24B-009 (3) BP-2023-0761
65 BARRETT ST COMMONWEALTH OF M SSACHUSETTS
Map:Block:Lot:
24B-009-001 CITY OF NORTHA PTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit'# BP-2023-0761 PERMISSION IS HEREBY GRANTED TO:
Project# ROOF 2023 Contractor: License:
Est. Cost: 9800 FLORENCE ROOFING 071107
Const.Class: Exp.Date: 04/24/2025
Use Group: Owner: G. BIB AU,MARK
Lot Size (sq.ft.)
Zoning: URB/WP Applicant: FIORE CE ROOFING
Applicant Address Phone: Insurance:
405 RYAN RD (413)585-9171 SOLE PROPRIETOR
FLORENCE, MA 01062
ISSUED ON: 06/12/2023
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 NO HAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: ,tmolictAx_ cgil •
'
Fees Paid: S40.00
212 Main Street,Phone(413)587-1240,Fax (413)587-1272
Office of the Building Commiss. ner
w
The Commonwealth of Massachu -tt ?'o�
Board of Building Regulations and Stan 0; •. ,� FO
; ) Massachusetts State Building Code, 780 C A't0°?'1'c� SEALITY
Building Permit Application To Construct,Repair,Renovate Or i ?S:I R sed Mar 2011
One- or Two-Family Dwelling 060Otis
This Section For Official Use Only
Building ermit Number: 60 )>r 70/ Date A lied:
�-9zvz
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
65 Barrett St
1.1 a 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 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Mark Bibeau Northampton,MA.01060
Name(Print) City,State,ZIP
65 Barrett St 972-632-8490 _
No. and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK' (check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units Other Et Specify:R000fing
Brief Description of Proposed Work2:Stripping roof and applying new shingles.
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
Item Official Use Only
(Labor and Materials)
1.Building $9,800.00 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire
Suppression) Total All Fees: $1 J''JJ
Check NdQ�U6 Check Amount: "I' Cash Amount:
6. Total Project Cost: $9,800.00 0 Paid in Full 0 Outstanding Balance Due:
I
a
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-071107 04/24/25
C.Philip Andrikidis/d/b/a Florence Roofing License Number Expiration Date
Name of CSL Holder
405 Ryan Rd. List CSL Type ;see below) U
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
Florence,MA.01062 Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
florenceroofin mai SF Solid Fuel Burning Appliances
413-262-8007 9@9l.corn I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 01573 8/26/23
C.Philip Andrikidis/d/b/a Florence Roofing HIClegistration Number Expiration Date
H416%n j Name or HIC Registrant Name
florenceroofing@gmail.com
No.and Street Email address
Florence,MA.01062 413-262-8007
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 8 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
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.
C.Philip Andrikidis 6/6/23
Print Owner's or Authorized Agent'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/dps
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
"MPS.
,���'` Massachusetts •
z. - rj4
Ae
4 4 DEPARTMENT OF BUILDING INSPECTIONS S 4
212 Main Street • Municipal Building ub C.
Northampton, MA 01060 "SNiy . :5%
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: Florence Roofing
Name of Hauler: Florence Roofing
Signature of Applicant: Date: 6/6/23
t
• .
ta__. The Commonwealth nith of Massachusetts
{'? '> Department of Industrial Accidents
�; 1 congress Street.Suite 100
Boston,.11A 02114-2017
WIMP.mass.geridia
11urkers*Compensation Insurance Aflidasit: Buildersl(odtractors/l:lectricianstPiumbers.
to BE FILED tt El tt"tui:PERHI VI IN(s Al L11 1414 S.
Annlicant Information Please Print IA-gibe
Name+iit rn:,..tzrg:is[rrattott tnaie.ntnal): C. Philip Andrikidis/d/b/a Florence Roofing
Address: 405 Ryan Rd.
007
City' State Zip: Florence, MA. 01062 Phone -: 413-262-8007
♦rt.von,an cusplarr 't.'tnnk the stpreltta'iartir bat: Type s!project(required):
..M 1 am a anplo)a with 5 ..'rr *it+toes:mai...du paatann.i' I 7. 3 New construction
2..2I am a bole pmpra.t.rr or partner-Alp and haw no employa+cs a(Aunt: k'r nee in S. 0 Remodeling
airy cr,,acity [No uorfla S:camp.i...,nr.ntk: rcquisu '
9. 3
.t: I ansabursaaratiertioing A.boa krtnacit Par aorke s e.ruap.:r uATIN:setenroll.
10 0 Budding addition
A. 1 atrt a h.mi.'rutn:t and roll be hiring contrattora to carndtrc9 all work on my property,. I a di
�t comet that all:aHiba:auh India a...axiom'1:430StatitxoLvon larYraEa a Of are Sate 110 Electrical repairs or additions
proprietors a uh no snit v ro. 110 Plumbing repairs or additions
.s Cam a ma rH asnasac*Asc andl Ilisat herodt a mb-karrnitactor.bated a rt the attaiiaca stem:
'chase wiii.ei actina.haw•a at�R.a.uara+ime awaken:1;02I.P.xawz:awc:• 13. rcpati7
I4.riothet Roofing_
6.0 VW°c arc a corporation and Nx officer,.bate exercised their nett cot rxccrsptiun pa Wit._4:._ �-_----
r`vitt anti r a lraw nn raat+yeres.jlev arson..r%"octal,.msarrawe rcquac L j
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'Any applicant that.h vk.but;i t mint adao till out the vtttuii bck,i .Frnatna dun aoill a a':.'rvperr,.;itarn policy information.
*;1ltrnaco arar%'a 6,sz.n-r»1 do.airfniat a.-wars ti an rumor ad wok Sonit16aa:tarn tit,i4k:a+n 104'.rsaa:st a,alr NA arena ai.&.ie d••.J..-01..^'Mild:.
^Cnairactam Ike cia[:i.this taax manor atLa.tanl AM 6 datncuta sfma t. sang Stan armor.00 ila wr.,c 63.n.Joni flare'a fictiior t•r 6,1 Tito,:amain:+h.,sc
emplo)ees_ It the sub-:or[tractt+rs 60.4:cry;tlo .v..Ilr:y must pro%ide then aoit i 'corup.Ir.3icy manla'r.
I am an employer that is providing warders'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Ccrinjt5a : Liberty Mutual Insurance Compan r_
Policy#or sell=ins.Etc.r.. WC2 31 S-374455 053 Expiration Date: 01/25/2024
.loan Site Addreac: 65 Barrett St. city.:cr,,tartzip: Northampton, MA. 01062
Attach a copy of theworkers*compensation pokey declaration page t"slusaii ag die policy aueiber and expiration date).
Failure to secure:coverage as r quired under MGI_c. 152.*25A is a criminal violation punishable by a tine up to S1.500.00
and/or one-year ttrtpri.onmcnt.as well as end penalties an the firm of a_ST()1"WORK ORDER and a tine of up to S2 50.00 a
day against the s tolator.A copy of this statement may be forwarded to the Office of livvestigations of the D?IA for insurance
coverage serilic.stiort.
!do benrbt certify under the pains and penalties ofperjuty that the information provided above is true and correct
`tttatttI e: --------7:1> > 1)ate. 6/6/23
Phone c= 413-262-8007
Official use only. Do not write in this area.to be completed by city or town official
('its or Town: Permit/License#
Issuing Authority firelc aovrj
1.Board of Health 2.Building Department 3.('ityi Toan Clerk 4.Electrical Inspector S.Plumbing Inspector
G.Other
Contact Person: Phone#:
1