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35-278 (5) 1 90 WOODLAND DR BP-2020-0642 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:35-278 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-2020-0642 Proiect# JS=2020-001086 Est. Cost:$5000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ENDA GARRY 113557 Lot Size(sq.ft.): 37722.96 Owner: HALLSTEIN DENICE Zoning: Applicant. ENDA GARRY AT. 90 WOODLAND DR Applicant Address: Phone: Insurance: 346 WESTERN AVE#2 (617) 908-0242 WC LOWELLMA01851 ISSUED ON:11/18/2019 0:00:00 TO PERFORM THE FOLLOWING WORK:STRI P & 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 11/18/2019 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 Northampton Status of Permit: . -'� Building Department Curb CutlDriveway Permit +lu 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability. Northampton, MA 01060 Two Sets of Structural Plans .ter 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 1.1 Property Address: This section to be complete"y office Map Lot a Unit 90 Woodland Drive Northampton, MA 01062 Zone Overlay District Elm St.District CB District i , SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Denice Hallstein 90 Woodland Drive Northampton,MA 01062 Name(PrinL Current Mailing Address: (802)380-0810 Telephone Signature 2.2 Authorized Argent: -3q( 1.•➢eS�r� �4V� �"z Ldwc�i Name(Print) Current Mailing Address: 617- 96f azNz Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only- 'completed by permit applicant 1. Building 5,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing i -Building Permit Fee O I 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) 5,000 Check Number This Section For Official Use Only Building Permit Number: g P' `' ie1• Date Issued: Signature: I -1 Building Commissioner/Inspector of Buildings Date permits @ greaterbostonroofing:com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) i SECTION'S-bESCRIPTION OF PROPOSED WORK(check all 60licable). New House ❑ Addition' ❑ Replacement Windows Alteration(s) ❑ Roofing ❑✓ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[0] Other[p] I Brief Description of Proposed nip and>r@ roof Work: Alteration of existing bedroom Yes x No Adding new bedroom Yes �" No Attached Narrative i Renovating unfinished basement Yes X No Plans Attached Roll -Sheet sa:if NeW.'house and or adtlitlon 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 1001 yr. floodplain Yes No i 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,ORCONTRACTO/R-APPUES:FORBUILDING PERMIT' -: I, get)I LC ��47 f61 Y1 as Owner of the subject property Enda Garry hereby authorize to act on m0lialf,in all matters relative to wo k 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. Print Name Signature of Owner/Agent Date I i a i I SECTION 8=CONSTRUCTION Sei4 ICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Enda Garry License Number 346 western ave#2 i 113557 Address Expiration Date 10/6/22 Signature Telephone 617-908-0242 i9.Re istered Home Im rovement Contractor Not Applicable ❑ Company Name B Registration Number __W0e5_40A 191498 Address Expiration Date Telephone—W-60q27_ 4/23/20 SECTION 10-WORKERS''COMPENSATION INSURANCE AFFIDAVIT(MG.L.c..1'52,§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...... ❑ I i i I w i I I City of Northampton -Ail Massachusetts DEPARTMENT OF BUILDING INSPECTIONS y, ; 212 Main Street a Municipal Building '� Northampton, MA 01060 rs....,••�`�4 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. I I The debris from construction work being performed at: 1o. AAV)d' (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 jdumpster onsite rented or leased from: (Company Name and Address) MA- �`�jW .(� Sig—fie 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. i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 • f www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization Individual): Greater Boston Roofing Corp Address: 346 Western Ave Unit 2 City/State/Zip: Lowell, MA 01851 Phone#: 978-905-5045 Are you an employer?Check theiappropriate box: Type of project(required): 1.0 I am a employer with 4 1 4. I am a general contractor and I employees(full and/or part-tne).* have hired the sub-contractors 6. New construction u 2.❑ I am a sole proprietor orpartner- listed on the attached sheet. 7. ❑ Remodeling These sub-contractors have - ship and have no employees �8. ❑Demolition workingfor me in an ca ac employees and have workers' Y p tY• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. EJ We are a corporation and its j10.0 Electrical repairs or additions 3.E] I am a homeowner doing all work officers have exercised their 11.F1 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.r—xl Roof repairs insurance required.] c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other 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 Mutual Policy#or Self-ins.Lic.#: VWC16060228482019A Expiration Date: 01/24/2020 Job Site Address:90 Woodland Drive City/State/Zip:Northampton, 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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 the pains and penalties ofperjury that the information provided above is true and correct. Sian e: Date: 8/20/19 Phone#: 978-905-5045 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 M 4 . Ofrice of ConsumerAffoirs&Businos Ac uiat7on Gommn,of Pr l of Massachusetts + HOME'MPROVEMENTCONTRACTOR' Division of Professional Licensure 4YPE.Corporation Board of Building Regulations and'Standards` We�Stration Ey i "Q Constructi�'Sboervisor" 191498 , 04/23/2020 + GREATER BOS74N'ROOFING CORP? CS-113557 E, ire's 10 06/2022- SNDA S GARRY T `� 278 K STREET " '' Np2 ENDA'GARRY BOSTON MA 02127 2781<ST#2 �� } ., BOSTON,MA 02127 -=--.� trrr V". Underaecrefary :< - . Construction SupeNTsof'. Unrestricted.-Buildings of any use group which contain Iessthan 35,000 cubic feet(991 cubic,meters)of enclosed '' ' '""" space.. Registration valid,for individual use only before ft explration date. It.found return,to, Office of Consumer,Affairs and Business Regulation; One Ashburton place-Suite 1301 Boston;MA_02108, Failure to possess a current edition ofthe,.Massachusetts 'State Building Codejs cause for revocation of this license. �Vwffhm For information'•about this licenseCall(617)727-3200or visit www.mass.govrdpiNotvat signature o- J r 4 } E , AC O CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 03/05/2019 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 Global Help Center Inc NAMEA°T TATIANA SALES 1252 LAWRENCE ST SUITE C2 PHONE 97821-7769 Fiuc ND7978-710-5581 Lowell MA 01852 E-MAIL ADDRESS:ghclowell@hotmail.com INSURERS AFFORDING COVERAGE NAIC N _ INSURERa:WESTERN WORLD INSURED -GREATER BOSTON ROOFING CORP INSUREaB:NAUTILUS INS 27 JACKSON ST APT 123INSURER C:AIM MUTUAL INS CO LOWELL MA 01852 INSURER D: INSURER£: 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� —1imn �I)n POLICY NUMBER POLICY EFF POLICY UMIDDIYYYYI LIMITS LTR TYPE OF INSURANCE II be COMMERCIAL GENERAL LIABILITY Li EACHOCCURRENCE31,000,000 CLAIMS-MADE F✓ OCCURA1AGff I OREN ED 100,000 PREMISES(Ea occunenca S MED EXP(Any one person) $5,000 A NPP8517412 01/2512019 01/25/2020 PERSONAL B ADV INJURY $1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE _ S 2,000,000 g POLICY❑PECT r_1 I.C. PRODUCTS-COMPIOP AGG $1.000,000 i OTHER: IS f COMBINED SINGLE LIMIT AUTOMOBILEUABILITI' I S (Ea accident) ANY AUTO BODILY INJURY(Per person( S OWNED SCJAUTOS HEDULED AUTOS ONLY BODILY INJURY(Per acddent) S I HIRED NON-OWNED PROPERTY DAMAGE S #• AUTOS ONLY AUTOS ONLY _(Per ayclden� 5 UMBREUAUA13 ✓ OCCUR I I EACH OCCURRENCE 52,000,000 B EXCESSLIASL_JCLAIMS•MADE ANA047621 D112512019 01/25/2020 AGGREGATE $2,000,000 DED 17 RETENTIONS S WORNERSCOMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY YIN I STATUTE_ ER _ _. .� ANYPROPRIETORIPARTNERIEXECUTIVE a NIA I E.L.EACH ACCIDENT 5100,000 f OFFICERIMEMBEREXCLUDED? C (MandatorylnNH) 'VWC10060228482019A 0112412019 0112412020 E.L.DISEASE-EA EMPLOYEE $100,000 If yes.describe-under {{ `• DESCRIPTION OF OPERATIONS below 1 I I E.L.DISEASE-POLICY LIMIT S 500,000 .f ,i HH h. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) THIS W.C.POLICY DOES NOT COVER ANY OTHER STATE THAN MA. i•' i 1 CERTIFICATE HOLDER CANCELLATION S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 ACCORDANCE WITH THE POLICY PROVISIONS. city of Northampton AUTHORIZED REPRESENTATIVE TATIANA SALES I ©1988.2015 ACMD''CORPORATION. All rights reserved. ? ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ;. Produced using Forms Boss Web Software.www.FormsBass.com(c)Impressive Publishing 800.2084977 i 11/14/2019 Estimate Print Preview A Greater Boston Roofing 11/14/2019 w� 346 Western Ave Lowell MA 01852 Phone:617-744-9690 GREATER BOSTON Fax:978-418-0233 Company Representative Stephanie Benitez Phone:(978)930-6722 stephanie.benitez@greaterbostonroofing.com 221R-090HALL Denice Hallstein Job:2228:221R-'090HALL Denice Hallstein Sunrun Solar 1 90 Woodland Drive j Northampton,MA 01062 (802)380-0810 ! i i Roofing Section •Strip existing shingles downito bare wood,Inspect integrity of roof decking thoroughly. (**IF UNUSABLE OR ROTTEN WOOD IS FOUND DURING INSPECTION IT WILL BE REPLACED AT A PRICE OF$60 PER SHEET OF PLYWOOD,SHEATHING OR$4 PER LINEAR FOOT OF LEDGER BOARD**) •Install ice&water shield to first 6-feet on eaves,3-ft in valleys and immediately surrounding all protrusions -Install synthetic vapor barrier underlay •Install all new white 8"non-vented drip edge on perimeter •Install manufacturer suggested starter course of shingles on eaves andrakes j -Install GAF Timberline HD 50 yr.Lifetime/architectural shingles in color of your choice •Install ridge vent •Cap ridge vent properly with manufacturers suggested cap -Properly flash any protrusions and all new pipe flanges •Install new lead flashing around chimney •Maintain a clean job site throughout project,with meticulous clean up of site upon completion •Submit project for manufacturers extended warranty upon completion of project ***ESTIMATE/CONTRACT PRICING INCLUDES THE TOTAL COST ASSOCIATED WITH(MATERIALS,LABOR, PERMIT COST,AND ANY DUMPSTER/REMOVAL FEES INVOLVED IN COMPLETING THE PROJECT*** i i Qty Unit GAF Timberline HD 10 SQ •Color of your choice •50 yr./Systems Plus Lifetime Warranty Ice and Water Shield 0 RL Vapor Barrier 1 RL Drip Edge j 0 PC GAF ProStart Starter Shingle 0 BD i GAF Cobra Snow Country Ridge Vent 0 LF GAF Seal-A-Ridge Hip and Ridge Cap 0 BD _ 1 Roofing Coil Nails 0.67 BX Chimney Lead Flashing 0 EA Pipe Flashing(up to 4") 0 EA Company Provided Lead Cost 0 SQ TOTAL $5,000.00 i I 1/2 i 11/14/2019 Estimate Print Preview Any work related structural deficiencies or work required to complete project to Massachusetts Building Code not covered in this estimate will require Change Order.Roof decking replacement cost will be billed at$60 per sheet of plywood or$4 per linear foot of ledger board. I Company Authorized Signature Date Customer Signature --` , Date Customer Signature Date 2/2