35-258 (11) 91 TURKEY HILL RD BP-2016-1111
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35 -258 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ROOF BUILDING PERMIT
Permit# BP-2016-1111
Project# JS-2016-001897
Est. Cost: $35840.00
r-ee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: CLASSIC METAL ROOFS LLC 100240
Lot Size(sq.ft.): 79714.80 Owner: WHITE CHRIS'T'OPHER
Zoning: Applicant: CLASSIC METAL ROOFS LLC
AT. 91 TURKEY HILL RD
Applicant Address: Phone: Insurance:
264 GLEASONDALE RD _ 978) 562-7770 WC
STOWMA01775 ISSUED ON:3/18/2016 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE ROOF W/METAL 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 3/18/2016 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
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City of Northampton tatUsrof2Dermrt; � '��
Building Department ��a
212 Main Street wrey'sgp-lid AI .,t�5k^,E E i s tYrk`4 ,kz�d ISMyal��4'a,��r�+1 k,G,�•
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phone 413-587-1240 Fax 413-587-1272 P�ot/�ite Plans 5hl I x k��l MI(ktl,l}c x,x J�.* fil j y
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Ot et Specs c I , 44i s s a ;��_ IF
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address: r f "
n Map;' Lo Unit
' -' TY+5 ' :1
/yZone x ` ' Overla District � `
" P.
i
EImSt Distract ,' .::._ � � � CBDistnc4
SECTION 2.-PROPERTY OWNERSHIP/AUT. ORIZED AGENT
2.1 Owner of Record-
5 d
�
Name(Print) Current Mailing Address:
9 Telephone
Signature t
`
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS. .
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building `� b (a)Building Permit Feb
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=0 +2+3+4+5) Check Number E7
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage ..
Setbacks Front [—_--_-
Side L:= R:l_.�--i L:!_ ...1 R:=
Rear
Building Height ]
Bldg.Square Footage % �
Open Space Footage �``— %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill: � .�_ ....,_. -.......... .w_.._�.._,......�. ........�
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW Q YES
IF YES, date
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES Q
IF YES: enter Book ~�— { Page and/or Document#L --
M
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtainedO Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO 0
IF YES, describe size, type and location: f
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q
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 Q NO Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ED
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [p Siding[fes] Other[O]
Brief Des ' tion of Pro �se f � 549
�r �j � /�
'CAC
rk:
Wol ' M'
Alteration of existing bedroom Yes k No Adding new bedroom Yes _� No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a. if Newhouse in&6i'addition to existlng:housing;lcornplete the followmq:
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. Masscheck 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.
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
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
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 pains and penalties of perjury.
Print Name
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable £
Name of License Holder: ,-e ,Lr
'cense Number
�� J /17y4 6/17% _l�2 q0
Address Expiration Date
Signat Telephone go
9 :Registered Home`Improvement"contractor , `
.. .. . . ..... ... _. . . � �. Not Applicable £
Company Name Registration Number
Address Expiration�7;171gob,
Telephone
SECTION 10-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....... £ No...... £
11... .Home Owner iempti0
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.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
~ Boston,MA 02111
www.mass.govldia
Workers' Compensation Insurance Affidavit'. Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/organization/Individual): , 4a;
Address: OiI,J Li le /�, d
0�
City/State/Zip: W '1 S� Phone #:
Are you an employer? Check the appropriate box: Type of project(required):
1Lgtn a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees (full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. E] Remodeling
ship and have no employees These sub-contractors have g. Demolition
working for me in any capacity. employees and have workers' 9 ❑ Building addition
[No workers' comp. insurance comp. insurance.
required.]
5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12'E§—Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
tHo meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
#Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site
information. _
Insurance Company Name: / /—
Policy#or Self-ins. Lie. #: / Expiration Date: /O�Z �Z �Q
Job Site Address: 7_6_)4y #/Y �Cd City/State/Zip•/VT ��'N' /� LltW
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form 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 statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify nder t e pains peva 'es of rjury that the information provided above is true and correct.
Signature: Date:
Phone# 7d`^ ✓ '� crZ �
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#:
f, City of Northampton
Massachusetts {S�s ,scjt
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
~A Northampton, MA 01060
j'`Y 4Y71
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her
construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which
he/she resides or intends 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 home owner."
The building department for the City of Northampton wants any person(s)who seek to use the home
owner exemption, to act as their own construction supervisor, to be aware that by doing so you
become responsible for compliance with state building codes and regulations. The inspection
process requires that the building department be called to inspect work at various stages, which include
foundation/footings (before backfill), sonotube holes (before pour), a rough buildinq inspection
(before work is concealed), insulation inspection (if required) and a final building inspection
The building department requires these inspections before the work is concealed, failure to secure
these inspections can result in failure to obtain a certificate of occupancy until the work can be
inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be
responsible to make sure that the trades hired secure their proper permits in conjunction to the building
permit issued, and that they get their required inspections. Failure of the individual trades to secure
the permits and inspections as required can DELAY the project until such time as the proper permits
and inspections are made
1, understand the above.
(Home owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit issued to me.
Date
Address of work location
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: �' 1
The debris will be transported by:
The debris will be received by:
Building permit number:
Name of Permit Applicant
Date 3 171,t Signature of Permit Applicant
This is an agreement between For Office Use Only
Classic Metal Roofs, LLC
264 Gleasondale Rd.
Stow, Massachusetts 01775
MA construction lic # 144235
Toll free 1-866-660-6668
And
Name(s): Chris White and Audrey Hall (Hereinafter will be referred to as the"Buyer")
Address: 91 Turkey Hill Rd
City/Town: Northampton. State.: MA.., Zip: 01062.
Phone#(617) 678-8594
Job Site address: same as above
Entered into on(date): October 3D ,2015
The Buyer is the recorded owner of the property described in the Job Site address above,and hereby contracts with Classic Metal
Roofs,LLC (hereinafter the"Contractor")and authorizes the Contractor to obtain the local building permit,supply all necessary
materials and labor to install, construct,and place the improvements according to the following specifications,terms,and conditions
(hereinafter the"Specifications")at the Job Site.
Specifications: Englert 18", 032, aluminum standing seam/color: '7—'<- -�
Buyer will:
Supply adequate electrical power for the Specifications.
Be responsible for all rot damage and any other necessary sub roof repairs not stated in the
Specifications.
Agree to compensate the Contractor for any additional work performed by the Contractor at a
cost that is mutually agreed upon by the Buyer and the Contractor before the work is,started.
Special Instructions:
Classic Metal Roofs,LLC will do the following in connection with said agreement.
1. Obtain Building Permit
2. Strip and properly dispose of existing roof. (includes 1 dumpster).
3. Supply&install Henry high temp ice&water shield to code
4. Supply"Roof Top Guard II"polypropylene metal roof underlayment. (full coverage)
5. Supply&install all edge metals and flashing details.
6. Supply&install Englert 18",,032 aluminum standing seam roof to manufacturer's factory spec.
7. Installation will be done with 4304 stainless steel clips with 2 screws per clip and the fastening will be
hurricane rated.
8. Two 3/8"backer rods will be installed behind each panel. (This eliminates"oil canning"in the panels.)
9. Install 38 linear feet of snow rail.
10.Landscaping will be protected and grounds will be cleaned up each day.
The Buyer agrees to pay the contractor the following scheduled payments:
Contract P Cce35,840.00
Deposit(1/3) $11,947.00
At the start of the project(1/3) $11,947.00
Balance on day of completion(1/3) $11,946.00
Make all checks payable to Classic Metal Roofs,LLC
In witness whereof: the Buyer and Contractor have hereinto freely signed their names this the +� day of
October, 2015.
The Contractor and the Buyer hereby mutually agree in advance that in the event that the Contractor has a
dispute concerning the contract,the Contractor may submit such dispute to a private arbitration service which
has been approved by the Office of Consumer Affairs and Business Regulation and the Buyer shall be required
to submit to such arbitration.
Signed: i &zW
Bryan Rusch,Partner Signed: 0 �i-4a..
Classic Metal Roofs,LLC uyer
Signed:
Buyer
This is a binding agreement between the Buyer and the Contractor.This is not a credit transaction and will not be financed by the
Contractor.If financing is required,the Buyer authorizes the Contractor to obtain credit information and the buyer hereby agrees to
provide and sign all necessary documents required by third party fimancial institutions to complete the financing immediately upon
request.The Buyer hereby acknowledges an original copy of this agreement and to the terms and conditions attached.All surplus
material is the property of the Contractor.