25C-235 (3) Board of Building eRM lations
One
Ashburton Place, 1301
t 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
Keep top for receipt and change of address notification.
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Board of Building Regula ions and Standards
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Registration: 120982
Type: DBA
Expiration: 3/25/2008
ADAM QUENNEVILLE ROOFING
ADAM QUENNEVILLE
P.O. BOX 612 --
SO. HADLEY, MA 01075
Update Address and return card.Mark reason for cba"L
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STATE OF CONNECTICUT.+ DEPARTMENT OF CONSUMER PROTECTION i
Be it known,that
i ADS QUENNENM I F
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is certified bY tbie Iegartlit > ectiort as a registers
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HONE.IMF yE .CONTRACTOR ,
i .ADAM QUEM4Evu ,. .
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'Effective: 12/01/2005
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Exuiration: 11/30/2006
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A ORD_ CERTIFICATE 4F LIABILi1'Y INSURANCE DATE(IrIfDD1YYYY)
Q 06/27/06
GOUGER THIS C IFICA7H IS ISSUED AS A MATTER OF IyFOR11ATION
ONLY PON THE CERTIFICATE
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ham-.413-538-7862 Paz.-413-538-7179 INSURERS AFFORDING COVERAGE NAICIIF
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OVERAGES
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ANN FWMIREMBR.TERM OR COMJWM OF ANY COWpACTOROTHFR DOCUMENT WITH RESPECT TO WHICH THIS CEHN MYE MAY OE ISSUED OR
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TR TYPE OF INSURANCE FOuGY NUMBER GATE MWD Wom DATE=4 r LIMITS
GEMEtALLMDUTY EACHOCCURRENCE $1000000
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CAMS MADE Q OCCUR MEDLAPtartyakpWN) $5000
PERMINALSAOVINJURY $1000000
GENBtALAGOREGILTE S2000000
GENL AGGREIGATELUTAPPLIESVIlft PRODUCTS-cOMP10PAGG $2000000
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CERTIRCATE HOLDER CANCELLATION
'tOTl�g'i` SHOULD ANY OF THE ABONH DEHCRIBED FOLICIBS�CANCEtJJiO BEFORE TIE E�lRA
DATE TH8 EAVORTOIIIAU. 10 DAYS WRITTEN
NDAfE T TO W".MY FAIWR6T000 SO SRAU.
WOSE A KM UPO/ITHE INSURER.ITS AGENTS OR
REPRESENTATIVES.
AUTIREPRF.BENTATNE
RTA Fiaaaced Bcco�uni:s:•�.
ACORD 26(2001108) j OACORD CORPORATION 1988
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1-S00-1VE' 1ZC:)4F 1-SOO-A -SIDING
Now W4.- Do Wladows!
160 Old Lyman Rd.•South Hadley, MA 01075 •Tel (413)536-5955•Tel (800)639-7663• Fax(413)536-1448
MA#: 120982 CT#: 575920•www.1800newroof.net
CUSTOMER: BERNARD GOLOB JOB LOCATION: 183 BRIDGE STREET
ADDRESS: 183 BRIDGE STREET NORTHAMPTON, MA 01060
NORTHAMPTON, MA 01060 CONTACT:
HOME PHONE: (413)586-7232 FAX: (413)478-5506
WORK PHONE: DATE: 6/12/2006
SCOPE OF WORK: Shingle Roof 1
1. Protect customer's siding, grounds, &landscaping with tarps and plywood as needed,
2. Remove 1 layer of existing roof to wood deck, renail and resecure decking as needec.
3. Replace any deteriorated deckingat an additional cost of$65.00 per sheet, material and labor.
4. Remove any bad step flashing and replace.
5. Install F 8 aluminum drip edge metal on all eaves and rakes.
6. install Ice&water underlayment on eaves, valleys, and around all roof penetrations in accordance with all building codes.
7. Install# 15 lb Felt Paper over exposed roof surface.
8. Fabricate and install new step and counterflashing at base of chimney.
9. Install Elk Prestique Raised Profile 30 ye shingles in accordance with manufacturer's specifications.
10. Color of roof to be customer choice. (ea ujcet,
11. Install Elk Seal A Ridge w/FLX Hip and Ridge Cap Shingles on all hips and ridges
12. Install Elk RidgeCrest ridge vent on ridges from end to end of main structures.
13. Grounds will be cleaned daily. Gutters in iling will be completed at the end of the job
14. Roof to carry Elk's 15-Year Umbr Coverage Limited rranty Upgrade
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A.sv,.;,4 fs% f top ifc4� . E �(L°
CONTRACT PRICE: $4,572.36 .,t -'
Vie` B dt7Terms d�C nditions
I "
4' 6
Payments are to be made as the work pr ses,as follows
All material is guaranteed to be as specNled. All work to be completed in a workmanlike manner according to standard practices. Any
alteration or deviation from above specMcation involving extra costs wiN be executed only upon written orders,and will become an extra
charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,
tornado and other necessary insurance. may cancel this proposal if N is not accepted wWn 30 days.
RESPECTFULLY SUBM6 ED,
By. ,*;� ' Date:---
i y
Acceptance of Proposal
The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will
be made as outlined above.A 1% (12%APR)late fee will be charged on all unpaid balances over 30 days.In event of default by buyer,buyer agrees to
pay all costs of collection including reasonable attorneys fees in addition to other damages incurred by seller. r
Signature: _ Date of Acceptance:
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UEPl�tZThlEtr-F OF BUIIDP) G INSPECTIONS
212 Main Street ' Municipttl Builtling
Northampton, A1nss. 01060
worzj='S COMTENSATTON INSURANCE, AFFMAVILT
i V� ��iVSLv _--
-- - (lictirs°:1rc.Illatcc) __
principal ptacc of buslnesslre_s dencc _ ( q p
-� (Strc�tic;t•<•i:,.=rN��;�).. .^ _ __
do 11cr eby Ccrl i)- t2il" l- UIC- On:115 ::iiu Pc la!L iCS
(\,)/"1"am an' cmpioyer pmvldlnl the f011O'.:'i1?C '•','Ork-cr`S c0117pn5auon CO!'CC:' C `or my
ettlpioyces wo6drig (in this job:
�a rtM � � al,t�/t��
(Lagu 31=CAIIr [I}'} (Poi:c:Nu-r-]t)ct) Data)
( j I am a sole proprier-or, l.enPra con—ccr 'r.on eo"vne- ,ci cie one) and, 't;atie nireci
the contrac:torS lzstei beiovi 1'.a.,, i1]? id1 '.Y� Or kQ S CSJ JeP4 Or t id!C:cS:
(Name of Cor u'.lctOr) Datc)
(Name of contractor) Com:,az •(Pchcv Numt-zr)
(Nagle of Coninc.or) (Ins-i mnc Hate)
(Name of Contrictor) —- (Ins tatlG Comr VIy!Policy Numtz) - (Exri::tic Date)
('t LlC�1 d.(S-{IJCY:1�f::YL:......... '.7 ti.:..�.. ....'Y:'.a....•. ��._..-. � Ali.`:t='.... ..•1
( 1 ml at ,:Qlc propnc,:O: i'..ld h v`, no 011 „'l:!" ii`' for i11C.
} 1 a,m t? 'home i,— '.,, .., i•-i" 1
No,rl::,.Ic.0 be a:rxrc L-,&! -% nlc =V-r.:Cim c:tc,air o e. n
not utoce than throe uniu in t:t dh a a; :.-c a.t
c: ploy=-3 une"the tvc i:rts cc -:c:_ire a r.(rL!52 •!;511,n,:Gca:ie;6y s F.n aco:, w:cr e bccu ct
logil rictus of"ecnployer uuurtLo Wokcr'x Cot{xrsation .�L
I unda.^itnnd th, s copy of thi,cia.ta,• ,r: y bo fo,w,,rd l to t!n of i::a.--:a for 11.
oovert,ge vc�iatr-tiw and that f_iluxc to s�.—tre :cc',, <.25A d AlGL 152 ew lead to the impaSL60 t of r= pn.& ics
consisting of a fux of up to S 1 SOU.M-nT,Y i,: riv=��._of::p to cn:}:; e:.j civil xrullia in d-C f+Tn er n Sic,':,''=i-n
f1 m of S100.00 a diy«rzinfa mz
Fear elq+um:A uao oil y
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S€ ON C*® ST�tUCilO[VSt=RV1Gf5
8 1 Licensed Construction Supervisor: Not Applicable O
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
Not Applicable ❑
Company Na�m}e,�yy{{��,�� Registration `}Number
11j.0) 00 L-wo an �� l)--1s -OAIDQ�
Address Expiration Date
c.CVI dto� � Telephone L ht S3GSq&-
S C'f10� 0 iN RKE�tS C,OMP�NSA7'ION 1NSU,RANO" FFI DAVIT(M..G z. 15;2,
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....... L4/ 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. 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
w[4 F'2.ar-vxtf. � k
` F bf DV .RK' ckx it.:a "I+ca'b ' .
New House O Addition O Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. O DemolitionO New Signs [ ] Decks [ ] Siding( ) Other [ ]
Brief Description of Proposed Work: pey"M exasN�Vno Rc loSa nett
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
' �:i��ronfia�rsti�g:�r"�singc°`"" prte`°feh`e `k1�owcng
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
ET( 0RI :ON TO BE jb&P�tEDNHEN
OTORA�PLIES°FORBU1LDtN� PERNfIT Y^�
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. a1-0_ ZGd4 f as Owner/Authorized Agent
hereby declare that the statements and informatid on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
A&t, l�-P
Print Name
4 21 - ILI- off
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
arkin
#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
l�� i; r h�Buill�iing Department
21,2 Main Street
I � ��1�,,
!Room 100
L��"C1 .rth-M'npton, MA 01060
phone 413.587.1240 Fax 413-587-1272 I
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION .1 SITE fNFORM.A
c�jlj,hls sect o �o betcompletDdb ff ceg� r
1.1 Property Address:
lFP
,LI t�-0istrici' _CB i icE s
SECTION 2 - PRGPER ' �IV
ON gG
.ERSHtPJAUTHQRIZED ENT
2.1 Owner of Record: f p
Name(Print) Current Mailing Addr ss
� F
Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Addr ss:
s gs.�
Signature Telephone _
SECTION4-3 EST.INIATEp CONSTRUCTION';. TS:
Item Estimated Cost (Dollars)to be Official Use Ortly
completed by ermit applicant
1. Building (a) Building Permit Fee
2. Elec,rical (b) -:stimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection _
6. Total = (1 + 2 + 3 + 4 + 5) t�57 -j Check Number
This Section For Official Use Only
Building-Permit Number: Date issued:
Signature: _
Building Commissioner/Inspector of Buildings Date
BP-2007-0176
CIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2007-0176
Project# JS-2007-000266
Est. Cost: $4573.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Adam Quenneville 120982
Lot Size(sq.ft.): 19079.28 Owner: GOLOB BERNARD M
Zoning:NB Applicant: Adam Quenneville
AT. 183 BRIDGE ST
Applicant Address: Phone: Insurance:
P O BOX 612 (413) 467-2426 O Workers
Compensation
SOUTH HADLEYMA01075 ISSUED ON:811512006 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 8/15/2006 0:00:00 $25.007235
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo