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28-004 (6)
BP-2023-1735 396 SYLVESTER RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 28-004-001 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-2023-1735 PERMISSION IS HEREBY GRANTED TO: Project# SIDING/ROOF 2023 Contractor: License: Est. Cost: 38390 TIMOTHY WALZ 103670 Const.Class: Exp.Date:03/17/2025 Use Group: Owner: HURLBURT MARTHA J&JOSEPH H HURLBURT Lot Size (sq.ft.) Zoning: WSP Applicant: FINYL VINYL INC Applicant Address Phone: Insurance: 6 LITHIA SPRINGS RD (413)592-2376 SOUTH HADLEY, MA 01075 ISSUED ON: 01/23/2024 TO PERFORM THE FOLLOWING WORK: SIDING/ROOF+W I►1c nOS 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: Fees Paid: $140.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner :, 'T Eligt� IZ-13 Ali /7._„ ...:.., �'L' 1/3 1ja The Commonwealth of Massach>zsetts,, 1 c9 20 FOR Pr i7 Board of BuildingRegulations and Standar+�t, �3 % "'-, -6,i MUNICIPALITY Massachusetts State Building Code, 780 CMR`/4A,';;?),;;, 1SE ,�� /, Building Permit Application To Construct, Repair, Renovate Or DeM4rli -,) Revised Mar 2011 One- or Two-Family Dwelling �,,,",' ' is ection For Official Use Only Building Permit Number: I t7-A�'/ /9 Date Applied: ,; ' 4 Ani.. •2 ' lil ° fr"i' cli Building Official(Print Name) I Signature Da SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 3'1f, Sy1 V2st-er ad 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❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: �-} ANca 4utibial- 3Atp Flor ice, rM4 oloto- Name(Print) City,State,ZIP 3qb 5/(ve'' e ad . 4.0.1-3ao 453o -Pi nyl v►niI0 V'rjZon.net 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 Other RP Specify: See,G A-1ftGh_¢cA Brief Description of Proposed Work': Sect I'if)9 .4- r00-1- C. / U S1 _ 't 1•n ra G� 1 S O1- , - tW i SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 38'r3Gj0 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ CIStandard 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 Fe s4 Check No. id Check Amount: Cash Amount: 6. Total Project Cost: $38, o 0 Paid in Full 0 Outstanding Balance Due: aP /0g3 Lto SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS— io34.7o 3-1 7-2LZ� i m J V V q,l z License Number Expiration Date Name of CSL Holde! �p� 1O L 1~T,i 1`tLSprin3 s p_R . List CSL Type(see below) No.and Street Type Description Ct/i`4 I_ � ��]I e Y 4 1) I 0 1 6 Or Unrestricted(Buildings up to 35,000 Cu.ft.) N! N 7 Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering '1 WS Window and Siding -a3�(� SF Solid Fuel Burning Appliances 1, , I—i`ny I vinyl(e)yet-ital.n� I Insulation Telephone Email ad&ess D Demolition 5.2 Registered Home Improvement Contractor(HIC) },a/953 4//,� �Q�t3 (my 1 Vl'y I Inc HICI Registration Number Expira ion Date Company Name or HIC Registrant Name �. Spn n5 s tzd vinyl(a) Vert•zor).n ef- No.and Street Email address ,444, I-t-ad rev ,M /4- 0075 4'13--,91 a 37(� 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 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 y I l c rl yl 1 �nC to act on my behalf,in all matters relative to work authorized by this building permit application. See 51 o r -e-01 Con frac 1 —&-2o Z 3 Print Owner's Name(Efectronic 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. �im(rlfi� Walt. 11 fs-Zb2.� Print Owner's or Auth rized 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 �srtnirr S .. s -it Massachusetts t 4 g; DEPARTMENT OF BUILDING INSPECTIONS vv 212 Main Street • Municipal Building ' '•, Northampton, MA 01060 fsf 3C�`� 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: a�05 OLG< 3 ad • (A.) : Ibt-ailam rna- The debris will be transported by: Name of Hauler: bt SA 1 k4 n 01 c eCyGl1 silj Signature of Applicant: Date: '4'23 The Commonwealth of Massachusetts ic "`*" Department of Industrial Accidents Ill= I congress Street,Suite 100 ;Witt— r Buxton MA 02114-2017 -„.r0. % www.mass.gor/dia Workers'Compensation Insurance Affidavit: BuildensiContractorsiElectricians,IPluo her+. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print i.eotibh Name(litui .'Otgantrationllndivi l):_ lnV 1_vinyl , lei _.-._. Address: (, LI ► Sp ritl s 4 City/state/zip::cSoi,t h_...A, ! 01075 Phone#: L/13 s1&.-a 3"7Ga Are you as eatployer?Cheek die appropriate box: Type of project(required): i.01 am a empkryas with.. __employees(full*Alm part-timd}.• 7. 0 New construction 20 l am a auk proprietor or prrinarahip and have no eisiplot,,rm working for me in , 8. 0 Remodeling any capacity.PM workers'cop.n uranox required.) 30 lam a haniaortxter doing all wort myself.P io workers'comp.ire roused.)r 9. Demolition 4.0 I anta homeowner and will be hiring contractors to conduct all work on mr property. heal 1D Building addition ensure that all corm-actors either have workers"WalpeillatiCa inrruranee or am auk i la Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions pi I atria general contractor and I have hired the sub-contractors listed on the attached sheet anise sub-contractors hove employe.i and have stutters'romp.insurance.: 13 Roof repairs 6.0 We are a corporation and its officers have cure-wed then right of exemption per MI e. 14.pother' S i ci t'h r 132.ii 1(4),and we hate no employes.(No workers'comp.insurance requued.j 7 "Any applicant that checks hot n I must also fill out the section below showing their workers'compensation policy information. t Hourxww°oers who submit this 5ff& suit indicating they,are doing all work and then hire outside contractors mint submit a new affidavit'it indimting such. :Contractors that check this boa must atta:hed an additional sheet showing the name of the sub itractors and state whether or not those entities hose employee,. If the sub-contractors 1i_«s:.curio:.ee,.The must •n"hie their workers`comp.puttee nwnh r- I um an employer that Is providing workers'compensation Insurance for my employees. Below is the policy and job site information. insurance Company Name: Policy#or Self-ins.Lic.=: Expiration Date: Job Site Address: City/Statei"Zip: 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 S1,500.00 andihr 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.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 ;,r , alt 4 r ry that the information provided abo correct.ve is true and corre Of Signature: ` Date: 1i'3r'vZ U'. Ptionc#: t) -I a 7l0 s Official use only Do not write in this area.to be completed by city or town official ('its or Town: Permit/License# Issuing authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector b.Other I' Contact Person: Phone 4: I1 #'Adirit Vow �r,� PRQP J L 6 Lithia Springs Rd. SOUTHHADLEY,MA 01075 Allengaged home knproveinhomment contractors and subcontracess e improvement contracting. unles (413)592-2376 specifically exempt from registration by Provisions t sf Chapter 142A of the general laws,must be registered wit h Submitted the Commonwealth of Massachusetts- Inquiries about To:Joe and Amanda Htulburt registration and status should be made to the Director, Home Improvement Contract Registration,One Ashburton 396 Sylvester Rd. Place,Room 1301,Boston,MA 02108 (617)973-8700 Owners who secure their own construction related Florence,MA 01062 permits or deal with unregistered contractors will be excluded from the Guaranty fund Provision of MGL c.142A. PHONE DATE REGISTRATION NO. -112653 CT-REG.NO.0665452 413-320-6530 1 5/7/23 LICENSE NO. -103670 JOB NAME/NO. JOB LOCATION We hereby submit specifications and estimates for work to be performed and materials to b©used: k" 1. Install 3/8 insulation as a backer. '"t kCiii ',; 2. Vinyl side house using Mastic Ovation Newport Bay D4'vinyl siding.Lifetime Warranty. f 3. Install brown corner posts, 13.Build hip roof over front door approximately 3'X7' ' ' 4, J-Blocks for all light fixtures,faucets,& existing poststop .-` y;'-. gdryer tie into roof line,install twoon 5- Install 3 Newport bay gable vents. of helical piles as footings,side to match louse. 6. Wrap all facia(trim)in brown aluminum coil 7. Wrap all windows&doors in brown aluminum coil,Anderson Bend. 8. Use brown center-vent soffit under all overhangs. 9. No gutters&downspouts. 10. No shutters. 11.SUip roof to the deck and install Cettainreed Landmark Burnt Sienna limited Lifetime warranty as follows A.Remove and replace ply Vood on rear shed roof only. B.Ice and water btirrier. C.Brown drip edge and rake edge. D.Pipe vent boot 12.Install 2 new Simonton NOV construction vinyl two light slider windows Lifetime warranty as follows: A.Low E glass. B.No grids—C.-Full screens. D.Brown outside and white inane.--— -`------ '—"__._._. WORK SCHEDULE contractor will not beget the work or order the materials before the third day following the signing of this Agreement.unless spooked herein wrmng.Contractor will begin the work 01I or about S months from date of signing.Barring delay caused by circumstances beyond Contractor's control.the wok will be completed within I year from dale M signing.The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not aodatle by the contractor shall not be considered as violations of this Agreement WARRANTY The Contractor warrants that the work furnished hereunder shalt be tree horn defects in material and workmanship for a period of one year tottowtng completion and shall comply with the requirements of this Agreement.In the event arty defect in workmanship or materials,or damage caused by the Contractor,his subcontractors,employees or agents,Is discovered within Of.year after completion of any job,including clean up.the Contractor shall,at his own expense,forthwith remedy.repair.correct.replace,or cause to be remedied,repaired.or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shag survive a local or state Inspection- We Propose hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: Thirty eight thousand three hundred ninety dollars and 00/100 38,390.00 dollars($ —) Payment to be made as follows:A finance charge of tr/2%per month(18%per annum)will be charged on unpaid balances. In additional thereto,in the event that this matter is placed in the hands of an attorney or collection agency,the owner herein shall be responsible for reasonable attorney's fees,collection costs,court costs,and other cost or fees associated with the collection of any outstanding balances here. 33 12,668.00 ._33— % ($.12_.6b8-o upon signing Contraival of materials Timothy J.Walz/Finyl Vinyl Inc Name of Connactor;Deslgnated Registrant 3_'''''' ($13-054-0+�upon completion of roof cvug,lction 6 Lithia S prings Rd. Street±% ($4304.06 upon completion of _. SOUTH HADLEY,MA 01075 CdyrState % ($ )shall be made forewith upon (413)592-2376 65-1215510 completion of work under this contract. Phone Federal ID No. Notice: No agreement for home improvement contracting work shall require a Timothy J.Walz or Terry ...Messier or John W.Walz Name of Sakrsper Ja Name of Salesperson down payment(advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make,in e advance,to order artdlor otherwise obtain delivery of special order materials aril equipment,whichever amount jp grealer. Note.This pmpo y be mtixirawn by us if not accepted wrtko----------days Acceptance of Proposal I have read both sides of this document and accept the prices,specifications and conditions stated.I understand that upon signing,this proposal becomes a binding contract.You are authorized to do the work as specified. Payment will be made as outlined above. You,the Buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.Cancellation must be done in writing. DNOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. sgatwa s//3 `,ignatum S q 21) oat orate IMPORT INFORMATION ON BACK II!J DATE(MM/DD/YYYY) A�o® CERTIFICATE OF LIABILITY INSURANCE 12/01/202;' 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(les)must 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 CONTACT David Jarry Neill&Neill Insurance Agency Inc PHONE FAX 662 Riverdale Street ►tc.No.WI: (413)732-4137 (NC No): (413)731-6629 West Springfield,MA 01089 ADDRESS: dj@neillins.com INSURER(S)AFFORDING COVERAGE NAIC S INSURER A: Scottsdale SCO INSURED Christopher Nascembeni INSURER B: Travelers Insurance Company 25615 19 Meadowbrook Road Agawam, MA 01001 INSURER C: INSURER D: 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 ADDL SUBR PO W M/LICY EFF POLICY EXP LIMITS LTR INSR VD POLICY NUMBER (MDD/YYYY) (MMIDD/YYYYI A GENERAL UABILITY CPS7703275 12/12/2022 12/12/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO Y COMMERCIAL GENERAL LIABILITY PREMISES(EaENTED occurrence) $ 100,000 CLAIMS-MADE vi OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 1.POLICY JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION OW771517 11/1612023 11/16/2024 WCSTATu- OTH- AND EMPLOYERS'UABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE YN N/A E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space Is required) Emailed to:finylvinyl@verizon.net CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Finyl Vinyl THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 6 Lithia Springs Rd ACCORDANCE WITH THE POLICY PROVISIONS. South Hadley,MA 01075 AUTHORIZED REPRESENTATIVE bamojR42_,E=6 @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD