34-024 (12) BP-2023-0904
119 TURKEY HILL RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
34-024-001 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-2023-0904 PERMISSIO IS HEREBY GRANTED TO:
Project# ROOF/SKYLIGHTS 2023 Contractor: License:
Est. Cost: 21700 MICHAEL FITZGE' D 100297
Const.Class: Exp.Date: 01/24/202'
Use Group: Owner: W. RE TER,BRETT J,&CAROLYN
Lot Size (sq.ft.)
Zoning: RR/WP Applicant: FITZG:RALD ROOFING COMPANY LLC
Applicant Address Phone: Insurance:,
93 OSCEOLA LANE (413)734-8438 6S62UB4N57150
LONGMEADOW, MA 01106
ISSUED ON: 07/14/2023
TO PERFORM THE FOLLOWING WORK:
REROOF AND SKYLIGHTS
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:
e: • 'iv . T1, .
Fees Paid: $80.00
212 Main Street,Phone(413)587-1240,Fax (413)587-1272
Office of the Building Commissie ner
cc c,O Pqck
RECE
IVE�The Commonwealth of Massachus ttsi
Board of Building Regulations and St: dar-,s IlkFO'
CH" ITY
Massachusetts State Building Code, :0 C R I,-i
'-,� s•• U
0
Building Permit Application To Construct, Repair, - .ova,> v• :r- i • ' h a ised' ar 2011
One-or Two-Family Dwelling ATNqTpG1N SpF
This�rr Section For Official Use Only N 1t t vi m
Building Permit Number:mb� 6 P k3` 6 Date Applied:
4110 /Kos, 1/i 7-1ll'20z3
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
kts
1.1 a Is this an 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?Check if yes❑ Municipal 0 On site disposal system 0
SECTION 2: PROPERTY OWNERSHIP1
2.1 Owner'of Record:
C.0.-rzDI } C�re-hAr Re)..\-e_ - 2.ore-nu- floc .•x-pAo-m,
Name(Print) City,State,ZIP 0100
WI `cv•At..., Vk:a k ed Co\..,,9-&\-ex-�r ..1•c.cirn
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 Otter Specify: 1oocs- Qeptace 1,
Brief Description of Proposed Work': — 6\TA. S\c„..,A." v k:1, / co o cep O1.d
- V\s\-+a� r-.
- P`cUJ d.-Ou s AID be-tr,
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ a\ ,OO co 1. Building Permit Fee:$ Indicate how fee is determined:
`
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Costa( em 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All F ]�
l� Check N Che Amount: P
6.Total Project Cost: $ `-Ibo 0 Paid in Full 0 Outstanding Balance Due:
I qco
City of Northampton
,'r _
Massachusetts 4-S-
e
it
' DEPARTMENT OF BUILDING INSPECTIONS r °
� 212 Main Street • Municipal Building .i s
b�
x Northampton, MA 01060k'3kj�, C
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR WINDOWS,
DOORS,ROOFS,RENOVATIONS,ROOF MOUNTED SOLAR,ETC.
1. Building Permit Application signed by legal owner and filled out
by owner or authorized agent.
2. One set of plans and specifications of proposed work(Digital and hard copy).
3. Construction Debris Affidavit filled out and signed by applicant.
4. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance.
6. Energy Conservation Compliance Certificate (new /replacement windows).
7. Home owner's License Exemption Form (if applicable).
8. Note any Special Permit requirements(if applicable).
9. Energy Code—all new construction(Gut/Rehab)requires a HERS Rater Affidavit
10. Please provide the appropriate fee in the form of a check made payable to: The City of
Northampton.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) C S\ \COW) O\-ay- ,%--t
License Number Expiration Date
Name of CSL Holder
List CSLtype(see below)
C3
Street Type Description
W \k.'A- C�,l O(o U Unrestricted(Buildings up to 35,000 Cu.ft.)
`
R Restricted 1&2 Family Dwelling
City/Town, tate,ZIP M Masonry
.V7 L ` ` c (� Q.
� RC Roofing Covering
i111y yN WS Window and Siding
SF Solid Fuel Burning Appliances
(Al --)34— 35 I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
uV. '-- HIC egi1�\
q-\�-14
Registration Number Expiration Date
HIC Company Name or HIC Regist ant Na e
No.and Street Email ad ess
1,.�vv--�� Vtik O tOj. 413-7 1 g`l3z `et`"^
City/Towt?,,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 17( 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 SiJ_. o-A-N.c C✓\P..e_A co vicrzLpi,
to act on my behalf,in all matters relative to work authorized by this buildi4 permit application.
Print Owner's Name(Electronic Signature) Datc
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.
Print'Owner'ss or Authorize gent's Name(Electronic Signature) /�// Date
3
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.) Habitab e 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
Department of Intiustrhtl Accidents
“_,17
1 Congress Street,Suite 100
INN t
Boston, MA 02114-2017
wwic.ntoss.govidia
‘1.41I kers' '4inipensation Insurance Affidas it:BuildersiContractorstElectrichtnstPlumhers.
WITH 1 BE 111-.11NIITTING.ArtneiulA.
Applicant Information Please Print Letibls
Name 4Business,urganizatiorvindivatual): 6•0 VA-4_
Address: OsccM
City'State/Zip: Pholie \--k`Or ONNOic \ —73 Li—St!
re y OE am employer?Cheek the appropriate hot: Type of project(required):
1.3 a employer with ,employees(full=Lim-part.{iinL 7. D Ness construction
20 lam a*ik proprietor or potheralup and ha‘c 110 CElipttrytv)working for me M 8. fl Remodeling
nay caraway_(Nu*token comp.niaurance roiporni I
9. 11 Demolition
30 1 ant hurugowner doing all work myself.[No worktzt*comp,insurance requircd,r
100 Building addition
40 1 am a hotritusvner and a dl he luring c•ontractora to conduct all work on my poupert).. 1 wdl
enanre that all emaratiors either ha,.e workers'cocncimiaaliOn in:0111/EUX or are aolc I IC Electrical repairs or additions
pfornovis with no ellipillytXT,
1_.D Plumbing repairs or additions
SC:3 1 ant a genetai contractor and I have hind the,ohontrator%listed on the attached sheet
I glir Roof repairs
Thew sub-iananicsois lust:employee and have viatica'comp.utaurance,:
14.0 Othet
AO We arc a eurNralidn and its talkers bate ckerciacd then right of exemption per Wel_
152.§114 1,and‘'‘e Int,e.nu ernyltqcea.[Slo workers'comp.jamce required.]
appLi,xtt tacittn ki box 42 I MUM Av.)fill out tli. oction below show the then*oilers'conmemation policy tnfornuition.
Ilinneow nen.IA tio thi%affitlakAt militating they are doing all work and then line outside contractri mtra sithnut a new affidai,ii aniticatine
1.:A.Intractorl that check thL4 box natal attached an additional sheet ahoy,ins the moot of the suli—zontntacirs and vule wh..iieor not thine
ce,.. 11 I otz leEL*,.Iaaa.Intepl‘P: t1I iu riros,•ide their workg:i,' number
1 um an employer that is providing woriers'compenNotion insurance fur my employees. Below is the policy and Joh site
information.
Insurance COmpany Name'
Policy#or Sell ins Lic. (s6 z s•lksp Expiration Date D —
Job Site Address: \\ \ ocr,fv. e_ City!State2ip: (.1\Liz,
Attach a copy of the‘10 rkers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverd ,,i:a requirod under NAGE c. 152, §,25A is a criminal s iolation punishable by a fine up to$1.500.00
andior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
day against the siolator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
cos eragc s crilkat
I do hereby certify under the pains and penalties of pe,riury that the infOrrnation provider!above Ix true and correct.
Signature: ../9444,--i re _47 Date: 7-/ I .23
['hone
Official use only, Do not write in this area,to he completed In'city or town officiaL
City or Tout): Permit/License I;
Issuing Authority teircle one):
I. Board of}Irak') 2.Building Department 3.t'ityrforvn Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Con hie t Person: Phone 4:
r ,.‘,-,-,
{i
City of Northampton
Massachusetts .t,:% f
of r
PPPPiiii���� , .. DEPARTMENT OF BUILDING INSPECTIONS ?, }
1` r 212 Main Street • Municipal Building -,9'�'r
Northampton, MA 01060 �S ,, {�'`"
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: USCr ,,��-e._ \- \e—e
The debris will be transported by: v \ t s\- \- Q_I-.. c�
Name of Hauler: IUS� mac_ \e \-- �Q < � 1'L=enc -
S Sh� - 4_4)
�aG\*- vJ`XSC-N, VC Cto�" S
%1oO - 1Litp - 3 oo
Signature of Applicant: \-70 a -�-),.,,"� Date: '7-1 I a3
City of Northampton
zr Massachusetts
a
ik.H.,4
rF DEPARTMENT OF BUILDING INSPECTIONS ,t,
1.1( le, 212 Main Street • Municipal Building -t ,
".-4 Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (insert full legal name), born_(insert
month, day, year), hereby depose and state the following:
1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or
work on a parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'
exemption, does not involve the field erection of manufactured buildings constructed in accordance with
780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a one-or two-family dwelling, attached or detached structures
accessory to such use and/or farm structures. A person who constructs more than one home in
a two-year period shall not be considered a home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I
qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of
the project or work on my parcel, I am not engaged in construction supervision in connection with any
project or work involving construction, reconstruction, alteration, repair, removal or demolition
involving any activity regulated by any provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on
my parcel, I acknowledge that 1 am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this day of ,20_.
(Signature)
Fitzgerald Roofing Company
CSSL# 100297-HIC# 192791
All Types of Roofs
Reasonable Prices-Free Estimates
All Work Fully Guaranteed
Mike-Jason
413-734-8438
Brett Reiter
119 Turkey Hill Road
Florence, MA 01062
May 9,2023
We propose to furnish the materials and perform the labor necessary for the completion of replacing
the roof on the house at the above address by:
• Stripping the existing roof on the house to deck
• Installing F5 Aluminum drip edge to the perimeter of the roof
• Installing Ice and Water Barrier 6 feet around the perimeter and in all valleys
• Installing Palisade as roofing underlayment
• Installing 30-year Architectural shingles
• Installing a new flange on stack pipes
• Installing Lead Flashing around chimney
• Installing Snow Country ridge vent
• Providing a dumpster on site to remove and dispose of all debris.
All material is guaranteed to be as specified,and the above work is to be performed in accordance with
the drawings and specifications submitted and completed in a substantial workmanlike manner for the
sum of ---Sixteen Thousand ($16,000) Dollars'
*Installation of(7) new fixed skylights is an additional ($5,700). S 1 .
1-11k( cP2( 1%'D
Payment upon completion of work.
Acceptance of Proposal
The above prices,specifications,and conditions are satisfactory ancJ are accepted. Any alteration or
deviation from the above specifications involving extra costs will beexecuted only upon written/verbal
orders and will become an additional charge over and above the estimate.
C--------
Signature
. 571 1
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street-Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
a-
Type: Corporation
Registration: 192791
FITZGERALD ROOFING COMPANY.LLC Expiration: 09/1812024
93 OSCEOLA LANE t r ti
LONGMEADOW,MA 01106
(Waft Address and Raba u Card-
THE COMMONWEALTH OF MASSACHIUSETTS
Office of Consorter AMatrs&Business Regulation Ragbaa'ss veld for indiridnal me only before the
HO ROVl3E hC CONTRACTOR dal deb- M ibd rebwn brc
TYPe Office of Cawsar Aihrksjewd Business Regulation
Rs F on 1000 Street-Ilia 710
192791 091182024 Boston,MA 0 11$
FITZGERALD ROOFING COMPANY,LLC
MICHAEL FITZGERALD , //� �'
93 OSCEOLA LANE LONGMEADOW,MA 01106 �i �.lr l .1
Undorar seebary Not va id I is •
Commonwealth of Massachusetts
Division of Occupational Licensure
,° Board of Building Re rations and Standards
Construct��Lpet r Specialty
CSSL•100297 x E c_p1res: O 1124/2024
MICHAEL FI GERALD
93 OSCEOLA4L.ANE
LONGMEADC if MA 01 f06
I� )�- i
t.
Commissioner M• Ire A' t
I