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35-004 (3) 88 TURKEY HILL RD BP-2019-0453 GIs#: COMMONWEALTH OF MASSACHUSETTS Map-Block: 35 -004 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-2019-0453 Proiect# JS-2019-000724 Est.Cost: $34000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NORTH EAST SPECIALTY CORP 103713 Lot Size(sq.ft.): 39988.08 Owner: RILEY JOHN D&PATRICIA F Zonin : Applicant. NORTH EAST SPECIALTY CORP AT. 88 TURKEY HILL RD Applicant Address: Phone: Insurance: 148 DOTY CIRCLE (413) 739-4333 WC WEST SPRINGFIELDMA01089 ISSUED ON:10/15/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMOVE SOLAR AND RE - 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 10/15/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City of Northampton Status of hermit: 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 phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, OLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Ma �� Lot Unit DEPT.OF BUILDING INSPECTIONS 88 Turkey Hill Road NORTHAMPTON,AAA Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: John & Patricia Riley 88 Turkey Hill RoadFlorence MA Name(Print) Current Mailing Address: 413-586-6272 Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Addr ss: Signature/ Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 34000.00 (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=0 +2 +3+4+5) 34000.00 1 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: �--� lO�?,6.g Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of ParkingS aces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DON'T KNOW O YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW e YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DONT 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 O NO e IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0 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 © NO O 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 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding [0] Other[�] Brief Description of Proposed Work: �� y ✓`� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other roof 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 unde .the pains and penalties of perjury. �' -eC to Pam nature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Keith Devin License Number 148 Doty Circle West Springfield MA 01089 cs-110285 Address Expiration Date 1-9-20 Signature Telephone 413-739-4333 9.Registered Home Improvement Contractor: Not Applicable ❑ Y\�)XT— Co any Name Registration Number (� 103713 Address o Expiration Date Telephone `�13_ �77' � 7-13-20 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 prmit. Signed Affidavit Attached Yes....... No...... ❑ \ The Commonwealth of Massachusetts Y Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Nescor Address:148 Doty Circle City/State/Zip:West Springfield MA 01089 Phone#:413-739-4333 Are you an employer?Check the appropriate box: Type of project(required): 1.E]I am a employer with 20 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.M I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. 14.❑✓ Other roof 6.F1We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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 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 and job site information. Insurance Company Name:AIM Policy#or Self-ins.Lic.#:vwc6003962-2017 Expiration Date:7-9-19 Job Site Address:88 Turkey Hill Road City/State/Zip:Florence MA 01062 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 certify u4der the pains andpenalties ofperjury that the information provided above is true and correct. Signature: Date: d Phone#:413=`/39-4333 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#: 10/8/2018 Details Tlj.c:Official VVei)Si e of the E X4,.,Otive,Offi(�e of Public.`safety and Security(EOPSS) ensee Details uemographic Information Full Name: KEITH W DEVIN Owner Name: IP icense ress norma ion City: WEST SUFFIELD State: CT Zipcode: 06093 o nt : Unjted, tates icense inTormation License No: CS-110285 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: Issue Date: Expiration Date: /9/2020 License Status: Active Today's Date: 0/8/2018 Secondary License Type: Doing Business As: atus Change Reason.: License Is ance rerequisia inTormation No Prerequisite Information Close.Window] ©2011 Commonwealth of Massachusetts Site Policies Contact Us http://elicense.chs.state.ma.usNerification/Details.aspx?agency_id=1&license_id=847296& 1/1 i I Office of Consumer Affairs and Business Regulation 4 One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: Corporation 103713 NORTH EAST SPECIALTY CORPORATION Registration: Expiration: 07/7/13/2 13/2020 148 DOTY CIRCLE WEST SPRINGFIELD,MA 01089 Update Address and Return Card. SCA 1 c:w 20M-05/17 CJ/ie�aneneorati o�C�/��acluAella Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 103713; 07/13/2020 One Ashburton Place-Suite 1301 NORTH EAST SPECIALTY CORPORATION Boston,MA 02108 SHARON M.TARIFF Q C 148 DOTY CIRCLE WEST SPRINGFIELD,MA 01089 Not valid without signat e Undersecretary N ESC -1 ACORO" DATE(MMIDDIYYYY)CERTIFICATE OF LIABILITY INSURANCE 07111012018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPO 4 THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVER kGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE SSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or 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). PRODUCER 413-737-5359 CT J Raymond Lussler Ins Agcy Inc J Ra mond Lussler Ins Agcy Inc AIC No,Ext):413-737-5359 {AIX,No):413 181 Park Avenue,Suite 8 PO Box 499 Mss:Ino USSIerinSurance. om West Springfield,MA 01090-0499 J Raymond Lussler Ins Agcy Inc INSURERS AFFORDING COVERAGE NAIC k INSURERA:COLONY INSURANCE CO INSURED Northeast Specialty Corp INSURERB:A LM. Mutual Ins.Co. Nescor 148 Doty Circle INSURER C:SafetInsurance Company 39454 West Springfield,MA 01089 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED N MED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCL MENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HE 1EIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR 101 PKGO094179-00 03/18/2018 03/18/2019 DAMESO RENTED SES(Ee occurrence) $ 100 000 MED EXP(Anv one erson 5'000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑jpeT El LOC PRODUCTS-COMP/OP AGG 2'000'000 OTHER: C AUTOMOBILE LIABILITY Ee BtitleDtSINGLE LIMIT $ 1,000,000 ANY AUTO 2433825 03/11/2018 03/11/2019 BODILY INJURY Per erson OWNED SCHEDULED AUTOS ONLY X AUTOS yy Ep BODILY INJURY Per accident $ X AUTOS ONLY X AUTOS V4N PPeOaCcRdent AMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X PEROTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N VWC6003962-2017 07/09/2018 0710912019 100,000 ��FFICERIMEEMgg����EXCLUDED? N 1 A E.L.EACH ACCIDENT $ (MandstorylnNH) E.L.DISEASE-EA EMPLOYEE $ 100,000 Ifes,describe under D SCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) EIRTIFICATE HOLDER CANCELLATION ENFIETO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF ENFIELD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 820 ENFIELD STREET ENFIELD,CT 06082 AUTHORIZED REPRESENTATIVE ^4- s ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Page 2 of 9 NORTHEAST SPECIALTY MA License #103713 1-888-NESCOR-1 CORPORATION d/b/a NESCOR 148 Doty Circle. WEST SPRINGFIELD, 1-888-637-2671 MA 01089 nescornow.com All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by Provisions of Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director of Consumer Affairs and Business Regulation, Ten Park Plaza, Suite 5170 Boston, MA 02116 - Phone (617) 973-8700 John & Patricia Riley jdriley@comcast.net Date: 09/27/2018 88 Turkey Hill Road 413-586-6272 Rep: Mitch Grant Florence, MA 01062 jdriely@comcast.net JOB NAME jdriley@comcast.net Date: 09/27/2018 JOB LOCATION 413-586-6272 Rep: Mitch Grant ESTIMATOR jdriely@comcast.net We hereby submit specifications and estimates for work to be preformed and materials to be used: Specifications and estimates for work to be preformed and materials to be used >> Please See previous product specification pages. Include 1 SO of plywood with project. Remove old solar on garage and dispose. WORK SCHEDULE Contractor, will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified herein. Contractor will begin the work on or about. Estimated Starting Date 09/27/2018 Baring delays cause by circumstances beyond Contractor's control, the work will be completed by Estimated Completion Date 10/26/2018 The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including, but not limited to strikes, Acts of God, shortages or materials, accidents, and all other delays beyond its control, shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects of materials of workmanship for a period of days. DAYS OF WARRANTY COVERED lifetime +50 WARRANTY CONTINUED following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, it's subcontractors, employees or agents, is discovered after completion of any job, including cleanup, the Contractor shall survive any inspection preformed in connection with the agreed-upon work. Total Contract Amount $361132.00 to hereby to furnish material and labor - complete in accordance with above specifications, for the sum of Total Contract Amount $361132.00 Payment to be made as follows Page 3 of 9 $ Due at signing $1,000.00 $ Due $0.00 Upon completion of start $ Due $35,132.00 Upon completion of finish finish Name of Contractor/Designated Registrant NORTHEAST SPECIALTY CORPORATION d/b/a NESCOR Street Address 148 DOTY CIRCLE City/State WEST SPRINGFIELD, MA 01089 413-739-4333 Registration No. 103713 Name of Salesmen Mitch Grant Authorized Signature Amount Paid in Cash $36,132.00 Cash Deposit $1,000.00 Cash Due Upon Completion $35,132.00 Form of Payment Check Check# 9243 Check Date 09/27/2018 Ownership of Property: The undersigned warrants that he/she is Owner of the property on which the work is to be performed or that he/she is otherwise authorized an behalf of Owner(s) to enter into this Contract. Notice of Scheduling Changes:Contractor agrees to provide Owner with notice when delays become known to the Contractor. Concealed Conditions: Should concealed conditions encountered in the performance of the contract be at.variance with the conditions indicated by the contract and/or Owner or should unknown conditions of an unusual nature, differ from those ordinarily encountered and generally recognized as inherent in the work of the character provided for In this con-tract be encountered, the contract shall be equitably increased. Furthermore, if unknown and/or concealed conditions prevent Contractor from completing the contract, the contract shall be equitably increased or decreased, as the case may be. Delays in Completion Due to Concealed Conditions: Owner hereby acknowledges that in certain remodeling work, the demolition of portion Of the pre-existing structure may reveal additional defects, conditions or the need for additional work, which must be repaired,altered or carried out in order to complete the wort described under the contract. In such case(s), Owner agrees that the duration of the work and the scheduled date of completion may differ from the date stated on the front, and that such variation shall not be considered to be a violation of this contract. Page 7 of 9 Serving MD Serving VA 123 Main Street NremoR_ 345 Gateway Dr Baltimore,MD 21222 Vienna Va,12345 Customer Information John & Patricia Riley jdriley@comcast.net Date: 09/27/2018 88 Turkey Hill Road 413-586-6272 Rep: Mitch Grant Florence, MA 01062 jdriely@comcast.net Locations INCLUDED in scope of work to be performed Single family home and attached garage Locations EXCLUDED in scope of work to be performed Detached shed in back yard Job Specifications Existing Shingles Asphalt Existing Shingles Asphalt Shingle Color Timberwood Install Underlayment Synthetic Install Drip Edge F 4.5" Install Ice & Water Shield on Gutter Eaves and Valleys Included Install Ice & Water Shield Around All Penetrations & Along All Flashings Included Install Ridge Vent attic ventilation system on all required areas (Length) 50 Number of Skylight(s) being installed 0 Platinum Warranty Included Additional Details Cleanup job site and haul away debris. All in package to include 6" gutters, shield, 3x4 downspouts and solar attic fan. Protect bushes on front and side of home. Unforeseen costs that could occur. Additional cost could arise due to damaged wood not recognized at time of estimate. Any wood replacement will be charged upon the homeowners approval an additional cost of $40 per 4'x8' sheet of CDX plywood and $50 per 4'x8' sheet of FRT plywood. Homeowner understands that damaged plywood can only be evaluated after the existing layer(s) of shingle(s) have been removed. Homeowner has completely read, and fully understands that any and all plywood replacement will be charged in addition to the total amount of this contract. I understand the additional charges that could occur at time of installation. (Customer Initials)