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35-285 (12) 28 SYLVAN LN BP-2020-0846 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:35-285 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-2020-0846 Proiect# JS-2020-001455 Est.Cost:$12000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ENDA GARRY 113557 Lot Size(sq.ft.): 33279.84 Owner: LEVAY BRADLEY Zoning: Applicant. ENDA GARRY AT. 28 SYLVAN LN Applicant Address: Phone: Insurance: 346 WESTERN AVE #2 (617) 908-0242 WC LOWELLMA01851 /SSUED ON.112712020 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: MQter: 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 1/27/2020 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner �—) F r Department use only City of Northampton, Citi latus of Permit: Building Department Curb Cut/Driveway Permit . 212 Main Street, y �� Sbwer/Septic Availability el Room 100 WaterNNell Aveifability Northampton, MA 010 �0 `41Two ets o tructural Plans phone 413-587-1240 Fax 413-58 '��(�L^ P t/Site Plans her Specify :c 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 completed by office Map Lot -:)�' Unit 28 Sylvan Lane Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Brad Levay 28 Sylvan Lane Name(Print) Current Mailing Address: Northampton, MA 01062 1427A - zue Telephone Signature 2.2 Authorized A ent: 0(f 5ktr? vc- Name(Print) Current Mailing Address: v� -()ZgZ Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 12,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) T 12,000 Check Number This Section For Official Use Only Building Permit Number: ' Date Issued: Signature: a 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 El Accessory Bldg. ❑ Demolition ❑ New Signs [r-3] Decks [p Siding[O] Other[o] Brief Description of Proposed w ma Work: Alteration of existing bedroom Yes xx No Adding new bedroom Yes xx No Attached Narrative Renovating unfinished basement Yes xx No Plans Attached Roll -Sheet Sa. 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 ORCONTRAFOR BUILDING PERMIT I, �(md �'Cj��Vl cA, as Owner of the subject property Enda Garry hereby authorize 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 pans and penalties of perjury. Print Name > Signature of Owne ent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ _ Name of License Holder Enda garry License Number 346 western ave #2 lowell,ma 01851 10/6/22 Address Expiration Date Signature Telephone 617-908-0242 9. Registered Home Improvement Contractor Not Applicable ❑ te4in . Company Name Registration Number 1 4/23/20 Address r1 _ �`'i q /� Expiration Date / � 4 C) / Telephone Vt 1 ! 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 Massachusetts ZZPAR7WNT OF BUILDING INSPECTIONS y Z►T ��; ! 212 Main Street •Municipal Building Jti ca 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: ZKYWO, 11 (Please print house number and street name) Is to be disposed of at: Kf('L� �)t i Sri (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: PeLkUc, Sef Ox,5 , -57S'�, OMWe, P"� (Company Name and Address) Signa a of Permit Applicant 6r Owher 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 Office of Investigations UV 600 Washington Street Boston, MA 02111 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 the appropriate box: Type of project(required): 1.E I am a employer with 4 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. E] Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑x Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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. #: VWC10060228482019A Expiration Date: 01/24/2020 Job Site Address:28 Sylvan Lane 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 of perjury that the information provided above is true and correct. Signature: .tQ 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#: Commonwealth of Massachusetts 0111101111,of Consumer Affairs d,Busfnes;�egulatiwn ® HOME IMPROVE!JENT CONTRACTOR Division of Professional Licensure TYPE:Cowrahan Board of Building Regulations and Standards Registntfon Expiration Conslrtiot on Superviso, 191498 04/24020 CS-113557 Expires: 10/06/2022 GREATER BOSTON ROOFING CORP ENDA 5 GARRY 278 K STREET f » NO2 ENDA GARRY BOSTON MA 02127 278 K ST#2 BOSTON,MA 02127 Underaecreiary Corninissioner f ,4yr� '� J Construction Supervisor Unrestricted Buildings of any use group which contain ^-- _.• less than 35.000 cubic feet(991 cubic meters)of enclosed space. Registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation One A--shburton place-Suite 1301 Boston,MA 02108 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. / For information about this license Call(617)727-3200 or visit www.mass.gov'dpl Not valk7"without signature II it r Aco® CERTIFICATE OF LIABILITY INSURANCE 033/105/205/201199 �i 0 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 endorsemengs). PRODUCER Global Help Center Inc N T TATIANA SALES_ 1252 LAWRENCE ST SUITE C2 PHONE 978-421-7769 FAx 978-710-5581 Lowell MA 01852 -- �ooRLss ghclowell@hotmail.com .. INSURER(S)AFFORDING COVERAGE NAIC N INsuaERA:WESTERN WORLD INSURED GREATER BOSTON ROOFING CORP INSURER B:NAUTILUS INS 27 JACKSON ST APT 123 INSURER C.AIM MUTUAL INS CO LOWELL MA 01852 INSURER D: I 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. I TR TYPE OF INSURANCE man�� POLICY NUMBER PMIDDYEFFn POLICY EXP UNITS ✓ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE ✓❑OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea owrwereJ -s MED EXP(AIIYorle person) s 5,000 A NPP8517412 0112512019 01/2512020 PERSONAL s ADV INUIRY s 1.000'N0 GENL AGGREGATE UMIT APPLIES PER. GENERAL AGGREGATE s 2.000.000 ✓ POLICY Q.PIECaT F1 LOC PRODUCTS-COMPIOP AGG f 1 1,000.000 OTHER: s AUTOMOB LELIABLRYULJ COMBINED SMIGLE LIMIT $ (EN saodera) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY IN.N1ftY(Per accident) f HIRED NON-OWNED PROPERTY DAMAGE _.... _-.--- AUTOS ONLY AUTOS ONLY (Per auld"ll $ S I9 B HUNBRELLAUAS ✓ OCCUR EACH OCCURRENCE S2+000+000 EXCESS Lum cLAlels4pm ANA047621 61/25/2019 01/25/2020 AGGREGATE s 2,000,000 OED 1 1 RETENTIONS S WORKERS COMPENSATION ' ✓ STATUTE ERH AND EMPLOYERS'LLAWLITY y r N ANYPROPRIETORIPARTNERIEXECUTIVE E L EACH ACCIDENT $100,000 C OFFICwend MInN REXCLUDED? � "'A 'VWC10060228482019A b1/24/2019 01/24/2020 100,000 'f yes. (under ' E L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 I ( FILD as DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) THIS W.C.POLICY DOES NOT COVER ANY OTHER STATE THAN MA. CERTIFICATE HOLDER CANCELLATION S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE TATIANA SALES ©1988-2015 ACORD'CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web Software.www.FormsBoss.com(c)Impressive Publishing 000-208-1977 1/20/2020 Estimate Print Preview Greater Boston Roofing 01/20/2020 346 Western Ave Lowell MA 01852 Phone:617-744-9690 GREATER. BOSTON Fax: 978-418-0233 ROOFINGCompany Representative Alex Lappin Phone: (978)905-5045 alex.lappin@greaterbostonroofing.com Brad Levay Job:2388: Brad Levay 28 Sylvan Lane Northampton, MA 01062 (413)320-3303 Roofing Section •Strip existing shingles down to 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 and rakes •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 dean job site throughout project,with meticulous clean up of site upon completion •Submit project for manufacturer's 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*** Qty Unit GAF Timberline HD 27 SQ •Color of your choice •50 yr./Systems Plus Lifetime Warranty Ice and Water Shield 3.03 RL Vapor Barrier 2.7 RL Drip Edge 0 PC GAF ProStart Starter Shingle 3.16 BD GAF Cobra Snow Country Ridge Vent 210 LF GAF Seal-A-Ridge Hip and Ridge Cap 7 BD Roofing Coil Nails 1.8 BX Chimney Lead Flashing 0 EA Pipe Flashing(up to 4") 0 EA Company Provided Lead Cost 0 SQ TOTAL $12,000.00 1/2 1/20/2020 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. 1 Z� Company Authorized Signature Date Ta,�Ya , Customer Signature Date Customer Signature Date 2/2