17C-211 (51) BP-2022-0713
81 MAIN ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
17C-211-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0713 PERMISSION IS HEREBY GRANTED TO:
Project# ROOF Contractor: License:
Est. Cost: 15000 FLORENCE ROOFING 071107
Const.Class: Exp.Date:04/24/2023
Use Group: Owner: FLORENCE SAVINGS BANK
Lot Size (sq.ft.)
Zoning: GB Applicant: FLORENCE ROOFING
Applicant Address Phone: Insurance:
405 RYAN RD WC2-315-374455-041
FLORENCE, MA 01062
ISSUED ON:06/16/2022
TO PERFORM THE FOLLOWING WORK:
STRIP AND RE-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:
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:
>2 . (VIT
Fees Paid: S 105.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Buldine Commissioner
T e ommonwealth of Massachusetts
JUN 1 5 2022 fice of Public Safety and Inspections
assachusetts State Building Code(780 CMR)
1 Building Permit Ap lica pion for any Building other than a One-or Two-FamiIy Dwelling
iot,Nv INC
_ 'ticjJ2TIMAM,TCAN iN PECTioNS(Thi�Section For Official Use Only)
� U
Building Permit Number:-A " .titi T-Date Applied: Building Official:
SECTION 1:LOCATION
85 Main St Florence 01062 Florence Savings Bank-ATM
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Building la Repair 0 Alteration 0 Addition 0 Demolition ❑ (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:Roofing
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Q
Is an Independent Structural Engineering Peer Review required? Yes 0 No 0
Brief Description of Proposed Work:_See attached Proposal.
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) I
Total Area(sq.ft.)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4❑ A-5 0 B: Business 0 E: Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-i❑ H-2 0 H-3 0 H-4 0 H-5 0
1: Institutional 1-1 0 1-2 0 1-3❑ 1-4❑ M: Mercantile 0 R: Residential R-ID R-2 0 R-3 0 R-4 0
S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 IB ❑ iIA ❑ IIB 0 IIIA ❑ IIIB ❑ IV VA 0 VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal:
A trench will not be Licensed Disposal Site 0
Public❑ Check if outside Flood Zone❑ . Indicate municipal 0 required 0 or trench or specify:
Private 0 or indentify Zone: or on site system 0 permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA f fisiorir t ommission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Name(Print) No.and Street City/"Town Zip
Property Owner Contact Information:
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(PIease fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0.
Otherwise provide Ark :s ti(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Company Name
Name of Person Responsible for Construction License No. and Type if Applicable
Street Address City/Town State Zip
Telephone No. (business) Telephone Telephone No.(cell) `�/e+-mail address
SECTIONI1: ;Yli�C.il1N� %`i[4 *1‘,'.:‘,i:V31. Ss.,„c• 1c:[I;WYf: (M.G.Lc.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes 0 No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $15,000.00
Building Permit Fee=Total Constructio st x ( ,sert here
2.Electrical $ appropriate municipal facto '
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (co , municipality)
5.Mechanical (Other) Enclose check payable to
6.Total Cost $15,000.00 (contact municipality)and write check number here U���, .
SECTION 13:SIGNATURE OF BUILDLNG PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of y knowledge and understanding.
C.Philip Andrikidisl d/b/a Florence Roofing Sole Proprietor 413 262 8007
Please print and sign name Title Telephone No. Date
Florence nv, 01062
405 Ryan Rd. fiorenceroofing&mail.com
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: & ' )6"zoZZ
Name Date
J�-
City of Northampton
3f(
Massachusettse
v ,
, - DEPARTMENT OF BUILDING INSPECTIONS flo
r '"' 212 Main Street • Municipal Building
Y Northampton, MA 01060
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in: Valley Recycling
Location of Facility: 234 Easthampton Rd. Northampton, MA. 01060
The debris will be transported by:
Name of Hauler: Florence Roofing
Signature of Applicant: Date: 6/10/22
7,114,
The Commonwealth of:Massachusetts
Department of Industrial Amitknts
I Congress Street.Suite 100
Boston. .41A 02'114-2017
www.mass.goildia
t$to-kers'Compensation Insurance Affidas it:BudderstContractorsitketrielans/Plumbers.
'it)ILL LLED WITH L ILL.PlAttill INC; U LtLORV.
‘011111Cailli Pkase Print Li:gilds
Natt;s: lndiv4hial1: C. Philip Andrikidis/d/b/a Florence Roofing
Address: 405 Ryan Rd.
city state Lir, Florence. MA. 01062 Phone 413-262-80017
Are'on AU t I: I1L nut tun. ; Type of project(required).
L.3-1,,,m,..v,..-niployv.r with 5 ca44,...y,44:,,,,tftati Lir„41,;_ur tarzir. -
I . !sew construction
:0 t ,,,tnl.prfatof of re.t.finp.o.t.!.isaott, etnytioy,:tn o.oft.trifi :ft.,: .Waraiit-lisig
any capacity.(No,watterl;ennwp.iatioaranne rognannd.1
9. Demolition
denty,ali N4osk rnyhcli F,Nin ittiox,' up.mstaanto.t.INtaa
0 J.Budding addition
4.0I an a 11011KNAV11.41 and will be luring contractors in conduct all work fin my prnperty. I IAdl
th.tti ; I t.n EkNecrieat repansIM
vnt...1.m.aorrs tuf Amtotto'
12.7j Piatrthing ItTatilN 'ad:dawns
30 I am a-general contractor and I have hired dse*tab-entail-actor.lignd on the ainiciat-d lbeet.
I 3.D Roof repairs
two:cmpitot:ecs and has,:woikeiN' infarao.a:;
j4 tVlØthei Roofing
We art,a earporalion and itv officers have exmised their right of c.velingion per MU e.
/32..t.444..and we law no anploy...-es.tNn uvap.imusailev. al
'Any appinaall*tat attic%bat cr1 nria4 alay td .nut dac 74ectiami*e1nw".bontina the eninpernsion ran.y inforttnaarec.
t Restxtovitatt who submit-rho.affidavit'tithe:ging they are&wig all watk and IS:rs hire otgode e&atr.ieter :tamt submit a nest littichu it indicattts
kfinttaeinivttiat 4:11nek thit Ixtik mina an:IONA an $.134e1%WA$tlit thL 1.1311.5C thi‘ akAons and iactbet e tk.q 12u .. .1.,
craployee it the+tareontr^444.14M1`4W6C tarty 1111141 pro,ade tittctr laotker.. comp ntnntler
UM an employer that is:providing worAers•compensation insurance for no emplarees. Below is the policy and job'ire
infOrmution.
onipany Name: Liberty Mutual Fire insurance Company
Policy#or Self-ins.Lie.tr.__ WC2-31S-374455-052 Expiration Date: 01/25/2023
85 Main St Florenoe MA. 01062
lob Site Address: City/State Lir
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
-•to sec we so'.el-age as.44:slii1ttil under Wit c. 152.§.:5A is.a cut-inn:1 violation punislithic by a tine up to$1.500.(1ed
and/or one-year iropriscwitnent,as well as civil penalties in the limn of a STOP WORK ORDER and a fine of up to S250.00 a
diy against the violator.A copy of this statement may be forwarded to the Office of Invettigations of the DIA ft-M.,F.IL,',AJEWI.Ce
coverage verification.
I do hereby certify under the pains and penalties of perjure.that the it:Jima:anon provided abore A true and unreel.
Sinature: 5J7Date:. 01/25/2023
Phone 413-262-8007
tOfficial use only. Do not write in this area.to be completed bt city or town official
City or'town: Permittiernie
Issuing Authority,(circle one):
1.Board of Width 2. Building 1)cpartinent 3.City iTow n Clerk 4.Etectrkar Inspector S. Plumbing Inspector
6.Other
Contact Person: Phone 0:
L R FLOC.PHILEP ANDRIK D S COM
it .
405 RYAN ROAD, FLORENCE,MA 01062
NOOFIN INSURED BY KING 8 CUSHMAN 413-584-5610
HIC #150673
.. � 5585-917 1 • CSL#171107
MSL#11282
F C. Ci> R 1= i' c, I fvi 3 413-262-8007
May 16,2022
Bill for: Pioneer Contractors
Job Location: 85 Main St. Florence, MA 01062
Description: - Removed stone ballast from entire roof. 1,750 sq.ft. +/-
- Mechanically attached(1)layer of%"fiberboard over existing roof system. 1,750
sq.ft.+/-
- Mechanically attached Versico VersiWeld.060 TPO using RhinoBond induction weld
system to entire roof. 1,750 sq.ft.+/-Color: Gray
- Brake form 24gauge Kynar finish gravel stop to all roof edges.Color to be determined.
- Installed retrofit drains to existing roof drain pans.
- All TPO related flashings and terminations installed per manufacturers
specifications.
- Area cleaned and all roof related debris removed to landfill or proper recycling facility by
Florence Roofing.
- All permits to be applied for by Florence Roofing.
- All material furnished and installed by Florence Roofing.
P
CONSTRUCTION CONTROL WAIVER
From: Florence Roofing
405 Ryan Rd.
Florence, MA. 01062
To:
Jonathan Flagg
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
The Massachusetts Building Code, section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, I request that you
grant a modification to waive the requirement for construction control of the project at
Florence Savings Bank-ATM 85 Main St Florence, MA. 01062
because the work is of a minor nature,will not affect structural elements, health,accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,
C. Philip Andrikidis