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05-063 (4) 487 AUDUBON RD BP-2020-0539 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:05-063 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-2020-0539 Proiect# JS-2020-000928 Est.Cost: $13500.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NRB EXTERIORS INC 99565 Lot Size(sg. ft.): 222591.60 Owner: KRAUTH JEFFREY& Zoning: RR(100)/WSP(100)/WP(32)/ Applicant. NRB EXTERIORS INC AT. 487 AUDUBON RD Applicant Address: Phone: Insurance: 510 NEW LUDLOW RD (413) 563-6354 WC SOUTH HADLEYMA01075 ISSUED ON.10/28/2019 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 Signature: FeeType: Date Paid: Amount: Building 10/28/2019 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 Northarr�pton EC ofi'/Dn it: . '� Building DepanEme utway Permit 212 Main Street OCT 2 8 Sewe Sept'/ vailability 1 '# Room 100 2� at /Wailability Northampton, A Two Setsructural Plans phone 413-587-1240apt 3F �21T in�sp SiteAl n7pNMqO o rn4 Sp APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DQE pM�OLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 11,®�)'0 � r This section to be completed by office 1.1 Pro(pjert7y Address: /-- ll > ( "'A�1�'u� ✓�� Map tlS Lot no ✓ Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ✓J Name(Print) Current Mailing Address: 4- �W&r� A Telephone Signature 2.2 Authorized -len : Name(Print) Current Mailing Address: i Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 8695 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee , 6 4. Mechanical (HVAC) IYj/�' 5. Fire Protection 6. Total =(1 +2+ 3 +4+5) f u 8695 Check Number l70 This Section For Official Use Only Building Permit Number: Date Issued: Signature: a?to Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors F-1 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding [p] Other[o] Brief Description of Proosed 1 Work: kc.^O-'Q � ], rSK;� �� `^� .�a ft:.ial -^ S 'F] (( ��lw/ (' -U<�fi 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 existingg housing, complete the following: a. Use of building : One Family Ix 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 I, Q �'� �\ ✓r/l<^ .k t` as Owner of the subject property hereby authorize �!" t / � -K 1 It)✓� r i� . to act on be a I matter tive to work authorized by this building permit application. Signature of Date 1 VQ Vl� �� L r�"S l '�t 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 pa nd penalties of perjury. Pri �me Sig a of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: n . / Not Applicable ❑ Name of License Holder: N 1 t,(n JI a Ih (��1 'w �, / I License Number Address Expiration Date nature Telephone 9.Reolstered Home Improvement Contractor: Not Applicable ❑ W`/7, 6 -�)(f tc-/I.A I'/--I ( . (q7 - ?C ( Company Name Registration Number <-�b A ji/t." L.,J �( -)7- �-6) Address Expiration Date e) 11) 7 Telephone 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 build" permit. Signed Affidavit Attached Yes....... No...... ❑ City of Northampton Massachusetts ?V { DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building 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: L( 97 iq�) LA � _ fj (Please print house number and street name) Is to be disposed of at.- (Please t:(Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Si Lure 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. The Commonwealth of Massachusetts Department of Industrial Accidents a ; 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 /A y� Please Print Legibiy Name (Business/Organization/individual): P" 'J ( .-1 J 1 n Address: (D u V L"') �` U�✓ City/State/Zip: S� /"� `► Phone#: �' AA�a&yer?Check the approprtate boz: Type of profect(reQulred): yer with 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. ❑Demolition 3.M I am a homeowner doing all work myself:[No workers'comp.insurance required.]t 10 Q 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.Q Electrical repairs or additions proprietors with no employees. 12.❑Pl ng repairs or additions 5.a I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. oof repairs These sub-contractors have employees and have workers'comp.insurance.[ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL C. 14.[:]Other 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: / ��✓ ('t' S / G '� Policy#or Self-ins.Lic.#: (1Z�a J /' S`07 Expiration Date: Job Site Address: L k7 V4-- v'u 6 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 form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un Ofins and penalties of perjury that the information provided above is true and correct Signature: Date: 7 11 Phone#: C� Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -*o Acc L--- 7�' CERTIFICATE OF LIABILITY INSURANCE °"n"'ww "M THIS CERTIFICATE!s NISUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RKiHTS UPON THE 08112Ml019 CERTIFICATE DOSS NOT AFFIRMATNELY OR NEGATNELY AMEND,EXTEND OR ALTER THE COVERAOM AFFOROEp lAy RDELOW TINS CERTIFICATE OF N4WRANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S).AUT1fORIZED REPR IMATIIIE OR PRODUCER,AND THE CERTIFICATE HOLDER holder1- Is anA051YRSW IwUw the POWN0111BY must have L INSURED providers or los ertdorsad If$U8ROGATION to 1iMA1M,sutlpat b#W terra and CorXWw-e of the pdk*corhdn poNclaa nay nmWra an Oft*wWkye doss not corder hts to the"MOW holder M )_lieu of such ondorseewnt(sartdors•nlerd. A slsoemwnt on MIODOCVt TIM"GroupTlemey Teem ilm 18 Noah Elm Sow (413)562-7007 (aaa)271-m PO Box 760 woomeavNium IN AAA 01086INSUR6RA: Russe~80nd&Company/Colony lnsura w cc e N R 8 Exteriors Inc INWA Mt a` S*kY ineunwm ComOenY 12x06 7 PhWp Ck de eNetsuMt C: VNCRwRravekre eNNlultat D., Orarlby E COVERAM AAA 01099 CERTIFICATE NUMBER; CLISS1200410 THIS I6 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED seLOW RAVE BEEN ISSUE TO THE INSURED NAMED ABOVE POItFCR REVISION R PERIOD iNNNACATEO. NOTYMTHSTANDNN<;ANY RECUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,T! DOCUMENT WITH RESPECT TO W*"CH THIS EXCWSIONS AND CONDITIONS OF SUCH AFFORDED THE POLICIES DESCRIBED HEREIN 18 SUBJECT 70ALL THE TERMS. POUCIE8.IJMIT$SHOVM MAY HAVE SEEN REDUCED BY PAID CLAIMS. TY"OF INSURANCE C0IMMMGM,a611RR4%L UAftM POL10Y NIMrblit Loom MKGM CWMe MANXi R OCdJR Subject to $1,000.00 Dedxx"Ne ls 100,000 A 101010081X!8301a 5,000 i?/23/2pta 12/29!2019 eENtA0GR6OATE LIWTAPPLIEe PER: 600,000 POLY❑ ❑Loc 1.000,000 1.000,000 Avr00094A UANLf1Y 8 ANYAUTO f 1,000.000 8 ONLY Ce8244143e004Y��Orrfaf f 03116=19 03116f2020 eDOLYWAAtYNpw@=oaip s Au1Ds DILV ALrr'Oe oNLr S UVIIRW A LLM MedbN PsM� s 10,000 OCCUR EXCM LIAI N 992mm ire AND WOMtM'L"UrYf YIN C ��TIIEXCUMED?ECtlT1VE NIA 6=11-0FU768.6-19 =13=19 02/18f2020 L AQpwNT jL ToFOibw OW".EAuwrr s Duadty From RMICY LOT T►a Company OpGItlP1gN OI OPER MUS I LOCATHM/vaNMn NCOItO AOeIIoaY RasaMa arlMiM aNy M.... rr waw�rM k Sidnp,Vowow Insa"on,Carpo"and Rcc& and duper RE: t 2,and 4 hlsteW6on C010d"V6Nege ApsttrnerlAs,181 MAtst Sheet,Vttue,MA SHOULD ANY OF TIME At1OVE DESCRaip POLICIES U CAMMOR MID BaKaE Fir V**Pn Corp THE EXPIRATION DATE TNtIWOF,Mgt W LL BE DELIVERED IN ACCORDANCE wITN TIMI POLICY PROWSIC1q. 131 Athky Avarua Suite Al MITU01lILEp RM1l6edITAT1N6 N w d AAA 01089 • � • ACORD 2S(M"3) 01011114015ACORD The ACORD nsrw end logo aro rogisbrod mart of ACORD Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration . Type: Corporation Registration: 147961 NRB EXTERIORS INC r I#.,, Expiration: 08/22/2021 510 NEW LUDLOW RD f $ _ SOUTH HADLEY,MA 01075 I �„ Update Address and Return Card. SCA 1 25 20M-05(17 Office of Consumer Affairs&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 147961 08/22/2021 1000 Washington Street -Suite 710 NRB EXTERIORS INC Boston,MA 02118 NICHOLAS R.BERNIER '� 510 NEW LUDLOW RD k SOUTH HADLEY,MA 01075 Not valid without signature Undersecretary Commonwealth of Massachusetts pil of Pla censure Board ot BuildingReguasand Standards rVtsOr Specialty .onstructiort Supe Upires. 0512812020 CSSL-099565 } NICHOLAS R BERNIER S110 NEVq RD SOUTH HADDLE MA 01075 C14 Commissioner lly Lei used and Insured a °"" that 510 New Ludlow Rd. • MA Reg#20-2015718 w� South Hadley,MA 01075 MA Lic#: 147961 NIA CSL#:99565 Cell:413-563-6354 413-707-ROOF �7663j Office:413-707-RooF(7663) Fax:413467-9748 SHINGLE RUBBER NICHOLAS BERNIER SELECT (Owner) ShingleMaster „t:.,,,T.K,� RoofProsM.com RoofPros@comcast.net ro osal submitted to: Phone# h:y 3 3 Yj 7' �SO ( � c: ^ 11a w' Special requirements ,t et 17Kat "^ ;ity,state,zip code e I o5�j 4400. c:,o 'roposal to furnish and install the following Re-roof (Tear-off ❑ Gutters vAr We shall acquire necessary permits for all work Complete Roof Preparation Home's exterior to be protected by tarps and plywood Q Shrubs,landscaping,trees to be protected,roofers buggy used [f 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 [� Deteriorated existing decking to be replaced at$aper sheet of plywood Complete CertainTeed Integrity Roof System [� Install Winterguard ice&water barrier along bottom ❑ 3 ft.of all roofs,K6 ft. Install Winterguard ice&water barrier around penetrations,in valleys and all critical areas W r Install CertainTeed Synthetic underlayment to entire decking []� Install 8"perimeter metal flashing to all edges of all roofs,❑white ❑brown [Y Install SwiftStart starter shingle to bottom and rake edges of all roofs (� Install CertainTeed shingles to manufacturers specifications,❑6 nails❑4 nails 5/ Install CertainTeed PVC ridge vent to all peaks in heated areas [� Install Shadow Ridge to all hips and ridges,over ridge vent where applicable Install new lead counter flashing to chimney Iew flashing installed where necessary nstall new pipe flashing to waste vent stacks Warranty options We guarantee our labor/workmanship for 20 years Upgrade CertainTeed 4-Star S - nonprorated coverage CertainTeed Landmark-color: ❑ 3-tab a ❑ CertainTeed Landmark Pro-color We propose hereby to furnish materials and labor-complete in accordance with above specifications for the stun of:Total Due $ l SJc7,va ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are - 1/3 Down Payment$ -- •l�d satisfactory and are hereby accepted.You are authorized to do work as specified. Balance due Payment will be 1/3 down at start of io an b e due upon etion. upon Completion $ ©i_T 00 Q,60 Date: pSignature: Date: / Estimator:( a e) �� (�,(.iA� ✓ _(Sign Name) 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 Mc.will not be responsible for debris dr dust in the attic or storage areas. A Finance Charge of I ''/a%monthly(ANNUAL PERCENTAGE RATE OF 18%)will be added to the unpaid portion of the balance due.I agree to pay and/or guarantee payment of these 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.By my signature below,acknowledges an agreement of the above is hereby made. -1"-/ "i