28-072 (2) 315 SYLVESTER RD BP-2017-0847
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block:28-072 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
Fermis BP-2017-0847
Project# JS-2017-001418
Est.Cost: $7200.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: BRANDON DENEAULT
Lot Size(sq.ft.): 80019.72 Owner: FANNIE MAE
Zoning: Applicant: BRANDON DENEAULT
AT: 315 SYLVESTER RD
Applicant Address: Phone: Insurance:
111 JAMES ST (774) 305-3005
ACUSUNETMA ISSUED ON:I/10/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:REMOVAL OF EXISTING ROOFING AND
INSTALL NEW ROOFING SYSTEM - 29 SQRS
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 tt 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 1/10/2017 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
1db—Q 7oti
".\. Depertrnent use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
< 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
\� Northampton, MA 01060
Two Sets of Structural Plans
` i phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOV�/ATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION `� a- / / 2 % 7
1.1 Property Address: This section to be completed by office
3i - 57cvEtre ?-0 a� Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
foannc mot a NU.1 tAaMas F1c,Awo, s.n1c Inn
Name(Print) Current Mailing Address: Qgth+S iy. 15 4-2Y I t.
1-113 • 1.87 -irate%
Telephone
Signature
2.2 Authorized Agent:
I�tJVt.f—b IJE • T / e. . - !et - .Z I. Pa.. el
- - r -
Name(Pring ' _ Current Mailing Address:
v.. L 1_ _ �a -'7a- 305 Zoos
.n.Ire Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building Zoo 00 (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) Check Number/l/' r
This Section For Official Use Only 76
�//� ,. Date
Building Permit N�� / / Issued: /� fir/
Signature: /'/v —/"
i
Building Commissioner/Inspector of Buildings Date
Section 4. ZONING Alt Information must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
TMs 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
ant area minus bldg&paved
parking/
#of Parking Spaces
Fill:
(volume&locations
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and Location:
E. Will the construction activity disturb(clearing,grading, xcavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO
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) ri Roofing El
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding[0] Other[0]
Brief Description of Proposed
Work:Tf,vtfvas of c,nNur67.ntcc rw1h aars in NEWrZeinVaW , Sys zr'v it jQ,/y
Alteration of existing bedroom Yes 1/ No Adding new bedroom Yes / No (/
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
w.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 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
rAMI C. n'I we- ,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
I, elirea knsPena EAta yf ,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.
g�RA , • t wmutrr
Print me
�' ' ' / 7
ignature of iC er/Agent D. e
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0 �s n
Name of License Holder:l5tA n ea ^) DFS(FA I)s .'1"
License Number
Addr: ' Expiration Date
_SAW, -77- - 305- 300
Signature Telephone
:red Horn r • . urn Contractor: Not Applicable ❑
2. fl ' — ♦ .r_ ±7,17-510__
y Company Name Registration Number
-t1 4 S S . .
)h(ul Address ExP alio Date
TelephoneM 393-�gt
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 buildi g permit.
Signed Affidavit Attached Yes BNo ❑
11. - Home Owner Exemption
The current exemption for`homeowners"was extended to include Owner-occupied Dwellings of one(I) 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.CAR 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
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: 3 15
The debris will be transported by: (/S4
The debris will be received by: US() 1 cX n
Building permit number:
Name of Permit Applicant gTAkrnoN7JERvsjr
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
IE ��� L Department ofD:dustrialAccidents
I Congress Street, Suite 100
`tf-.01 Boston,MA 02114-2017
sCwit:s0P www.mass.gov/dia
W orkers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/OrganizatioNlndividuaI)-PArad?. 4aa ? )J£{s,,62'
w
Address: 1193 f46WCcv
City/State/Zip: y/ tm_ tea-g4 a; Phone#:SSS- 343'259Q
Are_so n employer?Check the appropriate hoe:
Type of project(required):
I. l am a employer with employees(full and/or pen-tune)" 7. ❑New construction
2.❑I am a sole proprietor or pnrmership and have no employees working for me in g. ❑ Remodeling
any capacity.[No workers'comp.insurance required.)
❑I am a homeowner doin all workmyae If No workers'comp.insurance required.] 9. El Demolition
3
dome [ In e '
4.0 1 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will 10 ID Building addition
ensure that all contractors either have workers'compensation insurance or are sole I1,1:1 Electrical repairs or additions
proprietors with no employees. 12.0 mbing repairs or additions
s❑lam a general contractor and I have hired the sub-contractors listed on the attached sheet.
sub-contractors have employees 13. Roof repairs
These
and have workers comp.insurance
6.5 We are a corporation and its officers have exercised their right of exemption per MGL c. 4.0 Other
152,61(4),and we have no employees.(No workers'campinsurance required.]
'Any applicant that checks box k I must also till out the section beim showing their workers'compensation policy information.
'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contactors 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. lithe sub-contractors have employees,they must provide their workers'comppolicy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. ,/
Insurance Company Name: € )AjfEau 1/4 j()'4Ner(7tpef P
Policy#or Self-ins.Lic.k: t 7 A.') /,J Expiration Date: 1 j//t
Job Site Address: 3/5 3YI-V+F67EY KI7 City/State/Zip a a�/'�fj"/�fsca
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certif under tit:pain pen yes of perjury that the information provided above is true and correct.
Si nature' a- / A. q Date: / 6
Phone#: 4751.-193—Zet a
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License it
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#:
Massachusetts - Department of Public Safe ?
Board of Building Regulations and Standards
Construction Supervisor
License: CS-107822
BRANDON DENEAULT F404
111 JAMES STREET
Acushnet MA "02743
�- Fxpi n
Commissioner 07125/2017
11W)11.0.Clf(n 0/ C7V/4/:1aCkei l6-
Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Type: Supplement Card
Registration: 173750
Progroup Network Expiration: 11/05/2018
4 Lambeth Park Drive
Fairhaven, MA 02719 -
Update Address and return card. Mark reason for change.
Office of Consumer Affairs&Business Regulanan
= HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
4. ` Type: Supplement Card before the expiration date. If found return to:
'1 Office of Consumer Affairs and Business Regulation
Ae17375tion E1/05/2ion e9
1]3]50 11/05/2018 10 Park Plaza-Suite 5170
f30StOq MA 02116 .,
Progroup Network
Brandon Deneauit 77
F shaamvenk Drive \.Cc7.
. --
4 Lambeth MAPar 02719 —� /; L�
Undersecretary Not valid without signature
RENOVATION�y�� Customer Bid Request
MDPustomer
nie: Approvedtz
:vi11SERVICES than, 17062$2082 n '
Branch h„: Englaae nd n
Assigned Date 12/15/16 Pojed Total': $ 7,85010
t e 315 SYLVESTER RD FIM 0911
Phone (4131]667 800 4 PO
Emapl. mssigie esreaIonmm State MA
Bid scope l Zip. 01062 Home 59% A¢8 lwMm. Ne
Special i s%'EDF REPAIRED STRATEGY
adOrtional Info
... _. _..
5"Detail'I
29%97 Provider
Comments
7' 7
..o- .a ".T£cs .: w k ,k+ 729K812-7571%%2125V%' + n.
•.. epracernam orei . e[rtes fix�;
25 Year ComproartionSh installation of nem hrip ehtze installation or new fell pa pen inSta nation of new toofing system installed accordingto e:
Rod' .anufacturessonificatIons and In accordance with and stare buod.Q regulations.
29 4350
Rod Year Composition „Inn num water shield included en, nallowance No 55
Bid re Seblorsl: t 1901
lob Total p
5 7,85000 $61
90100 $ 2,94800
All In 591319"919h
57,850.00 4544Si,31220
5785000 $4,71000
57,85000 $5,10250
57,850 00 5549500
5785000 15% 55,88750
Labet only Sub Amount
9,65000 ,$58450
5785000 519100
5785000 520050
5785000 $593.00
57,85000 25% 598550