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29-233 (2) z , Board of Building ReC�ulatiolns Ashburton Pla One ce, !gym Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 06/22/1945 Number: CS 022840 Expires:06/22/2008 Restricted To: 00 JOHINT R RIGALIS 103 SOUTH STREET HOLYOKE, MA 01040 Tr.no: 23480 Keep top for receipt and change of address notification. DPS-C:: C- SOM-04/05-PC8698 Board of Building Regula ions and Standards = One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 101718 Type: Private Corporation Expiration: 6/29/2008 S.E. SULENSKI ROOFING & SIDING, CO John Rigalis _._ .. 103 South St —"------- - Holyoke, MA 01040 r._.-_---- ----.----- ... Update Address and return card.Mark reason for change. CPS-Ca,, 0 5OM-04io5-PC8698 �] Address ❑ Renewal [] Employment [_ Lost Card Board of Building Regulations and Standards License or registration valid for individul use only a - expiration date- If found return to-HOME IMPROVEMENT CONTRACTOR before the ex P Registration: 1.01718 Board of Building Regulations and Standards Expiration One Ashburton Place Rm 1301 : 6/29/2008 Boston,Ma.02108 Type: Private Corporation S.E.SULENSKI ROORNG 8,SIDING,CO John Rigalis 103 South St �dr,Y, •� —.— _ _—-- ------ Holyoke, MA 01040 Deputy Administrator Not valid without signature -JUN, 7. iiov:-111 ?2"AM�----M:ARTIN J 'CLAIYTGh, 1�V5 N'0. a�� D� ucwYYY� RQ CERTIFICAT t U!-f LIAMLI i INSURANCE `` DP- PtooucSR (413)536-0804 FAX (413)534-7974 IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Martin J. Clayton Insurance Agency, Inc. OIIILY AND CONFERS NO RIGHTS UPON THE CERTIRCATE 1649 Northampton Street A TDR THE COVERAGAFFORDED E YTHE PO LICE POLICIES OW. P. 0. Box 989 j Holyoke, MA 01041-0989 INSURERS AFFORWNG COVERAGE NAIC# INSURED S.E. Su ensk*I Roofing SSiding INSU"Kk H.T. Bailey Insurance Agency 103 South Street INSU e: $a ety insurance Company 0014 Holyoke, MIA 01040 INSU ERC: American Home Assurance Co. RLfu R D: I INVJ MR Pc OVERA THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREd NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUME*T WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIE8 DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CiAIM9 0 TYPE OF RISVRANC! POLICY NYMrER PO YE PO ExPI N UNIM GENERALIMPUTY NPP971670 06/0 /Z007 06/04/2008 EACHOccURRBNcE s 1,000 X COMMERCIAL GENERAL LIABILITY D" G T RENTED !3 S01000 1 MED E%P(Any one parson) S 51000 CLAIMS MADE [E OCCUR n A PERSONAL"V IN URY s 11 000,00 GENERALAGGREGATE $ 2.000,000 GIN I.AGGREGATE LWIT APPLIES PER_ PRDOUCTS•CO WIOP AGG 1 1,000.1000 POLICY PRO 11 JECT LOC AUTOMOBILE LIABILITY 1610306 01/10, /2007 01/01/2008 COMBINED SINGLE 0AT s ANYAUTO (Ea aeddenl), 1,090,000 ALL OWNED AUTOS BODILY INJURY (Pr oarlOA) B X SCHEDULMAU7CS X "IUDAU7CS 90011.YWJURY i X NON-OWNED AUTOS I (Pef ao>Idant) PROPERTYOAMAGE s � (Por imCanQ GARAGE LIABILITY I AUTO ONLY-CA ACCIDENT 'i ANY AUTO OTMFJ;THAN EA ACC S AUTO ONLY: AGG S s + LXCESSAgMBREI.LA UABIUTY ; J►CH OCCURRENCE t OCCUR CLAWS MADE i AGGREGATE s l i DEDUCTIBLE RETENTION 11 = WORKERS COMPENSATION AND WC9932443 12/ 1/2006 12/31/2007 we sTATU• o R PMPLOYOW LJAQIL17Y E.L.EACM ACCIDENT $ 100-00 r ANY PROPRtEroRlPAfcTN6R/E7CECUTIVE OFFICERAAEIAPER FJ(CLUDED? 1 E.L.DISEASH•EA EMPLOYE i 100, it yes.d.:4+1>e under SPECIAL PROVISIONS pNow I E L DISEASE POUCYUMIY i SOO OO OTHER l DESCRIPTION OF OPEUT1046I LOCATION$!VSHICLES!EXCLUSIONS ADDED BY ENDORSEMENT!S pjA7 W.PROVISIONS i QF.P,TIFICAIL IJOLDER Q�NCQLATICIN SHOULD ANY OF THE ABOVE DESCRI&V POLICES OE CANCELLED RFAORE THE "EXPIRATION DATE THEREOF,THE L%W#KS INSURER WILL ENDEAVOR TO MAIL nA►YS WRITTEN NOTICETp THE CERTIFICATE HOLDF•It KAMFD TO THE LEFT, gBUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIADIL IIY 8 OF ANY KIND UPON THE DISURHR.ITS AGENTS OR REPRE54*TATIvES. BRED REPRESENTATIVE 'i�Ralt N I rold Clayton Jr. CHERYL ACORD 25(2001108) CACORD CORPORATION 1981 h G -p Df Nart4a11r�tan Z : r �i assacl�nseffs I; cup• - " DEPARTMENT OF BUILDIN G INSPECTIONS INSPECTOR 212 Main Street • Muuicipal Building Northampton, MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction sups: ,•'ssor. 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.any person(s) who seek to use the home owner exemption, to 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 permits 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 me. Date Address of work location 1� Oy a f (ri 3 of TcrrfIla111ptoII _ DEPnR;ME"7 OF IIUILOr>�C 1"SPEC;,01"S 212 Alain Strcct Municipal Building Northampton, Mass. O1060 Z��OI.]Q R'S CO ENSATTON L tSURA.NC- :�=/.*.ti�I? —_ eC1w i�- I�i9cico �/ S C St�1.zrL?sk�__.`t��ar'i�9 � Sid/�,�5 — (Iiccm- Jpamlttcc) --. principal placz of business/residence at: fictY hekJ40 h-,C, DIZr/d ();hone:') 41-3 53Q Z`s do hereby certif).-, under the.pairls :md penalties of penury; `tat ( ) I am an employer providing the iollo.ving worker's cotnocns_n:ion cove r2se 'or III) employees ivor_Ung on tlus job: cpclic�i vmD=r) — :pii or. 1721) ( ) I a1n a sole proprietor, general contractor or homeowner (ciscie one) a bane hired the contractors liste—d below who have the `ono g worker's comoeasa 'on pokiest I " (i+1IDc Of COnc-71Cip") Onssurznc-- Compa )-/i cuci Nu.ffir<-) Ditc) . i (N me of Conmaor) (Irsarzncz: Comoazy/?ouc—i Nunccr) (i .��irrion Dar) ()`atne of Cotlaaczo;) (Insurance Comte/PoLq N rsbcr) (Expirtiea Datc) (Namc of Contractor) (Lnsuraa Comrzuy/Policy Numb r) ttxpiram)DaI )- � (aII�e;1:dQia'ocst zSoa.ifnooci.�-}•co c�e'u�iafocra.�oa pe-zaia:.ng to.11 m�-s_.o-�) I O I am a sole propnetor and have no one work-jog for me. ( ) I am,a home owner performing all the work myself. NO i E:plea be ew ue t*x� }e t�emeo�verz .moo c�rQY P�'loin u cl� si.a a rrnu •uric o�,d--c Z of ODE ranee*--M t`s,=r,.t iscaa the bomoowac resda or oe the daunts zpputte-,1ir1 theeo c-c ox Ccarlh•oec:C--off to be ctPlayc�uate Ih vi O=P— - ca Ac:(GL152=t(5)).=-ppticaon try+homeo-=fer c he:v_or pe=rt=y e ideooc tt;-_ 1�7 a aZU of sa esatoy.r under the Wor4o�a Compomatips Act t +ad 6a a Dopy of tb-mzemom o3+y be f«ward.d to the Dop.remen¢of Iad+uriJ ne ide��Offioe of tri.+r•noo fx Ih. 4O Q�C"�'iGctiao aid t!u Liltac to+oauc b� �ujcr,ctioa 25 w of,,(G L 152 c—tcd m the t p=i6oa of ciminst P=-116a ooaic=s$Of fiat Of Up to SiS00.00.adtor des orua f=of S t oO.00+ to Doc yr3r cod��il ptie io 6c form ofa Sion WorS Order--,d+ my c�yQy me � For OWY . Permit Numb= SigMazun of Lim-JPccmit( e J SECTION 8-CONSTRUC?ION SERF CES 8.1 Licensed Construction Supervisor: n r� Not Applicable 0 Name of License Holder: Oaf. License Number it7 3 S�;�t�►. Striz� �-aa- avo8 Address r Expiration Date �c 1�'clC,� �jL Djt;yfl Signature Telephone a- 363 I 13i, ..: . re`�Ham rte. Not Applicable .O S.E • S�!_e�tslC. `iZcoi%j* rf- StctlWS Co Company Name Registration Number I03 Sc��i. STu3Z� 4�— �29-3ooS Address II__ Expiration Date t�o LU K a_ YYt a. ©10 qt) Telephone SECTION 10.:WORKERS MMPENSAI X52,: 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....... Ji" No...... D F, 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.CMR 780. Sixth Edition Section 1083.5.1. 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 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 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 Arsr' :V. 4) 4 «.. SECTION 5-:DESC•RIPTiON OF'=PROPOSED•-W-ORKfich6itk-afl-:aoplicabl New House Addition Replacement Windows Alteration(s) Roofing Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0) Decks [[] Siding[C!] Other Brief Descdption of Proposed V/ Work: nn)! _e__ i^ FlK-r, cs }1)otu ripe' ' r1A- Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a1tiexiii!- o 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 build ing.conform to the Building and Zoning regulations? Yes No. L Septic Tank City Sewer Private well City water Supply SEC LION la 01tI1114ER lYt [OR1Z'�4T[©N�•-3 a,,818 QMP1 F D Wyk -011fkNERS--7kGEN�O�R=CO „AC�QK-Ate,PC1E (3R�B�Iii�711NG:,�FRlriltTt . ti I '~ l ffi A - ,-�1 fL� -r„l as Owner of the subject property hereby authorize t SkLk,v)SKL SI(4t w'4 C0 to act on my behalf,in all matter$re uthorized by this building permit application. r Signature of Own Date 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 Owner/Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage s Setbacks Front Side L: R:' L R:' .Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minas bldg&paved i palking) #of Parking Spaces ' Fill: I volume&Location)i A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW Q YES Q IF YES, date issuedd ' IF YES: Was the permit recorded at the.:Registry of Deeds? NO 0 DON-r KNOW 0 YES Q IF YES: enter Book Page' and/or Document# B. Does the site contain a brook, body of water or.wetlands? NO Q DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Q Date Issued: C. Do any signs exist on the property? YES ® 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 Q 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 0 NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required_ City of Northampton Building Department 212 Main Streeter f 4 .:.,,Room 100 - , ` Northam ton, MA 01060 phone 413-587-140 Fax 413-587-1272 T3 APPLICATION-TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECSlON"'I SITS,-I.NF�ORIIA�TIONI� •-- 1.1 Proi2erty Address: r T +s eGLn to Gec� lefed ifcce 1.-!_ l\ .,. ..IliQlt- 18t O a d— °�r.� a, '"�. . 'Y.e, �-,.'�„',. ,.Tc .S SECTION 2 PROPERTY OWNERSoIPFAtJ°ERORIZEDAGENT 2.1 Owner of Record: �I�! Ct_►•�3 ��[t_���,1 1 n;�rt�c,, (�. �4'V�-1�j i2J ��'rp�,, ��Lp�`fi ��tl'',►t'�i12(GL l Name(Print) Current Mailing Address: y1-8 - 3,�oC) y 7,;L Telephone Signature 2.2 Authorized Aoent: S.0 �uL�uLSK/ t�ccrl►v3 d �IC�,rt13 C'c : J D� -&,,gt S-r dip-i vkL. h7a, oitim Nam (Print) Current Mailing Address: q/,3- Sin ture Telephone SE'GTION>3':_.EST.h41AT-IXV0 ISTRft,TICi Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building Buddia -PerznrtFee 2. Electrical (bsUratedTatal>Cosrof' <Goi�struc'ttor��roi�;:6:- _ 3. Plumbing BuiComg Perm,t Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number J _. This Section For5Officral YlSe Only =. Da1e Building-Perrnif'.Number �-lssued: Signature: Building Commissioner/Inspector ofBuildings Date 4e. File#BP-2008-0128 APPLICANT/CONTACT PERSON S E Sulenski ADDRESS/PHONE 103 South Street HOLYOKE (413)532-3630 PROPERTY LOCATION 126 SPRUCE HILL AVE MAP 29 PARCEL 233 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tyueof Construction: REPLACE SHOWER FIXTURES&NEW BATHROOM FLOOR New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 022840 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION PRESENTED: Approved 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 -� O UA 7A 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. 126 SPRUCE,HI L-A FE BP-2008-0128 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.-Block:29-233 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: . Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2008-0128 Project# JS-2008-000199 Est.Cost: $8997.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: S E Sulenski 022840 Lot Size(sq. ft.): 18905.04 Owner: HARRINGTON RYAN Zoning: URA Applicant: S E Sulenski AT. 126 SPRUCE HILL AVE Applicant Address: Phone: Insurance: 103 South Street (413)532-3630 Workers Compensation HOLYOKEMA01040 ISSUED ON:81712007 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE SHOWER FIXTURES & NEW BATHROOM FLOOR 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 8/7/2007 0:00:00 $25.0016784 212 Main Street,Phone(413) 587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo