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25C-227 91te -Commowawaldoyq-1� Board of Building egula30o1ns One Ashburton Place, Rm Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 08121/1971 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 Keep top for receipt and change of address notification. of 0 50M-04An5-x8c98 B oard of B Building Re a�ns an tan as I. re� One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 120982 Type: DBA Expiration: 3125/2006 ADAM.QUENNEVILLE ROOFING ADAM QUENNEVILLE P.O. BOX 612 SO. HADLEY, MA 01075 - Update Address and return card.Mark reason for chang Address F-1 Renewal ❑ Employment u Lost Card �i i STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION r Be it known that ADAM QUENNEVILLE 78 WE ST ' GRASW A- 03, � ,.... is certified by the Deparo#tY b P> ection as a registered HOME.IMPlpVENTT CO JTRACTOR i POW- ADAM QUENNEVH.LE ROOFING `rRANSr � y Effective: 12/01/2005 Expiration: 11/30/2006 -U70-euUJ 11 : .Jz ACM memll,cra Insurance 141J;Jbbvll 1/ 1 ACORD CERTIFICATE OF LIABILITY INSURANCE CSR 1 DATE 1109/YY 5 ADANJ -1 11/09105 R aucER THI T WIVIC"A 5 A MATTER OF INFORMATION a A 0 S UPON THE CERTIFICATE 'emi.11ard Insurance Agcy, Inc HO ES NOT AMENp,EXTEND OR %° Lyman Street ALT HE DED BY THE POLICIES BELOW, South Hadley MA 01075 Phone: 413-538-7862 Pax:413-538-7179 INSURERS AFFORDING COVERAGE NAIL# . vsuRED INSURER A: I NI,C1oaA1 F1Se i lYZiae Iaa. l'a Ada3p Quenneville Roofing INSURERS Arbella Protection Ins Co & Skiing IrAc $ INSURER C: Adam Quenn vide Roofing Inc AIM Sritual Sasa:aace Coapmy P 0 Box 612 INSURER D. South Hadley MA 01075 r INSURER E: OVERAGES t�0 IA V E EIEfN ISSUED TO 7HE NSF ANY CONTRACT OR OTHER DO IN, CE A BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERRIS.E�(C!USK)NS ANO CONDIT IONS OF SUCH 'ILICI:S.AGGREGATE LIMITS SHOW N MAY HAVE BEEN REDUCED BY PAID CLAIMS. ItiS!i 1 T'I�N '.. T N TYPE OF INSURANCE POLICY NUMBER DATE WM/OOIYY DATE MMIDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1000000 A X COMMERCIAL GENERAL LIABILITY 72LPE703070 06/2/05 06/23/06 PREMISES(Eaocourence) 1 1350000 CLAIMS MADE a OCCUR: MFO EXP(Any one person) $5000 X Contractual L]ab. PERSONAL&ADV INJURY 51000000 X Waiver of Subro. GENERAL AGGR=GATE s2000000 GENL AGGREGATE LIMIT APPLP°S PER: i PRODUCTS COMPiOPAGG s2000000 POLICY PRO ------ — --- JECT LOC – AUTOMOBILE UA8ILITY COMBINED SINGLE LIMT ANYAUTO 54906400002 11/01/04 11/01/05 'Ea accident) $ ALL OWNED AUTOS 54906400002 11/01/05 11/01/06 i BODILY personURY S 250000 SCHEDULED AUTOS (Per person) i X HIRED AUTOS BODILY INJURY 5 500000 X NON•OWNEDAUTOS (Paraccident) PROPERTY DAMAGE i$100000 (Per acadenl) GARAGE LIABILITY AUTO ONLY-EA ACCIUENT I$ ANY AUTO EA ACC S OTHER THAN AUTO ONLY AGG S EXCESSIUMBRELLA LIABILITY I1 EACH OCCURRENCE S OCCUR Fl CLAIMS MADE {AGGREGATE S I{ I r S DEDUCTIBLE RE'T'ENTION $ I S WORKERS COMPENSATION AND X I TORY LIANTS ER EMPLOYER5LIABRITY AWC7012861012005 04/29/05 04/29/06 LEACHACCIDENT s 100000 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMSPREXCLUDED? AVOC7019733012005 09/16/05 09/16/06 E.L.OISEASE-EA EMPLOYEE $100000 x ycs,describe under SPECIAL PROVISIONS below E L DISEASE•POLICY LIMIT S 5 00000 OTHER ----- 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS This copy of certificate is for use by sales reps only. If job is obtained Please call for a new certificate that will show the property owner whom the .cork is being done for, this will then become a legal document for proof of insurance. CERTIFICATE HOLDER CANCELLATION ADAMQUE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Adam Queanevi Ile Roofing & DATE THEREOF. 941LO�XlygyOR TO MAIL DAYS WRITTEN Siding Inc & Adam Quenneville NOTICE TO THE _1�[f�i_.JJEO 7\T\{{$���£�//THE.EFT,BU T FAILURE TO DO SO SHALL Roofing Inc PO Box 612 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR South Hadley MA 01075 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE RIA Agency Financed Accounts. ACORD 25(2001108) ©ACORO CORPORATION 1988 I QUENNEV�LLE ELK4. MOO IF I N G The Premium Choice` 78 West State Street, Granby, MA'01033 We Are Licensed 1.800-NEW-ROOF • 1.800-4-SIDING Insured Email:info@1800newroof.net Website:www.180onewroot.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 RRC.38710 (Proposal Submitted To: Date Phone#'s MT. 5'%�tle_ �o �;°osv H: S& ©/ Cell: Street Job Location U- Al nwt- free Y`__41Zd::4 ;� s 7 City,State,Zip Code Special Requirements PIAfS Proposal to furnish and install the following ❑ Re-Roof R1 Tear-Off ❑ Gutter Complete Roof Preparation 2 Home exterior to be protected by tarps and plywood _ Da Shrubs, landscaping, trees to be protected from damage Entire 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 [} Deteriorated existing decking replaced at per sq. ft. 8 inch metal drip edge installed at eaves and rakes ❑ 5 inch for re-roof only ( New flashing will be installed where necessary(see Special Requirements) ® We shall acquire all appropriate permits etc.for all roofing work Complete Roofing System [� ELK Leak Barrier installed at all eaves to protect from ice dams (and meet codes in the north) ELK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas 15 pd. reinforced underlayment installed over entire decking Shingles: c ELK Prestige®Series 2�30 year El 40 year [1 50 year Color A,,'.k i,4 S kk Nailable ridge vent will be installed ELK ridge cap shingles Warranty Options: &?I—We guarantee our workmanship for 5 full years ❑ ELK10-Year Umbrella Coverage Limited Warranty upgrade. ❑ ELK15-Year Umbrella Coverage Limited Warranty upgrade. ��--- =VISA . r We Propose hereby to furnish materials and labor complete co d a a ith above specifications for the sum of: ` Total Sale Price $ D 1 �� } `�J Down PaymeT$ _S Upon Completion $ UV U ACCEPTANCE OF PROPOSAL:The above prices,spe I'fidatio sai d�are satisfactory and are hereby accepted. You are authorized to do work as specified.Payment w be 1/3 dow on signing,and balance due upon completion. Unpaid balances shall accrue with interest at 18%per ann . urchaser(s)will pay for all costs,expenses and reason- able attorney's fees incurred by Adam O enneville Roofing and Siding,Inc,to recover any sums due under this contract. Date: Signature: _ °`� Phone# �/ Date: T_)S Salesperson's Signature:- Estimates are honore 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 and Sidings will not be responsible for debris or dust in the attic or storage areas. n �Si1ANJlO �. 6 � �S�iSlAthilSrtl!• "t cm DEP!'.RTME-Nr OF BUILDDJ G 1NSPLCTIONS 212 Main Street ' Municiprtl Building NTorthampton, Mass. 01060 , WORKER'S COMTENSATION INSURANCE A.FFjDA'ViT i, (liccrs°Jrfrmiitc.) \vith a principal plact of businesshcsidenc_ al: PI) - _ Y (SiTC�(/6ty/iiaT_2/7�p) do hereby cer'Zy. unc+ :r the pz ns ,tild penal tics o perjury ?hi ( am an employer providing the follo\vim: •.vor'Ixr`s comncnsation coverage for Iny employees worEng on t±Iis job: J`1 u 4vc uj t 7QJ a oo�T _ y `a it v (LnSG=Coney) (Pc-ii c;Number) (Ea pirtioo Date) ( ) r am a sole proprietor, general c::)ntractor or one) and 'Have 'tlireti the contractors Este-' beio -,-,to h_7,vz,_ the lode' ^^u�g FJOrkwe s CAMpeII L*.o i p^v!1G:C5: (Name of Contactor) (I`nsu mncc Corppa y/Poh Nuinbcr) Datc) (Name of Contmctor) -- (7nsummcc Cou nv:},/Pc.hcy Nunbr) (E:uir Lion Dale) (N'ame of Contractor) — (Insumacc Cot;;;aziyi?0l;e: Nu1nb�Ir) ,` ,�uoa Date) - (Name of Contractor) —- (IDE'umncz Comm ;v/policy NllmCJ._S) - (Exni;:lion Date) C 1 iliI7 at �U1C 1?iUprletUi' i!Il`1 hi?VC [IO OI:' '::U!'l iii loi nie. 1 Tin L! home 0\'.''?l�r tiCrlCrnlln^ ,I( i_'i '+': ;C I cci cr,:pair.,„,}:im:d"nil o c! not ante them three L 2ju in wadi SC lii.::+�::+Z::'rc:w Q'ou L�:�-:•:-.^�zr�s-rice_rt tFICC:e a:e ex:<L'G7.ra1! cr•::::i:::c a tt. e-Mployaz urv:_r aw..%V06-,ees mT• icn:tc(GL?512--a I(Sl;,_r;:r:iia:by a hat:, o++-rr for a lx�_ze or p:rr.::::-:r.�..Zncc t:r legal rtatur of ea amployor uuu'er d:a works,,for n>C___ion AcL I undc-rtand tEt a cepy of thl,rtatm,=ruy bo fo.-nwde,i to tin IY_tiartavn:of Ind.utrial An6dm:1 Qirioo of l:::avv>:e for tlx °O"� �riratioa and that Gilttre to taaUC cov r_r-ut•.d.-: eaio 25A of:YGL,152 stn lead to kx imposition of r.'�irl peraL:u consisting of a fuse orup to S i mo.00 ecsJcr ir,: riy�zx: of::p to cn:1`.0 a;,j civil pcmj let in dc fimn of n Ste',Wm.0,ds ¢; a ]t>✓o(T 1 U�_OU ►day agmi>•.1 m- Fuc dq;uutriral u,c utl y i - loin}!Numtx.r l,qt t C:.._.....__. .............._ -....._ .._ ,',, air.. �____ -`---'--- I 8 1 Licensed Construction Supervisor: Not Applliccable ❑l Name of License Holder :�11Y1 \ � �V1C�Vi�IP CS V 1 7 6G U License Number Po CL "� �� rte- �� - og laI 1 A00 Address \1J Expiration Date cz IVS s3G scf5 Signature Telephone Not Applicable ❑ 1 0 Cl Company Name Registration Number Po b is &,ik k JL �b v lv,i 31 a5 l awe Address U Expiration Date Telephone SECIOf `0�4�fE�t2SkC0t111P1rNSAT10N NSURANGE AFFIDAVIT(M G11 c 152, § 5r0 6)) i , 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....... f9�� 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 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 acecptable 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 froin 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 U.5. :;. - - .. _efil(vMi%laF1.?•YYSP.FFS?.!.'3n .r. PGNWI:h+r=r l..!^I^4.�i�2. �• .- - �:"rf�""�Y.V':: ..wY.::.: .t+-,..`.^n:7sY.mV;' !r''.�`•...'?n�l!i'..-rF ,-�A1 .:_. -.:5V'kx ``t' ��Yi: -..} s iM 4'.. 'Irn e .. �.... !(r5i�-5.{v.,. .'vZ•-+a+n uP .:.w.. OMR:._:•�!vr. w..n.:,_ 4 :I¢lR-RN New House ❑ Addition O Replacement Windows Alterations) ❑ Roofing ®'-� Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ) Siding[ ] Other [ ] Brief Description of Proposed Work: Rem;, SwAplrc OOA �Ic R '�nc, ,�n�, r 1 r idlCia 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 6� o der 8 i on"�a> stirs rho s-� ^O,.,.'-' g .r 0nnp�e`�e h`�rLlowtrrrrg 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. bimensions 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 . 1. Septic Tank City Sewer Private well City water Supply PTO BED+'COMP.EEMED 41 YHE1 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' Ln- A ➢ryA QveV1V1evcl(�' y as Owner/Authorized Agent hereby declare that the statements and informs on on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. in Print Name Signature of Owner/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: City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413-587.1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITE INI=OWgTION 1.1 Proaerty Address: St cue aP y �a�lln01' -- 5 SECTION 2 - PROPE 1�YI11E RLY 0R$Fi14PlAUTHQRIAEN7 2.1 Owner of Record: t ohi n S on .�q `Ly Name(Print) Current Mailing Address: y 3 9011 Telephone Signature 2.2 Authorized Agent: .d Q II �cb Pt? U 1), so,st'�t No3 AA oi075 Name(Print) Current Mailing Address: &-/ 131 536 v5255 Signature Telephone _ SEC-TtON 3 EST111?174"7ED CONSTRUCTION CQST`S ' Item Estimated Cost (Dollars)to be Official Use©nly completed by ermit applicant 1. Building (a) Building Permit Fee I -2 . :JU .. 2. Electrical (b) estimated Total Cost of Construction from: 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check,Number This:Section For Official Use Only. Bulldl.ng P er N4mber Date 1ssued: Signature: Bw1drng:Goissioner/inspector of Buildings Dater mm 49 WALNUT ST BP-2006-0778 GIs#: COMMONWEALTH OF MASSACHUSETTS MW:Block: 25C-227 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0778 Protect# JS-2006-1188 Est. Cost: $10575.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Adam Quenneville 120982 Lot Size(sq. ft.): 4878.72 Owner: ROBINSON STEPHEN Zoning:URC Applicant: Adam Quenneville AT. 49 WALNUT ST Applicant Address: Phone: Insurance: P O BOX 612 (413) 467-2426 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:21312006 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF INCLUDING FLAT 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 2/3/2006 0:00:00 $25.006443 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo