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16A-002
BP-2024-0328 300 NORTH MAIN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 16A-002-001 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-2024-0328 PERMISSION IS HEREBY GRANTED TO: Project# GARDEN HOUSE ROOF 2024 Contractor: License: Est. Cost: 25000 FLORENCE ROOFING 071107 Const.Class: Exp.Date: 04/24/2025 NORTHAMPTON CITY OF LOOK MEMORIAL Use Group: Owner: PARK Lot Size (sq.ft.) Zoning: URA/WP Applicant: FLORENCE ROOFING Applicant Address Phone: Insurance: 405 RYAN RD (413)585-9171 WC2-31S-374455-054 FLORENCE, MA 01062 ISSUED ON: 03/26/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF GARDEN HOUSE 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: 1.72 Fees Paid: $175.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner c •irki Ltith, it - 4,Q The Commonwealth of Massachus-tts25 Office of Public Safety and Inspections., Massachusetts State Building Code(780 CICIR) r-1----- 2024 / I(Di Building Permit Application for any Building other than a One-o114N 6F.-Fit*Rsiptirelling 070, l"vs (This Section For Official Use Only) Building Permit Number:DI it• 3 .4 Date Applied: Building Official: A-10•411. SECTION 1:LOCATION 300 Set&Main St Florence MA 01062 Look Park-Garden House No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Ma. # Block#and or Lot # SECTION 2 PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 12 Specify:Roofing Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 12 Is an Independent Structural Engineering Peer Review required? Yes 0 No ca Brief Description of Proposed Work: See attached Proposal. ^ .`p G1,,t run, SECTION 3:COMPLETE 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): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)Sr Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(IL) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Facto F-1 0 F2 0 H: Hi: Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional 1-1 0 I-2 0 1-3 El I-4 0 M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 I Special Use 0 and please describe below: Special Use Description SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB 0 HA CI JIB El MA CI MB 0 IV 0 VA 0 VB CI SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: A trench will not he Licensed Disposal Site 0 Public 0 Check if outside Flood Zone CI Indicate municipal 0 required 0 or trench or specify: Private 0 or indentify Zone: or on site system 0 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 CI 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 Look Park 300 South Main St Florence Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Bob Lingenberg - - 413 5_47 1112 biingenberg@lookpark.org Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Florence Roofing 405 Ryan Rd. Florence MA 01062 Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this buildingpermit 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 D. Otherwise provide consuction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Florence Roofing Company Name C Philip Andrikidis CS-071107 Construction Supervisor Name of Person Responsible for Construction License No. and Type if Applicable 405 Ryan Rd. Florence MA 01062 Street Address City/Town State Zip 4132628007 - - Florenceroofing©gmail.com Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS COMPENSATION IN URAN 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 a••lication? Yes D No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $25,000.00 Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ 115. 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $25,000.00 (contact municipality)and write check number here 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 accura a be knowledge and understanding. C Philip Andrikidis Sole Proprietor 413 262 8007 Please print and sign name Title Telephone No. Date 405 Ryan Rd. Florence, MA. 01062 florenceroofing@gmail.com Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: /( � 3-26-ZOz1f Name Date • City of Northampton �OaY NA MP ti SAC.. Massachusetts �� x- ' d ; + ar4 DEPARTMENT OF BUILDING INSPECTIONS y` 212 Main Street • Municipal Building ca Northampton, MA 01060 st, 3)N1'1 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: Amherst Trucking, Inc. Name of Hauler: Signature of Applicant: Date: 3/25/24 —. ii.�'", The Commonwealth of Massachusetts r% t i Department of Industrial Accidents ;-_- . l Congress Street,Suite 100 fl� Boston, MA 02114-2017 ^r r�' nl " wow:mass.govhdia 11 ofkers'Compensation Insurance:hflidarit:BuildersiContractorsiElectriciai.siPlunthers. ID BE FILED%1 I f II'tliE PER.%UT1't.V3 At:ITIOKITli. Annlicant Information Please Print I.et:ibls Name(Bus i mess'Organlzat ion/Indrviduai):� T _ Address: City/State/Zip: Phone o: ,ire you aft employer?Check the appr•rtprkate box: Type of project(required): a ma a tmptoyer wide „ 4___, employees(full anutot pot-rinw t* 7- 0 New construction ,�I.ita wile proprietor or partnership and have no employee,winking fur sae in K. 0 Remodeling arty.apacrty [Nu worker.'curnp.insurance required] .10 I am a(ortsnrwner d'uing all work myself.[No workers'cusp.itrsursnte n�luired.I' 9. ❑ Demolition 4.0 I am a hors owner and will be hiring.onrtractor to conduct all work un my property. I will 100 BLit Wing addition ►aerie.•that all contractors either hate workers'4'4Xniknaaliurt In.YuriCIO:or an:sole 11 a Electrical repairs or additions proprietor with nu employees.. 1 2.0 Plumbing.repairs or additions 50 I air a general contractor and I hate hired the,ub•e'ntractors listed on the auae'nc l,beet 13.❑Root repairs These sob-contractors have employee,and have worker,'.•snip.insurance.; 6.0 We an:a corporation and its officers have exercised their right of exemption per MC&c. 14_E]Ot110' Roofing 151.t41141.amid we have no employees.[No workers'sump.insurance required.] 'Any applicant that checks box al must ahsu fill out the section beluw showing their worker;'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 indicuarig such. :Contractors that check this bos inmost aia_•I r•d an additional sheet showing the name of the sub-contractors and state whether ur nut those entities hate caIrluye.+ If tl::>ub•eunt..re.r,Terre.l:trl.,}ee:+.they reel>t par.i.k l'I.ir ,m utkc^%'.;-uq, 1:a,12;}IAIIIIIVI h am an employer that is prot'lding tvorAcrs'rnrnpenAafinn ins:trance fir my emplm'ee.s. Below is the police read lob site information. Liberty Mutual Insurance Insurance Company Name: WC2-31 S-374455-054 1/25/2025 Policy#or Self-ins. Lic. 4: expiration Date:_ 300 South Main St. Florence, MA. 01062 Job Site Address: CiEy'StatelZip:-_ 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, w25A is a criminal violation punishable by a fine up to S1,500.00 and.ior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ot'up to S250.00 a day against the violator.A copy ot'this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby eerie/r anger the ►runs and penaltf s of perjure•that the information provided above is true and correct. Signature: Date: 3/25/24 Phone?~: 413-262-8007 Official use only. po not write in this area.tt,leer c,wiplcted hy city or haw official ('itv or Town: PermitiLicense a Issuing Authority(circle one): I. Board of Health 2. Building Department 3.Cityllown Clerk 4.Electrical Inspector 5.Plumbing Inspector t;.Other - Contact Person: Phone 4: 1 FLORENCE FLORENCEROOFINGWMA.COM C.PHILIP ANDRIKIDIS ROOFING 405 RYAN ROAD, FLORENCE, MA 01062 INSURED BY KING &CUSHMAN 413-584-5610 HIC #150673 585_9171 CSL#171107 MSL#11282 ! ^ ^ CELL#413-262-8007 November 14,2023 Estimate for: Look Park Job Name:Garden House Job Location: 300 N. Main St.Florence,MA,01062 Description: - Strip(1)layer of asphalt shingles from entire building. 6,600 sq.ft.+/- - Apply ice and water barrier to the first 6' of all roof eves, in valleys,at sidewalls,and around all penetrations. - Synthetic underlayment to cover remaining surfaces. - Install aluminum drip edge to all roof edges. - Shingle roof with GAF Timberline HDZ shingles with System Plus Limited Lifetime Warranty.Color: To be determined - Install continuous ridge vent to peaks. - Area cleaned and all roof related debris removed to landfill or proper recycling facility. - All permits to be applied for by Florence Roofing. - All hoisting of roof related material performed by Florence Roofing - All material furnished and installed by Florence Roofing.