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17C-288 (2) 0 Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement-co,ntractor 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 change. Ps-CA1 0 Sono-04/05-PC0698 E] Address 0 Renewal Employment Lost Card Board of Building egulations One Ashburton Pace, Km 1301 Boston, Ma.,Q2108-1618 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 v...»r,•.-r.inr re,-vial and r.hannw of address notification. E b r ] a v,y X},�F §.:! 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' rqr.! r. � v3 � V + l%74 r ..�.n1`��d �!. } - ' •. + t^n :t» x.+: r ��' r`' t.�:..� .q, i I,t,,;..:i t,.i"'•: ':.,f , t Y.. _'4/.:r.. 4ti1 .,.��.. d...e+a., W, KX Uate/Tine U5/U7/LUV 1):4'1 1 q 1 )3a ouIu r. uul May-•07-2007 02:55 PM Remillard Insurance 1-413.538-6010 116 OP ID DATE(MWDDrnm) ,�EORD_ CERTIFICATE OF LIAEILITI( INSURANCE „� -1 o5/D7/D7 r"ODUCER THIS CERTIFICATE IS ISSUED AS A'MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Remillard Insurance Agcy, Inc HOLDER THIS cERTIFICATE DOES.NOT AMEND,EXTEND OR 79 Lyman Street' ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Hadley MA 01075 phone; 413-538-7862 Faxs413�538-7179 INSURERS AFFORDING COVERAGE NA1C# INSURED rINSURER URER A., hm wL"I Tern ""Qa.-"w URER& Scottsdale Ins Co. Rdam Quenneville Roofing & C Siding Incc South Hadley MA 01075 UaER,URER C. COVERAGES THE Pouces OF INSORANCE LISTED BELOW HAVE BEEN=UED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REDUIREMENT.TERM DR CONDITION OF ANY CONTRACT DR OTHER DOCUMENT WITH RE3FECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLK; DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE OMITS SHOWN MAY FuWE BEEN REDUCED BY PAID CLAIMS. EXFIRATION LTR NS TYPE OF INSURANCE POLICY NUMBER OA (.01W ATE MM/DD LIMITS GENERAL LIABLITY EACH OCCURRENCE 151000000 B CoMNIERpALOENERALLIABILITY CLS1274790 06/23/06 06/23/07 pREMls ramv) $50000 CLAIMS MADE a OCCUR MED EXP(Any one pwwn) S-9000 PERSONAL b ADV INJURY 51000000 GENERAL AGGREGATE $2000000 GFN L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2000000 POLICY M 7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO its acdd") ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per pemn) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS PROPERTY DAMAGE $ (Par mcddr,4) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC j S. AUTO ONLY. AGG s EXCGSWUMBRELLA LIABIJTY EACH OCCUFUMNCE s OCCUR D CLAIMS MADE AGGREGATE s _ s DEDUCTIBLE $ RETENTION s woRKg. AWC 3 CON re"ATION AND % RY MI ER A EMrLOYERSUABxrtY 7012861012007 04/29/07 04/29/08 EL EACH ACCIDENT s 100000 ANY PROPRIETORIPARTNERMEXECIUTNE OFFICERIMEMBER EXCLUDED? EL DW-ASE-EA EMPLOY S 10 0 0 0 0 Iyas��r� '4R O SV E.L.DISEASE-POLICY LIMIT 3 5 0 0 0 0 0 SPL:CJAL PROVISIONS blow OTHER DESCRIPTION OF OPERATIONS T LOCA'nON5I VEHICLES I EXCLUSIONS ADDED SY ENDORSEMENT I SPECIAL PROVISIONS Roofing CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE O0CRI3ED POLICIES I E CANCELLED BEFORE THE EXPIRATION OATS THEREOF,THE ISSUINO INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE& AUTHORMED REPRESENTATIVE RIA AgenEX F RPORATION 1988 ernon�s rinnllnRl - UENNEV�L..LE ELKS sl ROOFING INC. The Premium Choice- 160 Old Lyman Road,South Hadley, MA 01075 We Are Licensed 1-800-NEW-ROOF • 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: ate Phone#'s H: �;S? -3 � S/ Cell: treet Mail To: �1 City,State,Zip Code Special Requirements ) 0 2 Proposal to furnish and install the following �C�;� �//h P7-ew Re-Roof ❑ Tear-Off ❑ Gutter Complete Roof Preparation ©-�blme exterior to be protected by tarps and plywood 2-1�hrubs, landscaping,trees to be protected �Z4 ntire existing roofing material to be removed to existing decking, i I ding flashing,etc. ite to be cleaned everyday with roll magnet debris removed at project completion eteriorated existing decking replaced at t. 4 S0A, ,4 kite/Brown 8 inch metal drip edge installed at eaves and rakes ❑ White/Brown 5 inch for re-roof only ;�:_wflashin g wil l be installed where necessary(see Special Requirements)ll new pipe boot flashing We shall acquire all appropriate permits etc.for all roofing work Complete Roofing System �¢cKydh Dv�•�� [LELK 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 [J115 pd. reinforced underlayment installed over entire decking Shingles: Z5-ECK Prestique®Series 2-16-year ❑ 50 year Color j-K'a'lable ridge vent will be installed L K ridge cap shingles Warranty Options: ❑ We guarantee our workmanship for 5 full years ❑ ELK10-Year Umbrella Coverage Limited Warranty upgrade. ■�■ V/SA' Ej,�K15- Umbrella Coverage Limited Warranty upgrade. �� •� We Propose hereby t f rnl h m erials and labor-co, e e in cordance with abo4specifications for the sum of* r_r Total Sale Price Down/Payment$ LL // / pon Completion$ ACCEPTANCE OF PROPOSAL:The above prics,spe i is 4'0'/Uand onditio�s are satisfactory and are hereby accepted. You are authorized to do work as specified.R�1_1%ent will be 1/3 down uporf signing,and balance due upon completion. Unpaid balances shall accrue with Interest at per annum.ft rchdser(s)will pay for all costs,expenses and reason- able attorney's fees incurred by Adam Quenneville iRoofing-afid Siding,Inc.to recover any sums due under this contract. Date: j° ly 0. Signature: Phone# 5a6- J `3 1 Date: Estimator's Signature: — /229' Estimates are honored 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. 4�1twN PTO _ � d �Siassxt})usrtts' - .0 G-jill of Nilutijamptoll m DEPARTMENT OF BU1LDWG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Klass. 01060 '+ WORICER'S COMTENI SA'MN INSURANCE kFMAVIT with a principal plan of busIrTCSSIfesidence do hereby Cer-Li!V, LIIIC"'i dIC pains anj penaliticS of pc:rJllly, i.ha'. ( I rm an employer dim, the follo�.�,�inc v-01`-C'-s compensation coverage for Iny employees worming on this job: (Inmrancz Compam') (?ciic;Number) Datc) ( ) I ant a sole proprietor, ge,'nerall c:ontrac-Lor ar homeowner (circle one) and ,have 'tared the contractors listed beiow v-;ho have tht iollo-..'_Dg workers compensittorl polices: (N=C of Contactor) (Lnstlrancc Como::n !Pokey Nu3nbrr) (tx irn dor, Date) (Name of Contactor) _ (.ImSumncc Comb vlv/Po?imI Number) (Eypir tioa Date) (Name of Contractor) (IrIEU M.MCe ComE.:tn P?o)ic. NIUJ) -�T) - �Tx,.:;r:[or, Date) (Name of Contrictor) Jas[rmc_— Comrr:_'rynoUcy Numbs) (E::fi-itior Date) (. I ilITl �t pole proprlewi- a-d have lio O[J :i:rl iii 1Or iT1C. tin it home OVi'IC r iiei:C'1T11I1 11( it: ;Oi'., i"" :11. ct,.. NO"ff:ple se Lc atra a tJtz::�`•is herrc.*:I xr a wbo r,flay co—r•—ru=m Cr tr,:au• Ilk w. �•cf!: c. not mote th_n threo situ`s in wi dt Lhe k:- +::�ei rc= 3 e a-a;:.e �a art r_r1 ihcc o sc eKC Gcrl ra11 Y ca±ployca u..racr tl-k Ivorkee-cc x Ica:r (Cii.!52_-_-!(511,ars'•.:_;'ic::by a hotncow'a for a Lc=nc cc p_rt:i::::.:-r.`ncc t1 h': ItS21 status of an c=ployor uoder ttzo Workce.l ort.pasaixOn!.ci I undct stssad th,•a copy of this c:atci:si clay bo forwarded to tJn IY_tiarLZrzi2 of Jndustrial An iewi a&OfJioo or!:_.+.v,�:n for tlm oova-agc vaif c2ioo and that f--Jum to 25A of MGL,152 eta Ic:d to d.c imp-ition dr._"I paulf:cs oocnisting of a Irux of up to S 1.500.00 xn-&'cr i"pri�.r�a`_oft jp to rr,y,zz e,j Civil',,16C,in d c fi-.rin Of- For(kv.uIIIIIIJ u`vily Ycrmit Ntuntxr —._.---- -- i tJt 8 1 Licensed Construction Supervisor: Not App�Dlicable ❑ Name of License Holder : 0-7 kQ ADAM License Number QUENNEVILLE ROOFING&SIMNG,INO. Address 160 Old Lyman Rd. Expiration Date 4� So.Hadley,MA 01075 LiL5,3 S�'S5- Sign Telephone ITO Not Applicable ❑ DAM Company Name QUENNEVILLE ROOFING&SIDO�1 ,Mu. Registration Number 160 Old Lyman Rd. 3-as- Address so.fia-diey,MA Expiration Date Telephone L�1 S 3 -555 S CTIOFI O Vi w a EIS'�C�ONiPEN,SA�ION N5UF3ANGEyAFFIDAI/IT(M t c 352,-§.;. ) "4'-+: :Eh"3�'. ,.:e. J. L 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....... 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 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 N MI f vF 'NdIN ema M .%+ y` %shy r RI -Of2K r.,c t o "lira a .FIN^ '>uFInMG%lf®.: .ir>�.:xwM•,�'MiAG1911k : a .. .. ._ �: v.... • _. .. .%!i!fTfP' _ ..f.. ..f:�e..."�Y^..�^.._-'?.�1'i ioR #��'.::....e, +e^ °s k'.+:�aM1R:R'f�-Sr. .�xa�.,.•. ' New House ❑ Addition O Replacement Windows Iteration(s) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ J Other [ ] Brief Description of Proposed Work: yvsA p'lt'.w S�%u)e ('a n ol- Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll D- Sheet O 6Taa :e ;:4 0 i�tror isti g h:o ingam,�, i= � A : 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. Dimensions 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 L 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 . I. Septic Tank City Sewer Private well City water Supply � 2. (k�A�90N : G1O � FPUEStFORk6URI;'DISR 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 e� fro as Owner/Authorized Agent hereby declare that the statements and informati n on the foregoing application are true and accurate, to the best of my knowledge and belief.. Signed under the pains and penalties of perjury. Print ame a-7 Signature of n r/Agent Date Section 4. ALL INFORMATION MUST BE COWLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning 'Phis 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: '^laity of Northampton !Building Department 212 Main Street III 2 9CG7 Room 100 r Northampton, MA 01060 t. --oon-e- 4; 3.5$7.1240 Fax 413-587.1272 :t. r: APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION-1;- SITE ,fI�FOM�T10N �� ,.•4��1 .=tee �: b: omp t dtay�offpc ��, 1.1 Property Address: y Mal " 7ties ;ZO a '"d�a•• �� 1 't*G— .:a :. s"''�'�., Elri? t C�1`strict r � - B, r ct� s tia r SECTION 2 PROPERTY Q.�IJNERSH1P,,r/, UTl10RIZLD AG�NT. 2.l Owner of Record: nn Name(Print) Q Current Mailing Address: Telephone Signature 2.2 Authorized Aeent: 0107's- Name(Print) Current Mailing A ress: - Signature Telephone V. k 5ECTION 3 tESaT111�1A'v;ED COINS tRl1C�TfON�CO'STS Item Estimated Cost(Dollars) to be Official Use an{y completed by ermit applicant 1. Building (a) Building Permit Fee 2. Electrical (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) c» Check.Number Q U � This Section;For Official Use Ona .. Id in Permit Number Date issued; Sri mature: .. —_ Buildiag:Cor; missioner/inspector of Buildings,::,, Daie a gyp:= BP-2007-1252 �r 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) Cat—egor y: BUILDING PERMIT Permit# BP-2007-1252 Project# JS-2007-002003 Est. Cost: $8950.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group Adam Quenneville 120982 Lot Size(sq. ft.): 5314.32 Owner: RICKSGERS MAUREEN E&JUDY K Zoning: Applicant: Adam Quenneville AT. 22 SUMNER AVE Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON.612512007 0:00:00 TO PERFORM THE FOLLOWING WORK.-SHINGLE OVER EXISTING 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 6/25/2007 0:00:00 $25.0010840 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo