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44-046 29 PARK HILL RD BP-2017-1366 GIS4: COMMONWEALTH OF MASSACHUSETTS Map:Block:44-046 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 4 BP-2017-1366 Project 4 JS-2017-002273 Est.Cost:$8800.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NRB EXTERIORS INC 99565 Lot Size(sq. ft.): 17424.00 Owner: RADULESCU RODICA THERESA&JOHN J OTT Zoning: Applicant: NRB EXTERIORS INC AT: 29 PARK HILL RD Applicant Address: Phone: Insurance: 7 PHILIP CIRCLE (413) 563-6354 WC G RAN BYMA01033 ISSUED ON:5/26/2077 0:00:00 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 4 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 5/26/2017 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Department use only - l ity of Northampton Status of Permit: '" r\ B 'Iding Department Curb Cut/Driveway Permit \ \ 2 Main Street Sewer/Septic Availability �k6/' ,-��j/Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone'413-587-1240 Fax 413-587-1272 Plot/Site Plans �' Other Specify A' ' ATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH AONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 8P- 17- 1 .1610' ' is section to be cam leted by office 1.1 Property Address: -c. p4✓k it " I ( r� • Map Lot Unit V l Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Terry v TI Name(Print) Current Mailing Address: 0 I Telephone Signature / 2.2 Authorized Anent: I ,tom N2a t ✓ I , SNL 7 g Ivt Jr �� V� � ✓ By Name(Print) Current Mailing Add : Sipati(ure 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+3+4+5) X ,/\Q CO Check Number IS i 4 �7'�This Section For Official Use Only Building Permit Number: Date Issued: /' +7 'y/� Signature: �..�. � J 4-� �/ Building Commissioner/Inspector of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing 01 Or Doors O Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [q Siding[0] Other[0] Brief Descriptiopu of Proposed r� /— Work: ,A� ''''•• j� €L` Work: f`?w,]-�- vii- ku t.± ,�r/f7d4 I' IN's od- Vv Ii-4t4 . \0-c-C, Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Rolt -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 of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? I. 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 Cay Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR� � APPLIES FOR BUILDING PERMIT I, 1 Cfr1/4 ( O I t ,as Owner of the subject propel c hereby authorize N a rl 1-7----- ?CC/ j1 t1j2 / n_c- p.� to act on my behalf,in all iters rglafive to work authorized by this building permit application. 'fes ,rL Signature of L Date — I. Ail Kn� I/J ��' )--s Y , 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 underthe gip, pan-.,'=sof perjury. �j p iL �"TL 'h -) /cf n.1a N_.r /7 I n edA9e^r '— Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: ,t \ ' Not Applicable /❑ Name of License Holder: N T k. 0\' .s \� Q_-_ . )? Y€ c License Number • Address // Expiration Date • W (o S Telephone ( y 7 5 (e 9.Registered Home Improvement Contractor: Not Applicable 0 ) (L tce}-cam ✓r ( c4 7 9 G Company Name / Registration Number ^� 7�/IK� I:b � l/ ( r -1 , 4 ( �—�7 ' / � Addres Expiration Date Telephone St3{f331-1 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 0 No ❑ 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.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 he 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 a Department of Industrial Accidents P— e m ill_; Office of investigations __ 1 Congress Street,Suite 100 « Boston,MA 0211 4-2 01 7 ktrmwww.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information (� p y' \ Please Print Legibly Name (Business/Organization/Individual): UkJ . 1I kick/a., . Address: 7 7 kJ), l ,n C i f City/State/Zip: ()/,..4..? Phone#: &"-Ce-"S—Gra 3-1 Are you an employer? Check the appropriate box: Type of project(required): 1.Pam a employer with 4, ❑ I am a general contractor and I employees (full and/or parttime).' have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. Buildingaddition [No workers' comp_ insurance comp. insurance.] ❑ required.] 5. ElWe are a corporation and its 10.0 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❑ Roof repairs insurance required.] c. 152, §I(4),and we have no employees. [No workers' I3.0 Other comp. insurance required.] *Any applicant hat checks box#1 must also fill out the section below showing their workers'compensation policy inPonnation. *Homeowners 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 subcontractors and state whether or not hose 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 polity and job site information. Insurance Company Name: C. ,,rt CAS Policy#or Self-ins. Lie. #: \<:1 27 C.t 6,-eI (= /7qpimtioo Date: a- 13-( g Job Site Address: .71 (24- 1- 1-x in ic) City/State/Zip: Fit /4i 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. Ido hereby certifythe pains and penalties of perjury that the information provided above is true and correct Signat . ' t (rDate: i / Phone#: cif;—C1. kl—`tly'' 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#: 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: c7 Pi-t/ &v m I t\ /ix The debris will be transported by: [- o v r ``L(N Dry L Sc. The debris will be received by: (e).11/4A(e).11/4A �'-a-t I S Y1 Building permit number: Name of Permit Applicant k) N C 6 f i S7 '< Date Signature of Permit Applicant mice `o; 0 ,,,id O/e'�I�U 46aC17a111(t4 r=1" - y Office of Consumer Affairs and Business Regulation 1.4.7 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 147961 Type: Private Corporation Expiration: 823/201] Tra 267291 NRB EXTERIORS INC NICHOLAS BERNIER ----- _--7 PHILIP CIRCLE _- __-- - --------- GRANBY, MA 01033 -- ----- - - — - -- Update Address and return card.Mark reason for change. uI a weave Ij Address I Renewal l Employment n Lost Card fy]r Uommemece44.e ,unr/uv(( Office of Consumer Again&R ,Inns RKabtioo License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration dote. If found return to:ktn6on: 147961 Type: Office of Consumer Affairs and Business Regulation Expiration: flr(,VM17 Private Corporate IO Park Plaza-Suite 5170 Boston,MA 02116 NRB EXTERIORS INC NICHOLAS BERNIER / - 7PHILILCIRCLE GRANBY,M501033 --undersecretary -t - -- Not valid without signature agily Bb dao RUi1d R OePartTeOt CO uttloae. Rt,°R RC9ulatio °f Public S nstr pe slaty n SUPervisffilMflg orS a °g anB Standar s Mclq Pe°iahy ■ Plpc RAJER RAN fr MA O/fU�JJ17 t 'mm aion` Expiration: 06.48/2018 AC L.CI CERTIFICATE 0 LIABILITY INSURANCE DATE TE(MWD01Yn 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PHOOUOZR rci°AMe"GT Tierney Team Tierney Group PHONE (413)562-7007 FAX (88E27i me (AC No Etll: IML.Mo): 16 North Elm Street E-MAIL ADDRESS:_.- P 0 Box 750 -. --_ INSURER-IS)AFFORDING COVERAGE _ NAIC♦ Westfield MA 01086 INSURER A:RUBS ell Bond F Company InC INSURED INSURER e:S tandard Safety Product Lines 39454 N R B Exteriors Inc IN$uRERC:Travel ere Insurance Company 7 Philip Circle INSURER INSURER E. Granby NA 01033 INSURER F: COVERAGES CERTIFICATE NUMBER:CL172700288 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IL CMR TYPE OF INSURANCE amen)ry0 POLICY NUMBER POLICYEFTPODDYYTY MWpmYEFT I POUC YEXP LIMITS X COMMERCIAL GENERAL UABILSY I500,000 _ EACHE Tu RE NCE $ _ • oRENSE§( AENYE� A CLAIMS-MADE �CCCUR PgEMI$E$IEa uttuner¢e) $ 100,000 _I, a0D100144131 12/23/2016 12/23/2017 MED EXP{Mryone person) $ 5,000 PERSONAL&ADV INJURY $ 500,000 GEN'L AGGREGATE LIME APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY_ JET LOC PRODUCTS-COMPAOPAGG $ 1,000,000 OTHER: I 1 $ AUTOMOBILE LMBILITY COMBINED SINGLE LIMIT $ B ,ANY AUTO BODILY INJURY 07er person) 5 500,000 ALL ATOOMED SCHEDULED 6222362 3/15/2017 3/15/2018 BODILY INJURY(Per 0Cde4) 1 1,000,000 PROPERTY DAMAGE $ 200.000 X HIRED AUTOS X NON-OWNED AUTOS (Pe auk) Unesured materiel BI split limit $ 500,000 UMBRELLA UAB r OCCUR I EACH OCCURRENCE $ EXCESS LIAR 1 CLAIMS-MADEI AGGREGATE $ - DED RETENTION$ 1 8 WORKERSCOMPENSATION PER AH. AID EYPLDYERS'U &IUTY STATUTE EA YIN ANY PROPRIETOWEXCTNERDE%ECUTIYE G, /MandOFFICatory ER EXCLUDED? �1 N/A E.L.EACH ACCIDEACCIDENT, OM1 in NN) Mar13-91"59768-6-17 2/13/2017 2/13/2018 E.L.DISPo4-EA EMPLOYEE $ IIos _ DESCRIPTION OF OPERATIONS below To follow from company EL.DISEASE-POLICY LIMIT $ DESCRIPnON OFOPERATIORS/LOCATIONS/VEHICLES(ACORO 101,Additional RaMNa Schedule,—be aIacMd II more space Is required) roofing/residential/ three stories and under , Siding and window installation, Roofing / residential over three stories and/ or commercial, Carpentry - construction of residential property not exceeding three stories in height CERTIFICATE HOLDER CANCELLATION (413)467-9748 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE N R B Exteriors Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7 Philip Circle ACCORDANCE WITH THE POLICY PROVISIONS. Granby, MA 01033 AM$h4QED REPRESEN'{TAA ITV EE ©1 88&2014 ACOORRD CORPORA II rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered 'marks of ACORD INS025(20/401) gully Licensed and Insured U GCser the Co n 7 Philip Cir Granby,MA 1033 MA Reg#20-2015718 PCtitjon! Phone:413.56363$4 MA Lic#: 147961 Fault:467 9748 MA CSL#: 99565 spedali:ins in Roofing +4r *` NICHOLAS BERNIER Wigs (Owner) Ts mann !°'"-,:".. c_. EXTERIOR HOME IMPROVEMENTS,In. www.nrbexteriors.cam 1 ROOFING H SEAMI FSS GUTTERS Windows-Siding-Decks / VResidential-Q> ercial _4-3"2 L. U C Y P >sal submitted to: Phone( It 4/ -.} -$J c: SJ7 a //�/ +k Special requirements Street 1 (1 - a ���� a , '�s � tie., ti Cit state,zip code q� CA Proposal to furnish and install the following Ui Re-ra>fi .tTear-off ❑ Gutters 83 We shall acquire necessary permits for all work Complete Roof Preparation r! Home's exterior to be protected by tarps and plywood bili Shrubs,landscaping,trees to be protected,roofers buggy used (� Entire existing roofing materials to be removed to existing decking,including flashing,etc. (� Site to be cleaned on a daily basis with roll magnet,,,debris to be removed at project completion by dumpster la Deteriorated existing decking to be replacedllat$50 per sheet of plywood j ��„ Complete CertainTeed Integrity Roof System W Install Winterguard ice.@ water barrier along bottom U 3 ft.of all roofs. 6 ❑y Install Winterguard ice lc water barrier around penetrations,in valleys and all critical areas � Install 154 saturated asphalt felt paper to entire decking W Install Roofers Select Premium underlayment to entire decking (J Install DiamondDeck Synthetic underlayment to entire decking (e Install 8"perimeter metal flashing to all edges of all roofs,ED white U brown 1,g Install SwiftStart starter shingle to bottom and rake edges of all roofs M Install CertainTeed shingles to manufacturers specifications, U 6 nails I$4 nails te Install Shingle Vent II PVC ridge vent to ail peaks in heated areas • Install Shadow Ridge to all hips and ridges,over ridge vent where applicable • Install new lead counter flashing to chimney • New flashing installed where necessary O Install new pipe flashing to waste vent stacks Warranty options 0' We guarantee our labor/workmanship for 20 years EL Upgrade CertainTeed 5-Star Sure Start Plus.50-year nonprorated coverage,including workmanship ❑ Upgrade CertainTeed 4-Star Su • S.. ' - ,. : .. . . erage ):11 CertainTeed Landmark-color ishcon,)f -•+st Ui 3-tab o CertainTeed Landmark Procolor. --p We propose hnmby a ramrsb n,crit and labor—complete in accordance with above specifications for e sum of Total Due $r> O0j0• u7 ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are - 1/3 Down Payment$ c?"p0CLtL) satisfactory and are hereby accepted.You are authorized to do work as cpt ifie& Balance due Payment will be t/3 down at start orjob,and , o• due upon completion. upon completion $ �✓Dt.L) f. -� Date; 3;11 Si: Signature: at,kept *Ore / Date: c -i>✓r 7 Estimator:(Print Name) IV;t R{/Nie✓ (Sign Name)` .a1 Estimates are honored for thirty(30)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 in through cracks of the wood.NRB Exteriors Inc.will not be responsible for debris or dust in the attic or storage areas. A Finance Charge of 1+A%monthly(ANNUAL PERCENTAGE RATE OF i8%)Will be added to the unpaid portion of the balance due.I agree to pay and/or guarantee payment of there charges.In the event of default of payment.I agree to pay reasonable Attorney's fees and court costs.This agreement does not constitute a release of liability.liy my signature below,acknowledges an agreement of the above is hereby made. Signature: