25C-109 (4) BP-2022-0545
36 GRANT AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
25C-109-001 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-2022-0545 PERMISSIONISHEREBYGRANTED TO:
Project# ROOF Contractor: License:
Est. Cost: 22235 JASON SMEGAL CS-093889
Const.Class: Exp.Date:02/24/2024
BROWN, CAMERON S. & SILVIA XIMENA CRUZ
Use Group: Owner: DE BROWN
Lot Size (sq.ft.)
Zoning: URB Applicant: J SMEGAL CONTRACTING LLC
Applicant Address Phone: Insurance:
622 HANCOCK RD 413-655-7663 6S6OUB-6R311297
PITTSFIELD, MA 01201
ISSUED ON:05/19/2022
TO PERFORM THE FOLLOWING WORK:
ROOF REPLACEMENT
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: 1
(0, • 1 • 1 •
I III
Fees Paid: $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
. ter- '
VEI_i
MAY 1 2022
e Commonwealth of Massachusetts
Boa d of) uilding Regulations and Standards FOR
* T�F BUILD lNSPF MUNICIPALITY
NORTH4 I achuetts State BuildingCode, 780 CMR USE
ON.MAOtQ50
`Building a plIcation To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Buildin Permit Number: (3 0--.))."541C Date Applied:
fC L-veiJ 2055 5-14 ZOZ�
BuildingOfficial(Print Name) �Si�� Date
Signature
SECTION 1:SITE INFORMATION
1.11 Pr gerty Addrels: 1.2 Assessors Map&Parcel Numbers
310
(pron+ Ave • �c5'C toq
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 ZoningInfor ti• ,: 1.4 Property Ditrtie�gsio s:
P Y 'J \!
Zoning Districf ' o . -4 Use Lot Area(sq ft) l'i11rontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required ovided Required vided Required ided
1.6 Wa er 4p1 • ( .G.L c.40,§54) 1.7 Flood one f rmation: 1.8 Sewage isposa Syslip
em: —
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'ofReco'f
Cameron ,Oton tiprtharnpfon HA OIO(o0
Name(Print) City,State,ZIP
31, Grant tole . 443.44.10. 4i4 es
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building V Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other Olt Specify: roof replom./Tu li
Brief Description of Proposed Work2:
see con t r a Oi
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 222 3S.60 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) Total All Fees: $ ItoCheck No. i 0q 1Check Amount: . ' Cash Amount:
6.Total Project Cost: $ 22,23S.L� 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
093889 2/24/2024
Jason Smegal License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)U
622 Hancock Road
No.and Street Type Description
Pittsfield,MA 01201 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
413-655-7663 jsmegalofficeRgmail.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
200030 11/3/2022
J Smegal Contracting,LLC HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
622 Hancock Road jsmegaloffice(a,gmail.com
No.and Street Email address
Pittsfield.MA 01201 413-655-7663
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 O No ❑
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 c e�
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 Co 1 rQ Cl
contained in this application is true and accurate to the best of my knowledge and understanding.
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
y r.i.ri
Cr
r : Massachusetts Sys --_sc,`
!g s' t A).'. 'i tG
It
5 DEPARTMENT OF BUILDING INSPECTIONS �1 L
212 Main Street • Municipal Building Ji'�. Ca`
� ��,,... Northampton, MA 01060 :• ,10
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: Lenox Valley WT F 6 o \Ai; l\Ow CrC21c, ` i.) Len0�
The debris will be transported by:
Name of Hauler: wQ 6on e,RG 1
Signature of Applicant: Date: S • Li .2 Z
1\ The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):J Smegal Contracting LLC
Address:622 Hancock Road
City/State/Zip:Pittsfield,MA 01201 Phone #:413-655-7663
Are you an employer? Check the appropriate box: Type of project(required):
1.❑✓ I am a employer with 7 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor me in anycapacity. employees and have workers'
p tY ). ❑ Building addition
[No workers' comp. insurance comp. insurance.t
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
officers have exercised their 11.0Plumbing repairs airs or additions
3.❑ I am a homeowner doing all work
myself. [No workers' comp. right of exemption per MGL 12. ✓❑ Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
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.
tContractors 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.
Insurance Company Name:The Hartford
Policy#or Self-ins.Lic.#:6S60UB-6R311297-22 Expiration Date:03-21-2023
Job Site Address: 31+ Grant Ale . City/State/Zip:KOf th omp}Or Mq 61060
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fme 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 fme
of up to$250.00 a day against the violator. Be advised that 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 the and penalties of perjury that the information provided above is true and correct.
Signature: <- Date: 5. I 1 . 2022.
Phone#:413-655-7663
Official use only. Do not write in this area, to be completed by city or town official
City or Town: , Kor Orl Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#:
KLAUS ROOFING ORDER AND CONTRACT
SYSTEMS
;/.5,ne q.i l
Name:Cr2(1eran gcocutt Date: S/-S1�2
Street: 36 6rart4 A-(JGatji._ Town:ft/04w,pkM State:_
I agree to furnish all materials and labor necessary for the work (specified below) on premises located at
(rccek Au( --___._.__.
Specificati 7 er °"- Mit' - pin—)
Contractor agrees to remove existing layer(s) "—shingles down to wood decking on
110u ` ,1 f, 6a raj(7_4114A 5_k k) $0r4 ferck Any additional layers uncovered will be a charge
of$ per layer removed. NewLL roofing will consist of using an IKO Dynasty Performance
Architectural Shingle,color to be c-65iA-t (-;rz e
KRS SealoronXT ice and water shield will be installed on the bottom 6 feet of roof edges as well as 3 feet
in the valleys. Plywood seams will have 4" KRS SealoronXT deck tape then installed. Roofs with a 7/12 or
greater pitch will have 3' of ice and water shield installed on all rake edges.
A KRS Velora ONE synthetic underlayment will be installed on the rest of roof decking. We will install
new black aluminum vent pipe boots. Flashing to be installed as needed, where needed to ensure a
watertight seal. New aluminum F8 drip edge on eaves and C4 drip on rake edges in color to be(;(kbr...
* Cc* If any rotted/bad sheathing is found it will be replaced at an Additional Cost of$120.00 per
sheet. (INITIALS) *Full plywood replacement will be%"J/CDX plywood. Any deck repairs will be matching
sdt
dimensional plywood decking installed. 37 ,>✓c s /A pf t
The undersigned property ownersl agree upon completion of specified work to pay the sum of 31 f 57/(y y y3
$.2-2/ 3 5. contract price $/1//�7 S deposit Final Balance $ not including
any extra costs incurred during roofing install.
This contract constitutes the entire understanding of the parties, and no other understand, collateral or
otherwise. Shall be binding unless in writing signed by both parties. At any time before work is actually
started on the above-mentioned premises by us,we hereby reserve the right to reject this contract and,
in such case, your advance payment will be returned. IN WITNESS WHEREOF the undersigned have here
unto subscribe their names the day and the year first above written.
HOMEOWNER SIGN HERE: Price includes permits needed as well as all roofing debris
removal from property.
Sknej 41i
Contractor: Jason Smegal, Owner
Disclosures: CSL#093889 HIC#200030
**Not responsible for damaged caused by ice dams/ice backup, or for leaks caused by satellite dishes or re-install.
Solar panel install voids all labor warranties on installed sections. Partial roof replacements and all roofing installs
come with a minimum 5-year workmanship warranty. *Full KRS roofing system installs come with a 50-year leak
warranty. IKO Dynasty Shingles come with a 15-year 100%non-prorated warranty packet. Polyglass Elastoflex low
slope roofing systems come with a 15-year materials warranty. *All standard chimney flashings to be LEAD*
1 Smegal Contracting, LLC449 Pittsfield Road Suite 201 Lenox, MA 01240 413.655.ROOF