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36-226 -Z foaTrWouNin* Oeplaions g tan ar s One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Construction Supervisor License License CS: 70626 • Restriction: 00 Birthdate: 8/21/1971 Expiration: 8/21/2009 Tr# 3712 ADAM A QUENNEVILLE 160 OLD LYMAN RD S HADLEY, MA 01075 - Update Address and return card.Matjk reason for change Address Renewal E] Lost Card )PS-CAI i? 5OM-07107-PC8490 XYrorBuW1Idin Ve lat�ons an tandar s g � One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 120982 Type: DBA Expiration: 3125/2010 Trtt 264937 ADAM QUENNEVILLE ROOFING ADAM QUENNEVILLE 160 OLD LYMAN RD SO. HADLEY, MA 01075 Update Address and return card.Mark reason for change. 7PS-CAI �o 5OM-07/07-PC8490 ❑ Address (� Renewal F Employment � Lost Card ---`.--°'--'-r..,..,..� �. �--...m.—.,,-t*e+' �,-- ' +-k—S.•:+.c-L.-.�-r7r"5�. -^'--, :-'Y .':a.- .,,._^'"r�.�� ', -o-r-''`—�' ;— �i; r1. t r �f�'*. f[ 3. C�1 Fr "fi CU' ' � PA 'TNI 1 T OF; CCINSU R . Pk",0�1 EC'TI( llr1 +' 1 r Be tt l�t;oura that '" r.l� jE I S i4C1 y�. t i #` t3 '�Qt�*r"E�5 t �} � #�4 �U tZ � .t)�� Y�0101 � •�� 1� I N (1le. is certt�'e�b� �k '�okec�orr as a regts�ered 1 ur .0 i J ryL ' !. r ADD—— Q JE�TN VZLLE R4�FIfiT Er r � 7 i :Effective 12/0'3/�00'T j Explratlon:.�1 f 30f 2:00$ Apr-08.2008 02:03 PM Remillard Insurance 1-413.538-6010 1/1 AC CERTIFICATE OF LIABILITY INSURANCE CSR xL DATE(MMIDD/YYYY) ADAM '-1 04/08/08 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 MA 01075 Phone:413-538-7862 rax:413-538-7179 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: A114 xetual 1"_eeae c_W_y INSURER B: am Bain /Tzeselera loeereeoe Adam Quenneville Roofing & INSURERC: Scottsdale Ins Co. Siding Inc P 0 BOX 612 INSURER D: South Hadley MA 01075 INSURER E COVERAGES 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 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE. POLICYNUMBER GATE MM/DD DATE MM/ODM' LIMITS GENERAL LIABILITY EACH OCCURRENCE - $1000000 C X COMMERCIAL GENERAL LIABILITY CLS1384198 06/23/07 06/23/08 PREMISEs once) _ $50000 CLAIMS MADE v I OCCUR MED EXP(Any one person) $5000 PERSONAL&ADV INJURY $1000000 \ GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG s2000000 POLICY jECOT 7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B ANY AUTO BA745OL94607 11/01/07 11/01/08 (EA accident) $1000000 ALL OWNED AUTOS BODILY INJURY $ (Per person) X SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS / (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - AUTO ONLY•EA ACCIDENT S ANY AUTO OTHERTHAN EA ACC S AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION $ - S WC STATU- aim- WORKERS COMPENSATION AND ITORYLIMITS I X ER EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE AWC7012861012007 04129/07 04/29/08 EL EACH ACCIDENT $l000000 OFFICERWEMBEREXCLUDED? AWC7012861012008 04/29/08 04129/09 E.L.DISEASE-EA EMPLOYEE $1000000 If yes.describe under SPECIAL PROVISIONS below EE.L.DISEASE-POLICY LIMIT $10 00 0 0 0 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN ` NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 50 SHALL / \ IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES �6:OR17ED REP �TIVE �".� - ACORD 25(2001108) RD CORPORATION 1988 Department of Industrial Accidents '� Ot�ce taV�lastlirs�lms 600 Waskiugton Street Boston,Atria. 02111 Workers' Compensation Insurance Affidavit loreo V+' 1rY► Yi6'`� beor a4 -r, city F1 Yi phone# 5 k%- C] I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my tanployfes working on this job. company name: address: city: C7 bhone#: S Is insurance co. 1 w lie #: W 11 CJ f i am a sole proprietor,general coetr=MW.or homeowner(circle one)and have hoed the contractors listed below who have the following wodu='�compensation polices: cot�pa rtn�r name: - - - - address: phone#: I ancee co.. - -—_.—.. —-- - pol icy#= - company name: address: city: - ina=ance co.: policy#: Failure is secure eoveraw as regaiw wader Seciden 25A K MGL I52 raa lead to the iapattboa of tstatr d ptsaalltts of s rise of to SI.UGM aod/or ere years,i—priareaneet as wev as loll presides to at form eta STOP WORK ORDER sod a fine dSI00A0 a day agaieat me. I undentawd that a copy of this stateweeei nay be forwaednd N the Office of lovicetigatlons of the DIA for Coverage veri6Mtioa6 I do hereby certifyudo•AcpAdju and penalties df perjury that the inforaw6on provided above is true and correct iigasture C Datc _ Print name e'LCtrPYn n.. -e V1P 4P-V11f Phone it y15 y5,E,"5 q S S 7 o ial am o ly do not writs is this area to be completed by city or town ofLciai city or town: pertnitiuceese p I'1BWidial:Department C3Uccuaing Board 0 creek if immediate response is required Qseteetenea's Office (]Hearth Department i # contact person: phoac : n0[ber QIJENN EViI LL`E ELKMf. (ROOFING $ SIDING;, INC. The Premium Choice• . 160 Old Lyman Road, South Hadley,MA 01075 We Are Licensed 1-800-NEW-ROOF 0 413.536-5955 Insured Email:info @1800newroof.net webslte: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 Member of the Building&Trade Association Member of the Better Business Bureau P.P.C.38710 Proposat-S-ubmitted To: r Date Phone#'s J AMC5 Street I Mail To: -- :. 7 L i1 AJ City,State,Zip Code Special Requirements ( vt2CraG ) 'Ma C>1vL Z rut" 1C C •.`ArrYr c, C72r;t12: Proposal to furnish and install the following ❑ Re-Roof Tear-Off YGutter fl TZY F(45o nr, Complete Roof Preparation �1 CLA-J /i L.' 6 k s [ Home exterior to be protected by tarps and plywood [R`Shrubs, landscaping,trees to be protected �R'AEntire existing roofing material to be removed to existing decking, including flashing,etc. `Site to be cleaned everyday with roll magnet debris removed at project completion 2:beteriorated existing depking replaced at$2.50 per sq.ft. Z`Whita�Brown ifth metal drip edge installed at eaves and rakes. ❑ White/Brown 5 inch for re-roof only 5`New flashing will be installed where necessary(see Special Requirements) 2�lnstall new pipe boot flashing ® We shall acquire all appropriate permits'etc for all roofing work Complete Roofing System 2r ELK Leak Barrier installed of all eaves to protect from ice dams (and meet codes in the north) 2r ELK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas [Y� 15 pd. reinforced underlayment installed over entire decking Shingles: ® A 0,jc ELK Prestique Series ,930 year ❑ 50 year Color . T [Y'Nailable ridge vent will be installed ELK ridge cap shingles Warranty Options: lQ Q'We guarantee our,workmanship for,%full years ELK10-Year Umbrella Coverage Limited Warranty upgrade. v� ❑ ELK15-Year Umbrella Coverage Limited Warranty upgrade. id We Propose hereby to furnish materials and labor-com ate in accordance wit o_ spe Ifi ations for the sum of: d 2 Tota4 Sale Price$ f Do n Payment$ Tr �.�, Upon Completion$ ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are satisfactory and are hereby.accepted. You are authorized to do work as specified.Payment will be 1/3 down upon signing,and balance due upon completion. Unpaid balances shall accrue with interest at 18%per annum. Purchaser(s)will pay for all costs,expenses and reason- able attorney's fees incurred by Adam Quenneville'Roofing and Siding,Inc.to recover any sums due under this contract. Phone# 44301 Date: D signature: r—� Date: Estimator's Signature: r "`� 'lJ Estimates are hono for six 60) ays 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 and Sidings will not be responsible for debris or dust in the attic or storage areas. t ...nJ� .s<.: n,�s�+� �.t..¢e+4 1`Na•�S x . t�, 'RAC,.�. SOf�B�'(ld �l11C�7`ION Sf±FtVICES? $ 1 Licensed Construction Supervisor: Not Applicable //❑ Name of License Holder : 7062 (O License Number Address Adam Quellneft R00fillu&Sldinu, Expiration Date 160 Old Lyman Road Said Hadla MA 01075 Signat Telephone cl Not Applicable ❑ Company Name Registration Number Adam QuenneviNe Roofing 8 Siding,Inc., 3 y z f-._ � 100 Old Lyman Road Address South Hadley,MA 01075 Expiration Date Telephone w x SECTIO 0 Ufft ERRS �COMPEN5AT10[V PFSU ANCE AFFIDAVIT(M"G 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)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. CNM 7$0, 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 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 EMROMED � sl�ORKh a D V' ° °rir'r�-F:.Y;i.'....: :. .. i�...... ,.. .. .F�3..s?,a°' .'' "'':•�. .`?''`�_"..�:�`:_ib ^:?'e C?X�N9M;.:. `fit :' zP1;'fq'r.."+�,r.u°'�".'iU� New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing . Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [n] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: e- ew t,�e, old /Sr a o r ez v Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet 0 "a6". E: t�:. �'�� ron '.: ez��ti�tg�.h�`""t�s`in �Q•fnl="� =�'fe" 'he�`�lo.�:�n= A: 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 M �r � [ZA'��ONOBE'OOMPM.T'ED WHET" 3 0 , 0 t:7R0ft At'PL'11ES F OR� C`II Dt G'PER�MI " 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, 140l.i i �n.� v� !! �04 i `:z as Owner/Authorized Agent hereby declare that the statements and information on th oregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. A c4ym 0,1 e-j, Print Name Signature of Owner/Agent Date City of Northampton 2Vry Building Department ' X212 Aain Street m 100 �v ampton, MA 01060 VUr, J`phori�-413.587.1240 Fax 413-587-1272 r , APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A (.)NE OR TWO FAMILY DWELLING SEt;T1ON 1 SITE fNFOf?hrt TlON. 1.1 Property Address: � � # Y � w - Zo :ef =V r111 o .rVAst t- rElr> StDrstrrct € CBU - SECT1ON 2 'PROP,ERTY OICYNERSHLP,IAUTtiORiZED ;GENT: 2.1)Owner of Record: ) ol Name(Print) Current Mailin A dies Telephone Signature 2.2 Authorized Agent: / /' / r Q (�•. V1 a e-n—Q s1 G i-� G� L 6 L t j►t 10 © /4 �9 CY k'I Name(Print) Current Mailing Address: t�U V 7 Sign ture Telephone _ SE M,10N 3 :E5Mkfff ED CONST:ftUCkMN'COSTS ' Item Estimateq Cost(Dollars) to be Official Use Only completed by ermit applicant 1. Building -7 70 (a) Building Perml. Fee 2. Electrical / (b) -7:stim0ted Total"Cost.of Constructionfrom ,6 3. Plumbing Building Permit Fete 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 +4 + 5) / 7 (� Check Number C7 This Sectiomfor Official Use Only., Swldtng Pe.i mit Number >- _ Date ilssued signature: Burlduig;Gommrssroner/Inspector of Buildings, a BP-2008-0993 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 e.142A) Category: BUILDING PERMIT Permit# BP-2008-0993 Project# JS-2008-001489 Est. Cost: $7704.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group Adam Quenneville 120982 Lot Size(sq. ft.): 60984.00 Owner: IRELAND JAMES A&SIMONE HUVAL zoning: SR Applicant: Adam Quenneville AT. 56 WINTERBERRY LN Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:51712008 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 5/7/2008 0:00:00 $25.0012390 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo