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12c-035 (3) BP-2022-0344 39 BURNCOLT RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 12C-035-001 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-2022-0344 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: Est. Cost: 25000 NORTH EAST SPECIALTY CORP 081031 Const.Class: Exp.Date:09/06/2023 Use Group: Owner: CAGGIANO PATRICIA A Lot Size (sq.ft.) Zoning: RI/WSP Applicant: NORTH EAST SPECIALTY CORP Applicant Address Phone: Insurance: 148 DOTY CIRCLE (413)739-4333 VWC6003962-2021 WEST SPRINGFIELD, MA 01089 ISSUED ON:04/07/2022 TO PERFORM THE FOLLOWING WORK: NEW 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 14 • • CS) • Fees Paid: $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts APR ' , Board of Building Regulations and Standards ` 6 FOR 2Q22 RUNIC PALITY (` Massachusetts State Building Code, 780 C I USE Building Permit Application To Construct,Repair, Renovat-e'©p Nito1 ra- .Ievised Mar 2011 One-or Two-Family Dwelling n,,)f r This Section For Official Use Only Building P //1.17rmit Number: 31"),7--'-- S(-(� DateApplied: �'►-� ' +��'S y-lo-ZOZZ Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1Jp�ty Addres_s: g / 1.2 Assessors Map&Parcel Numbers ��JJ Ur'n c� �y /2c_ 0L3 6' 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 211 Owners of Recor . (:a /an0) 2t[rjeic �.Arfriay r/ore,x Mot p/o6.) Nameint) City,State,ZIP 39 &2( 00 No.and eet Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction ❑ Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: I? Brief Description of Proposed Work': _ pu S Co r .4e 11'oL P) riS n /(4 1/to k 77) eeep cpd 1 Ce +-IA Aa rj C 1 c) t n Pi52SCt 5O -As it 1 t ocvi n - SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $$ "C) �✓'� J` 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost' (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) ! $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ , Check No.1303 Check Amount: 1 Cash Amount: 6. Total Project Cost: $ ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervis r License(CSL) I �� / License Number -.x ira ion Date Name of CSL Holder r C✓i r' I l�j � L P Pik: ,.- ap ;� List CSL Type(see below)'" �`/r, Type Description No.and Street /� yP (" Ji /,r) - U Unrestricted(Buildings up to 35,000 cu.ft.) l ! / 1'<C_ R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding , SF Solid Fuel Burning Appliances l It r ,('�f 1 `/ l A1 f/e,: 0/: .- I Insulation Telephone Email address rCGo►`J D Demolition 5.2 Registered Home Improvement Contractor(HIC) /() ' /. I-IIC Reg istration Number xpira ion Date HIC ColiaparyhlAme or HIC e str Name A A Tye f f / `x fJi 'Ty f1 � i ej No.and,Str e .'7 P. t! -. } / P�'/1/��t'C.� y�ir1 � .. �/ �.. /5 C J Email address CityTTown,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 1 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 to act on my behalf,in all matters relative to work authorized by this building permit application. S/ 7-: ((')1 : I e Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER1 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 pplication is true and accurate to the best of my knowledge and understanding. ,7-57114•2 Print O er 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 IIIC 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 x = Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 wwoe.mass.gov/dia Wv.vkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly 11 ��` V("� r� Name (Business/Organization/Individual): (�l�.'.: 1 f;,,,.� . �:. : 1 --Address: ) p,� } City/State/Zip:I, ecg L D l l O)( Phone#: �J, ',. 7391�3,.53 Are you an employer?Check the // appropriate box: Type of project(required): l I am a employer withO employees(full and/or part-time).* 7. ❑New construction 2.01 am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]1 9. 0 Demolition 10[]Building addition 4.0I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or arc sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbin pairs or additions 5.01 am a general contractor and I have hired the sub-contractors listed on the attached sheet. I of airs These sub-contractors have employees and have workers'comp.insurance.t repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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. , / -. 11 T Insurance Company Name: J. 1/ M u I )C-" ,,,.,.. // C) Policy#or Self-ins.Lic.#: V,v V l e C" )):$9 t. _X ✓f Expiration Date: /��� ..mac 4 Job Site Address:, 7 Z)(7&) gd. City/State/Zip:P/Q lie HaD/c 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. ]52, §25A is a criminal violation punishable by 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.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 pains and penalties of perjury that the information provided above is true and correct. Si nature: I Date: Phone#: %< 9 3 3 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.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: • .................41 Ntbt.:0-1 _S.LEJ.Q.1..1Y1b A I, CERTIFICATE OF LIABILITY INSURANCE DATE(MINDOPNYY) likee.------ 02/23/2022 - — 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). 'CONTACT The Dowd Agencies LLC pitonticr a 413-737-5359 ;NAME; J Raymond Lussier Ins Agcy Inc ; PHONL 413-737-5359 ! FAX 413-732-2027 181 Park Avenue,Suite 8 WC,No,FYI): (NC,No): PO Box 499 D E-IRAIL ' ADRESS!:mslussier@dowd-com West Springfield,MA 01090-0499 James J.Dowd&Sons Insurance iNsuarritsTAfroerneo COVERAQE NNC 4 INSURER A Atlantic Casualty Co Insurance Company 39454 INSURED INSURER II:SafetY Northeast Specialty Corp , ._ . INSURER C A.M. Mutual Ins. Co. Nescor 148 Defy Circle • . . West Springfield,MA 01089 , i INSURER 0: i . ' 1 INSURERS. INSIRIER I= ------ COVERAGES CERTIFICATE NUMBER: REVISION_N_UMPEFk nits is TO CERTIFY THAT Thr.POI ICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDI TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH-MIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE: INSURANCE AFFORDED BY THE. POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERNIS. EXCLUSIONS AND coNortioNs OF SkR.:Il POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . , INSR .ADDL SUBS: POLICY EH' POLICY EXP i LIR TYPE OF INSURANCE ANall,WM; POLICY NUMBER .IMM/bOIT TANI IMM1I2D/YYTYL: , LIMITS A X COMMERCIAL GENERAL LIALIILI f Y , 1 1,000,000 EACH OCCURRENCE I S CAI .MADE I X I OCCUR • i M261001495 07/2012021 07/20/20221114VA EtT,LR,It,„k1;5,'Pienw., i 100,000 5,000 1,000,000 1 PERSONAL.A ADV INJURY ;$ , GE-NI.AGGREGATE LIMIT APPLIES PER . . ,Gc-witAt,./SOGRELATE ;$ 2,000,000 X POI ICY i 1 LOC • 1 PRODUCTS COMP1OP AGO ! 5 2,0p?,000 I.>mitt : 5 I __ B AUTOMOBILE LIADILDY . COMOINED SINGLE LIMIT 1,000,9001 • .if.liex;J:jr11: $ ANT AWE) ' 2433825 03/11/2022,03/11/2023 souliv maw oy p,n,A.4!) ,..1 . Omit o v SCHILDUIED AUTOS ONLY , AUTOS RODILY INJURY 4'or aceadorIL I $ X 1A11.11ft ONI Y i X !TAIIMM ' . ' ' ;TOPER-Fr DAMAGE. 1 i per scot:lent! • I S - . ` • . ------- . UMBRELLA LIAR ' OCCUR i- i EIAGITO.PC.URNPICT; . _ .] S EXCESS LIAB .CLAIMS-MADE. AGGREGATE : 5 In 0 LW II NIIONS . . -----. C WORKERS COMPENSATION PER , . OTH• 5 ANO EMPLOYEINV LIABILITY WWII. ' . LP ; Y i N . 'VWC6003962-2021A 07/09/2021:07/09/2022: 100,000 ANY 11201 HO IORA%RINI:RA*OMNI I I I,L.EACI I ACCIDENT .01 I X:EIVMEMILL it LSCLUOTI)r• I N 1 NIA i 1 •(Iliareialory lent') I : I;I DISE ASP-LA I$401.0Y11 4.$ 100,000 II yut•.,OW-4110u oviil i , •I)!;,;011.1.112.N or NI HAI IOW:,Wow El. DISEASE POI ICY I../MIT ;I 500,000 - . . — -• ' . I ------ LIFSCRIPIION OF OPERAND/CI LOCALIONS t VEHICLES (ACORD VII,Addilkatta1 Remark%Schedule,may be attached if more Spit141 it.requi --ted) CER • • ::;:k:•,, • ---- ---- — --..... .. If:t1Kg.12tfi _ CANCELLATION ... CLISTOME SHOULD ANY OF THE ABOVE DESCRIBED Pat MIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH 11-IE POLICY PROVISIONS. — --. AUTHORIZED REPRESENTATIVE , '5—CA'''r3-'..',.. ACORD 25(2016/03) e)1999-2015 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks ot ACORD ' • ......), ......' ,...‹.? (.')./K"'..." (4-• ... .. .. es.,/,463 6:::)(:',1792/2.?'6://?,e2:.e..::• 152::4?:::// e:',/-;•-"' . .././(... (...4'...0be...--67 -,......,:,...,-?...;,--:..4....- Office of Consumer Affairs and Business Regulation .1000 Washington Street - Suits 7'10 E3oston, Massachusetts 02118 • Home Improverrie.in,Contractor Registration • . Type: Corporation Li. .! NORTH EAST S F'I.7:CIALTY COF1POPINTIO '••;.. • — ,. Rogistration: 'I 03 t I d • EixpirEitiOn: 07/13/2022 D/B/A NESCOR .. . . .; . 148 DOTY CIRCLE , •• . ., .. . WEST SPRINCiFIELD, MA 01089 ' • . ...._....__,.. .. . . • .....,.................___._ , • Update Address end Return Card. '..)A 1 0 20M05/17 Y.4 -...' ' • ge,,,,,vnew,a,wade,,,,,'',1410exak,,t,,ra; Office of Collelliner Affalfs&filusineas noijultition HOME IMPROVEIVIENT CONTRACTOR Beciistration valid for Individual use only TYPE: Corooralion before the expiration date. If found return to: aggiatU211 fixokatisal °moo of consul-nor Affilif8 and Business Regulation • Ipqq,'::`... 07/1:V2022 1000\Noel. • •ton 8trost -Suite 710 ...-' NORTH EAS'Iqt(),IRE.:,'‘IMOACIIIII"O RATION I;3oston, 18 D/B/A NESOW ..:'! , , •• (...1-•----' i •, 0 .., .. .. SHARON M.TAlifirIP'.:;f: 148 DOTY CIRCA.. ••: ••• . (..,,,41A4i4"6")../eraoopoi' ...„...,.....„...,......... .......... ........ ..,. ,............_. ...,:.. WEST SPRINGFIL:1.0,';iglA:..kil 000 '"---------- No valid without dighv ••• -9 Undersecretary• . , • , ......... . . ......... • ............. • • ( .•• . . .. • • Commonwealth of Massachusetts t'f� Division of Occu Board of Building pational 1_icensure 9 Re ulations and Standards Consloith oiiS14414,rvisor CS-081031 MArrHEwSwe' til ' cpires:09/06/2023 PO BOX 692• tARIIS ( BECKET MA',4)1223 • lair;, .• r 4\': +kC Commissioner ' w,�za /i. Ui'.roick.c4k 0. HAM�: City of Northampton O O,y.. S .i.. S! ,> Massachusetts s 1 c ��� �<< * c DEPARTMENT OF BUILDING INSPECTIONS �'S: r 4 .+� 4:, -"" 212 Main Street • Municipal Building `7b cb` ,3 Northampton, MA 01060 ssN .=. `,\� 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: 0_s.„)-1-- 0//5 " V(/ C.?-7-- The debris will be transported by: Name of Hauler: 05 TI aU/% Signature of Applicant: # �,(,4�/ Date: 7 NORTHEAST SPECIALTY CORP DBA NESCOR All home improvement contractors and subcontractors MA License #103713 engaged in home improvement contracting, unless 148 Doty Circle specifically exempt from registration by Provisions of WEST SPRINGFIELD, MA 01089 Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries 1-888-NESCOR-1 . 888-637-2671 about registration and status should be made to the Submitted 413-739-4333 Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108 (617) To:f.O-_ - 727-8598 -- t-- - 12011 _ezjt z. C,e, --.f„At d.---QLS, 't'- JOB NAME i'_ ..1_' eJ'�t:i .0 44 Q (c d'''1,,, ( ' f�'yr' JOB LOCATION 4.y. 6,f?__ _�! 'LCQJ /}RJQ�� y -7 I7 1 uAtt , -i.,3' 7 C. ✓ J /_50 �`x/Z �? ESTIMATOR �i-'. ,//; . 7-St it /W/yee hereby/ � submit -specifications and estimates for work to be performed and materials to be used: u _ZGCr_y _!.r'lSca:e,f'_-1CC4 L_5+'[__4 .k--- - -.44,r k.4e.,/-l/°..GI.1-.V. 4--a- - - .164/` - 1-='' 9trcC__G4ai►24' _ ..Ckta.- -.�Tyl/ __,:ci� /mot :- _G t' *. -/At' ,.1.44..ef- . ..-.,.... i:„."7. .col..,.. .3/. ..4,_.i.,Q__.1.1)..s_c_cc..)44-L__-_-_,A.2_C4.CCar._ In * .1-- ' Do not do: Co ruction related permits: VJQRft5CR E Ulm °d f contraS •1 vgv the work or order the materials before the third day following the signing of this Agreement,unless specified here' in .Contractor will begin the work on or l about__ .._ (date).Barring delay caused by circumstances beyond Contractor's control,the work will be completed by C./ ' elate).The Owner hereby acknowl- edges d a es that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not /co idered as violations of this Agreement, WAR ANTY � The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period 6r lowing completion and shall comply with the requirements of this Agreement.In the event any defect in workmanship or materials,or damage caused by the Contractor,it s tractors,employees or agents,is discov- ered after completion of any job,including cleanup,the Contractor shall,at its own expense,forthwith remedy,repair,correct,replace,or cause to be remedied,repaired or replaced, such damage or such defect in materials and workmanship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. We P pose ereby furnish ma rial and labor-complete in accordance with above specifications,for the sum of: . r�r�rr�ge/i` /c' '"- --- .,. _. _dollars($�`� C"x,t • _) Payment to bei e follows: °r($_ d SIgr-).__)upon signing contract; .NQIIIIJEAZZSP_EGALIY Q4RPAJ@9JYESc_48 Name of Contractor/Designated Registrant ($_/9 '6'60 )upon completion of _1_4.Q RQTY cIRGLE. Street Address 4(0%,($ f��j1ZII� )upon completion of .; WEST SPRINGFIELD_ MA 413-739-4333 -------------- ---------------------------- . City/State Phone lie) Rio($ 4, .?p ..__)shall be made forthwith upon 10F1 3 completion of work under this contract. Re istration No n'L_ Notice: No agreement for home improvement contracting work shall require a down Name of Salesman` _..,, payment(advance deposit)of more than one-third of the total contract price or the ,�/` ------ total amount of all deposits or payments which the contractor must make,in advance, Authorized Signature .,,--_ ....-, to order and/or otherwise obtain delivery of special order materials and equipment, wrlichev.er amourttis9reator Acceptance of Proposal I have read both sides of this document and accept the prices,specifications asnd conditions stated.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 may cancel this agreement if it has been signed by a party thereto at a place other than art address of the Seller, which may be his main office or branch thereof,provided you notify the Seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement.See the attached notice of cancellation form for an explanation of this right. 7.- DO DO NOTrr SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature, 4... . �__L% ..l_i.. j�.0,h dte_!�:�a.L._,,,,,1 Signature. . -. . _..____ � Date_��_ 1 IMPORTANT INFORMATION ON BACK ar