Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
23C-066 (5)
93 BLISS ST BP-2021-1413 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23C-066 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-2021-1413 Project# JS-2021-002351 Est.Cost:$25450.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: U S METAL ROOFING DISTRIBUTORS, INC 018385 Lot Size(sq. ft.): 80019.72 Owner: CLOONEY DAVID Zoning: URA(100)/WSP(100)/ Applicant: U S METAL ROOFING DISTRIBUTORS, INC AT: 93 BLISS ST Applicant Address: Phone: Insurance: 740 HIGH ST, SUITE 2 (413) 536-5474 W(' HOLYOKEMA01040 ISSUED ON:6/1/20210:00:00 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. i Certificate of Occupancy Signature:/ FeeTvpe: Date Paid: Amount: Building 6/1/2021 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner / sic LN iffqy `� . Z, The Commonwealth of Massachusetts x,.. c',> W Board of Building Regulations and Standar409ZA �0� FORM Massachusetts State Building Code, 780 CM ciff.;%.,, / ICIPALITY �pt, ins USE Building Permit Application To Construct, Repair, Renovate Or De A Revised Mar 2011 One-or Two-Family Dwelling 'Oso°''s This Section For Official Use Only `'J Buildin Permit Number: 6 0- oil-/e-//3 Date Applied: Cu i 0 1455 ______IZZ 6-I-zazi Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Pro a' ddress: 1.2 Assessors Map&Parcel Numbers 9 I i s s 5+ Ak►"lilai+ip feu+t 3 c G 0-C, 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public CI Private 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: DcU'id¢ flintier Z looney ..Flore/2ee , Cl A aro(o a Name(Print) City,State,ZIP 7,3 /3 /,.s s S-I L/is 3'Iss ? 3J Amber,Kan nerj P12a om No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Ift Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition El -Accessory Bldg. 0 Number of Units Other Specify: Akio Rbo T1 Brief Description of Proposed Work': see a--l-ka c(,1 it era e f fry 0541 SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ a 3 1450 Ob 1. Building Permit Fee: $ Indicate how fee is determined: f ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: 10 00 Check No.ji heck Amount: Cash Amount: 6.Total Project Cost: $ s) y5D ✓ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ar r �n�er+,5 C S e u ber 'pll3 n Date License Number Expiration Date Name of CSL tI lder dor) ay Q� List CSL Type(see below) (J No.and Street �./ f` Type Description A vn her31 /► I DO a U Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town, State,ZIP J R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding ,,,,,// ' SF Solid Fuel Burning Appliances 1 (3 S37-4iyj dra4+z Q0I.6Q 1. I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) U, /y7e'IQ I Ian-frog� D is-/ Zh 13 y `a o ao a te S� /°� q S HIC Registration Number xpiration Date HI.C,,Company Name or HI Regist t Nape a /'./D N��1, .S �Sv i)P` ieel�li e US h Roo. rii,(0 01 No.and Street Email address NOLO/ea/ Pig alott`v Y13-.536-5417 City/T.Awn,Stdte,ZIP Telephone SECTION 6: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 .....0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize LI. 5, M e-4.1 PoO-+4 n 0 r` I h L to act on my behalf,in all matters relative to work authorized by this building permit apication. See CL QclkecL 5iyheJ Profos0 ( -7I13Iai Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. • -?� /i3/ 0cI Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 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 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts l' Department of Industrial Accidents G ..OI:,�; 1 Congress Street,Suite 100 To*. Boston, MA 02114-2017 ';,.a ,,,fi-' www.mass.gor/dia SS eaters'Compensation Insurance Affidavit:Builders/ContractoridEl ctricians+Plumbers. 10 BE FILE!)WITH THE PERMITTING AI!"hlt(RfIN. Anglican!Information Please Print l.eribir: Name it sus tnessiOrQanirat ion'lndn ideal l: V r Si tiltte41 R itVI C,� I(S tl'�b✓ 0 f'-- +y►c, Address: 9 LID I-4h i , 5+ 5 }e J city/state:rzip: \t0bo ve,u rip b HAI0 Phone#: yi3- S36-5 47 4 Me m an employes'?Cheek tle apprepAete bag: Type of project(required): t.a i am a employer with 1 5...employees(hill and'ur part-time! 7. 0 New construction 213 I am a sob proprietor or partnership and have no employers work mg fore m 8. 0 Remodeling any capacity.(No workers'comp.insurance required.] 9. 0 Demolition t I am a homeowner doing all work airmen'.(No workers'comp_rn,urance required.]« 10 0 Building addition 40 I am a homeowner and w ill be hiring cvniradors to conduct all vo 4 rk on my.property. I will ensure that all contractors either have wudcrs'compensation insurance or arc sole 11.3 Electrical repairs or additions prwr,eturs w ith DO crspluyres 12.0 Plumbing repairs or additions S0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. !3 hoof repairs These subcontractors have employees and have workers'comp.druurance.^ 6.0 Ih'e are a commotion and its offieers have vim-nits!their right dot exemption per ate&L c_ !{ commotioncommotion 132.$1(♦),ardor!have no employees.[No workers'croup_incur jnce required.) 'Any applicant the cheeks box PI must also fill out the section Wow showing rein workers cumpematien pdiry iateuae kte. t HOINIarwrnerx who mart this at/atoll indicating they are doing all work and dint tort m>sicie contractors tarot sates if a am iimtlessulk Veetraetorsthatchockroarboxmuttattached an additional short show ing the amp etissasreuntractors sad awe nkereesr eat rpannhishea employees. If the sub-contractors have employees.they most pruv ide their sterMs'CON,poky number. I am an employer that is providing workers'compensation insurance for my employers Below is the policy and job site information. jj�, j y�/� Insurance Company Name: L ei e rT j i r 1 t -u . I �v SQf ce li c e _ Policy#or Self-ins.Lie.#: I/V C ,� 3`1 S + 6p 1 d1 �b j D Expiration Date: 7 I j!G/.)�c.) I Job Site Address: 93 1 i S S Si- Cily!State.'zip: f pf f I1ain,p / M I/ Attack a copy of the workers'compensation policy declaration page(showing the policy number and eipiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to 51.500.00 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 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. Signiure: x 1 J \ _ 1�/Date. t Gti �{ �y � D I Phonett: LiU3 '— 33(4, ' s`a"7 L1 I J Official use only. Do not write in this area.to be completed by city or town official City or Tort n: Permitliicense# Issuing Authority, (circle one): 1. Board of Health 2.Building Department 3.City[Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other !'outset Person: Phone#: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste 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. Address of the work: ` 3 8 I(5 S AbrIlluM p1n, PI p The debris will be transported by: U. 5, Roo-I oy D i51- 74c_ The debris will be received by: £a S e_ I I a w 5 4 t sq,S-k Building permit number: Name of Permit Applicant U 5 , 11 e-4( ao Ply (1 5 Pl a at) ,d0 a 1 ks-Cjk Q Date Signature of Permit Applicant • Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Superv:sc CS-018385 Expires: 07/13/2021 BARRY L ROBERTS J 200 BAY ROAD AMHERST MA 01002 -'• y 1. t , Commissioner 7!/. / t7.4 F0/22/-120- 6)40;e)c)€7,04!".4-ej4- Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 134740 U.S.METAL ROOFING DISTRIBUTORS,INC. Expiration: 01/18/2022 740 HIGH ST.SUITE 2 HOLYOKE,MA 01040 Update Address and Return Card. SCA 1 0 20M--05/1177 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 134740- 01/18/2022 1000 Washington Street -Suite 710 U.S.METAL ROOFING,DISTRIBUTORS,INC. Boston,MA 02118 GARY C.REHBEIN %7 740 HIGH ST.SUITE2;-==_-_ -s°��i`�a'�ls•4 HOLYOKE,MA 01040 Not valid without signature Undersecretary • • • • e AC CPR CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/29/2020 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 Brenda Klaus NAME: Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 IA/C,No,Ent): (NC,No): 8 North King Street E-MAIL bklaus@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC B Northampton MA 01060 INSURERA: Continental Western/Acadia 10804 INSURED INSURER B: Union Ins/Acadia 25844 U.S.Metal Roofing Distributors, Inc. INSURER C: WCAR-Liberty Mutual Attn:Keith Rehbein INSURER D: 740 High Street INSURER E: Holyoke MA 01040 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 07/21 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) S MED EXP(Any one person) S 10,000 A CPA531260113 07/26/2020 07/26/2021 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000'000 POLICY PRO 2,000,000 JECT LOC PRODUCTS-COMP/OP AGG S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) S B OWNED / SCHEDULED MAA531260213 07/26/2020 07/26/2021 BODILY INJURY(Per accident) S AUTOS ONLY /� AUTOS XHIRED Ne NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) Uninsured motorist BI s 100,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 500,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE Y N 1 A WC231 S616974010 07/26/2020 07/26/2021 E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL DISEASE-EA EMPLOYEE S 50Q000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Keith Rehbein is Excluded from Workers'Compensation Coverage. 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 MA 01075 /tom n `I _ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD U.S. METAL ROOFING D I S T 1• I l i ( t T Cl R S . ' I N C . 740 High Street•Suite 2•Holyoke,MA 01040 14300-232-0399.1-413-536-5474•Fax 1-413-533-8166 DOTE a roe ooNEo„ www.usmetalroofng.net $/5/U eusyrmro „,ONE 1walee r a t/ld a./1r1 AmhPr 000 - /WS— Sys—9 ? MEET Jo.LOCATON � pa CO:4 nor-3 1 •I. ,/4 ._er ante -044i • r l�lt /f/ff JOG Z (,iCloaii.e y • _v)444/l .COIvL_ We will furnish and install new Englert Standing Seam mechanically locked system.24 gauge as listed below. Work Is guaranteed for years and the manufacturer warranties the fresh on the metal for 35 years. COLOR:Ir..,.h 1 t' SPECIAL INSTRUCTIONS/COMMENTS ROOF: yes Tr7�, i/7c lu"as' /s-fi-7 f,�r�g a/7g/ei/1<pas of socm: ex,�% t�//'Y1KS Tv�-'hoLlcc AI7C(FAsckA: L/ L . -441 /4// //f7—, -t/ G & 7r// PLYWOOD: rRysT2-31./ Sin Sfry/rf / / /0474/1 ski7lL,rr hi>1. kli17 uv "-RIP/REMOVE: OTHER: /�P /J1l //7STLl /7.e!1 Tr f l HOUSE: yes /'uhh�✓2b �r� 0/7 / p.'f7'h rear StC/7vrt PORCH: ADDITION: 1'S GARAGE: Q-S GUTTERS: / Cr DOWNSPOUTS \ • REPAIR: • op)°� .. Sror,J @ %2Q/o0z G«j�v Contractor will begin work on or about (date).Barring delay caused by circumstances beyond Contractor's control,the work will be completed by (date). All roofing panels are custom fabricated on-site with state-of-the-art rotiforming equipment. 'As with any roliform steel panels,a certain amount of waviness or oil canning may become evident at certain times of the day when sunlight hits them.This is standard in the industry and does not affect the integrity of the metal.This shall not be construed as a product defect and shall not be cause for refection. Contractor does not perform or assume any responsibility for any painting,staining or wood or wall finishing on interior or exterior. The contractor does further agree with the owner that(a)he will begin work within a reasonable time after the execution thereof,and will prosecute it diligently and with due care,and in a good and workmanlike manner;(b)in doing the work,he win comply with all statutes, rules,regulations and ordinances applicable thereto: Contractor to procure all permits regdired by law.Contractor shall provide public liability Insurances. Owner warrants that he is the owner of the properly on which the work is to be performed or that he is otherwise authorized on behalf of the owners to enter into this agreement. We Propose hereby to furnish material and labor -complete in accordance with above specifications for the sum ol: 7�e.4-7 / fill/ �QJ� h�5ou t Yiunc/f"P, Frply— donan(S o25 '-/So,07 )Payment to b`made as follows: / .06 %(f� —j upon signing Contract US.ME el TAL�FING DISTRIBUTORS,INC. 2C) f 74,E S �(.i %( �50)upon start et IeD 740 High Street,Suite 2,Holyoke,MA 01040 541 %n/3f �WWI 1nfobaomp•lnn: i1-a -0399 MAO 134740 CM 0025e6%(S�)KW be mach forthwith upon completion Nrnr �1 work under this contract 6�////'/7 Nolte:NO agreement to home improvement coneegkg work she t redoes a down payment km,.40r•sie (advance depouti of more than one-third of the t0W contract once or me total amount a1 ell r11/-L// v— y(� Nr r N W deposits on payments whkh the corurector meat maks,n adwtce,to order ender olnann. �V/,.::JJ 7 obtain dekr.ry or ape.)order matarwa and apulpnw>L afwhwar amount a stealer TO be wooer]by dad. Acceptance of Proposal I have read both sides Of this document and accept the prices,specifications and conditions staled. I understand that upon signing,this proposal becomes a binding contract.You are authorized to do the work as specified.Payment will be made as outlined above. You,the Buyer,may cancel this transaction at any time prior to midnight o tthe third business day after the date of this transaction.Cancellation must be done In writing.See accompanying cancellation. DO NOT SIGN THIS CONTRACT IF THERE ARRAN BLANK SPACES Signore t :11 . % / one ( I i LI slpwun