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32C-172 (3) RECE \i ; SIEGFRIED PORTH APR 252013 DEPT.OF BUILDING INSPECTIONS NORTHAMPTON,MA 07060 A R C H I T E C T A.I.A. 116 PLEASANT ST. SUITE 331 EASTHAMPTON , MA 01027 PHONE: 413-529-9434 04/24/13 TO: LOUIS HASBROUCK BUILDING COMMISSIONER 212 MAIN ST. NORTHAMPTON, MA 01060 I SIEGFRIED PORTH ARCHITECT REQUEST THAT YOU GRANT A MODIFICATION TO WAIVE THE REQUIREMENT FOR CONTROLLED CONSTRUCTION FOR THE PROJECT LOCATED AT 270 PLEASANT ST. NORTHAMPTON,MA. BECAUSE THE WORK IS OF A MINOR NATURE, AND WILL NOT AFFECT HEALTH, ACCESSIBILITY, LIFE SAFETY, OR ANY STRUCTURAL ELEMENTS. AN 0U, 1 SIE RIED PORTH Aoc ! I D- VISA c.a DISCOVER Q U E N N E V I L L E www.1800newroof.net ROOFING ■ SIDING ■ WINDOWS We Are Licensed 160 Old Lyman Road•South Hadley,MA 01075 1.800.NEW ROOF • 413.536.5955 Fully Insured Email:info @1800newroof.net Website:www.1800newroof.net Factory Trained MA Construction Supervisors Lic.#070626 MA Registration#120982 Factory Certifiedlnstallers Member of the Home Builder's Association of Western Mass. CT Registration#575920 Member of the Building&grade Association P.P.C.38710 Proposal Submitted To: Date Phone#'s C: I L/ `, t / H a m, 5 W: Street_' �_. Email: City, State,Zip Code Special Requirements: 1 S ! ;�r r � .� t a',.(, +- ) �.��`� ;;y'', n r: 1'.y, :, a✓ Flt'. ❑ Recover 0 Strip '`>r' Layers Complete Roof System • We shall acquire all appropriate permits for all work Home exterior and landscaping to be protected Strip existing roofing to existing decking and dispose of. Do not Do. 0 Deteriorated existing decking will be replaced at$3.47 per sq.ft.after full inspection. 0 Install Ice&Water Barrier at all eaves,valleys,chimneys, pipes and skylights �] install''(151b.felt/Synthetic)underlayment over remaining decking area • Install Metal drip edge at eaves and rakes(8"/5")( hiteJbrown/copper) ❑ Install manufacturer's starter shingle on all eaves"a a edges BBB • Install new pipe boot flashing/rstandar /. ooper)/vents �- ❑ Install Snow Country or Cobra'h1Neel-vefit ridge vent Winner of the 2010 ❑ Install proper soffit ventilation TORCH AWARD Shingles: ( 6 nails per shingle) .t� Shingles ❑ 25 year ❑ 30 year ❑ 50 year Color Ridge cap shingles Warranty Options: 0 We guarantee our workmanship for 10 full years(see our warranty coverage) ❑ GAF System Plus warranty C ❑ GAF Golden Pledge warranty Chimney Options: ❑ Lead Counter Flashing ❑ Water Seal&Tuckpoint ❑ Rubberized Crown ❑ Metal; rune c G 1t , We propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of:Total Due($ ) ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are t` ! ' ' * • Q `"� ) P P l Down Payment(�. satisfactory and are hereby accepted.You are authorized to do work,as specified. 1-, • I • 'Vf Payment will 11 113 down at start of job,ang1 balance due upon completion. B ue- rreoMpletion($'_ / ' ) • ) Date: t `- ignature: Date: ; ,f Estimator(Print Name) ? (Sign Name) / Estimates are horiored 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 responsible for debris or dust in the attic or storage areas. --1 Arc, cwoor CERTIFICATE OF LIABILITY INSURANCE 2Ais�2oi3 1 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 POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT:CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HO..DER. 4 IMPORTANT: if the oertlticate holder is an ADOCTIOt4AL INSURED,The po+iicy(les1 must be endorsed. if SUBROGATION is W A%VED,miltject 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 rT Lynne Methot, Ext. 102 Foley Insurance Group Inc. °) Eitt (413)214-7474 'Imo,Nok(413)214-7447 37 Elm Street VIA .lmethotAfo1eyinsur ono egroup.cam INSURERS)AFFORDING COVERAGE NAIC S West Springfield MA 01089-2703 Ramose A:Peerless Insurance Co pany 24198 INSURED BNSURIsta:Safety Indemnity 33618 Adam Quenneville Roofing & Siding Inc. itouitotc0cottedale Insurance Co. 160 Old Lyman Road INSURER D:AIM A/R INSURER E: ,South Hadley MA 01075-2632 MUM F: COVERAGES CERTIFICATE NUMBER:0L1.11106664 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTE. B LOW 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.LIMITS SHOWN Y HAVE BEEN REDUCED BY PAID CLAIMS. ROW y� TYPE OF DURANCE JAM[ HMI_ POL(CY I.. 7 I I i LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X CaENERCUL GENERAL LIABILITY DA MAG ..yTO TO-RENTED $ 100,000 PREMISES(Eocunnoel A ICLANNS.♦1MAOE © OCCUR 9L6912267 6/23/2012 '6/23/2013 MEDEX,(Mrale ) $ 5,000 PERBONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 OWL AGGREGATE LIMIT APPLIES PER: PRODUCTS.comptop AGO $ 2,000,000 POLICY© PRP ■ we f L AUTOMOBILE LABILITY y�„ 0. $ 1,000,000 B X ANY AUTO i BODILY INJURY(Per person) $ ^ D ^SCHEDULED 6215480 11/1/2012 '11/1/2013 BODILY INJURY(Per aaolden)'$� SED HIRED AUTOS e D p �E_ PtF, $ UMBRELLA LJAII OCCUR EACH OCCURRENCE $ 5,000,000 C X EXCESS UAS CLAIMS-MADE AGGREGATE $ 5,000,000 .DEO I IRETENTIONS ELS0082909 6/23/2012 6/23/2013 S D WORKERS CORIPIBMATION X I LI.TS I PER AND EMN.OYNSS LM NLITY YIN ANY PROFRIETURIPARTNEwpEcuTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? © NIA ` spy In NH) NPIC7012861012(012 4/29/2012 4/29/2013 EL.DiseAse.EA EMpIOYEp $ 1,000,000 Kyes,��escribe undK DESCRIPTION OF OPERATIONS bebw EA-DISEASE-POUCY LIMIT $ 1,000,000 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES[Attach ACORD 101.Addttio4teI Remarks Schedule,N more space b requited) 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 POLICY PROVISIONS. For Permitting Purposes AUTHORIZED REPRESENTATIVE ''-'.. "M —�.-"� - ' Brian Foley/LYNNE '�""- ACORD 25(2010105) @ 1988-2010 ACORD CORPORATION. All rights reserved. [NOM r)Mnne)ni The AP.APII mama anti Inn"taro rnniateroti marina of AI:Marl '.----*-..t:\—:\---- =-M,i. •-,.:1( ' .. s, ->-. NlassachusettN-Department of Public Saters , Board of Building Regulations and Standards License: CS 70626 ADAM A QUENNEVILLE 160 OLD LYMAN RD , S HADLEY, MA 01075 - - c,..... Expiration: 8(21/2013 (-..nuni,ioner Tr#: 21002 t Ili,e eoznon.04-tweeda ' , 4 '/4 Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Re,g,istratio,n. . 1,2,t,0,,9s,...,52,1,.s.100:fris...: Type: DBA Expiration: 3/25/2014 Tr# 222024 ADAM QUENNEVILLE ROOFING ADAM QUENNEVILLE 160 OLD LYMAN RD SO. HADLEY, MA 01075 Update Address and return card.Mark reason for change. r i Address j Renewal , Employment [ ! Lost Card DPS-CA1 0 50M-04/04-G101216 / 1, -•.- •t-•• •>,,,,-11., t --•;5 ti;i ;•;.•0-, )-4': .,.\ '1 :'••• ',>';'));V:4-•1A4.t•,; 9't,Via; i't Xttidtin i oh') ''',44 ip 1,44,4 rt 'llii „o„ ),,, olcp,itl:,* 1,AQ.,1)),,A, 3 .,0 ,d'illgoi.:„ SA „*.:7;i0y44-igi3O:N I,t,v,,, .44, N fig 4ip Sop STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION .r.t. ,---f”. Be it known that 4,-....- 2.1,4e 1;P. g-',Z• ADAM QUENNEVILLE ,..... , .....* ' 2%ift 160 OLD LYMAN ROAD SOUTH HADLEY, MA 01075-2632 - .".4... ,-4 ir: if is certified by the Departinent of Consumer Protection as a registered ,...,:, ..„-.• , ,...; .• ....: HOME IMPROVEMENT CONTRACTOR ,....c...,, &'' •Xii-- ? • , ..,..7 ...„,, ,:...ol,. Registration #HIC.0575920 ifif.'•‘., ;1 •:,2,_•-•,,:f 2,, ''....:," ADAM QUENNEVILLE ROOFING =,....11. Effective: 12/01/2012 ,,-. tiP*0•04;e:r— . Expiration: 11/30/2013 0 :..AS William M.Rubenstein,Commissioner Version1.7 Commercial Building Permit May 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)- - -- - ..... Independent Structural Engineering Structural Peer Review Required • Yes 0 No SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED_VVHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDINd-PERIVIIT I, T-0j01-? 1--0 ______ _ _____ ... ,as Owner of the subject property hereby authorize* _ Mani_Nen n evilleloofintaiding,Inc.____ act on my behalf,in all matters relative to work authorized by this building permit application. 3,12 0-671-111 - _ Signature of Owner Date nulle _ ' ItefillaStdiallut . ....,.._ ,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 ins and penalties olapAgg,_ _ il-dlaTh _Via/A le(2, t,_ _ ____________ Print Name L3,............_ 41/n /13 Signature of Owner/Agent Date SECTION 12-CONSTRUCTION.SERVICES 10.1 Licensed Construction Supervisor: - Applicable 0 - Name of License Holder: ..6.4zowi.L. -_,......_ '11112.,m — License Number ' 1 ! _ ____________ l&a. ilia_.---Winaia___20,aeat i ______ r 1 04,,), _______________ Address i Expiration Date ---- VS--5-36--5- -S- _ 9.1 -- Signature Telephone SECTION 13-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. r, Signed Affidavit Attached Yes 40 No 0 Ilse c,ommonweacen uJ tou�auc.�u�G«� Department of Industrial Accidents Office of Investigations 4'x a - e' 14, 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information A Please Print Legibly_ Name(Business/Organization/Individual): Adam 1 uenneville Roofs &Skim Inc. Address: j‘,0 City/State/Zip, ,>-Ui ' b/67C Phone#: t/ 3-536- Are you an employer?Check the appropriate box: Type of project(required): 1.14 I am a employer with /s" 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7: ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' g Y P tY 9. ❑Blrildi o addition c0 insurance.$ re - _ [No workers'comp.insurance We comp.are Electrical repairs or additions required.] 5. ❑ e a corporation and its officers have exercised their 11. 3.El ffi I am a homeowner doing all work h i h ❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. yy� Insurance Company Name: 4 v- � G - Policy#or Self-ins.Lic.#: 1'i l t�C' 1 O 1 () 10 1 Expiration Date: 41`x9 l/3 ip Job Site Address:L00 Rp - tr City/State/Zip: IUD j(i lax la Y1, I'M Q jtibD 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$250.00 a day against the violator. Be advised that a copy of thin statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 1 li )j/3 Phone#: 4 1 3-3 3 Official use only. Do not write in this area,to be completed by city or town officiaL - City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Version1.7 Commercial Building Permit May 15,2000 SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION;;SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CNIR 116(CONTAINING MORETHAN-36,000 C.F.OF ENF LOSED:SFACE) 9.1 Registered Architect: Not Applicable ❑ _ i i . Name(Registrant): �__._ __ __ I _.. ._.,._......._._.: _ __.__________._..._ _--�--. Registration Number Address __ — – __._._.,-...._.._.. Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name . Area of Responsibility Address __- Registration Number _._._._._______-___..___._ • Signature Telephone Expiration Date i , i - s • Name Area of Responsibility 1 Address Registration Number is _ Signature Telephone Expiration Date Name _____ ___... Area of Responsibility _�_ i Address Registration Number __ i Signature Telephone Expiration Date --_....__..___.._.�_.� _ _.-_._..__..._ - ..�_.._.-.___._ ...._..,_._._... ( ____�___ �_ _- t Name Area of Responsibility Address Registration Number I i Signature Telephone Expiration Date 9.3 General Contractor _•r/ Z Q� � 0C ` C� y( 1 1 _ Not Applicable ❑ _ Company Name: Responsible In Charge of Construction _Adoess_ . Signature Telephone Version1.7 Commercial Building Permit May 15,2000 8. NORTHAMPTON ZONING , . Existing Proposed Required by zoning This column tore filled in by Building Department Lot Size _ _T ._ _. ___ _ _-- Frontage ._-._...___.-.--_. _ _ Setbacks Front j ( ' Side L:':.. R: -' L:______I R:'__: .. Rear ___; t Building Height _ _ . Bldg.Square Footage – `' % --7 Open Space Footage %o ----- (Lot area minus bldg&paved L j - i -------- parking) #of Parking Spaces ! 1.____ Fill: (volume&Location) — �.__ __ __- _._ A. Has a Special Permit/Variance/Finding ever been issued for/on the site? - ` NO Q DONT KNOW 0 YES Q IF.YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q ___ IF YES: enter Book ` ' Pager: ` and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: —uv 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 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 Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Version 1.7 Commercial Building Permit May 1 ,z000 . '' SECTION_~~ S.~ ^ FOR ^~ 3 ' - , � - ,� CUBIC FEET OF ^` ' . ^ .~^..�~�' � � Interior Alterations [] Existing Wall Signs [] Demolition 0 Repairs 0 Additions [] Accessory Building Exterior Alteration 0 Existing Ground Sign 0 New Signs 0 y ' of 0 Other _ _ _ _ __ --_ Brief Description Enter a brief here. Of ". �l Proposed Work: u° ' 1~-»� SECTION 5-USE GROUP AND CONSTRUCTION TYpE'' , ' USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly A+1 [] A-2 [] A-3 [] 1A I [] 0 A-4 0 A-5 [] 1B [] ' B Business =+dm 2A 0 E Educational [] 2B [] F Factory [] F'1 0 F-2 [] 2C . [] _ H High Hazard [] - __ '�-` '` 3A / [] | Institutional [] 1-1 [] 1-2 [] 1-3 [] 3B [] M Mercantile 0 4 [] R Residential [] R-1 [] R-2 0 R-3 [] 5A 0 S Storage []g* S'1 [] 8s-2 [] 5B I/ [] . u Utility [] Specify:/ ---- M Mixed Use [] . SpacKfy: | -- ' ------ — S Special Use �] Specify: ------' -- COMPLETE THIS SECTION IF EXISTING BUILDING UNDEFtGOING_RENOVAT1ONS,ADDITIONS AND/OR CHANGE IN USE -- i ------- ----� Existing Use Group ___ . ^ Proposed Use Group ) ' � Ex�VngMazo��dexr8OCMR34�F - ' PmpoaodHozo��dex78OCMR34y] __ ---� SECTION 6 BUILDING HEIGHT AND AREA DU�O�GAREA BVSONS PROPOSEDNBwCONOTRUCTK]N Floor Area per Floor(sf) ^ * �m ; , 1 ' __' -________ 2mi < 2�� _--� . _---- 3m i 3* � - _� _ _ _-- m m 4~ + 4~ --' , � Total Area(sf) Total PmpunedNew Cnnnb � Construction� nQ �� `' ----'---------- r � ' Total Height(ft) , _---_'_________ __� ___- Total Height ft ' - 7.Water Supply §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public El Private D Zono�_ | Outside Flood ZoneD Municipal 0 On site disposal system . ' O ) Version1.7 Commercial Building Permit May 15,2000 s , RECEIVED ,,, , ,..,:::pellartrnefttnse,only::'':',:r. City of Northampton BJilding Department APR I 9 2 0 1 3 212 Main Street Room 100 . • iwo,o, erpit.:17.,,, ,...,-,,,,,PR,r,,:k.;:,,:i--,N.;', 7- ',''•::'-,,,:‘''',..2..,-. 1:',,t1,':::,...,' ,.;',.t.--,'.:':,•'...... ,',;: :'-',,,:. btite'eit/DriiterivaiPerrnit,,,r,.- eivefirS.00:tidAvattatillity,''-$"'-,','''' - ''.- --''' ••'' '-'-''':; ' WatetAiVell'Ava!labifity,t•-t----..,,,,-----•-. .- .- .... ,,„ DEPT.OF BUILDING Ns \iorhampton, MA 01060 174/6,teigrofSptiCtural,Planst,t :-=:--,.-„,-...,:-..t-t, ,--,-., -'.- -s,,, • •,• NORTHAMPTON 01060 - ,.... 87-1240 Fax 413-587-1272 i)icitiii661ans _ Other_BPAifw,„ --. APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office vs. ,0 . ....m..12>dait■-• • ' ; Map Lot Unit \f 4 +bll RIA Dr/64c° I a ot,rqi , . Zone Overlay District Eim-St:DietriCt CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED-AGENT . . 2.1 Owner of Record: 1 CL—j()--------- Name(- s(: Prii- Current Mailing Address:........_ _ Signature \—/e... 015/‘-ka.(1)f Telephone 2.2 Authorized Agent: _ ___ __ __, 7 ____ D - : LIkG eid 7 —146-6---a-enr1W71C r-e 44--.4- Si1.7 ' ' Y. -___.: Name(Print) Current Man 'Address • 1, yl,3-sA,— _ (:/27-- _____ Signature Telephone SECTION 3-ESTIMATED-CONSTRUCTION COSTS. Item Estimated Cost(Dollars)to be - , Official Use Only completed by permit applicant ' 1. Building 6 ' (a)Building Permit Fee i. . #11 000 8- -_ -_ . ... . 2. Electrical ..- I (b).Estimated Total Cost of I Construction.from(6) _ - __. 3. Plumbing -- I -Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection . ._ __ _ 6. Total (7 +2+3+4+5) ['PA, Ott) 00 Check Number 4 ,5-1 ' __. ------(Ik4;'.------ This Section For Official Use Only• Building Permit Number Date . Issued Signature: Building Commissioner/inspector of Buildings Date File#BP-2013-0985 APPLICANT/CONTACT PERSON ADAM QUENNEVILLE ADDRESS/PHONE 160 OLD LYMAN RD SOUTH HADLEY (413)536-5955 0 PROPERTY LOCATION 270 PLEASANT ST MAP 32C PARCEL 172 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ��d 8 O�I Fee Paid Q (o Typeof Construction: STRIP&SHINGLE ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 070626 3 sets of Plans/Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management Demolition Delay 4/34113 Signature of Building Official Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. 270 PLEASANT ST BP-2013-0985 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C- 172 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:ROOF BUILDING PERMIT Permit# BP-2013-0985 Project# JS-2013-001632 Est.Cost: $11000.00 Fee: $66.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq.ft.): 2352.24 Owner: DBR PROPERTIES LLC C/O AMY ROYAL Zoning: CB(100)/ Applicant: ADAM QUENNEVILLE AT: 270 PLEASANT ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:5/1/2013 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 5/1/2013 0:00:00 $66.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner