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32C-231 (9) Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 120982 Type: DBA Expiration: 3/25/2008 ADAM QUENNEVILLE ROOFING -- ADAM QUENNEVILLE P.O. BOX 612 SO. HADLEY, MA 01075 Update Address and return card.Mark reason for change. -CA! .:) 50M-04/05-P38698 El Address Renewal � Employment Lost Card korgo�uiing gu l ions�an tan�ar s One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Construction Supervisor License License CS: 70626 Restriction: 00 Birthdate: 8/21/1971 Expiration: 8/21/2009 Tr# 3712 ADAM A QUENNEVILLE 160 OLD LYMAN RD S HADLEY, MA 01075 - -- Update Address and return card.Mark reason for change WA M RNA ( STATE OF C.W NAc�f&T IlEPA1RTMENT OF CONSUMER PROTECTION B.e it:known that i ADAM QUENNEVII:E I 160 OLD L AN ROAD f: SOUTH Q�075-2632 3; + is Cernfied;by the DepartrnQonslr ?rotection as a registered HOME IM PR VEfTT �NTRACTOR } ADAM'QVIENNEVILLE RQOFIN rR,anrsrU Effectve. .12/01/2006 i` j Ex lratlori: l f0�200� RX Date/Time . 06/27/2007 10: 59 1 413 538 6010 P. 001 Jun-27-2007 09:50 AM Remillard Insurance 1-413-538-6010 1/3 ACORO CERTIFICATE OF LIABILITY INSURANCE CSR 7!1L DATE(MMIODIYYYY) RA 06/27/07 PRODUCER THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Remillard Insurance Agcy, Inc HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 79 Lyman Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, South Hadley. MA 01075 Phone: 413-53$-7862 Fax:413-538-7179 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A: Scottsdale Inc Co. INSURER B: ADK I ttual Iaa—once Company Adam Quenneville Roofing & Siding Inc INSURER C, P O Sox 612 INSURER D: South Hadley MA 01075 INSURER E: COVERAGES THE POLICIES OF INSURANCE USTED.BELOW HAVE BEEN ISSUEDTO 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 POUGES DESCRIBED HEREIN 15 SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. lNbK LTR NQ TYPE OF INSURANCE POLICY NUMBER DATE MM DD1YY DATE(MMIDOffr LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 A X COMMERCIAL GENERAL LIABILITY CLS1384198 06/23/07 06/23/08 PREMISES Eaormience 450000 CLAIMS MADE X❑OCCUR MED EXP(Any one parson) s 5 0 0 0 PERSONAL 8 AOV INJURY 4 1000000 GENERAL AGGREGATE $2 0 0 0 0 0 0 GENL AGGREGATE LIMIT APPLIES PER cc) \ PRODUCTS-COMPIOP AGG s 2 0 0 0 0 0 0 POLICY 7 281, 7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 4 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY s NON-OWNED AUTOS (Per eccldenl) PROPERTY DAMAGE 4 (Par acddenl) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 5 ANY AUTO OTHER THAN EA ACC S AUTO ONLY. AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S $ DEDUCTIBLE 4 RETENTION S 4 WORKERS COMPENSATION AND i X TORY IMITS ER- B EMPLOYERS'LIABILITY AWC7012861012007 04/29107 04/29/08 E.L.EACH ACCIDENT 15100000 ANY PROPRIETORIPARTNEWEXECUTIVE OFFICEWMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE S 10 D 0 0 D II yyeS deaal0e under SPEdIU1L PRDVISION5 below E.L.DISEASE-POLICY LIMIT 1 6 5 0 0 0 0 0 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS C) CERTIFICATE HOLDER CANCELLATION L.O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SMALL IMPOSE NO OBLI OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTA ALI } N . Ste en Radon ACORD 25(2001/08) OACORD CORPORATIIIN I9RR -AD&AM UEIVNEVILLE , n ELKS ROOFING & SIDING, INC. The Premium Choice- 160 Old Lyman Road, South Hadley, MA 01075 -7-9y_� We Are Licensed 1-800-NEW-ROOF • 413-536-5955 Insured Email:info @1800newroof.net Website:www.1800newroof.net Factory Trained MA Construction Supervisors Lic.#070626 MA Registration#120982 Factory Certified Installers Member of the Home Builder's Association of Western Mass. CT Registration#575920 Member of the Building&Trade Association Member of the Better Business Bureau P.P.C.38710 Proposal Submitted To: Date 7 Phone#'s eE . PAM S) H: S75- ..7" ! Cell: Street Mail To: � /��.� City,State,Zip Code 0/0&1 Special Requirements Proposal to furni nid nstall the following ,h ox-r�. �l� �� El Re-Roof Tear-Off ❑ Gutter Co plete Roof Preparation me exterior to be protected by tarps and plywood �� hrubs, landscaping,trees to be protected ntire existing roofing material to be removed to existing de ki g, inclu ing lashing, etc. ite to be cleaned everyday with roll magnet debris removed at project completion eteriorated existing decking replaced at$2.50 per sq.ft. hr`s-CIC? S��� I°�f 90r—A hite/Brown 8 inch metal drip edge installed at eaves and rakes ❑ White/Brown 5 inch for re-roof only New flashing will be installed where flecessary(see Special Requirements) Install new pipe boot flashing We shall acquire all appropriate permits etc.for all roofing work Complete Roofing System ELK Leak Barrier installed at all eaves to protect from ice dams (and meet codes in the north) ELK Leak Barrier installed in all valleys, around penetrations, and chimneys to protect critical areas 15 pd. reinforced underlayment installed over entire decking Shingles: . �( I ELK Presti4u' Series 30 year ❑ 50 year Color �f;°t<)t , Nailable ridge vent will be installed ELK ridge cap shingles Warranty Options: off. ¢� C0 4,Pw,`ee k"e guarantee our workmanship forg full years ❑ ELK10-Year Umbrella Coverage Limited Warranty upgrade. F-1 ELK1 5-Year Umbrella Coverage Limited Warranty upgrade. V We Propose hereby to furnish materials and labor-complete in accor for the sum of: Total Sale Price$7: )n o Down Pa ent$ . U n C pletion $_1 ACCEPTANCE OF PROPOSAL:The above prices,speZi4isst" is actory and are hereby accepted. You are authorized to do work as specified.Payment will be 1/3 down upon signing,and balance due upon completion. Unpaid balances shall accrue with inter?, at ISO/ per ann Purchaser(s)will pay for all costs,expenses and reason- able attorney's fees incurred by Adam u nneville Roofi a Siding,Inc.to recover any sums due under this contract. &�-07 r;/JO Date: Signature: Phone# Date: ° Estimator's Signature at are honored or sixt 0 days from above date I ATTENTION HOMEOWNERS:Please cover all personal belongings in the attic,garage or storage areas due to the possibility of roofing debris or dust coming in through cracks of the wood.Adam Quenneville Roofing and Sidings will not be responsible for debris or dust in the attic or storage areas. b 61ti11 of N' all 1:p LlII _ Z � d hiissach„crtts' e"r�• ^� m UEPARTMEArT OF BUILDING INSPECTIONS 212 Main Street ' hfunicipal Building Northampton, Mass. 010GO WORKER'S COMTENSATTON INSURANCE kr1FU)A'V1T r (]i czrs_Jpf rill ittcc) %with a principal place of busirress/rc:sidcncc n t: A ,t,.t I1 r --:%_. do hereby ccr-LZ}, u'Ildcr d1C l)n ins audl pel"altlCS Oi pCf]llf}r I am an crnpioyer providing the foilo,,vinc .:ork-cry comncnsation covcrz�'.e for lny eitiployees working an Leis job: v (Insuranc Co ' ;) ci�c. Nu-rn cr) (ExpirLion Date) ( j I ant a sole proprietor, genera( coat mc-Lor ,D7 homeowner, (circle one) arld •tlav-,hired, the contractors listed beiow h0 ha tile. vlorke;s urn pen on u0!lc'.�5: (Name of Contnctor) (Lnsu1-rncc ircrroan -'Pout Y Nu.m>xr) (L-x;::-aticn Datc) (Name of contract-:) -- (11-lstlr„rcc Comp pazy/Pok—, Nuntr,r) (3 xrirnlion Date) (Name of Counctor) (Inse_11CC Com anwPolic. iiusnlr'r) , Date) (Name of Contractor) — Ja5iimiac. Couirr_'ry!PoUcy Numb=) (Espi :ti-n Date) (attic#,:d-!iti cr:al sc::ct irr:oxs-, :n i:r_i•.v.:r L.Gx°uti cK:r-�:_.::r •..�i;.+:r:-o:�t:.-) i t I <Ull a Sole propne"01- a7l`d have 110 01?C il!liii` fo r -.11c. ( :.. ?ill t? 11017?C Ow!lCr pCi*Or!?lln all 2lo'rI::plcae tc n,+�e tl;:t u�i]e hcr;eo.�r a w o r. 71 ry;r .. to c:, s :unc4 cx _r.:C m cr r;ra it—,n.C::c not trtcYe th n throe t tti's in tai eft:.hc ls-ti�„�1 T=.:a c•ou :,.:�.•;;�zpp_rtcr_rt thCt,o c-c rx:{Carrall v ar;;ti:rt-4.3b, - c�playc3 u.v'cr t}r tw�:c>.ca s• im.c (GU!5��•!(51?,a( •!:;::ic:;by a hr.,mcou-,cr:`ar a!ccu ct p:r:tti:::a,-..tirAc 11'n legal rtafuc of An oxnployer uou' tun wwiccr.Co L7)a s.tion Aci. I und,c--its and chi a copy of t!u ctat=:at s..ay Fn ro,w tj S to,tin[Y_tiartzrnt of larbuiric]M-i,', e&Oilioo for U1 covrxise veriCtc-tioa And th_t G.ilurr tor-' tr:cow.r_sro ut•.d.-- er+im 25A of?.tGL 152 can lmd to the imposition of C�i !pa alt.cs comisting ora rux'of up to S l-M.00 nn-&'rx L' rli^^-I C:�of'up to pn:};J•:A civil xnzlt a in d7c form c.f. film of S1 OO.W a dsy xgZLjnnl m= . For dq uumrsl u,e u,ly Lot s cr o`rr td � � vIGT��o RV,�C.. . 8 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : 0_7 W Ar,AAA License Number Address 160 Old Lyman RT Expiration Date So.Hadley,MA 01075 Signature Telephone Re is er Not Applicable ❑ ADAM Company Name Registration Number OUENNEVILLE ROOFING&SIDING,INC. _ 160 Old Lyman Rd 3' S <-4 - C> - Address So. Hadley,.MA 01075 Expiration Date Telephone >.(e z � C�FIO aI OR RIfE115f;'kCOMPENSATION'II�[SURAIVCE AFFIDANIT.:(M°G L c 152, § 15 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...... ❑. The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or:two(2)families and to allow such homeowner to engage an individual for hire who does not.possess a license,provided that the owner acts as supervisor. CNM 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeoNvner" shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform.work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance.with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature �":° 4 � �!� .� .�'��w.Jx y..+s xtr35^• sti. i - # 3x�ry. It��li �,r i New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Ar Or Doors ❑ , Accessory Bldg. ❑ Demolition❑ New Signs [ j Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work:_ 'S r n .4 "(1'sh' \� t Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll D - Sheet D ,6aV ': e d_�;. d.�i ron tome isfit MIJVJ n c®� a =e R'WD-11 owcn= a. Use of building: One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction i. Is construction within.100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations?. Yes No . I. Septic Tank City Sewer Private well City water Supply C` WOM R °TOBEYCO IVIPETLIES�FOR `PF21V�(T�. . ,��:-'* ,q .' 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. Signature of Owner Date as Owner/Authorized Agent hereby declare that the statements and irWormation on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name _ off Signatu of ner/Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size -Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the pr�)perty ?YES No IF-YES, describe size, type and location: of Northampton Building Department 07 2 �? Main Street Room 100 - - Nflrtham�ton, MA 01060 phone 443i887-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTI01J:;1 S17E fNFtIVI�TIAN ..„u , sectr�""t-�b �com etdb off'rc, �.F; 1.1 Property Address: , g� s a (Jf�� \ \> 70 (:.tal DIS:t r 1� SECTION.2 PF 01 t. 01�1JNEF�SHIP,Ia.UTMQR1ZED gCENT .:. . 2.1 Owner of Record: 1 C, C r 01�kwwAfA 0)S Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: i� R- Igo ©la -R NCI n Name(Print) Current Mailing Address: Signature Telephone _ SECT10Ni3 . E5T111(1`ATED.C.ONS`TR.0 TV�NfC0S.7S Item Estimated Cost(Dollars)to be Offrciat U$e On y' completed b permit applicant ' 1. Building (a) Building P&rn1f Fee h 2. Electrical (b) =stimoted Total Cost:of Ccnstruction from 6 3. Plumbing building Permit Fee 4. Mechanical (HVAC) 15. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) ov Check.Number This Seection.For Official Use.Onl Biilding:Permit 1Vumber Date Issued. -Ignature Buildrng Commissioner/fnspector.of Buildings, . Date BP-2008-0279 GIs#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2008-0279 Project# JS-2008-000402 Est. Cost: $3000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groin Adam Quenneville 120982 Lot Size(sq. ft.): 7187.40 Owner: PACOSA PETER A Zoning: URC Applicant: Adam Quenneville AT. 19 HANCOCK ST Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536-5955 O Workers Compensation SOUTH HADLEYMA01075 ISSUED ON.911412007 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType• Date Paid: Amount: Building 9/14/2007 0:00:00 $25.0011342 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo