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31B-004 (14) SEXTON ROOFING AND SIDING CO. www.sextonroofing.com P.O. BOX 6327 HOLYOKE.MA.01041 Member of Better Business Bureau dk Setting the standard Certified Roofing Installer ='MASTER 6...< .�....... p (413) 534.1234 f(413) 539.9906 MA HIC # 118239 CT HIC #0605383 City of Northampton/Building Department 212 Main St. Northampton,Ma. I request that you grant a modification to waive the requirement for control construction for the project at 48 Round Hill Rd. (Clarke School for the Hearing and Speech) in Northampton, because the work is of a minor nature,will not affect health, accessibility,life and fire safety,or structural requirements and is impractical in that the cost of control construction is considerable when compared to the cost of proposed work Thank you for your consideration. Respectfully, Everett J.Sexton,Sr. Sexton Roofing&Siding Co. P.O. Box 6327 Holyoke,Ma. 01041 www.sextonroofn . cola► r� �r A cti�j k Satin the Standard OF MA HIC# 118239 ------- ------- ---- --------- -- ---- SUBMITTED TO Clarke School for the PHONE 582-1193 DATE 4-1-14 Hearin and Speech STREET 45 Rotmd Hill Rd. T JOB NAME Shingle section CITY STATE ZIP Northampton,Ma. l JOB LOCATION Same SEXTON ROOFING HEREBY SUBMITSSPECIFICATIONS AND ESTIMATES FOR: 1) Strip and remov e existing shin g les and dispose of in proper landfill. r 2) Inspect roofing deck and replace as needed. ($2.75 per sq.ft. ) 3) Install new metal edging to rakes and eaves of roof. (811) 4) Install ice and water shield on eaves(61), around chimney, vent stacks, skylights, in vallies , and at intersecting roofs 5) Install synthetic roofing felt on remainder of roof. 6) Install new flanges over existing vent stacks. 7) Install IKO Architectural style roofing shingles as per manufacturers' specifications. (Owner may select other manufacture.) 8) Install new cap over ridge vent. 9) Reinstall heat coil wires over entrance ways. 10) Supply manufactures 40 yr. warranty and SRC 25 yr. workmanship warranty. *Front section may be completed on weekend to avoid client interruption* ALL CONTRACTS INSURED WITH PROPERTY LIABILITY AND WORKMANS-COMPENSATION. lie Vropooe hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Sixty Thousand Dollars ($60,000.00 )Payment to be made as follows: Due in full up completion All Material is guaranteed to be as specified. All work to be completed in a Authorized Ever . Sexton, Sr. workmanlike manner according to standard practices. Any alteration or �� -- deviation from above specifications involving extra costs will be executed only Signature upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond Note:This proposal may be withdrawn by its if not accepted our control. Not responsible for water damage during construction. Owner within(14)days. to pay responsible legal fees for non-payment,and applicable interest. -- ------------ ------------ 9cceptance of joropogal The above prices,specifications and conditions are satisfactory and are hereby accepted. You Signature are authorized to the work as specified. Payment will be made as outlined above. Signature _-- Date of Acceptance. From:. . 07/16/2013 14:36 #860 P.001 /001 CERTIFICATE OF LIABILITY INSURAr4CE THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY- CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES o LOW. TT 11E ccmi-ICAT[ or INSURANCE DOES NOT C0N3TiT1= A CONTRAGT BEfWEtN IHt izit wj INSURER(S), AUrHIDRIZED TAEPRLULNTATIVE QR PRtODUCCR.AND THE C.RTIFTCATF HCII nFaR IMPORTANT: If tha rPrfifiratPhrdtfPriq2n QIInmCINAL INSURED,rho P*0054i oc) nwet bo andom- d. Ff eUDROCATION 13 WAIVCD,s uVjuL;L lu the terms and condtions of the policy,certain policies may require an endorsement A statement on this certificate does not conkr rights to the rw.rnnrarr�nnrn�r rn rralr nT clH;r�41YIY_i f,Nrrl4r, �y- I'RODUGt4t NAME: _ RraRnahan Tnsuranr_.a Agoncy Inc PHONE f41 536-0536 N (413) 534-4291 100 Whiting Farms Road E-MAIL Holyoko, 341 01840 ADDRESS; INOUr1t O ArrORGIr�S a.VVCRwvc Ivwws INSURMAtAtlant±a Casualty 1Ntl tAitU INSURER B: —._._.. Sexton Roofing & Siding FNSURERC: P.O. Box 6327 INSURER n INSURER E; xoiyoke, MA 01041 INSURER CERTIFICATE NUMBER: REVISION NUMBER: THIS LS TO CERTIFY THAT THE POLICIES Of:INSUPANCE LISTED 130-OW I IAVC OCCN IODUCD TO T1 IC"OURED NAMM AWJYa FOR THE PQLIGT t ttttt]IJ INDICATED. NOTWITHSTANDING ANY REQUIREMtN I IL-HM OR CONDITION OF ANY CONTRACTOR OTHER r)C)A IMFhIT WITH RFGPFC7 7 i I wHir-•H'THIS Uttt1 It-ICA1 L MAY BE ISSUED OR MAY PERTAIN,THt INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM$, EXCL1J31 ON3 AND CONDITION3 OF$UCH POLICIES.L IMrf S SHOWN MA'Y tiHV t dtLN t1tUUC;tU 13Y PAID C-,LAIMS. ILNTR TYPEOFINSURANCE 1NSR WV0 POLICE NUMB PO MM D� IIIIATS A t3ENat`Lu mars Z1430031D7 s/�sJls 6125124 CAOr10GGUM1_'hrie a 1 000 000 rk GENERAL ERCIAL GENERAL LIABILITY DAIVIA GETORENTED $ 10Q QQQ LAIMS-MADE a OCCUR MED E*(Anyone person) $ 5 000 PERSONAL&ADVINJURY $ 1 000 000 AGGREGATE $ 2,000,000 0.1'L,1oOr%=^Tr LRVIITArr Liea rer, PRODUCTS-CDNPIDP AGG $ 1,000,000 7X POLICY P coT LOG rvronaoon�LrApuur,• a�l�� nrv�eumll a ANVAUTO - OODILYrNJURV(P—Nc.aw,) y --�— AD SCHEDULED rMS BODILY INJURY(Per P=ARni) $S HIREOAU70S WNEO PATOSS a , tDAMAGE er -- $ UMBRElLALIAB OMUR GCIIOOOURREN¢E a ra�.oa uwn CLAIMS-MAOE AGGREGATE $ DED RETENTIONS $ V,61IMS COMPENSATION wC 3TATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXEC(ITIYE Y N OFFICERMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ Ify es describe Under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY L"" DESCRIPTION OF OPERATIONS I LOCATIONS I VENCLES (Attach ACORD 101,Additional Ren>arts Schedule,if nwe space is regJ red) Roofing and siding contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED M ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORrLED RE PRESENTATIVE. C 1988-2010 ACORD CORPORATION. All rights reserved. Amp 74(9nl nlnsa The Mt1Dn I IV V, V. L V I J I L- L V I I T I n V U V V e l, L u 1 11 V V I r I M V L Irv, iVLJ i I/ I ,a v CERTIFICATE OF LIABILITY INSURANCE oA08108ruorYYYn ,,, 081aS12013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS OERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN T14E ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT, If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to tho terns and conditions of the policy,certain poticies may ieS)uirs an endorsement. A statement on thle certificate does not confer rights to the certif(cats holder in lieu of such endorsom ent(s). PRODUCER 04931 .001 %JpcT Universal insurance Agency Inc ex!: (50$)752-9333 �Qc.Na: (50$)757-9303 374 Ee)mont Street , Worcester,MA 01604 A.I.M.Mutual insurance Company 33758 INSURED ALG Construction Inc 24 Prouty Lane Worwistar,MA 01602 COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER:, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWINSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR.OTHER DOCUMENT WITH RESp�CT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PEKrAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TC ALL THE TERW, EXCLU51ONSAND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR "PE OF INSURANCE p POLICYNUM6ER Has LIMIT$ OENERAL UABILrIY EACH OCCURRENCE a COMMERCIAL GENERAL LIABILITY. DAMAGE TOR WED $ CLAIMS-MADE F OCCUR MED EyLP(Any cns pareony +S PER$9NAL&ACV INJURY 11 GENERAL A0 3RCGATE S EN'L AGGREGATE LIM17 APPLIES PER: PRODUOTS-COMPIOP AGG S F-II01-10Y OC aMIA081LIF LIABILITY MBINED SINGLU LIMITs ANY AUTO 60QILY INJURY(Per person) $ ALL OWNW SCHEDULED BODILY INJURY(Per acold6n0 S AUTOS HIRED AUTOS AUTOS OOANED PR RTY DAMAGE S AUT06 5 OMBRELLALIAe OCCUR EACH OCCURRENCE 3 eJ(CE96 UA9 DEATHS MADE AGGREGATE S yyi+�pp OED RETENTION S AT 9 pAND Eh7PLOYER9,`IAalLTi1' X T�'��1M(�s OET� O FICEWMEMBfiRIEXCl t1 CU r ECUTIVE N N(A VVV0°100-6017679-2013A 7123/2013 °712312014 E.L.EACH ACCIDENT S 1,000,0K00 A (niandkory Teen NuH)d E.L,DISEA6E•Ems,EMPLOYEE $ 1 1000,O10.00 DEtiGFZ1PTI0fV _9FERATIONS belaw E.L.DI$EASE•POLICY LIMIT $ 1,000,D00.00 DPSCRII}TION OF OPERATIONS I LOCATIONS 1 VEHICLES(Athch ACORD 901,Addlnonal R4merXs 60bMile,If more apace is required) CERTIFICATE MOLDER CANCELLATION Sexton Roofing 91$Hampden Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Halyake,MA 01040 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEWVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTBOFJ=REPRE52NTATIVE nnan TI Gk All rights resorvad. The Commonwealth of Massachusetts Department of Industrial Accidents rya Ems! Office of Investigations } 600 Washington Street tx Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name (Business/Organization/Individual): , L G L 1l L I lii n zo Address: (� City/State/Zip: Phone#: Are you an employer? Check the appropria e box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time). * have hired the sub-contractors 6. F-1 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 g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.1 required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 11❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13,7 Other comp.insurance required.] *Any applicantthat checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors 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: I I 1.( Policy#or Self-ins.Lie.#:!� �1�1 Jl )� n ��� Expiration Date: (� 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature ( AIM-41- Date: Phone#: I P 159 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: _ Phone#: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information . Please Print Legibly Hanle (Business/Organization/Individual): Sexton Roofing Co. Address: P.O. Box 627 City/State/Zip: Holyoke, Ma. 01041 Phone #:413-534-1234 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. X I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees , These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. E] Building addition 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.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ 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. $Contractors 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: Policy#or Self-ins. Lic.#: Expiration Date: 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 hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 4135341234 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'S/uoervisor: ]� ,� / Not Applicable ❑ Name of License Holder: (�/ SF� ,6'v A) / License Number Address Expiration Date Signature Telephone 9. Realstered Home Imorovement Contractor: Not Applicable ❑ Comoanv Name Registration Number f 0 - &.�c A/ 6/�Lv Xe Address /� Expiration Date T e I e p h o n >r��3 y —16T /- 5 �! SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.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....... 1l No...... ❑ 11. - Home Owner Exeitotion The current exemption for"homeowners" as extended to include Owner-occu i Dwellings of one(1) or two(2)families and to allow such homeowner to engage an dividual for hire who does not p ess a license, Provided that the owner acts as supervisor.CMR 780 Sixth Edition ction 108.3.5.1. Definition of Homeowner: Person(s)who o a parcel of land on w ' he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwe 'ng,attached or d ched structures accessory to such use and/or farm structures.A Person who constructs more than ne home in 2.- ear shall not be considered a homeowner. Such"homeowner"shall submit to the Building O cial,o form acceptable to the Building Official,that he/she shall be responsible for all such work Performed under th rldin Permit. As acting Construction Supervisor your presence e job site will be required from time to time,during and upon completion of the work for which this permit is ' ued. Also be advised that with reference to Chap 152(Work s' Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in D th)of the Massa usetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you un this permit. The undersigned"homeowner"c >fies and assumes responsib ity for compliance with the State Building Code,City of Northampton Ordinances, Sta and Local Zoning Laws and Stat of Massachusetts General Laws Annotated. Homeowner Signat r SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ©� Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [0 Siding[O] Other[O] Brief Description of Proposed _ Work: �t�G✓� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existina housina. com lets the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Numb r of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new constru ion. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. N Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes o. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below fi fished grade k. Will building conform to the Building and Zoning regulations? Yes No . 1. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 �'6 as Owner of the subject property hereby authorize Wo t ' c) to act o half, in all matters relative to work au rized by this building peribit application. Signature of Owner Date 1 ' v,) � (J o-e h 6 • , as Owner/Authorized Agent hereby declare that the statements td information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pain and penalties of perju 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 Setbacks Front Side L: R: L: R: 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 in ing ever been issued for/on the site? NO 0 DONT K W YES IF YES, date issued: IF YES: Was the permit r corded at the gistry of Deeds? NO ® DONT KNOW YES 0 IF YES: enter ook Page and/or Document# B. Does the site con ain a brook, body of water wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has permit been or need to be obta ed from the Conservation Commission? Needs to a obtained 0 Obtaine ® , Date Issued: C. Do any ' ns exist on the property? YES ® NO 0 IF Y S, describe size, type and location: D. Are here any proposed changes to or additions of signs 'ntended for the property? YES 0 NO 0 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 ® NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only F ^- City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability, Northampton, MA 01060 Two Sets of Structural Plans e 413-587-1240 Fax 413-587-1272 Plot/Site Plans c`► 1 Other Specify "A�ELI A -4 ONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: L4�YE 5c. ceC. � �L S�'���N•fl- x 2/1� � /�Griyd �`�� �Z /U 'ell Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: X - L � Jt �{ Name(Print) Current Mailing Address: y/33 2- 3 y Signat Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection d Q dU 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-1346 APPLICANT/CONTACT PERSON SEXTON ROOFING CO ADDRESS/PHONE P O BOX 6327 HOLYOKE (413)534-1234 PROPERTY LOCATION 45 ROUND HILL RD MAP 31B PARCEL 004 001 ZONE URC(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: STRIP& SHINGLE ROOF New Construction Non Structural interior renovations Addition to Existing Accesso Structure Building Plans Included: Owner/Statement or License 99689 3 sets of Plans/Plot Plan THE FOL LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Permit DPW Storm Water Management o it' e B jlding O icial 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. 45 ROUND HILL RD BP-2014-1346 GIS#: COMMONWEALTH OF MASSACHUSETTS MapBlock: 3 1 B-004 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-2014-1346 Project# JS-2014-002263 Est. Cost: $60000.00 Fee: $360.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SEXTON ROOFING CO 99689 Lot Size(sq. ft.): 311018.40 Owner: CLARKE SCHOOL FOR THE DEAF Zoning. URC(100)/ Applicant: SEXTON ROOFING CO AT: 45 ROUND HILL RD Applicant Address: Phone: Insurance: P O BOX 6327 (413) 534-1234 HOLYOKEMA01041 ISSUED ON.612412014 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 SiSnature: FeeType• Date Paid: Amount: Building 6/24/2014 0:00:00 $360.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner