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29-271 (5) B '-2022-1305 71 LONGVIEW DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-271-001 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-2022-1305 PERMISSION IS HEREBY GRAN D TO: Project# ROOF Contractor: License: Est. Cost: 7650 VECTOR HOME INC 112389 Const.Class: Exp. Date: 06/18/2024 Use Group: Owner: PRATT LAURA A Lot Size (sq.ft.) Zoning: WSP Applicant: VECTOR HOME INC Applicant Address Phone: Insurance: 38 HUMPHREY LANE (413)204-0023 AWC-400-7039926 WEST SPRINGFIELD, MA 01089 ISSUED ON: 10/13/2022 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 VIO ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: >2 • CP ' I Fees Paid: n40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner iL, The Commonwealth of Massachusetts • Board of Building Regulations and Stand rds Massachusetts State Building Code, 780 MR OCT 1 2 OR&1i1NI IPA ITY SE Building Permit Application To Construct, Repair, RenOvatertfetnim is d Ma 011 One-or Two-Family Dwelling Ha " ' ' NspF`• 'ONs This Section For Official Use Only Buildin Permit Number: 1RjP" �- )-" I 6" Date Applied: ew►► )! `��s ,�e 7 M-13- z2 Building Official(Print Name) Signature Date I SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers ?/ Lv Pita/ kr , clarinet , All1.1 a Is than 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 ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIPI 2.1 Owner'of Record: /aura Pratt Harmer, f a O/26,e Name(Print) City,State,ZIP 9/ Lrhgv/ecr'/ Or 03.6a7.aspa? LPQn1 f 3b661'yahoan'ar No.and Street v Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s)it Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units ogre-Tra Other 0 Specify: Brief Description of posed Work': "4/1/9/.)x ch r, ro e/v y�Gj unr/.; Cor re raft% AZ"trghinigl, re /ocli W#14;44Atfc Ga4 i SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Costa (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (1-IVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees; f Check No.20 I Check Amount: '` Cash Amount: 6.Total Project Cost: $ 7661 OP 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.Ijtro uctin Supervisor License(CSL) 38.9 6 a o20ay a/gQ License Number Expiration ate Name of L Holder // , / _rn h/Wr G/ane List CSL Type(see below) N No.and Street { Type Description i /O�1 / r/� /� ///� O/��'9 U Unrestricted(Buildings up to 35,000 cu. ft.) V//VJ7 S t //�/�/ Restricted 1&2 Family Dwelling City/Town,St ,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances ff/3. ,%4( O 3 (/e(/vrJidme/a7( >taiEtorn I Insulation Telephone Email address D Demolition 5.2 Registeredt Home Improvement Contractor(HIC) da3efy6 /a� P ?3 Valor game 7ne HIC Registration Number Ex iration Date HIC paipy Name) rowIC strayrt Name p� Veebrharnt/OPr 'r?1 a/>� No. VV tree S/'j/�/� /rEZfil, YI 4tW PDa;'J Email address can-) City/Town,State IP 0 /AM 010,9 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 pro ide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ❑ 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 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 contained in this application is true and accurate to the best of my knowledge and understanding. Ti4'aia ud Print Ows or Authorized Agent's Name(Electronic Signature) ate 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,fmished 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 r: Massachusetts 44, .144_ { DEPARTMENT OF BUILDING INSPECTIONS (l. '7 212 Main Street • Municipal Building .6 Northampton, MA 01060 s�y ���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: /5- illt /3,97 , ii0deJ/ CT j %P The debris will be transported by: Name of Hauler: ?lS/1 /1 /2 I /2eei /2 Signature of Applicant: g12G- c&GdGecC7--( Date: /0/a d>raa The Commonwealth of Massachusetts zra/Isar .. IL Department of Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.gov/dia 1 Otkers'Compensation Insurance Affidavit: Buiklers/ContrartararElectriciansfPlumbers. Ti)BE FILED WITH THE PERMITTING AITHORITE, Applicant Information Please Print Letibly Name 4 Business,Orgarmation.Individual i: Vecit2r 14;tne 7,7e, Address: aflteconlhrf/one City/State/Zip: tt/&5/ r/)i t'A&/ MI Phone#: ///3-da •POP.3 kre yam au employer?Cheek the apprapr it hut: Ty pe of project(regaled): !3 I am a employ's with cirnplis i full anden part-tunct.• 7. CI NeW construct' 217:1 I am a uric ploprretut or partnership and bane nu ernployerl workma fur mat:in 8, 0 Remodeling any capacity.[No workers'curie jasmine": minima) . n Demolition 30 1 ani a Innnerrifrinet doing all with myself (No waiters'comp insArrunie ronurroi i' 9 I 0 El Building addition 4.0 lam a homeowner and will b.c hiring contractors to conduct all work on my property_ I will ensure thai all tontratiors either have waists*compensation insurance ot are sole l Lc] Electrical repairs or additions prOrrntkoft with no employees. 12.0 Plumbing repairs or additions .c.o lam a general contractor and I have hired the auts-conuatiors fished on the attached sheet These sub-contractors have employees and have uorkcrs'comp.insurance:. I 13 li: Roof repairs 14.0 Other kr We rue a corporation and its officers have exercised their right of exemption per Wit_c. 152,f I I.and ae fume no employees..[No workers eranp.insurance requirnd.1 *Any applicant that cheeks Leo.a 1 mast also fill out the suction below showing their withers'compensation polity infonnatim +Homeowners a ho suismit this atriskii.it intlicating they are doing all*ink and then hire outside contra...tors must suhmit a neu atlidak it anrhentrng on:h. IContraetor that check this Nix must atusehed an additional sheet stow in g the none of the suh-contractors and state is}tether or nut those entities base croployces II he sirb-conlyne(ors lune entrces,the most provide'their A orkers"samm policy nuittivr. 1 1 um an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name. 4.T iff. Alui-ktat Asi./,0/iee (pan-7101 Policy#Of Scif-ins. Lic.ts: AWC- 4(00- 0:3_9,9,?6 Expiration Date:, 1/t9/4 Pag3 Job Site Address: '?/ tan 1//ea/kr, "77re/74e, ,171/ C-a - yiState,Zip: Attach a copy of the worti.erlcompensadoa policy declaration page(showing the policy number and cipir don date). Failure to secure coverage as required under MGL c. 152. §25A is a criminal violation punishable by a tine 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 tine of up 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 co%erage verilicat ion . . . I do hereby certifr under the pains and&multi^of perjury that the information provided above is true and co4ect. Signature: 77e/Ira4a 1;Jtedue-a, Date /°/1,/f a a 1 Phone : //A .,229 -004,93 Officiul use only. Do not write in this area,to be completed by city or town official ('its or Town: Permit/License# Issuing Authority (circle one): ......... , I. Board of Health 2.Building Department 3.t'ityiTown Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: .. . „ Phone ; etts achus wealth ot Mass- . Comm � � OccupationalLicensor Boa Board Bu di �� Motions and Standards tr - . ConsT.ctftIon �� CSi12389 /202 �. 4. {�� �� �A Type, Corporation ovor720rat:n THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairt Business Regulation 1000 Washin• ci - Suite 710 Bostoris Massachusetts 02118 Home Im•ro enierlt COntractor Re isiyation :alstration: 203846 VECTOR HOME INC .**""*""*""mii Expiration: 38 HUMPHREY LN WEST SPRINGFIELD, MA 010419 41 se4 1,44 44$ Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Aft**.& Business Regulation Registration valid for Individual use only before the HOME IMPROVEMIENT.CONTR ACTOR expiration date. If found return to: TYPE:Coiooration Office Of Consumer Affairs and Business Regulation fleglsta'InoFaith:SACO 1000 Washington Street Suite 110 203846 12/01/2023 Boston, MA 02118 VECTOR HOME INC \ f AVEL DUDUCAL \d; 38 HUMPHREY LN ise40•44" WEST SPRINGFIELD, Olupp-- 1 Undersecretary Not valid without signature Acd CERTIFICATE OF LIABILITY INSURANCE DATE A E(MM/Do2 YYTY) 10/11 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 polioy(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 David R Jarry NAMENeill&Neill Insurance Agency Inc PHONE (413)732-4137 FAX 413 731-6629 662 Riverdale Street INC.No.Ext1 INC,Not:( ) West Springfield,MA 01089 ADDRESS: dj@neillandneill.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 TH POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEC�TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT T ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER IMMIDD(YYYY) IMM(DDIYYYYt LISTS A Y COMMERCIAL GENERAL LIABILITY WS517412 04/25/2022 04/25/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED ' CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 VI POLICY JECT PRO LOC PRODUCTS-COMP/OP AGO $ 2,000,000 I OTHER' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea acddentl 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 LIAB - OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AWC-400-7039926 01/19/2022 01/19/2023 VIPER OTH. AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOY=E $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS(LOCATIONS I 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 City of Florence THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 210 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE aroiii,Lit R 4E5=0 I ©1988-2016 ACORD CORPORATION.' All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD