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29-480 (8) 573 BURTS PIT RD BP-2020-0354 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29-480 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-2020-0354 Project# JS-2020-000597 Est. Cost: $13800.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CHRISTOPHER DORE 099561 Lot Size(sq. ft.): 69260.40 Owner: MULEA MICHELLE D Zoning: Applicant: CHRISTOPHER DORE AT. 573 BURTS PIT RD Applicant Address: Phone: Insurance: 84 GARDEN ST (413) 786-4081 WC FEEDING HILLSMA01030 ISSUED ON.9/19/2019 0:00:00 TO PERFORM THE FOLLOWING WORKSTRIP & SHINGLE ROOF - 20 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# 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 9/19/2019 0:00:00 $40.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner . j �,j)r 36Y Department use only ``� i:f•�'�~'s, City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit c 212 Main Street Sewer/Septic Availability Room 100 y 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, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION anol: 1.1 Property Address: 57 3 & R 7-SPI r/ yThis section to be completed by office (� Map / Lot —Unit-- Zone nitZone Overlay District Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: c 1 0NI(4 1q01Y4 S/?3 4 '&ICTsZ / Name(Print) Current Mailing Address: lephone Signature 2.2 Authorized A ent: Name Print) Current Mailing Address: y/+ Signature / 3 72 C v 8 / Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Offici 1 Us completed by permit applicant 1. Building go (a) Building Permit Fee —J�; 1 7 nnin 2. Electrical (b) Estimated Total Cost of LV Tj Construction from 6 L�� 3. Plumbing Building Permit Fee DEP OF BUILDING INSPECTIONS ORTHAMPTON,MA 01060 4. Mechanical (HVAC) S `K 0. 5. Fire Protection 6. Total= (1 + 2+3+4+ 5) 6'70 I Check Number a V l This Section For Official Use Onl Building Permit Number: Date Issued: Signature: J 9 Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) .c 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/Finding ever been issued for/on the site? NO O DON'T KNOW {e-'A YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW O YES O IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO O DON'T 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,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O 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) E7 Roofing Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [[] Siding [0] Other[p] Brief Description of Proposed NQWork: J7 C 6 LACf SaV/9&-"-S Alteration of existing bedroom Yes r)(' 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 X 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 as Owner of the subject property hereby authori C D A //��0 F- 1/t/ � L � C— to act on m e alf, in all matters relative to work authorized by this building permit application. Signature of O e 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. C t�lS X Print me Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ to Name of License Holder: Licens Number �D �1 �G H 1 c,�D4A �o � A ss `r Expir ion Date ignature Tele hone 7 9. Reaistered Home Improvement Contractor: Not Applicable ❑ r f)A PCO f 1/0 G L gel Company Name Registration Number Address Expiration Date Telephone f l 3 " 9"' 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....... No...... ❑ City of Northampton S Massachusetts I ' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street a 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: �0� t�f' G_ Est. Cost: 13 0 OC-) Address of Work: J (J� L, PIT RD / Date of Permit Application: C�� 1 q 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: q, ( , I -c I d( LA-� ( 70 20q ate 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 r G t 3: r DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Buildings �a Northampton, MA 01060 ssb ���`� Massachusetts Residential Building Code Section 110.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 110.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.R5, 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 DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building Jt Cb" Northampton, MA 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: 57 3 RU kTS � ( T � � (Please print house number and street name) Is to be disposed of at: C C A WST-C HOL�Okt, A (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: CDA OW/0ED DPAP�, 7/ 1� (Company Name and Address) Signature of Permit 06plicant 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. 'fry The Commonweaith of iWassacnusetts Department of Industrial Accidents f tD; ar Office of Investigations 600 Washington Street Boston,JVA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractorsfl✓lectricians/Plumbers Apolicant information Please Print Le;;iblti Name (Business/Orsanizationtlndividual): CDA Roofing & Sidin-0 Corl.tactoM. i_i_C Address: 1775 Main Street City/State/Zip:Agawam. MA 01001 phone#:413-786-4081 Arg You an employer?Check the appropriate box: Type of project(required): 1am a er1 to er with 4• U i ail a general contractor and I p y - 6. E]New construction employees(full and/or part-time).' have hired the sub-contractors :fisted on the attached sheet. 7. E] Remodeling 2.❑ I am a soie proprietor or partner- r ship and have no employees =`hese sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 4 17 Building addition fNo workers' comp. insurance comp. insurance.+ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions I 3.❑ I am a homeowner doing all work ofdcers have exercised their 11.E] Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12,Roof repairs insurance required.]_ c. 152,§1(4),and we have noj employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box 01 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractor 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-contactors 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: Continental lndemnity Company Policy 4 or Self-is-ls.Lied.4:46-544117-01-06 Expiration Date:06/19/2020 Job Site Address: J �V T'S el 7—C4D 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine up to$1,500.00 andior one-year imprisonment,as well as civil penalties in the for,n 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 DI_ for insurance coverage verification. d do hereby cern u d the p penal - qfzperjury that the information provided above is true and correct Signature: Date: Phone 4: Official use only. Do not write in this area,to be fornpieted by city or town ofltcial. City or Town: P ermitlLicense T # fff ij Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector ± 6.OtherContact i l rPerson: CDAROOF-01 IRILEY CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDYYYY) 8112/2019 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 NAME: Berkshire Insurance Group,Inc PHONE _— FAX PO Box 4889 (AIC,No,Ext):(866)636-0244 -_ (A� No):(413)447-1977 Pittsfield,MA 01202 AIL ADDRESS:__ _. INSURER(S)AFFORDING COVERAGE NAIL 0 INSURER A:Admiral Insurance Company_ 24856 INSURED INSURER-B:Safety_Indemnity CO 33618 CDA Roofing&Siding Contractors LLC _INSURER C: 1775 Main St INSURER D Agawam, MA 01001 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 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. INSRTYPE OF INSURANCE ADDLfSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S x'000'000 CLAIMS-MADE a OCCUR 300,000 CA000035578-01 8/9/2019 8/9/2020 DAMAGE TO RENTED _- cancel__:-€----.--..-- — MED EXP(Anyoneperson) S 5,000 PERSONAL 8 ADV INJURY S 1,000,000 i GEML AGGREGATE LIMIT APPLIES PER: N R GAT S 2'000'000 X _u POLICY u j LOC PRODUCTS-COP/O AGG S 2,000,000 17 OTHER: S B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO 5M329 8/12/2019 6112/2020 BODILY INJURY Per mon) !$ 1'000'000 OWNED SCHEDULED 1,000,000 X AUTOS ONLY X AAUUT�OSSyy Ep BODILY INJURY Per accident S i X A�RTOSONLY X AUTOSONIiY P�0P M AMAGE 1,000,000 X Comp:$500 Dad X Colk lon:$500 Oed UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR_�;CLAIMS-MADE AGGREGATE DEC) RETENTION$ WORKERS COMPENSATION PER TH- AND EMPLOYERS'LIABILITY ___///NNN ------- ANY PROPRIETOR/PARTNERIEXECUTIVE (� E.L.EACH ACCIDENT QFFICER/M�MBE.R EXCLUDED? u NIA __— _---- (Mandatory in ) E.L.DISEASE-EA EMPLOYE M yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT i I DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Addldonal Remarks Schedule,may be aMacMd H mora space Is mgWred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, City of Northampton ACCORDANCE WITH THE POLICY PROVIS ONSCE WILL BE DELIVERED IN 712 Main St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE AAM WJAJ ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CDAROOF-02 J HOINIERE ACORN► DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 611912019 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 NAME: McClure Insurance Agency,Inc. PHONE FAX A 103 Van Deene Ave. /C,No,Ext). (413)781-8711 (A/c,No):(413)731-8548 West Springfield,MA 01089 ADDSS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Markel Insurance Company INSURED INSURER B:Kinsale Insurance Company CDA Roofing&Siding Contractors,LLC INSURER c:Continental Indemnity Co. 1775 Main St INSURER D: Agawam,MA 01001 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 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. INSR ADOL SUBR POLICY EFF POLICY EXP LTRTYPE OF INSURANCE INSD WVD POLICY NUMBER (MMLDD/YYYY) IMMIDDlYYYYI _ LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR. 3042726 8/9/2018 819/2019 PREMGE SES Oa occurrence) $RENTED 50'000 MED EXP(Any one person) s 10,000 PERSONAL B ADV INJURY S 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JE LOC PRODUCTS-COMP/OP AGG S 2,000,000'1 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT = (Es accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOSBODILY EEpp RR AUTOS ONLY AUTOStONLY R-Or ac�n1�AMAGE $ S B X UMBRELLA U5,000,000AB X OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE 0100070474-0 711912018 8/912019 AGGREGATE $ 5,000,000 DFD X RETENTION$ 10,000 C AND EMPLO ERRS S*'LIABILITY YIN ENSATIONX STATUTE ERS ANY PROPRIETORIPARTNERIEXECUTIVE 46-544117-01-06 6!1912019 6/19/2020 1,000,000 OFFICER/MEMBER EXCLUDED? N NIA E.L.EACH ACCIDENT S (Mandatory in NH) 1,000,000 E.L.DISEASE-EA EMPLOYEE 5 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cit Cit Mf Nort ACCORDANCE WITH THE POLICY PROVISIONS. Northampton,MA 01060 — -- – AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 'Come-nwwea,#t�of Messachuset'•,s Qivision of oreessional Licensure "Board of Buifd4ng Rec_ulations and Staandafts Constr-uctc�,�s1 et .r S.pecia!ty j i. CSSL-099424 '2!�-,pires: 0310512020. jAMES S adze SPRLNC-F!E D its a`- J` =T.10 Commistjoner L � 0, L Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructiotvr Specialty f CSSL-099561 t ires: 07,115/2021 CLARK L DOBE 948 SOUTHWEST FEEDING HILLS MA ,4 `� Z Commissioner 0 Commonwealth of Massachusetts Division W Professiohaf Licensure Board of Building Regulations and Standards Cons`r��Y�r.`ISiS�rvisor .rJ-10�9L4 i_res: 1.010712020 ' C fR€STOPHM y 84 GARQEN -f i EE--)FiNG HILL "Car-±-taissionei vow � Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, M usetts 02108 Home Improveme tractor Registration Type: LLC Iu Registration: 170804 C.D.A. ROOFING&SIDING CONTRACTOf� _ 1775 MAIN ST _ Expiration: 12/18/2019 ,� � AGAWAM,MA 01001 �^ v F Update Address and Return Card. , A 1 so 20M-05/17 C-�/LE (0G.7UhL0�2[l1P.fLG/./G O�VI�(.¢d6gf,/7"[[6P,�6 _ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only � p LLC " �— before the expiration date. If found return to: Ex iration Office of Consumer Affairs and Business Regulation 12/1$/2019 10 Park Plaza-Suite 5170 C.D.A. ROOFING" _ RACTORS,LLC Boston,MA 02116 I^ CLARK DORE r; y' -Q � 1775 MAIN STREELew u AGAWAM,MA 01001 Undersecretary Not valid without signature ROOFING & SIDING CONTRACTORS Clr1l@@ft aid S CoatnwWr� •(MA Reg.#128355/CT Reg.#60.32M, 1775 Mail St,Apow r11.WM 733.4 •f03)786-4081 -1.844.786-4081 -FAX 413-7V,2= eftaber9mmcast.net lComy Am West Hartford,CT 06110(860)9:3-5'30 .CDAR00FINC.NET Pr+opoadsww~toc ONK �— G Phone#'s I Home: 9Cell: shMt Mail To: ,527 Zictf J C&A t Special Requirements: Pryaeil Ib ferslsh sat brstall the following / / 0 weasel I3 rear-OH ( Cam'!gM fte Preparation % �'' ids esb.r'ior to be protected by tarps and plywood - Ing,trees to be protected dillAreexisthg roofing material to be removed to existing decking ] S#te to be cleaned everyday with roll magnet debris removed at project completion ] Deteriorated existing decking replaced at$_per sq.ft.($_per sheet of plywood ] Metal drip edge installed at eaves and rakes ❑White❑ Brown ZI 5 inch ❑8 inch / New flashing will be installed where necessary Q cut lead into chimney $ Q Install new pipe boot flashing We shall acquire all appropriate permits ect.for all roofing work AH roof related debris removed by means of dumpster Complete Roofing System ZI Ice, water shield installed at all eaves to protect against ice dams(and meet codes in the north) 0 aft ❑ 6ft ] Ice, water shield installed at valleys, around penetrations and chimneys to protect critical L Synthetic reinforced underlayment installed over entire decking Shingles 60irtainTeed ❑ OAF ❑Tamko QOwens Cornbig v 30 year 0 50 year ❑ Color Q 'Nail able ridge vent will be installed f 0,Ridge cap shingles llr / ! r/2�1��C( G.—�?66ie" G Warranty Options �f��/� ��`,�� 172- 0 2-0 We guarantee our workmanship for 10 full years All prices include dumping fees unless noted otherwise. We Propose hereby to furnish materials and labor-complete inaKc with above speCMCatbns for the sum of: ��< G .f Prn pon Completion$ Total Sale Price$ 12 r Down Payments �C.(X 7 U ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are satisfactory and are herby accepted.You are authorized to do wort specified.Payment will be 1/3 down upon signing and balance due upon completion.Unpaid balances shall accrue with interest at 18%per annum. Purchaser(s)will pay for all costs,expenses and reasonable attorney's fees incurred by CDA Roofing and Siding Contractors LLC to recover sums due under this contract. Date. Signature. > / Phone: Date: S ' 7 Estimator's Signature: Estimates are honored for thi (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 coming through the cracks of the wood.CDA Roofing and Siding Contractors LLC will not be responsible for debris or dust in the attic or storage areas.