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14-022 (2) B P-2 021-2 063 141 KENNEDY RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 14-022-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-2063 PERMISSIONISHEREBYGRANTED TO: Project# ROOF Contractor: License: DAVE MINER EXTERIOR HOME Est. Cost: 15345 LLC 74920 Const.Class: Exp.Date:03/06/2023 Use Group: Owner: FAPPIANO SHERYL C Lot Size (sq.ft.) Zoning: WP/WSP Applicant: DAVE MINER EXTERIOR HOME LLC Applicant Address Phone: Insurance: 264 SOUTHAMPTON RD (413)374-0720 622UB9F45112620 HOLYOKE, MA 01040 ISSUED ON:10/27/2021 TO PERFORM THE FOLLOWING WORK: 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. Signature: �� ., te I � Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Zvb RECEIVED The Commonwealth of Massachusetts FOR of Building Regulations and Standards OCT 2 1 2021 MUNICIPALITY Massachusetts State Building Code, ^80 CMR tJSE Building Permit Application To Construct,Repair,1 enotyg irpiF ff Yc1 cno isedMar 2011 One-or Two-Family Dwelling ^F1T1- AMrroN.MA o1 o This Section For Official Use Only Building Permit Number: f5fi" a/-A°O 3 Date Applied: -Vt�U , //�/� JO- 27.20ZI Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers /( ! JLeItzd7 ,4 1.la 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 0 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: /11 r/ic-r, /--ie a rlr/-I a✓ z rctS y -64 Name(Print) City,State,ZIP / K1 Jct .(., J f pJ t7 7! 7 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORD(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': o L SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire Suppression) $ 1 Total All Fees: a �� Check No. 4 Check Amount: Cash Amount: 6. Total Project Cost: $ �� 7 G'S- 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) s 6 t,Q 10 A 1�g c N PGA L License Number Expiration Date Name of CSL Holder List CSL Type(see below) li Po . 3 ex `3 b l u No.and Street Type Description ala-1 A U Unrestricted(Buildings up to 35,000 Cu.ft.) , R Restricted 1&2 Family Dwelling City/Town,StateZIP M Masonry RC Roofing Covering WS Window and Siding '7 SF Solid Fuel Burning Appliances / !i-O860 i?PiG2 36 6 Cot Iet{)-rN I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) l�A� 1Kci 6 fea. �c l'^p ICc, / e6rs2- /Y/2s HIC Registration Number Expiration Date TiCmpan. ,Namo�'++e or aHIC Re 'strantN / !n Ql yo c✓ Ii k4 IYoIc ()ivy*, v4vc e „,"'uc/ri/nz/tLG,fi Nq oi Street /L Email address yc/ce /V U y �'7- tov —0720 City/Town,State,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 V No 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIESFOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize 0/T /C- /11 i n zr "G et /at I c..- to act on my behalf,in all matters relative to work authorized by this building permi application. //// LCry file A ,'Jo✓✓ tp(a6 /zl 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. ' j 9fy ,,, 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" City of Northampton as °� s Massachusetts �wS �( (�; �r * • 1. t DEPARTMENT OF BUILDING INSPECTIONS 3. }'Ar t 212 Main Street • Municipal Building Jti L.Northampton, MA 01060 �J'ry CONSTRUCTION DEBRIS AFFIDAVIT (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: I L l ge L,C/iif The debris will be transported by: Name of Hauler: Xfr."74rifF9 ?. f1:( Signature of Applicant: Date: 1.-;,. �--+ s•ccan•mcla a J a••••w..••w•.al,.............,3"" 1 Congress Street,Suite IQt? Boston,:%L4 02114-201 • www.mass.gor/dill 110tkers'Compensation Insurance Affidasit:Builders.EC"ontractorsJElectriciansfPlunthers. _ 7.0 BE FILED WITH THE PERMUTING AUTHORITN. . nnlitant Information / Please Print Leeibls Name(ausin s:Organirauon Individual �/�e r /_✓_Z Z'1_.._-`' G G___-____---------. Address: ?b i ✓ G+✓vi' __ W 40e1 C ityIStateiZip: 1.Y Ayt,(be._ _ /11- Phone n: ?? q: ifis?..8 . Are:von an employer?Cheek the npprupriate but: 1 Type of project(required): 1 urn a employe:'. it:) 7 ern lice?ttull and Jr part-tint:I." a 7, 3New construction i l _. I tan a",ire.`+ruprector or raimenlrrr and hati a no en )t°et e.:,t..+rkin. for tre Ir. R. ' Remodeling ' any curac':t1.t ti UtRY T> comp.itl.i.rarle'e riNaned. i t 9. Demolition i l-sin a homeowner d'int.r.alr work to ,e1 ihho ,' LtT> Cvrt43.iL.,:mi ka required:1 i 10] Building addition r7 I::nr a Ito:rec..titter and'AM be hirin_c:•ntrac..rr to,conduct al':•trk or my property. I will t eta+4r that al +ntra<tun either l sir u'orl.rn'i srn+ateon i ucruuc or arcirlr 11.7 Electrical report or additions rtormeu.,r.A kb nl cinrk"ce 1s. t, ,— l:_ Plumbingrepairn or addition. ti 1_ri a uciterat et ntris.tor and 1 h'.c trrred the sub-eirtricton listed or the attached aliect. j l+t:e,e.uxb-contra tt'r.i::•-e employee,anti!.axc'.torker,' onrp.insurance; j 13. Roof repairs l 14.©Other „ 11'c arc a 1:ems+rsticnt and ri,officer,tune exerei>ed their nei:t of clan tin per Mtil.c. - t^:,F•114t.and,,,,,isa.e nil e'!rr•ta+..ee:..[No•+*vies'cttnp.irt+Wance rcyt.inu.j '_1n,'*01x:rat that check:,box al:mat alit fill via the,e:tip'n Is.dov..him ina then er oiler.'eornpcmatwn policy ini na`sliti. 'Horrun*r:r,.\au,ti mit th_,atlial+it inul:atirg they are'riving all a urk and dam hire uubide etnniraeier,meat,tibrnii a retie aflidaN it indicating welt. l_"unirxtan that cheek trail lvt mu,-;utu.ch.:d an addstrunai.Eeet.ht:•u ino the name el the at►k,:c,atraeiar,and%Y..ate u hether ix not thou snttics h-r.c ernplu eft,. It the set,-elm'actam It.Ae employ oe.they mu:::pro,hie their und'ers'comp.policy ntanb.r. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 2i.,ri___i--(7' Policy#or Sell-ins.Lit.4: to :2 7'-'0 mot'F'Ct I ( ?L a a Expiration Date: re p /.)i / 3l/ lob Site Address: I LC I /Zesi4 e fly X O City.Stale Zip: Gar✓`r ,r _ 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 tine up to S1.500.00 and'or one-year ixnprisonmerit_as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.90 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance co%erate verification. I do hereby certify under the airs and penalties of perjury that the information provided a/ /boveis true and correct. • S lima tu /re: Date: b f 1 S-- / . -I Phone t: 7 l C. -- G — ..2 6 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.C1ty1Town Clerk 4.Electrical inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: bAVE MINER Date: // f Exterior Home Improvements (413) 533-0481. www.DaveMinerRoofing.com 347 Newton Street,South Hadley,MA 01075 MA Registration#186552 Customer Name: , 'f r /4"r /AI'fob Telephone Number �,/ 74 G)-3/3 Address, City/Town, State: / 'l l y 42 I CertainTeed Roof System • Strip off existing roof and remove all debris from worksite • Line all edges with 8" aluminum drip edge • Install_ feet of WinterGuard ice & water barrier along eaves and up any valleys • Install Roof Runner Diamond Deck synthetic water resistant underlayment • Install CertainTeed Landmark Landmark PRO Landmark Premium Other shingles to manufacturers specifications. Color: /1 B t (r �i C • Install SwiftStart starter strip along eaves eaves and rakes • Install using_4 nails 6 nails for maximum wind coverage up to 130 mph • Install a ridge vent along the length of house approx. 15" in from edge of roof • Install new vent stack collars • Replace step flashing as needed along walls and chimney • Re-flash chimney with lead flashing as needed. Install Cricket at chimney. • Plywood Install 1/2" CDX plywood Install 1/2" CDX plywood as needed @ per sheet • CertainTeed SureStart Plus 4-Star 5 Star Warranty Coverage • All workmanship is guaranteed for 10 years unless otherwise specified. • Protect siding and exterior of house • Protect trees and shrubs • Magnet ground for loose nails • See Other below for any additional work or comments • Other: /c '1 l ( / Contractor is not responsible for any damage to interior of home.Any loose articles on walls/shelves should be removed before work starts We Propose hereby to furnish material and labor-complete in accordance with the above specifications for the sum of: dollars($ ) A deposit of 1/3,$ ,is to be paid before materials are ordered. A Payment of$ '2' is due at the halfway point,and the balance of$ paid upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above specifications involving extra costs will be executed upon written orders,and will become an extra charge over and above the estimate. Our workers are fully covered by Workmen's Compensation Insurance and Liability Insurance. Authorized Signature: '-` Note: This Proposal may be withdrawn by us if not accepted within 30 days Acceptance of Proposal—The above prices, specifications and conditions are satisfactory and we hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature: Signature: .. Date of Acceptance: This agreement may be cancelled by Customer within 3 days of acceptance for any reason as detailed in the accompanying Notice of Cancellation Customer's Initials