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36-078 (9) BP- 022-0899 340 WESTHAMPTON RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 36-078-001 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-2022-0899 PERMISSION IS HEREBY GRANTED TO: Project# ROOF Contractor: License: Est. Cost: 5000 GREATER BOSTON ROOFING CSLI 13557 Const.Class: Exp.Date: 10/06/2022 Use Group: Owner: NELSON DAVID P&KIM KRIZEK Lot Size (sq.ft.) Zoning: WP/WSP Applicant: GREATER BOSTON ROOFING Applicant Address Phone: Insurance: 27 JACKSON ST#123 (978)905-5045 VWC-100-6022848 LOWELL, MA 01852 ISSUED ON:07/29/2022 TO PERFORM THE FOLLOWING WORK: STRIP AND RE-ROOF -PARTIAL ONLY 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: I � O . yQ Fees Paid: S40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner r The Commonwealth of Massach efts W Board of Building Regulations and tan ds %/Lk FO Massachusetts State Building Code,780 MR 2 8 20�2 CI ITY Building Permit Application To Construct,Repai Rerffvittt olish a ised M r,2011 One-or Two-Family Dwelling " 714g41R, N rNSPFc=� This Section For Official Use Only MA oroso Ng Building Permit Number: al.; 9q9 Date Applied: S, 7261 zZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Asses Map&Parcel Numbers 22 340 Westhampton Road Northampton,MA 01062 1.1a Is this an accepted street?yes x 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❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner'of Record: David Nelson Northampton, MA 01062 Name(Print) City,State,ZIP 340 Westhampton Road (860)778-4029 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': Strip and Re-Roof 12SQ * Partial Roof Only* SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $5,000 1. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All FeeVit Check No.11041WCheck Amount: 1.4) 6.Total Project Cost: $ 5,000 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-113557 10/6/22 Enda Garry License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 10 Stevens St. #481 No.and Street Type Description Andover, MA 01810 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 617-908-0242 permits@greaterbostonroofing.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 191498 4/23/22 Enda Garry HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 10 Stevens St. #481 permits@greaterbostonroofing.com No.and Street Email address Andover, MA 01810 617-908-0242 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 0 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 Enda Garry to act on my behalf,in all matters relative to work authorized by this building permit application. 06kNalil I\V/44AZYn 7-Z6 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's true an accurate to the best of my knowledge and understanding. i/zd/zZ- Print Owner's or Autho ' d ent'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/dp 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 DEPARTMENT OF BUILDING INSPECTIONS r r a • 212 Main Street • Municipal Building Northampton, MA 01060 �t't-yy ,0o. 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: 385 Dunstable Road tynsborough,MA The debris will be transported by: Name of Hauler: Republic Services 7 a, Z� Signature of Applicant: Date: The Commonwealth of Massachusetts Department of Industrial Accidents - _' Office of Investigations Lafayette City Center —� 2 Avenue de Lafayette, Boston, MA 02111-1750 ww w.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Phi bers Applicant Information Please Print Legibly Name (Business/Organization►ndividual): Greater Boston Roofing Address:27 Jackson Street#123 City/State/Zip:Lowefl,MA 01852 Phone#:978-905=5045 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 6 4. ❑ 1 am a general contractor and I b. New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 i am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub- ontractors have 8. fl Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance.: required.] 5. 0 We are a corporation and its , 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing al]work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' com right of exemption per MG[. y r p' c. 152,§1(4),and we have no 12.E Roof repairs insurance required,] 13.E Other 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 i lomeowners 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. Insurance Company Name:AIM Mutual _ Policy#or Self-ins. Lic.#:VWC-100-6022848-2020A Expiration Date: 1/24/23 Job Site Address: 340 Westhampton Road City/State/Zip: Northampton, MA 01062 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 MG[.c. 152 can lead to the imposition of criminal penalties of 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. 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 cern;fy under the pains and penalties of perjury that the information provided above is true and correct Signature: % 'i Lat Date: _ 1/24/22 Phone#: 617-908-0242 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): ID Board of Health 20 Building Department 3fCity/Town Clerk 4.0 Electrical inspector 5.0'lumbing Inspector 6.00ther Contact Person: Phone Oh 7/25/22,11:04 AM Estimate Print Preview Greater Boston Roofing Corp 07/25/2022 Greater Boston Roofing 10 Stevens St#481 Andover, MA 01810 GREATER BOSTON Phone:617-744-9690 RO O F I N G Fax: 978-418-0233 Company Representative Lisa Zonfrillo Phone: (978)761-9202 lisa.zonfrillo@greaterbostonroofing.com David Nelson Job:6142: David Nelson Sunrun Solar 340 Westhampton Road Northampton, MA 01062 (860)778-4029 Roofing Section -Remove existing shingles down to deck. -Renail any loose wood.If bad or rotten wood is discovered,it will be replaced at a price of$60 per sheet of plywood or$4 per linear foot of ledger board -Install 6'of ice and water shield at eaves, 3'in all valleys and around all protrusions -Install synthetic underlayment to keep roof dry. -Install GAF ProStart Starter Shingles along eaves and rake edges. -Install GAF Timberline HD Lifetime Dimensional Shingles per specifications using 1 1/:'roofing nails. -Install GAF Seal-A-Ridge Hip&Ridge Shingles. -Install new Snow Country ridge vent. -Install new pipe and chimney flashings. -Clean up all job related debris -Provide 5 yr workmanship warranty and provide owner with GAF LIFETIME WARRANTY -Our Crews are licensed and insured. -Crews will maintain safety requirement at all times during the construction process Qty Unit Materials TOTAL $5,000.00 about:blank 1/2 7/25/22,11:04 AM Estimate Print Preview *Any work-related structural deficiencies or work required to complete the project to Massachusetts Building Code not covered in this estimate will require a Change Order.Roof decking replacement cost will be billed at$90 per sheet of plywood or$5 per linear foot of ledger board. **Estimate includes single layer strip and replaces unless specifically noted in the contract.Additional preexisting layers of shingles to be removed will require a Change Order.Strip and removal for additional layers of shingles will be billed at$.20 per square foot per layer. ***In the event that the customer becomes past due and is referred by Greater Boston Roofing to an outside collection agency or attorney,the customer will be responsible for the cost of the collection services at the rate of 20%of the balance due along with reasonable attorney fees and court cost incurred by Greater Boston Roofing 7 z/ia_ Company Authorized Signature Date VtailAj Ne& i 7- Z6-z Customer Signature Date Customer Signature Date • about:blank 2/2 CS-113557 10/6/22 tAIDAsGAMY 778r bIFar' M yOs tOn MA orlr h_441h v r GaAuve 1n pewees a current».+e., , Sr Mr 1ftwMAnq t:Mt ra muse foe.svrw Mors of tls c Fus,rd.,•, aLUu't• Catt 417,"r' • rr vf111 w. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston,Massachusetts 02118 Home improvement Contractor Registration Type- Corporation GREATER IROSTON ROOFING CORP Ra xpitabosta n. 19149823I2 10 STEVENS ST d481 Exwrshbn. (?41?.3 2024 ANDOVER.MA 01810 Update Addreea end Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&business Regulation Regletration valid Tor indNkfuel use only before the HOME IMPROVEMENT CONTRACTOR expiration date. It Sound return to: TYPE:Corpraaton Office of Consumer Afhlre and business Regulntlon R++gl5tre10n LINO= 1000 Washington Street Sods 710 191855 04121112024 Boston,MA 02110 GREATER BOSTON ROOFSNG CORP ENDA S.GARRY . 27..1ACNSON ST APT 123 C ,� a ffs,* L- �. UNIT 2 LOWELL•MA 01852 Undersecretary Not valid without signature ACC)1? CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIVVYY) 01/24/2022 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). PRODUCER CONTACT NAME: Ginette Preto Insure New England PPH(/H�/C�ON�Eo (603)270-9221 j ,(,101_ (781)538-0556 814 Elm Street ADEDRSS infoainsurene.net Suite 90-B INSURERS)AFFORDING COVERAGE HAIC O Manchester NH 03101 INSURERA: WESTERN WORLD 524126 INSURED INSURERS, PROGRESSIVE CAS INS CO 24260 Greater Boston Roofing Co INSURERC: MARKEL AMER INS CO 28932 27 Jackson St INsuRERD: A.I.M.MUTUAL INSURANCE COMPANY L 33758 INSURER E: Lowell MA 01852 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 SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE INSD.WVD POLICY NUMBER (MMIDD/YYYY) (MWDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR i PR S RENTED PREMISES( occurrence) 100,000Ee S MED EXP(Any one person) $ 5,000 A NPP8667067 01/25/2022 01/25/2023 PERSONAL&ADVINJURY $ 1,000,000 GENt AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY Ra LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 500,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ 20,000 B OWNED SCHEDULED AUTOS ONLY 01122643-2 09/17/2021 09/17/2022BODILY INJURY(Per accident) S 40,000 X AUTOS BO HIRED NON-OWNED PROPERTY DAMAGE $ 5,000 AUTOS ONLY _AUTOS ONLY (Per acddent) _ $ X UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS UAB CLAIMS-MADE XOBW8464820 01/25/2022 01/25/2023 AGGREGATE $ 1,000,000 DED I RETENTIONSWORKERS COMPENSATION I STATUTE I I ER AND EMPLOYERS'LIABILITY D OFFICER/MEMBER ER EXCLUDED?ANY ECUTNE YNH N/A VWC-100-6022848-2020A 01/24/2022 01/24/2023 E L EACH ACCIDENT $ 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) it 1 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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