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05-029 (7) J a4 T V, QUENIVEVILL.E! �',�,�- R(I-`'�� ROOFING & SIDING, INC. ,,.,, r-) 160 Old Lyman Road, South Hadley, MA 01075 r ' W Are Licensed 1-800-NEW-ROOF 9 413.536-5955\`-- __. --� Insured Email:info @1800newroof.net Website: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 ! Proposal Submitted To: / ( Date 2 c 1ov Phone#'s Work: , c �YvlPc �'f�r�`�r. ,(( H: t(I , ��. 51c%y2 Cell:t(t `'�2 !` e Street E° Mail To: City, State,Zip Code Special Requirements i jl A Proposal to furnish and install the following ED Re-Roof [ J Tear-Off ❑ Gutter cv- �4-��� LP I,- .7 s �i i' Complete Roof Preparation R Home exterior and landscaping to be protected Entire existing roofing material to be removed to existing decking, including flashing, etc. jSite to be cleaned everyday with roll magnet debris removed at project completion © Deteriorated existing decking replaced at$239 per sq.ft. FA White/Brown 8 inch metal drip edge�installed at eaves and rakes ❑ White/Brown 5 inch for re-roof only I New flashing will be installed where necessary(see Special Requirements) /p Install new pipe boot flashing I �]/ New lead counterflashing to be cut into chimney '© We shall acquire all appropriate permits etc.for all roofing work Complete Roofing System GAF-ELK Leak Barrier installed at all eaves to protect from ice dams (and meet codes in the north) GAF-ELK Leak Barrier installed in all valleys, around penetrations,and chimneys to protect critical areas ❑ GAF-ELK Leak Barrier installed at all Rake Edges JZ Install 15 pd)felt/Synthetic) underlayment installed over entire decking area Shingles: / r ({�(�( Shingles ❑ 25 year 130 dear-❑-50-year. Color Continuous GAF-ELK Snow Country Ridge Ve wili`b`e'tnstai+ed j P' GAF-ELK ridge cap shingles ! Warranty Options: f ] We guarantee our workmanship for 10�fu years (see ot�.r vYarran�jr cw2ra e) H N K � e,� We Pro h reby to furnish materials and lab r-co lete in accordance with above specific ons for the sum of: j� v. X 8 4 to, (� J \\ Total Sal6.Price U� Down Payment � y��� Upon o pletion $ ACCEPTANCE OF PROPOSAL:The above prices,\specifications a re satisf ctory and are hereby accepted. You are authorized to do work as specified.Payment will be 1/3 down upon signing,an alance due upon completion. Unpaid balances shall accrue with interest at 18%per annum. Purchaser(s)will pay f all costs,expenses and reason- able attorney's fees incurred by Adam Quenneville/Roofing and Siding,Inc.to recovs any sums due under this contract. rG Date: ! m �' Signature:, Phone# Date: Ll,�,IC, Estima4or's Signature: Estimates are honored for thirty(30)days from above date I 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 oar o ul, 1119 egul ions a tan ar s One Ashburton Place - Roo 1301 Boston, Massachusetts 0 108 Construction Supervisor L cense License CS: 70626 Restriction: 00 Birthdate: 8/2111971 Tr# 3712 Expiration: 8/21/2009 ADAM A QUENNEVILLE 160 OLD LYMAN RD S HADLEY, MA 01075 Upda a Address and return card.Mark reason for change Address Renewal E] Lost Card DPS-CAI to 50M-07/07-PCB490 r = Boar o uil�dirig� egulat ons a 'tan ar s One Ashburton Place - Roo 130.1• Boston, Massachusetts 0 108 Home Improvement--Contractor Registration Registration: 120982 Type: DBA Expiration: 3/25/2010 Tr# 264937 ADAM QUENNEVILLE ROOFING:, ; ADAM QUENNEVILLE 160 OLD LYMAN RD SO. HADLEY, MA 01075 Update Address and return card.Mark reason for change. ED A dress' E3 Renewat Employment Lost Card DPS-CAI Co 5OM-07/07-PC8490 _ _ BC 1t k110Wri tilt r :ADAM-QY71V E 160 i` R' ' . s.. t S b 52632 V i I t�. IMI_P L `T O ', ACTOR i Re 2� AMS 1 lug k AnA Qi7E�ii�1EV 1�,L 1� 4F� TC ,t 4;f Z/ 4$ T + I I 1'7 r � •d .Lrvlr•�-K� '���"�d'�+"'`�'� �r ''�"�W,r;i--.ya-r� tr. .b i:: . . . . . • w w�urrr�e+arrre e e e s A•�"A. t'�'�"!�°i... ItA Ua urq r ljuG UV/ Ul/ ---- Aug-01-2008 01,42 PM , Remillard Insurance 1.413-538-60'10 1/1 Mom— . CERTIFICATE ®F LIABILITY INSURANCE s of 1/08 os NCE csR xl DATE AnAMQ-x PRODUCER THIS CERTIFICA E IS ISSUED AS A MATTER OF INFORMATION ONLY AND CON RS NO RIGHTS UPON THE CERTIFICATE Remillard Insurance Agcy, Inc HOLDER,THIS C RTIFICATE DOES NOT AMEND,EXTEND OR 79 Lyman Street ALTER THE COV RAGE AFFORDED BY THE POLICIES BELOW. South Hadley MA 01075 Phone: 413-538-7862 Fax:413-538-7179 INSURERSAFFOR INGCOVERAGE NAIL# INSURED INSURER A: AW HU mat Zaeuraooe Qenpany INSURER B: Travelers Ins. Co. Adam Que=eville Roofing & INSURER C: Scottsdale Ins Co. siding Inc 160 Old Lyman Road INSURERD: South Hadley MA 01075 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED W HA N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY P RIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CO ON OF ANY CO CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ERTIRCATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE ORDED BY THE POL ES OF HEREIN IS SUBJECT TO ALL THE TERMS,EXC USI01�5 AND CONDITIONS OF SUCH POUCIES.AGGREGATE LIMITS OWN MAY HAVE BEEN EDUCED BY PAID CLAIMS. LTR NSR TYPE OF IN URANCE POLICY NUMBER I DATE MM/DD .DATE MM/D0 LIMITS GENERAL LIABILI kMAE EACH OCCURRENCE $1000000 C X COMMERCIAENERAL LIABILITY CLS1517923 06/23/OB 0 /23/09 PREMISES(Ea oocurence) _ $50000 CLAIMS XX OCCUR MED EXP(Any arm person) 5 5000 PERSONAL L ADV INJURY $1000000 GENERAL AGGREGATE 5 2 0 0 0 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER:' PRODUCTS-COMP/OP AGO $2000000 POLICY JECTT 7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 10 0 0 0 0 0 B ANY AUTO BA745OL94607 11/01/07 11/01/08 (Eaamdent) ALL OWNED AUTOS BODILY INJURY 5 Fxx SCHEDULED AUTOS (Per parson)HIRED AUTOS BODILY INJURY y X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Par accident) GARAGELWBILITY "' " ' AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGO S EXCES6NMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION 3 5 WORKERS COMPENSATION AND k TORY LIMITS X ER- A EMPLOYERS'LIABILITY AWC7012861012008 04/29/68 1/29/09 E,L EACH ACCIDENT 61000000 ANY PROPRIETORIPARTNERJEXECUTTVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 51000000 If qqas.deaalbe under E.L.DISEASE-POLICY LIMIT 5 10 0 0 0 0 0 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/.EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PRON'ASI.ON S, V CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATETMEREOF,THE SSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE:TD'THE C FICATE HOLDER NAMED TO THE-LEFT.BUT FAILURE TODD 50 SMALL IMPOSE NO 0 I • N OR LIABILITY or ND UPON THE INSURER,ITS AGENTS OR REP E AUTHEB - Ste hen E. Radon ACORD 25(2001108) 0 ACORD CORPORATION 1998 x� �) Office of Investigation -i 600 Washington Stree Boston MA 02111 www.mass.gov/dia Workers' Compensatio n Insurance Affidavit: Builders! ontrac ors/Electricians/Plumbers Applieanf Informatiop Please Print LeLibly Name (Business/OrganizadonMdividua)): OLM alicnrleluAt (7y) 1t1 Address: t- City/State/Zip- , P- C31Q ^ Phone#: HIS �53L Are yo an employer?Clieck the approPria'te bax: ' Type of project(required): I. I am a em lover with l 4. ❑Tam a general contracto and I P �� 6. ❑New construction employees(fiill.and/orpart-time).* have hirad the sub-con ctors 2.❑ I am a sole proprietor or partner- listed on the attacbed sh et.t Remodeling ship aAAd have no employees These sub-contractors h ve 8. [Q Demolition worlan� for me in any capacity. workers' comp.insuran e. 9. ❑Buil' ing•addition [No workers'comp.insurance 5. ❑ We area corporation' Bits required.] officers have exercised it 10.[3 Electrical repairs or.additions 3.❑ I am a homeowner doing all work . right of exemption per GL 1 LEI Phimbing repairs or additions myself} [No�HOrkers' comp, c. 152, §'1(4),and we h ve no 12.[1 loof repairs insurance required.]t employees. [No work" l3 ❑ Other co]np.insurance rpquir d.] ;Any'Arty applicant t§at checks box#1 must also fill out tie section below showing their workers' ompensation licy information. rs o submit this affidavit indicating they are doing a1J work and then hire outsi c contraaM ust subfnit a new affidavit indicating such.• . $Contractors that1choek this box must attached an id&liooa]shi=t showing'•the.name of the s atraciois'� ¢thou we comp.policy Wormatioq. I am..an ernptpyer thiat is providing workers'compensation insurance for y employ es.'Beldw is'•the policy and job site information. 1 Insurance Company Name: 110' `,S Policy#or S"lf--ins.Lic.#: �� �� ��•iaQO� Exp' lion Date:_ Lt_ q- CF. Job Site Address:, O (r� City/S telzip: /�. . +1u� Attach a copy of the workers' compensation policy declaration page(s owing th policy number and expiration date). Failure to sequre coverage as required under Section 25A of MGL e. 152 c lead to a imposition of cr'irilil�al penalties of a fine up to$111500.00 and/or-ono-year imprisonment,as well as civil Pmalti in tho fd 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 tatement ' ay be forwarded.to the Office of Investigations of t1•ie DIA for insurance coverage verification. Z do herebyetlifyi under pair and penalties of perjury that the info n pr ed above is true anrl'cbrr 14r, ` Si�ature: Phone#: yt5; OffSciol use only. Do not w tiYe in this'area, to be eomplefed by city o town offl L City or Town: Permit/Li ease# Issuing Authority(circle one): :. 1. Doard of Health 2.Duil ling Department 3. City(Town-Cl' 4 Electrica Inspector: 5.Plumbing lnspector b. Other" - - Contact Person' one#• it 8 1 Licensed Cons ruction_ Supervisor: Not Applicab e ❑ Name of License Holder Inc. — License Number Adam Quennevi►►e Roma load Q 160 01d. - 75 _ Address South►ruduloy, Expiration Date Signature Telephhoone F3et��fiQ e o rrt ttn nitCern ra tQt Not Applicable ❑ Com2any Name Adam Quehnevole Roofing 51 t Registration Number 1160 Old Lyman Road :2— �!� / _a1_.. 01075 Address Expiration Date Telephone £'s .T.F+.'. rJ''' iF " :dn•'; Ji?aN,1,�II'; n:x ',st'� .,:I_ �.�.:`;•..=.;�'2 n•.. ra.1:},d:�i�!::b:.. .4 R ii`` A' IT+IVI �fL:-.:...,,.� ,,,., ..�� ri.. — _ .,,Tip.. -�C... : : Workers Compensation Insurance affidavit must be completed and submitted with this application. Failu e 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 Dwellin s of o e(1) or:two(2)families and to allow such homeowner to engage an individual for hire who does not possess d license, rovi ed that the owner acts as suaervisor. CMR 780, Sixth Edition Section 108.3.5.1. Derinitiori 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 homy;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 S.uOervisor your presence on thejob 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 (Lial,ility of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated, you m iy be liable for person(s) you hire to perfonn.work for you under this permit.. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Bu lding Code,.City of E. Northampton Ordinances, State and Local Zoning LBWS and State of Massachusetts General Laws AT notated. Homeowner Signature i -�H_?x- u='-5;3 ''n.� d• ' rJ:Nai�'�I��r In w. _ �'!I�i's�t''r !i� I^' � 'a � =ir I New House O Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ J Siding[ J Other [ ] Brief Description of P-roposed Work: 00 Vz 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 r-ONE "M n h 'I.N-9171>I a. Use of building: One Family. Two Family . Other. b. Number of rooms in each family unit: Numberof 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 -Noriberbf each g. Energy Conservation Compliance. Mascheck .Ene,rgy 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 ce'llaf floor'below finished grade k. Will building conformao the,Building and Zoningregufations?. Yes No I. Septic Tank City Sewer Private well _ City water Supply--_ " R. � ' DP" Mr }l . A tR as Ow er of the subject property hereby authorise _ to act on my behalf, in all matters relative to work!authorized by this building permit application. Signature of Owner Date l-7 fl. Uf i Ile. . as Ow er/Authorized Agent -- hereby declare that the statements and information on the foregoing appli6eion are true and accurate to the best of my knowledge and belief. Signed. unde the pains and penalties of perjury. Print Name Signature of Owner/Agent Date ' City of Northampton t ' Building Department >� 212 Main Street Room 100 ' Northampton, MA 01060 ;s phone 413-587.1240 max 413-587-1272 a h APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING '.'•S`':"m'+..'•"'�'''!'' �� t--cy8 t ;�isse�t�n Yb co pFefedb L;ofihce� z ,� F�:. 1.1 Property Address: w • !�+Zg�n tiu 4: �. .�� '�V is�..Y Di tr4Ct �' u nc. - a.t,��y��. �. ;EI.. NE. ��nrri� fir` � ��,r�� yr. f :��...��1 ..(�k to JT�uiv4....._._..... ._..wo L55PYi:�r"�.'. _.� n .�, r A i 'SECT'IQ,N:.2 P,, Q;1?,EE ` jf�,.Q E /(r U� ,:.. ''9;v• 1`:,r.,!..-, ;c.,'-.'�.�:;�.(•7.`'� 5.''`,� n'..r;'i�.rFt:aV^y.�f.+^:;!.P!i::'_M'!!i`X',.1. 2_1'Q of Record: Q Name(Print) Current Fling Addre ' Telephone Signature 2.2 Aut rized A e t r Name(Print) Current Mailing Address: Signature Telephone �r ,�r41P'dt;'.�' _ ' Hu,S ,l5 *` f:0 fV3 E �fff ,4teE'F)'C. :1�1'cScR :GsT 'I`:,- item Estimated Cost(Dc)4 s) tc be ;.Q;fficiai m leted b ermif a licant 2.w. x. 1. Building 1 0 (a� Building Perrm.4 F' 2. Electrical ).�Itim qo To t'�' (b Gast'of 3. Plumbing Building Permit f''p'. - - 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number This Secfiioh'Far Official Use'.d;iily. <Bull�fing Perrt�r k bier '`i r t�,Nur71y, :,�.' Date iissued:•:. , 's' fi Agry' n i�rtature.. .,, 1 :`. r,rr i,: _ Building:Go,Irlmissloner,' Iii pector of B.Niadings,;a;•n ,. . WON P `' BP-2009-0693 GIS#: COMMONWEALTH OF MASSACHUSETTS 0 029 �if CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2009-0693 Project# JS-2009-001012 Est. Cost: $10700.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Grouu: ADAM QUENNEVILLE 120982 Lot Size(sq. ft.): 27268.56 Owner: STOCKWELL BRYCE&SYDNEY FLUM- STOCKWELL Zoning: RR(100)//WSP Applicant: ADAM QUENNEVILLE AT. 240 AUDUBON RD Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:211312009 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 2/13/2009 0:00:00 $35.0014140 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo