The URL can be used to link to this page

17A-170 (5) BP-. 022-1406 22HOWESST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-170-001 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-2022-1406 PERMISSION IS HEREBY GRANT S TO: Project# ROOF Contractor: License: DAVE MINER EXTERIOR HOME Est. Cost: 10661 IMPROVEMENTS LLC CSSL09995 Const.Class: Exp.Date: 10/20/2024 Use Group: Owner: MENCHER JULIE A Lot Size (sq.ft.) DAVE MINER EXTERIOR HOME IMPR•VEMENTS Zoning: URB Applicant: LLC Applicant Address Phone: Insurance: 264 SOUTHAMPTON RD 6ZZUB9F45112621 HOLYOKE, MA 01040 ISSUED ON: 10/31/2022 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 DriN en 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: I A . 3-11 • 111 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner The Commonwealth of Massacbuse RECEI\P.L ~i ! Board of Building Regulations and Stan ards IPL�I f�` % Massachusetts State Building Code;780 Mk 2 7 ' US$ TTY Building Permit Application To Construct,Repair,R vate Or Demolish-a Revis d Mar 2011 One-or Two-Family Dwelling �-+ i fir2T aTH brFf fIrl- SPE I lug. This Section For Official Use_OnIjP oN,MA Buildin Permit Number: &P— 2.1— 1 0 Date Applied: evil-) 7Z,,- /7 -1 1.02_0Z2.— Building Official(Print Name) Signature to SECTION 1:SITE INFORMATION 1.1 Property-io S / 1.2 Mrs Map&Parcel Number�s-7 1.1 a Is this an accepted street?yes _ no Map Number Parcel Numer 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 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? Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP1 2.1 Ow'ert of Record: 7-u 1 e- /`'(r- c krJ' f/o!t4cr. /mA Name(Print) City,State,ZIP 3 a, 1 tc tv-ri .3 1— 53'O Y3't S ,-.T. I i e /4i eoc.4 e i 4. a '-t sic . c'c.^-, 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) ❑ Alteration(s) 0 Add_tion 0 Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Work2: 4,4-r rn f /?rict./ 1 LA- Jfile.,ar fifile.,/ et- ,r".-1c / SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs. Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ IDStandard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All iq ,(/) Check No. •1 7 Check Amount: 4V Cash Amount 6.Total Project Cost: $ f 0 6& 1 — 0 Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) °CNN!�1 72 (O a_4 cut) M i 1()�el' Liven`see��N1Iumberr Expiration to Name of CSL Holder No Souilicuinp4on 6cd List CSL Type(see below) No.and Street Type Description l O O H Q 1�L n ail 1 0 j10 U Unrestricted(Buildings up to 35,00p cu.ft) City/To State,ZIP �'_(!J. lJ V —I R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 4►33h'1o1 (J diedvner1Le. ovvt. Insulation Telephone Email address D Demolition 5.2 Registered Home Im rovem nt Contractor atUe ROM-110114e rlitorovevvieiti5 HIC Registration Number Expua idn Date lig4.tinpf7c/MotretimR154s.o. tranitt IMacke ' ectime N .and Street Email address 1101 V OPSe, WA 010 40 413 37i4 07/0 City/Tov4n,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 l 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 -Dave p Mi v e r to act on my behalf,in all matters relative to work authorized by this building permit application. pricO 1 I` /17e4iw /6 (a t-t /�- i. t Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION 1 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. MUST BE SIGNED by Owner or Authorized Agent 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 nal have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can beround at ww w.mass.gov/oca Information on the Construction Supervisor License can be found at«ww.mass.gov/d s 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or p rch) 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" The Commonwealth of Massachusetts l _.c, = I Department of Industrial Accidents ,5rfer�= 1 Congress Street,Suite 100 =lst tc Boston, MA 02114-2017�� www.tnass.gov/dia \Varkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Anplirant Information t , ;�„ Please Print Legihlh Name(Busii-ness/Organization/Individual): �.�/ Ve Lre- F:_a teri©r veTVY r vie t+5 Address: &LOf SOAC01.00 Loa City/State/Zip: HO I y0 H ei RQ 0 t 040 Phone#: 14 (5 NlL • (31 2.0 Are you an employer?Check the appropriate box: Type of project(required): 1.E I am a employer with employees(full and/or part-time).* 7. 0 New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. RRemodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole MO Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El Other 152,§1(4),and we have no 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 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 entitiCs 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: 2—�o f'i Gh Policy#or Self-ins.Lic.#: ��L.,, _O661 P 4 b il a(„2 p Expiration Date: I V 1 Job Site Address: )-)- 14a...e-4 S City/State/Zip: lC►'e.we ,rr� Attach a copy of the workers'compensation policy declaration 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$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 tb$250.00 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 certify under the pains and penalties of perjury that the information provided above is true and correct Signature: /y Date: %e �42-.2'` Phone#: 14 L.') 1 Lt 0 ti 10 Official use only. Do not write in this area,to be completed by city or town official City or Town: 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#: City of Northampton aptH+�Mp o S .: S ?'mot, Massachusetts <,. _,_ ; I,�l wi M. Z. { > DEPARTMENT OF BUILDING INSPECTIONS �` M • ut r ' 212 Main Street • Municipal Building yvb:., i�a; w_, r+' Northampton, MA 01060 j:11 ?1' I:jN'‘ CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, 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: VG el lc,c- rc t‘vtI The debris will be transported by: Z.- /u 1 nY c Name of Hauler: i/ ' 4 Z Signature of Applicant: Date: • Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC DAVE MINER EXTERIOR HOME IMPROVEMENTS,LLC Registration: 186552 347 NEWTON STREET Expiration: 02/04/2023 SOUTH HADLEY,MA 01075 Update Address and Return Card. SCA 1 0 20M-O5//177 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 186552 02/04/2023 1000 Washington Street -Suite 710 DAVE MINER EXTERIOR HOME IMPROVEMENTS,LLC Boston,MA 02118 DAVE MINER ,/ 347 NEWTON STREET, C. �/ SOUTH HADLEY,MA 01075 Undersecretary Not valid without signature Commonwealth of Massachusetts HDivision of Professional Licensure - • Board of Building Regulations and Standards ronstrwionSlIp r° sar Specialty CSSL-099953 • Expires: 10l20l2021- DAVID MINER 347 NEWTON STREET SOUTH HADLEY MA 01073 • '{ ,. • �_111 n"lissioner ACORD 0025 2016-03 Acroform-Certificate-52.pdf file:///C:/Users/emc/Down14ads/Certificate-52.pdf AC OR CERTIFICATE OF LIABILITY INSURANCE DATE(MM,°D/YYYY) `.----- 10/19/2022 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 provision;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 CONTACTAE Beth Carbalio ' FINCK& PERRAS INSURANCE AGENCY INC rAHO No.Est): (413)527-3000 (JC.No): ADDRESS: bcarballo@finckandperras.com 6 CAMPUS LANE INSURER(S)AFFORDING COVERAGE NAIC 0 EASTHAMPTON MA 01027 INSURER A: AMERICAN ZURICH INSURANCE COMPANY 40142 INSURED INSURER B: DAVE MINER EXTERIOR HOME IMPROVEMENTS LLC INSURER C: INSURER D: 264 SOUTHAMPTON RD INSURER E: HOLYOKE MA 01040 INSURERF: COVERAGES CERTIFICATE NUMBER: 826487 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. 1 INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXPD/ LIMITS LTR INSD,WVD, POLICY NUMBER (MMIDYYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ _I UMBRELLA LIAR — OCCUR EACH OCCURRENCE I$ EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PERTUTE ERH AND EMPLOYERS'LIABILITY • ANYPROPRIETOR/PARTNER/EXECUT1VE Y/N E.L.EACH ACCIDENT 1$ 1,000,000 A OFFICER/MEMBEREXCLUDED? ,NIA NIA NIA 6ZZUB9F45112622 10/21/2022 10/21/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE,$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I ATI N O L C O S/VEHICLES E ICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above p licy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Cover.) over ge Verification Search tool at www.mass.govAwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main St AUTHORIZED REPRESENTATIVE Northampton MA 01060 a , - _.. I Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. II rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1 of 1 10/19/2022,4:55 PM 41ks DAVE MINER Date: 72 ... Exterior Home Improvements (413) 533-0481 www.DaveMinerRoofing.com 264 Southampton Road,Holyoke,MA 01040 MA Registration#186552 Customer Name: ‘'/ Telephone Number 0y'Cr K Address, City/Town, State: '� ` CertainTeed Roof System • Strip off existing roof and remove all debris from worksite • Line all edges with 8" aluminum drip edge • Install_feet of WinterGuard ice & water barrier along eaves and up any valleys • Install Roof Runner Diamond Deck synthetic water resistant underlayment • Install CertainTeed Landmark Landmark PRO Landmark Premium f � Other shingles to manufacturers specifications. Color: • Install SwiftStart starter strip along eaves eaves and rakes • Install using 4 nails 6 nails for maximum wind coverage up to 130 mph • Install a ridge vent along the length of house approx. 15" in from edge of roof • Install new vent stack collars • Replace step flashing as needed along walls and chimney • Re-flash chimney with lead flashing as needed. Install Cricket at chimney. • Plywood Install 1/2" CDX plywood Install 1/2" CDX plywood as needed @ per sheet • CertainTeed SureStart Plus 4-Star 5 Star Warranty Coverage • All workmanship is guaranteed for 10 years unless otherwise specified. • Protect siding and exterior of house • Protect trees and shrubs • Magnet ground for loose nails • See Other below for any additional work or comments • Other: Contractor is not responsible for any damage to interior of home.Any loose articles on walls/shelves should be removed before work starts We Propose hereby to furnish material and labor-complete in accordance with the above specifications for the sum of: dollars($ ) A deposit of 1/3, $ , is to be paid before materials are ordered. A Payment of$ is due at the halfway point,and the balance of$ paid upon comp! tion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to stand practices. Any alteration or deviation from the above specifications involving extra costs will be executed upon written orders, nd will become an extra charge over and above the estimate. Our workers are fully covered by Workmen's Compensation Insurance and Liability Insurance. Authorized Signature: Note: This Proposal may be withdrawn by us if not accepted within 30 days Acceptance of Proposal—The above prices, specifications and conditions are satisfactory and we hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature: Signature: Date of Acceptance: This agreement may be cancelled by Customer within 3 days of acceptance for any reason as detailed in the accompar ying Notice of Cancellation Customer's Initials