22D-107 15 AVIS CIR BP-2021-1089
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:22D- 107 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-2021-1089
Project# JS-2021-001839
Est.Cost: $13000.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: NRB EXTERIORS INC 99565
Lot Size(sq. ft.):_19166.40 Owner: BAJAG APOORVA
Zoning: URA(100)/WSP(100)/ Applicant: NRB EXTERIORS INC
AT: 15 AVIS CIR
Applicant Address: Phone: Insurance:
510 NEW LUDLOW RD (413) 563-6354 WC
SOUTH HADLEYMA01075 ISSUED ON:3/30/2021 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 NORTHAMPTO U r ►. IOLATION OF
ANY OF ITS RULES AND REGULATIONS.
. V •
0
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 3/30/20210:00:00 $40.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
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1
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41
The Commonwealth of Massaciuse 202J 7 ,
wr.44 Board of Building Regulations and Stanfi FORno!(ol� ,r CIPALITY
Massachusetts State Building Code, 780 H,qa,„`h fnSP-vr— USE
Building Permit Application To Construct, Repair, Renovate Or Demo q ` ooNSRevised Mar 2011
One-or Two-Family Dwelling
This Se ion For Official Use Only
Building Permit Number: (?)O-a?f,-1(f D 7 Date Applied:
L-:_,),s-5 /2)55 , —.2-- 3-3o--zo2i
7
Building Official(Print Name) / Signature Date
SECTION 1:SITE INFORMATION
1.1 Properly Address: 1.2 Assessors Map&Parcel Numbers,
l5" l 'L.V! S . t Qivvll / /
1.1a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use I Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
t
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes0
SECTION 2: PROPERTY OWNERSHIP'
2.1 fpwner'of Record:
�� /✓e-t �J�'i3 `l ` (S- f 4.4 ,3 ( `. ,.-
Name(Print) City,State,ZIP
Tkit-, - 'i_S- 7ic f c,& (/
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction ❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) Cl Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work: (..L , vty--t C..S J-,1 A ;, -j i .i(.. , �j
vtS.)'-t l f 0•1 r�r e'4i,.-%( p1 k-- .�
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
Z Electrical $ 0 Standard City/Town Application Fee
fl Total Prniect Coct3(Item F)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ $ � �
Suppression) Total All Fees: $
t Total Project Cott: jy' ,
Check Nq��� Check Amount. Cash Amount:
I """"_ 1 O/ W" 1 U Paid in hull U Outstanding Balance Due:
SEC"TION 5: CONSTRUCTION SERVICES
5.1 Construction License(CSL) 11 i J (P S -).(' )-r
Na L,^ t tA S K ( ,!r,...12/ License Number Expiration Date
Name of CSL Holder S
Q {{ List CSL Type(see below)....s_4..w
1'Q �t r,J �.^-w✓�l O t,-' l - _ Type Description
t� U Uar atrieted�HuiIdings up to 35,000 Cu.ft.)
N.7:1 Yl t► (ft\tea w A D Res is w1 l a?Fpmily nu•..Mau
c � c
City/Town,State,ZIP t - M Masonry
RC Roofing Covering
WS Window and Siding
�('� SP Solid Fuel Burning Appliances
Lid, Jl4''43 I insulation
o,.ohont Email address I) Demolition
(HIC) -c7L( r-) - )
5.2 Registered2 Home Improyement Contractor HI �.�
(i 6 C-fit"u'( i ~,_ — HIC Registratitm Number Ex ion Date
HIC Company Name qqr Mc egistr n Verneco) b✓� L. t^.
Co.and Street .1 7°0 7 .�.-_ R.7+`I N Email address(i`tyf1'bwn,State, IP Telephone ' _
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 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.
fft ev- --
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ,
1.as Owner of the subject property,hereby authorize i"U (4'`7 K�Qs',0 i l ^ -
to act on my behalf,in all matters relative to work authorized by this building permit application.
` ..ip/- s r ? -a I
Print Owner's Name(Electronic Signature) Date
SECTION lb:OWNER'OR AUTHORIZED AGENT DECLARATION
tsy entering my rrawc below,1 he reby*Alt t 4W�'l thi;palm and Ncnallic of perjury that oil of the ir. rmet'-cn
contained in this application is true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I. An Owner who obtains a building permit to do btsiber own wont,or an owner wino hires an rurregiaicrau ei+uu:c.:oi
(not registered in the Home improvement Contractor(HIC)Program),will rild have access to the arbitration
program or guaranty Hind under M.G.L.c. 142A.Other important Information on the HIC Program can be found at
mouggsa.gov/oca Information on the Construction Supervisor License can be found at yvww.mass,gov/dpI
2. When substantial work is planned,provide the information below:
Total floor area(sq. ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
"Total
_..Square r..ot....c" 1... bc-tit tcd for Tat.!Project Cost"
3. �Vim,�1V'�i{Y�.7N�Ye{{ti rootage'may W dMVJYf\YWV 4. "Tote Cost"
City of Northampton
4t,;. .¢ a Massachusetts +Sr-µ -F•e
c
w
' � DEPARTMENT OF BUILDING INSPECTIONS
"I'rr ?4.rior 212 Main StrNt • Municipal Building �b�
Ni rthanmtnn MA 01060 `^' -.-�i10
a-,.
CONSTRUCTION DEBR.I) AFFID i`viT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: t `-' X. '- (---1
`\ ( I j
The debris will be transported by:
Name of Hauler: S f\---
Signature of Applicant: Date: 3 j) ? I
cox (62 , 62/ 0/7,1a4octeitetoe/6,
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 11 U
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
�.,T.-.,,,�� \ ,�'Atk Registration: 147981
IVRB EX ERIOR3;NC r a::.-mot "" ;- Expiration: 08/22/2021
510 NEW LUDLOW RD
SOUTH HADLEY,MA 01075 i'41 t:1
'"^ , ''" Update Address and Return Card.
SCA 1 a 20M-05/17
'-Ti,,- nmmo„weer/,A rye('/17.1,,i-re ,,.ef,s
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Corporation before the expiration date. B found return to:
Ruyia`untwil EAwiluuuii Office Of Consumer Affairs and BUscinexs Heguiaiion
147981 08/22/2021 1000 Washington Street -Suite 710
NRB EXTERIORS INC Boston,MA 02118
NICHOLAS R.BERNIER
510 NEW LUDLOW RD .a.s'a
wuTn newt_c 1,non uiv75 Not t, lid.,Ieh0..t rip ..e
Undersecretary "'�'"..
ComrnOnpt Process opal L censure t Massachusetts r
Division ulations and Standards
Board of Building Reg rvisor Specialty
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p51200empires:
CSSL�yn,�
NICHOLA�uO1 BERM
Souls HANI-EY Mp► pi
am..
C°mmissper l
ACO' CERTIFICATE OF LIABILITY INSURANCE DATE
"' ""
• 03/05/2021
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 POUCIES
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 polky(iss)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 Denise Sawicki
Amherst Insurance Agency Inc (413)253-5555 I FAI Nor.._(413)256-8354
20 Gatehouse Rd. , }, dsawi kt®nathanagenciea.com
P.O.Box 48 INSURER'S)AFFORDING COVERAGE MAC a
Amherst MA 01002 mum A; Russell Bond 3 Co Inc
INSURED imam B: Preferred Mutual 15024
N R B Exteriors Inc. NISUREIC:
7 Philip Circle INSURER D
INSURER E
Granby MA 01033 INSURER F.
COVERAGES CERTIFICATE NUMBER: CL212303459 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO AU.THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LIMITS SHORAN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE DMID�yyp POLICY NUMBER (Mtl1001'YYIr) {MMRDplYWY1 ULSTS
X COMMERCIAL GENERAL UABHJTY EACH OCCURRENCE s B00.000
DAMAGE TO RENT ED
CLAIMS-MADE I OCCUR PREMISES(Ea occurtana] $ 100,000
MED EXP(My one person) $ 5,000
A 101 GL008938303 12/23/2020 12/23/2021 PERSONAL a ADV INJURY $ 5°°•°°°
GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 1,000,000
POLICY 1ECT LOG PRODUCTS-COMPrOPAUG s 1,000,000
I OTHER: Employee Benefits S
AUTOMOBILE LIABILITY TEA COMBINED�IT $
AM
ANY AUTO BODILY INJURY(Per person) $ 20,000
B OVN(EO
x SCHEDULED PCA0100300761 03115/2021 03/15/2022 BODILY INJURY(Pr sadder') S 40.000
AUTOS ONLY AUTOSPROPERTY DAMAGE
:
x OS ONLY X AUT ONLY (Par(Per ecddunll
( APOTC
UMBRELLA LUMP _ OCCUR EACH OCCURRENCE S
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED 1 I RETENTION$ S
WORKERS COMPENSATION STATUTE I 1 ER
AND EMPLOYERS'LMBMUTY
YIN
ANY PROFRIETOR/PARTNEREXECUTIVE NIA Et EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
Mandatory InNH', I.L.OISEASE-EA EMPLOYEE $
If yes.ee$at00 under
DESCRIPTION OF OPERATIONS below E.L.ORSEA.+E-POLICY UMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddIdonM Remake$cMedule.may be alMehed a ame epee le rp1/req
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN
Certain Teed Select ShingieMaater ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 20126 AUTHORIZED REPRESENTATIVE
Lehi;h Vey; P.". 18882 C12C t�.
V•C OL-Via«v
1985-2015 ACORD CORPORATION. All rights reserved
ACORD 25(2016/03) The ACORD name end logo are registered marks of ACORD
Fully Liceused and Insured a ova the .. 510 New Ludlow Rd.
ILIA Reg#20-2015718 NMISouth Hadley,MA 01075
MA Lic#:147961 1,
MA CSL#:99565/ Cell:413-563-6354
4K 413-707-ROOF (7663) Office:413-707-ROOF(7663)
Akzi .i � SHINGLE RUBBER Fax:413-467-9748
SELECT ------GUTTERS --- NICHOLAS BERNIER
ShingleMaster
(Owner)
asitheaaiRoofPros413.com RoofPros@comcast.net
Pr9tposal submitted to• Phone# h: .3]S 7S + - y( it(
p J Q Special requirements
Street
I - '1IS ` .� — pf/tic c p`So e JA-rts
City,state,zip code
(ofg" _ 114� ^ .6-%
3
)u._
Proposal to furnish and install the following
❑ Re-roof Tear-off ❑ Gutters
❑ We shall acquire necessary permits for all work
Complete Roof Preparation
Home's exterior to be protected by tarps and plywood
Etf Shrubs,landscaping,trees to be protected,roofers buggy used
JEntire existing roofing materials to be removed to existing decking,including flashing,etc.
71 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$!! Sper sheet of plywood
Complete CertainTeed Integrity Roof System /
el Install Winterguard ice&water barrier along bottom 0 3 ft.of all roofs,0 6 ft.
(� Install Winterguard ice&water barrier around penetrations,in valleys and all critical areas
[l, Install CertainTeed Synthetic underlayment to entire decking
RI/Install 8"perimeter metal flashing to all edges of all roofs,Pilrwhite 0 brown
r Install SwiftStart starter shingle to bottom and rake edges of all roofs
• Install CertainTeed shingles to manufacturers specifications,❑6 nails❑4 nails
• Install CertainTeed PVC ridge vent to all peaks in heated areas
Di I Install Shadow Ridge to all hips and ridges,over ridge vent where applicable
Install new lead counter flashing to chimney
ew flashing installed where necessary
Install new pipe flashing to waste vent stacks
Warranty options
�yWe guarantee our labor/work ' or years
�F' grade CertainTeed 4-Star Start Plu 50-y r non�mrated co ge
LI CertainTeed Landmark co or. pfitA 1 3-tab
❑ CertainTeed Landmark Pr olor
We propose hereby to furnish materials and labor-complete in accordance wikbov yic ons for[hg a�of� D_yy,T I .0. 13 4 c Q. oa
ACCEPTANCE OF PROPOSAL:The above prices,specifications and con Lions are - 1/3 Down ayment s COL:) -4.33
satisfactory and are hereby accepted.You are authorized to do work as specified. Balance due
Payment will be 1/3 down at start of job,and balanc on completion. upon completion $ 7 b Jt) _�
Date: ,1 Signature:
/
Date: �/I( Estimator:(Print Name) L L i- PIA/1 r t-/- (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 Inc.will not be responsible for
debris or dust in the attic or storage areas.
A Finance Charge of I I %monthly(ANNUAL PERCENTAGE RATE OF 18%)will be added to the unpaid portion of the balance due.1
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 n -Mute a release of liability.By my signature below,acknowledges an agreement of the above is
hereby made. illIllii
.I
Signature: r