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35-279 (12) Department use only City of Northampton Status,Qf Permit: Building Department` SPR Z Curb CLt/Driveway Permit 212 Main Street 2 e 5ewerfSeptic Availability Room 100 - WaterMell Availability Northampton, MA 01060( TWQ-$ets of Structural Plans phone 413-587-1240 Fax 413-587-1272 _."� 01OSite 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 completed by office Map Lot � 7 Unit 98 Woodland Dr — Florence, MA 01062 Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 owner of Record: 98 Woodland Dr Peter Bond Florence, MA 01062 Name(Print) Current Mailinq Address: same as above Telephone Signature 413-537-7555 2.2 Authorized Agent: Rene Gauthier 301 N. Elm St. P.O. Box 1959 Westfield, MA 01085 Nam (Print) Current Mailing Address: 1� 413-579-5798 Signature Telephone SECTION 3- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 7,821.15 (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 = (1 + 2+ 3+4 + 5) 7 821 15 Check Number This Section For Official Use Only BuildingPermit Number: Date ����� �� �� Issued: Signature: Building Commissioner/Inspector of Buildings Date info @ nextgen413.net EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) up strip shingles as your ridge cap Advantages: Stays In Place Dura GripM Self-seal Adhesive seals each piece tightly and helps reduce the risk of shingle blow-off Easier to Install:Improved pre-scored design makes hand- tearing pieces easier than ever-no cutting on the roof! StainGuard®Protection:Helps ensure the beauty of your ridge cap shingles against unsightly blue-green algae(Supplied by others) Pipe jack 3"-4"pipe boot flashing 3.00 $45.00 2 stones 2 to 3 stories additional charge per square 15.00 $226.05 Roofing disposal Charge for hauling construction debris to the recycling 3.00 $698.70 facility.This charge is per 10 square of roofing with a minnium charge of$455 GAf system install Installation of shingles,underlayment and edge metal(price 26.00 $5,046.60 per square) Warranty Because We are Certified Master Elite GAF Installers we 1.00 $0.00 will give you a 50 year System Plus manufactures warranty and a 10 year labor warranty Sub Total $7,821.15 Total $7,821.15 SPEC IAL INSTRUCTIONS 24 square actual measurements+10%=26 square Thank you for the opportunity to to install our roofing system on your home. We look forward to working with you! SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing L x, Or Doors F1 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[:J Siding [O] Other[U Brief Description of Proposed Work:,remove and replace roof to code and manufacturer's specifications 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 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 OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, Peter Bond as Owner of the subject property hereby authorize Rene Gauthier to act on my behalf, in all matters relative to work authorized by this building permit application. 04/10/2020 Signature of Owner Date I, Rene Gauthier 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. Rene Gauthier Print Na e 04/10/2020 Signature of Owner/Agen Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Rene Gauthier CS-098654 License Number 301 N. Elm St. Westfield, MA 01085 08/19/2021 Add s Expiration Date , 413-579-5798 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ NextGen Construction Services Inc 176989 Company Name Registration Number NextGen Construction Services Inc. 06/27/2021 Address Expiration Date 301 N. Elm St. Westfield, MA 01085 Telephone 413-579-5798 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....... 2 No...... ❑ City of Northampton � r�� {S`5 Massachusetts ��, �• ,, j .s DEPARTMENT OF BUILDING INSPECTIONS �'• J s. 212 Main Street •Municipal Building Northampton, MA 01060 s67yFyj�� 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: 98 Woodland Dr Florence, MA 01062 (Please print house number and street name) Is to be disposed of at: Casella Waste 686 Main St. Holyoke, MA 01040 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from.- (Company rom:(Company Name and Address) v 44.o4 04/10/2020 Signature of Permit Applica6t 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 U 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass gov/dia 4 Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Ley-ibls Name(Business/Organization/Individual): NextGen Contructi0n Services Inc _ Address: 301 N. Elm St. STE. 2 City/State/Zip: Westfield, MA 01085 Phone#: 413-579-5798 Are you an employer?Check the appropriate boa: Type of project(required): 1.[a I am a employer with.5 _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.[J1 am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 Building addition 4.EP 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.❑Electrical repairs or additions proprietors with no employees. 12.F�Plumbing repairs or additions 5❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.®Roof 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.(3 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: Alm Mutual Policy#or Self-ins.Lic.#: VWC-100-6023118-2019 Expiration Date: 07/14/2020 Job site Address: 98 Woodland Dr city/state/zip:Florence, 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 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 under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 04/10/2020 Phone#: 413-579-5798 Official use only. Do not write in this area,to be completed by city or town offieiaL 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#: DATE(MMIDDIYYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 6.�- 1 11/01/2019 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 Jeffrey Brochu Brochu Insurance Agency Inc IPAAHIONE 413 536-3311 FAX 413 536-0900 725 Grattan Street E"MAIL-A DRE . jeff@brDchuinsurance.com INSURERS AFFORDING COVERAGE NAIC A Chico _ MA 01020 INSURERA:Atlantic Casualty Insurance Company 00000 INSURED INSURER B: Commerce Insurance Company 34754 Nextgen Construction Service Inc INSURER C: Aim Mutual Insurance Co 0075 82 Pequot Rd INSURER D INSURER E Southampton MA 01073 INSURERF: 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 TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY F POLICYEXP LTR YYLIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000 DAMAGE TO RENTEIT_ CLAIMS-MADE a OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5.000 A L307000545-0 10/162019 10/162020 PERSONAL&ADV INJURY $ 1,000.000 GEMLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000,000 X POLICY❑JJEC 7 LOC PRODUCTS-COMP/OP AGG $ 2.000,000 OTHER: $ ED AUTOMOBLE LIABLITY COM'Eaaccident'.dl SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED AUTOS ONLY AUTOS RPLO82 10/042019 10/042020 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Pera ident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ riDED I I RETENTION $ WORKERS COMPENSATION PERTUTE I X ETH AND EMPLOYERS'LIABILITY YIN A ANY PROPRIETOR/PARTNER/EXEClfI1VE E.L EACH ACCIDENT $ 1.000,000 C OFFICER/MEMBER EXCLUDED? a NIA VWC 100 6023118-2019A 07/142019 07/142020 (Ma nclAory In NH) E.L.DISEASE-EA EMPLOYEE $ 1.000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICYUMIT $ 1,000.000 OESCRIPT10N OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Construction and Remodeling,Roofing. Blanket Additional Insured and Waiver of Subrogation is automatically provided to any certificate holder when it is agreed to and required in the contract or written agreement CERTIFICATE HOLDER CANCELLATION 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 Fax: (413)787-6023 Email: ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Invalidity or unenforceability of one or more provisions of this Agreement shall not affect any other provision of this Agreement. Contractor and Owner acknowledge that this Agreement is subject to the laws and regulations of the Commonwealth of Massachusetts. Peter A Bond Owner Name NextGen Construction Services,Inc. *--��, W Owner Signature NextGen Construction Services, Inc. CONTRACTING AGREEMENT This agreement("Agreement")is made this 24th day of March,2020 between NextGen Construction Services,Inc.,henceforth known as"Contractor,"and Peter Bond henceforth known as"Owner." Pursuant to the work described the Contractor and Owner agree to the following. Section I The Work The Contractor and Owner agree that the following work will be done on 98 Woodland Dr Florence,MA 01062;see attached estimate for scope:k-1572 Section 2 Timeline The Contractor and Owner agree that the work detailed above(or on attached sheet)will be completed according to the following timeline: Work Start:4-13-2020 Work Completion: 5-13-2020 This date is tentative and subject to change as needed. Any delays that arise during the course of the work must be discussed with Owner immediately. Section 3 Payment Owner agrees to pay the Contractor a total of$7,821.15 payable in the following manner.$2,500.00 deposit due at signing,balance due upon completion. Invoices past due are subject to a purchase money security interest and a finance charge of 1.5%per month,which is an annual rate of 18%. In the event an invoice becomes uncollectible, and contractor brings suit to collect the amount due,buyer agrees to pay all court fees,interest,and reasonable attorneys fees incurred by seller in collecting the sum due on this invoice. Initial Section 4 Changes/Power Supply Should there be any changes made by the Owner,there may be additional costs which are added to the price based on labor and materials,etc.Owner agrees to provide a source of power at no additional expense to the contractor.Should a source of power not be available,the contractor may provide a generator to provide required power at an additional expense to the owner. Section 5 Permits Contractor agrees and has permission to secure any permits necessary so that this work will be done within the parameters of the laws of Massachusetts.Contractor agrees fees for these permits are already included in total. Section 6 Subcontractors Owner agrees that the Contractor may hire subcontractors at his discretion,the Contractor agrees that the payment for said subcontractors is entirely the Contractor's responsibility.Owner is not in any way liable for a subcontractor's missed payment. Section 7 Insurance/Liability Owner agrees to maintain the appropriate insurance on the property. Contractor agrees to maintain an insurance policy that covers them,any employees or subcontractors,their equipment, and any damage caused by the work. Owner agrees to take necessary precautions to protect their personal property,and further understands that as a result of vibrations being caused by work being done can cause wallhangings and items on shelves to shift and fall,and contractor shall not be liable for any damages as a result. Contractor is not liable for dust or debris that may enter the home during the roofing process. All screens are to be removed by homeowner prior to roof work,neglecting to do so could result in damaged screens and contractor shall not be liable. Skylights:the life expectancy of skylights is about 20yrs,for this reason it is recommended to replace all skylights when replacing a roof.Contractor has counseled owner on this.If owner declines replacement contractor shall not be liable for any damages as a result of skylight failure. Section 8 Cleanup Contractor agrees that any debris,equipment,etc.will be removed from the property upon completion of the job.The location will be returned to the state in which it was found prior to the work,excepting,of course,the changes made as a result of the work. Section 9 Workmanship Warranty Contractor agrees to a ten year warranty on all workmanship.This warranty is your coverage against workmanship,or installation errors. NextGen Construction Service Inc. Owner/Operator: 301 N.Elm St., Rene Gauthier Jr. P.O.BoxNEXT EN Westfield,,MA MA 01085 (413)579-5798 C0ISTRUC�O\SERWES www.ne gen413.net CS#098654 Ma REG#176989 Peter Bond Estimate# E-1562 Job#J-1579-Bond Roof 98 Woodland Dr Date`—� 3/20/2020 Florence, MA 01062 Item Description Qty Amount Shingle roof removal Removal of single layer of roofing material,underlayment, 24.00 $1,479.60 and edge metal.(price per square) GAF Tiger Paw Quantity per 10 sq roll(Supplied by others) 2.00 $0.00 WeatherWatch®Leak Barrier--X GAF WeatherWatch®Ice&Water Leak Barrier-Mineral 7.00 $0.00 Surfaced-2 SQ.Roll is installed 6'up from all the eves,in the valleys.around all roof penetrations,and where ever a wall meets the roof.(Supplied by others) .019 x 10'F8 Premium Painte-X(White) TRI-BUILT.019"x 10'F8 Premium Painted Aluminum Drip 30.00 $229.80 Edge White will be installed on the entire parameter of the roof Generic 1-1/4 Coil Roofing N-X 3.00 $95.40 Pro-Start®Eave/Rake Starter-X GAF Pro-Start®Eave/Rake Starter Strip Shingles(105 4.00 $0.00 lineal feet)(Supplied by others) GAF Timberline®Ultra HD®Shi-X *"4 Bundles per square"Timberline Ultra HD Shingles offer 104.00 $0.00 (Charcoal) a natural beauty and incredible thickness that you'll notice and appreciate.(Not to mention how much that they can increase the resale value of your home!).This will cost you just pennies-a-day more than standard architectural shingles.In return,you can enjoy the thickest,most ultra- dimensional wood-shake look for your roof.thanks to layers that are up to 53%thicker than standard architectural shingles combined with our High Definition blends.(Supplied by others) 11.5 x 4'Cobra®Snow Countr-X GAF 11.5"x 4'Cobra®Snow Country Roof Ridge Exhaust 19.00 $0.00 Vent(Supplied by others) Item Description Qty Amount GAF Timbertex®Premium Ridge—X Timbertex®Premium Ridge Cap Shingles comes with 6.00 $0.00 (Charcoal) below features:(coverage 15') Accentuate the natural beauty of your newly installed architectural shingle roof(or even add dimension and depth to a strip shingle roof) Offer multi-layer protection at the highest-stress areas of your roof(The hips and ridges) Match the performance of your new roof(unlike using typical 20-or 25-year cut-up strip shingles as your ridge cap) Provide a striking and higher-quality alternative to using cut- up strip shingles as your ridge cap Advantages: Stays In Place Dura GripM Self-seal Adhesive seals each piece tightly and helps reduce the risk of shingle blow-off Easier to Install: Improved pre-scored design makes hand- tearing pieces easier than ever-no cutting on the roof! StainGuard®Protection: Helps ensure the beauty of your ridge cap shingles against unsightly blue-green algae(Supplied by others) Pipe jack 3"-4"pipe boot flashing 3.00 $45.00 2 stories 2 to 3 stories additional charge per square 15.00 $226.05 Roofing disposal Charge for hauling construction debris to the recycling 3.00 $698.70 facility.This charge is per 10 square of roofing with a minnium charge of$455 GAf system install Installation of shingles,underlayment and edge metal(price 26.00 $5,046.60 per square) Warranty Because We are Certified Master Elite GAF Installers we 1.00 $0.00 will give you a 50 year System Plus manufactures warranty and a 10 year labor warranty Sub Total $7,821.15 Total $7,821.15 S P E C I A L I N S T R U C T I O N S 24 square actual measurements+10%=26 square Thank you for the opportunity to to install our roofing system on your home. We look forward to working with you!