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36-310 (8) BP-2024-0462 133 CARDINAL WAY COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 36-310-001 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-2024-0462 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: Est. Cost: 15000 FLORENCE ROOFING 071107 Const.Class: Exp.Date: 04/24/2025 Use Group: Owner: PELIS PERSAUD MARY J&ANDREW S Lot Size (sq.ft.) Zoning: WSP Applicant: FLORENCE ROOFING Applicant Address Phone: Insurance: 405 RYAN RD (413)585-9171 WC2-31S-374455-054 FLORENCE, MA 01062 ISSUED ON: 04/19/2024 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: r2. Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ' tQ-c------ z. The Commonwealth of Massachusettlliti _ Board of Building Regulations and;Standard4p FOR MUNICIPALITY Massachusetts State Building Code, 780/CMR 1 8 2Q24 • USE Building Permit Application To Construct, Repair, Renov Demolish a Revised Mar 2011 ''-'` ,./8 n,nr "� One-or Two-Family Dwelling � ��'��..,, .r,�„�� ° This Section For Official Use Only -....Fvf4 n,060 6NS Buildin Permit Number: FOP 14'I • 4C'z_ Date Applied: • i (2_5 //12 il-ig-ZOZL/ Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 133 Cardinal Way 1.1a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use l.ot 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: Zone: __ Outside Flood Zone? Public 0 Private 0 Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Andy Pelis Florence,MA.01082 Name(Print) City. State.ZIP 133 Cardinal Way 413-695-9429 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 Ca Specify: Brief Description of Proposed Work2: see attached propsal. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $15,000.00 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ 0 Standard City/Town Application Fee - . 0 Total Project Cost3 (Item 6)x multiplier_ x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire Suppression) $ Total All Fees: r iats Check No. + Check Amount: Cash Amount: 6.Total Project Cost: $15,000.00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C. Philip Andrikidis/d/b/a Florence Roofing cs-071107 4/24/2025 License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 405 Rayn Rd. No.and Street Type Description Florence,MA.01062 U Unrestricted(Buildings up to 35,000 cu.ft.) R _ Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-262-8007 florenceroofingagmail.com I Insulation t elephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 01573 4/24/26 C.Philip Androikis HICHIC Registration Number Expiration Date Company Name or HIC Registrant Name 405 Ryan Rd.Florence,MA.01062 florenceroofing©gmail.com No.and Street Email address 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 t1 No .O 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. 1rint 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 applicatio ' e an ate to the best of my knowledge and understanding. C.Philip Andrikidis 4/18/24 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: I. 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 og o �s S.; Massachusetts ��s r,e d *.I ( ; 4 it DEPARTMENT OF BUILDING INSPECTIONS s ' 'ir 212 Main Street • Municipal Building Jti� `CD Northampton, MA 01060 sNky AnN� 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: --Z;; "- :::;) Signature of Applicant: Date: 4/18/24 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02114-201 7 wwn:mass.gor/dia hunkers' Compensation Insurance Affidasit: Builders Contractors/ElectrielansiPluurbers. 'fO BE FILED«ITN'fllk I'F10tl rrtm At:rHORfrt. Annlicant Information Please Print Leeihis Florence Roofing Name 113uslmcss;Orkantzation,l lid ividue 1} Address: 405 Ryan Rd. City/State:Zip: Florence, MA. 01062 Phone#: 413-262-8007 Are you an empkytr?Check the appropriate bat: I Type of project(required): 1.®I All a clnploycr with 5.__.__en puyees(full audur part-tinsI' 7. New construction =Q I.rnl a sole prupryetur ur partnership and have no anployev>workings fur me in 8. E3 Remodeline any capacity-(Nu wurkees'quip.innuruncr required) 31J I am a horinsaw net doing all wur1e myself.[No workers'comp insurance uJIv reeiunia.I j 9. 0 Demolition 40 lain a Iit'ruwee u n and will be hiring.vutraciurs toccxlduet all work un my property- I will 10 Cpuilifing addition elraute lhat all eortttav'tors either Ilase workers c'axrspertsation lnsurancs:OF all'sole 1 I Electrical repairs or addition, proprietors with nu employees 1 i__1:1 Plumbing repairs or addition 50 I am a general euntractur and I tuts a hired the sub-eontraeturs listed on the attaawd,fleet_ These sub-euntracturs have employees and has a workers'cutup.insurance. 13❑Rtwf repairs h.Q we are a corporation and its uffi.ers have exercised their nght of ekemplrun pa Mt L e. 1 ❑C7tlttri I 52, 11+1.and see base nu crnpluyces.lNu workers'comp.insurance required.] *Any applicant that ellsk•ks boa el must also till out the section Muss showing then workers'compensation policy information_ +Inomeuw'ners who submit this atlidasit indreatiuu they arc doing all work and tlsrn hue outside contractors must submit a new of fidala it indicating such. tContractura that cheek this bus must tliLachcd an additional sheet snow trig the narrle of the sob-euntractocs and state w helln'r UT clot those entities!rase employees IftL:sub-clmlr.i ,rl+ha. cr irk.ccs.Ilzcy ut:e.l 1.1 ••,Id,1 t.I` .1111ke:T.JJnlp•pslla:.'IHilt11N1 1 am an employer that is providing workers"compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Liberty Mutual Insurance Policy#or Self-ins. Lk. #: WC2-31S-374455-053 Expiration Date: 1/25/25 Job Site Address: 133 Cardinal Way city,'StateZip: Florence, MA. 01062 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 anchor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage yenlication. ./do hereby certrffl?er the 1 rcn Metes of perjure'that the in%ornurtion pro►1ded above i.s true und cr,rt air. 4/18/24 sivn.tturl. Date: Phone c: 413-262-8007 Official use only: Do not write in this area,to he completed by city or town o/Jicial. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone 4: FLORENCE ansimit FLORENCEROOFINGWMA.COM C.PHILIP ANDRIKIDIS maionpria 405 RYAN , FLORENCE, MA 01062 INSURED BY KINGROAD&CUSHMAN 413-584-5610 HIC #150673 • 585_9 17 1 --------. - CSL# 171107 MSL#11282 F= L } c I CELL#413-262-8007 November 18,2023 Estimate for: Andy Pelis Property location: 133 Cardinal Way, Florence, MA, 01062 Description: - Stripped entire house of(1) layer of asphalt shingles - Remove existing skylight and replace with Velux fixed skylight. Interior trim work if needed to be performed by a contractor other than Florence Roofing - Apply ice and water barrier to the first 6' of all roof eves, at sidewalls, in valleys, and around all penetrations. Apply ice and water barrier to entire front porch and upper low-pitched roof between front dormer and garage roof - Synthetic underlayment covering remaining surfaces - Installed aluminum drip edge to all roof edges - Shingle roof with GAF Timberline HDZ architectural shingles - All new flashings installed to roof penetrations - Install continuous ridge vent to all peaks - Clean area and remove all debris to landfill - All material furnished and installed by Florence Roofing - All permits included in this estimate