17C-211 (9) 1j7/1r/1�JYJf� 1'1:51 41J—b8b—b11b YUUNU KUUr1NU J.NI-/_. r-140C rJZ
Contr. Supervisors Lie. No. 011878
Tel. 413-584-1367
0 1'W10 UNG R Q ()PM( (00, DUC0 413-586-9167
Fax 413-585-0226
P.O.BOX 60056 FLORENCE MA 010600056
Customer : Florence Savings Bank Date: 10/26/08
Address:- Main St. Florence, MA. 01062
Job Location 78' x 35" roof area.
SPECIFIC,A.TIONS:
1. Remove the existing J.P. Steven's Hypalon roofing. .
2. Apply one inch polyisocyanurate insulation. Aged R Value 6.0
3. Install Carlisle's .045 gauge reinforced mechanically attached roofing system. Adhere the
membrane to all parapet walls and caps.
4. Flash all walls, edges,and roof penetrations with an approved Carlisle detail.
5. Install three new Wade roof drains and connect to the existing plumbing by a licensed Plumber.
6. Fabricate and install .032 gauge brown aluminum edge metal.
7. Remove all our roofing debris from the job site and dispose of in a legal land fill.
8. Obtain a building permit for this work.
9. Upon completion of the work Carlisle will inspect the job an issue the owner a Fifteen (15) year
Total system warranty.
All material is geuaramaed C be as spedtled. qny gltwatrons or devlatwn rrom wove
eDeelflcatlana Involving extra mats will b e eKaeyted pnry upon write,onaera and will
Decome an eAM charge ova and above the asti n e. An agreoments oontingent uoon /
sinkes,acdoenta or delays beyond porttrol, owner m carry Ilre and otner necessary
Inwranee. All soWunts not pa d vrithin 8004 are euge/A to a late charge of 1 112 y
oar manta on me wtpaid bAlgnea. In the overt that leper action to Instituted b cones Authorized �r/ f
any eumE due under tNs agreement,the unoorsignoa apre9e to Day all costa(named ,r,�///� ,
Indudlryteeeanehleabomeysfees, Signature_1;IC and XC1ula . !resident
Acceptance of Proposal-The above prices specifications
find conditions are satisfactory and are hereby accepted. You are authorized Signature
to do the work as specified.Payment Will be made as outlined above.
Acceptance kpo(_ Date of Acceptance
�� ��' f4VIAlr n �
I
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes No
SECTION 11 -OWNER AUTHORIZATION-TO BE.COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby authorize�..PN.. _..............................
...... .. .... .........}to
act on my behalf,in all matters relative to work authorized by this building permit application
Signature of Owner Date
as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the ,ins and a Ities oej V
Print Name C .. .,..0
Signatu&Vof Owner/Agent Date
SECTION 12.CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: �, i�„zt---�.�......�._w...,...�._�.__,.... -,. ,�-1,�.���.,�,:�.-:,.,w�u..��...ww,v�,�j
License Number
Ec�x IcVv.MC ie,.. ! .._oICX��? . _---_..---.._.
Address - Expiration Date
Signature Telephone ..
SECTION 13-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 0 No
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES.FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT_TO 7.80.:CMR:116(CONTAINING MORE THAN 35,000 C F.OF ENCLOSED SPACE).
9.1 Registered Architect:
Not Applicable ❑
r,jqe(Registrant):
Registration Number
..._................................................._...........__...........,......................_..................--...................................
3
Address _.-.1
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name � � � Area of Responsibility
_..._...._...........----.........................___._._................_........
..__..._......_......_..........................._..._._......_....._........ � __ m. .. .___
Address _ _ _ Registration Number
Signature Telephone Expiration Date
Name _ _ _ _ _ Area of Responsibility
Address Registration Number
._.. __. ....... ........................................._............._...............
..._......__........
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable ❑
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
Wt
Versionl.7 Commercial Building Permit May 15,2000
8 NOR1'HAMPTONZONING''
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage _.___. _.. . =1 F— _._ __"_, _._. 1 _.._...
Setbacks FrontM ..,.
Side L:= R:= L:= R:�._= _m
Rear -
Building Height "
Bldg.Square Footage %
Open Space Footage % r J l
(Lot area minus bldg&paved ry -
parking)
#of Parking Spaces
_............. _,",_....
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW ® YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW ® YES 0
IF YES: enter Book Page(( and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW ® YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES ® NO 0
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:
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 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.7 Commercial Building Pertnit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing® Change of Use❑ Other❑
i
Brief Description Enter a brief description here
Of Proposed Work.
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ® 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
..._..... .
U Utility ❑ Specify:I
i
M Mixed Use ❑ Specify:
..,v.,....
,._.. _. ......... ..... ..._..,
S Special Use El Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: .... ___, __ _.__,___ _.....__... ..._, Proposed Use Group .
Existing Hazard Index 780 CMR 34):L_ .............. Proposed Hazard Index 780 CMR 34): 1--.........._.............
... ... .
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
1 St - -- J ..
nd
2nd
2 3 _ .._,........... _
3°
3rd ?.,._.. _._. . .. _,.,.._ ..._... .. w_.,. . . ,.:._,
4th
4th _ __.. .... ..... .... . .,w. .._. _._...._._..?
Total Area(sf) { Total Proposed New Construction(s1)
Total Height(ft)
Total Height ft _.., ..,_...?
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal'System:
Public ❑ Private ❑ Zone „ j Outside Flood Zone❑ Municipal ❑ On site disposal system❑
r
r
Version 1.7 Commercial Building Permit May 15,2000
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
os.
phone 413-587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be'completed by office
Ci'2V1c'e— 'Su�d►'K�J il?rz rll
L Map Lot Unit
4�5 1�l ce i h ST V
-lobe � 11 C to Zone Overlay District
,,,,,., _ ..,.__....,...._ ,. ____,...M. ...x. ... Elm St.District CB District
SECTION 2=PROPERTYOWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
f � r�t^C �c„v/ SIC. 1�iv1ST Flweti mA NOV 1
Name(Print) Current Mailing Address
Signature 5e e a 14ckctie6i, p ui't''.cL 1, Telephone
2.2 Authorized Agent:
_... ff00 15� ..., - , lit DA.J'
Name(Print) Current Mailing Address:_..i
Signature ij Telephone
SECTION 3'-ESTIMATED CONSTR ON 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
6. Total=(1 +2+3+4+5) j Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signatures
Building Commissioner/Inspector of Buildings Date
BP-2009-0476
GIS#: COMMONWEALTH OF MASSACHUSETTS
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-2009-0476
Project# JS-2009-000649
Est. Cost: $16000.00
Fee: $96.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: YOUNG ROOFING CO INC 011878
Lot Size(sq. ft.): 25482.60 Owner: FLORENCE SAVINGS BANK
Zoning: GB(100)/ Applicant: YOUNG ROOFING CO INC
AT. 85 MAIN ST
Applicant Address: Phone: Insurance:
P O Box 60056 (413) 584-1367 Workers
Compensation
FLORENCEMA01062 ISSUED ON:1013012008 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL CARLISLE ROOF SYS
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 10/30/2008 0:00:00 $96.0023210
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo