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32C-155 (3) �� o Board of Building Regula ions and Standards 0 . One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvemenf-C 'ntractor Registration Registration: 120982 _ Type: DBA Expiration: 3/25/2008 ADAM QUENNEVILLE ROOFING . ADAM QUENNEVILLE - P.O. BOX 612 SO. HADLEY, MA 01075 Update Address and return card.Mark reason for change. DPS-CAI 0 5OM-04/05-PC8698 ❑ Address F� Renewal F� Employment E] Lost Card AA"dwiJea Board of Building ePm ulations One Ashburton Place, 1301 Boston, Ma;_02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 08/21/1971 Number: CS 070626 Expires:08/21/2007.. .- . Restricted To: 00 ADAM A QUENNEVILLE 160 OLD LYMAN RD S HADLEY, MA 01075 Tr.no: 3761.0 V—•,.,f-, tee-eI.,f end channa of address notification. 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'wE' •r w�� 1 ,•� ..3.. it .,n r"" .?r�"'ar :�j;•. �' er=c..r �ush� ae r t rpG �,�,k >.�.�j; a '+Y�: Q//�� j''� `�+� •,r .e '"" i..!:�.',,'. ;•';• i."^ 'r� -,,k;.n�' t:;'."::",:s f'�i".f, 4..,..,r.! > 4'Gt��st, '..�_,',��r. 'Rl�d ��SLrii., °` V����'"��' A}. I f.f; '.y ��,Z ,...lr.. ">�S ��rrr;^,:a�,�i�r,�✓> d' �,,,>4 r:at F :r:= .._. a tt�� ..•y"P y, ' n;3 Jc�'.i�.,S�.���,:,t,^Y.. �wl;c"c.'<.i: .. '."•a.. �:;'Z+.:• _ ,t .,»:�'a,rs:'aC'.:...:74:'.:tt- t. RX Date/Time, 46/27/2007 10: 59 1 413 538 6010 P. 001 Jun-27-2007 09:50 AM Remillard Insurance 1-413-538-6010 1/3 ACOWL . CERTIFICATE OF LIABILITY INSURANCE CSR RL DATE(MMIODI ADAM -1 06/27/07/07 PRODUCER ;, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Remillard Insurance Agcy, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 79 Lyman Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Hadley. X& 01075 Phone: 413-53$-7862 Pax:413-538-7179 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Scottodalo Inc Co. INSURER B: MN Iwtval In==ca co v—y Adam Quenneville Roofing INSURER C:• Siding Inc P O Box 612 INSURER D: South Hadley MA 01075 INSURER E. --4 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEOTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITH 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. F0UC-Y E" rA N TYPE OF INSURANCE POLICY NUMBER DATE MM DD DATE MM1DD UMRS GENERAL LIABILCfY EACH OCCURRENCE $1000000 DD-- GENERAL COMMERCIAL GENERAL LIABILITY CLS1384198 06/23/07 06/23/08 PREMISES Eaoccurence $50000 CLAIMS MADE a OCCUR MED EXP(Any one paean) f 5 0 0 D ! PERSONAL d ADV INJURY S 1000000 C) P\ AGGREGATE $2000000 GEML AGGREGATE LIMIT APPLIES PER ` PRODUCTS-COMPIOP AGG 3 2 0 0 0 0 0 0 POLICY 7 jter LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (En sodden!) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-0W NED AUTOS (Per acddenl) f PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC 5 AUTO ONLY. AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE f S OEDUCnOLE f RETENTION S f WORKERS COMPENSATION AND X I TORY IMITS ER B EMPL.OYELS•LIABILITY AWC7012861012007 04/29/07 04/29/08 E.L.EACH ACCIDENT $100000 ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMSER EXCLUDED? E.L.DISEASE-EA EMPLOYE S 10 0 O O 0 It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1 6 5 0 0 0 0 0 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION AMBERCO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRrTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLI OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTA AU N . - Ste n Radon ACORD 25(2001/08) OACORD CORPORATION 1988 QUM14MfEV1ILLE LK� ROOFING & SIDING, INC. The Premium Choice- 78 West State Street, Granby, MA 01033 We Are Licensed 1-800-NEW-ROOF * 1.800-4-SIDING Insured Email:agrnewroof@wmconnect.com 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 Proposal Submitted To: Date Phone#'s ! C° H: W: Street Y 7 Job Name City,State,Zi ode Job Location Proposal to furnigh and install the following �� � �'✓S E��'4'<< ❑ Re-Roof Near-Off ❑ Gutter ❑ Repair Complete Roof Preparation 19-<me exterior to be protected by tarps and plywood v- L3'S/O rubs, landscaping, trees to be protected from damage ;tire existing roofing material to be removed to existing decking, including flashing, etc. L� Site to be cleaned everyday with roll magnet debris removed at project completion E4 eteriorated existing decking replaced at$50 per sheet of plywood ©4etal drip edge installed at eaves [�-ibietal drip edge installed at rake edges L -11e_w metal step flashing will be installed where necessary Ask us about 7 7;/N w plumbing vent flashing will be installed and flashed. affordable bank L�'Shingle valleys will be installed financing metal flashing will be installed around all chimneys - r � / 0 ve"� 54 e shall acquire all appropriate permits etc.for all roofing work Complete Roofing System ��yYtQ�� � E, ,� �y� //C�rs�d�/,Pv�� Cam' [�K Leak Barrier installed at all eaves to protect from ice dams(and meet codes in the north) [ .g'LK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas C�pd. reinforced underlayment installed over entire decking 5 1:;("/J ve<d 5 r y k, Shingles: -` [9-'61K PrestigeO Series 0 year ❑ 50 year Color —` ailable ridge vent will be installed L3'ELK ridge cap shingles Warranty Options: El We guarantee our workmanship for 5 full years • ELK10-Year Umbrella Coverage Limited Warranty upgrade. • ELK15-Year Umbrella Coverage Limited Warranty upgrade. VISA We Propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of: G _ , i yJ c�c r dollars($ S✓7 S L / _ n ACCEPTANCE OF Pjk'PCSSi'L Th a o re prices,se tf conditions are satisfactory and are ereby accFq ed. You are authorized to do work as specified.Payment will be 1/3 down at start of job,and balance due upon completid'n. Date: 7`3�`r77 Signature:_1 '. ='y� �1—_� � Phone#__�� //^6?t4 Date: salesperson's Signature: 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 responsible for debris or dust in the attic or storage areas. �, Cizitr afL7� tll�iiir}rtnli i � 6 �ilassxrhusrtls _ DLPARTME1\7 OF EIUILDrXG INSPECTIONS 212 Alain Street ' Municipal Building Northampton, Mass. 01060 WOP,TCCR'S COi TENSATION INSURANCE AFFMAVLT n� (]i c�rscJrcrniittcc) vAth a principal place: of busiresslresidence :�t: (SLTCCf/Cit,i c',:.17! do hereby certify. un"c-n- the pains and penaitic'; of perjury, .01r1l. (1,K1 am an employer providing the follo\vim, "vor1:cr`5 compensation coverzge for my employees worEng on this job- v (lnRtran=Cor7party) elic;Nu-mbcr) (Ex.pirat on Date) ( j I am a sole proprietor, gentrai coLltrcror or honleowner (circle one) and l]z\e ivreti the contractors listed below vto h---e the '011c,-,V1rg workers compens-zrdon policies: (N=c of Contractor) (111SLi�7C �CIT^;:1Tr�OlICf NLL171tYr) ?.i:riilCi D3tc) (Name of Conti ctor) — (Imsurarcc Compagy[Pok—, Numtr_r) (E�pirnuin:i Date) (Name of Contractor) (Insurance CotnF.an}i�olic; nc,:i Datc) - (Name of Contractor) -- (Insurance Corm,:,-+.),/Policy Numb-ir) - (Expi-:tinr:Date) (r.tLid:=dditiec a1 ri�Q ifrc._.:,r :o i '✓i<...:c<:7:r:. , -._...ir.; .,il c:c _....,.•) r- i ( I ml it Solu proprleLOr m"d have no 0I1:: ',vorkino for me. I ril i! 11017?e 0\VI1Cr Del-ormin all i!i -,vC+::: ii] *i0•IT•-:plcaac be ra%wc(t:::.t`•i]c he<rco:%ir_rs: uo csrplay;r. to Cr r:,.air not Ux<c than Ihma uni ts in uL dr tic k::�>cu cr-rc s a a; `. .•;.�x, u1.^r 11 thcc o c tx t�xrrall.r'co :iri:r:�:�ti —ploycs urs cs the tw:l cr s ccY a• icn Ax:(GL!52-"1(5)),zr•i:r:tic::by a hot:tco%Nma fcr a Ur=--o or p:r t:i:: •..n c tt legzl rtntua of an amployor ua' r tho Workcrc t on,sxr atioa f.cL I undo.-=rand thi a copy of 01:1 rratcr. Wuy bo fofwnrdi d to t!»I'p-t--xa of It+dusSriel An6dm:!Oiroo for t m -age vai[tctioo and that f_ilure to m--vt=6 -_s„ur-&-r sccticn 25 A cd MOL,152 can Imd to the imposition cf cz--ni-J tcrLah=ca inz ofiSI .a Carr_ay up to S 1.SQU.QO att.�.'ry i.:privr.��.�oC::p to r•.n:}.zr r.:.j civil;>�t Jl C3 in d'c firm of n Stc;,',Jcri;Oru�a:d a Lr>✓oCS100.oU a day s�:�n:.l m� . ._ For dq,arumcaJ u,o vIly Pcrrnit - "� ;tidap;! rsOt�'�l"$P,� 17TttUG �`ON SERVICES y 1 . 8 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : 01()Ct � License Number nnM E. -„:'.G.INC. C) Address 160 Old Lyman Rd. Expiration Date So.Hadley,MA 01075 Signature Telephone MWURff.,a y; n,.. ,.: Not^Applicable ❑ Company Name ' ADAM Registration Number QUENNEVILLE ROOFING&SINNG,INC, S- -o� Address 160 Old Lyman Rd. Expiration Date So.Hadley,MA 01075 Telephone GT10 ON, �RSC�O,MPf�SAT10NH5U ,4�tGEAFFIDAVIT(M: L 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 Dwellings of one(1) or two(2)fami:ies 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"homeoNvner" shall submit to the Building Official,on a form acccptable to the Building Official that he/she shall be responsible for all such work performed under the building 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 �,y1r �vR .J , IiD 0"KOSED I©`KKIM U .,?r1!?IIL'e�'xc:_�.GS�:. �'3''.?!� ! :;+�+ I�.. _ r. New House 0 Addition ❑ Replacement Windows Iteration(s) ❑ Roofing 4]� Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ J Other [ ] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet❑ 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. Mascheck 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 [?MW.N M MUMI 0 y G*ROPL ESOF; >;Up1�L�I ;PTrF �l�� #.°1:V'— I, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, 1-+'6y-f)Q'enu as Owner/Authorized Agent hereby declare that the statements a d 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 Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO.LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES 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 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES No IF-YES, describe size, type and location: Qty of Northampton l§wilding Department 212 Main Street 1 % ;�(� Room 100 Northampton, MA 01060 phone �4- •5871-1240 Fax 413.587-1272 0i"'C" r r_')T—PLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION ] -SITEFftFO1VigfON:' 1.1 Property Address: _ a ,�gE1rr�Y..D�strict -�""�� . . w�. .... ._:. ,G`B,Dr ',�cf,_..._r�Ar•--g __h-3�'.� ` 5�CTIfJN 2 PROFE.RT=Y O1LyNERSHPs// UTf•IORIZ�D 'EN i °v 2.1 Owner of Record: Name(Print) Current Mailing .dd s: Telephone Signature 2.2 Authorized Agent: ALM Name(Print) ( Current Mailing Ad ss: Signature Telephone . nL ON 31 E 3 E5711lAED CONS7Rl�C�fON{COSTSF " • ,:rte— : Item Estimated Cost(Dollars)to be Offrclai?USe Only completed by ermit applicant 1. Buildin g (a) Building Perrn rt Fee -?yoo CID 2. Electrical (b) -Estimated TotabCost:of Construction from:: 6 3. Plumbing Building Permit Fee i 4. Mechanical (HVAC) 15. Fire Protection • 6. Total = (1 + 2 + 3 + 4 + 5) `?`-(00. 00 Check,Number This S'ectiorl Official Use 0pl Bu+ldtng Perrhit dumber Dat61'ssued rgnatvre. _ Building Gom.missionarll, pecta of 6uildmgs ;:; Dane: 39 KINGSLEY AVE BP-2008-0178 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C- 155 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Perrnit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2008-0178 Project# JS-2008-000260 Est. Cost: $7400.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Adam Quenneville 120982 Lot Size(sq. ft.): 6011.28 Owner: SHOTWELL DONNA M Zoning:URC Applicant: Adam Quenneville AT. 39 KINGSLEY AVE Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:812012007 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 si nature: FeeType• Date Paid: Amount: Building 8/20/2007 0:00:00 $25.0011118 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo BP-2008-0178 GIs #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate BUILDING PERMIT Permit# BP-2008-0178 Project# JS-2008-000260 Est. Cost: $7400.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Adam Quenneville 120982 Lot Size(sq. 1): 6011.28 Owner: SHOTWELL DONNA M Zoning: URC Applicant: Adam Quenneville AT. 39 KINGSLEY AVE Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON.812012007 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 8/20/2007 0:00:00 $25.0011118 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo