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02-025 ROOF SHINGLES OR SPECIALTY ROOFING UNDERLAYMENTS,ROOF VENTILATION SYSTEMS 1) ❑ None in this agreement ° 2) © Included in this agreement are the items checked below: Changes to Roofing for e for new roof additions A. ROOFING PRODUCTS: ❑ ❑ 1) None in this agreement ❑ 2) CertainTeed Landmark-240 lbs/sq,3 bdl/sq © ❑ 3) Eave starter shingles;CertainTeed Swift' start Starter Strip ❑ ❑ 4) Standard architectural laminated shingles,fiberglass or organic ❑ ❑ 5) Rubber roll roofing on low-slope roofs ❑ ❑ 6) Sunsky polycarbonate panels,Grandrib style,single thickness ❑ ❑ 7) Aluminum"standing seam"roofing with snow guards ❑ ❑ 8) Steel"standing seam"roofing with snow guards ❑ ❑ 9) Other: B. ROOFING UNDERLAYMENT: ❑ 10) Snow and ice guard,start at eave 7 up: Polyglass Polystick IR-XE 36"Granular ® ❑ 11) Above snow and ice guard:Synthetic Titanium UDL-30 ❑ 12) Aluminum rake metal-None CI ❑ 13) Aluminum eave metal: Reuse existing gutter guard C. ROOF VENTILATION ITEMS: ❑ 14) Ridge vents:Shinglevent II SHFV203 with CertainTeed ridge shingles ❑ 15) Vented soffits: Existing,no change ❑ 16) Gable vent: None © ❑ 17) Install 2 new waste pipe vents on existing waste pipes. ❑ 18) Reuse existing roof bath exhaust vents. ❑ N/A 19) Cut ventilation access opening into existing attic(when new addition has rear dormer)over an existing unfinished attic ❑ ❑ 20) Vent interior gable wall of screen and/or open porches D. OTHER INCLUDED ITEMS: OO N/A 21) Strip existing asphalt shingles down to existing sheathing,#of layers: N/A 22) Add 4 L brackets to interior of chimney box. D ❑ 23) Reuse existing chimney step flashing,if damaged;replace damaged pieces E. SHINGLE COLOR AND WARRANTIES 1) ❑ New addition roof shingle will be a different color than existing shingle color,see client for color selection 2) ❑ Equivalent to existing material if available. Finding existing shingles is based on local availability of roof products and current colors. Existing colors may not match new material colors. 3) ❑ Minimum shingle warranty: ❑ 25 yrs ❑ 30 yrs ❑ 35 yrs ❑ 40 yrs ❑ 50 yrs © Warranty is based on CertainTeed Limited Warranty Program Note Roofs under 3/12 pitch have no warranty. Remarks: Color: CertainTeed Burnt Sienna Replace pine chimney box corner boards with PVC trim. Purchase Agreement Page 3of11 SIGNATURES By signing below,you agree to items A,B and C. DO NOT SIGN THIS AGREEMENT IF THERE ARE ANY BLANK SPACES. A. Alternative Dispute Settlement(Arbitration Clause):The Seller and the Buyer hereby mutually agree,in advance,that in the event of a dispute concerning this Agreement,the parties shall submit such dispute to a professional,state-approved arbitration service(cost,if any,to be paid by the submitter)prior to either party proceeding to legal action in the courts. B. By signing this agreement,you,as the owner of record,are hereby authorizing Barron&Jacobs Associates Inc.to act as your authorized agent in all matters pertaining to the building permit application. C. This is a binding Agreement. You may not cancel it except as sta •. This Agreement covers and supersedes all conversations,statements and agreements,expressed or implied, . •-,, le part' the' ag j is or representatives. ll17 - , Y_/,L 10/2/13 You,the Buyer,may cancel this transaction Buyer Date at any time prior to midnight of the third / business day after the date of this transaction. 4 , . - __ 10/2/13 See the attached notice of cancellation form Buyer _ Date for an explanation of this right. Seller retains an equal right to cancel. 1° 4. _ 10/2/13 "JrBarron&J:cobs Rep e Date Designer/Salespersons Registration Numbers El Cecil R.Jacobs MA HIC 100809 ❑ Christopher R.Jacobs MA HIC 100809 CT HIC 0518617 CT HIS 0554397 Barron and Jacobs-Key Personnel Contact Information: Office Cell Home Office Manager:Sandy Scavotto 413.586.8998,x100 Vice President and General Manager: 413.586.8998,x103 413.250.6677 413.665.9113 Chris Jacobs President:Cecil R.Jacobs(Jake) 413.586.8998,x101 413.250.2327 413.584.4447 Purchase Agreement Page 11 of 11 C../ite WO / I, 0/6/(//a/Joadu6ea, NI Office of Consumer Affairs and Business Regulation n r' 10 Park Plaza - Suite 5170 Y`•+. O4 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 100809 Type: Private Corporation Expiration: 6/23/2014 Tr# 225654 BARRON & JACOBS ASSOCIATES, INS, Cecil Jacobs 70 OLD SOUTH STREET NORTHAMPTON, MA 01060 Update Address and return card.Mark reason for change. Address Eil Renewal ❑ Employment ❑ Lost Card SCA/ 0 20M-05/11 �e`Comnanwealtic 0/0/1l jJacAteiett License or registration valid for individul use only Office of Consumer Affairs&Business Regulation v ; • IMPROVEMENT CONTRACTOR before the expiration date. If found return to: n • •iabation: loo$o0 Type: Office of Consumer Affairs and Business Regulation :y �' {' • ration 6la 14 Private Corporation I0 Park Plaza-Suite 5170 Boston,MA 02116 BARRON&JACOBS ACS INC. Cecil Jacobs 70 OLD SOUTH STREET Q,,,a,., _ _ . / L NORTHAMPTON,MA 01064 Undersecretary Not valid withou r_ ature The Commonwealth of Massachusetts I Print Form ,I .� ............ Department of Industrial Accidents _ t--63 Office of Investigations � 1 Congress Street, Suite 100 _; Boston, MA 02114-2017 _.-- ►vww.inass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Barron & Jacobs Associates, Inc. Address: 70 Old South Street City/State/Zip: Northampton, MA 01060 Phone#: (413) 586-8998 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 1` 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 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 # 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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' 13.0 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. tContractors 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. Insurance Company Name: Webber & Grinnell Insurance Agency, Inc. Policy#or Self-ins.Lic.#: WMZ 800-8006365-2013 Expiration Date: 3/1/2014 Job Site Address: City/State/Zip: 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 this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb certify under the pains and penalties of perjury that the information provided above is true and correct Si ature: ..1/ / A A . - Date kPm Phone#: 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Suoorvisor: Not Applicable ❑ firer.of Ucerae Holder: Lam(∎S 'i_.�=�rly 0 Lc,1.–t-K License Number Address Expratron Date Situ Telephone Not Applicable ❑ Comnamr Name Registration Number Address Expiration Date Telephone L3 "5 b li SECTION 10-WORKERS'CONPENSATION INSURANCE AFFIDAVIT(IMI.O.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 93 No ❑ 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.MR 780. Sixth Edition Section 108.33.1. Ddln&ion 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 Denson who constructs more than one home in a two-year neriod 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 b@ responsible for all such work performed alder the bulldina permit. As acting Casirsctios 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 '.1.° .L ".'..!.._.!.1.c New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing cm Or Doors O Accessory Bidg. ❑ Demolition ❑ New Signs [D] Decks [D Siding[D] Other[0] Brief Description.of Proposed vet Work: )C`r► n.�►�. SY\% U� ►v\yi\1 Yom:.,d i`Y r-1 o'vz:- } s\(t►nS\,�.N -12' Alteration of existing bedroom Yes .x No Adding new bedroom Yes .)<. No II Cur Attached Narrative Renovating unfinished basement Yes A. No Plans Attached Roll -Sheet cv-a 115 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 WREN MARS MENTOR CONTRACTOR APPUES FOR MINT I, y j Vii,r ' ,'>c,v� ( ( �C ' as Owner of the subject I, hereby authorize Vh r J Jeu-i:OS I ?)C►Y‘&)-\,‘ 'fi Juti��I to act on my behalf,In all matters relative to work authorized by this building permit application. 1ta L Ay 1 rvw-Pci—V9 'I1 I Ve,r. t� Signature of Owner Date I, ,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 OwneriAgent Date Section 4, ZCNING M lntamalioii tad Be C'xliplOaa1 Perron bran Be Coned Ore To Jntcaaop ete Worm::tone Existing Ptoposed ]Requited by Zoning Dui a:al1+W>iAa* be Midst=hy ∎nr j. •t (S fives f - (1)C(.1 C. L1 Batas*D Lot Size Frontage Setbacks Front Side L~ R: Rear Building:Height Btdg.Square Footage Open Space Footage (Lot area aa+uimi*3&paved #of Policing Spaces Fill: (voltam=&Loratke0 A Has a 3ecial Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT IGIOW YES 0 IF YES, date issued: IF YES Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES 0 IF YES enter Book Page and/or Document# B. (bee the site contain a brook, body of water or wetlands? NO 0 DCNT dCW/ () YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued C. Do any signs exist on the property? YES () NO 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 YE5 describe size, type and location: E. Will the construction activity disturb(clearing,grading..excavation:or lilting)over 1 acre or is it part of a common p an that will disturb over 1 acre? YES 0 NO to IF YES:then a Northampton Storm Water Management Permit item the OPW is required. D y of Norlhampton Mao Ild ng Department Mat Cutenvolepay Parma :1.1 OCT I 1 2013 12 Main Street SalbabSiblic Room 100 watarniveShmaaonity JN hariip, 01080 T Sall sf Ptsans ElectriNorthampton& i 4 ':4 3 r:7.1240 Fax 413-587-1272 RASO Maas Mir APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY SECTION 1 •SITE INFORMATION 1.! °SP L!' �T�!!� This ss n to bb eempr d by office Vvem s Map Lai Zona Oawtay District Mm it Dom CB It SECTION 2•PROPERTY OWNERSHIP/AUTHORIZED AGENT Piome(`rinh Current MAiritg Acktr � 1 • c��,< ��r A- a I \ _, . � ,r'2�? V Telephone . r9r+eturs �(\S :JG�CG1ri� •\ L S' VZr44"4:-. Paws(Prirrl) Current MaiingAbdress: /V — -- Suature Telephone ItECTIOH 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be O iicial Use Only completed by permit applicant 1. Building 1 D`-A'to Q (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Censtnucticn from(6) 3. Plumbing Bonding Permit Fee 4. Mechanical(H'!/AC) 5.Fire Protection 6. Total=(1 4 2+3+4+a) \O, 0 Check Number /7 7 79 3,S This Section For Official Use Only Date Building Permit Number: Issued: Signature: Bulking Cammissusn er lnspector of Buidbgs Date 661 NORTH FARMS RD BP-2014-0450 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 02-025 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-2014-0450 Project# JS-2014-000774 Est.Cost: $10760.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BARRON & JACOBS 60475 Lot Size(sq. ft.): 99752.40 Owner: COULON STEPHEN C&SUSAN V Zoning: WSP(103)/RR(100)/SR(3)/ Applicant: BARRON & JACOBS AT: 661 NORTH FARMS RD Applicant Address: Phone: Insurance: 70 OLD SOUTH ST (413) 586-8998 Workers Compensation NORTHAMPTON MAO 1060 ISSUED ON:10/11/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Numbing 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 10/11/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner