25C-008 (13) BP-2021-2066
150 NORTH ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
25C-008-001 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-2021-2066 PERMISSION IS HEREBY GRANTED TO:
Project# 2021 ROOF Contractor: License:
DAVE MINER EXTERIOR HOME
Est. Cost: 16438 LLC 74920
Const.Class: Exp.Date:03/06/2023
Use Group: Owner: ARMSTRONG ELIZABETH A&STACEY A DAKAI
Lot Size (sq.ft.)
Zoning: URB Applicant: RONALD PELC
Applicant Address Phone: Insurance:
P O BOX 364 (413)478-0860
GRANBY, MA 01033
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: I
Ti .10
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
n.
The Commonwealth of Massachusett V 111
<,n_ r Board of Building Regulations and Stan ds — . OR
'• i CIPALITY
',,. ,, Massachusetts State Building Code,:780MlbCT 2 Z 21 USE
n
Building Permit Application To Construct,Repair,;Ren•vate Or Demolish a •d Mar 2011
One-or Two-Family Dwelling ,, .
This Section For Official Use.(Znl ��,sPFcrioNs
7N een G
Building Permit Number: a p.A. I-- 20 Cl fr Date Applied:
/�uji- ,5 / /62-272021
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1/rop�erty Address:
d�� r� 1.2 Assessors Map&Parcel Numbers
1.1
1.l a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: Jt
Name(Print) City,State,ZIP
jc& we6J.s l-- 320 - 2$-41'
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORKS(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.❑ Number of Units Other 0 Specify:
Brief Description of Proposed Work2:
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:
❑ Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ ,�(
Suppression) Total All Fees:, I /
Check No.( heck Amount: Cash Amount:
6. Total Project Cost: $ 16 3 g' CI Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) C 5 &,i }a / , 1. g
r N � C. License Number Expiration Date-
Name of CSL Holder J
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
�� ►�-
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
/�
77tS -08(bb i?Pa-c 36 g Co of()-, Nei' I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
>M liter er JC Cft�! i�.' ' t -tet _ ` L G / �' t 5'2- /L 3
HIC Registration
Expiration Number Expiration Date
Cgmpany,Name or HIC Re 'strant NariA
S v aes^ ei✓ i,� 0 41 y c/4&• ( t VC 124 € nz/L'.Lc-.tes---
Nor d Street Email address
(' lYc`�te r►/ vlc'to 774 -n72t'
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 .. ...W 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 p `v( ✓1't r o z 14c 4 /
to act on my behalf,in all matters relative to work authorized by this building permi application.
(Lt e !11"`Ci ,3O3 k /U/at /2.%
Print 0 er'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.
0 A- t/ ✓/—tom 7 /1/ f 11
Print Owners 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
,,„w.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"
1
.-;ts....\ The Commonwealth of Massachusetts
;.. Department of Industrial Accidents
'4'r.l. . 1 Congress Street,Suite 100
- ' '?-_ Boston,MA 02114-2017
ww:v.mass.gov,'dia
j - ss skers'('otnpensation Insurance Af idas it:Builders?('ontractorslEiectriciattsl Plumiters.
1'0 HIS FILED WITH THE PER\trt-I lit:At THHHORfl%
Applicant Information Please Print Leeibh
Name kBusin_ess Or ntzation.tndwidual,:
•
Citv:State:Zip: Aft,((' /of,p- Phone : . Y " It 7 &.
\re+u{t an employer?('heck the appropriate boy F •
Type of project(required):
1 ari a crnpley.z'.siyr _-.::rrr s=_tes iiu'.1 and or putt•tint 6" ^ 7. 71 New construction
I
'. I an:a w o seethes or r nnc-rsh;.and have no a (1
I p p mil`%LIiS S+li{llltt for .[ 8. e modelin`_
any c:,r.:c•t:,-rNo ucnkas•ecanp.Ueda: ix ny aired_;
9. D Demolition
+.:�1 I lim a h.t:rtr+a nt*inn at.uutk to -4:1. :'..•r.cn tic+ corm.in,unince:waired
��j'.� { 10 0 Building addition
4.i f I art a han. +n.r and a Ell lastly ..•ntra.'ur.tt.c..:ndy.tt ad 1.t'zI.on in west}. I::ill = `
'— i i i. )Electrical repairs or additions
ctt•ur.that al:i•.rnttaCltlrS tirM:t Isatc ..i,ritts c r x2 at.. ysu�ranic i a e svlc 1
reuprie.•r,,t ith no cr:rrlo:,etn. s r-
I_.j Plumbing repairs or additions
.f,.ril I-in a cc-ion-al contractor and I I as c inrcd the Verb-cunt tors lists:e on the attached,hest.
E 13 r-- Roof repairs
1'l.e+,:,ub-contractor,Law onpk + '.+n tx,and haictt;.tsi'c'cnnp.t:sr•t:rurcc. ` -
i 14.j0thez
6.0`.l'.:an:a t:.:rporai un a_nn a,mf:ic.ra its:.:e:cn:ucd ti::::r rtrh:al•cccnx Lon pet MU_:.
:32,5:14I.Line.+,:c haw noacg1,•:.ccs.IN-uuri.zs'comp.ir:st.:a. ' reyy,u:-.`I
':ices aplihiccn that cheeks hut.=1 nu:st alan fir,out tile w-.ti:rtt iv:luut shvct ma tlsnr uuwkisa'eomp.m.:Mon pulu1 in::sma€tun.
`ti_,rnivt►r..-ra V.in..minnii tic:,aflitat:r incLratinn they are de.-ire ail a-ork and then hire vut,•idt:cantracturs mug..ubmit a c a al:id:st it indica::nr i.o b.
-t.'ontsacti•ri titsi check.this b:rt inns:att:nln-ti an a+lcl.tzuml shut s.tiov.ino the name of Liu:i.ut=•.-cstraii•.ra and sate a.he.her it not those.mane.hair
emplo+•cot, lithe s.4+•cvr_ar4n.-.Eat,c::slu ues.they must pro.ide their '.tm:lots'comp.poiie:.ncmt,-r.
I am art employer that is providing workers'compensation insurance for my employees. Below is the policy anti job site
information.
Insurance Company Name: .lL L� -____--
Policy t or Self-ins.Lie-»: 61 2 7 ul 13 4'p I4 s-I f )L Z , Expiration Date: ! 0 /.>f / 2//
Job Site Address: // - b JA.# 4 f/ City State Zip: /ie fr `
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failun;to secure coverage a required under MIGL c. 152. §25A is a criminal violation punishable by a line up to S1. 00.00
and:or One-year impnsonnitlit.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.1)0 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
cot eras verification.
I do hereby certify under the +tins and penalties of perjury that the information provided aboveis true andl correct.
Sanrtature: Date. J 6 // 1 S- / ,-
Pitar.0 i:: 7 7 Lf — G / 2 (,6
i
Off ial use only. Do nor write in this area.to be completed by city or town official
City'.or Town: PertnitiLicense k
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.('ityiTown Clerk 4.Electrical Inspector 5. Plumbing Inspector
b_Other
Cont•act Person: Phone 4: J
City of Northampton
MassachusettsA).;:s '<<
�k w :lf
.S' * DEPARTMENT OF BUILDING INSPECTIONS IT .T
212 Main Street s Municipal BuildingyO a
'1114fort Northampton, MA 01060 Pd?!
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: 11 e-r fie eye letif
The debris will be transported by:
Name of Hauler: lc
Signature of Applicant: Date:
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ComIIIW�lR�at h o Massachusetts.
Division of Professional Licensure
._ - Board of Building Regulations and Standards
Co # b
CS-074920 a
3a05 02
EJcpires: 0 j? 3
�' RONALD E PELC ,-..
« , PO BOX 364 '.
'
�" —:,. GRANBY MA 01033
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DAVE MINEW Date:
Exterior Home Improvements
(413) 533-0481
www.DaveMin erRoofing.c om
347 Newton Street,South Hadley,MA 01075
MA Registration#186552
Customer Name: Telephone Number
Address, City/Town, State: 1^''e, ` ''
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 Premiujn
Other shingles to manufacturers specifications. Color: r � " •�'`
• 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 t 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: g/
it/1-,,6; 10/l~i�
A - ?o 7e5
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, $ l/7 ) "" , is to be paid before materials are ordered.
A Payment of$ ''-7 ` 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