17C-041 (9) 63 SHEFFIELD LN BP-2017-0718
GIS 4: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C-041 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-2017-0718
Project# JS-2017-001183
Est. Cost: $8300.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const, Class: Contractor: License:
Use Group: NRB EXTERIORS INC 99565
Lot Size(sq, fl.): 15725.16 Owner: CHODOS LEIGH
Zoning:URt3tI001iURA(r)1 Applicant: NRB EXTERIORS INC
AT: 63 SHEFFIELD LN
Applicant Address: Phone: Insurance:
7 PHILIP CIRCLE (413) 563-6354 WC
GRANBYMA01033 ISSUED ON:
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 ft Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: 001: Insulation:
Final: Smoke: Final:
Tills PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy signature:
FeeTvoe: Date Paid: Amount:
Building $40.00
212 Main Street.Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
•
- -
". ' » a Dement use -4. y4
:„,„-
City of Northampton S s1fi -
Building Department CdrhlCuhDnvewayPermit
212 Main Street Sewer/Septferlvailab1Iity.
� .:� Room 100 Wa{er[WellAvpllablGry- _
Northampton, MA 01060 Twu,Sets ofSfudural Plans
3 phone 413-587-1240 Fax 413-587-1272 PIoUSdePlans
Other Specify
APPLICATION:TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION b/L 17- 7/
1.1 Property Address This section to be completed by office
+D3 Sb e {-koJ L Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: t^ ! t 1 ,,
-E c (stili{U /S Ca- J ke c-t-r y t 5 L t.- Id/Air f cl
Name(Print Current Mailing Address.
kt
dippir /- 0 Telephone
Signature Tear riti
2.2 Authonzed Agent:
N2o,� n40-s � t . 7 /kV, ct„ , G.., 127 ./t ()Kir,
Name(Print) Current Marling Address:
CIO (Z 'CI r 't
Slgelrr— Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit 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 it.3+4+5) 7jOO (C)1/4‘-`( Check Number /% d0 etre
This Section For Official Use Only
Budding Permit Number Date' +� p' ,(�
Signature: / Q ��(Z`d /2"
Building Commissioner/inspector of Buildings Date — .t
23 E
,
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 __.______ .. I
Fronde : ._ ._.._._ i 1 I _._ 1
Setbacks Front I i ..�'
Side L R._. L'1 R!_.__!
. _
Rear. —_ ,._.__ �.....__
Building Height —J
Bldg. Square Footage f 1 I .__...__I
Open Space Footage __ % I — 1-.
(Lot area minus bldg&paved — 1 L _, .-,...._J .
parkins)
1` I
of Parking Spaces _
Fill:
(volume&Location) --_ �_._
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 'IVDONT KNOW O YES 0
IF YES, date issued:
IF YES: Was
'^the permit recorded at the Registry of Deeds?
�
NO (3 DONT KNOW Q YES Q
IF YES: enter Book I: Pagel and/or Document d; ',
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW Q YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued: i�
C. Do any signs exist on the property? YES Q NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO
IF YES, describe size, type and location: L
E. Will the construction activity disturb (clearing, grading,excavation,or filling) over 1 acre oris 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) n Roofing
Or Doors O
Accessory Bldg, ❑ Demolition E New Signs [C] Decks [0 Siding[C] Other rm
Brief Description of Proposed (� }�
Work (Z44 +rc e- tck- j QadX , ata{J tad (.A su MCI, 4Vet Ofb4}✓kk(—t(.
Alteration of existing bedroom Yes No Adding new bedroom Yes _ No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
Ba.If New house and or addition to existing housing.Complete the following:
a Use of building : One Family ( Two Family Other
b. Number of rooms in each family unit: Number 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 APPIJES FOR BUILDING PERMIT
y
I, �L t 7 1, `�C
in a I O � ,as Owner of the subject
property q/ (� A. /'
hereby authorize .4 r `!l Q x-g/i D-s 4- rn C
to act oafters relative ark authorized by this building permit application.
w-..._ / l—c) .. - 1 (17
Signature�o Owner / S. Date
1, LOA Y `iJ '€‘rit l<r 1/41'4 t es C - -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.
.- te kfe.l 1 , /.ti's --
Print Name
/0_ Cr,? -1--- / !--n-J.6
Sign:Cof Owner/Agen Date
SECTION 6-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor. NetApplicable ❑
Name of License Holder: �t tk,ok4\ 3Q/h •Li / ( /
f ( SCa c
/ License Number
7 se (t f,. it e• i")rti, ,~ ,�4
s-A% - IR
Andres Expiration Date
nature Telephone
9• Registered Home improvement Contractor. Not Applicable 0
Company Name Registration Number
71+4-le L 6., c .,j ii , -33 - 17
Address Expiration Date
Telephone_S L c-&5�1
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 J No ❑
•
1 . -
Home Owner Exemption
The current exemption for"homeowners`was extended to include Owner-occupied Dwe((ivasf one(I) or two(2)families
and to alloy such homeowner to engage an individual for hire who does not possess a license,pr vided that the owner acts
as supervisor CMR 7811, Sixth Edition Section 108.3,5.1.
Definition of Holm gwner 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,aore or two family dwelling,attached or detaEhed structures accessory to such use and/or farm
structures.A person who constructs more than one home in -Iwo-Year period shall not be considered a homeowner.
Such"homeowner"shall submit tetiv Building Official,of form acceptable to the Building Official,that he/she shall be
responsible for all such work perforrpedAnder the b dine permit
As acting Construction Supervisor your prese ec on the job site will be required from time to time,during and upon
completion of the work for which this permit is isku'ed,„
Also be advised that with reference to Chaptey152(Wo -'. s' Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Dc:, of the Massae 'ens General Laws Annotated,you may be liable for person(s)
you hire to perform cork for you under . is permit.
The undersigned"homeowner"certi -s and assumes responsibility fo -ompliance with tie State Building Code,City of
Northampton Ordinances,State . i Local Zoning Laws andState of Ma. . husetts General Laws Annotated.
Homeowner Signature
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 MOL. e 111, S 150A.
Address of the work: 63 S P , dJ L
The debris will be transported by: (Or rli k ( I' S( t
The debris will be received by: (u�C(t X cis Pc. S 0 (
Building permit number: Y
Name of Permit Applicant N a
PP / �ylk/ yvs
/7—))- ce,
/I -
Date ignature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
lertjte
Office gfInvestigations
1 Congress Street, Suite 100
Boston,B24 02114-2017
wwwsmass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): tR 7 + ' r'( i)✓ r-c+ •
Address: 7 (, t /
City/State/Zia: A„ ems Phone #: . .'La
Are you an employer?Check t appropriate box:
4. I am ageneral contractor and I Type of project(required):
d):
1_�e am a employer with 6. L New construction
employees(full and/or part-time).* have hired the sub-contractors
2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
working for me in any capacity. employees and have workers'
insurance 9. 0 Building addition
[No workers' comp. insurance comp.
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3. I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No worker,' comp. right of exemption per MOT 120 Roof repairs
insurance required.] f c. 152, §1(4),and we have no
employees. [No workers' 13.]Other
comp. insurance required.]
"Any applicant that checks box 41 must also till out the section below showing their workers'compensation policy information.
Homeowners who suhmilthis affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicatiay such
te.ontractors that cheek this box must attached an additional sheet showing thename 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.
7 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
— � ... ,t/t LAN,
Policy k or (
Self-ins.Lie.#: 7c( l7"f} eo`yl-7 1' - �l— ) (o Expiration Date: ��j �
Job Site Address: C, 3 S keV.„ tic.; L"--. City/State/Zip: (/l� tl« lk� , lV//Lt
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 MCL c. 152 can lead to the imposition of criminal penalties of a
fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a foe
of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the I)IA for insurance coverage verification.
Ido hereby ceerrtif/y and, a pa',s and penalties of perjury that the information provided above is true andt
correct.
Sianature: ( 7C3 -
Official
v y Date: / / d!� ' /
Phone r; j - Li
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):
I.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other__
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"._every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer,"
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please 611 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply sub-confractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC.or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please he sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information (if necessary) and under"Job Site Address"the applicant should write "all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call,
The Depat unent's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
1 Congress Street, Suite 100
Boston, MA 02114-2017
Tel. #617-727-4900 ext 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 7-2013 www.mass.gov/dia
City of Northampton
Massachusetts
c w
P i p ?t `PARTeNT OF BUILDING INSPECTIONS �- s
SSt.;
t212 Main Street • MuCal BVLld'ing
MA
�.,,..n. MortMavpton, MA C1060 ?Pr: C..''!S:
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 parol 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 tha{lke building department be called to inspect work at various stages, which include
foundationffcotinas;W?tare back ' I .o •t_ *e toles(before pour). a rough building inspection,
(before work is concealed) insulation inspection (if ree wired) and a final building inspection
The building department requites these inspections before the work is concealed, failure to secure
t -s- in , .- 10 sc_n -s . i faiur- toe�btain . c 'f' at: ofoc u.a c uttil . ework 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 DECAY the projectuntil such time as the proper permits
and inspections are made --__
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
/l€ {I/ommC, neveIt,744 o/YYa&1acke eat
Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 147961
Type: Private Corporation
Expiration: 812372017 Trk 267291
NRB EXTERIORS INC
NICHOLAS BERNIER
7 PHILIP CIRCLE
GRANBY, MA 01033
Update Address mid return card.Mark reason for change.
aeAl 0 2OML5/lI ' Address !p7 Renewal Employment `—i Lost Card
to ni,onrce2 o/cw ,nrkr e
Ocoee of Consumer Again&Business Regulation License or registration valid for individul use only
ME IMPROVEMENT CONTRACTOR before the expiration date. if found return to:
egistration: 147961 Type: Office of Consumer Affairs and Rosiness Regulation
Expiration: 8/23/2017 Private Corporatic n 10 Park Plays-Suite 5170
Boston,MA 02116
NRB EXTERIORS INC
NICHOLAS BERNIER
7 PHILIL CIRCLE *. a-7 _ .r
GRANBY,MA 01033 Undersecretary Not valid without signature
aMassachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CSSL-099665
Construction Supervisor Speualty
NICHOLAS R BERNIER
7 PHILIP CIRCLE
GRANBY MA 01033
Nei...An Expiration:
Commissioner 05120/3010
A CERTIFICATE OF LIABILITY INSURANCE DATE aMIDDIT YYI
3/8/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEO
REPRESENTATIVE OR PRODUCER,AND TIE CERTIFICATE HOLDER.
IMPORTANT: I the certificate holder is an ADDITIONAL INSURED,the policy/ s)must be endorsed. If SUBROGATION IS WANED,subject to
the imlna and conditions of the polky,certain policies may require an endorsement. A statement on Mks certill ate does not confer 0ghts to the
certificate holder M lieu of such endmwm.ngsl.
PRomrcEA CIWTACT Tierney Team
NNW
Tierney Group Ma jin (413)562=7007 ./01(en1{n-era
16 North Els Street _AMMO-
P O Box 750 INSURERS.AFFORINO COMMON MMCF.
Westfield HA 01086 RnuNEa ARussellBoncliCo/Sudaon Ins
iNSOREa mem.ae Saety Insurance CmpanS __. 39454
N R 3 Exteriors Inc swarm c:Travelars/Aseriean Zurich Ins Co
7 Philip Circle m$IMEao:
m6URERE:
Granby ML 01033 ,goafRF.
COVERAGES CERTIFICATE NUMBER:CL1511300214 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAW BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. ROTferTH57Afl G ANY RE011mfNEWWT. TERM OR 03110FIWR OF MEL'CUM RAC 1 OR OTHER DYAAmrENT HUM RESPECT TO WITCH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
'/EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PND CLAIMS
)y Tma,xewurlCE ATAXAMIR
nen Am POW.NORM asllamerIYEFF l ee ODflYYn IP
UNITE
: WrraeaGRL GENERAL L41mL11YEACH OCCURRENCE $ 500,000
A CLA4SIALOE x OCCUR !. OPMAGE TO MIRED
gE , s 100,000
i I RW10016413 11212312015112/23/2016 LID EAP(NyanFpawn) s 5,000
; 1 10 ALLOW mot WRART PERSONAL a/LV mamr s 600.000
IGENL AGGREGATE mar APPLIES PER. GENERAL AGGREGATE L 1,000,000
I
1I MKT n SCT 7 LOC I
I Pa00&CTS-COMPOPAGG 6 1,000,000
I OTmu $
AUTONW,LE LNB6JTr i PJB ISIHIXEIAn y
9 MY AUTO I
BODILY NSW(PePNw) ,r 500,000
kALL OWNS .__ 9CNEDIAEO _.._. __. _......... _..
AUTOS ]L AUTO 6222362 13/15/201513/15/2036 GOWN MIRY(Pet YFMOi r 1,000,000
r HIRED AUTOS X NC D Ret.rel et: PROPERTY DAMAGEIAN=nano f 250,000
6222362 13/15/2016 3/15/2017 E
INISRELLACIAB / I
OCCUR F/CN OCCURRENCE f_
EWER WE :
— i CWLSNME AGGREGATE �_...
OEO I I RET[MpNs !3
iµ lIN fiM-IID3175-6-15 2/13/2015 1 2/13/2016 1 sunny I I Eyµ
�TPE yT M1SER LING�EWiNE iY Ni Renewal of: EL EACH ACCENT S 100,000
C IrMMNFl my I 62f0-2203175-6-16 12/13/20162/13/2017 EL DISEASE-EAEMPLOYE(r 500,000
tlyw.dwb tiger
OFwamrgN Of OPERMIONS Ara. • A Atidr not Cmc lY EL MAST-POLICY LIMIT s 100.000
,
I 1 I I ,
DESCRPRON OF OPERATIONS I LOCATIONS IYNOCLES(ACmm 101.AWNM Return e.NWm,ay N RNNNO N awe fNFe x.WLM
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
N R R Exteriors Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
7 Philip Circle ACCORDANCE WITH THE POLICY PROVISIONS.
Granby, la 01033
41.11110RIZED REPRESENTATIVE
/
06ete#9
O 1908- I '�ACORD CORPORA ON. MI right reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
174025("Ann
• RY]V
-Proposal submitted to. PSva'tf h. k C f g 6 3- )-j l l c
LEI G-l{ CItC)DOS Special requirements
Som -
4 � ;L.
.)i l 11,4ti ^ P ..x _..._ .
Cl) , vxss rct: i - r' ..-t -4,..,;(t1
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Proposal to furnish and install the following i, r „o-+ c nz-. S.DW 3' ptn.,
.
kl We shalt acquire necessazy p ss tui ati wras:} j wk i n
•Complete Roof Preparation Ijv his‘,,,te n y Ci - cc, 0 NC i,V DG1>
VI Hour's exterior to be protected by tarps and plywood
d
'• 5-..L2. ar• 'gram, >.:t fir tris- .F. . . rut.. ; m4 .a,:.5)
E Entire existing roofing ttracenats to tie retnh/IWO.stir sc.,, atiAceIp6,.a...,t-^ce ;ceiticefl e. .. `
6 Site to be cleaned on a daily basis with roll magnet,debris to be removed at project comptstion by dumpster
✓ Deteriorated existing decking to be replaced at$50 per sheet of plywood (tt r a }I(
rasoete CertainTeed£ntei at Roof System -
e instal) Y4 rmetguaru re elc Waal warrior limit,N:iS4'.ff3, , ;1.11 ,
ai Install Winterguard ice& water bather around penetrations, in valleys and all critical areas
'Install 15#saturated asphalt felt paper to entire decking
lInstall Roofers Select Premium nnderlayment to entire decking PPC(L rk
6-E" \
F Skit 'w,v jj..t m ;<' `.n i.Sw .t ,3iv3.144 a vaml i .:ti+i� ,$xwai3s 'De t1 f- ,-
• Install 8" perimeter metal flashing to all edges of an roofs, 3swone a vrervaxi i Jren.-
✓ Install SwiftStart starter shingle to bottom and rake edges of aft roofs r ES 30-D
yr Install CertainTeed shingles to manufacturers specifications, 0 6 nails kP4 nails 4 Cat_ &moil -41oi-t
Install Shingle Vent II PVC ridge vent to all peaks in heated areas i o/t tki t t,
k- is;L ^,.:x"'4 Ill Ufilfis" It.Sc .u_ cert - rrc 'oolong, tarsi iL,a`fie- . : ----,.-._.—.__..
VI Install new lead counter flashing to chimney Sh t ) 1 r• "jl . t t.44 ePSni
tii New flashing installed where necessary �-S �r
p Install new pipe flashing to waste vent stacks SiK4 1,4 Es K `# -14 is t}h it OC Li-Ltd
Warranty riedOSIS SYi .! ..,7... t SAP tit Sit-I 6szi akil^12'.5 i
§ We guarantee our iabortwohcmanship for 2Yr years 1Q Upgrade CertainTeed 5-Star Sure Start Plus, 50-year nonprorated coverage, including workmanship
SO Upgrade CertainTeed 4-Star Sure Start Plus, 50-year nonprorated coverage
U CertainTeed Landmark-color: a �Co t-Ot3 i Al- S(-KMCl3-tab
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We propose hereby to furnish materials and labor-complete m accordance with above specifications for the sum of:Total Due $ c7-abo'. ex
ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are! - 1/3 Down Payment$ 3 cob
att;`Eattaay and me bemivyae.:-Nrri..Yam ailk aat)raedtndmak arsekas.wedged: Balance due
Payment will be 1/3 down at start of job,and b i iv dote open completion. I upon completion $ L r C,k '"-'
Date: • 1 fl '21'i bSignature: • IS or -
Date:g_D - ^ - Estimator: (P NL e) , I '.4,-..- (0-- (Sign Name)
Estimates arc enured far Moly 13 'j days from Vic:&tan
ATTENTION HOMEOWNERS: Please cover all personal belongings in the attic,garage or storage areas due to the
possibility of roofing debris or dust in through cracks of the wood.NRB Exteriors Inc.will not be responsible for
debris or dust in the attic or storage areas.