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23C-079 (3) 32 BLISS ST BP-2021-1506 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23C-079 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-2021-1506 Project# JS-2021-002502 Est.Cost:$40000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: CDA ROOFING & SIDING COTRACTORS, LLC 108924 Lot Size(sq. ft.): 6838.92 Owner: KING LINDA Zoning: URA(100)/WSP(100)/ Applicant: CDA ROOFING & SIDING COTRACTORS, LLC AT: 32 BLISS ST Applicant Address: Phone: Insurance: 1775 Main Street (413) 315-0587 WC AGAWAMMA01001 ISSUED ON:6/17/20210:00:00 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. )8' • >2 .1 0 I Certificate of Occupancy Signatur FeeType: Date Paid: Amount: Building 6/17/20210:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner it �a Department use only �� -T:,,� v.r City of Northar� pton v� �5 f Permit: Building Departs t ' 't/Driveway Permit "�' 212 Main Street �6 Sewe ptic Availability ,t, F Room 100 ° ry4e,,�0 ���/Water ell Availability Northampton, MA 0106b,;'N'It, Tw ets of Structural Plans phone 413-587-1240 Fax 413-587- k,0 P t/Site Plans n'r?s'0°, they 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 $t7' (�h'SS / Map A & Lot 0 7q Unit �J Zone Overlay District LO o tiCC. /14A Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: i-- 'INDA / 4j 307. 3L1S3 .57- Name(Print) Current ili g ddress: see Ai t1 c ICo Co'ireAC fE (- i� y s�Y,1 Telephone Signature 2.2 Authorized Agent: CfPR('c 2C CO/1 P Ochf'V k T7 -7Sfrvi (N ST 4 GA 14-1 r 44 Na rint)......wt, Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building yoloti (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) tL4/0 5. Fire Protection 6. Total=(1 + 2+3+4+ 5) % C P! Check Number 6.1 `b--y This Section For Official Use Only Building Permit Number:L3 -. 4.71..../500 Date Issued: Signature: /42 -/ - 2OZ G 1 i Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW zip YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O Date Issued: C. Do any signs exist on the property? YES O NO M IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO X5- IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House n Addition ❑ Replacement Windows Alteration(s) n Roofing LK Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding [lam] Other[0] WorkDes isl ptiQn\�Prim� ISTI/(1G-S -1-W(S AiD ',C,6LACF. WITN,/Ew ASpH lc:Tv/v(4 Alteration of existing bedroom Yes No Adding new bedroom Yes X SQ 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 /4/ p�1 r IN' 6- , as Owner of the subject property /�/ (��- hereby authorize CD r A` i r ( " L L C to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date I, CIAO S Da RC CV eoo c \t" G , as Owner/Authorized Agent hereby declare that the statements a d information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains an penalties of perjury. Ckkt\S00e Print Na e G- 16- \ Sign re o O r/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervnisor: Not Applicable 0 Name of License Holder: C Q DO .. C 1 6 Q f P f 5-70 L1'.\\uiLLO ,.CT ,31)00 License Number (06 01(0 /0_--7 - a D- Add ss Expiration Date ki \3-78 G 6'6\ Si ature Telephone 9. Re istered Home Improvement Contractor: Not Applicable 0 C 0 A Ropt-i G L LC 170 O Company Name _ Registration VI t-? -7s t (ij s i / mga/eel 14 - ig - ) \ Address /"� Expiration Date J 0d Telephone & 'V 8l 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 X No 0 City of Northampton o. Massachusetts J , DEPARTMENT OF BUILDING INSPECTIONS �* 212 Main Street • Municipal Building Northampton, MA 01060 y, �10 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted�ed with/^ a corporation or LLC, that entity must be registered Type of Work: /Q� f - cc, Est. Cost:O 32 Address of Work: 3d- ,3.L(5 S J Date of Permit Application: 6"-16 - 01 ( I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): _Job under$1,000.00 _Owner obtaining own permit(explain): Building not owner-occupied n �^ n n Q Other(specify): tM� 13 (4-1 S 6( E l o 4,�,`rl c-p1�s OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: Crt‘—el Ctk I -7o go Date Contractor Name HIC Registration o. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature �rr�r City of Northampton N Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 7S 212 Main Street • Municipal Building -1 Northampton, MA 01060 4.-^ Massachusetts Residential Building Code Section 110.R5.1.2 Homeowner: Person (s) who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. City of Northampton Massachusetts JDEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building 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: (Please print house number and street name) Is to be disposed of at: VA \-\o4W( 3 V) .sTs f21'lIDAAP . (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) c_ Signature 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. The Commonwealth of Massachusetts ,. s Department of Industrial Accidents s; g Office of Investigations i 600 Washington Street f Boston,M4 02111 ; -' www.rnass.gov/di.a Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers milicant Information Please Print Legibly Name(Business/Organization./IndividuaI): CDA Roofing & Siding Contactors, LLC Address: 1775 Main Street City/State/Zip:Agawam, MA 01001 Phone;?:413-786-4081 Are you an employer?Check the appropriate box: Type of project(required): Il`Ci I am a employer with /0 4. ❑, I am a general contractor and I f empioyees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2 --� .stet on the attached sheet. 7. 0 Remodeling �.1_1 I am a sole proprietor or pa.comer- ship and have no employees These sub-contractors have 8. [] Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp.insurance comp. insurance.: _ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions Q all officers have exercised their 11.0Plumbingrepairs or additions 3.Li am a homeowner doing work P myself. [No workers' comp. right of exemption per MGL 12 Roof repairs insurance required.]_ c. 152, §1(4),and we have no employees. [No workers' I3. Other comp. insurance required.] *Any applicant that checks box=1 must also fill out the section below showing their workers'compensation policy information. +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: Continental indemnity Company — Policy#or Self-ins.Lic.#:46-544117-01-0g Expiration Date:06/19/2024 Job Site Address: 3 %Ll S 1a •S`\- city/State/Zip: PO►`n CC /n4 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 ce under _ ins nd penalties of perjury that the information provided above its true and correct. t t7 Signature Date: 62- I - Phone#: l`�1 8 6 'r Gg\ —4 Official use only. Do not write in this area,to be completed by city or town official "1 I City or Town: Permit./LicenseII ie Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector il 6. Other 11 Contact Person: Phone#: ii CDAROOF-02 JCHOINIERE '4�Rom„ CERTIFICATE OF LIABILITY INSURANCE DAs/22/2020 TE ) 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 NAME: McClure Insurance Agency,Inc. PHONE 103 Van Deene Ave. (A/C,No,Eat):(413)781-8711 FAX No):(413)731-8548 West Springfield,MA 01089 E-MAILDSS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Continental Indemnity Co. 35289 INSURED INSURER B: CDA Roofing&Siding Contractors,LLC INSURER C: 1775 Main St INSURER D: Agawam,MA 01001 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER I POLICY EFF POLICY EXP LIMITS LTR INSR,wVD _a/IM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY Tef LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY (Ea SINGLE LIMIT (Ea accident) $ __ ANY AUTO I BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY NON-OWNEDO (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 46-544117-01-08 6/19/2020 6/19/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. 712 Main St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD __..�..40 CDAROOF-01 JMORENO ACOREY DATE(MM/DD/YYYY) 4.---- CERTIFICATE OF LIABILITY INSURANCE 8/12/2020 r 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 Berkshire Insurance Group,Inc PHONE ,Ext (866)636-0244 I FAx 413 447-1977 PO Box 4889 k (MC,No):(� Pittsfield,MA 01202 'VEXkW: _.—. INSURERIS)AFFORDING COVERAGE MAC I INSURER A:Admiral Insurance Company 24856 INSURED 1 INSURER B:Safety Indemnity Co. 33618 CDA Roofing&Siding Contractors LLC i INSURERC: 1775 Main St 'INSURERD: Agawam, MA 01001 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. INSR TYPE OF INSURANCE INSD SUBR POLICY NUMBER I PMMIDD1YYCY YYl (F MMODlYYYY1 UNITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 7 CLAIMS-MADE f X 1 OCCUR CA000035578-02 8/9/2020 8/9/2021 FRAMEs°cEsEoca,rrence) 3 300,000 MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY 31,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X ja LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $_CCO eBir ED $SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO 5909329 6/12/2020 6/12/2021 BODILY INJURY(Per person) $ 20,000 X OWNED ONLY X SCHEDULED BODILY INJURY(Per accident) $ 40'000 _X._ AURTOS ONLY X AUTO ONLY P�2e E tDAMAGE 3 ( )) S __ UMBRELLA LIAB OCCUR EACH OCCURRENCE ___ EXCESS LIAB CLAIMS-MADE AGGREGATE .1_______ DED I RETENTIONS $ WORKERS COMPENSATION STATUTEPER O_ AND EMPLOYERS'LIABILITY ----- --- ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ {OFFICER MEMBER EXCLUDED? NIA (Mandatory in NH) E.L DISEASE-EA EMPLOYEEJ Byes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 712 Main St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE e;t,. rr' ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Ill Division of Professional Licensure Board of Building R ulations and Standards Constructlq tFir Specialty CSSL-099424 L�icpires:03/05/2022 JAMES S ACERRA 1 �, 73 BILTMORE ST SPRINGFIELD.MA . f " i 410 4ss---4,1u— Ilk i) . Commissioner dail i . ` Emc:Q , IP Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construcfis9.r Specialty CSSL-099561 , Uyires 07/15/2021 CLARK L DORE e 948 SOUTHWEST ' Eft' FEEDING HILES M!► 1 �,N()ANTI Commissioner • • Commonwealth of Massachusetts 11. Division of Professional Licensure Board of Building Regulations and Standards Cons r 't't-4 !visor _ t CS-108924 f� pires: 10/07/2022 CHRISTOPHER DO • frg'. 570 PLAINFIEL,D S SPRINGFIELD IA. eO Commissioner d# K. bi&vniita. . • ciite folyviito~tectia eicAwadutza6 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 170804 C.D.A. ROOFING&SIDING CONTRACTORS,LLC Expiration: 12/18/2021 1775 MAIN STREET AGAWAM, MA 01001 Update Address and Return Card. SCA 1 0 20M-05/177� -��� rC'aonmenn«wa/l affrvicr<tzarAuav/7 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 170804 12/18/2021 1000 Washington Street -Suite 710 C.D.A. ROOFING&SIDING CONTRACTORS,LLC Boston,MA 02118 CLARK DORE 1775 MAIN STREET /;.,(41,4 AGAWAM,MA 01001 Undersecretary Not valid without signature v ^ k cip_Almadit/Jei6 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card C.D.A. ROOFING&SIDING CONTRACTORS,LLC Registration: 170804 1775 MAIN STREET Expi ration: 12/18/2021 AGAWAM,MA 01001 Update Address and Return Card. /L, Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: Supplement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 170804 12/18/2021 1000 Washington Street -Suite 710 C.D.A. ROOFING&SIDING CONTRACTORS,LLC Boston,MA 02118 JAMES ACERRA 1775 MAIN STREET %06, AGAWAM,MA 01001 undersecretary Not valid without signature e ROOFING & SIDII f —v CONTRACTORS '- CDA Roofing and Siding Contractors •(MA Reg.#128355/CT Reg.#603213) 1775 Main St.,Agawam,MA•(413)733-4080•(413)786-4081 •1.844-786-4081 •FAX 413-786-2196 ,. cdroofer@comcast.net 1 Carney Avenue West Hartford,CT 06110(860)953-5730 WWW.CDAROOFING.NET Proposal Submitted to: Date: Phone#'s// Home: 5 0 7626 Cell: ` r Street: Mail To: �} /T Z0 s City,State,Zip Code: Special Requirements: Proposal to furnish and Install the following g U//t //' 0 Re-Roof 0 Tear-Off e - Complete Roof Preparation ❑ Home exterior to be protected by tarps and plywood 7 )('Q '•••"` 0 Shrubs,landscaping,trees to be protected ❑ Entire existing roofing material to be removed to existing decking 0 Site to be cleaned everyday with roll magnet debris removed at project completion ❑ Deteriorated existing decking replaced at$_per sq.ft./$_per sheet of plywood O Metal drip edge installed at eaves and rakes Q White 0 Brown 0 5 inch 0 8 inch 0 New flashing will be installed where necessary ❑cut lead into chimney $ O Install new pipe boot flashing ID We shall acquire all appropriate permits ect.for all roofing work O All roof related debris removed by means of dumpster Complete Roofing System talcs,water shield installed at all eaves to protect against ice dams(and meet codes in the north) 0 3ft 0 6ft U 4ce,water shield installed at valleys,around penetrations and chimneys to protect critical 0 Synthetic reinforced underlayment installed over entire decking Shingles 0 CertalnTeed 0 GAF 0 Tamko J°Owens Corning ❑30 year 0 50 year 0 A M Color rk& &lU Ch./ ❑ Nail able ridge vent will be installed ❑ Ridge cap shingles Warranty Options Q-We guarantee our workmanship for 10 full years a t* U�$ All prices include dumping fees unless noted otherwise. r , We Propose hereby to furnish materials and labor-complete in accordance with above specifications for the sum of: Total Sale Price$ f d .) C Down Payments 00 a p Upon Completion$ ACCEPTANCE OF PROPOSAL:The above prices,specifications and nditions are satisfactory and are herby accepted.You are authorized to do work specified.Payment will be 1/3 down upon signing and balance due o completion.Unpaid balances shall accrue with interest at 18%per annum. Purchaser(s)will pay for all costs,expenses and reasonable attorney's f es incurred by CDA Roofing and Siding Contractors LLC to recover sums due under this contract. Date: ::: ature ? _ Phone: t' 1�. _!�1 - Estimates a 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 ,'Y` coming through the cracks of the wood.CDA Roofing and Siding Contractors LLC will not be responsible for debris or dust in the attic or storage areas. d