Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
25C-168 (2)
Ui ! /-dUUS lU: Jj hm Kemlllard insurance 141.j3JbbUIU 1 / 1 RYA DATE(MMR701YYYY) ACORD_ CERTIFICATE OF LIABILITY SR ILITY INSURANCE ACS _1 06/29/05 vRODUC @R 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 shone:413-538-7862 rax:413-538-7179 INSURERS AFFORDING COVERAGE NAIL# i1jSUREO INS1RIERA= etasional tiro & Marino ice. Ca INSURERS: Arbella Protection ins CO j Adam nennevillie Roofing INSURER C Aml neutual meoraoce Coamaay & SidP O 13 Inc 612 INSURER D: South Hadley HA 01075 ENSURER E: L ,:OVERAGES TTHE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED A60VF FOR THE POLICY PERIOD INDICATED.NOTWCMSTANDING ANY REQUIREMENT,TERMOR CONOITIO14OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR NAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;EXCLUSIONS AND CONDITIONS OF SUCH I POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS POLICY NUMBER DATE UODDNV DATE MAVDDlYY') LIMITS TR 14 TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE S 1000000 m�I;vE TDE A X COMMERCIAL GENERAL LIABILITY BIL3DER#15168 06/23/05 06/23/05 PREMISES(Ea ro cwnc oa) $50000 CLAIMS MADE XX OCCUR MED EXP(Anyone Person) $5000 1 PERSONAL&ADVINJURY $1000000 GENERAL AGGREGATE $2000000 i CENL AGGREGATE LIMB APPLIES PER- PRODUCTS•COMPIOPAGG 52000000 POLICY FT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 3 ANY AUTO 54906400002 11/01104 11/01105 (Eaaxidenq ALL OWNED AUTOS BODILY iNJURY s250000 X SCHEDULED AUTOS (Per pe son) X HIRED AUTO$ BODILY INJURY S500000 X NON-OWNED AUTOS (Pcracodcnt) PROPERTY DAMAGE S 100000 (Per aeGda+y GARAGE LIABILITY AUTO ONLY•EA ACCIDENT !S I ANY AUTO OTHER THAN EA ACC(5 I AUTO ONLY: AGG S EXCESSAIMSRELLA UAHILITY EACH OCCURRENCE 5 OCCUR CLAIMS MADE AGGREGATE S ]DEDUCTIBLE $ RETENTION S S 1 WORKER$COMPENSATION AND X TORY UMITS ER EMPLOYERS'LIABILITY C ANY PROf+RIETORIPARTNER/EXECUTIVE AWC7012861012005 04/29/05 04/29/06 E.L EACH ACCIDENT 5100000 OFFICEPJMUIBEREXCLUDED7 EL.DISEASE•EA EMPLOYE $100000 if yes describe under E.L.DISEASE-POLICY LIMIT 5§0 0 0 0 0 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS C=RT IFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BBFORE THE EXPIRATION GATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRD'TEN NOTICE TO THE CERT IFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATIQ tWj LIABILITY OF ANY KIND UPON V THE INSURER,ITS AGENTS DR REPRESENTATNE .� AUTHORIZED +. Ste h a o � '- ACORD 25(2001106) i ©ACORD CORPORATION 1988 _\ 91te Board of Building a ulations <= - One Ashburton Prace, gm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 08/21/1971 Number: CS 070626 Expires: 08/21/2007 Restricted To: 00 ADAM A QUENNEVILLE 160 OLD LYMAN RD S HADLEY, MA 01075 Tr no: 3761.0 '= r ',�3 Board of Building Re ula ons an r it One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Reqistration: 120982 Type: DBA Expiration: 3/25/2006 ADAM QUENNEVILLE ROOFING ADAM QUENNEVILLE P.O. BOX 612 - - - SO. HADLEY, MA 01075 -- -- --- - -- - -- -- - Update Address and return card.Mark reason for c6ang r STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION i Be it Known e ADAM QUENNEVILLE 79.W:$TAXE,- T V ' is certified by the Departs ant oft,pns tit r tection as a registered HOME IMP]IiOVElt ITT CONTRACTOR G � Regrattoln -57:520 � AVSr,n 4 J ADAM QUENNEVILLE ROOFING -.. Effective: 12/01/2004 Expiration: 11/30/2005 C ADAM QUENNEVILLE ROOFING & SIDING, ( P.O. BOX 612 SOUTH HADLEY, MA 01075 1-800-NEW-ROOF E-MAIL: inform 1800newrooLnet WEBSITE: 1800NEWROOF.NET MA CONSTRUCTION SUPERVISORS LIC. #070626 MA REGISTRATION#120982 MEMBER OF THE HOME BUILDER'S ASSOCIATION OF WESTERN MASS. CUSTOMER ADDRESS: Chris Millett 32-34 Orchard Street Northampton, MA PROPOSED DUTIES: 1) Protect siding by hanging a tarp from gutter,where required 2) Strip off old layers of shingles down to sheathing on main house 3) Completely de-nail roof and re-nail loose boards(cover entire roof surface with '/z" plywood) 4) Install aluminum drip edge(.018)on bottom and sides of all roofs 5) Install 3 ft.of ice&water barrier along bottom and sides of heated areas and valleys 6) Install new pipe flange flashing,where required 7) install 15 pound felt paper to the remainder of exposed roofing area 8) Install new side wall flashing and chimney flashing, where required 9) Install shingles of choice in accordance with ELK manufacturer's specifications 10) Install continuous ridge vent 11) Back flat porch will have new Lo Slope Material Applied 11) Work site shall be cleaned on a daily basis and gone over with a magnet to pick up nails. Removal fee of debris is included. 12) Roof is warranted not to leak under normal weather conditions for 30 years WE PROPOSE: to hereby furnish materials and labor in accordance with above specifications for the sum of: ELK 30 year Architectural S 17,000.00 NOTE: This quote may be withdrawn by us if not accepted within 90 days. Signature Date l 4 UJ ACCEPTED: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do work as specified. Payment will he 113 down at start of job and balance due upon completion. Please sign one copy,state color requested and return to the above address. Thank you! Date 1 v 1 � signature Phone Phone M_ 7�(O— ATTENTION HOME OWNERS: Please cover all personal belongings in the attic or storage areas due to the Possibility of roofing debris or dust coming in through the cracks of the wood. Adam Quenneville Roofing will not be responsible for debris or dust in the attic or storage areas. 6 ja1 i50AC[t tsCtt!' DEP,J2I-MENU OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building 'o 2,'orthampton, Mass. 010GO ` wore ,R'S COMTENSATTON INSURANCE AFFIDAVIT �1 f vAth a prineipawi place of buslnesslr, s-denc; CIO 11creby cCr-z1 '- L'aCl 11C ) iilS ;:ilu OCrI.'lm" 111 enap!oyei" provldlrl- th.,- iollovv:l-S_ %.o[kc1"5 cottJpens?UOII COVCr2gl: ror my employees wordng (in this job: mufy (Insuimmc= Coe~zpam') (Poie;Num_ Kr) J (F�Timi or Date) ( ) I ?nz a sole proplitror, g.eaArL come of nomeowDer ;ci;cie one) and gave nirf:d the cont"actOCS lliste�, beiov, :tiho the i0�C'.:, P� •.-O i it �S y -'OCk S COu.�ei_��Oit (Na-me of Coatr actor) (Ins�rcc Cct o':��,Pc�:icr Nn�r) �L>::;:-,tlor. Datc) (Na-me of ConL—.c,,or) — . --- Nun,b,--r) r_`:Cr:ain!Date) - (1,'ame of Contractor) (Name of Cont ctor) — JaEulalJCe Colnl,:_ly!t olicy Numn,2.rj (E:ri-:tio Dace) (.:fUCf11t"�3t1Mal:dret t...-_-... •-n::_.....-.- 'r--:,':c;�.�-_._-... - •.is:..<.__......-.) i C I r11I1 dt EO1C l%("Cl7rletOi <till h vc- [10 •:)i'. UC _ii': I0; 2]}E j aill ?_ home crvn1C oui-f( 7MJIi' f NOTE.:pleae In awr,rc lfsf.%,17e 6c<;c:�nrrs o c.—�I y o<'.:-r. ',�sne�cL.:-nom e :-;-air ,;•:c^ not U)Ccc thn ttvvo units it tct ctt he 1 rc: 3 c a ` ca ploys urs:er thr avcti;er s cc z• :et:rn r (G�!S�V•:(S)1.n =...._;by>6nrt o« cs.`cr c L arc c-r p:r legal ctatvc of an omployor under tLa Wukce& oz twrition!.ct- t und.c-rtand the a copy of tSv ctatc,-s_•r"y bo fa-x nrdo;l to c!n Dctwrt-„w of lrndu&,riJ of for tfx oovcmg--vcti =joc and tltt G.ilttrc to!! -co«s-ut d c�.iM 25.k of MC-L,152 can lc:d to d)c imposition of cooks ing of a fur-of up to S l SQO.00 o:-"Jcr o f-:r to r.: - :.j evil ixtull fi nn cf�Sic;, 'cri'.(m.e:f_ i Lt�of Sl�.OU a d.sy a��-in�t m-- l Fcr dq;unmtAl 11 oily , j SCOT!!$ dltl& tUCarON SERVICES" 4 8.1 Licensed Construction Supervisor: ` Not Applicable ❑ Name of License Holder :�dr '� IX C t\1�i1 V�L� _ CS C)—) 04 AL4 License Number J` k 0 10-7 1 a IL): Address Expiration Date X113 53(� 59s� i Signature Telephone i Not Applicable ❑ 1 ao�g2, Company Name Registration Number po (I I�, moo+�LG 3 l2 5"1 d G 'iddress Expiration Date Telephone DQ � SECTI 430 3N'4� S�COMPE�ISAI ION--INSURANCE:AFFIDAVIT(M:G:L c 152 § 25go) workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit Yoh result in the denial of the issuance of the building permit. S fined Affidavit Attached Yes....... III, No...... ❑ The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)fami:,es and to allow such homeowner to engage an individual for hire who does not possess a Iicense,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"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 __ gv ..V'a S _ L iF tg6W K ¢ c 11f a '`lizabTe r �rtF s j New House ❑ Addition ❑ Replacement Windows Alterations) ❑ Roofing f� { Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ J Decks [ ] Siding[ ] Other r - j Brief Description of Proposed Work: RemuA C) ei-(%�, Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Mans Attached Roll 0 - Sheet 0 5a ifitonta ex<fisting::hafasingcomRehellowing Use of building: One Family Two Family Other r Number of rooms in each family unit: Number of Bathrooms A c Is there a garage attached? Proposed Square footage of new construction. Dimensions e Number of stories? t Method of heating? Fireplaces or Woodstoves Number of each i g Energy Conservation Compliance. Mascheck Energy Compliance form attached? Type of construction Is construction within.100 ft. of wetlands? Yes _ No. Is construction within 100 yr. floodplain Yes No Depth of basement or cellar floor below finished grade Will building conform to the Building and Zoning regulations? Yes No . Septic Tank City Sewer Private well City water Supply RfZ'AVON TO BE COMPUTED 1NHEN OWN Q ' RiTORAPPLIESkFOR`BUILDING PERMIT'' sl as Owner of the subject property hereby authorize i to acs on ry behalf, in all matters relative to work authorized by this building permit application. signature of Owner Date V)ri.t,V l R CVX t L ---- as Owner/Authorized Agent ')ereby declare that the statements and information e foregoing application are true and accurate, to the best of my Knowledge and belief. ;gned under the pains and penalties of perjury. nt Name Signature of Owner/Agent Date r 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 prr.)perty ?YES _ No IF-YES, describe size, type and location: __ A i City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413.5871240 Fax 413-587-1272 r, APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-S ITE fNF,-OEtM/TION - 'This sect'o-A be�com 'ted,�b" 'ffice� 1.1 Property Address: j Y o Rid W A V .ilv� �7 8 J .?i l�'" ''' - '�V �" 1°14.♦ ' m EIntSt S_tr'ict �_.:° Dtt ? f " .4. ! SECTION 2-`PROPERTY OINNERS.Hy IP/AUTHORIZED gGENT 2.l Owner of Record: (lets l 8"',AVIo,, LL C _P,c� 8ox 68- (P k)D Aawvv-,. /fA- rJarne(Print) Current Mailing Address: Telephone Signature 2.2-8u thorized Agent: _Gv-chrwt PO � a &D", 'dame(Print) Current Mailing Address: Signature Telephone SECEION 3 • ESTIMATED CONrSTRUCTION COSTS, :Tern Estimated Cost(Dollars) to be Official Use Only completed by ermit applicant Building (a) Building Permit Fee 17, voo ,o Electrical (b) timated Total Cost of Construction from 6 Plumbing _ Building Permit Fee Mechanical (HVAC) Fire Protection Total = (1 + 2 + 3 + 4 + 5) 000 ou Check Number i This Section For Official Use Only_ I Building Permit�Number: Date Issued:_ Signature: Building Commissioner/laspector of Buildings Date 32 ORCHARD ST BP-2006-0352 GIS#: COMMONWEALTH OF MASSACHUSETTS MM:Block:25C- 168 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0352 Proiect# JS-2006-0521 Est.Cost: $17000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Adam Quenneville 120982 Lot Size(sg.ft.): 8102.16 Owner: MILLETTE CHRIS Zoning URB Applicant: Adam Quenneville AT. 32 ORCHARD ST Applicant Address: Phone: Insurance: P O BOX 612 (413) 467-2426 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:10 1512005 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 10/5/2005 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo