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37-047 (2)
BP-2022-03.53 186 ROCKY HILL RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 37-047-001 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-2022-0353 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: Est. Cost: 11600 VECTOR HOME INC 112389 Const.Class: Exp.Date:06/18/2022 Use Group: Owner: AL SEK ANDREW & IRENA MARIA ET Lot Size (sq.ft.) Zoning: SR Applicant: VECTOR HOME INC Applicant Address Phone: Insurance: 38 HUMPHREY LANE (413)204-0023 AWC-400-7039926 WEST SPRINGFIELD, MA 01089 ISSUED ON:04/07/2022 TO PERFORM THE FOLLO WING 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: ' >2 . 33Ata Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ' /45.) r-, /L, The Commonwealth of Massachusetts 0 ,�!y` . r Board of Building Regulations and'Stan ards 9 R Massachusetts State Building Code, 78tr. R IC ALITY 4; op �c2? SE Building Permit Application To Construct,Repair, Renov`a' , olish a %ReviSd Mar 2011 One-or Two-Family Dwelling ` =„!,-1^'14/6.i,-, / This Section For Official Use Only ‹L'0.),;1cNt Building Permit Number: ,3 P-Y)...- 3 ! 3 Date Applied: `''..Al Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers /fib teen /1/aPO/ 7 /'� 71.1 a Is this an accept6d street?yes no Map Number Parcel lmber 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 Own 'of Record: • MI o/1e a y Se,� /Vdr/h a nifroii , AO Name(Print) City,State,ZIP /IX yea cif pia ,ed 4(13- 3 I#- 73,51 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)1d Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: re sA//2p rve/ /marn how( am/ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ I. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) (,� Total All Fees:r Check No. 1(v Check Amount: `O Cash Amount: 6.Total Project Cost: $ //', 600 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C�— / 3IY' 6A1A. 7?� ?na License Number Expiration ate LG Name of SL Holder 349 i"G(/nO `rJ Kz // List CSL Type(see below) �J No.and Street G Type Description Wei/ , /'[ / /r/> /'E� /�/mpg U Unrestricted(Buildings up to 35,000 Cu.ft.) VI/UJ/ 7{'/ 7 ,Jvl// !/ !� R Restricted 1&2 Family Dwelling City/Town,State,tIP M Masonry RC Roofing Covering WS Window and Siding Sq ,nV`7 W3 VPbrhare/oo 7"Q'.e I Solid Fuel Burning Appliances !,f7 GW Insulation Telephone Email address C 0,71 D Demolition 5.2 Registered Home Improvement Contractor(HIC) _0Re n 20�6 ,e/a/a00U V/IG�r / C' HIC RegistrationNumber Expiration Date HIC C mp am HIC R strant Nam Hum it �rl �/.eCiorAvine xod efv,/r oae cv� No.w/and� reet��r/ / _ o�/ j/A 1i 3"eV va4e2 Email address City/Town,V S ate,Z ,(/(/0I/0/99 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 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. 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 application is true and accurate to the best of my knowledge and understanding. �� /ona / /eoa�? Print Owner's or uthorized 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 Massachusetts �,4.• .�. 'c{ E4 t DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 44.$1, j1'‘4 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: Uf/ Wade 1 /Zecrez6v The debris will be transported by: Name of Hauler: Signature of Applicant: Qvia ,GaveteGa Date: VeAV The Commonwealth of Massachusetts Department of Industrial Accidents , 1 Congress Street.Suite 100 i Boston,MA 02114-2017 www.mass.gorldia Worters'Compensation Insurance Affidavit:Builders/Contraetors/Elettricians/Plumbers. TO RE FILED WITH THE PERMITTING ALIT . Applicant Information - Please Print Legiblv /3 4, Name 4 kJ Us t wax'Orgit nem t i 0 rt'Ind I V dua I I: Address: 3/ ,e4ii-ilibhirev //7 oadg- . . , Iiii City/State/Zip: WAti Qr//7i et a; "'In Phone#: 1-7/1- 112 -6' 2,2,3 ... An)04 iklb employer?Cloth tbe appropriate bat: Ty pe of project(required): in lam a employee with employees tfull major parttarna• 7. 0 New construction 2.0 I am a sok proprietor of partorrAlp and have nu employees working fur me in 8, 0 Remodeling any capacity. (No workers corm.insuranee required.] 9, ID Demolition 10 lam a homeowner doing all work myself.(No workers'temp.ithurance required]' 10 El Building addition 4.0 I am a homeowner and will he hiring contractors to conduct all work on my property, I will email:that all iircarections either have*ambers'compensation insurance or an sole II I:3 Electrical repairs or additions propnct0r5 with nu employees. 12.E1 Plumbing repairs or additions 30 1 am a ktriamii t:uniractor and I hr.e hired the sub-contructurs listed on the attached shect these oih-euntravetors two,:employees and leave workers'eonnp.insurance.: 10 Roof repairs d.12i14. Other We are a corporation and rts officers have est:wised their right of exemption per NCI c. 132.4,144),and we have nu employers.No workers'comp.insurance required] . .. ._ 'Any tiro icarti that checks him al alma also tilt out the stetson helow showing their workers'compensation policy information. +tiorntrAvrters who submit this affulavit nulteerung they an doing all work and then hue outside cimtmetors mint,idernit a new affidavit Indicating such. It'untractors that cheek this hoe mint attached an additional Meet showirig the name of the eab-vontractore and state wlivtivr ON nut those utilities haw employees If the sub-eontreet‘ns il..v.,.employees.they must provide their worker,',oftip pulu.::.nt.,:xibcr. I ant an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job site information. _ A/ Insurance Company Name: (../././ . fri tda t4,1 fils ti/I:J.nee e,0171A1v7s/ _ Policy St or Self-ins.Lir.4t:: ciWC"'"Ill:2P— - 0 3,0026 Expiration Date._ 1//1/2042'ej Job Site Address: ie6 ieoc. I-ha 42/, or/4,9,74yA?tattle„zp: Ji4 Attach a copy of the workers'compediation policy declaratioa 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 fine up to S1,500.00 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 coverage verification. .. ... I do hereby(waft under the pain% anti penalties of perjury that the information provided above is true and correct. Signature. '-7/ ana oteviw,a,e i Phone#: 413- at 17- oa3 ...., , (Oriel use only. Do not write in this area,to be completed by city or town°Vida i City or Town: Permit/License ii Issuing Authority(circle one): 1 I.Board of Health 2.Building Department 3.City/Tows Clerk 4.Electrical Inspector 5. Plumbing Inspector 6,tither ,, Contact Perm: Phone#: ... . — — I, ® DATE(MM/DD/YYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 04/06/2022 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(les)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 David R Jarry Neill&Neill Insurance Agency Inc PHONE FAX 662 Riverdale Street (A/C.No.Est); (413)732-4137 ( No);(413)731 6629 West Springfield,MA 01089 ADDRESS: dj@neillandneiil.com INSURER(S)AFFORDING COVERAGE NAIC N INSURER A: Northfield Solutions NOF INSURED Vector Home, Inc. INSURER B: A.I.M Mutual Insurance Company All 38 Humphrey Lane West Springfield, MA 01089 INSURER C: INSURER D: 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 ADDL s POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) IMMIDDIYYYYI A V COMMERCIAL GENERAL LIABILITY WS470075 04/25/2021 04/25/2022 EACH OCCURRENCE i 1,000,000 DAGE CLAIMS-MADE V OCCUR PREMSETO EaENTED occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 V1 POLICY r PRO LOC2,000,000 JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea acciOND ANY AUTO BODILY INJURY(Per person) $ OWNED — SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY " AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY " AUTOS ONLY (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ — EXCESS LIAB CLAIMS-MADE AGGREGATE $ I DEC RETENTION$ _ $ B WORKERS COMPENSATION AWC-400-7039926 01/19/2022 01/19/2023 s I PER STATUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? El 1 1 1 OO,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ _ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ DESCRIPTION OF OPERATIONS/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 Town of Northampton THE EXPIRATION D TE THEREOF, NOTICE WILL BE DELIVERED IN 212 Main Street ACCORDANCE WITH T'H OLICY PROVISIONS. Northampton,MA 01060 '.t r AUTHORIZED REPRESS T>S VE 4 t c u I ,� ©1988-2015 ACORD CORPORATION. Alh"'ghts reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD , 1 t Cc mmonwealtfi of Massachusetts ptvision of Professional Licensure Board of Building Regulations and Standards Cons r sr . rvisor r J. CS-112389 •J. ires: 06/18/2022 ,' im' •: TATYANA r # y 38 HUMPH'• • :1 •..4.4- *' .] WEST SPRING F€,1• ,� ..•:f'` ;��, ,: ,w Commissioner CAL . ` -„ THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affair§ And Business Regulation 1000 WashingickaVcot - Suite 710 Home Bimosstrorovem a . ent C%hnusetractttsor °?Relli8stration : , , pm , .. .,,,A4 kW 1 I P. Corporation 203846 VECTOR HOME INC Zo ,. „,.. ,.., • :egaltation: pit,bon: 12/01/2023 38 HUMPHREY LN WEST SPRINGFIELD, MA 01089 Illk -- — =I= . . 000.00. iv 43 4 ........ e , 7 el S Update Address and Return Card, THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs& Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. Pt found return to: .. TYPE: Corporation Office of Consumer Affairs and Business Regulation RagiattatIon 1: Eiptratiito 1000 Washington Street •Suite 710 203846 .44 1 2/0 1/2023 Boston, MA 02118 VECTOR HOME INC ..f.'f .,. t t tt - I. PAVEL DUDUCAL 38 HUMPHREY LN , .,,,,;d4,44,0ir 4 .',•e(40•44" WEST SPRINGFIELD,MA 01089 s Undersecretary Not valid without signature Vector Howe, Inc 38 Humphrey Lane, West Springfield, MA 01089 (413) 883-1636 vectorhonie 100 mail.com Contract Customer's name linja �r s',., -, ...--- Customer's ( 8 6 R D �' kyc` �C eCod o-��a7 (E7h address h l i�- Customer's phone number ( L/f�j - J�c7 e— -r Roof Estimate: what is included. " l. trip off an old (existing)shingle -0-4--frl' (.24exie' ---- - 3 Replace all rotted plywood sheets included 7 per sheet 3. Cover the whole roof with the new plywood 4. Lay down underlayment 6 feet ice barrier,the rest is synthetic felt roof underlayment 5. Cover roof with the new shingle color 6. New flashing around chimney -...,� 7. Replace new skylights 8. Reflash skylights 6. Cut new ridge vent 0. Price include dumpster container OP. Clean all debris after the job is done �122. New gutters and downspas 0j� 1 . Include roof material 14. Solar fan installed / I 604 a `-- 1174 diq OF_ - ----7 TOTAL PRICE 11 9 '! ""' c7q>1 629 n a ent dx0 0 al_____J Amount left 9 6 0 °L r7.--------- Iv—DC .2a02 -- C s omer's Si . Date