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38B Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-070626 Expires:08/21/2018 ADAM A QUENNEVILLE.s. 160 OLD LYMAN ROAD, SOUTH HADLEY MA 01075 Commissioner %'fly04. % r�:3r7:!�,!t� > ' Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: Corporation ADAM QUENNEVILLE ROOFING AND SIDING,INC.' - Registration: 191083 160 OLD LYMAN RD, Expiration: 03/22/2020 SO.HADLEY,MA 01075 Update Address and Return Card. SCA 1 20?.b05;17 a STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION Be it known that ADAM QUENNEVILLE i 160 OLD LYMAN ROAD SOUTH HADLEY, MA 01075-2632 E is certified by the Department of consumer Protection as a registered HOME IMPROVEMENT CONTRACTOR Registration # HIC.0575920 ADAM QUENNEVILLE ROOFING I I � � Effective: 12/01/2017 Expiration: 11/30/2018 f+tic6etk seagull,Commissioner ACC)RL r� DATE(MMIDDIYYYY) V CERTIFICATE OF LIABILITY INSURANCE 08/13/2018 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),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 CONTACT Melinda Karakula NAME: Goss&McLain Insurance Agency PHONEJAIC, E (413)534-7355 No: (413)536-9286 1767 Northampton Street E-MAILS; mkarakula@gossmclain.com P O BOX 112$ INSURER(S)AFFORDING COVERAGE NAIC A Holyoke MA 01041-1128 INSURERA; Nautilus Insurance Company INSURED INSURER 8: Nautilus Insurance Company Adam Quenneville Roofing&Siding Inc INSURER C! A.I.M.Mutual ins Co. 160 Old Lyman Road INSURER D: The Bond Exchange,Inc. INSURER E: South Hadley MA 01075 INSURER F: COVERAGES CERTIFICATE NUMBER: CL185104974 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. /LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDYIYYYY MMIDD P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTFIT_PREMISES Ea occurrence) $ 100,000 MED EXP(Anv one person) $ 15,000' A Y NN952216 06123/2018 06123/2019 PERSONAL&ADV INJURY $ 1,000,000 GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- 2,000,000 JECT L PRODUCTS-COMPIOPAGG $ OTHER_ Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $� HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Underinsured motorist Bi $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,080,000 B EXCESS LIAB CLAIMS-MADE AN055464 08/13/201$ 08/13/2019 AGGREGATE $ 5,000,000 DED:[X RETENTION$ 10,000 — WORKERS COMPENSATIONPER CH- AND EMPLOYERS' Y t N LIABILITY X STATUTE ERT ANY PROPRIETOR CUTIVE 1,000,000 E.L.EACH ACCIDENT $ C OFFICER/MEMBER EXCLEXGLUDED?DEO? � NIA AWC4007012861-2018 041291201$ 04129/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 it yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Surety Bond-HSS Affiliate D 3364848 04119/2018 04/19!2019 Bond Amount 20,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Certificate holders are additonal insured on the above captioned GL policy;subject to policy forms,conditions,and exclusions.Adam Quenneville,as an officer,is excluded from the Workers Camp policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Adam Quenneville Roofing&Siding Inc. ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 �M www mass.gov/dia ZYorkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Adam Quenneville Roofing &Siding Inc. Address: 160 Old Lyman Rd City/State/Zip:South Hadley, MA 01075 Phone #:413-536-5955 Are you an employer?Check the appropriate box: Type of project(required): I.Q I am a employer with 15 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 g, 0 Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.M I am a homeowner doing all work myself[No workers'camp.insurance required.]r 10[]Building addition 4-[:Il am a homeowner and will be hiring contractors to conduct all work on my property. l will ensure that all contractors either have workers'compensation insurance or are sole 1 I.0 Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.rl i am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.: 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGI.c. 14.[]Other 152,§1(4),and we have no employees.[No workers'camp.insurance required.] *Any applicant that checks box 91 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 far my employees. Below is the policy and job site information. insurance Company Name:AIM Mutual _ Policy#or Self-ins.Lia#:AWC4007012861-2018 Expiration Date::s4/29/2019_ Job Site Address: 1`7 6 �,r,kJ� 54-. City/State/Zip: t4V/4'k6 , &N 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 under he pain and penalties of perjury that the information provided above is true and correct. Signature Date: -- phone#:413-536-5955 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#: City of Northampton � • els �'^s!c, Massachusetts `�^ DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building, Northampton, MA 01060 " AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR") regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"}. M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note.If the homeowner has contracted with a corporation or LLC, that entity must be registered Type of Work: Est. Cost: Address of Work: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): Job under$1,000.00 _Owner obtaining own permit(explain): Building not owner-occupied _Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 1 Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature 'We propose hereby to furnish materials and labor—complete in accordance with above specifications for the sum of. Total Due: ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions areDown Payment:($ satisfactory and are hereby accepted.You are authorized to do work as specified. Balance Due Upon Completion:($ Payment will be 1/3 down at signing,and balance due upon completion. I � "'A (114,�,CLVx Date: Signature: Date: Estimator:(Print Name) —I& D,eY(Sign Name)— Estimates are honored forsWk(60)days from above date. NOTICE OF SCHEDULE CHANGES The contractor agrees that when delays become known to the Contractor,the Contractor will advise the Owner as soon as reasonable. DELAYS IN THE COMPLETION SURE TO HIDDEN CONDITIONS The Owner hereby acknowledges and agrees that In certain remodeling work,the demolition of portions 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 commence or complete the work described under the contract.In such case(s),the Owner agrees that the dura'tion of the work and the scheduled date of completion may differ from the date on the front,and that such variation which Is not avoidable by the Contractor shall not be considered to be a violation of the contract, ADDITIONAL WARRANTY INFORMATION All warranties for equipment supplied by the Contract under the Agreement shall be those given by the manufacturers of such equipment,which shall be and are hereby passed through directly to the Owner.Under such manufacturer's warranties,the Owner may be required to register or mail in a warranty card or other evidence of ownership and use of such equipment in order to activate such warranties. The warranty give the Owner specific legal rights,and Owner may also have other rights which vary from state to state.Under Massachusetts law,sale of goods carry an Implied warranty of merchantability and fitness for a certain purpose.All material is guaranteed to be as specified.All work shall be completed in a workmanlike manner,according to standard practices.Any alteration or deviation from above specifications Involving extra costs will be executed only upon written orders and will become an extra charge over estimate.All agreements are contingent upon strikes,accidents or delays beyond control. SUBCONTRACTING Contractor agrees that,notwithstanding any agreement for materials and/or labor between Contractor and third party,Contractor is responsible to Owner for completion of all work described in a timely and workmanlike manner. NO ACCELERATION OF PAYMENTS BUT ESCROWING ALLOWED The Contractor may not require payments to be made in advance of the times specified in the Payment Section(front)for the reasons the he deems himself or the payments to be Insecure.If,however,he deems himself to be Insecure,he may require,as a prerequisite to continuing the work described herein,that the balance of the payments under this contract that are In control of the Owner,shall be placed in a joint escrow that requires the signature of both the Contractor and the Owner for withdrawal. You agree to pay cash according to the terms shown above or,if we approve your credit,to sign a note provided by us for payment of the amount due.You also agree to sign a completion certificate upon completion of the work.If you fail to pay according to the above terms and have not signed our note,the entire unpaid amount becomes immediately due,and you must pay a collection cost equal to our actual collection costs up to 15%of the total amount you owe,plus attorney's fees and court costs.In addition,you understand that by failing to pay according to the above terms,the Contractor may have a claim against you which may be enforced against your property in accordance with the applicable lien-laws, INSURANCE Contractor will be responsible to Owner or any third party for any property damage or bodily injury caused by himself,his employees or his subcontractors in the performance of,or as a result of,the work under this Agreement.Contractor agrees to carry insurance to cover such damage or injury. The Contractor recognizes his obligation to maintain a workers'compensation insurance policy to cover his employees.Contractor further recognizes the obligation of any and all subcontractor to maintain a workers'compensation policy to cover their employees. Contractor maintains a liability Insurance policy with minimum coverage limits of one million dollars($1,000,000.00) CONSTRUCTION RELATED PERMIT ACQUISITION QUENNEVILLE12G UL;AwAR6 DISCOVER' ROOFING w SIDING 2010 WINNER VISA 1lJC� 160 Old Lyman Road•South Hadley• MA 01075 We are Licensed 1.800.NEW.ROOF a 413.536.5955 Fully Insured Email:info@1800newroof.net Website:www.180onewro6f.net Factory Trained MA Construction Supervisors Lic.#070626 MA Registration#120982 Factory Certified Installers Member of the Home Builder's Assoc.of Western Mass. CT Registration#575920 Member of the Building&Trade Association P.P.0 38710 Proposal Submitted To: Megan&Alan Wolf Phone#'s: 4-1 C',V\ _ C: 503-522-2551 Date: 11/9/18 7�3 lr-n�^�.Sa� W: Street: 176 South St. Email: mega nm urphy.wolfOgmail.com City,State,Zip Code: Northampton, Ma.01060 Proposal to furnish and install the following: Re: 176 South St., Northampton, Ma. (2)Tin Flat roofs—total of 2,500 square feet including flashings Scope of Work: 1) Furnish and install W High Density Coverboard, mechanically attached,over the(2)existing tin roofs. 2) Furnish and install pressure treated nailers around perimeters to match the height of the new HD Coverboard. 3) Furnish and install 60 mil Firestone EPDM over the new HD Coverboard complete with all associated flashings. 4) Furnish and install termination bar with all necessary accessories for securing EPDM to all roof edges above gutters. 5) Clean jobsite of all roofing debris. 6) Adam Quenneville Roofing to provide 10 year labor and material warranty. Note: Re-use existing gutters and downspouts. Price$20,555(Twenty thousand five hundred fifty five dollars) Price valid for 45 days. Note:All costs related to obtaining a building permit are excluded from this proposal. Terms: $6,855 dueupo ropos cceptan ,$13,700 due net 30 days upon job completion Israel Schepps Director—Commercial Roofing Division Ask us about affordable bank financing! ATTENTION:Please cover all personal belongings below roof deck due to the possibility of roofing debris or dust coming in through cracks in the roof deck.Adam Quenneville Roofing will not be responsible for debris or dust below. e roof deck. Customer Initials: � k�'"'``�` City of Northampton /' __ 914"""•' SEC y! Massachusetts , H ' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building 9�J, Q�a� Northampton, MA 01060 rd�y'" rJ11 Debris 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. The debris from construction work being performed at: 17 GR 15,ot�t Vt (Please print house number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company N me and-Address) Sign ure of Permit Applicant or Owner Date If,for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Su ervisor: i_ Not Applicable 0 Name of License Holder: t-s- Qr7q4,,a License Number ko 0� 01M 06a/�O/q Address Expiration e k- - 1113 Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ A,t� �J�MCT 11c- 1�1't1/�� G S( i]!A --VA G (a (Oq I Company Name j Registration Number 160 73/ai-tJoaV Address �,t Expiration Date S0 Vk- r t �t.f �a p(G"] S' Telephone 413- S76-vsr 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 buildi2g permit. Signed Affidavit Attached Yes....... No...... ❑ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [13] Decks [Q Siding[p] Other[o] Brief Description of Proposed a ��P s ` /5-C' 1 ,,/AHO " d Work: ancC e510pM oyy" La4LkiAc +,'A ryp(— co,K�IIc�Ly +'k d,tl �ss,uc.r+r.0 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 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 Sty- Ss�r�tcd ��o�►ora�-� as Owner of the subject I roperty /�� hereby authorize O"K '�e✓'l� 1�0filk 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. Adm ��- Print Name Signature of Owner/Agent 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: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Find! g ever been issued for/on the site? NO ® DONT KNOW kU YES IF YES, date issued:' IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW Q YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW () YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained O , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,ex (%ation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO UV IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit: ✓ "" Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability, Room 100 WaterMell Availability Northampton, MA 01060 Two Sets of Structural Plans ,.r phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, LTEnn LISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 7NUV TG ti 1.1 Property Address: 2n,8 ThiIss section to be completed by office -1Map 0 Lot /5V Unit DEPT.OF BUILDING INSPECTIONS Ir ^ NORTHAMPTON,MA25M! Overlay District 'mak "fes r Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: b I II 6 0 A Ir-h We,((, Mfj to Av iP h7 wo V 1,7& Name(Print) Current Mailing Address: _Sce- Ccl l 703- Lt7`d- GS13'" pl'y. ) Telephone Signature 2.2 Authorized Agent: ©I p q Name(Print) Current Mailing Address: 4t3— 534- S4 S5- Signature V Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed b permit applicant 1. Building � (a)Building Permit Fee 04 0 f eXvc� ti 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 7� 4. Mechanical(HVAC) V 5. Fire Protection 6. Total=0 +2+3+4+5) d!d SSI' Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: l/(27/`. Building Commissioner/Inspector of Buildings Date lSCh osoaq'eS@ EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 176 SOUTH ST BP-2019-0635 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:38B- 154 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-2019-0635 Proiect# JS-2019-001037 Est.Cost: $20555.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq.ft.): 20386.08 Owner: WOLF ALAN C&MEGAN L MURPHY Zoning:URB(100)/ Applicant. ADAM QUENNEVILLE AT: 176 SOUTH ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON.•11/28/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-ROOF OVER 2 EXISTING TIN ROOFS 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: 01i 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 11/28/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner