24D-190 45 FINN ST BP-2019-1021
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24D- 190 CITY OF NORTHAMPTON
Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category ROOF BUILDING PERMIT
Permit# BP-2019-1021
Proiect# JS-2019-001675
Est Cost$8825 00
Fee: S40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: MAJOR HOME IMPROVEMENTS 103054
Lot Size(sa. ft): 5270.76 OWner. MURRAY JOHN EDWARD&PAULA RIGANO MURRAY
zoning URC(100)/ Applicant: MAJOR HOME IMPROVEMENTS
AT: 45 FINN ST
Applicant Address: Phone: Insurance:
19 HUNTER SLOPE (781)913-6405 WC
WESTFIELDMA01085 ISSUED 0X.•3/20/2019 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# 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 s e amt
FeeType: Date Paid: Amount:
Building 3/20/20190:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
(2�1
City of No ham ---
Building D part ant
212 Mai Stre t MAR 1 9 2019
Room 100
Northampton MA
phone 413-587-1240 Fa)F41�--
enno�c
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION 18 10 0 Z'
1.1 ProoemAtldress: LIS Fv"ru s r,eA
Nor4-ha4- Pk-Y) , PA 01 0 60
SECTION 2-PROPERTY ONL13SHIP/AU7HORQED AGENT
2.1 Owner of Record:
Pauka ( RkLt rz a.4 4 5 " oil) D40 f
Na (Print) � �jirtent Mallin Atltlress. U(06(7
Signature
2.2 Authorized Anent:
Name(Print) Cunent Mailing Atltlress:
f /tE�' ) 6�- �C)4
ignatun, TZlepaone
SECTION S-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official use Onh/
completed b noir scolicant
1. Building C, g a j (a)Building Permit Fee
2. Electrical D (b)Estimated Total Cost of
Constft¢bon from 6
3, Plumbing Building Pal Fee
4, Mechanical(HVAC)
5, Fire Protection
6. Total=(1 +2+3+4+5) Check Number
This Section For Official this,Only.
..,'Building Pang Numbs Date
. Issued;
179-00
re. 3 T-0' 'ZQIq
Building Data
MA-30QHvMG @ '�AH,>3 - �M
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING All Information Must Be Completed Permit Can Be Denied Due To Incomplete formation
Existing Proposed Required by ning
This column r be filletl in by
Building Ed moment
Lot Size
Fronts a L»J
Setbacks Front rr O
Side L:LJ RL:Q R:
Rear t--+
Building Height 14
Bldg.Square Footage O %
Open Space Footage u % l�
(tm arts minus bldg&mocd
o
#of Purging S ces
Fill:
vnmme&LCCelimn
A. Has a Special Permit/Variance/Finding ev been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at th Registry of Deeds?
NO O DONT KNO O YES
IF YES: enter Book Page= and/or Document#
B. Does the site contain a brook, b dy of water or wetlands? NO O DON'T KNOW O YES O
IF YES, has a permit been need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued: E=
C. Do any signs exist on th property? YES O NO O
IF YES, describe siz , type and location:
D. Are there any pro sed changes to or additions of signs intended for the property? YES O NO
IF YES, descri size, type and location:
E. Will the mnstr ion activity disturb(d anng,grading,excavation,or filling)over 1 acre or is it pad of a common plan
that will distu overt acre? YES 6 NO O
IF YES,in o a Northampton Storm Water Management Permit from the DPW is required.
SECTION S DESCRIPTION OF PROPOSED WORK/cheek all aoolleabiet
New louse ❑ Addition ❑ Repbcement Windows I Alteration(s) Roofing
Or Doors 0
Accessory Bldg. ❑ Demoli lon ❑ New Signs [0) Decks [0 Siding[0) Other[M
Brief D nption of Pfoppsed �
Work: �1Ylf) 1511 Y1C��Ll�PJl �I15'�Q,Q,Q,P1.P-U/CLC�'Lc t tll�
Alteration of existing bedroom_Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement _Yes _No
Plans Attached Roll -Sheet
h� Gt
a. Use of building One Family V 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 h.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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, P 1 A� I yJLCM!!LCJ as Owner of the subject
property
hereby authorize , (a ls� (l 'L (`>✓C. -)'�(,(�I��1-
to ad on my behalf,in all matters relative to work authorized by this building permit application.
AW
Sig um of Owner I , I ,f p� �� Data
I, �� 7c1 1 e �!c.l.IG41cc,�U'h(.l.l� as OanerlAuthorized
Agent hereby declare that the statements antl information on the foregoing application are true and accurate, to the beat of my knowledge
and belief.
Signed under the pains and penalties of perjury.
�
/ a5111 ; e kt,tkkafecku �
Print ame
3 ) 6 - I �
SigneumoUOukeWAgent Data
SECTION 8•CONSTRUCTION SERVICES
8.1 Licensed ConstrucllonnSupervisorr: ,Nott�Applicable ❑
�++
Nerve of Llemse Xolder �iC�S� ( l 4CcA.lC1 .�2c,4�u,L,k- t—J — ( C) ?,0 ✓ 1
License Number
Adtlress Expire0on oa
Telephon
,h.ri
Signa e
(m QA DiNot Applicable
❑
FLfYR (15U dT
(
Co—{i-ioenv�N mek Registration Number
�
Atld ss //fr� Explrati n Date
Telephok,--%— r /,
SECTION 10•WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L o.152,;25C(S))
WOdters 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....... No...... ❑
City of Northampton
Massachusetts
122PAR1 T OF BUILDING INSPECTIONS
212 Hain -treat a Municipal Bvilmnx,
Bortaampton, w. 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 most 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 preexisting 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 o corporation or LLC,that entity mast he registered
Type of Work: C-e —V-VV') 0C. Est.Cost: �d S
Address of Work: 1-( J {—I Yl Yl ,S(I�'l -CC-U �JI"f r1C•c.11��'��` (1
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: —
L��
I hereby apply for a building permit as the agent of the owner:
3-16-(a Uca�); I; e Vu-k�chct k C�, -( o3c)SI={
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
City of Northampton
Massachusetts
C
DEPB&TMENT OF BUILDING INSPNOTIONS
212 Mein Street • Min 010 euilainq
Nartaemptou. l�A 01060
Massachusetts Residential Building Code
Section I10.R5.1.2
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.
Section i IO.R5.1.3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR 110.85,provided that if a homeowner engages a person(s)
for hire to do such work, then such homeowner shall act as supervisor.
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
City of Northampton
Massachusetts
DEPNtS T OF HOZZDZNG INSPECTIONS
212 lain Street *M icipel Building
NortAampton, M 01060
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:
t{S Ft Vlo SIlyl
(Please print house number and street name)
Is to be disposed of at: l
I
USA { Ia��Qux R (2ncl , �Qu� � Wiyds0 U
(Please print name and cation of faal4y
Or will be disposed of in a dumpster onsite rented or leased from:
USA5aAlar IQrAI SS CJI b� ( ( T06oda
(Company nd Address)
S' 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.
`cox The Commonwealth of Massachusetts
Department of InduchrialAccidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.massgov/dia
WWorkers'Compensation Insurance Affidavit: Builders/Contractors/Elmtricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Aoolicant Information Please Print I 'bl
Nettle(Business/OrganaanoMndividual):
Address: t]
Ctry/State/Zip:(Ajj54_U -U /I(-(,1 C)IC) PhGD .13 636 -6OY4
Are you an employer?Chuk the appropriate box:
Type of project(required):
1-olumaemployerwith -employees(full ardor parr-time).• 7, ❑New construction
2❑laasolepropnempanm
rornershipand have no employees working forein
y"I'mrs [No workers mnc
comp.ineue mquim4.l 8. E]Remodeling
anm
3 E]I am a homeowner doing all work myself.INo workerscomp insureau required]' 9, ❑Demolition
4.❑I am a homeowner and will N hiring contmamrs to conduct all work on my mr,out, Iwill 10❑Building addition
ensure that all Contractors either have workerscompensanvin insurance or are sole I1.❑Electrical repairs or additions
•,promotion with no employee%. 12.❑Plumbing repairs or additions
5.halam ageneml sureacmr and l have hired on,obcornowton eared once altatudaheet 13. Roof repairs
Ptffhh esub-rearmeturs have employees and have warkets'comp.ion cel ® P
6 E We are a corporation and its mothers have exercised their right ofexemption per MGL c. 14.[:]Other
152,§10),and we have no employees.[No workers'comp-insomere requites]
•Any applicant ikon checks box#1 must also fill ora the section below showing their workers'compensation poliry inomnation.
t Homeowners who submit this affidavit indicating they ere doing all work and then hire nature contractors most taboo a new andevit indicating such.
IContruWrs that check this box must attached an additional sheet showing the name of the subcontmcmrs and state whether to not those entities have
tons!o)'ees. Ifthe sulconrecmrshave employees,they must provele their workers trust,.policy number.
I am an employer thatis providing workers'compensadon insurance for my employees. Below is the policy andjob site
Information.
Insurance Company Name:
Policy#or Seif-ins.Lia#: Expiration Date:
Job Site Address: City/State/Zip:
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 font of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may he forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby cer¢(y under the pains andpenaides of perjury that the information provided above is nue and Correct
Si n m Date -(6 - I
Phone#:
Off[cial use only. Do not write in this area,to be completed by city or town ofclaL
City or Town: Permit/License 9
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#:
Proposal Dab — / IJab% MAJOR HOME IMPROVENENTS
Customer Nam ....IA
N A
0 0 19 Hunter Slope WestfeH,MA 01085
ustaner's Work Phoma Office:(413f636-6046
tlrNu S ESTIMATE auo PROPOSAL
Chy F ziPC a binatallROOFING MA CS 103054
Cof,% fol 0 a6on within city limb? ICT LIC 611632
N n raw Oa ra ❑No
Wing Address(if dRemntham above) I City Sba I lip Cm Pro.CometlbmN.&l-.mss Nn.(d10 bis)
Description W as Prolsot and Duabtlon of time SbnMmM Me1erlaH to he Dead and Eaulnmard to be inffiYed
The work to be cion urdw this contract includes the folloMng(where checked)'.
Not
iogh d S
pmmm u 1. ❑ Tar of meting rool shingles dorm to wood deck on entire housNgaragelismuoeer
2. ❑ Inspect wood deck and replace any room wood found inthe tied area atarate st
PLEASE NOTE'.this amount a not included inthe TOTAL PRICE shown balm..
Customer and MHl agree that ere TOTAL PRICE MII be amended via a Contract Change Authorization form to add the
costs of replacing rotten wood in the deck area discovered after existing roofing materials are Removed.
C 9
all
fifififififidifir, 3 ❑ Wms
TYPE14n9CSsO oCCOLOR
4, byl ❑ Furnish and install Synthes;Paper
5. O Furnish and Insall icedamming eave protector
6, ❑ Furah and Insall salter shingle on all saves.
1. ❑ Famish and lnerald'replam aMdeyergraatl V flashing: ❑ Well CMmney ❑ Donner
S. a0 ❑ Fumah anti seem metal imp edge along rake arges and eaves While ❑ Brawn
9. ❑ Furnish and install skylgM systsaw.
10. Fumbh and instal new vent coven on all vent pipes.
11. Qs ❑ Furnish and install into ventilation system(Check all appilcabe): Shirgaover more vena ❑Sofftvers
12. ❑ W Funnel,rubber cost 2
13. )& ❑ Fumish and Insall new fat roof Exte is Protection System: COLOR. CJ IFS y
Annip Edge ❑T.m undersh'ngles ❑SAbasesheet
d43 base sheet �SAmpshest
Blti� 74, ❑ Furnish anti inaallg ring: COLOR'.
15. O Oapma of atl gubenrg.
ams 16. O Cbrvup and removal of all lobe6aled dabM irxdudimg comers maamab (Extra materials an shipped with each job to avoid delays).
fNnuacswen issymardt,will be sem upon MTVW tea remission,
MHI recommends had Customers have dark drimney siding or mater beffiew briod1,sane,a boodle suspected periodlally by a prdesslonal and tuck pointed anNa
wa*pmoMa Deeded. MHI shall not be rsYponsiblefor chMnnay Integrity other than reloading the training in conjunction with the Installation ofthe roofing material
described above.
Cusamer(s)Instals ,
Additional wakabe der: ND/'/Q BA f/ �
Work NOTA be done:
SPECIALINSTRUCTIONS: GRO'V P02o
All of the above check bones and the'Work NOT to be done section have been reviewed and exPlained to me. Customene)inhials
APPROXIMATE START DATE end APPROMMATECOMPLETION DATE The work earl startapproxMately (Approomate Start Date)and will be
substantially completed by approzlmately (Approximate Completion Date). These dates are subject to change at the time the contract is accepted by Major
Home Improvements or at any other time by mutual written agreement. Cusomer understands that theAppr000mates Start Date is only an estimated date and the Customer
will be contacted prior to this data to schedule the actual start date.
The TOTAL PRICE 1npkOV all labs,marc lel,tars and any aPPI able discount is$ S Contract Price $ 2
Initial Payment(not to axaed 50%of Total Prior unless Special Order)$ State Sales Tax(_ % $
Final Payment(balance payable upon completlon of job)$ 14 F9 5 Local Sales Tax(%1 $
The Initial Payment Is due prior to MHI ordering products. TotalAmount Due $ ] v=
NOTICE TO BUYERYOU,THE BUYER MAY CANCELTHIS TRANSACTION AT ANYTIME PRIOR TO MIDNIGHT OF THETHIRD BUSINESS DAY(FIFTH BUSINESS
DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU AREAGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSACTION.
Custana(s)initats
CONTRACT APPROVED Cuslommi Signature
BY f—�
ACCEPTED BY MAJOR HOME IMPROVEMENTS Coauitod ale
' rw mnnweatth of Massachusetts
Oivisbn of Professonal Lkenwre
Board of Suilc ing Regui l s arM StaoM rEs > j{
Const` '%Wwlsor
it
CS-103054 S _2 _ fSpi," 08/24!2020
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WESTFIELD �`
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CERTIFICATE DOES NOT AFFIM"TWELY OR NNEI.Y ANEND. EXTENq OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUSNO INSURER14 AUTHOFI
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER
IMPORTANT.V the m0ficate hoWer is an ADDITIONAL INSURED,fie padayli")moat IN endorsed. H SUBROGATION IS W= to
the lama SIId condMons of 1130 policy,Certain potkMs may requks an eMorsement A statemmn on IDM cmDDcek does notconkr�Oti to ttN
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INDICATED. NOTMTYSTANDWG ANY REQUIREMENT, TSIN OR OCND(TION OF ANY CONTRACT OR OTHER OOCUMENT' M"BCT TO MON Tlae
CERTIFICATE MAY BE MUM OR MAY F AN.T INSUW VCE AFFORDED BY THE POUOES DESCRIBED HEREIN IS SUIUB CT TO ALL THE TERMS,
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:UUEMaT iCATE HOLDER CANCELLATION
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