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25C-251-002 RESTROOM BIf-2023-0122 54 FAIR ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25C-251-002 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-2023-0122 PERMISSION IS HEREBY GRANTED TO: Project# RESTROOM ROOF 2023 Contractor: License: Est. Cost: 24000 VECTOR HOME INC 112389 Const.Class: Exp.Date: 06/18/2024 Use Group: Owner: HAMPDEN HAMPSHIRE FRANKLIN & Lot Size (sq.ft.) Zoning: URB Applicant: VECTOR HOME INC Applicant Address Phone: Insurance: 38 HUMPHREY LANE (413)204-0023 AWC-400-7039926 WEST SPRINGFIELD, MA 01089 ISSUED ON: 02/02/2023 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF 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 VI I LATION OF ANY OF ITS RULES AND REGULATIONS. Signature: / I • 'l 41, Fees Paid: $168.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 4' L J16 60 VZ adi The Commonwealth of Massach se 2 /23 f\ Office of Public Safety and Inspections 0 t.„ /;;r Massachusetts State Building Code(780 CMR) ---- Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number.�`Z3. 122. Date Applied: Building Official: ___ SECTION 1:LOCATION PiFG7/R SV //or/Iia ',6/ '1 ti/A d/a6/0305' Thre Cawv'r /- ?, or No.and Street City/Town Zip Code // Nam of gilding(if plicable) k a m S�' ,Building, 44', O' ' Assessors Map# Block#and/or Lot # L/Q�/ Oeh friadizetat Stood SECTION 2 PROPOSED WORK o �, Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building% Repair Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 IVo Is an Independent Structural Engineerin Peer Rev' w require ? Yes 0 o Brief Des ription of Pro..sed Work: % i/c"i Sid tar/rYi a � , rp/{�o Gf/a �or /�tb `! d !f/!ttree . l <v GinQtt ay 6 - / //c' rrr'er d, f/5 s 1/444e / n i r v >1 - ' Sofia/rip Se 7/ ' ,499/ of6iLa /n Gra n d / ,/-a's. S IO 3:COMPLET 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): 1QfAt ro&/Y1 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) ( 'X a211)X); o?C7 -y SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2 0 Nightclub 0 A-3 ❑ A-4 0 A-5 0 B: Business ' E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4❑ H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile❑ 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 ❑ HA IIB 0 IIIA ❑ IIIB ❑ IV 0 VA 0 VB 0 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: Public 0 Check if outside Flood Zone 0 Indicate municipal ElA trench will not be Licensed Disposal Site,gr Private 0 or indentify Zone: or on site system 0 required 0 or trench or specify: permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission 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: (9(11t`a, /`laha�et �/�3- RU263a - 3cvu/kf6y /ri 9ffifiai 7 ork-, Title Telephone No.(business) Telephone No. (cell) e-mail address If a plicable,the property owner hereby authorizes: iarna Pr—O_ek 5�i/ /=Q%r �� �nrjhdmihn /�/9 O/O6 d Name Street Address City/TowA 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(Please 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 O. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Waivir a 004(W - - NamL(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Exp' ation Date 10.2 General Contractor Vedar Rain, /ne Co man Name ' 9na CS- lla' 3�9 a/7,- 'i l d Name Person Responsible for Construction License No. and Type if Applicable f Itan0hr /one l/.e,s/ k 1- ido/ S4- P/dd9.4 Street Address City/To State Zip *i3-gi3 /6.36 "/33 -ao . 0,9,3 I/' r%oh-mE/aa9mna/t cos-,2 No.(business) Telephone No.(cell) e-mail add ss SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.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 CI No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor ,an�dd�Materials) Total Construction Cost(from Item 6)=$_ 1.Building $ U�'7.aaP Building Permit Fee=Total Construction Cost x'—�(I sert here 2.Electrical $ appropriate municipal factor)=$ . ,a. 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municip lity) 5.Mechanical (Other) $ Enclose check payable to fa 6.Total Cost $ ( 4 OVD (contact municipality)and write check number here AA ` J SECTION 13:SIGNATURE OF BUILDING 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 my knowledge and understanding. ant. JV,oke 1% e Araid a7 #6 - V as?3 003 Please p ' and sipame the Telephone No. Date 3f �um /ram //int 14/a/ �ri o/�,/ waeg vacIprhora/voevinaieeon Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: i72 _ 2 Z Zoz 3 Name Date Vector Home, Inc 38 Humphrey Lane, West Springfield, MA 01089 (413) 883-1636 vectorhome100@gmail.com Contract Customer's name /f7r-c " CoGC/27l'G raft'_ meg i9 /€A) Customer's address 14(fait(' S� /0YIfGa/i Ire Ad d i oc Customer's phone number If/3- 6 ' /31 email: . / " m ` / _ earn Roof Estimate:what is included. 0 Strip off an old(existing)shingle a 7 /'d'le' .3 ' `. Replace all rotted plywood sheets included »v per sheet (sraralieF F} 3. Cover the whole roof with the new plywood Lay down underlayment 6 feet ice barrier, the rest is synthetic felt roof underlaymen (...59 Cover roof with the new shingle Ypf petals caz color 6r°P f�'iD i 5�m526 �'- 6. New flashing around chimney ci 7. Replace new skylights 8. Reflash skylights Cut new ridge vent (i( n ad a) ) Price include dumpster container Clean all debris after the job is done 12.New gutters and downspa Include roof material 14. Solar fan installed �/ tali//fit4` ''2-(//4// /1`I6 64de TOTAL PRICE oc.g.f, A96 Down payment .97 /I go Amount due g / e2 O Cust mer's Signature' Date City of Northampton SAYka P Pk 1c 40 Massachusetts "'S 4 z �• \ ( DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 �ty4 jl'�`� 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: 7/ Fa/12 i ,,Vat a/nl17!'I, �� O�a6d The debris will be transported by: Name of Hauler: VUQ.�TI' diy Signature of Applicant: le-d1GZ Date: 7/c26/43 The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 .„...., Boston,MA 02114-2017 ''' .. wwwinass.govidio '-"- Workers't'ompensation Insurance Affidasit:BuildersiContractors/E:lectricians/Plumhers. '1'0 HE FILED WITH'IllE PERMITTING A1411014E111. Applicant information Please Print 1-egiblv Name 411usitiesvorganizanedv Individual): Vee.,7-Cr /(1.0.file,/nt‘7 ^1- Address: ,qtr /4-Lirj/his Zare City/State/Zip:WM( 97/>9 /60/ii oiall Phone#: Ate yes Se etYlpkYyte Ciletit tilt appropriate twit: Type of project(requl d): la I ant a ensployes with cinptoyets(full andier part-tiner).* '' 7. 0 New construction 20 I am a wk pcupriettar or pumorrslop and have no employees working tor ma in R. 0 Remodeling any capacity. Nu workers comp.insurance retputed.) 9. El Demolition 30 I am a fronseoviret doing all Irma myself,ftrio workers'tOgVV,nniunince'intuited.)" i 0 El Building addition 4.ri I am a homeowner and will be hiring coituriotors to inarthict all work on my property. I*di erasure that all t'ordractties either have*miner*compensation insurance or:Ste(H.Sic I I a Electrical repairs r additions proprieurts with no crtipluyces. I 2.0 Plumbing repairs additions 50 I am a general contractor and I have hued thc rob-isinuactors listed kt!3 the attached sheet i 3,11Roof repairs These sub-cuntractors have employees and have workers'v-ortth Obit:influx) 1 4.0 Other ri...[?3 We are a corporation and its anima have ahatehted then'noin of trscrtentott per Mt it c 152,¢1(4),and sec have no errarlitytes.[Nu workers'comp.insurance i equired.1 *Any applitaint that eitaxiii bust n 3 Inuit also lilt out the wawa;haus%skarn ung their 14,,,arkm`4.1stirpens anon put icy inforthatnai. Homeowners who submit this affidavit indicating they an:doing all work and then Fore outside cuntractors mud'submit a now aft-Kilo it indicating mica, kantradors that check this hiss must attawhed an additional sheet showing the Wale of the sttb-eontraetot-s and state whether m not those minim have employee, It the aub-comiraetta,haw.,nrtpluyeet.thcy mini pruvide their wlarker,,'comp.puhey number, , 4ttJIMIIIIIIMIIIIIIIIIIIIMIMIIIIIIIIISII= I am an employer that is providing Ivor/kers'compensation ifOlicaner fir my employees. Below is the policy and job site Information. Insurance Company Name: A .)./1//. /111(410/ 7114ttiati et' 3 ii Policy#or Self-iris.Lie. 4: n 14/C-ito-3-(23 99,26' Expiration Date: ai / al Job Site Address: 57/ Ta/r. / 442/Aar0b/3 /1/4 '°71e(2 / City/Statelip: Attach a copy of the workers`compensation policy declaration page( bow Mg the policy number and expire on date). Failure to secure coverage as requirixi,under!VIOL c. 152,125A is a criminal violation punishable by a fine up to S .500.00 ari&or one-year imptisomnent.as well as civil penalties in the form of a STOP WORK ORDER and a line of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the OtTice of Investigations of the DR for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided abtore is true and correct. Signature' r apt? ;0-4,wk-i_e-tq..t phone#: z//& ,a04/--a0,2 Official use only. Do not write in this area,to be camp fried by city or town official f City or Town: Permit/License* 1 Issuing Authority(circle one): 1. Hoard a'Health 2.Building Department 3.City)Town Clerk 4. Ekctrical Inspector 5. Piwohing Inspector 6.Other ('outset Person: Plittite 0: T ® DATE(MMfDDIYYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 01/25/2023 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). CONTACT PRODUCER David R Jar NAME: ry Neill&Neill Insurance Agency Inc PHONE 732 4137 FAX ' (413)731-6629 662 Riverdale Street ((UC.No.Eel): (413) (A/C,No):E . West Springfield,MA 01089 ADDRESS: dj@neillandneill.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Northfield Solutions NOF INSURED Vector Home,Inc. INSURER B: A.I.M Mutual Insurance Company All 38 Humphrey Lane INSURER C: West Springfield,MA 01089 INSURER o 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 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 TYPE OF INSURANCE ADM SUBR POLICY EFF POLICY EXP LIMITS LTR INSD_NVD POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYYI A t✓ COMMERCIAL GENERAL LIABILITY WS517412 04/25/2022 04/25/2023 EACH OCCURRENCE $ 1,000,000 �i CLAIMS-MADE ✓{{�OCCUR PREMISES(Es occurrence) $ 100,000 MED EXP(Any one person) I$ 5,000 k A.RR PERSONAL&ADV INJURY $ 1,000,000 µGEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I$ 2,000,000 r_.— PRO- i 1 POLICY;e...." -. 1 JECT „,,w!LOC PRODUCTS-COMP/OP AGG i$ 2,000,000 e,. ,OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - _ (Ea accident) ZANY AUTO BODILY INJURY(Per person) $ OWNED )SCHEDULED. .„,„AUTOS ONLY __ BODILY INJURY(Per accident) $ . AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ,..,,„,AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB !OCCUR EACH OCCURRENCE $ I EXCESS LIAB 1 CLAIMS-MADE AGGREGATE $ ,.„_„„ DED 1 RETENTION$ _ II$ B WORKERS COMPENSATION AWC-400-7039926 01/19/2023 01/19/2024 �* ff J AND EMPLOYERS'LIABILITYI STATUTE t,_ ERH OFFICER/MEMBER OIETOEXCLUDEE ECUTIVE YYN NIA E.L.EACH ACCIDENT I$ 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/LOCATIONS/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 Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 212 Main Street ACCORDANCE WITH THt P ICY PROVISIONS. Northampton,MA 01060 { _ 47 AUTHORIZED REPRESENT AI No 4,teio 1 . 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CONSTRUCTION CONTROL WAIVER From: V:6( r k(C2 -t9 Ae- 3g 1-4mAhr / `ie 1 t/,,GS/ 0--/*/e49/ JA11 - O/12(f, 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 ��� Pa pp h/ri, Fran/�ii and ka� oleo Ao'lei-e-/I / s* ✓.cOrrav1 etc(( /Ho Coca//0,1 5zt ca r ./, /Uorf-arrr fvh, r/1 because the work is of a minor nature, All not affect structural elements, health, accessibility, life or fire 9/0669 safety, and will be done in accordance with the prescriptive requirements of the code. Thank you for your consideration. Respectfully, \\ y® Commonwealth of Massachusetts \ !� Division of Occupational Licensure • Board of Building Regl irations and Standards fill Cortst ion SVOgrvisor CS-112389 pires:06/1812024 TATYANA DIDUCAL 38 HUMPHREfr( LANE WEST SPRII4 FIELD t P 01089 4()I. L'Lrlal3' r.. X THE COMMONWEALTH OF MASSACHUSETTS Offm:e-of-Consumer Affarrt ..` . Business Regulation .... 1000 Washingt441r: t - Suite 710 Bostoryt-Massachusetts 02.118 Home Im•ro 7-, sot 60 tractor • : •istration Type: Corporation =1= . . • .• iri 203846 VECTOR HOME INC 12/01/2023 38 HUMPHREY LN _ _ WEST SPRINGFIELD, MA 01089 . ..._ 1 IMO woos Aortas and Return Card. THE COMMONWEALTH OF mAssAcHusens officio of Consumer Af1W &Business Regulation Registration valid for Individual use only before the HOME IMPROVENIEKTVONTRACTOR expiration dot*. If found return to: TYPE:edip&abon Office of COMIMIer Affairs and Business Regulation = Registretion 1000 Viashington Street -&de 710 f Entritlaa Boston, MA 02118 203846 -..A 1 2/0 1/2023 VECTOR HOME INC r to.'• = tt, PAVEL DUDUCAL 4 38 HUMPHREY LN 1:i\,• , , S-464,,,,,tra ,4a004` WEST SPRINGFIELD, MA°01089 Undersecretary Not valid without signature