEO SY ENDORSEMENT' !FBCIA'. PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY Of THE ABGVE DESCRIBED POWDER BE CARCEU.SD BEFORE 114E EXPJPATJCN DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR 'TO MAIL 10 DAYSwRnTEN NOTICE - '0 The CERTIFICATE HOLDER wimp TO Tee LEFT, BUT FA4..;1RE TO DO SO SHALL City of Northampton WOW No OBLIGATION OR LIABILITY OF ANY KIND UPON THE POURER, ITS AGENTS OR 210 Rain Street REFRESENTATirp6. Northampton. MA 01060 AUTHORIZED REPRIMEHTAT7vE 3enna Rodri- e CISR ]ER ACORD 25 (2009101) () 1985 - 2009 ACORD CDUPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 03/04/2011 12:17 4135850226 YOUNGROOF PAGE 03 FROM :MTAUEURN TMG UPPI Ca-ITS FAX t'U. :14135666787 Mar-. 02 2011 03:20PM P1 contr. ®upervisora Llo. No. 011878 Pro e ip. K., : ,, , Tel. 416-684-1567 Y , l,1 1,‘'.11:. i t (!' (0, I TJ . (C ft� /) r1 ,I C r 413- 886 -9167 -:-.e- Pax 413 - 888 -0228 1.:1:11301.1/058 ROM= MAQ.8 Customer : The Montague Grou.p erte: /26/11 Addr : 26 Market Eft. Northampton, MA. 01060 Job • : tlOn 26 Market St. Northampton, Ma. SPEC] CATIONS: __ .. _ 1 . Remove the ballast stone and membrane roofing. 2. Apply 1 inch Polyisocyanurate insulation over the complete roof. 3. Install Carlisle's .045 gauge reinforced mechanically attached roofing system. (The membrane will be adhered to all parapet walls and caps.) 4. Flash all walls, edges, and roof penetrations with an approved Carlisle detail. 5, Remove and dispose of all terra coax caps and install a 2x12 wood nailer. 6. Fabricate and instant .032 gau a brown aiwninum edge metal locked to a kicker strip. 7. Install insulated panels bthred 7 wall vents and back of access door on the upper concrete roof. 8. Install vent pipe extensions. 9. Obtain a building permit for the work. __ 10. Remove all our roofing debris and dispose of in a legal land fill . . 11. Upon completion of the work Carlisle will inspect the job an issue the owner a Fifteen (15) year Golden Seal Total System warranty. If the rear fire escape can not be removed intact the owner will have to ve new one built, �.,.,,wnaw,,• n ,- + award iV i i tl iw =41= b i G la mew d f moral ry s wr tlr�np rd M w 1h itie mr it e++ b PA II MN 1 wrrw It A�7E'1z9d. ,. Signature icba�rd Y i1'i nrt Aoaoptsnee of proposal -rho kbov. pn.Ap ratio: Nod xidlsions are sadat'actery and ere hereby .axpud. You race aulhasizad signature _,�...;ri j l � w do the Walt sa specified, Payment will be Made as outlined above. 1 4:00 i100 WA4k5 L.'"( 1)0"+:t Azotplattue ---)—L— 2- a 6 i / ova at c' _ -+ 03/04/2011 12:17 4135850226 YOUNGROOF PAGE 02 The Commonwealth of Massachusetts Department of Industrial Accidents • L )il; = L ''' Office of Investigations • y 4 ,n = ; `= 600 Washington Street � - ' B oston, MA 01111 -Workers' Compensation Insurance Affidavit: Bui ders /ContractortElectrielans /Plumbers pp.Uca'Jnt Information Please Print Legibly Name musiaessrorganizacont1ndivduai): in; =if a al . - - Address: F. 0 ti iX C 6(0 City /State/Zip: Jf U ( N e _ M Al G / O O Phone. #: Are you an employer? Check the appropriate lion: Type of project (required);. 41 ' • 1. RI I am a employer with, 1 4 - Q I am a general contractor and 1 employees (full and/or part - Mme) -* have hired the stab- contractors h- ❑ New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling ship and have no employees These sub actors have . ,8. 0 Denxnlli1iion working for me in any capacity. employees and have workers' p inx�;ra�,nrr,$ 9- CI Bt3S7 addition [No workers c comp. insurance comp. required:] 5. 0 We are a corporation and. its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers ha 11xercined the 11.0 Plumbing repairs or additions myself o workers' crimp. night of exemption per MGL insurance t c. 152, §1(4), and we have no 12.2) Roof repairs "� employees. [Na workers' I3.0 Other imp. insurance reed -} "Any appii nt that c* ks box #1 muss also fill out the section below showing *err wedelns. men policy iafamatioa t Homawne d who submit dhis affidavit indicating they are doing all work and the hire outride contractors must submit a new affidavit indicating suds. =Contractors that check this box must attached ant additional sheet showing the name of the subcontractors and slate whether of not those murices have . anployeas. if the sub - contractors bane en oye*, they must movide their workers' comp- policy nuugxr. . • I am an employer that is. providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A c.,e L•( q Polic # or Self-ins. Luc. #.! a `4 (P (.O 1i ( e _ ,,,' Expi Date: te: - , J i 1/ a Soli Site Xharess- s3C.1 Ii i� • 31. M 4 *Itir City/State/Zip: Ito 4- 0/0( 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 cab. lead to the imposition of nal. polies. of t 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 fie of up to $250.00 a day against die violator. Be advised that a copy of this statement may be forwarded to the Office of Eaves' , tions o the DIA for - , - . ce cover. le verification. . I do hereby certify uttir the pains and allies of perjury that the Wormed= provided 1,..11,4_, above Is true and correct Suture �6" e a , .. t ,� Pho `lam ' . 1 t, ic' use only. Do not write in ts area, to be comps by city or town official 1 Ci ty or Town: •• Permit/License # issuing Aratluinlly (cirel'.rw.$): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector - 6.Other . . . Contact Person: Phone #: l Version! .7 Commercial Building Permit May 15, 2000 :SECTION iti.iSTRUCTORAL I'EER REVIEW (780 Clmitrii0:11) • ' • Independent Structural Engineering Structural Peer Review Required Yes 0 No • SECTION 11 OWNERAUTHORIZATION ..TO BE.COMPLETED WHEN : OWNERS AGENT OR:CONTRACTOR APPLIES Fok,ilithuiike:OgRpiiiti:::' . ; • .. L:. • : • : . : ;::: . : I. I , as Owner of the subject property hereby authorize r ito act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date • I, I Al Ard - • , 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. - SI ned under the Ins anclpenalties of oarturv. • 1_0 YOUV Print Name MIS*Alla A Signatur , Owner/Agent Date SECTION 12 CONSTRUCTION SERVICES . 10.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder i v 0(,)/1 . . License Number 000 Ore ‘V / e/o/- g maw 1 Expiration Data Address / 2 z , qi3 13(e'rl Signature Telephone SECTION 13 COMPENSATION INSURANCE AFFIDAVIT 25C(6)):' i • 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 0 No • • Yeraion1.7 Commercial Building Permit May 15, 2000 SECTION:° 9- PRVPEe910NAL•DE3IONAND t;dNSTRUCTION.BER1/10ES FORBUILDINOS AND' STIOGTURES.SUBJECT TO • CONBTRUCi1O N CONTROL; P URBUANT-TO'7 O 61111R lie (CONTAININC9;.'MORE T1!?kwaS OF'EN BPACE 8.1 Registered Architect: 1 I Not Applicable ❑ Name (Registrant): I .,,..,, Registration Number Address I 1 ( J Expiration Dale Signature r Telephone 8.2 Registered Professional Engineer(s): • I . I Name Area of Responsibility I I f . .. Address Registration Number • Signature Telephone Expiration Date 1 11- Name Area of Responsibility I II • l Address . Rlatretion Number __A Signature Telephone Expiration Date I 11.... I • Name Area of Responsibility I • I Address Registration Number Signature Telephone Expiration Date f _ I L_ I Name Area of Responsibility II I Address Registration Number I 1 .. I Signature - Telephone Expiration Date 11.3 General Contractor - Not Applicable 0 Company Neme: . Responsible in Charge of Construction L • • Address I 7 Signature Telephone I • Yersionl.7 Commercial Building Permit May 13, 2000 J l � r� f w ac's'^ •• •`! .'YE.:�' .Y'rR jt.:. �raMf — sk0.% Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size i I I I I Frontage I _ _ _1 I I . Setbacks Front I I I I [� ,Side L: 1 -r R[ I L:I I R[ .1 [ i I L I I I f I Building Height Bldg. Square Footage I L=1 % I I 171 Open (Lot area Space inus bldg & paved r I I I % I . J Ci f I mu # of Parking Spaces I I I I �- Fill: (volume & Location) ' A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW S YES IF YES, date Issued: I IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW • YES IF YES: enter Book' 1 Pager and /or Document /f1 B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 " Obtained () , Date Issued: f C. Do any signs exist on the property? YES 0 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 IF YES, describe size, type and location: f 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. • Versionl.7 Commercial Building Permit May 15, 2000 • • SECTION 4L CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000E • CUBIC FEET•O : ENCLOSED SPACE • , : • : • :. ' •: Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing. Change of Use ❑ Other ❑ • Brief Description Enter a brief description here. Of Proposed Work: I • See.. c �cln•2u1. evC.)p . • . SECTIONS :US GROUP AND:CONSTRUCTIONtTYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ID A - 1 ❑ A -2 ❑ A -3 ❑ 1A 1:1 A-4 ❑ A -5 ❑ _ 1B ❑ B Business ® 2A ❑ E Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F - ❑ 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ❑ I -1 ❑ 1 - ❑ 1 - ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S - ❑ 5B ❑ U Utility ❑ Specify: _ __ ____ `� M Mixed Use ❑ Specify: • S Special Use ❑ Specify: COMI 1t= EXISTING BUILDING umbeRobiNd f NOVATIONS AD131TIONS AND /(*Ct-1 IN USE Existing Use Group: Proposed Use Group: r -- I Existing Hazard Index 780 CMR 34 :1 . I Proposed Hazard Index 780 CMR 34): 1 - 7 --------- 1 BECON BUIL.DING'Hn3N ET A ND TI AREA. EUSEO • S BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION ;,T ' 7 a: ; o ' tic :.. ; r. N• .;•'.,:•. ,;::,••,•:,;:;.'.: � t! r i 4 Floor Area per Floor (sf) .ri ' t i : a R ' ' I ---- - 1 . , i ., t 1 I I 151 • ' ' er ' J t {uyt list" ? , i :,.• 1 :. 2 of -t t!a 'tJ i 2 114 tf 2_ 6 L t F ,S rF a ▪ .5r4_ ttt ?, I � . try � � ' r�� , 1� 3 t ;, .:' r i t a g'� Ir t o rr r ' I 401 : ; c : r � '1F,',3".' F et ; • : 4 y r , Total Areas Total Proposed New Construction sf) r { ` :: ' r ,, 1 j , r. • Total Height (ft) I 1 , t z ' . . Total Height ft - ' .. 1, + •. 1,tirc• N :k A •t N,7 1 :? 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Z e nfoation: 7.3 Sewage Disposal' System: ' Public ❑ Private ❑ Zone 1 _� rm Outside Flood Zone❑ Municipal ❑ On site disposal system❑ W i Siff f: w t r a , Versionl.7 Commercial Buildin_ Permit Ma 15 2000 • ;t iv ri ity of Northampton I iiding Department i ffigst - f 212 Main Street Room 100 - :: N ' Vthampton, MA 01060 �r , r' • ho n : 41 . - 587 -1240 Fax 413- 587 -1272 rn cr • MA 01060 !. - APPLICATION TO CONSTR , REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTIOai'= SITE INFORMATION`::. 1.1 J''rooertvAddress: .: , s ` 4 ' : A : : : hks Settled to 8 c b plate y office t it j 42 W Mcrr :6. „-jf ,gyp L ot t , ,X! L I� h � l vii / tong ~ i r - ,, r , 'r �.� y 1fi so ,�.4 r y y. �` .,� y F w G1 OVef �io � i m c 0 i O(0 , yet h. � x ,� � a k ria i , : ,', ,,, ,:, ----- ;gird,. U is rict p. dI yf SECTION 2 - PROPERTY' OWNERSHIPIAUTHORIZED. • ..1 Owner of Record: ' Name (Print) Current Mailing Address: • I 3. -- -�� a 3 � 4) 1 Signature - ee ( L 6 ,, c in sd Pc i` Telephone s • 2.2 Authorized Agent: __ , ;<._ in rd `ICl 1Y1� yoLl f \(x t'i t U I`X >< tQ (X`i -�4 T l (; 2 j i 'f q o l(J�G 1 I Name ( P ) ,� / Current Mailing Address: Signature ----t” Telephone : SECTION 3 ESTIMATED CONSTR ON COSTS Item Estimated Cost (Dollars) to be : Official Use Only; : , : : completed by permit applicant .. .. „ .. . 1. Budding (R (a) Building Permit Fee: . b Estimated Total Co t pf 2. Electrical f . f O .`• ..Constr f rdln(.6) ::. : :: ; .:: : 3. Plumbing Building Permit Fee.:.:• 4. Mechanical (HVAC) 5. Fire Protection I .... . . . .. ........... .. .. .. . n 6. Total = (1 + 2 + 3 + 4 + 5) .. .. 3) W(a 0 - 0 Check Number. ' . ' ' . I. This Section For Offic i al I Use.Only Building Permit Number . Date .. : ... 'Issued Signature , 3 1 � B uilding Commissitinei-linspdctor of Buildings - . ' ...:.. : Date .. :...............:' :..... .................... 26 MARKET ST BP-2011-0713 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32A - 101 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 -0713 Project # JS- 2011- 001172 Est. Cost: $31000.00 Fee: $186.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: YOUNG ROOFING CO INC 011878 Lot Size(sq. ft.): 0.00 Owner: MARKETSQUARE CONDOMINIUM TRUST C/O JANET GEZORK Zoning: CB(100)/ Applicant: YOUNG ROOFING CO INC AT: 26 MARKET ST Applicant Address: Phone: Insurance: P O Box 60056 (413) 584 -1367 Workers Compensation FLORENCEMA01062 ISSUED ON:3/7/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: REPLACE MEMBRANE 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 3/7/2011 0:00:00 $186.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner