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38C-035 (4) BP-2024-0464 23 CEDAR ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38C-035-001 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-2024-0464 PERMISSION IS HEREBY GRANTED TO: Project# roof 2024 Contractor: License: TODDY HAPPY BOYNTON Est. Cost: 3945 ROOFING 106166 Const.Class: Exp.Date: 07/05/2025 Use Group: Owner: NICOLE BALL DAVID R& Lot Size(sq.ft.) Zoning: URB Applicant: TODDY HAPPY BOYNTON ROOFING Applicant Address Phone: Insurance: 83 SILVER ST 413-775-2775 6S62UB-4N47586-A-23 GREENFIELD, MA 01301 ISSUED ON: 04/19/2024 TO PERFORM THE FOLLOWING WORK: REROOF HALF OF UPPER MAIN ROOF ONLY 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. Signatu re: /6" 0 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner i The Commonwealth of Massachusetts 7 8 cvm4 FOR Board of Building Regulations and Standards • Massachusetts State Building Code,* c'i ,, MUNICIPALITY 1r I/v USE Building Permit Application To Construct,Repair,Renovat&Ot a Revised Mar 2011 One-or Two-Family Dwelling ° r This Section For Official Use Only Building Permit Number: 4654 Date Applied: K i i 4:Y35 /t%C q-1 q ay.,/ Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Addre 1.2 Assessors Map& Parcel Numbers 1.1 a Is this an accepted street?yes V 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' f Record: ,1 L 1 �►^'�� �c l Name(Pri t) City,State,ZIP No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work': SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 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: Check No. Check Amount: 6.Total Project Cost: $ c7y77 0 Paid in ull ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 10616 WI6 rn on c Todd BoyntonLicense Number Expira ate Name of CSL Holder 83 Silve . List CSL Type(see below) Greenfield,Ma 01301 No.and Street 4137752775 Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) ` i(g/7 7 ., j/�, HIC Company Name or HIC Registrant Name odd Boynton HIC egistration( Number Expiirattiion`l/Daate`e'! 83 Silver St. .�/ No.and Street Greenfield,Ma 01301 At, f)e.i l e T/�'�'/C i r?,1 4137752775 Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.5 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 C 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 to act on my behalf,in all matters relative to work authorized by this building permit application. 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 is applica• and accurate to the best of my knowledge and understanding.is true ng. ✓/00 *1 VAX?, Print Owier'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 trot 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.massgov/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 ov,(H A M 0 S% /� .' E ~` Massachusetts �4., -- ��e c. i"' ,4) � DEPARTMENT OF BUILDING INSPECTIONS /� 1, ,� 212 Mailifn Street • Municipal Building yvk cam \ \r 1(�f„'s Northampton, MA 01060 rs�W ',�o 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: , / 41e i✓�v:"'��(J � The debris will be transported by: Name of Hauler: 4Aliei �61w I r Signature of Applicant: Date: C�////.I February 27, 2024 Todd I3OvntOt1 83 Silver St. Greenfield, MA 01301 (413) 775-2775 tvalinetehotmail. com Complete Asphalt. Slate, and Rubber Roofing Systems and Repairs, Siding, Replacement Windows. Chimney Pointing, Sheetrock, Painting and Gutters Customer: David Ball Roof quote 23 Cedar St. Northampton, MA 01060 Work to be done: Oen half of upper main roof only (NW facing, right side of house only): Install new white aluminum rake edge. Install Harvey ice and water shield on lower edge. Re-roof with Tamko 30 year Heritage designer architectural roofing shingles, color TBD. Install new ridge venting system to complete peak. 10-year guaranty on labor, 30-year Manufacturer's Warranty on roofing. David- I am currently scheduling for March 2024, weather permitting. Any questions,feel free to call or message. Todd Total Cost $ 3,945 r, r7,� (Labor and material) Deposit required of: $ 1,900 Homeowner: Balance upon Completion: $ 2,045 Contractor: (Sign and return one copy with required deposit) Make checks payable to: Todd Boynton Top quality materials used — complete insurance coverage References available. All trash removed by contractor. Visa, MC, AMEX and Discover accepted; Venmo and Paypal available SCHEDULE: Work scheduled to begin around 3/15/24 and to be substantially completed on 5/15/24 DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES MA HIC*126807, MA Construction Supervisors"MS1-106166 1U:CA-k a� The Commonwealth of Massachusetts ,i'tt■ia. !.! Department of Industrial Accidents _,.itv_ rl I Congress Street,Suite 100 _Tit= 1.7�` Boston. MA 02114-2017 _. www.mass.gov/dia 11 wkern'('umpensatinn Insurance Affidas it:Builders/C ns/Plumbers. Ira RE FILED%S iI H t nh.PERMITTING AUTHORITY. Anolicant Informatiog Please Print Lei ibis Name 1 Business OrganirattonlIndividuall: Todd Boynton 83 Silver St. Address: Greenfield,Ma 01301 4137732773 ._ City/State/Zip: Phone#: Are yea an employer?Check the prapriate hot: Type of project(required): 1.41 am a employer with employees I lull and or put-tinit•i• 7. 0 New construction 20 1 am a suk propnetur or partnership and hats no eiripktytx,working fur me in it. o Remodeling any capacity.[No workers'rump.mauraner required_] 30 lam a humrwwmT doing all work myself.[No workers'camp.irrsunamm c required.)" 9. 0 Demolition 100 Building addition 4.0 1 am a IiumaiowmT and will he hiring comments to conduct ail work on my property. heal erasure that all aunera.-turs either base workers-comp rtxt1xm insurance or are sole I I.Q Electrical repairs or additions proprietors w ieh nu employees. 12.0 Plumbing repairs or additions S.0I ant a general contractor and I bare hired the sob-euntracturs fisted un the attached sheet. [301 Roof repairs These sub-contractors have empluyees and have workers'comp.insuraninsurance.:urae.: 14. Other 6.0 we are a corporation and its officers have exercised their tight of rat nphon per AC(AL c. 152.§11.41.and w c hart nu employees.[No workers'comp.insurance required.] •.-'trey applicant that cheeks boa a mint also till out the section below shooing their workers'rongrensation policy infuernatiun. +Homeowners w ho submit flus Aida..it indicating they are doing all w irk and then hire outside contras:tors must subnut a new affidar it Indic atiag such. :Contractors that cheek this but must atus.:hed an additional sheet show ing the name of[lc suh-contra,i.tors and state whether or not those audit-.hare employees. It the sub-contractors hate employees.then must pros tde their wurkers'Dump.puhey ntanbet OM I am an employer that is providing workers'compensation insurance for nay employees. Below is the policy and job site information. Insurance Company Name: C,C _— Policy#or Self-ins.Lie.#: �R U,A'� ti/r � C (7 A"- Expiration Date: , / 0 e)0 � V erde Job Site Address: C C' City/State/Zip: 0. x c i,/ Attach a copy of the workers'compensation policy declaration page(showing the policy number an expiration date). Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a fine up to S I,500.00 andlor 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 violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. _ 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and Correct_ -- v- --'L! rtF 5igna[u -% i- I)ati•- i i i '1 / Phone>+: C./;,'3- 713 i`? Official use only. Do not write in this area,to be completed by city or town official (ity or Taws: Pernhit:'License t+ Issuing Authority(circle one): I.Board of Health 2.Building Department 3.('it)f1 ossn Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone tt: A`ORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/06/2023 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 polioy(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 CONTACT Nadine West NAME: Blackmer Insurance Agency I?H Nc. exn: (413)625-6527 FAX No): (413)625-8210 1147 Mohawk Trail E-MAIL nadine@blackmers.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Shelburne MA 01370 INSURERA: ACE American Ins Co(ARWC) INSURED INSURER B: Todd Boynton,DBA Boynton Roofing&Siding INSURER C: 83 Silver St INSURER D: INSURER E: Greenfield MA 01301 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2310601184 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO RENTED $ CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 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 EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 100,000 A OFFICER/MEMBER EXCLUDED? ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A 6S62UB-4N47586-A-23 09/20/2023 09/20/2024 E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I 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 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Greenfield ACCORDANCE WITH THE POLICY PROVISIONS. 14 Court Square AUTHORIZED REPRESENTATIVE, Greenfield MA 01301 i ir(// (�- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD