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32C-090 (16)
BP-2021-2062 33 WILSON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-090-001 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-2021-2062 PERMISSIONISHEREBYGRANTED TO: Project# ROOF Contractor: License: DAVE MINER EXTERIOR HOME Est. Cost: 15426 LLC 74920 Const.Class: Exp.Date:03/06/2023 Use Group: Owner: REGAN-TALBOT KATHRYN M TRUSTEE Lot Size (sq.ft.) Zoning: URC 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: • D R Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED The Commonwealth of Massachusetts (14, j,c9 Board of Building Regulations and Standards OCT 2 1 202! FOR \ Massachusetts State Building Code, 78b CMR Ml NIU�ITY Building Permit Application To Construct,Repair,Rekiovdt -Onl y *PEo gedlldar 2011 One-or Two-Family Dwelling __-9THAMPTON.MA 0'060 ,�n a��Z0i Section For Official Use Only Building Permit Number: (9 Date Applied: 4k..))13,14-5 /4' /1f- 27-20ZI Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 PrQp y Addres�C v 1.2 Assessors Map&Parcel Numbers o 1.la Iss 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❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 2.1 O ner1 of Record: Name(Print) City,State,ZIP 3 3 U..rt reel 4 8-7 C No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(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': 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 Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ 1 Suppression) Total All F • Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ % V a 6 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) L 5 v 14 a 34 /�g '~1 '- " WI L, License Number Expiration Date Name of CSL Holder u List CSL Type(see below) LI j3 dx ��* l No.and Street Type Description ir�� 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 117F-08-bo j?J'4C 3 e 6 LC>/`rC'4td-r Nth' I Insulation Telephone Email address D Demolition 5.2 nnRegistered Home Improvement Contractor(HIC) t1) (k•ie Y' tne" (�P4 /1 / �fvt 'i.` - t 6C.. �e st j 2 E a/nD 1 � � HIC Registration Number Expiration Date C mpan Name or HIC Re istrant i n b 1 5 ° ''i", u✓ Na23L1 gel y G/Ct �j I'4b Oh (le lG , ,0-..e/1�/mr-f L� 14-a Ge No d Street /� Email address J�YG.lte / - C>(c y 0 774 —©7 Z(a 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 AV 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 0 I vC ✓Li r 1'i r 1- l e''t Pet c— to act on my behalf,in all matters relative to work authorized by this building permi application. / / yw tbiat !zi Prmt Owner'sName E(fie<'pJ tronfc Si ature 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. 911.- - /Li v✓1-t't /e/i-' / 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 ,ww.mass.uovioca Information on the Construction Supervisor License can be found at n wW.mass.go\'/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 s s P Massachusetts w2, �': Abe ' DEPARTMENT OE BUILDING INSPECTIONS y_ 212 Main Street • Municipal Building Northampton, MA 01060 S1.4, T,�^' 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: V ik e--r )2e eye le^f The debris will be transported by: Name of Hauler: 1"`'A�✓fl-:- tc 1' f Signature of Applicant: `Date: I 1 1 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 . Boston,MA 02114-2017 - www.mass.gov/din - nutters'Compensation insurance Atl-tdas it:Builders/Contractors/Electricians/Plumbers. TO BE FILED'WITH THE PERMITTING AtTHORITl'. Annficant Information /� Please Print Legibly Natty:(t3usinnas`Organtration individual I: (1) t //1 /✓ 2''.�_.__ 4.4 _ �._.�_,___ Address: ?6 ii '.5-,./ddiaivel-of- Ai City'StateiZip: N'el is (t,,' ,A' r- Phone;t: .7 ? Y 0 7 )-45 k rc,ttu All employer?Check the appropriate box: Type of project(required): ----- 1 pm a employer with 7 employees tfedt and Of Fart-Lim:I.' • 7. a New construction _ I am a sole ptoprsetor or partnership and have nu employees vsorking for me m $. enodelini arty'capacity.[No workers'emir.insurance requital K-a 9. 0 Demolition 30 I lien a!isms osm.-r doing all work inyself.[tile workers'comp.insurance required. 10 CI Building addition 4.0 I lout a Iwnsassw Tier and u ell be hiring corttratitu is to conduct all work on my property. I will c'fonrrc that all contractors either have workers'vaniperrsatwa msuranix or arc sole 1 10 Electrical repairs or additions tTopn`tors with no employees. 12.0 Plumbing repairs or additions 30 I'µm a c..-it ral contractor and I has c hired the sub-contractors listed on the attached sleet. I 3.0 Roof repairs These soh-contractors have employees and have workers'comp.insurance.: , 6.0 We arc a eorporrusun and Its oliteers have exercised their right of exemption per MU c. 14. Othrt It(-',;Hat.and we have no emplosc+es.[No workers'comp.insurance required] 'Any apalicant that clta-ks box al must also fill out the section helow showing their workers'compensation policy information. i ti[xrsoo nets who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ..ontrvckrs that cheek this box must attached an additional sheet showing the name oldie sub-coistmetors and state whether or not those entities have employed.- If the sub-contractors have employcv:s.tiny must provide their workers'comp.policy ntnnher. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 2v it c-vt Policy it or Self-ins,Lie.#: (9 2 7 lam✓ itr F 4 S i( >L 2 a Expiration Date: t' O /,t i Job Site Address: 33 1,-, -I $w e- /4-Ir CitylState:'Zip: "-Je-1, '''•-(04-_-•— -- Attacba copy of the workers'compensation policy declaration page(showing the policy number and expiratlbn date). Failure to secure coverage as required under MGL c. 152,y25A is a criminal violation punishable by a fine up to S 1.500.00 and&or One-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance co%crag: verification. I do hereby certify under the ins and penalties of perjury that the information provided above is true and correct. • Si}nnature: D 16 ( 1 / .'-1 Phone#: 7 7 if Q 17 .6 Official use only. Do not write in this area.to be completed by city or town official. City.or Tov%a: Permit/License Si Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: 14-4ti$). r i . a a 6 1,2, avoc 7-71tc�,—_ DAVE MINER Date: t' /.--` joZ Exterior Home Improvements (413) 533-0481 • www.DaveMinerRoofing.com 347 Newton Street,South Hadley,MA 01075 MA Registration#186552 Customer Name: Telephone Number `'r Address, City/Town, State: 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: • 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: Contractor is not responsible for any damage to interior of home.Any loose articles on walls/shelves should be removed before work starts I 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$ _ 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