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23A-273 (3) BP-2023-1647 27 MIDDLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-273-001 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-2023-1647 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2023 Contractor: License: Est.Cost: 47000 EAST COAST METAL ROOFING 115124 Const.Class: Exp.Date: 06/20/2024 Use Group: Owner: HOPKINS SKINN HEATHER D& LARISSA E Lot Size (sq.ft.) Zoning: URB Applicant: EAST COAST METAL ROOFING Applicant Address Phone: Insurance: 254 SUTTON AVE 5087310415 79803 OXFORD, MA 01540 ISSUED ON: 11/21/2023 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 1 ft()\al, 1 61,„t Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ovna R VYJJ '- .~ 1 e_vb The Commonwealth of Massachusetts Board of Building Regulations and Standards N 0 V 2 1 2023 F Massachusetts State Building Code, 78 CM ICI ALITY U'E Building Permit Application To Construct,Repair,Re ovatte rnl: pl ; pF;TR3N. ed Altar 2011 One-or Two-Family Dwelling --- '0", "sA n, This Section For Official Use Only Building Permit Number: Oa'0,1 3' /6 y Date Applied: eC 5-TdrAPO )1 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1. P1 pgrtyrrcy s s 1.2 Assessors Map&Parcel Numbers 1..11 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? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record. Lc - so p6 nS /UOr+ Oiiv\ 1() ,hn r4 010(0Q Name(Print) City,State,ZIP M,cvcl e. s - 50313j-5g/5 'ng-ecA r, tarn 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) l . Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': \ �( O nS ,I I �`cf. / uitt 9A t 10 FAO t insi-e�,� e r�maOF ac.�C. rood9S SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ LI� l b0 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ 0 Total Project Costa (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees:�$ /� O Check No. of heck Amount`: 6. Total Project Cost: $ l V 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ` I.51a y / / j j G Min LicenseL Number Expiration Date Name of CSL Holder 1W1 et! , - 1. I List CSL Type(see below) No.and Street Type Description -sr �y ' y�^ �` 2 U Unrestricted(Buildings up to 35,000 Cu.ft.) W r �. net U' 3 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofin Covering WS Window and Siding �/y��t-� p�h^ ,,\ SF Solid Fuel Burning Appliances WO !5` 0LPs -t-S(1,(,L.1 f 1,r. WM I Insulation Telephone Email address D Demolition 5..2��RCCegistereedd Home/Improvement Contractor �((HIIC) ( D)I��� EJY�� c�'tS� / '"Q CL t ('"`"' ' ! HIC Registration Number E irat on Date HIC Comp anyar qr I I egis ant N e No,�ndP5ee� ,,\ � �btSLip '3I64 IS Email address City/Town,ty (JYStaatte,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 Cif No .0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT '�C�b I,as Owner of the subject property,hereby authorize ell + Ron to act on my behalf,in all matters relative to work authorized by this building permit application. � -¢-e ., f ►9 / abd3 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. 1 / 3 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 .�" Massachusetts ��,'' ... �<< * Gyy II /F DEPARTMENT OF BUILDING INSPECTIONS P. I' 7 yJ 212 Main Street • Municipal Building 6 Q Northampton, MA 01060 .5. `gyp 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: unk4e6 Nkter` co mat nr ,l13- The debris will be transported by: Name of Hauler: Signature of Applicant: Ct�t�l�l.i i Date: L I ) L LI /cb3 DATE(MM/DDYY) AC RO® M' CERTIFICATE OF LIABILITY INSURANCE 10/25/23 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). PRODUCER CONTNAME: SABRINA SABRINA SANTOS FIRESIDE INSURANCE AGENCY INC PHO No.Eat); (508)487-9044 FAX(NC,NgL (508)487-0649 E-MAIL #10 Shank Painter Cmn POB 760 ADDRESS: SABRINA@FIRESIDEINSURANCEAGENCY.COM Provincetown, MA 02657-0760 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: SAFETY INSURANCE COMPANY INSURED INSURER B: ASSOCIATED EMPLOYERS INSURANCE COMPANY GAGNON SITE SERVICES LLC INSURER C: 44 WYCHWOOD HEIGHTS INSURERD: LITTLETON, MA 01460 INSURERE: 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 POI ICIFS LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL,SUBR POLICY EFF I POLICY EXP LIMITS LTRINSR MD POLICY NUMBER (MM/DDIYYYY),(MM/DDIYYYY) X COMMERCIAL GENERAL�/LIABILITY !I -EACH OCCURRENCE $ 1,000,000 AMAGE TO RENTED CLAIMS-MADE /� OCCUR PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 A BMA0032208 08/12/23 ! 08/12/24 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE__ $ 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) 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 1 EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED ,RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY STATUTE ERH YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100 000 B OFFICER/MEMBER EXCLUDED? N NIA WCC-500-5027960-2023A 10/21/23 10/21/24 (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 i l I DESCRIPTION OF OPERATIONS 1 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 EAST COAST METAL ROOFING THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 254 SUTTON AVENUE OXFORD,MA 01540 AUTHORIZED REPRESEN YE al/k" I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth af Massacli u et` c Division of Professional : ocensure Board of Building Regulations lid Standards _ _ConstrpióifSUervisor•:6„:„...,....•_. p ......„ ..,-,:, ,- ! , _ , :• [L'--:._-; p i F,t' 2 : ,S,V bill(.-::.'i,g.)//i/'_..z.,L)‘./-. 1. 1A;.ip `titom' ` �U :-,L'VI?L � WAL�� = ' P.' r"' r-q -- 27) -4e-sliA.IF"- [irw\r[I, R\ al 630 . ..._.... ' . f .k w . ..1 1 -.1 1r_..- 7.. is '! _ ''' . 01 1„ — I:Ci2 o rn---. rri]H'. .„.9 S. .11 0 fil 8 Er - i ' C 0 Fil 7/24,1 (G ' ll V.06 I' u 41 Ir EAST COAST EAST COAST METAL ROOFING,LLC 254 Sutton Ave,Oxford,MA 01540 METAL ROOFING Customer Contact:1-844-611-3267 Visit our website at:EastCoastMetalRoofing.com NAME Lari ssa Hopkins ("Purchaser") JOB ADDRESS 27 Middle street ("Premises") CITY/TOWN Northampton Ma ZIP CODE 01062 MAILING ADDRESS same ZIP CODE HOME PHONE 413-658-8554 E-MAIL Lehopkin@gmai1.com CONTACT NAME Larissa WORK CELL 413-658-8554 The Purchaser is the registered owner of the Premises and hereby contracts with East Coast Metal Roofing,LLC.(the"Contractor")authorizing the Contractor to furnish all necessary materials and labor to install,construct and place the improvements according to the following specifications, terms and conditions(the"Specifications")on or at the Premises: PROFILE:_SHINGLE/X SLATE/_HYBRID/_PVC COLOR Charcoal Si ate Strip 1 layer of cedar shake and dispose Home Improvement Contractor Rep#184472 Install permalock roofing system, Install pvc roofing system in marked areas, install Charcoal Durolast flashing, install plywood, install ridge vent, install snowguards as discussed Install pvc breaker board where porch roof connection is if needed, re/re facia board on front Porch, collar chimney, boot pipe, install i&w 3ft up eaves and breathable on remainder ADDITIONAL SPECIFICATIONS 596- per sheet for plywood install if needed $90- per square for extra layer/plywood (strip, clean up, disposal) YES NO ROOFING MATERIAL YES NO ROOFING MATERIAL x Rubber/PVC Low Slope Roofing Color CharcoalX Supply adequate electrical power X Flash Skylights* Outlet Location: Inside garage / front porch X Work with the Contractor to fix damage uncovered X — Flash Vents# 1 small boot — — during installation at a cost agreed to by the parties. X — Ridge Vent Standard Plywood for rot repair min charge$2.50 sq ft X _ Respect the work site. In the interests of everyone's X — Underlayment I&W / Breathable safety,Purchaser will not use or borrow Contractor's X — Snowguards# 25 +/ equipment or tools and will not access or interfere with the project during installation. Skilled professionals ROOF REMOVAL should be hired for any work that requires access to or traversing your roof. X — Strip existing roof(#of layers 1 ) LOCATION FOR DELIVERY X — Haul away roof debris and pay refuse fees. Behind the garage X Supply plywood I 1/2" I ood Start Date* 4-12 weeks or sooner, weather permitting "Projects may be delayed due to inventory supply issues from certain manufacturers. LOCATION FOR BIN: In the driveway ** 1-2 weeks or sooner Towards the back Substantial Completion Date **Unless circumstances are beyond the Contractor's control. THIS CONTRACT INCLUDES THE ALUMINUM SHINGLE COMPANY LIFETIME LIMITED WARRANTY,50 YEAR TRANSFERABLE,NON-PRORATED FOR MATERIALS MANUFACTURED BY THE ALUMINUM SHINGLE COMPANY,PLUS LIFETIME LIMITED WORKMANSHIP WARRANTY PROVIDED BY EAST COAST METAL ROOFING CERTIFIED INSTALLERS. SPECIAL INSTRUCTIONS Contract Price $ 46,668 ------- Sales Tax $ Incl uded Financing Requested YES X NO OAC upgrade 7.99 12yr Total Contract Price $ 46.668 Interest Rate 0%to 29.99% Less 1/3 Down Payment $ 15,556 Payment not to exceed$289 Progress Payment $ 15,556 Total Balance on Completion $ 15,556 MAKE ALL CHECKS PAYABLE TO:EAST COAST METAL ROOFING,LLC. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office of branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mall posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right IN WITNESS WHEREOF,the Purchaser and Contractor have hereunto signed their names at the Premises,this 23 rdiay Of October ,2021. EAST COAST METAL ROOFING LLC. Do not sign this contract if there are any blank spaces. Per: Purchaser: Signature kj\i‘" riliC Signature Print Name Taft Manzotti Signature THANK YOU FOR YOUR BUSINESS This is not a credit transaction. If financing is arranged,the Purchaser agrees to sign and provide all necessary documents required by any lender, immediately on request. In order to complete the financing. All surplus material is the property of the Contractor. See reverse of contract for additional terms and conditions. DocuSign Envelope ID: E91FD7D4-3947-4CF0-8199-43ABF418093C East Coast Metal Roofing, LLC. C J 11.U J I 4254 Sutton Ave, Oxford, MA 01540 METALROOFING Te1: 8446113267 eastcoastmetalroofing.com REQUIRED PERMITS Registered Home Improvement Contractor MA #184472 Registered Home Improvement Contractor CT #HIC.0644642 Rhode Island Registration #40663 Homeowner Information Name: Larissa Hopkins Address: 27 Middle Street City: Northampton Ma Zip: 01062 Phone: 413-658-8554 Required Permits: The following building permits are required and will be secured by the contractor as the homeowner's agent and I/We as Owners of the subject property, hereby authorize East Coast Metal Roofing, LLC. to act on my/our behalf,. in all matters relative to work authorized by the building permit application:/ �_�_--- 10/27/2023 Owner's Signature Date Owner's Signature Date Owners who secure their own permits will be excluded from the Guaranty Fund provision of the MGL Chapter 142A This permit notice forms a part of the Purchase and Installation Contract of the same date. <. 1ne wmrnunweuun uj immucnu3eu3 9. Department of Industrial Accidents 141 Office of Investigations Lafayette City Center r=� 2 Avenue de Lafayette, Boston, MA 02111-1750 ''', wwx.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): East Coast Metal Roofing _ Address:254 Sutton Ave City/State/Zip:Oxford, MA 01540 Phone #:508-731-0415 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑■ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *My 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. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities 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: Safety Insuranc Company Policy# or Self-ins. Lic. #:WCC-500-5027960-2023A Expiration Date:10/21/24 Job Site Address:al A&(d O i.e. S4- City/State/Zip:NO1 T1 1am 1)t MA�I,�',, Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). IO(Jc Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 to$250.00 a day against the violator. Be advised that 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: q-'1W-- Date: III I y / o,Q l3 Phone#: 508-731-0415 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 10Board of Health 20 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 50Flumbing Inspector 6.0 Other Contact Person: Phone#: 1 THE COMMONWEALTH OF MASSACHUSETTS 1 Office of Consumer Aff. l^ `s. Business Regulation 1000 Washing •c : -Suite 710 I Bosto ®i. ..:-.. •..> _ 0-'118 1 Home impro •- leon;,, tractor- e•istration ' : L (rype: LLC - anon: 184472 I EAST COAST METAL ROOFING,LLC �' anon: 01/1 9120 24 ! 254 SUTTON AVENUE "" OXFORD,MA 01540 iii tim-ii i �pOff v 1 Update Address and Return Card. I I 1 I l THE COMMONWEALTH OF MASSACHUSETTS r OMce of Consumer &Business Regulation Registration valid for individual use only before the I I HOME IMPROVE'i • ONTRACTOR expiration date. If found return to: I ^�� Office of Consumer Affairs and Business Regulation I •;.3ai I I A a o 1000 Washington Street-Suite 710 ' ` ` •.1_ Boston,MA 02118 I I ��yy 1 1 JLSrCOASTMET•rl"-'„••: t�frI�lir LECHIARA j, met .�_• " ,...qerAep -" ?S4 BUTTON AVENUE ��i.� I )XFORD•MA 01540 - � t IMP Undersecretary Not valid without signature I